Sleep Donation: A Novella (Kindle Single) (2 page)

For the next year and seven months, Dori barely slept. Then the
loss became total. The final day of my sister’s life unwound with
zero regard for the moon or the sun. She died awake, after twenty
days, eleven hours, and fourteen minutes without sleep. Locked
flightlessly inside her skull.

As an adolescent, I used to seethe with jealousy, because
whereas I got auburn stubs, Dori had these fringed butterfly eyes,
jet lashes that curled so outrageously around her Caribbean-green
irises that strangers assumed were drugstore falsies. During her
endless Last Day, I remember studying those eyelashes pasted to her
skin, at an angle of unrelieved attention. She blinked at me, her
thinking slow as syrup, and I wished that she would not smile
again, not ever again, not like that, because by that point every
smile was an accident, a twitch driven by nothing that I recognized
as human. My mouthy, gorgeous, stupid-brave sister Dori, Miss
“Drive It Like You Stole It” (even when the only “It” available to
us was our great-aunt’s haunted house of a wood-panelled
Chrysler

—who ever heard of a car with
termites?), Miss “Three Jobs, Two College Majors,
and
There’s a Flask in my Purse,” was at this point a nobody. A
“vegetable,” as they say

—the doctors’ potted
plant. And I hated the sight of her facial muscles pumpkin-grinning
on the pillow, her pale eyes twitching, and I hated watching her go
speechless under the conglomerate weight of so much unrelenting
looking and thinking and listening and feeling, her mind worn thin
by the sound of every cough and the plinking moisture of every
raindrop, these noises exploding like grenades through her naked
awareness

—her mind crushed, in the end, by
an avalanche of waking moments. Once sleep stopped melting time for
Dori, she could not dig herself out. She was buried under
snowflakes, minutes to hours to months.

The official cause of death was organ failure.

I know it doesn’t sound like much, on paper.

The same month Dori died, the CDC released the
first case definition of the new terminal insomnia. Early estimates
suggested that several hundred people in the United States were
suffering from a total sleep loss; one year after my sister’s
funeral, this number had swelled to twenty thousand. “Orexins,” the
media taught us to call them. So that, almost immediately, the
disorder became a metonym for its chosen victims. George Washington
University Hospital opened the first dedicated critical-care
insomnia ward

—it was full within days.
Congress allocated two billion for research.

It was not long thereafter that the mechanics of sleep donation
were refined by Gould’s team at the D.C. sleep clinic,
and the Slumber Corps began its good work.

In the months following the CDC release, many
people dismissed the disorder as an exaggeration of a universal
American condition. Who was sleeping enough? Nobody! The “crisis”
seemed like more TV hyperbole designed to keep us
glued to our screens, watching mattress commercials. America, in
the childhood of our understanding of the insomnia crisis, called
the first victims liars, hypochondriacs, wackos, crank-addicts,
insurance defrauders, anxious plagiarists of “real,” biological
disorders.

Now, of course, we know all too well that the insomnia epidemic
is real. You need only consult its victims’ pink-spoked eyeballs,
their gaunt faces engraved behind moonlit windows. Neuroscientists
have since concluded that for a significant portion of the
country’s population, the signalling function of the neuropeptide
orexin has become impaired. Orexin deficiency has been linked to
human narcolepsy, but this dysfunction causes the opposite effect:
an untenable hyperarousal. Sleep becomes impossible. People like
Dori remain conscious for months and even years, hostages of their
brain’s chemicals, trapped in the vigilance state that eventually
kills them.

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.