Asleep: The Forgotten Epidemic that Remains One of Medicine’s Greatest Mysteries

4 Responses to “Asleep: The Forgotten Epidemic that Remains One of Medicine’s Greatest Mysteries”

1. E. Bukowsky says:

   April 25, 2010 at 6:43 am

   Molly Caldwell Crosby’s “Asleep,” traces a weird malady whose origins are shrouded in mystery. Encephalitis lethargica (“a swelling of the brain that makes one sleepy”) “came in two waves–the first started in 1916 and peaked in 1920.” A second wave struck in 1924. Today, few people remember this curse that killed closed to a million people all over the world. One of the victims was Crosby’s grandmother, Virginia Thompson Brownlee, who became ill in 1929 at the age of sixteen but was fortunate enough to survive with limited long-term effects. Tragically, many of the afflicted were children and young adults whose brains were not yet fully developed; they were not all equipped, physically or emotionally, to battle this destructive illness.

   Although the symptoms of encephalitis lethargica varied from one individual to the next, some of the manifestations were: disconnectedness from one’s body, lethargy, delirium, garbled speech, stiffness, seizures, tics, Parkinsonism, and extreme personality changes. Some people became catatonic or went into a deep sleep for long periods of time. Nearly one third recovered, one third died, and one third survived. But, some became so disabled that they were everlastingly institutionalized. One common thread is that many of the sufferers had recovered from the flu before they came down with encephalitis lethargica. Even those who appeared to have recovered fully were vulnerable to recurrences years later. It was nearly as if a demon lay dormant in their bodies only to reemerge when they least expected it.

   Crosby divides her book into seven chapters, each of which recounts a compelling case history, including that of Jessie Morgan, the wife of financier J. P. Morgan. The author brings her theme to life not only by delving into the experiences of individual victims, but also by exploring the careers of prominent physicians who cared for patients with this ailment. Enhancing the narrative are richly described details of the social, cultural, medical, and political climate that served as a backdrop for the pandemic. Crosby puts encephalitis lethargica in context as she recounts the horrors of World War I, the bug outbreak that killed more than twenty million people, the building boom in New York City, the incredible technological developments of the 1920’s, the Stock Market Crash, Fantastic Depression, advances in neuropsychiatry, epidemiology, and broadcast health, and the construction of new facilities to house the mentally ill.

   Theories abound, but to this day no one knows what causes encephalitis lethargica. Oliver Sacks, the celebrated novelist and neurologist who wrote about his work with encephalitis patients in “Awakenings,” asserts that “this weird, often terrible disease is not extinct, only quiescent. It may well strike again in our lifetimes.” “Asleep” reads like a riveting novel that one wishes were merely a nightmare invented by an imaginative novelist. Unfortunately, it is all too real. Crosby’s facts are meticulously documented; she includes photographs, extensive endnotes, a lengthy bibliography, and a thorough index. This is a perfectly written, lucid, multilayered, and unforgettable work of non-fiction.
   
   Rating: 5 / 5
2. J. A. Monfort says:

   April 25, 2010 at 7:18 am

   An interview on NPR alerted me to Ms. Crosby’s book. I, too, had a grandmother diagnosed and recovered from sleeping sickness. Crosby’s investigation shed light on how this disease affected families and how victims were trapped in their own bodies. Having grown up in an era where children didn’t question probing questions of family members, I found this to be a book worth sharing with siblings.
   Rating: 5 / 5
3. Kurt A. Johnson says:

   April 25, 2010 at 8:35 am

   From roughly 1915 to roughly 1926, the world saw an epidemic with weird symptoms. Most sufferers fell into a deep and near indissoluble sleep, though other experienced unending insomnia, Parkinson’s-like symptoms, and even violent lunacy. Neurologists at the time exposed through autopsies that sufferers of the disease experience a swelling of the hypothalamus (in the brain), and labeled the disease Encephalitis Lethargica – which is to say, a swelling of the brain that makes on sleepy.

   But, this was a description of the effects of the disease, rather than a description of the cause. This book tells the tale of the disease and its effects on the world (Did Woodrow Wilson narrow the disease? And, did Hitler?), and it tells the tale of the efforts to combat the disease and its effects on the science of neurology.

   Overall, I found this to be a very fascinating book. As the title suggests, when historic epidemics are discussed, Encephalitis Lethargica never seems to show up, and yet at the time it was quite well-known (or infamous). The author does an brilliant job of telling the tale of the disease, the world it entered, and the effects it had on the world.

   I have read a number of books on diseases and epidemics (yeah, my wife thinks it’s a weird theme to be interested in), and some are better than others. As for this book, it was fascinating from start to end, and a cracking excellent read!
   Rating: 5 / 5
4. Feathered Quill Book Reviews says:

   April 25, 2010 at 9:11 am

   The year was 1918, and even as the world was caught in the midst of a massive war, it was also facing a silent, but quite deadly strain of bug that ripped through every people leaving a massive quantity of death in its wake. Oddly, in the crux of all the horror and death, another disease surfaced in Europe that proved to be perplexing and absolutely stumped physicians. The patients suffered from anomalous sleeping symptoms, facial tics and often savage lunacy. This weird illness eventually spread nearly the world, and left a profusion of
   
   everlastingly debilitated patients in asylums, and caused death in
   
   other patients. Physicians scrambled for answers to this unknown sleeping sickness, which was finally named Encephalitis Lethargica, and by the time they believed they had some answers, although not any concrete enough to consistently help those suffering from it, Encephalitis Lethargica simply vanished from the world in 1927.

   This tale is about the few neurologists, primarily in New York, who tirelessly studied this disease’s effect. They visited homes and asylums, documented every patient and their unusual and devastating symptoms, spent further hours researching, and finally gave presentations on the disease to educate others. Their hope was to place an end to the ravaging effects of Encephalitis Lethargica before it reared its hideous ahead again.

   Molly Crosby truly has a knack for mixing elegant storytelling with researched historical events that entices readers aptly from the beginning, smoothly and consistently interests readers throughout with biographies of the key players, and well documented case studies, and closes with a private account that brings the book full circle. Encephalitis Lethargica is a dreadfully serious disease, but is effectively an unknown and mysterious risk that continues to linger, throughout the world. But, thanks to this engrossing book, light is being shed upon the possible potential risk EL may possibly have on people in the bestow day by exposing the events in detail that led up to the original epidemic.

   Readers should not be turned-off by this medical correlated topic when selecting their possible next read because although it is indeed packed full of research, it reads more like a fascinating medical mystery, rather than a stuffy research paper. Still, the book includes critical documentation that also makes it a crucial read for those in the medical field.

   Quill says: This is a well told and quite informative read about a effectively unknown disease, and is highly not compulsory.
   Rating: 5 / 5