What triggers the dysfunction in some brains as opposed to others? Do these people have some inherited anomaly—an underlying genetic predisposition to wakefulness? A higher-wattage consciousness? Or is the trigger environmental? Nobody knows. It’s the two-billion-dollar question. To date, every known case of the orexin-disruption has occurred in the Americas; nobody knows why this should be so, either. Some speculate that the sickness is connected to the oceans’ tides, magnetism, the poles, the hemispheres, the net of light and shadow on the globe.
Other pundits promise, with weird relish, that we are seeing “the end of sleep as we know it.” TV has become a glum Hall of Prophets: Dr. Daveesha Frank from the Boston Sleep Tank, who speaks like a robot programmed to self-destruct; dour professors wearing sunflower-yellow ties that film well. According to these professional Cassandras, sleep has been chased off the globe by our twenty-four-hour news cycle, our polluted skies and crops and waterways, the bald eyeballs of our glowing devices. We Americans are sitting in an electric chair that we engineered. What becomes of our circadian rhythms, the “old, glad harmonies” that leapt through us like the vascular thrust of water through leaves of grass? Bummer news, Walt: that song’s done. And the endogenous clock, the suprachiasmatic nucleus, hereditary prize of every human, that tiny star cluster of neurons in the hypothalamus which regulates our yawning appetites for hard winter light and spacey blackness, the master clock that syncs us to one another, and to the Earth’s rotation, the sun and the moon? To all the sister kingdoms on the twenty-four-hour circuit? Bacteria, Gila monsters, great sequoias, blue whales, orange groves, bear cubs, mustangs, toadstools, leopards, golden eagles, hyacinths, hippopotami, those tiny wizards, the butterflies, those glue-artists, the arachnids, and all the sequined life on the seafloor, the black urchins that improbably still clock time with us? Bummer news, everyone: the clock stops for humanity. Time itself will soon become an anachronism. Time, as our species has lived it on this planet, will cease to exist. No more dark/light binary. No more active red daytime, blue evening dissolving. No longer is sunshine the coagulant of consciousness, causing us to clot into personalities, to cohere once more on our pillows each morning. These TV scientists predict “a global desertification of dreams.” Soon, they promise, the disruption will afflict all of us. Sleep will go extinct. And eventually, unless we can find some way to synthesize it, so will we.
Generally, I’m mistrustful of these warblers, who do the dread-crescendo. But I’m embarrassed to report that the Slumber Corps has borrowed a page from their playbook, “eschatalogical manipulation.” At Sleep Drives in Alabama, Georgia, and Florida, we are test-screening a documentary created by those ratings whores, the worst of the cable news fear lords, “Is Sleep Going Extinct?” I’m afraid to say it’s been very effective. We show it at night, like a popcorn horror flick. Terror, we’ve discovered, is a powerful donation-stimulant.
Meanwhile, sleep clinics in this country are operating at two hundred percent capacity; “Night Worlds” have sprouted all over America. “Night Worlds” have some kinship with the circled wagon trains of the West: the sleepless closing ranks against the night. They form spontaneously, on the margins of cities, but have developed an oddly standard layout: mazes of tents, nocturnally blooming speakeasies. Night World merchants cater to the sleepless ones with black market remedies: “moonlamps” to ease the dreariness of unremitting wakefulness, “cave medicines” derived from ancient myrtles and lichens. Songbirds from Germany and Thailand are sold as “bio-cures”—their binary chirping is said to reprogram dreams into the mind. Some Night Worlds function as quasi-legal campgrounds for homeless and unemployable insomniacs. These places are tolerated by the local authorities because they help the hospitals with overflow. At the ERs, many new insomniacs are being turned away nightly. Sent back to twist in exile on their mattresses, cutting their eyes on the moon’s blade until a donor can be found for them. They await our call. Until they are eligible for a sleep donation, there is nothing to be done for the majority of these people.
At Sleep Drives, we also screen the now-infamous footage of one of the first cases of the terminal insomnia: a young Guyanese woman from a suburb of Houston. After five weeks of near-total sleep loss, her braids have turned totally white. Her frosty hair looks almost comic, like a fright wig; her face is child-smooth. She presented at the Gould clinic in D.C. after fourteen complete days and nights without cycling into sleep. She is wearing a fluffy pink sweater, lilting gibberish. Her eyes bulge so that you cannot see the lids.
Nothing newsworthy, you might correctly assert, about the public performance of illness. Death’s dress rehearsal is ongoing at any bus stop in America, where sick people beg us not for minutes of sleep but for metallic dollar-flakes, wealth dandruff. Long before the sleep crisis, our downtown was a maze of sidewalk asylums. Immobilized people form a human shrubbery behind the courthouse, their lips whispering, their pink and brown palms extended, flat fronds shivering with need. Which is all to say: nothing the least bit strange to us, about public psychosis.
What makes this footage harrowing is its juxtaposition with a photograph of this Guyanese woman taken just five months earlier, before the onset of her orexin-disruption: her hazel eyes were shining and calm, tenanted by a sane woman, tethered to her memories; the eyes were seeing, presumably, only what was visible to everyone else in a room; her face was happy and plump, irrigated by sleep.
The young Guyanese insomniac never slept another minute. Unbeknownst to her doctors at the time of filming, she had already entered her LD, the ultimate interval of wakefulness that precedes death. “LD” for Last Day was a new acronym then, midwifed into the language by the sleep crisis; today, it’s universal med-slang. Kids of six use “LD-er” as a playground insult. Schools instruct children to treat orexins as “ordinary” humans (an instruction that contains its own defeat, doesn’t it?). The video is now nine years old. We’ll keep looping her forever, for donors. Twelve days after they shot her segment, she died. Her true name was then released to the public, like a genie unbottled: Carolina Belle Duncan, age nineteen. Today she is a CDC celebrity: the first recorded death from the orexin-impairment. Dori was the East Coast’s inaugural mortality, the fourteenth recorded death nationally.
A Johns Hopkins neurologist claimed that a mere two hours of recovery sleep would have prevented Carolina’s death from cardiac arrest. Nine to thirteen hours, he said, would have ended her hallucinations and readmitted her to the waking world with stable vital signs. The insomnia’s worst effects could be undone that speedily. One night’s sleep would have saved her life. He compared it to getting an emergency tank of oxygen to a stranded diver.
Nine to thirteen hours—that figure haunted me.
It haunted everybody, apparently.
Without sleep, how long can a person live? The record was set last year when a woman in Devil’s Creek, Nebraska, collapsed after twenty-two days. Five hundred and four hours, without a minute of replacement sleep. Masked like a raccoon, at half her original weight. Her body had rejected all transfusions. She was a white lady, but her face had turned a blotchy black. Yet this is a deceptive figure: twenty-two days. Months before her death, the Devil’s Creek woman had reported a complete cessation of sleep. Many insomniacs who claim they haven’t slept a wink in years are actually, unwittingly, lying to us. Patients swear they are awake. But the EEGs show that regions of the brain are going off-line. Neuronal networks shut down, fire on again, in a sort of cortical round-robin. “Micro-sleeps.” Rolling blackouts. Some areas go dark for whole minutes; still the insomniac claims to be fully awake. In effect, the brain doses itself with eyedroppers of unconsciousness. We think “microsleep” must account for certain orexins’ surprising longevity; some LD-ers, like Dori, can hang on for weeks before death from cardiac arrest, stroke, multiple organ failure.
Since joining the Slumber Corps, I’ve become obsessed with statistics. For bedside reading, I’ll sometimes turn to our brochures. I do
a dozy arithmetic under the skirted blue lamp, until these numbers add up to a temporary conviction that I deserve a night’s sleep.
18 Insomniacs Will Dream Tonight, Thanks to Your Gift.
Less than 1% of donors experience any kind of adverse reaction.
Since its inception, this branch of the Slumber Corps has helped over 3,000 insomniacs.
There are close to 250,000 people currently on our wait-lists nationwide. Priority always goes to urgency of need.
And my favorite:
34% of Insomniacs Will Regain Their Natural Ability to Sleep After a SINGLE TRANSFUSION.
Our work really does save lives. Nobody can deny that extraordinary fact. During the early trials of the sleep donation procedure, Gould’s team made an astonishing finding. For roughly a third of patients, full recovery from the orexin-disorder is possible after a single ten-hour transfusion.
Doctors cannot yet account for why some patients continue to suffer from the orexin-disruption and require multiple transfusions, whereas others are “reset,” cured. The mode of action is unknown. Some doctors posit that, like electroconvulsive therapy, ECT, treatment, a sleep transfusion can produce profound changes in a recipient’s brain chemistry. Cases do exist where a single session of ECT results in some shockingly happy customers, says Dr. Gary Peebles, the Director of the National Sleep Bank (and where is the humor-transfusion of authentically funny jokes for Dr. Peebles? I wonder). In these cases, the administration of a strong electric current through the suffering patient’s brain reverses all symptoms of catatonia and depression, breaks cycles of mania and relieves many other plaguing shadows and diagnosable sorrows that can be found in the DSM-12. Our researchers, says Dr. Peebles, are working to discover just why the delivery of sleep to a dreamless body can and does produce a full recovery for certain patients—and only a temporary reprieve in others.
To date, every former insomniac who regained the ability to sleep, post-transfusion, remains fully rehabilitated. We have no recorded relapses. No longer are these patients dependent on the sleep of strangers. Post-transfusion, they can achieve REM in their home bedrooms: colors of their own freakish and individual manufacture flood their minds again, plots spiral up, imaginary faces and animals bubble and flume: they dream. It’s heartbreaking, of course, when this does not happen. Some people, we now fear, might require weekly sleep transfusions for the rest of their lives. A blank check to float their nights.
The Slumber Corps pledges to get sleep to every insomniac “for as long as her or his need persists.” That’s our mission statement. Where is all that sleep going to come from, you’re wondering? Us, too. Fiscally, it’s a bankrupting promise. Mathematically, I’m told, it’s a future lie. In five years time, the Slumber Corps’ monumental commitment to these insomniacs may well be an abandoned ideal, like a temple buried in the jungle. Smart people on the Slumber Corps’ own advisory board call our pledge a “pipe dream,” as dangerous as anything we test for at the Elmhurst, New Jersey, sleep-processing plant. Yet we continue to make this promise to our incurables.
On nights when sleep continues to elude me, I consult my “zeros.” My own recruitment stats.
And when even this does not work?
On my worst nights, when my eyes are burning and dawn is two hours away, I’ll give up on fact, give in to fantasy. I’ll shut my eyes and pretend that Dori is receiving one of these transfusions. They were not available, of course, when she needed them—when she lived. Which was not so long ago, not at all. The sun rises, and she’s home. Birdsong is twittering in the air, proof of invisible birds. Dori is back in the world. Her eyes open on her pillow, and they are sea green and absolutely clear. Voided of all nightmares. No earthworm nest disturbs her now, no crumb of boneyard dirt. Her waking is an instantaneous rebirth. Her hair spools onto the pillowcase, happy memories are coiling in her head, and tomorrow is laid out at her feet, a net of yellow light and blue shadow that stretches from bedframe to door.
And then?
Written out like this, you know, it sounds a little Frankenstein.
Pinkly flushed, arisen, my sister startles from the room. Grape bunches of curls spill down the back of her pajamas. She is the age she would be today: twenty-nine.
Baby A
Last July, the Supreme Court ruled that babies could be donors, with their parents’ consent. Babies are deep, rich wells for us. They serenely churn forth a pure, bracing sleep, with zero adult terror corrupting it. Since the new law went into effect, we Corps volunteers have been trying, with renewed zeal, to sign up whole families. We’ll tap the parents’ sleep, which is often useless to us (a fact we don’t advertise, of course), just to get a baby’s donation. “Pump me first,” the mothers implore, so overwrought that they vitiate their draws with cortisone. We do not discuss this with the women—their polluted sleep, the futility of their generosity. We draw from parents because the experience reassures them. Really, what the nurses are draining is these mothers’ fear of the unknown. They wake up, refreshed, with no memory of the draw, awash in goodwill.
Then we enroll their children in our donor program.
Four months ago, I pitched Mrs. Harkonnen at a Drive outside the Piggly Wiggly grocery. I spotted a baby’s face pinking out of her pretty woven papoose, and I introduced myself. Mrs. Harkonnen was an easy convert to the Slumber Corps, crying freely at Dori’s death story; the baby witnessed our exchange with that eerie calm babies have, dry-eyed and blank. Was her husband with her? No? Could I arrange to speak with him, get his signature? To dispatch a Sleep Van, we’d need both parents’ consent.
One week later, I paid a visit to 3300 Cedar Ridge Parkway to collect the consent forms. Mrs. Harkonnen greeted me on the porch with a shy smile, her hands starfished out in front of her; the nail polish was still wet. She’d remembered my name: “Trish! Come on in.” She’d put on red lipstick, was ready with a pot of decaf. Upstairs, the baby was crying; we’d both smiled automatically at the sound. “My husband’s with her. He signed your papers.” She pushed over the consent form; I saw that Felix Harkonnen’s autograph was freshly inked. “He’s a little worried about the procedure—she’s our first child, you know, he’s a very protective father.”
The note of apology in her voice unnerved me a little; this was perhaps my first intimation that Mrs. Harkonnen was a very special sort of donor. I’d never met a mother like this, for whom the gift of a daughter’s sleep seemed so matter-of-fact. Why did she assume her husband’s reluctance needed explanation?
“But I told Felix all about those poor people on the waiting list. Why this sleep donation is so important to them. How did you call it? A ‘life serum.’” Then she’d paused, staring intently at me, and I saw that I’d been wrong to think this woman was in any way naive. There was some shrewdness alive inside her kindness, a perspicacity that thrilled and frightened me, that I did not understand. The quality of Mrs. Harkonnen’s attentiveness caused my whole body to prickle, as if invisible quills were lifting under my skin. This was a surprise. For the past eight months, I’d felt brain-dead and nerve-dead when I was not recruiting. I’d stumbled around in a daze during the periods between our Sleep Drives, those jagged white intervals of time, which I had formerly experienced, in unity, as “a day.”
“Your sister. I can’t stop thinking about her.”
“Oh?”
I’d stared up at the unshaded bulb above the Harkonnen kitchen table. Gravity can be exploited in these situations; moisture slid into my pupils. A swimmy seepage of green light contracted back inside the white bulb. I did not cry. Once the kitchen went matte again, I was able to meet her eyes:
“Well, thank you, thank you very much for keeping her in mind. My sister would be here today, if we’d had Gould’s technology . . .”
Then my voice broke, and I had to really work to keep my grin from stretching into something crooked and hungry; my eyes felt suddenly dish-sized, much too large for my face. Ordinarily I only resurrect Dori during a pitch.
That’s where I feel her. But that night I was certain that I sensed my sister’s presence in that stranger’s kitchen. Or almost certain. I badly wanted to see you, Dori, as you existed for Mrs. Harkonnen. Typically, my recruits receive the story of my sister’s death day with a mixture of sympathy and horror; many people give sleep as a kind of frightened oblation, a way to sandbag their healthy lives from her fate; if she “works” on them, they respond with a donation. But all most people ever really know about my sister’s life is how she died.
My smile became natural in response to Mrs. Harkonnen’s smile as she offered me a reheat on the black coffee, cream and sugar—Mrs. Harkonnen was the kindest and gentlest inquisitor I’d ever met. Somehow she intuited all that I could not say about my sister, and she asked me only questions to which I possessed factual answers; I heard myself telling stories from our Pennsylvania childhood, these shadowy green memories of Dori that I’d never shared with any donor.
All this time, the baby had been wailing. At first I’d been astonished by her volume. Once Mrs. Harkonnen got me talking about Dori, however, I’d stopped noticing, until I was barely aware that I was shouting to be heard. Then that pour of solar sound cut out. The infant’s silence was as loud as her screams had been, at least. We turned from the forms together, and there was Mr. Harkonnen. He was standing at the top of the stairwell, holding the baby.
“I’ve changed my mind,” he said.
I stood, and so did Mrs. Harkonnen.
“Sit down,” Mrs. Harkonnen commanded me, suddenly steely. “Felix, we made a promise to these people—”
Sleep Donation: A Novella (Kindle Single) Page 2