![]() ![]() (Patients with Parkinson’s disease also show damage within the substantia nigra.) Sacks eventually decided to treat a group of these patients at Beth Abraham with L-DOPA. In the late 1960s, the experimental drug L-DOPA was first given to Parkinson’s patients, with encouraging results. Patients immobilized by encephalitis lethargica were sent to institutions, which is where Oliver Sacks encountered them. By 1917, Baron Constantin von Economo, a Vienna-based psychiatrist and neurologist, had described the illness in an article titled “Die encephalitis lethargica,” and would later find that these patients had damage in the mid-brain, in a structure called the substantia nigra. The French pathologist Jean-René Cruchet first witnessed cases of the disease on the battlefields of World War I. Although their minds appeared to remain clear during their brief interludes of lucidity, those who suffered the “sleepy sickness” lacked all sense of the passing of time. Some slowed to the pace of sleepwalkers, others became motionless, living statues for years. Some would recover, but the majority of survivors would face the disease’s final phase, where movement became stiff and slow, as it does in those with Parkinson’s disease. Those who survived often felt apathetic, detached and had trouble concentrating. Roughly one-third of patients died during this phase of the illness, typically of respiratory failure. Then the characteristic symptoms would appear: lethargy and deep slumber. At first, a patient might simply feel unwell, and perhaps experience a sore throat. Nearly forgotten today, encephalitis lethargica infected nearly five million people between 19, and killed roughly a third of this population quickly. And while Sacks has more than 40 years of published work, he may be best remembered for his first successful book, which chronicled an enigma he encountered as a neurologist at Beth Abraham hospital in the Bronx: encephalitis lethargica. The British physician is best known for capturing detailed, narrative case histories that convey a human experience of disease. ![]() ![]() Medical writing owes a debt to Oliver Sacks, whose books bring readers nose to nose with great neurological puzzles. ![]()
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