Analynn Peterson-Allen

3/7/2015
Psychology 1010

Awakenings

Encephalitis lethargica or sleeping sickness was an epidemic that

occurred around the world between 1915-1926. Millions of people
were affected and many died. However, those that survived suffered
side effects from the neurological damage. The symptoms of patients
with encephalitis lethargica were limited body movements, ticks, head
bobbing, inability to speak, write, or feed themselves, and they would
freeze in the middle of doing a task. Some patients were
unresponsive to the point of being catatonic. Essentially these patients
could not function normally.
Dr. Sayer proved that these seemingly unaware patients are
really just prisoners in their own mind. He would demonstrate this by
throwing a ball to them, which they would in turn catch. At first this
was not so convincing and seen as simple reactions, however, Dr.
Sayer believed this was a conscious human will. He continued by
bringing all patients suffering from encephalitis lethargica to one floor
where he had them interact with one another passing a ball around. He
then experimented with music, which proved quite successful. When a
song was played that the patient related to they would be able to do

simple tasks, such as feeding himself or herself. One patient, Leonard,

was able to use a Ouija board with the doctor to communicate. Both of
these examples were ways that Dr. Saver was able to show their
human will, with the help of different types of stimulation the patients
were able to control their behavior to some extent.
L-Dopa was a new drug that had been seen to decrease tremors
in Parkinson patients. Dr. Sayer decided to try this drug with the
patients, which proved extremely successful. This marked the point
when the question of their awareness was proven. Once the patient
had been administered L-Dopa they would become completely active.
A once catatonic patient would be able to walk and talk quite normally.
If these patients were unaware then they would not be able to
function normally once the drug was administered. L-Dopa did have
extreme side effects. Patients would develop a tolerance to L-Dopa and
although the dosage would be increased, side effects such as: ticks,
repeating themselves, violent shaking, or undignified behaviors would
somewhat torture them; forms of aggression and paranoia could also
become evident in the patients. Eventually, most patients would no
longer respond to the drug while some other patients would choose to
be taken off of the drug for a variety of reasons including, protecting
their dignity, the inability to live in the modern age, or they could not
stand the side-effects of L-Dopa any longer. Dr. Oliver Sacks describes
the miracle and effects of L-Dopa in his book Awakenings. He says

For the first time, then, the patient on L-DOPA enjoys a perfection of
being, an ease of movement and feeling and thought, a harmony of
relation within and without. Then his happy state-his world- starts to
crack, slip, break down, and crumble; he lapses from his happy state,
and moves toward perversion and decay.
The accuracy of this film was somewhat remarkable in the
portrayal of the patients symptoms and the process of Dr. Oliver
Sacks research. He has videos of his encephalitic patients while in
their catatonic state where he would administer the medication and
their transformation or awakening would occur. After taking the
medication the patients would be up walking and talking, singing, and
dancing. These patients would be administered the drug several times
daily; once the medication wore off the patient would immediately
become frozen or catatonic. Despite the intense side effects
associated with L-Dopa some patients enjoyed their newfound abilities
so much that they would choose to cope with the side effects until they
became more unbearable than being in their catatonic state. While in
the catatonic state some patients claimed that they were stuck in a
mind loop, they would continuously add 2+2 or be stuck following a
theme from a song repeatedly. Some patients were stuck in this loop
for 40+ years. Dr. Oliver Sacks described this as a sort of purgatory
or hell. He has continued his research on L-Dopa and the effects it
has on patients with encephalitis lethargica since his initial discovery.

Unfortunately, his research has not found any medication or

combinations of treatments that were as successful as high doses of LDopa, although, new research has led him to believe that using an
antibiotic in combination with L-Dopa could prove successful. The work
that Dr. Sacks has done in proving cognition in these catatonic patients
and then bringing them back to life is quite remarkable and somewhat
unbelievable.