Jarrett Porter and Joyce El-Khoury in the Odyssey Opera performance of Awakenings. Photo by Kathy Wittman

The COVID-19 pandemic is the most significant public health crisis of our time. However, from 1916 to 1927, there was another pandemic that shaped and ended lives—encephalitis lethargica, or sleeping sickness, which afflicted more than one million people worldwide, causing 500,000 deaths. Of those who recovered, many were left in a catatonic state, speechless and motionless. Most of these patients were warehoused in mental health or hospital facilities, with no ability or means to treat them successfully.

The story of three of these patients in the Bronx, and their physician, Oliver Sacks, MD, is the subject of an opera by a Mount Sinai neuroradiologist, Aryeh Lev Stollman, MD, and his composer husband, Tobias Picker. Awakenings made its debut in June 2022 at the Opera Theatre of St. Louis and its East Coast premiere in Boston in February 2023 with Odyssey Opera in a limited run at the Huntington Theatre. The opera was recently featured in The New Yorker and The New York Times.

Oliver Sacks, a neurologist, was struck by the similarities between encephalitis lethargica and Parkinson’s disease. He advocated to hospital management that L-dopa, an experimental drug used to treat Parkinson’s, might be an effective way to treat these patients. He was given permission to treat one patient as a test. The patient, Leonard, made a spectacular recovery, and Dr. Sacks gained authorization to treat many more patients. Unfortunately, the effects did not last, and most patients relapsed into their former trance-like state.

Dr. Sacks wrote a book, Awakenings, in 1973, detailing the cases of 20 patients. Dr. Stollman and his husband became friends with Dr. Sacks after being introduced at a dinner party in Manhattan in 1993. Mr. Picker had Tourette syndrome as a child, and over the course of his friendship with Dr. Sacks, was helped by him, both in accepting his condition and learning to live with it. Dr. Sacks noticed that Mr. Picker, who wrote the music, was relieved of his symptoms while playing piano, which Dr. Sacks wrote about in his book describing the therapeutic effects of music, Musicophilia.

Dr. Stollman, who is also an award-winning novelist, wrote the libretto for Awakenings. “We based the story on Dr. Sacks’ book, but because he wrote about 20 separate patients, we chose three main patients and created their interaction with each other and Dr. Sacks,” Dr. Stollman says. “Dr. Sacks realized that his book wasn’t just a collection of case histories, but rose to the level of allegory or myth. It’s symbolic of our own lives and what we go through. Even if we’re not afflicted like these patients, we have our own awakenings and then have to return to everyday life. So we framed this story in the myth of Sleeping Beauty, and Dr. Sacks is the prince who awakens our characters. However, Sleeping Beauty doesn’t have to go back to sleep, but these patients do.”

In the opera, as Leonard responds to his treatment and awakens, he sings:

It’s a lovely feeling!

A lovely feeling.
To walk. To talk.

I have watched you every night and every day for years.
How many years have I been imprisoned in that chair?
I could only live in books,
And live through other people’s lives.
It’s a lovely feeling.
A lovely feeling!
I am reborn.

“The opera was ready to premiere in June 2020 when the pandemic struck,” Dr. Stollman says. “Every opera company closed, and Awakenings had to be delayed. Perhaps audiences can now understand a little better and can relate through their own experience, coming out of this pandemic.”

Tobias Picker, left, and Aryeh Stollman, MD, at their wedding at the U.S. Supreme Court in Washington, D.C. Photo by Jon Fleming

In the opera, Dr. Sacks has an awakening of his own, coming to an awareness of his own identity as a gay man. But he feels he is not ready to fully embrace that fact, singing, “I am no longer the man I was / But I have not truly awakened yet.” “When Dr. Sacks came out, it took him a long time, but he wanted to do that before he died,” Dr. Stollman says. “In the end, he was a proud gay man. And we were fortunate to be his friend.”

While Dr. Sacks’ book was also the basis for a film starring Robin Williams and Robert De Niro, the opera written by Dr. Stollman and Mr. Picker is a fresh and original take on the story, enriched by their personal friendship.

As a neuroradiologist, Dr. Stollman reads CT scans and MRIs for neurological diseases and disorders of the spine. “My background in medicine certainly helped in writing the story, but I think writing and medicine are both life-affirming pursuits. As a doctor, you have an intense engagement with life. You can learn more about a patient in a few minutes than perhaps their closest friends know about them. And writing reflects the more intense and emotional aspects of our lives. They’re not that different, in some ways.”

Dr. Stollman has written several novels, including The Far Euphrates, which won the Lambda Literary Award and has been translated into German, Dutch, Italian, Portuguese, and Hebrew. His second novel, The Illuminated Soul, won the Harold U. Ribalow Prize for Jewish literature from Hadassah Magazine.

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