Awakenings (1990)

Official trailer

Awakenings is Penny Marshall’s 1990 American medical drama adapting Oliver Sacks’s 1973 memoir of the same name. The film depicts neurologist Dr. Malcolm Sayer arriving at a Bronx chronic care hospital in 1969 to find a ward of patients who have been catatonic for decades due to encephalitis lethargica. Sayer recognizes that the patients have parkinsonian-like symptoms and convinces the hospital to allow him to try the new dopamine precursor L-Dopa on Leonard Lowe, the patient who has been catatonic since age eleven.

The treatment produces dramatic awakening but the effects don’t last.

Robin Williams plays Dr. Sayer. Robert De Niro plays Leonard Lowe. Julie Kavner plays head nurse Eleanor Costello. Ruth Nelson plays Mrs. Lowe. Penelope Ann Miller plays Paula. John Heard plays Dr. Kaufman. Max von Sydow plays Dr. Peter Ingham. Steven Zaillian wrote the screenplay. Columbia Pictures produced the film on a budget of approximately 29 million dollars, and it grossed approximately 52 million dollars worldwide.

The work received three Academy Award nominations including Best Picture and Best Actor for De Niro.

Few films get under my skin like Awakenings. De Niro and Williams play two men reaching for each other across a disease neither of them can beat, and the last stretch hurts in a way most medical dramas never allow themselves. My only wish is that the other patients on the ward got a little more of the screen, because Leonard takes up nearly all of it.

Medical dramas based on real cases face special challenges.

The patients and their families deserve respectful treatment. These films must depict the medical procedures accurately enough to maintain credibility. The drama has to come out of the actual circumstances instead of being imposed through fictional addition. Awakenings handles all three. Oliver Sacks consulted extensively during production. The patients are composites based on actual people whose stories appeared in his memoir, and the Williams performance as Sayer captures Sacks’s combination of clinical rigor and personal warmth.

The De Niro performance as Leonard required extensive research into actual catatonic and parkinsonian symptom patterns. The combination of source author engagement, committed acting, and Penny Marshall’s direction produced one of the strongest medical dramas of its decade.

The De Niro Performance

Robert De Niro plays Leonard Lowe across the full range of his condition.

The character is catatonic during the opening sequences, gradually awakens after L-Dopa treatment, experiences increasing tremors and dyskinesia as the drug effects deteriorate, and returns to catatonia by the film’s conclusion. The performance required De Niro to depict multiple distinct physical states with technical precision. He studied actual patients with parkinsonian conditions and consulted with Oliver Sacks throughout preparation.

The performance shows physical acting at its most demanding. Conventional acting depends on facial expression and vocal delivery. De Niro’s Leonard can’t reliably control either across most of the runtime. The catatonic scenes require remaining completely motionless for extended sequences. The dyskinesia scenes require generating involuntary movement that appears medically accurate.

The brief periods of full mobility require playing a man who hasn’t moved in thirty years discovering motion again. The Best Actor nomination acknowledged work that few performers could have delivered.

The dyskinesia scenes are the hardest part of the film for me to sit through, and that’s the highest compliment I can pay De Niro. Watching Leonard’s body turn on him after his brief freedom hurts more than any death scene I can think of.

The Williams Restraint

Robin Williams plays Dr. Malcolm Sayer against his established comedic tone.

Williams had been known primarily as a stand-up comedian and as the star of comic films including Good Morning Vietnam (1987). The Awakenings role required restrained dramatic work that the comedy persona would have damaged. Williams played Sayer with controlled clinical demeanor that allowed his natural warmth to emerge in small moments instead of constantly.

The performance showed that Williams could carry serious dramatic material when the role supported his capabilities. His dramatic work in Dead Poets Society (1989), The Fisher King (1991) and Good Will Hunting (1997) showed the same range. The pattern of comedic actors taking serious roles successfully has continued through later decades. Williams set the model partly through Awakenings. The performance also reflected his interest in Oliver Sacks’s actual work. Williams had read Sacks’s books extensively before the casting and brought real intellectual focus on neurological material to the role.

I think this is Williams’s finest dramatic work. He keeps the comedian locked away, and the warmth he lets through in small moments hits harder for being rationed.

The Sacks Source

Oliver Sacks wrote the original Awakenings memoir in 1973 about his 1969 work with post-encephalitis patients at Beth Abraham Hospital in the Bronx.

The book established Sacks as an unusually accessible neurological writer for his generation. He combined detailed case histories with humanistic prose that treated patients as full people instead of as disease subjects. The book’s success led to later works including The Man Who Mistook His Wife for a Hat (1985) and An Anthropologist on Mars (1995).

The film respects Sacks’s approach by treating Leonard and the other patients as full people instead of as medical curiosities. The L-Dopa experiment is presented with both its initial dramatic success and its later tragic failure. The film doesn’t pretend that medicine could fix the patients permanently. The L-Dopa awakening allowed the patients brief return to consciousness before their conditions returned. The temporary nature of the recovery gives the film its dramatic structure. Conventional medical drama would have arranged a more lasting cure.

Awakenings respects the historical reality that the actual cure didn’t last, and I’m grateful for it. A cleaner ending would have been easier to sell and would have insulted the people this happened to.

Is Awakenings as good as people say?

Awakenings shows medical drama at its strongest when it’s based on actual cases and treats patients and families with respect.

The 9 is for De Niro’s physical precision, for Williams keeping his comic instincts on a leash, and for a script with the spine to let the cure fail. The only thing between it and a 10 for me is a supporting ward that stays mostly in the background. I’d recommend it to anybody who cares about great acting or about films that tell real lives straight.

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