I just ride it out and wait for the storm to clear… That L-Dopa, that stuff should be given its proper name – Hell-Dopa!” Some of L-Dopa’s side-effects had a frightening intensity: in one patient’s words: “I can no more control it than I could control a spring tide.

Awakenings became his account of a unique experience, the return to humanity of men and women whose personalities had become immured in post-encephalitic torpor. Oliver Sacks was the brilliant young neurologist who administered the wonder drug, keeping meticulous notes on his patients’ recovery. In one hospital in particular – the Beth Abraham in the Bronx – some 80 patients, long regarded as effectively moribund, returned explosively to life. In 1969, after more than 40 years of lives as insubstantial as ghosts and as passive as zombies, these “extinct volcanoes”, scattered in hospitals for chronic neurological disability in Britain, Europe and the US, erupted into life through the intervention of a remarkable new “awakening” drug, L-Dopa (laevodihydroxyphenylalanine). Yet some lived on, getting older and frailer, inmates of institutions, profoundly isolated, deprived of experience, half-forgetting, half-dreaming of the world they had once lived in. And yet, unable to work or see to their needs, frequently abandoned by their friends and families, these patients were put away in hospitals, nursing homes and lunatic asylums and forgotten, like lepers of the 20th century. Their minds, however, remained clear and unclouded. For many survivors, this was the 1920s, a time that would remain more real to them than any subsequent decade.

In the majority of cases, these patients had their thoughts and feelings unchangingly fixed at the point at which their long “sleep” had closed in on them. They would sit motionless and speechless all day in their chairs, totally lacking energy, impetus, initiative, motive, appetite or desire. These survivors were described by the doctor who first identified encephalitis lethargica as “extinct volcanoes”. Other patients who suffered an extremely severe somnolent/insomnia attack often failed ever to recover their original vitality and lived out their days, cut off from humanity, in a deeply strange, inaccessible, frozen state (“a kind of Alaska”), oblivious to the passage of time or what had befallen them. A third of those afflicted by encephalitis lethargica died in its acute stages, in advanced states of coma or sleeplessness. The “sleepy sickness” pandemic of 1916-17, which persisted into the 1920s, ravaged the lives of nearly 5 million people before it disappeared, as mysteriously and suddenly as it had appeared, in 1927.

Awakenings by Oliver Sacks