At the key moment of The Iliad, one of the pivotal points in all of literature, Achilles offers Priam a souvlaki: lamb, roasted on a rotisserie spit, cut into pieces, and served in bread. The souvlaki is hardly a royal feast. But it does what the sharing of food and hospitality has done for ages. It creates healing and community. The souvlaki is a symbol of forgiveness and reconciliation. Priam finds that his sense of taste, which grief has dulled, returns. Immediately, both Achilles and Priam are ready to sleep:
Priam broke the silence first:
Put me to bed quickly, Achilles, Prince.
Time to rest, to enjoy the sweet relief of sleep.
Not once have my eyes closed shut beneath my lids
From the day my son went down beneath your hands …
Day and night I groan, brooding over the countless griefs,
Groveling in the dung that fills my walled-in court.
Achilles sets up exquisite bedding for them both in the porch, that liminal place between the inner and outer world.
This is not just an experience that belongs in ancient texts. Even closer to home, there was a time when Benny was ten years old when he was plagued by the most devastating anxiety. He was sleeping badly, often turning up in our bedroom at ungodly times. Indeed, there was a period in which we had to get a secondhand mattress and put it on the floor of our room, because Benny simply couldn’t sleep on his own. A contributing factor was the way he had been bullied at his school. We ended up having to move him to a different school.
Around this time, I took part in a radio program for the BBC (British Broadcasting Corporation) on the theme of forgiveness. The other guest was Mpho Tutu, the daughter of Desmond Tutu, who has long been one of my personal heroes. Together with her father, Mpho had written a work called The Book of Forgiving, a result of the journeys both father and daughter had traveled. Among his many commitments, Desmond Tutu had been the chair of South Africa’s Truth and Reconciliation Commission between 1995 and 2000, a post from which he saw quite intimately how tangled and complicated forgiveness can be. Yet Tutu writes about forgiveness with no podium, only with deep humility. He talks about the difference between forgiveness and weakness. In fact, they are opposites. He also explains that forgiveness is not a simple story with a beginning, middle, and end. It is often rather more like putting a puzzle together. Forgiveness is one of the most difficult things anybody can do for their own well-being. Both father and daughter have written about the positive impact it makes on insomnia.
Because of the time zones involved, I found myself in the wee hours of a wet and cold night huddled in a radio studio at a quarter past three in the morning with Mpho Tutu in South Africa and the presenter of the program at the BBC studios in London. I was put in a small booth that felt like a confessional. The technician on the other side of the window was eating corn chips, an activity that, because of his work, he had learned to do in complete silence. It was an amazing talent, one whose secret he should share with the universe. It might not lead to world peace, but it might lead to peace on family car trips, a step in the right direction.
“You drew the short straw to get this time slot,” he said.
Nothing could have been further from the truth. I would have turned up at any time to talk to Mpho.
It had been a long day. Benedict had struggled to get out of the car and face school. He’d been quiet on the drive there, but once we reached the gates where he was supposed to be dropped off, he fell apart. This was a regular occurrence at the time. He ran through all sorts of emotions, from tears to anger, and tried all sorts of threats, from promising to run away from home forever to promising to never leave home so that we’d have to look after him forever. I sat in the car beside him, wondering what would happen and how late I was going to be for work or if I was going to make it at all today. But I waited patiently with Benny, feeling like I was sitting on the edge of a precipice. Eventually, after half an hour, his mood swung and the storm had passed for today. He got out of the car and was soon embraced by the gates of school. It reminded me of that moment at the airport when you see someone go through the gates at customs and there’s nothing you can do but let them go to find their own way.
That night, I had expected to be talking with Mpho Tutu about what forgiveness might mean in a political context as she looked back on twenty years since South Africa gained a new constitution and Nelson Mandela became president. Instead, she got on the topic of family. That was where she had learned about forgiveness.
When it was my turn, I told a story about Benedict. He left his first school because of the merciless manner in which he had been bullied. It is painful even now to think about what he endured, and it would be better not to share the details because I’d rather celebrate my son than anything else. Benedict was crushed but, I believe, found a bedrock within himself of great strength. He made an extraordinary video in which he confronted his aggressors with the catalogue of what they had done. In a calm and detailed manner, he told his story and demanded that people listen, something that he had not been prepared to do earlier. The former school wanted a watered down version, but Benedict held his ground. He then had the courage to insist that this was played to the children concerned. He showed great generosity in giving those kids an opportunity to realize their need for forgiveness. He was creative in the way he relinquished some of the burden he himself was carrying.
“Wow,” interrupted Mpho Tutu from the other side of the world. “That is a wonderful story,” she continued after a pause. “I am so full of admiration for that young man.”
Later she commented that the road to forgiveness is all about finding strength and finding your voice, exactly as Benedict did. I went home at 3:15 AM, full of gratitude. I checked on the children before I turned in. Ever since he had made that video and shown it, Benedict was happy to sleep in his own bed. His thrashing in the night had come to an end. There was peace at the end of an honest road.
There are many forms of torture, but two have appetites all of their own. One is to not be able to stay awake. People with narcolepsy and even those with sleep apnea know how hungry sleep can be; it can eat you whole.
The other form of torture is to not be able to stay asleep. Insomnia is a fussy eater. It will calmly let a person stew; it can sit on the end of someone’s bed and watch them cook. Insomnia doesn’t believe in comforting pillow talk. It can whisper horrible things at half past three. Experts say insomnia is a symptom rather than a disease, but it can be hard to know what it is a symptom of. Sometimes it is a symptom of itself: it is often the case that the worse people sleep, the worse they sleep.
History is a catalogue of the strange things people have done to get a decent night’s sleep. Benjamin Franklin was a one-man renaissance and an individual of spare common sense; he embodied what became the governing myth of American independence: that a single person could be an entire culture all on their own. Like Thomas Edison, he was fascinated by electricity. Unlike Edison, he had time for sleep. What he didn’t have time for was sleeplessness. His remedy for insomnia was simple: get two beds. If you couldn’t sleep in one, then surely you’d be able to sleep in the other. His reasoning was typically transparent: people slept badly because they were too hot. The reason they got too hot was either because they had too many bedclothes or they had eaten too much or both. In an essay entitled “On Procuring Pleasant Dreams,” published in 1786, he writes, “Nothing is more common in the newspapers than instances of people who, after eating a hearty supper, are found dead abed in the morning.”
In this essay, Franklin recommends having a cool bed handy to hop into. If you can’t afford two beds, then you should get up and walk around without your clothes until “your skin has had time to discharge its load” and you can’t take the cold anymore. If you do that, Franklin says, “You will soon fall asleep and your sleep will be sweet and pleasant. All the scenes presented to your fancy will be, too, of the pleasing kind. I am often as agreeably entertained by them as by the
scenery of an opera.”
Franklin says that he learned these lessons from the story of Methuselah, the grandfather of Noah, who holds the distinction of having lived longer than anyone else in the Bible, a work full of folk who were in no hurry to meet their maker. According to Franklin, Methuselah’s secret was that he spent most of his nine hundred and something years sleeping out of doors in the fresh air and, indeed, only agreed to his second five hundred years on condition he could continue sleeping under the stars. It would be interesting to know Franklin’s source for this information, because the Book of Genesis deals with Methuselah’s millennium in a couple of lines as it rushes headlong toward the flood. Franklin condemns aerophobia, a word he used to describe fear of sleeping with the window open. These days the same word can mean fear of flying, as well as fear of airborne germs. Not only do we have more phobia words but the ones we have are working harder.
If only it were as easy as Franklin thought. Those who suffer from insomnia know that the condition can be callous, often defying explanation and thumbing its nose at attempts to deal with it in a reasonable way. One result has been that, for centuries, insomniacs have been an exploited group, and their difficulties have been a goldmine for everybody from hypnotists to pillow makers. Insomnia is worth lots and lots of money; its hostages can be prepared to pay a king’s ransom to escape. As long as people continue to be lured by images of perfect sleep, as opposed to adequate sleep, this will remain the case. For centuries, the insomnia industry has been good at selling a product that it can’t deliver and that people often don’t need anyway. In this, it shares something with the cosmetic surgery trade: there’s no such thing as a perfect body and, even if there was, nobody needs one. But it’s harder to make big bucks out of reality. Fantasies are cheap to build and easy to rent.
Drug companies are among those who have done very nicely out of insomnia. The trouble is that not everyone has done nicely out of them.
On the evening of September 13, 2007—the night she died—Mairéad Costigan was staying with her parents, Michael and Margaret, in the harborside suburb of Lavender Bay in Sydney, Australia.
“Her name rhymes with lemonade,” explains Michael nine years later. “So that became her nickname at school. I think possibly we were unkind to give her a name her little friends couldn’t say or spell.”
Mairéad, then aged thirty, retreated here occasionally from her place in Paddington on the other side of Sydney’s fabled harbor. She had had a busy day; she had applied for more teaching work at the university, she’d bought a top to wear, paid for new glasses, which she would collect later, and arranged some meetings for the following week. It had been a full day in a full life. She was planning to meet her sister for brunch on the weekend, a friend for coffee the following week, and was talking about a trip to London in the near future; she wasn’t saying good-bye to anyone. Mairéad had just completed her doctorate in philosophy two weeks earlier, having written a thesis on aspects of justice and politics in Plato’s Republic. She was a gifted thinker, and her work in philosophy had turned heads. A semester’s teaching at the university had proved demanding, partly because Mairéad’s main interest was research, but there was only a couple of weeks of that to go; the pressure was lifting. In many respects, it was a life to envy. There was no conceivable reason to let it go.
That night, she watched TV with her mother in her parents’ room and then, at 9:25 PM, said she was going to correct some essays. She changed into her pajamas in readiness for bed and wrote an e-mail arranging a work meeting for lunchtime the following Monday, a message that she never sent.
Mairéad had lived with insomnia for a long time. According to her sister, Siobhán Costigan, she didn’t have trouble falling asleep, but staying asleep could be a real bother. Nocturnal noise was especially difficult; she had a ritual for closing windows tight before going to bed to ensure quiet. She even made sure there were weights on papers in the house so that they didn’t rustle and disturb her.
Mairéad had tried different remedies over the years and, for about nine months, had been taking a drug called zolpidem, prescribed for her at a walk-in group medical practice where she had seen three or four different doctors, all with access to the same records. The practice had kept Mairéad on zolpidem far longer than recommended. Despite advice from friends, she kept going back and getting more prescriptions. She was desperate.
Zolpidem is marketed in Australia as Stilnox but is known in Britain as Stilnoct and in the United States as Ambien. Since it came on the market in the early nineties, it has been a bonanza for the company behind it, Sanofi-Aventis. Over twenty-five years, Ambien became the market leader in the United States, where although it is only available by prescription, it advertises for business in the open marketplace so that patients know what to tell the doctor to write on those little pads at the end of their nine minutes. By 2015, its position was being challenged by Belsomra, but at its peak, Ambien was worth $2 billion a year in the United States alone. It was a very big slice of a very big pie.
Siobhán was concerned when she heard that her sister was on zolpidem. There had been a well-publicized incident the year before when Jon Mark, a 37-year-old male, had climbed over the balcony of his twelfth-floor apartment while sleepwalking and had fallen to his death. Jon, who had been taking zolpidem, had only been married for a couple of months; his wife had been at preschool with Mairéad and her sisters, Siobhán and Sascha, so they were troubled by the story. They were troubled, too, by Mairéad’s consumption of the drug. In the time Mairéad had been taking zolpidem, Siobhán and some friends had noticed changes in her personality and behavior: she had been easily confused, jumpy, prone to lose things such as her wallet, keys, or phone, and her short-term memory seemed poor. And, perhaps even worse, her insomnia seemed to be getting worse, not better.
Six days before she died, Mairéad switched medication. She moved to a drug called zopiclone, sold as Imovane, which she took scrupulously according to instructions. When she died, there were precisely six missing from the pack, suggesting to the police that she had done what she was told and taken one a day.
Zolpidem, zopiclone, and the more recent zaleplon (sometimes sold as Sonata) are known, because of their names, as Z-class drugs. Z-class drugs have been seen as successors to benzodiazepines (such as Mogadon and Valium), which appeared in the sixties and dominated the market from the seventies. These, in turn, took over from the barbiturates that were developed in Germany before World War I and became common in forties and fifties; Adolf von Baeyer, whose name survives in that of another famous drug company, invented barbituric acid in the 1860s when, for reasons best known to himself, he wondered what you got when you mixed animals’ urine with apple juice. It was over forty years before someone else noticed that this brew made dogs fall asleep. Both “benzos” and “barbies,” simple sedatives by the standards of contemporary pharmacology, had notorious side effects, not least their addictive properties. They didn’t just help lives, they took them over.
Before benzos and barbies, there was opium, which dealt wonderfully with insomnia, but in addition to being highly addictive, it had the shortcoming of replacing insomnia with chronic sleeplessness. For some people, this wasn’t so bad because the little sleep that was produced by opium, often taken as laudanum, was visited by such appalling dreams that users were just as happy to be awake after all. Samuel Taylor Coleridge, the famously garrulous poet, was crippled by opium, although his fellow addict, Thomas De Quincey, author of 1856’s The Confessions of an English Opium Eater, loathed Coleridge’s “eternal stream of talk which never once intermitted” and lamented that Coleridge never shut up, either awake or asleep, so it was hard to tell what state he was in at any time. Shakespeare knew both about opium (“the poppy”) and mandrake (“mandragora”), as well as other “drowsy syrups of the world,” none of which could help poor Desdemona. Before Shakespeare, there was valerian, used by the Romans and Greeks. Before that, there was bound to have been something
else. In short, there has been a long and time-honored quest for sleep aids—one that is by no means over yet.
At the other end of the spectrum, the US military has reportedly been trying to develop medication to enable soldiers to survive for longer periods without sleep, making them immune to the effects of sleep deprivation. Researchers have been trying to find drugs that will enable the human brain to mimic what happens in the brains of birds that stay awake for long periods during intercontinental migration. They have also been experimenting with modafinil, often sold as Provigil, a drug used in treating narcolepsy, hoping that it might offer a key to enabling soldiers to be alert to some degree 24/7. It’s an interesting new scientific field, of course, but one that must be approached with a great deal of caution. Bear in mind that the Three Mile Island nuclear disaster of 1979, the Challenger space shuttle disaster of 1986, the Chernobyl nuclear disaster of 1986, and the Exxon Valdez oil tanker disaster of 1989 have all been attributed to various levels of sleep deprivation in key personnel. Sleepless soldiers sitting in front of panels of flashing buttons are a quite scary idea.
The Z-class drugs of the last twenty years sound like a new line from Mercedes-Benz. But they are not without problems of their own. Z-class drugs act fast, which is one of their attractions. And that was certainly the case with Mairéad Costigan on that fateful night.
Soon after getting into her pajamas, Mairéad Costigan got up suddenly and left her parents’ apartment. On her way out, she walked past her father who was asleep in front of the TV, something her sister says she would never have done if she’d been conscious because she’d been concerned about her dad’s health and would have stopped to check on him and get him to bed.
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