María Isabel Jiménez Serranía J Med Mov 3 (2007): 102-112 JMM Awakenings (1990): The epidemic of children who fell asleep María Isabel Jiménez Serranía Facultad de Medicina. Universidad de Salamanca (Spain). Correspondence: María Isabel Jiménez Serranía. Facultad de Medicina. Alfonso X El Sabio s/n. 37007 Salamanca (Spain). e-mail: :[email protected] Received 18 April 2007; accepted 1 June 2007 Summary The film Awakenings is testimony to the dream of a neurologist who transiently gave back “freedom” to his post-encephalitis patients, paralyzed by Parkinson’s disease for decades, treating them with what was considered a miracle drug: L-dopa. These awakenings ope- ned his eyes to the tragedy: the passage of time that not all of the patients could admit to having lost. The dichotomy between the benefits and adverse side effects, however evident they seem, is a difficult area in the doctor-patient relationship. Both must accept the reality of the situation. The film is indeed a masterful depiction of medical ethics and of the value of existence. Keywords: Encephalitis Lethargica, Postencephalitis Parkinson’s Disease, L-dopa. Technical details Synopsis: The victims of an epidemic of encephalitis lethargica that broke out in the Title: Awakenings twenties have been progressively reduced to a Country: USA vegetative-Parksinsonian state in a hospital Year: 1990 for the chronically ill. Years later, in 1969, Dr. Director: Penny Marshall Sayer (Robin Williams) uses one of his Music: Randy Newman patients – Leonard Lowe (Robert de Niro) to Screenwriter: Steve Zaillian. An adaptation test a new drug -Levo-dopa- able to “revive” of the book under the same name by Dr. him. He then decides to use it on other Oliver Sacks. Based on a true story. patients. Cast: Robert de Niro, Robin Williams, Awards and nominations: Oscar nomina- Penelope Ann Miller, Julie Kavner, Ruth tions (1990) for Best Picture, Best Actor in a Nelson, John Heard, Alice Drummond, Leading Role (Robert De Niro) and Best Judith Malina, Barton Heyman, George Writing, Screenplay Based on Material from Martin, Anne Meara, Richard Libertini, Laura Another Medium. Awarded the Scriptor Esterman, Dexter Gordon, Jayne Haynes, Award in 1991. Gloria Harper, Keith Diamond, Marie Cinematographic analysis Catherine Wright, Mary Alice, Gwyllum Evans, Steve Randazzo, Anthony J. Nici and In the credits, we learn that the film is set in Max Von Sydow. the twenties of the last century, with scenes from the Color: Color life of Leonard (Anthony J. Nici) a studious child who Runtime: 121 minutes has to stop going to school owing to the appearance Genre: Drama. Melodrama. of tremors in one of his hands. In the next scene, por- Production Companies: Columbia Pictures traying a jump in time, we are in 1969. Dr. Sayer Corporation (Robin Williams) has become a neurologist at the Bainbridge hospital for the chronically ill. He is an 102 © Ediciones Universidad de Salamanca María Isabel Jiménez Serranía J Med Mov 3 (2007): 102-112 absent-minded person who does not get on with other nurse who deals the first card of a game in the case of people and has no family of his own. The hospital Miriam (Anne Meara), or the human contact that where he works is reduced to long corridors filled with allows Frank (George Martin) to walk without stop- statue-like patients confined to wheelchairs, and activi- ping and starting (figure 3). It is then when Leonard, ty wards where the people sit around vacant-faced. The spelling the word Panther, by Rainer María Rilke, with atmosphere is claustrophobic, with bars over the win- a ouija board tells the doctor how they feel: Their eyes dows that appear not to have been opened in years. (….) cannot see anything else, (…) it’s as if (…) there were no world behind these thousands of bars. Dr. Sayer is obliged to familiarise himself with the case reports and with the support of the chief nurse, Eleanor Costello (Julie Kavner), he discovers that all the patients had had encephalitis lethargica in the twenties. He is shocked by the words of the emi- nent doctor, Peter Ingham (Max von Sidow), when he is told that the patients are children that just fell asleep and that they cannot think. Sayer, who is sceptical, doubts this. It is here where the images and action in the film begin to accelerate. The doctor offers Lucy Fishman (Alice Drummond) a complete visual field by painting the floor tiles to help her get to the window; if not, there is nothing to entice her to move (figure 1). He then meets Mrs Lowe (Ruth Nelson), who looks after her son Leonard Lowe (Robert de Niro), now an adult, whose electroencephalogram shows that his brain activity is sparked when he hears his name. Dr. Sayer Figure 2: Leonard Lowe before awakening, accompanied by his is right: his patients are alive inside (figure 2). mother The next part of the investigation, and of the film, which accelerates in parallel with the discoveries, involves the use of Levo-dopa as a possible treatment for the patients. After attending a conference, the Director of the hospital -Dr. Kaufmann (John Heard)- allows Sayer to use the compound, but only on Leonard, and after getting permission from Mrs. Lowe. After testing several doses, the last one of which is very high, Leonard wakes up exactly half way through the film, awakening (if the reader will pardon the pun) a broad series of emotions in the spectators. At one moment, Leonard discovers a photo of him- self taken 30 years previously and suddenly realises the number of years of his life he has lost. This grieves him deeply, but with the help of Sayer he adapts to the personal and social changes that have Figure 1: A patient, Lucy Fishman, slowly manages to walk towards the window. occurred during that time. This is the first of a series of similar scenes in The emotional scene in which he wades out which, on-screen, the discovery of the patients’ into the sea to the tune of a rock and roll song is an responses is accompanied by more light and move- example of his being alive and well (figure 4). The clear- ment:: groups of patients playing ball; the different est confrontation between two opposite situations is styles of music able to induce Rose (Judith Malina) seen when Leonard discovers that the doctor, from and Bert (Barton Heymqn) to eat, or Frances (Jane being isolated from his body as he has been for 30 years, Haynes) to react; readings that capture the attention of is terminally shy of others and of developing social rela- Roland (Dexter Gordon); card games encouraged by a tions, and tries to get him interested in Eleanor. 103 © Ediciones Universidad de Salamanca María Isabel Jiménez Serranía J Med Mov 3 (2007): 102-112 Figure 3: Other patients - Rose, Bert, Frances, Roland, Miriam, and Frank The doctor receives money to obtain the drug who wants to take her blood pressure. Rose, who used for the rest of his patients. One night, as though it to lead an active social life, asks for make-up and dye were a miracle, they all begin to wake up and walk. for her hair once she realises the present state she is in Sayer becomes a satisfied man. He looks with fond- from her image in the mirror. Frances, who has a ness upon Leonard, who enjoys seeing his peers back strongly aristocratic bent, asks Dr. Sayer to prune the in the world. This is the second climax of the film; the fruit trees because she doesn’t like them the way they extent of the success. are. Bert, fed up with the hospital food, asks for a spe- cial menu. Roland hums a jazz song, fuelling what The next scene is chaotic. Whereas previous- seems to be a passion for him (figure 5). ly life had been calm and quiet in the post-encephali- tis ward, all is now hustle and bustle; almost alarming- The joy and the awakenings are celebrated ly so. Miriam runs through the ward chased by a nurse with a trip. Leonard, by contrast, goes to the hospital refectory and starts talking with Paula (Penelope Ann Miller), a young woman who had drawn his attention earlier on, and makes friends with her. Meanwhile, his companions go back on a visit to some botanical gar- dens and prefer to go dancing. For Rose, happiness continues and she receives a visit from her friends: Miriam, relieved, finds out that her husband had been granted a divorce many years ago; Bert shows that he is well versed in cars… but on the other side of the balance is Lucy, who asks Sayer to allow her to leave and Frank, who finds himself alone, old and swindled at the many years of life and the friends he has lost. We glimpse that something is going to happen: sig- nals that the drama has not yet been resolved. The scenes of light begin to revert to Figure 4: Leonard wakes up after 30 years thanks to L-dopa penumbra when Leonard is unable to sleep and he 104 © Ediciones Universidad de Salamanca María Isabel Jiménez Serranía J Med Mov 3 (2007): 102-112 calls Sayer because he wants to talk about things that Sayer begins to treat Leonard with increasing- matter: people must be reminded about the miracle of ly higher doses, but he merely becomes ever more being alive. He asks the hospital authorities for free- paralysed. The situation is: Nothing…I’m not a person any dom to come and go as he pleases: to have the choice to more, just a collection of tics.