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Despertares (1973)

por Oliver Sacks

Otros autores: Ver la sección otros autores.

MiembrosReseñasPopularidadValoración promediaMenciones
2,450256,107 (3.93)87
Este libro relata la extraordinaria historia de un grupo de veinte pacientes ingresados en el Hospital Monte Carmelo de Nueva York, supervivientes de la gran epidemia de encefalitis letárgica que alcanzó dimensiones planetarias en los años veinte del sigl
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» Ver también 87 menciones

Mostrando 1-5 de 24 (siguiente | mostrar todos)
an unimaginable experience, like being in a time machine for the patients involved and bot touching and heart-rending ( )
  cspiwak | Mar 6, 2024 |
Finishing this I find myself returning to what I wrote on here 3 years ago (woof) about The Man Who Mistook His Wife for A Hat - Sacks has this humanistic, personable mode that's really great, and this dry, academic/polymath mode that can be really hard to follow. I enjoyed this quite a bit, but unlike Man Who... I feel like it was mostly despite that other part of Sacks. I look forward to reading more from him, but I think I'm going to pursue his memoirs rather than his more medical writings. ( )
  skolastic | Feb 2, 2021 |
The most devastating book ever. ( )
  victorvila | Oct 29, 2020 |
What I got out of this book is that illness is a coping mechanism. L-DOPA removed one illness response to life. That illness then gets replace with another coping mechanism, which we call a side effect. The greatest value from this book comes from the reminder that we are whole beings with experiences and unmet needs that cannot be met with the addition of a drug or drugs.

Here are some notes that I jotted down while reading.

One third of the way through the book, in every case so far Oliver Sacks increased the does to 3 grams/day and saw bizarre symptoms (problems were sometimes there before the dose increase). It made me wonder if a smaller dose might have been more effective. But no, getting the dosage right was a balancing act that tended to get more difficult after the patient had been on L-DOPA for a while.

Lucy K was lucid for one day. Even increasing the dose to 5 grams/day did not bring her back. She died 2 years later. Several patients had a similar response: They tried the medicine that brought back some normalcy, found life still unacceptable, got discouraged and wasted away

“We rationalize, we dissimilate, we pretend: we pretend that modern medicine is a rational science, all facts, no nonsense, and just what it seems. But we have only to tap it’s glossy veneer for it to split wide open, and revealed to us it’s roots and foundations, it’s old dark heart of metaphysics, mysticism, magic, and myth.” (Page 28-29 of 408)

Miriam H at almost halfway through the book told the Dr. to resume L-DOPA and she wouldn’t have complications. He did and she continued to function well on it. Some other patients also correctly told how their future health would go.

“She goes mad in your madhouse because she is shut off from life.” (Page 160)

Some of his patients develop Parkinson’s symptoms early in life, others in their 40’s or 50’s.

Footnote 88: “Life changes, powerful emotions, cannot only exacerbate, but can precipitate parkinsonism. … it has been shown that dopamine levels may be reduced in the brain by 30-50% without producing any clinical symptoms; but that if it is reduced still further, to less than 20% of normal, parkinsonian symptoms promptly appear. (Pages 191-193, yes, an extended footnote)

“In the sixteenth month on L-DOPA ... (Mr. E’s return) to Mount Carmel Hospital ... caused a wave of apprehension among the seventy other Parkinsonian patients receiving L-DOPA. They had seen Mr. E. leave in triumph, and now they saw his tragic return.” (Page 196)

A number of patients, including Mr. E. Managed to achieve some level of a normal life with or without L-Dopa.

Being trapped in the Parkinsonian state was described as: ‘a mixture of nagging and pushing and pressure, with being held back and constrained and stopped. ... The absence is a terrible isolation and coldness and shrinking - more than you can imagine, Dr. Sacks ... a bottomless darkness and unreality. ... a sort of total calmness a nothingness, which is by no means unpleasant. It’s a letup from the torture. ... it’s something like death.’ (Page 205)

L-DOPA crosses the protective blood–brain barrier, whereas dopamine itself cannot.[4]Thus, l-DOPA is used to increase dopamine concentrations in the treatment of Parkinson's disease and dopamine-responsive dystonia. (Wikipedia)

The chapter “Tribulation” is summed up in this statement: “The perverse need for illness — both in patients themselves, and sometimes in those who are close to them — must be a major determinant in casing relapses, the most insidious enemy of the will-to-get-better:” (Page 263) ... “we must ... deal with the person and his being-in-the-world.” (Page 265)

“The need for rest becomes especially important, whether in the form of night-sleep, ‘naps,’ ‘taking it easy,’ or ‘relaxation.’ ... One observes this even in out-patients with Parkinson’s disease, ... and may be considerably in excess of ‘normal’ needs;” (Page 268-269)

The L-DOPA experiment wasn’t as dire as I understood it to be before I read the book. “We still have more than fifty survivors at Mount Carmel, most of whom require, and are maintained on, L-DOPA.” (Page 278)

Contact with other humans is crucial. “Many a Parkinsonian cannot walk by himself ... yet he may walk perfectly if there is someone with him.” (Page 281) ( )
  bread2u | Jul 1, 2020 |
2.5 stars
Some positives: the writing in Awakenings is significantly better than in The Man Who Mistook His Wife For A Hat . I particularly enjoyed reading the case histories. Sacks has a humane approach to every patient and their stories are remarkable. I was also pleased to see there was a glossary (unlike in The Man... ) - especially when first reading it, the glossary was very helpful.

I was, however, a bit disappointed with the editing. For one, the prologue and epilogue/appendices take up a lot of space. The case histories only take up 45% of the book (yes, I calculated it). The rest of the book consists of essays, Sacks' perspectives and the history of the drug L-DOPA and Parkinsonism in general. I personally wasn't really interested in those scientific essays, and thought they were unnecessary for the most part. Sacks also really loves his footnotes; in total there are 175 (!) in my edition (1990) - these footnotes were long and as a result made the book less readable.

Despite my complaints, I am grateful Sacks gave these post-encephalitic patients a voice and I'm glad I got to read their stories.

Also, I thought this passage in one of the appendices (A History of the Sleeping-Sickness) was relevant to the situation we're currently in: "Pandemics of viral diseases, as Lederberg points out, are a natural and almost predictable phenomenom (Culliton, 1990), and there is certainly no reason to think that encephalitis lethargica is extinct. Our best protection, as von Economo stressed, is a continuing vigilance, so that we are never again, as in 1918, taken unawares." ( )
  frtyfour | Jun 16, 2020 |
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» Añade otros autores

Nombre del autorRolTipo de autor¿Obra?Estado
Oliver Sacksautor principaltodas las edicionescalculado
Bekker, Jos denTraductorautor secundarioalgunas edicionesconfirmado
Eliot, T. S.Contribuidorautor secundarioalgunas edicionesconfirmado
Jones, ErnestContribuidorautor secundarioalgunas edicionesconfirmado
Keynes, John MaynardContribuidorautor secundarioalgunas edicionesconfirmado
Lawrence, D. H.Contribuidorautor secundarioalgunas edicionesconfirmado
Wensinck, F.Traductorautor secundarioalgunas edicionesconfirmado
Wittgenstein, LudwigContribuidorautor secundarioalgunas edicionesconfirmado
Wroblewski, ThomiArtista de Cubiertaautor secundarioalgunas edicionesconfirmado
Debes iniciar sesión para editar los datos de Conocimiento Común.
Para más ayuda, consulta la página de ayuda de Conocimiento Común.
Título canónico
Información procedente del conocimiento común holandés. Edita para encontrar en tu idioma.
Título original
Títulos alternativos
Fecha de publicación original
Personas/Personajes
Lugares importantes
Acontecimientos importantes
Películas relacionadas
Información procedente del conocimiento común holandés. Edita para encontrar en tu idioma.
Epígrafe
Dedicatoria
Información procedente del conocimiento común holandés. Edita para encontrar en tu idioma.
To the memory of W.H. Auden and A.R. Luria
Primeras palabras
Información procedente del conocimiento común holandés. Edita para encontrar en tu idioma.
The theme of tis book is the lives and reactions of certain patients in a unique situation - and the implications which these hold out for medicine and science.
Citas
Información procedente del conocimiento común holandés. Edita para encontrar en tu idioma.
... and now, a preternatural birth in returning to life from this sickness / Donne
Últimas palabras
Información procedente del conocimiento común holandés. Edita para encontrar en tu idioma.
(Haz clic para mostrar. Atención: puede contener spoilers.)
Aviso de desambiguación
Editores de la editorial
Blurbistas
Idioma original
Información procedente del conocimiento común holandés. Edita para encontrar en tu idioma.
DDC/MDS Canónico
LCC canónico

Referencias a esta obra en fuentes externas.

Wikipedia en inglés (2)

Este libro relata la extraordinaria historia de un grupo de veinte pacientes ingresados en el Hospital Monte Carmelo de Nueva York, supervivientes de la gran epidemia de encefalitis letárgica que alcanzó dimensiones planetarias en los años veinte del sigl

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