Vintage Sacks by Oliver Sacks Read Free Book Online

write two sorts of books, wholly different but wholly complementary: “classical,” analytic texts (like
Higher Cortical Functions in Man
) and “romantic,” biographical books (like
The Mind of a Mnemonist
and The Man with a Shattered World). I was also conscious of this double need, and found there were always
two
books, potentially, demanded by every clinical experience: one more purely “medical” or “classical”—an objective description of disorders, mechanisms, syndromes; the other more existential and personal—an emphatic entering into patients’ experiences and worlds. Two such books dawned in me when I first saw our post-encephalitic patients:
Compulsionand Constraint
(a study of subcortical disorders and mechanisms) and
People of the Abyss
(a novelish, Jack Londonish book). They only came together, finally, in 1969—in a book which tried to be
both
classical and romantic; to place itself at the intersection of biology and biography; to combine, as best it could, the modes of paradigm and art.
    But
no
model, finally, seemed to suit my requirements—for what I was seeing, and what I needed to convey, was neither purely classical nor purely romantic, but seemed to move into the profound realm of allegory or myth. Even my title,
Awakenings,
had a double meaning, partly literal, partly in the mode of metaphor or myth.
    The elaborate case history, the “romantic” style, with its endeavor to present a whole life, the repercussions of a disease, in all its richness, had fallen very much out of favor by the middle of the century—and this, perhaps, was one reason for the “strange mutism” of the profession when
Awakenings
was first published in 1973. But as the seventies progressed, this antipathy to case-history diminished—it even became possible (though difficult) to publish case histories in the medical literature. With this thawing of atmosphere, there was a renewed sense that complex neural and psychic functions (and their disorders)
required
detailed and nonreductive narratives for their explication and understanding. 7
    At the same time, the unpredictable responses to L-DOPA I saw with my patients in 1969—their sudden fluctuations and oscillations, their extraordinary “sensitization” to L-DOPA, to everything—were now being seen, increasingly, by everyone. Post-encephalitic patients, it became clear, might show these bizarre reactions within weeks, sometimes days—whereas “ordinary” Parkinsonian patients, with their more stable nervous systems, might not show them for several years. Yet, sooner or later,
all
patients maintained on L-DOPA started to show these strange, unstable states—and with the FDA approval of L-DOPA in 1970, their numbers mounted, finally to millions. And now, everybody found the same: the central promise of L-DOPA was confirmed, a million-fold—but so too was the central threat, the certainty of “side effects” or “tribulations,” sooner or later.
    Thus what had been surprising or intolerable when I first published
Awakenings
was—by the time the third edition was published in 1982—confirmed for all my colleagues by their own, undeniable experience. The optimistic and irrational mood of the early days of L-DOPA had changed to something more sober and realistic. This mood, well established by 1982, made the new edition of
Awakenings
acceptable, and even a classic, to my medical colleagues, where the original had been unacceptable nine years before.
    It is the imagination of other people’s worlds—worlds almost inconceivably strange, yet inhabited by people just like ourselves, people, indeed, who might
be
ourselves—that forms the center of
Awakenings.
Other worlds, other lives, even though so different from our own, have the power of arousing the sympathetic imagination, of awakening an intense and often creative resonance in others. We