A Half-century of Awakenings

Fifty years have passed since the 1973 publication of Awakenings, a remarkable book by a remarkable author, Oliver Sacks.1 At the time he wrote it, Sacks was a newly minted neurologist and, approaching age 40 years, struggling to find his place in the world. By chance, he sought work at a hospital in New York that housed patients who, decades earlier, contracted encephalitis lethargica. First encountered in Vienna in 1916, the epidemic of this mysterious malady (also known as von Economo disease) spread worldwide over the following decade, killing thousands young and old. Survivors developed lasting neurologic impairments including Parkinsonism and catatonic states.2,3 For decades afterward, hundreds of victims remained in chronic care wards. As recounted in Awakenings and in a later autobiographical memoir,4 Sacks was fascinated by the aftermath of this disorder. He was equally intrigued as to how his patients might respond to levodopa, a novel treatment recently developed for Parkinson disease. Previously, a few English postencephalitic patients had shown improvements with levodopa.5 Sacks initiated a small placebo-controlled trial and, after encountering promising results, began to treat other postencephalitic survivors. Although the extraordinary pharmacologic outcomes he encountered might have been sufficient material for a good tale, Sacks envisioned a far more encompassing project for his book.

Automated summary

Awakenings, written by Oliver Sacks, is a remarkable book that explores the aftermath of encephalitis lethargica and the effects of a new treatment for Parkinson's disease.