`Awakenings' Shortcuts Fact To Stir Emotion

OLIVER SACKS wrote the book called ``Awakenings,'' and more recently he served as technical advisor for the movie based on it. The most remarkable thing about the two projects is how utterly different they are, even though one person - who was intimately involved in the real-life events the book and movie tell about - had a hand in both of them.

Dr. Sacks is a physician with training in neurology, a flair for writing, and a keen interest in the limitations of accepted medical practice. Doctors and patients would be better off, in his view, if medicine became more of a ``romantic science'' emphasizing individuality and philosophy rather than norms and statistics. This doesn't mean he's part of the ``antipsychiatry'' movement that sees mental aberrance as just another kind of behavior. Sacks believes no two cases are alike and that precise observation coupled with profound sympathy and compassion are the keys to successful care of the afflicted.

In keeping with the depth and breadth of Sacks's thoughts on these matters, his book ``Awakenings'' is a densely woven tapestry of case histories and philosophical ruminations centering on an unusual group of patients he came to know in the 1960s: veterans of a ``sleepy sickness'' who had spent decades in a trancelike condition that severely limited speech, movement, even thought. Sacks treated patients with an experimental substance and found that most responded with a vigorous awakening, regaining abilities virtually overnight.

Problems and paradoxes soon arose, as patients found themselves in ``time-warp'' surroundings different from the world they knew before their trances. And the ``miracle drug'' proved to have ``side effects'' worse than the original condition. Sacks faced the task of helping patients steer between the emptiness of illness and the false energy of a treatment that failed to match the hopes it inspired. Sacks's book first appeared in 1973, and since then it has grown and evolved and covers an enormous amount of territory, from the factual and precise to the speculative and poetic.

How could this be made into a Hollywood movie? Simple: Narrow your focus to a wistful ``human interest'' story concentrating on one colorful hero, hire two of the world's most charismatic stars to play him and his doctor, and condense all the other ``awakenings'' into a batch of colorful cameo performances. Call it oversimplified, call it manipulative, but it's bound to sell tickets, and that's what counts in Hollywood.

For a platitudinous tearjerker, the movie ``Awakenings'' is skillfully made by director Penny Marshall, cinematographer Miroslav Ondricek, and an expert cast including Robert De Niro at his most engaged and Robin Williams at his most restrained. Also praiseworthy are Ruth Nelson as a patient's mother, who discovers that she liked her boy better when he was totally dependent; and Julie Kavner as a self-effacing nurse.

If the movie is effective on its own limited terms, why not accept it on those terms and avoid comparing it with Sacks's book? There are two reasons not to do this. First, the movie's avoidance of almost everything that made the book thought-provoking is an example of Hollywood's worst impulse to aim at the lowest common denominator, and this should be discouraged.

Second, and more important, is the fact that Sacks's book is designed to make us think, while Hollywood's movie is designed to make us feel and nothing more.

The film version of ``Awakenings'' falls into the traps of sentimentality and audience-pandering. It makes you laugh, cry, and marvel. But it also simplifies and falsifies all kinds of issues, from the intricacies of medical care to the realities of inner-city hospital funding.

Watching it diverts attention from the problems' complexities and creates an illusory sense of involvement and understanding. That's a dubious achievement.