Review: Awakenings

awakenings

AwakeningsOliver Sacks. London: Picador, 1991.

Summary: Chronicles the experience of post-encephalitis patients existing as prisoners in their own bodies in a trance-like state, who, when treated with L-DOPA, experienced dramatic “awakenings” nearly always followed by debilitating side effects, often resulting with withdrawal of the drug, and a return to their former state.

From 1916 to 1927, there was an epidemic of encephalitis lethargica, or “sleeping sickness.” The sickness often resulted in a period of profound lethargy, sometimes ending in a return to normal or nearly normal life. A number of patients experienced symptoms of Parkinsonism, leading to increasing paralysis and necessitating institutionalization. Many lived as prisoners in their own bodies, limited in movement and speech.

Oliver Sacks, in this book chronicles his work with a group of such patients, some institutionalized for as long as forty years in Mount Carmel Hospital in New York. During the time that he was caring for them, a new drug, L-DOPA, began to be used with great effect on Parkinson’s patients, and since these patients symptoms were similar, Saks, and other attempted to use the drug with them with dramatic, and ultimately, troubling, effects.

After introductory chapters on Parkinsonism, sleeping sickness, Mount Carmel, and L-Dopa, he describes the patient history of twenty patients who he treated with this drug. It turns out they responded very differently than Parkinson’s patients. Nearly all of them experienced “awakenings” where they regained the ability to move and speak. One patient, Leonard L. described the experience as follows:

“I feel saved. . . I feel like a man in love. I have broken through the barriers which cut me off from love. . . . I have been hungry and yearning all my life, . . . and now I am full. Appeased. Satisfied. I want nothing more. . . . L-DOPA is a blessed drug, it has given me back the possibility of life. It has opened me out where I was clammed tight shut before. . . . If everyone felt as good as I do, nobody would think of quarrelling or wars. Nobody would think of domination or possession. They would simply enjoy themselves and each other. The would realize that Heaven was right here down on earth.”

Sadly, with few exceptions, these awakenings did not last but turned into wide awake nightmares. Coherent speech would become rushed faster and faster, and degenerate into repeating of words or phrases. “Tics” would appear and become debilitating. Movement would accelerate to the point that the person could harm themselves. Psychological changes occurred as well and a normal personality would generate into mania.

The histories describe the heart-wrenching efforts to bring these symptoms under control by reducing dosages. Sometimes things were so bad that they had to withdraw the drug, leading to a return to a trance-like or coma-like state. He also describes three stages he observed patients going through: awakening, tribulation (side effects is too mild to describe this stage) and accommodation. Some are able to resume L-DOPA, and some not. What is striking is how they come to terms with their dashed expectations and suffering. Leonard writes, “I am a living candle. I am consumed that you may learn. New things will be seen in the light of my suffering.”

Sacks also observes how significant the human connection is with his patients, and how they do significantly better when there is at least one person in their lives with whom they connect, whether someone on the ward, or a family member or friend. For one patient, the chance to cobble shoes again enhanced his physical well-being and checked his descent into profound Parkinsonism.

He concludes with some profound reflections on the nature of disease and the human personality. Sacks then includes series of fascinating appendices at the end of the book exploring the history of “sleeping sickness,” the past experiences of “miracle drugs,” and the electrical basis of awakenings. Two of the most fascinating were his studies of the different perceptions of space and time of his patients, and the application of chaos theory to understanding patient responses to L-DOPA, which did not follow any orderly progression.

The last appendix is an account of the various radio, stage, and screen adaptations of Awakenings. Most notable is his description of working with actors Robert De Niro and the late Robin Williams and director Penny Marshall on the film version of Awakenings. He pays a wonderful tribute to their craft in getting “inside” what it was like to be one of these patients and the portrayal of fifteen “awakenings” at once and the chaos, brilliantly choreographed by Marshall.

Sacks gives us a narrative that helps us understand the often heartbreaking process of medical research, where advances and setbacks often come together, and where, more than science, the bond between doctors and other caregivers and patients remains paramount, whether treatments effect cure or not. Through one rare condition, Saks gives us a lens into the human condition we all share.

 

The Month in Reviews: January 2017

slow-kingdom-coming

I began and ended the month with classic mysteries — a great way to turn aside from the concerns of the day that I would commend to any reader. I read one of the best explanations of the Enneagram and one of the best studies of the idea of “mystery” in the Bible. I read a history of Americans in Paris in the nineteenth century, and a fictional account of westerners in Haiti in the “Papa Doc” Duvalier era. I read books on civility and sensitivity. I explored the philosophical beginnings of the American republic, and what might be the brief history of the Affordable Care Act. Sprinkled into this mix was a delightful Oliver Saks book, Kent Annan’s wonderful Slow Kingdom Coming, and an exploration of the importance of relationships in Christian discipleship. Fourteen books reviewed in all summarized right here with links to the full reviews!

strong-poison

Strong PoisonDorothy L. Sayers. New York: HarperCollins, 2012 (originally published 1930). Harriet Vane is accused of murdering her lover with arsenic. Lord Peter Wimsey believes she is innocent despite damning evidence and sets about to prove it. (Review)

the-road-back-to-you

The Road Back to YouIan Morgan Cron and Suzanne Stabile. Downers Grove: InterVarsity Press, 2016. Describes the Enneagram and each of the nine types, and how these may be helpful in self-discovery, uncovering one’s true self and experiencing spiritual growth. (Review)

the-comedians

The ComediansGraham Greene. New York: Penguin, 2005 (my edition 1976). Three men, Brown, Smith, and Jones meet on a ship bound for Haiti during the reign of terror of “Papa Doc” Duvalier. They are the “comedians” who must confront not only the tragedy of Haiti, but themselves. (Review)

the-greater-journey

The Greater Journey: Americans in ParisDavid McCullough. New York: Simon & Schuster, 2011. Vignettes of the waves of Americans who came to Paris as writers, artists, medical students, musicians, politicians, diplomats, and members of the cultured elite, and the profound impact the “City of Light” had on their lives. (Review)

adventures-in-evangelical-civility

Adventures in Evangelical Civility, Richard J. Mouw. Grand Rapids: Brazos Press, 2016.  An intellectual memoir, tracing Mouw’s efforts to find common ground while maintaining reformed and evangelical convictions. (Review)

sensitive-preaching

Sensitive Preaching to the Sexually HurtingDr. Sam Serio. Grand Rapids: Kregel Ministry, 2016. Explores the different kinds of issues that arise around sexuality in our post-sexual revolution society, and how pastors and others extending pastoral care might counsel and preach with sensitivity that may open the door to the healing of sexual wounds. (Review)

the-minds-eye

The Mind’s EyeOliver Sacks. New York: Picador USA, 2010. Narratives of those who because of optical or neural issues experience distortions in or loss of sight, and how they adapt to such losses. (Review)

rescuing-jesus

Rescuing Jesus: How People of Color, Women & Queer Christians Are Reclaiming EvangelicalismDeborah Jian Lee. Boston: Beacon Press, 2016. An account of how three marginalized groups within American evangelicalism are finding increasing acceptance, and the struggles they have faced along the way. (Review)

hidden-but-now-revealed

Hidden But Now RevealedG. K. Beale and Benjamin L. Gladd. Downers Grove: InterVarsity Press, 2014. A study of the word mystery in scripture, particularly considering its use in the Old Testament book of Daniel, and how nearly all New Testament usages connect back to this book, and show the once hidden but now revealed realities surrounding the person of Christ, his kingdom, and the inclusion of the Gentiles. (Review)

slow-kingdom-coming

Slow Kingdom ComingKent Annan. Downers Grove: InterVarsity Press, 2016. From years of experience in justice work, Kent Annan commends five practices that both better enable us to serve and to sustain our efforts for the long haul. (Review)

unraveled

Unraveled: Obamacare, Religious Liberty, and Executive Power, Josh Blackman. Cambridge: Cambridge University Press, 2016. A history of the writing, passage, and defense, both in the courts, and by the executive branch of the Affordable Care Act, against those who would attempt to unravel it and prevent it from becoming part of the fabric of American society. (Review)

power-of-together

The Power of TogetherJim Putnam. Grand Rapids: Baker Books, 2016. A pastor of a thriving church explores what he believes to be the key to both spiritual maturity and the ministry effectiveness of his church–the fostering of relationships of depth between believers throughout the church. (Review)

and-then-there-were-none

And Then There Were None, Agatha Christie. New York: Harper Collins, 2011 (first published 1939). Ten strangers are invited to an island by a mysterious U.N. Owen, accused by murder, and one by one are murdered following a rhyme found in each of their rooms, Ten Little Soldier Boys. (Review)

natures-god

Nature’s God: The Heretical Origins of the American Republic, Matthew Stewart. New York: W.W. Norton, 2014. An argument that the key ideas at the foundations of our country were not Christian but rather traceable back to Lucretius and to European thinkers, the foremost of whom was Spinoza, whose ideas were shaped by Enlightenment reason resulting more in a materialist atheism or nature pantheism/deism. (Review)

Best of the Month: Kent Annan’s Slow Kingdom Coming is my choice because he delineates the practices that sustain anyone pursuing God’s kingdom, particularly those pursuing advocacy work. The book is real, clear, and concise and reflects the authenticity of Annan’s own “long obedience” in these things. I haven’t seen this book get much notice but believe it can serve as a kind of manual for our times.

Best Quote of the Month: This is from Oliver Saks The Mind’s Eye describing the adjustments a concert pianist made when she lost the ability to read music due to a progressing neurological problem and gives you a taste of his wonderful writing:

“Lilian had been ingenious and resilient in the eleven or twelve years since her illness started. She had brought inner resources of every kind to her own aid: visual, musical, emotional, intellectual. Her family, her friends, her husband and daughter, and above all, but also her students and colleagues, helpful people in the supermarket or on the street–everyone had helped her cope. Her adaptations to the agnosia were extraordinary–a lesson in what could be done to hold together a life in the face of ever-advancing perceptual and cognitive challenge. But it was in her art, her music, that Lilian not only coped with disease but transcended it. This was clear when she played the piano, an art that both demands and provides a sort of superintegration, a total integration of sense and muscle, of body and mind, of memory and fantasy, of intellect and emotion, of one’s whole self, of being alive. Her musical powers, mercifully, remained untouched by her disease.”

Coming soon: Look for a review of John Inazu’s Confident Pluralism tomorrow, another important book in how we engage the conversations of our time. I’ve just started a book, From Bubble to Bridge that also explores these conversation virtues in the context of interfaith conversations. The Power of Meaning explores the role of connection, purpose, story and transcendence in a meaningful life, and strikes me could be a great book for discussions in an interfaith context. I’m also reading a book looking at the future of evangelical theology from a pentecostal Asian American perspective–the last four words of which are decidedly not my own perspective but actually quite stretching.  The Faculty Factor explores the changes in the career paths of university faculty in the last decade. And I’m thoroughly enjoying a re-reading of Uncle Tom’s Cabin, having just finished reading that memorable scene of Eliza and her son escaping across moving chunks of ice on the Ohio River. Having seen the Ohio River like that, my heart was racing!

 

 

 

Review: The Mind’s Eye

the-minds-eye

The Mind’s EyeOliver Sacks. New York: Picador USA, 2010.

Summary: Narratives of those who because of optical or neural issues experience distortions in or loss of sight, and how they adapt to such losses.

Neurologist Oliver Sacks left us a series of narratives of neurological impairments and how people with these adapted to life. In this volume he considers cases of visual impairment or loss, describing both a collection of different impairments, some in the eye, some in the brain, and how real people have adapted to losses or changes in this seemingly essential sense.

He begins with a concert pianist who loses her ability to read music. She could remember pieces and play them with perfection, and yet could not make sense any longer of musical notation. In this, as in other narratives, he wrote eloquently, and with admiration of her adaptation:

“Lilian had been ingenious and resilient in the eleven or twelve years since her illness started. She had brought inner resources of every kind to her own aid: visual, musical, emotional, intellectual. Her family, her friends, her husband and daughter, and above all, but also her students and colleagues, helpful people in the supermarket or on the street–everyone had helped her cope. Her adaptations to the agnosia were extraordinary–a lesson in what could be done to hold together a life in the face of ever-advancing perceptual and cognitive challenge. But it was in her art, her music, that Lilian not only coped with disease but transcended it. This was clear when she played the piano, an art that both demands and provides a sort of superintegration, a total integration of sense and muscle, of body and mind, of memory and fantasy, of intellect and emotion, of one’s whole self, of being alive. Her musical powers, mercifully, remained untouched by her disease.”

In succeeding chapters, he describes a patient with receptive aphasia resulting from a stroke, a man who no longer could decode letters into words and sentences, even though he could continue to write them, the challenges of those who are face-blind, a woman who through therapy, achieves stereoscopic vision for the first time in her adult life, and how this changed her perception of the world, and what happens within the brain when a person becomes blind and yet continues to have a “visual sense” of the world– a “mind’s eye.”

Perhaps the most moving was the description of the author’s own experience of visual distortion due to a form of melanoma and eventual loss of stereoscopic vision with retinal bleeding in one eye. He describes the changes in his own perception of the world, his loss of a sense of the existence of half of his visual field, and how he personally adapted to this loss.

Like other books by Saks, he brings together the fascinating world of neuroscience, and the marvelous uniqueness of the human beings whose stories he tells. He helped me marvel at the sense of sight that I take so for granted, and yet could change or be lost for a host of reasons (I need to make that eye check up appointment!). And he helped me appreciate the tremendous ingenuity of individuals, and the fascinating properties of the brain, that enable people to adapt to devastating loss.

The Month in Reviews: September 2015

This month’s list of books reviewed clearly is a reflection of my (odd, eclectic?) reading tastes. A good dose of biblical studies and theology with books on Mark 13 and Ephesians, universalism and substitution. Books on restoration and renaissance–topics of interest for one who hasn’t given up on the possibility of Christians having a truly redemptive influence in society. There’s historical fiction, a book by an environmental writer and the late Oliver Sacks on music and sci-fi based on Mars. In case you missed any reviews in September, they are all here, with links to the full review and publication information in the book title:

AgincourtAgincourt, Bernard Cornwell. Through the eyes of Nicholas Hook, we see the massacre of Soissons, and the English invasion of France under Henry V including the frustrating seige of Harfleur, and the miraculous victory at Agincourt.

Evangelical UniversalistThe Evangelical UniversalistGregory MacDonald. This book provides the biblical, philosophical and theological arguments for why the view that all will finally be saved is consistent with evangelical theology and also includes additional appendices responding to issues raised since the book’s first edition.

Wild IdeaWild Idea: Buffalo & Family in a Difficult Land. Dan O’Brien. Dan O’Brien continues the story begun in Buffalo for the Broken Heart, describing the growth of the Wild Idea Buffalo Company, the move to a new ranch, and the challenges of a maturing daughter, an aging friend, and the struggle to build an ethical and ecologically sound business on the ever-challenging Great Plains.

Jesus the Temple and the Coming of the Son of ManJesus, The Temple, and the Coming Son of Man, Robert H. Stein. This commentary on Mark 13 sorts through the complex interpretive issues concerning the fall of the temple, apocalyptic events, and the return of the Son of Man.

Restoring All ThingsRestoring All ThingsWarren Cole Smith and John Stonestreet. This book narrates the impact of mediating institutions and efforts by Christians in bringing restoration into some of the most challenging situations faced by our society today.

Drama of EphesiansThe Drama of Ephesians, Timothy G. Gombis. This book approaches Ephesians as a drama of the victory of God over cosmic powers in opposition to Him through Christ and through a redeemed and transformed church that acts as Divine Warrior. I also posted an interview with the author here.

MusicophiliaMusicophiliaOliver Sacks. Renowned neurologist Oliver Sacks chronicles the neuroscience of music–the various ways music affects the brain, and the unusual effects of various neurological conditions on our perception, performance, and experience of music.

RenaissanceRenaissance, Os Guinness. Against the doomsayers speaking of the darkness of the times, Guinness remains hopeful for a spiritual and cultural renaissance in the west, rooted in the power of the Christian message; and he charts the tasks of faithful witness that precede this and the contours of such a renaissance.

Reading C.S. LewisReading C.S. Lewis: A CommentaryWesley Cort. This book provides an undogmatic look at C.S. Lewis, considering the influences upon his life and writing, and a commentary on Lewis’s major Christian works.

Defending SubstitutionDefending Substitution: An Essay on Atonement in Paul, Simon Gathercole. Gathercole defends the oft-maligned doctrine of substitutionary atonement, responding to the criticisms and challenges raised and demonstrating from key biblical texts that it can be argued from scripture that “Christ died in our place.”

The MartianThe MartianAndy Weir. Mark Watney, left by his crew for dead on Mars, survived a potentially fatal incident and must find a way to survive on Mars alone until he can be rescued.

Beyond AwkwardBeyond Awkward: When Talking About Jesus is Outside Your Comfort ZoneBeau Crosetto. Talking about faith with others often feels awkward and is why most of us don’t do it. This book explores how to press through that awkwardness to important and life-changing conversations.

Best Book of the Month: I rarely choose a religious book as my best book of the month but I found The Drama of Ephesians by Timothy Gombis particularly compelling for its fresh perspective on Ephesians that highlights the spiritual warfare aspect of the book. I also appreciated that Gombis combined good scholarship with clear writing that could be grasped by any thoughtful student of the Bible and applications set in the life of real congregations.

Best Quote of the Month: This is from The Drama of Ephesians:

“In the logic of Ephesians, the two groups are not the saved and the damned, the in and the out. The two groups are those whom God is transforming by his love and those to whom the first group is sent in order to embody God’s love” (p. 77).

Among the things I’m currently reading are a couple books on environmentally sustainable agriculture by an early exponent, Ohio novelist Louis Bromfield, a book seeking to reconcile the philosophy of Ayn Rand and Christianity, a thoughtful work on ways we abuse scripture, and an account of Robert Kennedy’s last campaign by David Halberstam. Last month,I mentioned the Zaleskis’ book on the Inklings. I hope to start it before the month is out. Whether I do or not, isn’t part of the fun of reading the anticipation? At any rate, happy reading!

Review: Musicophilia

MusicophiliaMusicophiliaOliver Sacks. New York: Vintage Books, 2008.

Summary: Renowned neurologist Oliver Sacks chronicles the neuroscience of music–the various ways music affects the brain, and the unusual effects of various neurological conditions on our perception, performance, and experience of music.

Oliver Sacks died on August 30 of this year. A few months earlier, my son gave me this book, and it seemed especially appropriate to pull it off the “to be read” pile and acquaint myself with the work of this neuroscientist and physician. Before opening the book, I had one of those heart-stopping moments as I found myself staring at the cover picture of Sacks and thought I was looking at a doppelganger! I guess balding men with graying beards, glasses and a certain shape of head can look a bit like each other.

What Sacks does is chronicle the fascinating ways music and the brain interact and some of the unusual conditions that involve unusual responses to music. In the course of this book he explores a range of phenomena beginning with a sudden onset of musical interest following a lightening strike, the ways music might evoke seizures or suppress the tics of Tourettes or the shaking of Parkinson’s. He wonders whether the advent of iPods will result in more brainworms–those tunes we can’t get out of our heads.He describes musical hallucinations, where one hears music in one’s head even when none is playing.

He explores musicality from tone deafness to perfect pitch (which occurs more in musical families and where musical training begins early) and synesthesia, where music is associated with color. He explores the connections between music, memory and movement. He describes Clive, who because of brain infection that affected his temporal lobes lives in a perpetual present with no memory of past moments. Yet somehow he remembers music he knew in the past.

Perhaps a highlight of the book was his description of a camp for people with Williams syndrome, a genetic disorder that affects the development of the brain resulting in low IQs and yet incredible verbal and musical skills. He describes the delight these people had in talking and making music with one another.

In one of the concluding chapters he describes the work done with Alzheimer’s patients and how, for them as well, music is a connection to memories of the past, and an anchor to their no-longer remembered lives that is profound. He talks about “the loss of self” and how music helps Alzheimer’s patients connect to some sense of “self” when the other memories are gone.

The book left me in wonder at the intricacies of the human brain and how the neural circuitry related to our perception, memory of, and making of music interact with speech, thought, emotion, and other memories. And it reminded me of the power of music–a power to evoke emotions, memories, and even to address troubling neurological conditions. It reminds me of how when I am learning, singing and performing a piece of music, I find myself tapping into a different aspect of who I am from when I am simply speaking or writing or reading. And I found myself thankful for the life of Oliver Sacks, who cared for people with troubling conditions and brought together his love for his patients, his skills in research, and his own musicality and life history into this fascinating narrative of music and the human brain.