News Analysis
Economics of Aging
Aging Well
Tom Kirkwood
Investor Profile
Case Studies
Photo Essay
In Every Issue
Editor's Letter


Perchance to Dream

Like sleep for a wretched few, a complete explanation of the mechanism of human consciousness still eludes us.

In the Veneto region of Italy, an aristocratic family is cursed with a macabre disease. This wealthy family is cultured, and its women are beautiful, but its members cannot easily find spouses and are routinely denied life insurance because many of them will die from a genetic disease called fatal familial insomnia, or FFI.

Once stricken, typically at about age 50, the FFI victim is suddenly unable to sleep. After being awake for weeks, the victim�s pupils grow tiny, and blood pressure and pulse become permanently elevated. He or she sweats incessantly; the males become impotent. Victims lose the ability to balance and walk, though initially their consciousness remains intact. Victims may talk about their agony, as long as they are able to speak; after months of unrelenting wakefulness, sufferers are reduced to howling in terror. Still, even when a sufferer�s exhausted system finally shuts down, the victim�s desperate eyes show an awareness of what�s happening. Only in the very last moments before death does the FFI patient lapse, mercifully, into a quasi-coma.

What does this loss of the ability to sleep—to suspend, at regular intervals, the onus of consciousness—tell science? To start with, if it weren�t such a mundane recurrence, one might regard sleep as a terrible mystery. Yet as much as one-third of a person�s existence is spent in this unproductive, highly vulnerable condition. As the sleep researcher Allan Rechtschaffen, Ph.D., has commented, “If sleep does not serve an absolutely vital function, it is the greatest mistake evolution ever made.”1

The fate of FFI sufferers suggests two related conclusions. Firstly, if sleep—periodic nonconsciousness—is so essential, then its alternative—consciousness—is hardly likely to be just a hypothetical state. Secondly, if consciousness is indeed so demanding that an organism cannot sustain the condition without periodic rest, then sleep evolved to perform an absolutely vital function.

These are not minor assumptions. Twentieth-century science, unfortunately, possessed no tools to measure the reality of human consciousness. At least, it often acted as if it possessed none. The blame for this incuriosity does not lie with timid nonscientists who feared that science might explain away the human soul, but with the doctrines that scientists themselves subscribed to. During the first half of the 20th century, behaviorism was ascendant in American psychology. Aspiring to the status of hard science, psychology treated humans and other organisms as black boxes for which measurable stimuli must elicit measurable responses.



Prescription for the FDA

» Perchance to Dream

Their Eyes Were Watching God


By Antonio Damasio, M.D., Ph.D.
Harcourt, 355 pages, $28

1  Max, D.T. (May 6, 2001) Case study: fatal familial insomnia; location: Venice, Italy; To Sleep No More. The New York Times Magazine.