A revisit to Medical Ethics and Professionalism based on the movie ‘Awakenings’.

‘Awakenings’(1990) a movie directed by Penny Marshall is a movie based on a historical epidemic after world war I, which is Encephalitis Lethargica which was started in Vienna and spread across the world. Many of those who survived developed a range of post encephalitic syndromes. In that period Dr. Oliver Sacks worked at Mount Carmel, an institution outside New York, which has 80 patients with intractable, post-encephalitic parkinsonian syndrome. It affected all aspects of behaviour and trapped patients within themselves, often for decades. In 1969 levodopa (L-dopa) was hailed as a miracle drug that would cure parkinsonism. Dr. Sack’s book Awakenings is a series of clinical case report describing how patients with parkinsonism re-awakened by decades of stupor and inertia. ‘Awakenings’ is an important reminder that healing is a complex art and that the notion that one pill can cure disease remains a fantasy. In this movie the first patient to awake by long sleep is Leonard Lowe, and depicting the Dr. Sack’s role is Dr. Malcom Sayer who works at Bainbridge mental hospital, New York City.
In the movie we can see Dr. Malcom Sayer worked tirelessly in a very dedicated way with the catatonic patients and their families. First he observed that though the patients seems immobile, muted and with few stereotyped movements they are responding to specific stimuli which significant to them. Such as specific genre of music, throwing an object towards them, sensing human touch. Then he finds that post-encephalitic lethargica is common condition in their history reports. After that he found the history of that epidemic and start thinking on new treatment methods that would work he got to know about Levodopa and he talked to his colleague Dr. Kaufman first about the new idea but he doesn’t concern about this not only that but also he hesitate to believe that those catatonic patients are still alive inside them. His response to Dr. Sayer “let chemists do the damage.” shows that he wants to protect his reputation and by involve with Dr. Sayer’s trial treatment he doesn’t want to ruin his carrier as well as his name. This isn’t a good thing, healthcare system should improve day by day for the enhancement and improving the quality of life of patients. This incident shows Dr.Sayers’ medical ethic- Beneficence: Doing good for the patient.
We can see when Dr. Sayer treating his catatonic patients he is describing what he is doing to them throughout the movie though those patents can’t reply by words. It’s kind of respecting him to the patients’ Autonomy. But the problem with Dr. Sayer was he had no idea of the doses of L — Dopa which he should used regarding the catatonic patients. He gave the amount of doses he felt. This is a point where he went wrong and acting in an unethical way. When he observing that Leonard is not responding to the medications he increased the doses by many times even it could be lethal he didn’t concern about that at all. Although Dr.Sayer has taken the consent from Leonard’s mother, he has no any idea whether L- Dopa may work or not. According to the movie he just had a basic knowledge which he learnt from a chemist. This is opposite to doctors’ one of medical ethic; ‘do not harm’- ‘Nonmalfeasance’.
When we consider about the professionalism aspects in this movie there is a scene that except Nurse Eleanor Costello other nurses are watching television after gave medicine to the patients. It’s kind of concerning those catatonic patients are worthless. This is kind of prejudice as well as lack of sensitivity. We shouldn’t rundown any of our patients just by looking how they wear, how they talk, how they behave. Every human life is important equally. And when the movie comes to and end we can see that they all understand their duties and work together with Eleanor and other doctors in a passionate way understanding their mistakes. When considering the main character of the film which was Dr. Sayer he should be respected as at least he tried without any help from others he just had the appreciation from nurse Eleanor when he start just to make those catatonic patients’ life beautiful. After side effects of medications cause kind of dyskinesia as well as return them to their catatonic life again but revealing that Dr. Sayer has not given up his dedication towards his patients, film ends with Sayer standing over Leonard behind an Ouija board with his hands on Leonard’s hand.