Vintage Sacks Read Online Free PDF Page A

profound emotion—it was the most significant and extraordinary in my life, no less than in the lives of our patients. All of us at Mount Carmel were caught up with the emotion, the excitement, and with something akin to enchantment, even awe.
    It was not a purely “medical” excitement, any more than these awakenings were a purely medical event. There was a tremendous
human
(even allegorical) excitement at seeing the “dead” awaken again—it was at this point that I conceived the title
Awakenings,
taken from Ibsen’s
When
We Dead Awaken
—at seeing lives which one had thought irremediably blighted suddenly bloom into a wonderful renewal, at seeing individuals in all their vitality and richness emerge from the almost cadaveric state where they had been frozen and hidden for decades. We had had inklings of the vivid personalities so long immured—but the full reality of these only emerged, indeed burst upon us, with our patients’ awakenings.
    I was exceedingly lucky to encounter such patients at such a time, in such working conditions. But they were not the only post-encephalitic patients in the world—there were, in the late ’60s, still many thousands, some in large groups, in institutions all over the world. There was no major country
without
its complement of post-encephalitics. And yet
Awakenings
is the only existing account of such patients—their decades-long “sleep” and, then, their dramatic “awakening” in 1969.
    I found this exceedingly peculiar at the time: why, I thought, were there not other accounts of what must be happening all over the world? Why, for example, was there not an
Awakenings
from Philadelphia, where I knew of a group of patients not so dissimilar to my own? Why not from London, where the Highlands Hospital housed the largest post-encephalitic colony in England? 4 Or from Paris or Vienna, where the disease first struck?
    There is no single answer to this; there were many things that mitigated against the sort of description, the “biographic” approach, of
Awakenings.
    One factor that made
Awakenings
possible had to do with the nature of the
situation.
Mount Carmel is a chronic hospital, an asylum; and physicians in general avoid such hospitals, or visit them briefly, and leave as soon as they can. This was not always the case: in the last century, Charcot virtually lived in the Salpêtrière, and Hughlings-Jackson at the West Riding Asylum—the founders of neurology realized well that it was only in such hospitals that the depths and details of the profounder disorders could be explored and worked out. As a resident I myself had never been to a chronic hospital, and though I had seen a number of patients with post-encephalitic Parkinsonism and other problems in outpatient clinics, I had no idea how profound and strange the effects of post-encephalitic disease might be. I found coming to Mount Carmel, in 1966, a revelation. It was my first encounter with disease of a depth I had never seen, read of, or heard of, before. The medical literature on the sleeping sickness had virtually come to a stop in 1935, so that the profounder forms of it, occurring later, had never been described. I would not have imagined it
possible
for such patients to exist; or, if they existed, to remain undescribed. For physicians do not go, and reports do not emerge, from the “lower reaches,” these abysses of affliction, which are now (so to speak) beneath the notice of Medicine. Few doctors ever entered the halls and back wards of chronic hospitals and asylums, and few had the patience to listen and look, to penetrate the physiologies and predicaments of these increasingly inaccessible patients.
    The “other” side, the good side, of chronic hospitals is that what staff they have may work and live in them for decades, may become extraordinarily close to their charges, the patients, get to know and love them, recognize,