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

and legs not to move, relaxing muscles, keeping eyelids closed, slowing the beating heart and breathing lungs.
    In a damaged brain, as messages rapidly travel through the basal ganglia and thalamus to trigger movement, emotion, thinking, or sleeping, they pass through the mangled switchboard and are redirected, sending garbled messages to the body. Disorders associated with the basal ganglia are Parkinsonism, Tourette’s syndrome, attention deficit disorder, obsessive-compulsive disorder, cerebral palsy, and stuttering, among others. Whenever these signals, carried by chemicals called neurotransmitters, are interrupted, receptors in the brain waiting to receive the signals get mixed messages instead.
    In Parkinsonism, for example, the cells that produce dopamine begin to die off and mixed messages overwhelm the muscles’ nerves that control movement. With static messages coming through, the body may have trouble moving at all or lose the ability to stop unwanted movements. In cases of obsessive-compulsive disorder, the basal ganglia forward mixed messages back and forth to the frontal lobe. In an OCD patient, those messages are sent too quickly and too frequently. When that happens, the message overrides logic and tells the person to keep doing the same action again and again. An OCD patient could no more keep from the obsessive thoughts or compulsive behaviors than a Parkinson’s patient could keep from shaking, because it is the wiring in the brain automatically controlling the impulse, not their own willpower. Both Parkinsonism and OCD, among many others, were conditions common in encephalitis lethargica patients.
    The messaging center of Adam’s mind had been damaged when he first contracted encephalitis lethargica. The physicians and his family did not even realize it was a case of encephalitis—they saw symptoms of flu or a bad cold and diagnosed it as such. Adam, like so many other people, would learn only later that his brain had been harmed during his illness. Messages going through the basal ganglia in Adam’s brain became rewired, and actions that he normally did automatically, without thinking, were happening out of his control—sniffing over and over again, shaking, stuttering, and other odd movements. The “stop and go” part of his brain would not stop these behaviors. But it was the messages going to and from the frontal lobe that would make the dramatic changes in Adam’s personality.
    Adam was taken to see several doctors. One found an obstruction in Adam’s nasal passage, and surgery was planned, but then Adam was involved in a car accident and the surgery was postponed. That was in August 1922, and Adam soon left again for school. But it was apparent something was wrong with the boy. He could not pay attention and fell asleep at his desk. He was accused of being lazy and lacking enthusiasm. Adam felt tired all of the time, but was rarely able to fall asleep before 2:00 A.M. Teachers threatened that if he would not stay awake, he would have to leave. He managed to finish the school year, but failed two of his subjects. To those who knew him, it was clear a distinct change had happened. Adam had always been sociable, easy to get along with, funny, a boy who loved music and playing pranks. The Adam that left school at the end of that school year was none of those things.
     
     
     
    I t had been over a year since Adam’s case of the flu, if that’s what it was. By the summer of 1923, new symptoms began to arise. The breathing spells became rapid and painful. His face would grow stiff, his hands and feet stiffen, and he began drooling. His brother told Adam it looked like he was foaming at the mouth, and his mother reminded him repeatedly to use his handkerchief. His feet began to shuffle, and he walked strangely. As Adam’s condition grew worse and more inexplicable, he was taken to an institution for treatment, where he continued his downward spiral, often refusing to get out of bed until a