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Asleep by Molly Caldwell Crosby: A great epidemic history story, up until the last chapter

The book:

Asleep: The Forgotten Epidemic that Remains One of Medicine’s Greatest Mysteries by Molly Caldwell Crosby (2010)

What it’s about:

Asleep is the story of the encephalitis lethargica epidemic that followed in the wake of the 1918 flu. Encephalitis lethargica is mainly known by the nickname “Sleeping Sickness”, but shouldn’t be confused with African trypanosomiasis, a tsetse-fly-borne malady that also goes by the “Sleeping Sickness” moniker. The two diseases are unrelated (as far as we know) but have vaguely similar symptoms.) It is terrifying.

Each encephalitis lethargica case began with an innocuous sore throat. Most people thought nothing of it at first. But then weird things began to happen. Patients began to fall asleep and not wake up for days or weeks or else began to lose motor control of their own bodies. They moved like zombies or puppets on strings. Still others retained normal motor function but began to feel uncontrollable violent urges, while remaining completely lucid and logical in normal conversation. (There was one story of a teenaged girl who dug her own eyes out of their sockets with her fingernails and then calmly denied doing any such thing because they had “fallen out during the night”. Otherwise, her behavior was completely rational.)

I couldn’t help but think of the Reavers on Firefly. (If you haven’t seen Serenity, I don’t want to spoil it for you. But seriously? Why haven’t you seen Serenity?)

Asleep follows the doctors and neurologists who tried to help these patients. Their efforts were overshadowed by the 1918 Spanish Flu pandemic, fragmented by war, complicated by the pathogen’s invisibility (whatever caused sleeping sickness couldn’t be isolated under microscopes of the day), and hamstringed by the fact that the symptoms varied so widely. In fact, sleeping sickness initially appeared to be several different diseases.

Crosby is working off of case studies from the era, so the overall effect is almost like reading a series of interconnected short stories (featuring some of the same lead detectives). Separately, the chapters are kind of creepy and puzzling, but together they add up into a portrait of the neurology and epidemiology fields in their nascent state.

The Upsides:

It’s incredibly vivid and well researched. My favorite passages in the book actually had nothing to do with science; they were the passages where Crosby describes the bustling streets of 1910s & 1920s New York City. Her descriptions are extraordinarily cinematic, and I loved the way she presented the history of the disease almost as an anthology of stories based on the original case studies. Plus, it’s just an interesting disease. Creepy, ethereal, & unresolvable. Continue reading “Asleep by Molly Caldwell Crosby: A great epidemic history story, up until the last chapter” »