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

Adam’s eyes would dilate and his face would turn into a mask. Sometimes, his hands would clench and cramp like they were trying to grasp something. Adam described it as “Jesusly painful.” He grew to dread the attacks so much that he could become anxious and cry just thinking about them.
    Jelliffe started asking Adam to record his dreams. Ever the psychoanalyst, Jelliffe found Adam’s dreams rife with sexual content, innuendo, and Oedipal tendencies. The fact that Adam had seen angels the night his delirium first started seemed clear from a psychoanalytical point of view: wooden angels were etched into the back of the sofa where his mother had nursed him as an infant. After particularly vivid dreams, including one in which a dog was biting and shaking his hand—an obvious symbol of masturbation in Jelliffe’s analysis—Adam would feel rotten and spend the next day in bed.
    Toward the end of the month, Adam arrived at Jelliffe’s office after a hard trip from Philadelphia. He had gone into a trance in the taxicab over a fear of hitting an elevated train pillar. Adam came into the office bent over and stooped like an old man. Jelliffe patted him hard on the back and said, “Limber up! Brace up!”
    Jelliffe noticed a look cross the boy’s face like a shadow. He asked Adam what he felt just then.
    “I wanted to say, Cut it out—God damn you! I hate you! You were so like father trying to make me get up in the morning. The goddamn son of a bitch!” Adam left the office agitated and angry.
    Jelliffe was convinced there was a link between the stress still present in Adam’s mind and the triggers for the physical reaction. Adam’s particular case, it turned out, was not so unusual. Throughout Europe there had been strange respiratory tics occurring in epidemic proportions—hiccups, unceasing yawning, and breathing tics like Adam’s. All of them had been triggered by a case of encephalitis lethargica. Jelliffe would later write, “No single situation in neurology has offered so much opportunity for the analysis of physio-pathological phenomena ... as has epidemic encephalitis.”
    Epidemic encephalitis created an opportunity to study the effect of an organic disease of the brain damaging the mind—the very argument being made by neuropsychiatrists like Jelliffe. The disease injured the brain and caused physical repercussions that could not be controlled by patient or doctor. Yet the symptoms could change given certain personal circumstances. Patients responded to different types of stimulation and different types of people.
    In New York in 1920, epidemic encephalitis kept a twenty-nine-year-old woman asleep for more than one hundred days. Knowing how she loved music, her husband hired a young violinist to play at her bedside. He started with one of Liszt’s Hungarian Rhapsodies, to no effect; but when he played Schubert’s “Serenade,” the woman suddenly opened her eyes and remained awake. She had a full recovery. The London Times reported, “This is the first case in the records of the New York Health Department of a cure in a case of Encephalitis Lethargica.”
    Decades later, Dr. Oliver Sacks would encounter similar cases in his studies of encephalitis lethargica survivors at the Beth Abraham Hospital in the Bronx. Sacks was able to revive the patients briefly with the drug levodopa or L-dopa—a story he chronicled beautifully in the book Awakenings. Although Sacks encountered these catatonic, “extinct volcanoes” in the ward, he found they were anything but extinct. If thrown a ball, a patient would reach up and catch it. They would respond to certain pieces of music, but not others. If held by the hand, a patient could walk. Sacks found that the dysfunction was not in physical impairment or paralysis, but in the inability to initiate movement. The patient simply did not have the “will” to begin to move. Inside their brains, damage to the basal ganglia corrupted message signals like interference