In 1966, the London-born neurologist Oliver Sacks, then in his early thirties, started working at Beth Abraham, a hospital for the chronically ill, in the Bronx. He soon began noticing dozens of patients, scattered among the wards, who were virtually immobile and unable to communicate. Going through their records, he realized that they were all survivors of encephalitis lethargica, also known as sleeping sickness, which had swept the globe after the First World War. This disease could be fatal; those who survived it sometimes developed syndromes that could seem like an extreme form of Parkinson’s. By the sixties, some of Sacks’s patients had been hospitalized for forty years, and the encephalitis epidemic itself had largely been forgotten.
In 1968, the medical community was galvanized by the news that people with Parkinson’s could be helped by a new drug called levodopa, or L-dopa. Sacks wondered whether “DOPA,” as he called it, could also help his patients, and he applied to the F.D.A. to use it as an experimental drug. His findings would become the basis of his groundbreaking book “Awakenings,” published in 1973.
Years later, Sacks became friendly with the director Peter Weir, who was considering taking on the film adaptation of “Awakenings.” In the end, Penny Marshall directed the movie, which came out in 1990 and was nominated for three Academy Awards. Robin Williams was cast as the doctor modelled on Sacks, and Robert De Niro as one of his post-encephalitic patients.
March 26, 1969
Dear Ma and Pa [Elsie and Samuel Sacks, both doctors],
I hope you are keeping well and in good spirits. . . .
Things at Beth Abraham continue on their blundering course. The DOPA still never came (my chief, a schnorrer at heart, is trying to beg for some . . . despite the fact that he is rolling in funds specially donated for its purchase), and I can hardly bear to face my poor Parkinsonian patients who have been promised and promised, and let down and lied to, a dozen times in the past six months. You will not be surprised that this stupid situation fills me with rage and guilt. Fortunately, there are a few other patients whom I can study quietly, in my own time, in my own way. It is obvious, however, that I can depend on Beth Abraham for nothing. . . .
Before I forget, thank you, Ma, for the motorcycle leathers which arrived a few days ago.
I imagine Spring is arriving in England, and things are bursting from the ground.
Keep well, write soon, say a special hello to Michael, Auntie Len, David and family, etc.
Love,
[c. April, 1969]
Dear Ma and Pa,
. . . My three patients are doing extraordinarily well on the DOPA: one of them, who was virtually unable to talk or move . . . is now chatting and toddling down the corridors. I am inclined to think that DOPA may indeed turn out to be as useful for Parkinsonians as insulin for diabetics, or nearly so. In the meantime, I have been studying the three patients closely, and am gathering some novel and fascinating insights into their state. . . .
As usual, I have said more than I should; but you will gather, if nothing else, that the emotional Barometer (to which all other things are secondary) has moved to FAIR: occasional showers, but sunny intervals. . . .
Love to everyone (as the Hippies say),
May 17, 1969
Dear Ma and Pa,
. . . I now have 15 patients on DOPA, and am staggered and gratified at its ability (in many though not all cases) to reanimate patients who had been virtually petrified for years. . . . This, of course, in turn leads to a very complex state of affairs: one cannot restore the potential of movement and independence to someone who has been helpless and dependent for decades without creating a most complex, unprecedented situation for them and everyone associated with them; I am fascinated by this aspect, among others. . . .
I have been working like a madman for the last fortnight. . . . I am gathering almost more information than I can deal with and starting to nibble on the huge Parkinson literature. . . .
Robin Williams and Oliver Sacks on the set of “Awakenings” at Kingsboro Psychiatric Center, in Brooklyn, in 1989.Photograph by Joanne Cohen
[Charles] Messeloff [Beth Abraham’s medical director] still wants to get everyone involved . . . in his stupid American concept of a Big Deal and a Multidisciplinary Approach, etc. I try to ignore all this and arrogate the patients to myself. . . .
I have very little to say otherwise, for I have indeed had very little life outside the hospital lately. . . . I hope you are all keeping well.
Love,
May 25, 1969
My dear Mike [Warvarovsky, a friend from California],
I should have replied earlier to your charming letter written in Venice, all bubbling with the freshness and joys of travel. I adore the wide-openness, the innocence, with which you see the world. . . . How right you are about catacombs and secret thoughts!
Everything we build is an allegory of ourselves: the whole human world a metaphor of the human state. My own love is for city walls . . . those high stone walls which enclose, defend, and unify a city, as we wall off the citadel of ourselves. . . .
I have started the intensive work on my Parkinson patients . . . and I have had the intoxication of seeing l-DOPA, a ravishing drug, restore to an incredible life . . . patients who had been almost literally turned to stone, speechless, motionless, and even thoughtless, for twenty years or more by the horror of their disease. My first patient, a man of fifty, who had had the severest Parkinsonism since the age of fifteen and had not spoken or moved for more than ten years, said (his first words): “I am reborn. I have been in prison for thirty-three years. You have released me from the custody of my symptoms.”
Neurophysiology shows what poetry and philosophy have always known: that we are—in a very fundamental sense—automata, reflex-machines; and also that we are composite. Knowing that we are necessarily passive and composite, we can then make ourselves, for daily purposes, active and unified. But there is no “soul” and no “will”—these are fictions, universal fictions, like the Garden of Eden.
Cartoon by Maggie Larson
Oooh! I am sorry, I didn’t mean to ramble ahead like this. . . .
July 30, 1969
Dear Ma and Pa,
A very brief note, whose arrival I may myself precede.
You sound like you enjoyed Malta very much—islands have something lovely about them. . . . I nearly blue [sic] everything I had to go for a voyage to the Galapagos Islands with the Darwin Society, but alas! have had to content myself with reading The Voyage of the Beagle as my bedside book. . . . The last three months will turn out to have been, I suspect, the most interesting and productive in my entire life: what I started, reluctantly, as a trial of just another drug has proved an almost incredible tool for the dissection of a vast range of human behavior, from the most primitive postural reflexes to the most complex psychotic reactions. . . .
