Sie sind auf Seite 1von 11

Ordering Disorder

From the Preface to Ordering Disorder Dr H H Winkler (Marshall Academic Press, 1998)

I reflect with some pleasure upon the case of a boy who was brought through my doors 24 years ago this very day (14th January 1998) and who proved to be the most fascinating client of the Sleep Clinic. The subject was a real Pandoras Box initially his illness seemed very minor at most, non-existent at least. Then he seemed like the most unsolvable case I had ever encountered. Finally, I found a workable solution, from which has flowered my entire meaningful research. It seems amazing to consider that a near mute seven year old boys sleeping patterns could wield the influence they have done over the way we live now, aiding with progressive legislation and revolutionising government policy, education and matters of home security. Such are the marvels of the disturbed mind.

From the Case Notes of Dr H H Winkler Scraps handwritten unless otherwise stated. Notebook paper. 14th January 1974 Subject is a seven year-old boy. Subject has received referral to the clinic following near continuous referrals by parents, mostly mother, to Accident and Emergency in town hospital of BHouse visit has occurred (by Social Care Team) outcome shows little cause for interest: nice middle-class home, well-kept. Tidy. Usual risk-factors minimal. Seventeen (!) referrals to A&E in three months have prompted this referral. Very few referrals included any actual injuries (2, in fact. Minor). [Et voila. Merci beaucoup, etc!] Subject presents as drowsy (big, dark rings around eyes) but otherwise healthy and normal. Somewhat uncommunicative. Possible diagnosis of somnambulism subject is of the age. Parents perplexed by scope of his sleep walks and range: seems to appear in NREM (early sleep phases) and REM (later sleep phases) without predictability. No witnessing of somnambulism (hence unclear diagnosis) but evidence of subject awakening in places other than bed. Parents unsure as to start point father references the recent autumn as the start point; mother states age 5. This disagreement seems to be a source of some frustration between the pair. The subject sits and watches this conversation. When asked for when he feels it started he shrugs. When asked Who of mummy or daddy may be more right? subject replies No.

No evidence of family history of condition. Subject is always passive upon awakening. No talking during sleep [Very little otherwise, either]. No evidence of completing or attempting complex procedures but 7 is early for high-level development of this nature. [For research purposes it would be ideal for a semi-complicated and favourite toy to be in the room Barclay - do not include this in full notes] Mother notes the boy is more of a reader than one for playing games. Surprising. When pushed she ventured he has some passing interest in arts and crafts but can be no more specific than that. Parents in disagreement over viable next steps for treatment (if any). Father keen for no treatment at all. Was not happy to be in consultation at all. Mother keen for sedatives (for subject). Might be more suitable for her. [Barclay - this is a joke]! Advised for securing of points of danger. Father asked whether to put a lock on the s ubjects bedroom. Advised stair-gate, as used to protect infants, would work better but would need a higher placement and more sturdy fixture. [Father mumbled about the comparative costs unsure of how seriously to treat this comment. Yellow form? Lets discuss+ Advised sleep diary. When mother realised no prescription would be forthcoming she became agitated. Something seems to not be right. [Please schedule appointment in 4-6 weeks time. Include diary blank with appointment letter+

25th February 1974 P- family from B- second visit. There has been an A&E referral (19/01/74) and several follow-up visits. The boy has broken his arm. Four nights after previous visit (night of 18/01/74) the family returned home and went to bed, as usual. Father had not fitted stair-gate by this point (!) Boy found in kitchen with broken arm (radius) completely asleep. Kitchen is three rooms away from the foot of the stairs. Subject seems to have fallen down the stairs, picked self up while still asleep and taken himself to the kitchen (for a snack possibly, although no food was eaten). Subject has then settled down for further sleep. Second social care visit as before, except the subjects bedroom was in a state of some untidiness, with clothing and comics strewn everywhere. Otherwise clean. Not abnormal in itself for a 7 year old boy [in fact, the reverse would seem to be more of a cause for suspicion!] Family have requested revisit to myself repeatedly but there really is no point without the diary completed. I cannot fix their sons broken bone or fix a stair-gate to their wall or fix the parents inability to communicate with each other. The remit is sleep, which may be the nexus of two of the afore-mentioned problems, but the treatment was, and is, to complete the diary and secure the landing area.

The diary relates four nights of activity:

15th January 16th January 17th January 18th January

Subject sleeps in own bed, awakes at foot of parents bed. Subject sleeps in own bed; awakes at foot of parents bed. Subject sleeps in own bed; awakes in kitchen. Subject sleeps in own bed; awakes in kitchen with broken radius.

The diary has not been completed since the injury. The family all claim that the somnambulism seems to have ceased from that point. The son even pipes up I dont go anywhere anymore, he says, almost wistfully. His father, glaring at his broken arm, seems to not concur with his tone on this matter. There is full accordance for the need for a follow-up visit, to ensure that the degradation of the condition is as it would seem. Not totally keen to rule-out the broken arm as a contributory factor to the retardation perhaps his access to phase three sleep is being blocked or time-limited by wakefulness. Reiterated the need to complete diary assiduously, even if to record nothing unusual. [Barclay usual 4-6 please. Dont forget Zurich 21st-23rd. Actually, 5-7 at a push. Maybe a longer view actually preferable. Please send duplicate blank of diary]

1st April 1974 No show from P- family. Guess who feels a fool! *Would imagine this marks case closed in reality but please schedule repeat visit in the usual, stiffly-worded letter from file, Barclay. Fairly keen to see boy but not so interested in parents so please schedule right in the middle of a working day!]

24th April 1974 Second no show. Case notes closed.

31st January 1975 Referral from Psychiatric care (10/01/75) following initial referral from A&E about the subject (arrival 03/01/75). Police, fire brigade and social care very interested! Subject admitted to A&E in very bizarre condition. Black!

The subject went to sleep in his bedroom and awoke downstairs in the family front room. From head to toe (in his pyjamas at least) the boy has been found covered in soot! It would appear than the boy had sleepwalked down the stairs to the front room, then somehow dislodged the fireplace impedimenta, rupturing the gas supply pipe in doing so, and then tried to crawl into the chimney. Subject had numerous cuts and bruises from the attempted ascent (he looks like he had made it all the way into the chimney before then removing himself and returning to sleeping position in the middle of the carpet [which I expect must be ruined!] Unable to say whether father has added to the general bruising. A&E suspected yes but the son, if assaulted, was assaulted in his sleep. Mother unwilling to discuss this side of matters. The sons claim I was being Santa Claus provides an odd motivation but perhaps we should not dwell overmuch on this. Psychiatrics are convinced this is more play than belief and I concur. [Must have been a real to-do in that 10th Jan meeting: three complete loonies, where does one start?] In discussion it is revealed that the son has recently returned to sleeping upstairs in his bedroom. Since the accident (fracture: 19/01/74) he has slept in a small downstairs room, which has enabled him to overcome his somnambulism. This is all except for a small period around the last two scheduled visits where he was tried out back in his own room. Only mother and son attend the appointment. Mother is apologetic for the missed appointments (April 1974 x 2) claiming a very difficult time at the family home *I dont doubt it!+ and a worsening rather than improvement in conditions. When I point out the illogicality of not coming to sleep clinic appointments when the condition is deteriorating she agrees/cries. We agree for the diary to be kept properly for the next month. I am interested in brain patterns and may need to consider neurological monitoring depending on the outcome. The subject is still very much in the age range for the condition and is likely to remain so for a period of four more years. The disappearance of symptoms for eight months, followed by such a dramatic reappearance, is an unexpected phenomenon. [I fear that the family (or more probably, the father) may have taken a more pragmatic approach to controlling their sons condition. Barclay, please raise a yellow form for social care. I would like every downstairs rooms architrave and door checked for locks or signs of unused screw-holes. I think they have been locking him in every night. Please also rebook ASAP I dont want this boy left to the whimsy of his mother and father any longer than necessary.]

3rd March 1975 A kept appointment with four full weeks of diary entries, in itself an amazement, but more so still when considering the contents. The detail can be seen for itself in the log itself (attached) [This document is no longer with the source document.] They seem like a horrendous tissue of lies when compared with the social care report (20/02/75) which reveals precisely nothing. [The conclusions I am currently nudging towards in the dark would mark me out as a madman. Suffice to say, the boy has been able to exit a locked house and make his way into the garden up to three times in a single night, seemingly without keys.] The level of operation during somnambulist

episodes detailed suggests an inordinate level of mental activity, not to mention physical acuity and dexterity. I despise illogicality and being made to think the thoughts of a madman. ] During the visit the [mother seemed as crazy as usual and the] son seemed as introverted as usual. He seemed very interested in my Nelsons Cradle, watching it ping back and forth with rapt attention. [He took time varying the balls swings, selecting a single one first, then two, then three (Wow, he utters at this point watching the centre ball change allegiance with the swing). He selects two from each side and drops them simultaneously. With the whack comes inertia. Wow, he says again. He then continues playing with it, drawing his gaze ever closer to the balls until he can see the regular distortions of his face in each of the charged balls. Me, he comments, and I wonder whether he has ever had a sharp knock to the head. What do you make of that B?] Admission for observation to monitor neural activity. [Schedule for nearest weekend available given need to arrange observation materials/venue. Get quality obs. support Dr Jamal ideal. Two nights with parents in adjoining room crucial not same room! ECG as standard. Book me in to cover both shifts. This overrules diary. Can we go this weekend with follow up appointment as soon as possible after?]

10th March 1975 Two nights of observations of a patient not sleepwalking. Standard phases of NREM and REM sleep. Standard mental activity on the charts. Not even a hint of wanting to get out of bed at any point. [Case notes are absolutely dreary. Back to square one. Only two facts of any interest whatsoever: 1. No father (again). He had taken the opportunity to refit his downstairs room into a library. A disappointment. Not a breach of social care but an indicator of something, thats for sure. What that is I am not so sure about. 2. Subject demonstrated signs of what can only be described as mood swings upon waking. Big smiles to see his mother in the ward upon waking. Subject is effusive (See, I did it! he exclaims but then will be drawn no further on this in staff presence. Later, during the day Dr Jamal notes the boy seems withdrawn and sullen, as if preoccupied. Also, he reads rather more than a typical patient, exhausting the childrens bookshelf during the first day and then becoming really moody. I bring him in a few of Peters old books that he has grown out of from home before he is discharged and he has a Cheshire Cat-sized grin upon leaving.

[Appended note- different coloured ink. The Cheshire Cat grin is clumsily triple underlined in blue fountain pen ink; the original text is written in black ballpoint ink]

From Chapter four of Ordering Disorder Dr H H Winkler (2nd Edition, Marshall Academic Press, 2006)

The events to relate are now the most astonishing to commit to print and you must please excuse me if my prose becomes a little florid in the telling. In the summer of 1979 the case of our most famous subject takes its first major detour. The boy goes missing. The police investigation is massive and, as you will know from the press coverage, unless you slept through 1979 and 1980, the boy remains unfound. My papers are subpoenaed and I am interviewed as a witness throughout the case. I am hesitant to reveal any of my more outlandish theories, particularly as they are based on no reliable evidence whatsoever and my heartfelt apologies go out to the family for what was to happen next. My reputation would have been shattered if I had shared even an inkling of my most febrile suspicions regarding the boys condition and I would have been struck off for witch-doctoring. And these were fanciful thoughts, and I, am man of science. I did not come to the conclusion that his father had killed him and I did not tip his mother over the edge of teetering chasm of her of sanity. The facts, for the purpose of posterity, were as follows: On 8th September 1979 the boy goes to bed as usual. Upon the mid-point check (his mother checked his bed at 2am each night) he is missing. She searches the household and he is still missing. She awakes his father (at this point) and they search the neighbourhood. The police are called at 4.30am to deal with a disturbance in which Mrs Porter has been hammering on neighbourhood doors and demanding entry to neighbours properties. The boy is reported missing at this point. Mrs Porter- is hysterical. A search continues and the boy is not found. Some weeks later rumours of a murder start to surface. The neighbours sketch in a picture of domestic violence. Teachers report the boy as a withdrawn, bookish child, in keeping with the classic picture of an abuse victim. Shortly thereafter Mr Porter- sits on remand on questionable charges. The academic community rally for Mr Porter- and his release is secured some months later. In January 1980 the family house and crime scene goes up in flames. An accelerant is detected at the scene. In February 1980 Mrs Porter- takes an overdose of barbiturates and is admitted to Accident and Emergency. From here she is admitted into the Psychiatric Care unit and from there Hindmarsh Hospital for a longer period of residence. Mr Porter remains the subject of a hate campaign and leaves the country in October 1980. MI6 keep him under surveillance (The 2005 Governmental data release confirms this fact you may recall the furore of him being granted permission to travel to Germany at the time this was not wasted on the fairly new government who, having failed to bar his release, at least did maintain surveillance). And then the case is closed. But in 1983 it reopens with a seismic shudder!

From Chapter five of Ordering Disorder Dr H H Winkler (Marshall Academic Press, 1998)

1st January 1983 Happy New Year! They take him into custody at Heathrow. Agents bundle him into a car and into Aviation Security before the press catch up. He is aboard an airbus travelling from Egypt when he reveals himself as not the Abdul Ben-Japhari stated on his documentation. Upon landing he is seized by customs and checked against the database. A positive identification is made fairly swiftly. He is taken to the control room to be charged but with what? No one quite knows. He is cautioned for his breaches of customs rules and then a telephone wrangle between customs and the metropolitan police ensues. Unmarked MI5 solve the debate by interceding and he is whisked from the airport into central London. Press by now have got the wind of the story and pursue at speed. A section of the M4 is closed and MI5 officers then complete their journey relatively undisturbed. Newsrooms go haywire. The maelstrom that arrives with the return of the boy sweeps me into it and I am sped across the capital to verify or declaim the craziest story I have ever and will ever hear.

Transcript of Interview between Dr H H Winkler and Subject U-011101 1st January 1983 Interview starts 17:14pm Dr W- How are you? Its amazing to see you again. How are you? Subj I want to see my mother. Dr W-I believe that is being arranged. There have been a few complications. Subj- Such as...? Dr W- Wellyour parents struggled to deal with your disappearance. That is what we are here to discuss today. Subj I am not 8 years old now. I am completely aware of the private lives of my parents. If private is the right word. Nonetheless, I would like to see my mother. Now. Your culpability can be dealt with at another point. Dr W My culpability? Subj (cutting across Dr W) This conversation has finished.

From Chapter five of Ordering Disorder Dr H H Winkler (Marshall Academic Press, 1998) I was stunned to hear that the boy held me responsible for his troubles. I believe that I have already said enough in this book to quell any such unfounded accusations made in the heat of the moment by a 14 year old adolescent. Nonetheless, this young man sitting before me that day held in his mind some of the most amazing discoveries known in the field of the science of sleep.

The story that emerged following consultation was as follows. On 8th September 1979 the boy went to bed as usual. He was not especially tired following a fairly lazy Saturday. In the aftermath of his visit to the hospital for monitoring (three years prior) he had returned to sleeping in his room. An interest in playing football had emerged and he spend most waking hours kicking said ball around his neighbourhood or playing for local childrens teams. He also enjoyed model-making and had converted his bedroom into a miniature war zone of dangling Spitfires and Sopwith Camels. In other words, he had become an ordinary boy. Something happens in August 1979 (I do not know what) and he is brought back downstairs to sleep in the old box room, now his fathers library, on a folding camp bed. In interviews the parents disagree about what the nexus was but it is agreed that it was a rare somnambulistic episode. On the night of 8th September he retires to the library and picks up a book from a box on top of the shelf. He begins to read the Arabian Nights. Peters copy, the first of the books I had sent home with him following his admission three years prior. A book that he was to come to believe had magic powers. In the early hours of the following morning all hell lets loose as his parents search the local area for him. But they neednt have bothered. They should have begun their search in Arabia!

From Phase the First, by Anthony Porter (Stylistics Publishing under license to Her Majestys Information Services, 1992) I went to be reading the Arabian Nights and by morning had arrived there in body Arabia- daytime! This was not the surprise you might think it would be as I have a long history of this. Cruelly misunderstood by all adults, I knew that I would have to make my way home again. This was to take quite a long time I awoke in a sort of tent, literally slumped over some old manuscript. All well and good you might think, until you reflect that I had fallen asleep in my fathers library. More bizarre still to consider that I could barely recall an occasion on which I had ever awoken in the same place that I had first laid my head. The light poured in through the west window blinding me and, with forearm over eyes, I clambered from behind the desk, clicked off the reading light, and set to embark upon a new days confusion. It all started when I was a small child, perhaps around two or three maybe even before. The phasings, as I have come to call them, were subtler in those days and even now I cannot really be sure whether there was something amiss or whether my own grogginess and some fairly strange parenting could account for my shifting. I do, however, recall dozing in the back-seat of the car, then awaking, quite disturbed in the lounge-room on a large pillow. Or bedding down on said pillow to awake in the full beams of the sun in the garden. I even think that I once came to in the shed, door wide open, key-chain still swinging from the lock but this I may have confused with a Saki story that I later read, during my teens. In time I got used to this increasingly strange state of affairs and even refused to believe that nighttime travel was not a pleasant excursion enjoyed by all. As I recall, my parents largely ignored me, allowing me to become quite used to the status quo. Even now, when I awake to the smell of freshly-

baked bread, wherever I may actually find myself, I stir with a joyous feeling of security that all is as it should be. I could awake in a Nazi bakery (if such a monstrosity were to exist) and be happy, I imagine. I began to first realise that things were not as they should be when I contracted winter flu for the first time, when I was six. With clogged pores and aching skull I was instructed to take 48 hours bed-rest by the GP, who also prescribed penicillin. Having no TV or radio in the upstairs of the house, I was packed off with some lemon and ginger tea, a box of tissues and a pile of ancient comics found amongst my fathers belongings for company, while my father set out for his day of work and my mother did whatever it was she did during the daytimes. The next two days seemed to pass in a reverie. I certainly fell asleep in the bed on numerous occasions, but only fitfully did I sleep and I awoke in a multitude of places, like a magician. I thought that I had dreamt of waking in terror in a frozen forest: sprinting barefoot in a shadowy pursuit, then coming-to in a saloon bar , and then finally lazing in an overnight train crossing the wilderness. My time in these places was so short and fitful as to have the feel of something imaginary. I awoke on the third morning rolling gently as if to the rhythm of the train, then suddenly finding myself very shaken. I was back in my bed, where I had intermittently found myself over the previous two days, with my symptoms lifting. I had a violent pain in my big toe (right foot) and when I investigated I saw that its nail had discoloured quite extremely. It was blue-black on the nail and a similar, lighter shade around on the flesh itself. It felt agonising and when I managed to touch it pus oozed out of a crack running down the full length and made me swoon. It throbbed with a severity that was like a burning pin lancing straight into the heart of its swollen mass and the throb shot up through my body like ice in the blood, into my back, my heart, even my eye. I looked at it again and wanted to retch but resisted. I tentatively laid my finger next to the crack and contemplated a second salvo. I gently, oh so gently, edged my finger up to the crack, then onto it, bracing myself for the pain that did come, but in slightly more manageable units for the time being. I pressed again, with only the lightest touch, producing another shudder and another emission. I continued pressing in tiny prods until a conclusion struck me. The out-of-my-body pain contrasted with that which was in my usual frame of reference. And then it dawned on me something was there, under my toenail. The next half hour was spent freeing the foreign object from its resting place, a disgusting and unpleasant task that made me repeatedly have to wipe my fingers on the furthest corner of the bedsheet possible, having run out of tissues at some inconvenient moment in the night, it would seem. When I prized it clear I was still none-the-wiser as to what it was. I cleaned it of its grotesquery and held it to the light (solid, natural) and concluded that it was probably a rather substantial bit of wood sliver gone old and worn and smooth. Possibly a pine needle, I computed with a gasp! I stowed it in my pyjama pocket, mused on how it may have got there, and then abandoned my highdudgeon for the more tangible tales of Long John Silver and Treasure Island. Following this, I had a wonderful afternoon and slept as if bathed in a glorious blanket of warmth all the following night long. Eventually I found myself back at home and, in time, I regained my health and fitness. Life continued as normal, or as abnormally as usual

From Afterword of Ordering Disorder Dr H H Winkler (2nd Edition, Marshall Academic Press, 2006)

Much has been said in the press and on internet forums about the parenting lessons that can be learnt from Porters Syndrome. It seems to be taken as an index on care not too much, not too little and certainly not both of those at the same time! While there are lessons that can be drawn from Her Majestys most famous inmates childhood, it is the condition that yields the most valuable learning, with the sideshow of the rearing process just that. I was of course delighted to have been able to use Anthony for my research and was thrilled to see on the imager that an entire rainbow seemed to flood his cerebral cortex when he dreamt, causing him to literally disappear. It was like a tidal sweep, beginning with a faint red glow on the screen and then enveloping the cortex in a single, glorious passage before ebbing away to nothing: Porters Yawn as it is known in the tabloids - the moment of connection. The first time we saw it we lost the patient into the grounds of the hospital. This was a real problem that needed a solution if our studies were going to get anywhere. Anthony was not an especially willing patient in the early days but then, he was 14. By experimenting with electroshock therapy we were able to halt the yawn and jerk Anthony awake at the moment of connection, thus retaining his presence. This was a troubling experience for all involved as you might imagine and, fortunately, has proved to be a stop-gap solution that we do not use but rather merely keep on stand-by nowadays due to the discovery of the trigge- input for the syndrome. Various laboratories have been incredibly generous in their funding for the research into the syndrome and, no doubt, are interested in any practical applications of Anthonys brain. An American foundation have recently been rejected in their 2 billion bid to buy his post-mortem brain from the British government, when it becomes available. Tens of thousands of unverified copycat cases have sprung up over the world. We wait to see whether other subjects are as data-rich as Anthony has been. Diagnosing Porters Syndrome has been the event of my career and of my life; undoubtedly the most significant medical discovery of our times, but at the moment it seems unique to Anthony. With a carefully selected diet of reading matter the boy really can go anywhere, and I mean anywhere. With that in mind, we have had to place a quarantine on reading matter (the trigger material) around this unit. Nothing allowed in and nothing out, with no exceptions. This humane approach led to the removal of the electroshock management system and has created a much calmer study environment for all concerned (excepting the day when the now infamous Chinese student tried to smuggle contraband in while posing as a nurse that day was not calm at all)! The continuing cordon of intellectuals around the compound remains a sore frustration and a block upon the study, thinking and humanity that they claim to be so committed to. Television has no effect it would seem. Ditto other broadcast media. It is literally (no pun intended) the effect of reading that allows him to phase from one place to the next. Thinking more publically for a second, as a precautionary measure we are introducing brain scanning of infants from 3 months. We are building a huge database of neurology so that we will be able to identify those especially receptive to/in danger from the printed word when we have been able to unpick the labyrinth of Anthonys mind. A split-map of phasings (take-off and landing, as it were)

has been established online and when we get a second hit we will be able to compare brains and try to isolate the gene that allows the phasing to occur. It is then in the hands of the worlds governments to decide what to do with said gene when it is isolated, which has some potentially miraculous applications. My fervent prayer is that the decision is not a fear-driven one, with removal of the gene as the solution. The next phase of human evolution may be upon us. For now we have had to take precautionary measures to control phase activity until such time as we can discover the true size and shape of it. Through some carefully orchestrated work with media outlets and providers it has been possible to produce a general dampening effect on the populace as a whole, intended to limit the opportunities for unwarranted brain stimulation. Anthony has been the first and most significant beneficiary of this, of course. He likes his cell, enjoys his daily television and (as you are doubtless aware) is a keen contributor to social media sites. As a result, he is nicely under control and never goes anywhere anymore.

Russell King 18th February 2013

Das könnte Ihnen auch gefallen