In his new foreword, Sacks pays tribute to his mentor, the great Russian neurologist A. R. Luria, who founded the field of neuropsychology and created a rich new form of clinical biography. Luria spoke of the “classical” (analytic and reductionist) and “romantic” (holistic and existential) tendencies in medical science and of how these approaches needed to be combined in the care of patients. In writing Awakenings, Sacks has tried to combine both approaches, to go beyond the clinical case histories of his patients to capture their interior lives, the subjective dimension of their imprisonment and sudden release with L-Dopa. From the poet W. H. Auden, his other mentor, Sacks discovered the value of parables and metaphors in conveying these experiences. In trying to combine what he calls the “biological” and the “biographical” dimensions of his patients’ afflictions, Sacks has transformed the medical narrative into a rich new literary genre, one full enough to encompass a precise clinical discussion of sleeping sickness and its development into parkinsonism; to include personal narratives of the awakenings of his twenty patients; and to offer clinical and philosophical perspectives on their affliction.
More than a collection of neurological case histories, Awakenings is a deeply moving testimony to the possibility of hope for people trapped by disease in strange and almost inconceivable worlds yet who are in other ways indistinguishable from their fellow human beings. As Sacks indicates in his new preface, his central concern is to show how his patients struggled to maintain their human identities under the most adverse circumstances, to show “what it was like to be human, to stay human, in the face of unimaginable adversities and threats.” As a physician, Sacks tried to understand his patients as people and not merely as pathological case histories, maintaining with them, in Martin Buber’s terms, an “I/Thou” and not an “I/It” relationship. His goal was to reveal his patients in the full emotional contexts of their lives, to depict the terrible isolation of a progressive, degenerative disease, the sudden awakening, years later, and the brief hopes and excruciating disappointments of L-Dopa therapy. Sacks pays tribute to the tremendous courage and fortitude of his patients, admitting that he often learned more from them than he could ever acknowledge. Through Sacks’s narrative depictions, each of his patients emerges as a real, unforgettable person with whom the reader identifies. The reader finds himself caring deeply about their fates and rediscovering the power of the imagination to awaken empathy and concern for others.
Even with his most severely disabled patients, Sacks conveys a sense of the personality, mannerisms, and dignity of each individual. Rose R., for example, was a lively and vivacious young socialite who was struck down by sleeping sickness at twenty-one and awakened twenty years later. At first, she seemed hyperactive and disoriented, unaware of the passage of time, but as she realized what had happened to her she relapsed into parkinsonism, overwhelmed with sadness at the knowledge of what she had lost. Miriam H. contracted sleeping sickness at twelve and suffered from progressive, degenerative parkinsonism for the next thirty-seven years, until she awoke at age fifty-five and began to create a new life for herself. One of the few patients who was able to tolerate the sustained use of L-Dopa, she now enjoys excursions outside the hospital, keeps a diary, reads voraciously, and is a terror at bingo. Not all patients, however, did as well. Leonard L., once a brilliant graduate student at Harvard University, was speechless and severely withdrawn until he was given L-Dopa, at which time a remarkable transformation took place. He awoke to a feeling of radiant good health and typed out a fifty-thousand-word autobiography in the three short weeks of recovery that he enjoyed until he...
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