Asleep

January 25, 2010
Here’s medical curiosity combining history, mystery, and riveting storytelling. Crosby (The American Plague
) relates the vexing appearance during WWI of encephalitis lethargica—sleeping sickness—through the stories of patients, doctors, and public health servants swept up in an epidemic that affected as many as five million people worldwide in a little over a decade. Despite a high mortality rate, writes Crosby, surviving the epidemic was worse than dying from it. Survivors were left insane and locked in a statue-like immobility. As interesting to Crosby as the mystery of sleeping sickness’s sudden appearance and spread, possibly in tandem with the Spanish flu, is the aftermath, which taxed the burgeoning fields of neurology and mental health. The mystery of the epidemic isn’t yet solved, leaving concerns about a future recurrence. The remarkable human connection Crosby brings to this scientific oddity helps enlighten readers about a pandemic forgotten in the shadow of the contemporaneous Spanish flu and till now memorialized only in Oliver Sacks’s Awakening.

January 1, 2010
The engaging story of the outbreak of a bizarre disease.

In 1917, a young neurologist named Dr. Constantin von Economo was faced with a sudden influx of unusual patients at a clinic in Vienna, Austria. They exhibited a bizarre array of symptoms, including uncontrollable blinking, twitching, salivating or other tics—or even psychotic behavior. Others were locked in a catatonic state. All the patients had one symptom in common—difficulty staying awake. Indeed, some patients fell deeply asleep and never woke up. Autopsies showed that patients had swelling in the section of the brain that controls sleep. Von Economo identified the disease, which became known as encephalitis lethargica—sleeping sickness—but neither he nor anyone else could pinpoint what was causing it. It became a worldwide epidemic during the next few years, affecting millions—but after 1927, the epidemic tapered off, and new cases became rare. Crosby (The American Plague: The Untold Story of Yellow Fever, the Epidemic that Shaped Our History, 2006) relates the history of encephalitis lethargica by using several case studies. They range from a New York girl who had violent seizures and then fell into a sleep from which she never awoke, to a woman whose disease drove her to grotesque self-harm—including tearing out her own eyes. Some of the catatonic victims of the disease became the subject of Oliver Sacks's book Awakenings (1973) which was later made into a film. Crosby is a fine storyteller, peppering her case studies with facts about the history of neurology and details about 1910s New York. She also provides fully realized portraits of not only her case studies' patients, but also the brilliant doctors who treated them, such as Frederick Tilney, a neurologist who later gained fame for his study of Helen Keller, and Josephine B. Neal, a rare female bacteriologist, neurologist and encephalitis expert in a male-dominated profession. Crosby also provides the latest theories of the causes of this strange disease, the origins of which are still elusive.

A capable, readable account of a medical mystery.

(COPYRIGHT (2010) KIRKUS REVIEWS/NIELSEN BUSINESS MEDIA, INC. ALL RIGHTS RESERVED.)

February 15, 2010
On the heels of World War I, another atrocity emerged to take millions more lives: flu. Overshadowed by that worldwide viral menace was an equallyindeed, Crosby believes, an even morefrightening killer, encephalitis lethargica (EL). If the name rings no bell, perhaps that isnt surprising, since the malady claimed only a million lives, though it left at least that many more permanently disabled, before dropping off epidemiologists maps around 1927. The illness popular moniker, sleeping sickness, is more familiar, to the point of seeming innocuous. But the disease was and is anything but. No one has ever been able to articulate its etiology. Just because it flared up during a flu pandemic doesnt mean it is linked to flu by either causation or correlation. Yet the concurrence cannot be discounted. Whats more, the disease is unpredictable, having re-emerged a couple times since the 1920s. Crosby and others fear EL may return simultaneously with another worldwide outbreak of flu. Medical science is, they insist, no better prepared for it than it was 90 years ago.(Reprinted with permission of Booklist, copyright 2010, American Library Association.)