AWAKENINGS

L-DOPA has been hailed by researchers as a "miracle drug," a "cure" for schizophrenia. Sacks provides 20 case histories of patients to whom the drug was administered, most of them victims of the "sleeping sickness" epidemic of the 1920's, further complicated by Parkinsonian symptoms: that is, their volition was undermined, they had difficulty in starting and stopping movements (though the problem was not muscular). The fact that they remained thinking, feeling beings placed them in a sort of "ontological death": conscious, yet not fully awake. The results of L-DOPA were inconsistent and unpredictable. It produced an "awakening," but one which was almost universally followed by "tribulation," some instances of which led back to the pre-DOPA state, others to even further fragmentation of personality. One patient called the drug, "hell-DOPA"; another said, "If you ask whether L-DOPA is good or bad for me, I'd say it was both. It has wonderful effects, but there is a hell of a 'but' . . ." Some effected a final "accommodation," a new level of being far richer than the pre-DOPA level. Sacks argues that "altering. . . chemical circumstances may be a prerequisite to any other alteration; but that it is not, in itself, enough." A drug cannot fulfill psychological needs, and it may intensify those needs when they are not otherwise met. In the eerie shadow-world where mind and body meet, Sacks remains extraordinarily compassionate and perceptive. A sagacious, discerning book.