# Awakenings (book)
**Awakenings** is a 1973 nonfiction book by the British-born neurologist [Oliver Sacks](https://www.edgepedia.org/oliver-sacks) (1933–2015) that recounts his treatment, beginning in 1969, of about twenty patients confined for decades by postencephalitic parkinsonism, and the dramatic but often temporary recoveries they experienced on the then-new drug levodopa (L-DOPA).[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10558160/) • [2](https://pmc.ncbi.nlm.nih.gov/articles/PMC1885331/) It was Sacks's second published book, after *Migraine*, and it made his reputation as a writer.[3](https://www.oliversacks.com/write-on-2/) • [4](https://www.theatlantic.com/books/archive/2024/12/oliver-sackss-letters-reveal-search-recognition/680997/)
| Key fact | Detail |
|---|---|
| Author | Oliver Sacks, a neurologist working at a chronic-care hospital in New York in the late 1960s[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10558160/) |
| First publication | 1973; revised editions followed in 1976 and 1998[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10558160/) |
| Subject | About 20 case histories of survivors of the encephalitis lethargica epidemic treated with levodopa from 1969[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10558160/) • [5](https://cdnc.heyzine.com/files/uploaded/v2/b5a4d2a8be1ed1860f25c9163cd2db1ccbae1717.pdf) |
| Literary recognition | 1974 Hawthornden Prize for imaginative literature; praised by W. H. Auden as "a masterpiece" and by Doris Lessing[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10558160/) • [6](https://www.oliversacks.com/oliver-sacks-books/awakenings/) |
| Best-known adaptation | The 1990 film *Awakenings*, directed by Penny Marshall, starring Robin Williams and Robert De Niro, nominated for three Academy Awards[6](https://www.oliversacks.com/oliver-sacks-books/awakenings/) |
| Other adaptations | Harold Pinter's one-act play *A Kind of Alaska* (1982); a ballet by Tobias Picker (2010); an opera by Picker with libretto by Aryeh Lev Stollman (premiered June 5, 2021)[6](https://www.oliversacks.com/oliver-sacks-books/awakenings/) • [1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10558160/) |
## Background: encephalitis lethargica
[Encephalitis lethargica](https://www.edgepedia.org/encephalitis-lethargica), also known as von Economo disease, was first encountered in Vienna in 1916, and the epidemic spread worldwide over the following decade, killing thousands of people young and old.[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10558160/) Survivors developed lasting neurologic impairments, including parkinsonism and catatonic states; postencephalitic parkinsonism is a characteristic chronic sequela of the disease.[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10558160/) • [7](https://pubmed.ncbi.nlm.nih.gov/36503127/) For decades afterward, hundreds of victims remained in chronic care wards, often motionless and unresponsive, trapped within themselves.[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10558160/) • [2](https://pmc.ncbi.nlm.nih.gov/articles/PMC1885331/)
By chance, Sacks sought work at a hospital in New York that housed many of these patients; the institution he calls [Mount Carmel](https://www.edgepedia.org/mount-carmel) had 80 patients with intractable postencephalitic parkinsonian syndrome.[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10558160/) • [2](https://pmc.ncbi.nlm.nih.gov/articles/PMC1885331/) In the opening section of the book, Sacks also researched past instances of epidemic encephalitic disorders, each followed by parkinsonism, the last of them in the 1880s.[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10558160/)
## The levodopa trial
Levodopa, a novel treatment recently developed for Parkinson disease, was hailed in 1969 as a miracle drug that would cure parkinsonism.[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10558160/) • [2](https://pmc.ncbi.nlm.nih.gov/articles/PMC1885331/) A few English postencephalitic patients had already shown improvements with the drug, and Sacks initiated a small placebo-controlled trial before treating other postencephalitic survivors.[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10558160/) The results were striking: patients previously immobile for decades abruptly became animated, leaping up to stroll and even dance, banging out tunes on the ward's piano, with smiles returning to previously masked faces.[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10558160/) One patient, not having spoken for a decade, thanked Sacks with the words "I am reborn. I have been in prison for thirty-three years. You have released me from the custody of my symptoms."[4](https://www.theatlantic.com/books/archive/2024/12/oliver-sackss-letters-reveal-search-recognition/680997/)
**The awakenings did not last.** Levodopa's effects differed dramatically between patients and within the same patient, and even careful titration produced unpredictable results.[2](https://pmc.ncbi.nlm.nih.gov/articles/PMC1885331/) Leonard L, started on the drug, returned to a happiness he "had not felt for thirty years," yet six weeks later developed such exaggerated sensitivity that even tiny doses caused uncontrollable side effects.[2](https://pmc.ncbi.nlm.nih.gov/articles/PMC1885331/) Side effects among the patients included tics, ballism, oculogyric crises, and behavioral aberrations such as irresistible pacing, emotional instability, sexual acting-out, and hallucinations.[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10558160/) [Postencephalitic parkinsonism](https://www.edgepedia.org/postencephalitic-parkinsonism) proved far more difficult to control than Parkinson disease as managed today, and for some patients the drug was, in the words of one BMJ review, "a nightmare rather than a fairytale awakening."[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10558160/) • [2](https://pmc.ncbi.nlm.nih.gov/articles/PMC1885331/)
Psychological and environmental factors seemed to shape the drug's efficacy. Miron V initially responded well but became violently unstable; when he resumed work at a cobbler's workshop, his mood stabilized and he remained well on levodopa.[2](https://pmc.ncbi.nlm.nih.gov/articles/PMC1885331/) Rose R, struck by sleeping sickness at 21, awoke in 1969 to find her world of 1926 vanished; she remained rooted in the 1920s and stopped responding to the drug.[2](https://pmc.ncbi.nlm.nih.gov/articles/PMC1885331/) Sacks also came to recognize that levodopa did not enhance cognition.[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10558160/)
## Content and style
The book is a collection of 20 case reports with details of each patient's levodopa experience.[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10558160/) • [5](https://cdnc.heyzine.com/files/uploaded/v2/b5a4d2a8be1ed1860f25c9163cd2db1ccbae1717.pdf) Each vignette goes beyond a standard neurologic history, chronicling the patient's early years, personality, and hopes for the treatment.[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10558160/) Sacks recorded his own day-by-day observations and the words his patients used to describe their encounters with the drug.[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10558160/)
The writing is dense with literary citation and commentary. Almost every page carries quotes and footnotes drawing on Nietzsche, Donne, Auden, Proust, and many others, and a closing section titled Perspectives ([Awakenings](https://www.edgepedia.org/awakenings), Tribulation, and Accommodations) drifts from the patients toward broadly philosophical reflection.[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10558160/) The abundance of words posed an editorial problem: pages of footnotes had to be removed to meet the publication deadline.[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10558160/) Sacks later said of his method, "it seems to me that I discover my thoughts through the act of writing, in the act of writing."[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10558160/)
## Reception and criticism
The neurologic community gave the book scant recognition shortly after publication, although it quickly became popular with a diverse readership.[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10558160/) Praise came from the literary world: [W. H. Auden](https://www.edgepedia.org/w-h-auden) called it "a masterpiece," and the Washington Post described it as "one of the most beautifully composed and moving works of our time."[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10558160/) • [6](https://www.oliversacks.com/oliver-sacks-books/awakenings/) In 1974 it received the Hawthornden Prize, a prestigious British literary award for "imaginative literature."[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10558160/)
The intimate patient portraits also drew criticism, since they divulged highly personal information, and it is uncertain whether all patients authorized these invasions of privacy.[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10558160/) The British disability rights activist Tom Shakespeare described Sacks as "a man who mistook his patients for a literary career," and the scholar Leonard Cassuto likened the popularization of disabling neurologic maladies to "freak show" entertainment.[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10558160/) In later writings Sacks acknowledged these concerns, commenting on the difficulty of navigating between compassionate case histories and the glorification of human oddity.[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10558160/)
## Adaptations
The book inspired a series of works in other media. [Harold Pinter](https://www.edgepedia.org/harold-pinter)'s one-act play *A Kind of Alaska*, based on *Awakenings*, opened at the National Theatre in London in October 1982 with [Judi Dench](https://www.edgepedia.org/judi-dench), Paul Rogers, and [Anna Massey](https://www.edgepedia.org/anna-massey), and had its US premiere at the Manhattan Theatre Club in April 1984.[6](https://www.oliversacks.com/oliver-sacks-books/awakenings/) Tobias Picker composed a ballet for the Rambert dance company, choreographed by Aletta Collins, premiered in Manchester in September 2010, and an opera with a libretto by Aryeh Lev Stollman, commissioned for the Opera Theatre of St. Louis, which received its world premiere on June 5, 2021.[6](https://www.oliversacks.com/oliver-sacks-books/awakenings/) There were also radio and dramatic readings, including a CBC Radio adaptation in 1986.[6](https://www.oliversacks.com/oliver-sacks-books/awakenings/)
The best-known adaptation is the 1990 [Columbia Pictures](https://www.edgepedia.org/columbia-pictures) feature film *Awakenings*, directed by [Penny Marshall](https://www.edgepedia.org/penny-marshall) from a screenplay by [Steven Zaillian](https://www.edgepedia.org/steven-zaillian), starring Robin Williams as a fictionalized Sacks (Dr. Malcolm Sayer) and Robert De Niro as the patient Leonard Lowe.[6](https://www.oliversacks.com/oliver-sacks-books/awakenings/) • [8](https://www.rogerebert.com/reviews/awakenings-1990) The film was nominated for three Academy Awards and received the 1991 Scriptor Award.[6](https://www.oliversacks.com/oliver-sacks-books/awakenings/) Sacks served as technical consultant, and the actors, especially De Niro, studied footage of the actual awakenings.[9](https://www.latimes.com/archives/la-xpm-1990-12-23-ca-9472-story.html) Reviewers noted that the film condensed the book's many case histories into a single human-interest story; a New Yorker account of the production observed that the filmmakers chose to have the whole troupe awaken at once, which falsified the gradual sequence of the actual events.[10](https://www.csmonitor.com/1991/0207/lwake.html) • [11](https://www.newyorker.com/magazine/1991/02/11/the-doctor-and-the-director)
## Legacy
*Awakenings* exerted an influence beyond its subject that the neurologist Peter Alfred LeWitt, writing in *Neurology* in 2023, called transformative for the literature of neurology: a new genre of humane neurological writing emerged around it, in Sacks's own later books and in works by neuroscientists such as [Antonio Damasio](https://www.edgepedia.org/antonio-damasio), Harold Klawans, and Michael Gazzaniga, and *Neurology* began a "Humanities in Neurology" section in 2001.[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10558160/) The book remains popular among medical trainees and has been credited with inspiring career choices; a word-search analysis of personal statements by medical students applying for neurology residency found "Oliver Sacks" among the most frequent citations.[1](https://pmc.ncbi.nlm.nih.gov/articles/PMC10558160/)
The book also stands as a caution against unbridled optimism about medical breakthroughs. As the BMJ's review put it, *Awakenings* is "an important reminder that healing is a complex art and that the notion that one pill can cure disease remains a fantasy."[2](https://pmc.ncbi.nlm.nih.gov/articles/PMC1885331/)
## References
1. [LeWitt, Peter Alfred (2023). "A Half-century of Awakenings." *Neurology* 101(13):582–584.](https://pmc.ncbi.nlm.nih.gov/articles/PMC10558160/)
2. [Allan, Charlotte (2007). "Awakenings." *BMJ* 334(7604):1169.](https://pmc.ncbi.nlm.nih.gov/articles/PMC1885331/)
3. ["Write On!" Oliver Sacks official website.](https://www.oliversacks.com/write-on-2/)
4. ["Oliver Sacks's Lifelong Search for Recognition." *The Atlantic*, December 2024.](https://www.theatlantic.com/books/archive/2024/12/oliver-sackss-letters-reveal-search-recognition/680997/)
5. [*Awakenings* (book jacket text), heyzine PDF.](https://cdnc.heyzine.com/files/uploaded/v2/b5a4d2a8be1ed1860f25c9163cd2db1ccbae1717.pdf)
6. ["Awakenings." Oliver Sacks official website, books page.](https://www.oliversacks.com/oliver-sacks-books/awakenings/)
7. [Kanda, Takashi (2022). "[Encephalitis Lethargica: Awakenings]." *Brain Nerve* 74(12):1327–1330.](https://pubmed.ncbi.nlm.nih.gov/36503127/)
8. [Ebert, Roger (1990). "Awakenings" review.](https://www.rogerebert.com/reviews/awakenings-1990)
9. ["Wake Up Call." *Los Angeles Times*, December 23, 1990.](https://www.latimes.com/archives/la-xpm-1990-12-23-ca-9472-story.html)
10. ["'Awakenings' Shortcuts Fact To Stir Emotion." *Christian Science Monitor*, February 7, 1991.](https://www.csmonitor.com/1991/0207/lwake.html)
11. ["The Doctor and the Director." *The New Yorker*, February 11, 1991.](https://www.newyorker.com/magazine/1991/02/11/the-doctor-and-the-director)
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*Topic: Encyclopedia › Life and health › Human health and medicine › Diseases and injuries › Nervous and sensory conditions › Cultural depictions of neurological conditions*
*Initially written Sep 17, 2026 · Reviewed: Oct 21, 2026 · Edited: Oct 15, 2026; Oct 21, 2026 · Last review: Oct 21, 2026*
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License: Edgepedia Community License 1.0, https://www.edgepedia.org/edgepedia/license