Free Asleep: The Forgotten Epidemic That Remains One of Medicine's Greatest Mysteries by Molly Caldwell Crosby Page A

stood in the bathroom, frightened and concerned. It took nearly half an hour for Adam to calm down and for the burst of delirium to subside. His teeth stopped chattering; his hands quit jerking; his body stopped convulsing. Adam looked up at his brother and said, “I can’t tell you what happened to me last night except that it was something terrible. I suffered all night. I dreamt that I died and then came to life again and saw angels.” They could have been the delusions of a feverish boy, except that Adam’s fever was never that high.
    Finally, Adam told his brother, “It was just as if I died and came back to life. Mark what I tell you. This is going to change my whole life. I’ll never be the same again after what happened last night.” He repeated it over and over: “I’ll never be the same again.... I’ll never be the same again.... I’ll never be the same again.”
    At first Adam’s parents worried that their son’s reaction could have been caused by an accidental overdose of codeine. But there were only trace amounts in the cough medicine, barely enough to cause any reaction at all. Although Adam’s family was worried, they went ahead and let the boy return to school the next day and hoped that the strange reaction, whatever it was that caused their son to depart so dramatically from his senses and personality, was over.
     
     
     
    I t was not until summer break that the next episode began. This time, it arrived in the form of a respiratory tic, a compulsive sniffing. Adam also began to talk incessantly and excitedly—again, as though it was something compulsive he could not control. His brother slept in the room with him and was kept awake at nights listening to the quick, unceasing, bizarre sniffing. When the sniffing wasn’t keeping Adam’s brother awake, his talkativeness was. He asked questions endlessly, coherent questions, but unceasing. Finally, his brother would tell him to shut up and go to sleep. The talking would stop, but moments later, the sniffing would begin.
    For Adam, it was maddening. He would lock himself in the bathroom, turn on the faucets, and run water in the cast-iron basin to try to keep from waking his family members with the sniffing. Still, he could not stop the tic. It was like wheezing with asthma or suffering from breathing spasms. The sniffing would stop only if something distracted Adam; if his attention was diverted, the attack would come to a halt.
    As strange and random as his symptoms seem, they actually made sense within Adam’s brain. The brain is an intricately wired communication system where signals run along pathways to other parts of the brain, almost the way a telephone signal runs along telephone lines. And like a person-to-person call, those signals deliver a message to receptors in the brain telling them to perform a movement or to start thinking or to begin feeling certain emotions. The messages are sent through a system, a switchboard, the same way a telephone operator will connect one voice to another. In the brain, that switchboard is called the basal ganglia, and they connect messages within the brain and to the body, including the nerves that ultimately control movement. The basal ganglia also connect messages going to and from the frontal lobe, the part of the brain that controls personality, behavior, inhibitions, and emotions. In the brains of encephalitis lethargica patients, the basal ganglia are damaged.
    The basal ganglia also serve another important purpose: they send messages to the thalamus and neighboring hypothalamus, the small part of the brain von Economo identified as the electrical switch for sleep or the lack thereof. Even today researchers can’t explain the exact relationship between those two parts of the brain, but they do know the basal ganglia send messages to the hypothalamus to halt certain movements so others can take place. Even with something as simple as falling asleep, the brain is put to work, telling the arms