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Fiction #503
(published September 9, 2010)
Polysomnogram
by Simon Groth
and a deep breath. Slow. I close my eyes a little too long and it feels nice. It feels right. For a split second my head swims and I'm pulling layer after layer over me, settling over my head, my eyes, my ears.

10:28 am.

The glass panel in the door marked STAFF ONLY is covered in fingerprints and bits of grit and grime. A sign hangs on the wall beside it:

CONSCIOUSNESS: THAT ANNOYING TIME BETWEEN NAPS

I think it's meant to be funny.

Wood panelling and big bricks the colour of mint ice cream, a faded and warped print of an English cottage; it looks less like a sleep laboratory than the flat my nana used to live in. I sit in one of three plastic waiting chairs.

The carpet is brown and worn through to stringy bits of plastic under my feet. The faint outline of splodgy stains. An empty water cooler. I guess I expected something a little more, I don't know, high tech. Definitely cleaner.

The door swings open and a man in a white coat peers into the room, spies me, and grins. His hair sticks up and his eyes are red and googly.

"Ryan?"

"Yes."

"I'm Doctor Abraham." He doesn't look much like a doctor. He produces a thin file from somewhere behind him and frowns at it. "It says here you came from emergency at St Sebastian's. What prompted you to go there?"

"I fell over."

A long pause before he says, "Okay, so, when you say you fell over, give me an idea of what happened. What did you experience?"

"I don't know, it was sort of like my legs gave out from under me."

"Before you fell, did you have any chest pains, palpitations, anything like that?"

I shake my head.

"Did you know you were going to collapse? Any dizziness, ringing in your ears?"

"Well I wasn't dizzy or anything like that, but I sort of knew it would happen."

"Why do you say that?"

"A horse walks into a bar and the bartender says, 'Why the long face?'"

Doctor Abraham stares at me blankly. He doesn't seem to get that the

 

punchline hangs in the air between us while I wrap my head around the shortened joke. She nods and winks at me. I feel a flutter. I smile, but I'm pretty sure I never make it to actual laughter. The legs go, blubbery at first, then they turn to liquid like warm flat ginger ale. It travels from my feet up. My arms, my back, everything goes limp and spongy. Then I'm on the floor. The warmth of the room drops away from under me. And faces hang above, I come together again pretty quickly. It never lasts long. Everyone frowning and worried. Are you alright? Over and over again. I'm fine, I

 

tap a pencil against the clipboard.

The television now presents an old married couple: the man to the right of his wife. I assume it's his wife. From looks alone, she could just as easily be a coal miner in drag: ghostly pale, receding hair, her hands crossed neatly over the huge folds of her skirt. While her husband grins moronically at the camera, she sticks her bottom lip out like a horse looking for an apple.

"You noticed the documentary?" says Doctor Abraham. "I keep it running out here, but most people ignore it. Did you know that most of our basic understanding of the gastrointestinal system came about because that man," he points to the ugly man with the friendly face, "Alexis St. Martin was accidentally shot in the stomach?"

"No."

"It's a fascinating episode." He allows the television to take up the story:

"Alexis St. Martin became one of the most celebrated human experiments in the history of medical science. Doctor Beaumont collected samples of gastric juices and observed digestion, dropping food into the cavity with string."

"Brilliant man, William Beaumont," breathes the Doctor Abraham, momentarily awestruck. He seems to catch himself and shakes his head a little. "What about the rest of you?" he says. "How do feel generally?"

"Tired."

"You look pretty tired." He hands over a clipboard. "Take a look at this form. Where would you rate yourself on this scale?"

The form declares itself The Stanford Sleepiness Scale (SSS): An Introspective Measure of Sleepiness. An introspective measure? What's that supposed to mean? Do I have to spend hours gazing at my navel before answering the questions? I'd doze off then for sure.

1—Feeling active, vital, alert, or wide awake. Vital? I don't think I've ever felt vital. Who says that anyway? Sounds like something from an early morning infomercial and I've seen plenty to know.

2—Functioning at high levels, but not at peak; able to concentrate. Doctor Abraham tells me I'm lucky that I've been picked up so early. People can go for years like this without being referred to a sleep clinic. I don't feel lucky.

3—Awake, but relaxed, responsive, but not fully alert. You can tell this was written by someone normal. I don't meditate, so I guess I don't ever hit number three.

4—Somewhat foggy, let down. Let down sounds a little better. Partly deflated and useless would be even better.

5—Foggy; losing interest in remaining awake, slowed down. Doctor Abraham stands over me. I think he expects me to say something. Maybe he asked me a question. He blinks and a quick smile snaps across his face.

6—Sleepy, woozy, fighting sleep; prefer to lie down. There's a space at the end of this list. I have a pencil. I don't remember being handed a pencil. Doctor Abraham says something about taking copies away with me for the next few weeks and noting down how I feel on this scale throughout the day. I'm supposed to hit peak alertness at nine in the morning and nine at night.

7—No longer fighting sleep, sleep onset soon; having dream-like thoughts. I quickly mark a 5 at the bottom of the page and hand it back, although I'm starting to sway a little and I wonder if I'm slumping more to a 6.

X—Asleep. Dream-like thoughts? What happens when dreams drift in and out? What happens if you can't tell the difference?

Doctor Abraham accepts the paper, stares at it, "Excessive daytime sleepiness," he nods. "Ryan," he paces back and forth for a moment like a television lawyer, "could you stand up for me?"

"Stand up?"

"Yeah, just on the spot there, that's it. Now just stay there for a second. I want to try something."

He retreats to the other side of the room and puts the file down on the reception counter. He stretches his back, cracks his knuckles, takes in a deep breath, and lifts his shoulders up.

"After nearly forty years in practice as a gynecologist, Vernon decided he'd try something different and enrolled in car mechanics course. He studied hard over the semester, but he struggled with the content and worried that he might not be able to keep up with his younger classmates. On the day of the final practical exam, Vernon took the entire allotted time to finish, almost twice as long as anybody else."

I look around, half expecting an audience to have suddenly arrived.

"He was pretty worried that he'd failed the course. Vernon was a consultant gynecologist; he never failed exams. But when the results were posted he was more confused than relieved. Not only had he passed, he'd scored a hundred and fifty per cent!"

"I'm sorry, what are you doing?"

He waves a dismissive hand. "Vernon approached his teacher and asked whether the result was a misprint. 'No, no misprint,' said the teacher. 'I gave you fifty per cent for taking the engine apart and fifty per cent for putting it back together again perfectly. But I really had to award you another fifty per cent for doing it all through the exhaust pipe!'"

Doctor Abraham grins a "ta-da!" I stare back at him.

"Don't you get it?" he says.

"Get what?"

"It was a joke. I wanted to see if you'd have the same reaction as you did earlier."

"That was a joke?"

He drops his demeanor and slumps his shoulders. "Don't give up your day job," he mutters. He retrieves the file, writes something down in it, and scrunches his face up. His nose whistles when he breathes. "Well, since jokes are getting us nowhere, let's go inside for a polysomnogram."

The word has barely reached me (Poly-what-o-gram?) before blanket after blanket of sleepiness rolls over me and attempts to tuck me in. Pins and needles flow down my back and to my legs and feet and I feel my head loll a little too far forward. I feel like I'm going to roll off the chair and onto that sticky carpet. There are no armrests on these chairs, I could easily lie down across them and drift away to the sound of that American voice over:

"With St. Martin now in his employ, Doctor Beaumont was free to experiment at will to advance not only medical science, but his own career. Doctor Beaumont's scientific love affair with the hole in his patient's stomach relegated St. Martin to a life that made him at best an experimental subject, at worst an exploited circus freak. In 1825, less than a year into the arrangement, St. Martin absconded, making his way back home to Canada. There St. Martin first met Marie where he

 

cast a dull glow through the corridor. We pass a number of doors, all closed, but some with glass viewing panels. In one room a dachshund lies next to a bowl of dry food looking for all the world like a droopy cartoon dog. Doctor Abraham notices me lingering at the door.

"Have you spotted a like-minded soul?" he says. "Rex here has narcolepsy."

"The dog has narcolepsy?"

Doctor Abraham smiles. "We've learned so much from narcoleptic dogs; the big thing of course is the complex influence of heredity." He leans in close, joining me in peering through the viewing window. "Poor old Rex. He loves his food, you see. Gets so excited he drops on the spot. Classic cataplexy: heightened emotion leads to complete loss of muscle control. That's what I think you may have had when you heard the joke." He clears his throat and adds, "The original joke. Not mine."

Rex emerges from his slumber, blinking and dragging himself to his feet again. He spots the bowl of food and his legs shudder a moment before again giving away completely.

"Come on, Ryan," says Doctor Abraham. "We need to get you set up. Have you got a change of clothes?"

10:53 am. Stanford Sleepiness Scale: 3

"No."

"That's okay. Some patients like to change before they go home, but what you're wearing looks comfortable enough to see you through until breakfast."

Breakfast?

We arrive at a dimly lit room.

"Hi, Ryan. My name is Laura. I'm Doctor Abraham's assistant." She has dreadlocks. What kind of doctor has an assistant with dreadlocks? Laura hands me a magazine to read, a chunky National Geographic from the early 1980s, and seats me in a big, comfy wingback. I look around. Laura plaits individual wires into a colorful net. Doctor Abraham is tapping at a laptop keyboard and adjusting monitors.

With a satisfied grunt, Laura finishes weaving and turns her attention to me brandishing a fistful of wires—technicolor spaghetti. At the end of each wire is small electrode, like a button for dolls" clothing. She squeezes some clear gel onto the button and parts my hair to stick it directly to my scalp. "Don't worry," she says taping the electrode in place. "The transmission gel will wash right out." She repeats the process on my temple, my chin, my ear, on both cheeks, my legs, around my eyes. And every electrode leads to a bank of machines, each more severe and sinister than the last. If I move my head the slightest bit, another machine tugs at my skin or my hair.

The light in the room takes on a darker, greenish pall. Behind one blipping block of inscrutable technology, a cockroach scuttles up the wall and across the ceiling.

"What did you call that machine?"

Doctor Abraham looks up from his screen. "I didn't. This is an EEG."

"You called it a polygraph or something."

"We're not going to give you a lie detector test!" he laughs. "The EEG is just one component of the polysomnogram. All night this will measure your brain waves which record over here." He points to the classic needles-over-rolling-paper set up from every psychological crime movie. "And you can watch some of it yourself on the oscilloscope." This one is definitely an old movie prop: a luminous green wave quivering on a round black screen straight from a black-and-white on a doomed submarine.

I take in a deep breath and try to stop my voice shaking. "Why are all these machines so old? Where's all the high tech stuff?"

The doctor slips a surgical mask over his mouth and nose. "Don't let looks fool you. We've got the EEG measuring your brain waves, there's the EOG that tests your eyes, which is really important to see when you go into REM, and the EMG to see if we get any leg jiggling."

Why is he talking in code? I can't concentrate on what he's saying anyway. From behind the oscilloscope, a nest of cockroaches breaks free and fans out across all the surfaces in the room. Some are big, dark brown with yellow circles on their backs. Others are smaller and striped. They scurry over every available surface, in the sink, on the bed, the table, across screen surfaces, some of them flickering a test pattern.

"Okay," I can hear my voice quiver. Sweat runs off my forehead over my eyes. The salty water feels warm, sandman. It will take a lot more than sweaty tears to stop my heart thumping through my t-shirt and my hands shaking.

"I need you to stay still." The doctor's eyes grin. "Medical science is littered with the wreckage of its experimental subjects. We've only scratched the surface of narcolepsy and we've reached the limit of what the dogs can teach us. The real breakthroughs will come from human experimentation."

"No," I try to push myself back.

"Ryan?" I hear Laura's voice, but I can't see her. All I can see is Doctor Abraham flicking cockroaches off his white coat.

I grip the arms of the chair, digging my nails into the fabric. My stomach twists into one of Laura's wire plaits and waves of nausea flow through me. I can't speak. A single insect scuttles up my neck, inches over my chin, and tickles my lips with its antennae. From somewhere in the periphery, a distant, abstract feeling, a twitchy nervous energy. I'm fine, I'm fine.

"Ryan? Hey!" Gentle shake of the shoulder.

They haven't strapped me down. This is it. Still sitting in my lap is the old copy of National Geographic. I need to be quick.

Without warning, I spring out of the chair, torpedo the cat's cradle of wires, and swat at my face with the rolled up mag. Electrodes dig their fingers into me, attempting to drag me back down into the chair. I stamp my feet and flick my hands in a manic dance to rid myself of the cockroach infestation.

"Laura!" Doctor Abraham bustles past me. Laura is on the floor. Did I knock her down? Was she already there?

I have an opening. I don't think they locked the door behind

 

me and dark clouds cross the setting sun. The dry grass crinkles under my head. I'm still breathing heavily and my heart thumps a heavy waltz against my chest. Where has the time gone?

5:54 pm. Stanford Sleepiness Scale: 1.

I'm still not vital, but I've never been more awake. I've never run so hard.

My legs pumped electricity and I exploded out of the laboratory, past Rex, past the waiting room, long plaits of multicolored wire streaming from my hair. No one followed. When I made it out the door I kept running. What else could I do with all that pent up fear? I ran through traffic, down footpaths. I ran into this park, collapsed onto the grass, and stared at the sky.

I explore my scalp with my fingers and try to pick one of the electrodes out. It just pulls my hair. I roll onto my side and something digs into my hip. I sit up and from my pocket I pull out an envelope and a small plastic bottle. The bottle says:

XYREM®: SODIUM OXYBATE ORAL SOLUTION. WAKE UP TO THE DIFFERENCE.

In the envelope is a standard doctor's script for the same medication and what looks like a letter:

Thank you for seeing Mr Ryan Hobbes for ongoing treatment for narcolepsy. . .

I skip to the end, signed off Doctor Mark Abraham, J. S. Ensor Sleep Centre. I scrunch the paper up and tip the bottle's contents onto the grass. I don't know where this stuff came from, but I won't play the game. Whatever is happening to me, I can sort it out myself. What I don't need is


Simon Groth Brisbane, Australia. He usually writes between the hours of eleven and three. Stories about narcolepsy were probably inevitable. Find more of his fiction at simongroth.com.

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