1 00:00:01,080 --> 00:00:04,000 Speaker 1: Welcome to Stuff You Missed in History Class from how 2 00:00:04,080 --> 00:00:12,560 Speaker 1: Stuff Works dot com. Hello, and welcome to the podcast. 3 00:00:12,680 --> 00:00:16,680 Speaker 1: I'm Holly Frying and I'm Tracy D. Wilson. So I 4 00:00:16,720 --> 00:00:20,759 Speaker 1: have always been fascinated with sleep disorders, partially because absolutely 5 00:00:20,800 --> 00:00:23,240 Speaker 1: no one in my family is what you would categorize 6 00:00:23,280 --> 00:00:26,920 Speaker 1: as a regular sleeper. Like, growing up, if you woke 7 00:00:27,000 --> 00:00:28,480 Speaker 1: up at any hour of the day or night, there 8 00:00:28,520 --> 00:00:32,159 Speaker 1: was already someone awake in my house doing something. And 9 00:00:32,200 --> 00:00:34,120 Speaker 1: I grew up with insomnia. I had it for decades 10 00:00:34,120 --> 00:00:36,040 Speaker 1: and decades, and it sort of suddenly went away in 11 00:00:36,040 --> 00:00:38,919 Speaker 1: my mid thirties. And I know that sounds crazy when 12 00:00:38,960 --> 00:00:41,440 Speaker 1: I'm about to say, when I say what I'm about 13 00:00:41,440 --> 00:00:44,599 Speaker 1: to say, but I actually quite miss my insomnia. I think, 14 00:00:44,600 --> 00:00:47,400 Speaker 1: when that's your standard operating mode and then you don't 15 00:00:47,400 --> 00:00:50,680 Speaker 1: have it anymore, it just feels weird. I missed the 16 00:00:50,760 --> 00:00:52,879 Speaker 1: quiet time alone in my head. But today we're not 17 00:00:52,880 --> 00:00:55,480 Speaker 1: going to talk about insomnia, although it is going to 18 00:00:55,560 --> 00:00:59,680 Speaker 1: be mentioned in relation to narcilepsy, which is the topic 19 00:00:59,680 --> 00:01:02,000 Speaker 1: where a really covering and I kind of feel like 20 00:01:02,080 --> 00:01:05,360 Speaker 1: narcolepsy suffers from a similar problem in the public consciousness 21 00:01:05,360 --> 00:01:09,800 Speaker 1: as schizophrenia. UH. While schizoade behavior is often really incorrectly 22 00:01:09,840 --> 00:01:15,600 Speaker 1: conflated with other mental disorders, particularly multiple personality disorder UH 23 00:01:15,920 --> 00:01:20,399 Speaker 1: in film and television and even casual conversation. Narcolepsy is 24 00:01:20,440 --> 00:01:24,160 Speaker 1: often misrepresented in cultural shorthand as being the scenario where 25 00:01:24,160 --> 00:01:27,280 Speaker 1: someone just can't stay awake or is very sleepy. And 26 00:01:27,319 --> 00:01:30,959 Speaker 1: while sleepiness is certainly one of the symptoms of narcilepsy, 27 00:01:31,000 --> 00:01:34,280 Speaker 1: to describe it that way is a pretty serious oversimplification. 28 00:01:34,920 --> 00:01:38,160 Speaker 1: And additionally, sleep medicine has really only come into its 29 00:01:38,160 --> 00:01:40,600 Speaker 1: own in the last three decades or so. There were 30 00:01:40,640 --> 00:01:42,400 Speaker 1: was work being done before that, which is what we're 31 00:01:42,520 --> 00:01:46,880 Speaker 1: primarily going to talk about. But UH, people were experiencing 32 00:01:46,880 --> 00:01:49,840 Speaker 1: these sleep disorders long before they were studied to the 33 00:01:49,880 --> 00:01:52,160 Speaker 1: degree they are now, and so there was this whole 34 00:01:52,200 --> 00:01:55,000 Speaker 1: history of it. And you may remember that we talked 35 00:01:55,000 --> 00:01:57,920 Speaker 1: a little bit about sleepwalking during our Albert Terrell episode 36 00:01:57,920 --> 00:02:00,560 Speaker 1: almost two years ago, and in that one we mostly 37 00:02:00,560 --> 00:02:04,120 Speaker 1: discussed Terrell's lawyer using sleepwalking is a murder trial defense, 38 00:02:04,440 --> 00:02:06,960 Speaker 1: and the science around it was mostly contextual in terms 39 00:02:07,000 --> 00:02:08,680 Speaker 1: of how it did or did not match up with 40 00:02:08,800 --> 00:02:12,360 Speaker 1: Terrell's claims. UH. And in this episode, however, we're going 41 00:02:12,400 --> 00:02:14,600 Speaker 1: to go much deeper into sleep science and talk about 42 00:02:14,600 --> 00:02:17,920 Speaker 1: what narcailepsy is, how it was first identified at least 43 00:02:17,919 --> 00:02:20,720 Speaker 1: in the records we know, and how research continues to 44 00:02:20,760 --> 00:02:24,040 Speaker 1: reveal new information about it all the time. So the 45 00:02:24,120 --> 00:02:26,920 Speaker 1: time traveling science tale it ranges from the sixt right 46 00:02:27,000 --> 00:02:30,639 Speaker 1: up to present day. UH. But first we're going to 47 00:02:30,720 --> 00:02:32,880 Speaker 1: talk about what the disorder really is. And I will 48 00:02:32,880 --> 00:02:34,680 Speaker 1: put the caveat out there out of the gate that 49 00:02:35,320 --> 00:02:37,519 Speaker 1: the sources that we're working from here are pretty much 50 00:02:37,520 --> 00:02:44,160 Speaker 1: covering narcolepsy as it has been addressed and discussed in UH, 51 00:02:44,320 --> 00:02:49,119 Speaker 1: Europe and North America. There have certainly been other recognitions 52 00:02:49,160 --> 00:02:51,200 Speaker 1: of it, but in terms of like clinical papers that 53 00:02:51,240 --> 00:02:54,639 Speaker 1: I could access and read and UH study on it, 54 00:02:55,400 --> 00:02:58,840 Speaker 1: pretty much sticking to these UM. I would really love 55 00:02:58,880 --> 00:03:02,240 Speaker 1: to do a whole other episode or a series at 56 00:03:02,280 --> 00:03:04,400 Speaker 1: some point on sort of how different cultures view sleep 57 00:03:04,440 --> 00:03:06,200 Speaker 1: and sleep disorders, because, as I said, it's one of 58 00:03:06,200 --> 00:03:08,679 Speaker 1: those pet areas of mine. But today we're most sleep 59 00:03:08,720 --> 00:03:10,920 Speaker 1: sticking to kind of the Western approach. UH. And I 60 00:03:10,919 --> 00:03:13,120 Speaker 1: want to give one really quick note and trigger warning, 61 00:03:13,160 --> 00:03:17,720 Speaker 1: and it's really probably UM kind of an over being 62 00:03:17,720 --> 00:03:21,000 Speaker 1: overcautious with this. One of the earliest recorded cases that 63 00:03:21,000 --> 00:03:23,920 Speaker 1: we're going to talk about does involve a patient with 64 00:03:24,000 --> 00:03:27,400 Speaker 1: a history of sexual violence towards children. Uh So, if 65 00:03:27,480 --> 00:03:29,440 Speaker 1: that is an issue that you're sensitive to you or 66 00:03:29,520 --> 00:03:32,120 Speaker 1: one that you are not comfortable having a younger history 67 00:03:32,160 --> 00:03:36,320 Speaker 1: buff here about today. Heads up. It is a really 68 00:03:36,320 --> 00:03:39,200 Speaker 1: brief mention and it falls pretty late in this first 69 00:03:39,240 --> 00:03:42,160 Speaker 1: of two episodes. It's not going to be any sort 70 00:03:42,160 --> 00:03:45,280 Speaker 1: of detailed situation, and we'll give you another quick warning 71 00:03:45,280 --> 00:03:46,960 Speaker 1: as we come up to that point in the history, 72 00:03:46,960 --> 00:03:48,920 Speaker 1: so you can skip past it if you want to. It's, 73 00:03:48,960 --> 00:03:51,120 Speaker 1: like I said, it's pretty brief. So first up, we're 74 00:03:51,120 --> 00:03:54,920 Speaker 1: going to talk about what narcolepsy actually is. So if 75 00:03:54,960 --> 00:03:57,400 Speaker 1: you're not actually familiar with it, it's a brain disorder 76 00:03:57,760 --> 00:04:01,160 Speaker 1: that's characterized by sort of an out of wax sleep 77 00:04:01,280 --> 00:04:04,520 Speaker 1: wake cycle. Somebody with narcolepsy might have moments where they 78 00:04:04,560 --> 00:04:07,080 Speaker 1: do fall asleep in the middle of their normal activities, 79 00:04:08,400 --> 00:04:11,960 Speaker 1: and cataplexy, which I always want to call catalepsy, but 80 00:04:12,000 --> 00:04:15,680 Speaker 1: it is. Cataplexy is a common symptom of narcolepsy, and 81 00:04:15,720 --> 00:04:18,360 Speaker 1: this is actually the most specific symptom of the disorder, 82 00:04:18,440 --> 00:04:21,800 Speaker 1: as it's unusual for cataplexy to exist as a symptom 83 00:04:21,800 --> 00:04:25,720 Speaker 1: outside the presence of narcolepsy, and this involves an involuntary 84 00:04:25,800 --> 00:04:29,720 Speaker 1: and sudden loss of muscle control. Although the person is awake, 85 00:04:29,839 --> 00:04:32,800 Speaker 1: they are unable to move that you'll sometimes see it 86 00:04:32,960 --> 00:04:36,359 Speaker 1: referenced in UH documents as being a loss of muscle 87 00:04:36,440 --> 00:04:41,080 Speaker 1: tone as well. Narcoleptics may experience paralysis on either side 88 00:04:41,080 --> 00:04:44,400 Speaker 1: of the sleep cycle, and sometimes they have really vivid 89 00:04:44,440 --> 00:04:49,880 Speaker 1: hallucinations UH sometimes concurrent with this paralysis. It's not uncommon 90 00:04:49,920 --> 00:04:53,280 Speaker 1: at all for any person to actually experience some level 91 00:04:53,320 --> 00:04:56,880 Speaker 1: of sleep paralysis and really vivid imagery in their dreams. 92 00:04:57,360 --> 00:04:59,440 Speaker 1: It's pretty normal for this to occur during the rem 93 00:04:59,520 --> 00:05:02,359 Speaker 1: cycle of sleep. But whereas someone with a so called 94 00:05:02,440 --> 00:05:05,599 Speaker 1: normal sleep cycle would hit RAM at about ninety minutes 95 00:05:05,640 --> 00:05:10,480 Speaker 1: into sleep, somebody with narcilepsy hits RAM almost immediately when 96 00:05:10,520 --> 00:05:13,560 Speaker 1: they have an episode of sudden sleep. So this rapid 97 00:05:13,680 --> 00:05:17,680 Speaker 1: transition both entering and exiting sleep explains the symptoms of 98 00:05:17,720 --> 00:05:22,680 Speaker 1: hallucinations and paralysis, and it's also not uncommon for the 99 00:05:22,720 --> 00:05:26,960 Speaker 1: average person to experience sleep paralysis in some form when 100 00:05:26,960 --> 00:05:30,440 Speaker 1: they don't transition smoothly from deep sleep to wakefulness or 101 00:05:30,520 --> 00:05:33,599 Speaker 1: vice versa. I'm sure many of our listeners are like, 102 00:05:33,680 --> 00:05:36,400 Speaker 1: I've had that happen. Uh, so have I. But for 103 00:05:36,560 --> 00:05:39,479 Speaker 1: someone with a fairly regular sleep cycle, this really only 104 00:05:39,520 --> 00:05:42,880 Speaker 1: happens occasionally, But for narc eileptics this is a frequent 105 00:05:42,920 --> 00:05:46,120 Speaker 1: and persistent state of affairs. I think I remember one 106 00:05:46,240 --> 00:05:48,039 Speaker 1: time that happening to me in my life, and it 107 00:05:48,120 --> 00:05:52,159 Speaker 1: was scary, really, just the once once that I remember. 108 00:05:52,440 --> 00:05:55,400 Speaker 1: Like I said, I've had insomnia and some sleep issues forever, 109 00:05:55,480 --> 00:05:57,720 Speaker 1: so I have lots of instances of them, and I 110 00:05:57,760 --> 00:06:00,800 Speaker 1: was actually way into my adult years where I realized 111 00:06:00,839 --> 00:06:02,839 Speaker 1: like that I was not a freak like part of 112 00:06:02,839 --> 00:06:04,640 Speaker 1: me thought there was something really mentally wrong with me, 113 00:06:04,680 --> 00:06:06,440 Speaker 1: and I had never really talked to anybody about it 114 00:06:06,680 --> 00:06:08,680 Speaker 1: until one of my friends was talking about her sleep 115 00:06:08,680 --> 00:06:10,520 Speaker 1: paralysis and I was like, wait, other people have this, 116 00:06:12,520 --> 00:06:15,880 Speaker 1: which is shame on me for not doing the research. So, 117 00:06:16,120 --> 00:06:19,960 Speaker 1: despite sometimes dropping off to sleep during the day, narcileptics 118 00:06:20,000 --> 00:06:22,560 Speaker 1: don't usually get any more sleep than the average person 119 00:06:22,600 --> 00:06:24,919 Speaker 1: does in a twenty four hour cycle. And this is 120 00:06:25,000 --> 00:06:27,719 Speaker 1: because even when a person with narcolepsy is in bed 121 00:06:27,880 --> 00:06:30,560 Speaker 1: and able to frequently do the thing that might appear 122 00:06:30,600 --> 00:06:33,040 Speaker 1: to some that their body is constantly trying to do. 123 00:06:33,640 --> 00:06:35,719 Speaker 1: The quality of sleep that they get at that point 124 00:06:35,800 --> 00:06:39,920 Speaker 1: is extremely poor. It's punctuated by frequent periods of wakefulness. 125 00:06:39,960 --> 00:06:42,640 Speaker 1: And it's not uncommon for narcilepsy to be diagnosed in 126 00:06:42,720 --> 00:06:47,000 Speaker 1: tandem with other sleep disorders like sleep paralysis and insomnia. 127 00:06:47,200 --> 00:06:50,520 Speaker 1: I think that was the thing that tripped my really 128 00:06:50,920 --> 00:06:53,200 Speaker 1: trigger the first time I learned about narcolepsi was that 129 00:06:53,240 --> 00:06:57,120 Speaker 1: you could have narcolepsy and insomnia at the same time. Yeah. 130 00:06:57,720 --> 00:07:00,960 Speaker 1: It's also sometimes really difficult for narcolepts to be diagnosed 131 00:07:01,040 --> 00:07:03,720 Speaker 1: at all because most of the symptoms that are associated 132 00:07:03,760 --> 00:07:06,880 Speaker 1: with it can also come from other issues. Yeah. I 133 00:07:06,920 --> 00:07:09,680 Speaker 1: mean that's part of like sort of the tricky business 134 00:07:09,720 --> 00:07:12,280 Speaker 1: of sleep science, right, is that I'm not getting good 135 00:07:12,280 --> 00:07:14,720 Speaker 1: sleep is a common complaint for people with a lot 136 00:07:14,880 --> 00:07:19,720 Speaker 1: of different melodies. Um And you know, because it can 137 00:07:19,800 --> 00:07:22,960 Speaker 1: happen concurrently, like we just said, with insomnia, and in 138 00:07:22,960 --> 00:07:24,920 Speaker 1: this case, it's the type of insomnia where they really 139 00:07:24,960 --> 00:07:28,000 Speaker 1: don't have difficulty falling asleep, but they often wake up 140 00:07:28,040 --> 00:07:33,640 Speaker 1: from sleep quite frequently. Um. But narcilepsy is actually pretty common, 141 00:07:33,680 --> 00:07:37,640 Speaker 1: despite not always being diagnosed. It's estimated that about one 142 00:07:37,680 --> 00:07:42,520 Speaker 1: and three thousand Americans have narcolepsy with cataplexy, and researchers 143 00:07:42,560 --> 00:07:46,080 Speaker 1: believe that many more have non cataplexy narcilepsy. Those two 144 00:07:46,080 --> 00:07:50,760 Speaker 1: are are uh different, They're categorized differently, and these numbers 145 00:07:50,760 --> 00:07:53,840 Speaker 1: are only estimates because, as we said, uh, with many 146 00:07:53,840 --> 00:07:58,600 Speaker 1: sleep disorders, many instances of narcilepsy go undiagnosed. So what 147 00:07:58,680 --> 00:08:00,480 Speaker 1: we do know is that there's a pretty even split 148 00:08:00,520 --> 00:08:03,120 Speaker 1: between men and women. It doesn't seem to present in 149 00:08:03,320 --> 00:08:08,800 Speaker 1: any um particular racial population or culture any more than another. 150 00:08:09,600 --> 00:08:13,000 Speaker 1: It's it's pretty fair in how it distributes, and it 151 00:08:13,120 --> 00:08:17,040 Speaker 1: usually presents sometime in adolescence or early adulthood, although there 152 00:08:17,080 --> 00:08:20,080 Speaker 1: are certainly cases of it happening in children and in 153 00:08:20,400 --> 00:08:25,040 Speaker 1: people that are way past their early adulthood. Usually, cataplexy 154 00:08:25,160 --> 00:08:27,320 Speaker 1: is the first symptom to present in about ten p 155 00:08:27,680 --> 00:08:31,480 Speaker 1: of cases, and it's sometimes misdiagnosed as a caesuar disorder. 156 00:08:32,040 --> 00:08:34,839 Speaker 1: For a lot more people, Excessive daytime sleepiness or e 157 00:08:34,920 --> 00:08:37,400 Speaker 1: d S is the first symptom, and because many people 158 00:08:37,440 --> 00:08:39,920 Speaker 1: are leading busy lives and cutting back on sleep to 159 00:08:39,920 --> 00:08:42,440 Speaker 1: accommodate their to do list. It's really easy to chalk 160 00:08:42,520 --> 00:08:44,640 Speaker 1: up e d s to just getting too little sleep, 161 00:08:45,480 --> 00:08:48,480 Speaker 1: but it eventually can manifest into micro sleeps. So there's 162 00:08:48,480 --> 00:08:51,560 Speaker 1: our brief periods of very sudden sleep, sometimes only lasting 163 00:08:51,600 --> 00:08:53,640 Speaker 1: for a few seconds, during which the body just sort 164 00:08:53,679 --> 00:08:57,520 Speaker 1: of goes into an autopilot mode. During micro micro sleep, 165 00:08:57,559 --> 00:09:00,320 Speaker 1: a person might continue to perform the activity that he 166 00:09:00,400 --> 00:09:03,120 Speaker 1: or she was engaged in when the sleep episode hit, 167 00:09:03,640 --> 00:09:05,560 Speaker 1: but they're not usually aware of it and then have 168 00:09:05,640 --> 00:09:09,600 Speaker 1: no recollection of it later. Yeah, and it's you know, 169 00:09:09,840 --> 00:09:11,920 Speaker 1: sort of scary to think about because if you're driving 170 00:09:11,960 --> 00:09:14,720 Speaker 1: a car, you could have a microsleep and you'll keep 171 00:09:14,800 --> 00:09:18,480 Speaker 1: driving that car, but you won't be consciously aware of it. Uh. 172 00:09:18,640 --> 00:09:21,160 Speaker 1: A lot of times people pass through that cataplexy stage 173 00:09:21,200 --> 00:09:25,240 Speaker 1: where they are still aware before they doze off, but 174 00:09:25,320 --> 00:09:27,280 Speaker 1: they can't do anything and then they're just in sleep 175 00:09:27,280 --> 00:09:31,560 Speaker 1: really quickly. Uh. So there's some terrifying stuff to be 176 00:09:31,600 --> 00:09:34,760 Speaker 1: had around it. Um. You know, for some people, there 177 00:09:34,760 --> 00:09:38,200 Speaker 1: there are clinicians that will talk about their patients writing 178 00:09:38,240 --> 00:09:40,560 Speaker 1: notes and they doze off and they keep writing their note. 179 00:09:40,600 --> 00:09:42,760 Speaker 1: But of course it becomes scribbling scrawl, and it makes 180 00:09:42,800 --> 00:09:45,520 Speaker 1: no sense. But their their body is still doing the movements, 181 00:09:45,520 --> 00:09:48,480 Speaker 1: and it's still doing what it thinks is penmanship of 182 00:09:48,559 --> 00:09:51,880 Speaker 1: some sort. But it's just nonsense. Uh. Before we get 183 00:09:51,920 --> 00:09:54,880 Speaker 1: to the first appearance on record that we have, do 184 00:09:54,920 --> 00:09:56,600 Speaker 1: you want to have a quick word from a sponsor, 185 00:09:56,880 --> 00:09:59,880 Speaker 1: Let's do that. So while narcolepsy and other sleep just 186 00:10:00,080 --> 00:10:03,640 Speaker 1: orders undoubtedly existed for some time before any record of 187 00:10:03,679 --> 00:10:06,520 Speaker 1: them was set down, the first mention of a narcolepsy 188 00:10:06,640 --> 00:10:09,440 Speaker 1: or an ecilepsy like situation that we know of is 189 00:10:09,440 --> 00:10:13,319 Speaker 1: attributed to Dr Thomas Willis, and Willis, who was born 190 00:10:13,320 --> 00:10:15,920 Speaker 1: in sixty one, is often referred to as the father 191 00:10:16,000 --> 00:10:19,560 Speaker 1: of neuroscience. UH. He's most famous for his publication of 192 00:10:19,600 --> 00:10:24,359 Speaker 1: Cerebri Anatomy Brain anatomy text that described the nervous system 193 00:10:24,400 --> 00:10:27,000 Speaker 1: in a much more thorough and advanced way than any 194 00:10:27,000 --> 00:10:30,080 Speaker 1: writing that had preceded it. And he really promoted the 195 00:10:30,120 --> 00:10:34,000 Speaker 1: idea of taking a very methodical approach to brain analysis. 196 00:10:34,120 --> 00:10:37,320 Speaker 1: And he actually suggested that some flawed techniques on the 197 00:10:37,360 --> 00:10:42,440 Speaker 1: part of previous researchers had led to some incorrect conclusions 198 00:10:42,440 --> 00:10:46,480 Speaker 1: regarding anatomy and specifically that of the brain and nervous system. 199 00:10:46,600 --> 00:10:49,520 Speaker 1: While Willis didn't call the sleep condition, but he witnessed 200 00:10:49,640 --> 00:10:54,719 Speaker 1: narcilepsy in his sixteen seventy two writing the Anima Rotorum, 201 00:10:54,760 --> 00:10:58,040 Speaker 1: he described people who were likely to experience it this way, 202 00:10:58,480 --> 00:11:02,000 Speaker 1: a sleepy disposition. Eat and drink well, go abroad, take 203 00:11:02,040 --> 00:11:05,400 Speaker 1: care well enough of their domestic affairs. Yet whilst talking 204 00:11:05,520 --> 00:11:08,680 Speaker 1: or walking or eating, yea their mouth, their mouths being 205 00:11:08,720 --> 00:11:11,600 Speaker 1: full of meat, they shall nod, and, unless roused by others, 206 00:11:11,720 --> 00:11:16,040 Speaker 1: fall fast asleep. And what's interesting is that Willis suggested 207 00:11:16,080 --> 00:11:19,080 Speaker 1: in his notes again writing in sixteen seventy two, that 208 00:11:19,160 --> 00:11:22,319 Speaker 1: caffeine might be a suitable treatment for this, and in fact, 209 00:11:22,400 --> 00:11:25,600 Speaker 1: caffeine and other stimulants have been used in ourcilepsy treatment 210 00:11:25,679 --> 00:11:29,640 Speaker 1: throughout clinical history. Then we have a gap before we 211 00:11:29,679 --> 00:11:31,839 Speaker 1: see much more mention of this in the historical record, 212 00:11:31,840 --> 00:11:35,199 Speaker 1: and it's a pretty large gap. Yeah, there are some 213 00:11:35,400 --> 00:11:38,640 Speaker 1: mentions of narcalyptic type cases in the writings of several 214 00:11:38,679 --> 00:11:42,679 Speaker 1: doctors between the Willis description and the late eighteen hundreds 215 00:11:42,720 --> 00:11:45,640 Speaker 1: when a ecilepsy study re emerges with more information, but 216 00:11:45,679 --> 00:11:47,559 Speaker 1: there aren't a lot. And even so it's into the 217 00:11:47,600 --> 00:11:50,680 Speaker 1: eighteen hundreds before we really see them again. In eighteen 218 00:11:50,720 --> 00:11:54,280 Speaker 1: twenty nine, Heinrich Bruno Schindler included a description of what 219 00:11:54,400 --> 00:11:58,720 Speaker 1: sounds like an oarcilepsy and his publication Idiopathic Chronic Somnolence. 220 00:11:59,200 --> 00:12:02,880 Speaker 1: Let's book contains twenty different sleep disorder cases and begins 221 00:12:02,920 --> 00:12:06,400 Speaker 1: with one that was observed by doctor Johann Peter Frank, 222 00:12:06,440 --> 00:12:09,120 Speaker 1: who was a prominent physician working in the late seventeen 223 00:12:09,160 --> 00:12:13,120 Speaker 1: hundreds and early eighteen hundreds, and the case is laid 224 00:12:13,160 --> 00:12:16,840 Speaker 1: out as follows. Peter Frank mentioned a chief huntsman in 225 00:12:16,880 --> 00:12:20,480 Speaker 1: the Upland who had suffered from somnolence throughout eighty years 226 00:12:20,520 --> 00:12:24,280 Speaker 1: his whole life. He could not withstand the irresistible sleepiness 227 00:12:24,320 --> 00:12:26,960 Speaker 1: and fell asleep, even at table with the Prince, where 228 00:12:26,960 --> 00:12:29,640 Speaker 1: he poured too much more too much into the wineglass 229 00:12:29,679 --> 00:12:32,920 Speaker 1: while sleepy and stained the tablecloth. The son of the 230 00:12:32,920 --> 00:12:35,640 Speaker 1: man was also afflicted with the same somnolence at the 231 00:12:35,679 --> 00:12:39,520 Speaker 1: age of forty years. An eighteen thirty six account by 232 00:12:39,600 --> 00:12:42,160 Speaker 1: Dr Richard Bright, who's known to many as the father 233 00:12:42,200 --> 00:12:46,600 Speaker 1: of nephrology, also noted a seeming oarcalyptic condition and a 234 00:12:46,640 --> 00:12:51,200 Speaker 1: patient and then Irish surgeon Robert James Graves mentioned in 235 00:12:51,200 --> 00:12:55,000 Speaker 1: our Ecalyptic Case in his eighteen fifty one writing Observations 236 00:12:55,080 --> 00:12:59,520 Speaker 1: on the Nature and Treatment of Various Diseases. Pathologic sleepiness 237 00:12:59,600 --> 00:13:01,920 Speaker 1: is also been mentioned in the writing of French doctor 238 00:13:02,040 --> 00:13:05,440 Speaker 1: Mr Calf in eighteen sixty two when he detailed a 239 00:13:05,600 --> 00:13:10,240 Speaker 1: very sleepy patient, but notes made by doctor John Baptiste 240 00:13:10,320 --> 00:13:12,920 Speaker 1: Edward Jellanu who will talk about it just a bit, 241 00:13:13,600 --> 00:13:17,240 Speaker 1: suggest that Calf's patients may have actually been dealing with 242 00:13:17,280 --> 00:13:22,280 Speaker 1: an obstructive sleep afia rather than narc eclepsy. Yeah. Calf's 243 00:13:22,360 --> 00:13:24,839 Speaker 1: case involved a man who was forty seven years old, 244 00:13:24,960 --> 00:13:27,480 Speaker 1: and this man had to resign from his job because 245 00:13:27,559 --> 00:13:30,240 Speaker 1: his sleep urge was so great that he just could 246 00:13:30,280 --> 00:13:33,600 Speaker 1: not do his duties effectively. And the patient was described 247 00:13:33,640 --> 00:13:39,920 Speaker 1: with quote attitude detached, stupor mental sluggishness, persistent stoutness effect 248 00:13:39,920 --> 00:13:43,920 Speaker 1: on overall health as well as being puffy. And there's 249 00:13:43,960 --> 00:13:47,079 Speaker 1: no mention of cataplexy or sleep paralysis in this description, 250 00:13:47,679 --> 00:13:50,920 Speaker 1: and modern researchers believed that in this case the patient 251 00:13:51,040 --> 00:13:54,960 Speaker 1: probably was obese, as indicated by the description of his stoutness, 252 00:13:55,720 --> 00:13:58,200 Speaker 1: and as no treatment save a stay at a SPA 253 00:13:58,400 --> 00:14:01,840 Speaker 1: offered the man any relief. There's been some speculation in 254 00:14:01,880 --> 00:14:04,520 Speaker 1: the sleep research community that he may have lost weight 255 00:14:04,559 --> 00:14:07,840 Speaker 1: while he was the SPA, which can sometimes help those 256 00:14:07,880 --> 00:14:11,559 Speaker 1: who have obstructive sleep apnea, so it may or may 257 00:14:11,559 --> 00:14:15,679 Speaker 1: not qualify as an earcailepsy case. Calf's patient later had 258 00:14:15,679 --> 00:14:18,800 Speaker 1: a traumatic experience and the research that Holly found didn't 259 00:14:18,840 --> 00:14:22,080 Speaker 1: offer a clear indication of exactly what it was. Then 260 00:14:22,080 --> 00:14:24,960 Speaker 1: he fell into a state of sexual addiction and alcoholism 261 00:14:25,000 --> 00:14:28,240 Speaker 1: and he was treated for this by another doctor. Yeah, 262 00:14:28,320 --> 00:14:30,440 Speaker 1: and then he kind of disappears from the record in 263 00:14:30,560 --> 00:14:32,960 Speaker 1: terms of what what happened to him. And we're gonna 264 00:14:33,040 --> 00:14:35,960 Speaker 1: kind of jump into another word from a sponsor kind 265 00:14:36,000 --> 00:14:38,000 Speaker 1: of quickly, but that's because the next chunk is all 266 00:14:38,080 --> 00:14:40,080 Speaker 1: kind of juicy, and it's the research of one man, 267 00:14:40,160 --> 00:14:42,120 Speaker 1: and I want to keep it all together. So we 268 00:14:42,160 --> 00:14:43,800 Speaker 1: are going to have that word from a sponsor of 269 00:14:43,880 --> 00:14:48,920 Speaker 1: Tracy's down with that, Let's do it. So, uh, next 270 00:14:48,960 --> 00:14:53,320 Speaker 1: we get to one of the gentleman who's really kind 271 00:14:53,320 --> 00:14:58,360 Speaker 1: of uh masthead of this whole sleep disorder movement, in 272 00:14:58,400 --> 00:15:02,200 Speaker 1: particularly narcolepsy, and that's Earl Friedrich Otto Westfall, and he 273 00:15:02,240 --> 00:15:04,480 Speaker 1: was a German physician. He was born in eighteen thirty 274 00:15:04,520 --> 00:15:09,200 Speaker 1: three in Berlin, and he followed his father in terms 275 00:15:09,280 --> 00:15:12,280 Speaker 1: of his career choice when he went to medicine. His 276 00:15:12,400 --> 00:15:15,160 Speaker 1: father was also a doctor, and Westfall studied medicine in 277 00:15:15,200 --> 00:15:19,200 Speaker 1: schools throughout Europe. He eventually joined the Berlin Charite Hospital 278 00:15:19,720 --> 00:15:22,640 Speaker 1: as a member of the smallpox team there, and a 279 00:15:22,720 --> 00:15:25,320 Speaker 1: year later he actually made the switch from the smallpox 280 00:15:26,080 --> 00:15:29,240 Speaker 1: ward to working with mentally ill patients, and he eventually 281 00:15:29,280 --> 00:15:33,720 Speaker 1: became a professor of psychiatry in eighteen seventy four. Westpall 282 00:15:33,840 --> 00:15:36,520 Speaker 1: is often cited for his work in agoraphobia, which he 283 00:15:36,560 --> 00:15:40,200 Speaker 1: wrote about just extensively starting in eighteen seventy one. This 284 00:15:40,280 --> 00:15:43,240 Speaker 1: is more than a century before agoraphobia would end up 285 00:15:43,240 --> 00:15:46,560 Speaker 1: in the Diagnostic and Statistical Manual of Mental Disorders, which 286 00:15:46,560 --> 00:15:50,040 Speaker 1: is the thing that's often used to sort of categorize 287 00:15:50,480 --> 00:15:54,560 Speaker 1: different uh disorders. Yeah, you'll sometimes see those headlines of 288 00:15:54,600 --> 00:15:56,520 Speaker 1: like this was added to the d s M, or 289 00:15:56,560 --> 00:15:58,040 Speaker 1: this was taken out of the d s M, and 290 00:15:58,080 --> 00:16:01,680 Speaker 1: that's that's where we're talking about. Uh. Westphall was also 291 00:16:01,720 --> 00:16:04,880 Speaker 1: one of the first doctors to study homosexuality, but that 292 00:16:05,040 --> 00:16:07,080 Speaker 1: term had not even been coined when he was doing 293 00:16:07,160 --> 00:16:10,520 Speaker 1: his work, and he instead called same sex attraction quote 294 00:16:10,800 --> 00:16:14,840 Speaker 1: the contrary sexual feeling, and that was indicating his assessment 295 00:16:14,880 --> 00:16:17,320 Speaker 1: of it as a contradiction between the mind's desire and 296 00:16:17,320 --> 00:16:19,960 Speaker 1: the body's anatomy, and he felt that as such it 297 00:16:20,000 --> 00:16:21,720 Speaker 1: was a condition which should be cared for from a 298 00:16:21,760 --> 00:16:25,680 Speaker 1: psychiatric standpoint rather than being dealt with through the legal 299 00:16:25,680 --> 00:16:30,680 Speaker 1: system as a crime. In eighteen seventy seven, Westpall presented 300 00:16:30,680 --> 00:16:34,200 Speaker 1: two different cases before the attendees of the Berlin Medical 301 00:16:34,280 --> 00:16:37,720 Speaker 1: and Psychological Society meeting, and the first was about epilepsy. 302 00:16:38,280 --> 00:16:42,960 Speaker 1: The second focused on a patient with cataplexy and his patient, 303 00:16:43,040 --> 00:16:47,040 Speaker 1: who was a bookbinder named Alert, had experienced two different 304 00:16:47,040 --> 00:16:50,760 Speaker 1: phenomena which Westpall discussed at length. First, he did not 305 00:16:50,840 --> 00:16:54,240 Speaker 1: lose consciousness during these incidents of the loss of muscle control, 306 00:16:54,360 --> 00:16:57,680 Speaker 1: so that's in line with what we've describe as catoplexy today. 307 00:16:58,040 --> 00:17:02,840 Speaker 1: And second, this patient had persistent insomnia. So these uh, 308 00:17:02,880 --> 00:17:04,720 Speaker 1: that was you've just listened to our first part where 309 00:17:04,760 --> 00:17:07,920 Speaker 1: we kind of broke down what insomnia is. These are 310 00:17:07,920 --> 00:17:12,040 Speaker 1: two very common elements of narcolepsi diagnoses. Taylor was first 311 00:17:12,080 --> 00:17:16,520 Speaker 1: admitted to the Berlin Charity Hospital on July seventy one. 312 00:17:16,920 --> 00:17:20,240 Speaker 1: The Bookbinder claimed that several months before he was admitted, 313 00:17:20,280 --> 00:17:22,919 Speaker 1: he had a fit of anger, which caused him to 314 00:17:23,000 --> 00:17:26,080 Speaker 1: become ill. He lost his job after a fight with 315 00:17:26,119 --> 00:17:29,200 Speaker 1: a coworker, then got out for drinks, and then went home, 316 00:17:29,240 --> 00:17:32,000 Speaker 1: where his wife yelled at him. At that point, he 317 00:17:32,040 --> 00:17:35,440 Speaker 1: had a short episode of sixty to nineties seconds during 318 00:17:35,440 --> 00:17:38,280 Speaker 1: which he couldn't speak, trembled, and had to sit down. 319 00:17:39,760 --> 00:17:43,360 Speaker 1: And though he remained somewhat agitated throughout that evening, Alert 320 00:17:43,400 --> 00:17:46,800 Speaker 1: reported that he slept well that night, but after this incident, 321 00:17:46,960 --> 00:17:51,040 Speaker 1: even slight stimulation would cause another so called fit uh. 322 00:17:51,119 --> 00:17:53,760 Speaker 1: The degree of muscle weakness that he would be struck 323 00:17:53,800 --> 00:17:58,320 Speaker 1: with when these moments overtook him grew in severity as 324 00:17:58,359 --> 00:18:02,600 Speaker 1: the attacks continued. Westpall was the first position to explore 325 00:18:02,600 --> 00:18:06,600 Speaker 1: an ourcilepsy with the common accompanying cataplexy, and he also 326 00:18:06,640 --> 00:18:09,520 Speaker 1: examined the possibility of some kind of genetic factor in 327 00:18:09,600 --> 00:18:13,679 Speaker 1: cataplectic patients that it could be inherited. The mother of 328 00:18:13,720 --> 00:18:15,840 Speaker 1: his patient in this case had a history of it. 329 00:18:15,920 --> 00:18:19,280 Speaker 1: Throughout her life. Although hers had decreased in its severity 330 00:18:19,280 --> 00:18:22,960 Speaker 1: as she got older, her symptoms didn't start to happen 331 00:18:23,040 --> 00:18:25,320 Speaker 1: until she had an accident in which she was struck 332 00:18:25,320 --> 00:18:30,640 Speaker 1: by a brick. However, and the patient in west Fall's case, 333 00:18:30,640 --> 00:18:35,360 Speaker 1: while he primarily talks about cataplexy, also had sleep attacks, 334 00:18:35,440 --> 00:18:37,760 Speaker 1: and these would happen Westall seemed to think as a 335 00:18:37,840 --> 00:18:42,520 Speaker 1: result of the cataplexy, So these events would sometimes happen 336 00:18:42,680 --> 00:18:46,480 Speaker 1: when the patient was quote strolling around quietly and aimlessly. 337 00:18:47,320 --> 00:18:51,800 Speaker 1: Here's how Westpall describes Alert's episodes. I've had the opportunity 338 00:18:51,800 --> 00:18:55,120 Speaker 1: to observe the attacks and the patient himself on repeated occasions. 339 00:18:55,720 --> 00:18:57,600 Speaker 1: He had one of these attacks while I was engaged 340 00:18:57,600 --> 00:19:00,840 Speaker 1: in conversation with him. While he was still speaking, one 341 00:19:00,880 --> 00:19:03,280 Speaker 1: could see that a certain change had occurred in his face. 342 00:19:03,480 --> 00:19:06,720 Speaker 1: Facial coloration is up, where eyelids lowered gradually, like those 343 00:19:06,760 --> 00:19:09,800 Speaker 1: of a person falling asleep, during which the eyes roll upward. 344 00:19:10,680 --> 00:19:13,960 Speaker 1: Then they opened again once or twice, seemingly with great effort, 345 00:19:14,040 --> 00:19:18,120 Speaker 1: until they finally shut completely, whereupon the patient stopped speaking 346 00:19:18,160 --> 00:19:21,960 Speaker 1: after murmuring something incomprehensible, his head sank down to his 347 00:19:22,080 --> 00:19:26,640 Speaker 1: chest and his brow seemed forcefully knit. Small sporadic nostril 348 00:19:26,680 --> 00:19:29,800 Speaker 1: contractions were observable, and the patient's appearance was that of 349 00:19:29,840 --> 00:19:33,840 Speaker 1: a seated person asleep. After a short time, several minutes, 350 00:19:34,160 --> 00:19:37,080 Speaker 1: the eyebrows relaxed, the patient raised his right arm a 351 00:19:37,080 --> 00:19:40,080 Speaker 1: few times, he's stretching upward, and rubbed his eyes sleepily, 352 00:19:40,160 --> 00:19:43,920 Speaker 1: like one awaking from slumber. The scene then repeated itself 353 00:19:43,960 --> 00:19:47,080 Speaker 1: all over again, during which one could observe that, though 354 00:19:47,119 --> 00:19:51,000 Speaker 1: apparently asleep, the patient hears is what if one addresses him, 355 00:19:51,119 --> 00:19:55,199 Speaker 1: Since he nods in response to questions directed to him afterwards, 356 00:19:55,280 --> 00:19:59,360 Speaker 1: he also knows everything that was said during the time. Yeah, 357 00:19:59,400 --> 00:20:01,639 Speaker 1: and that's a little it different in that our modern 358 00:20:01,680 --> 00:20:04,600 Speaker 1: research suggests that like people, right up to the point 359 00:20:04,640 --> 00:20:07,600 Speaker 1: where they hit microsleep, they may have consciousness, but there 360 00:20:07,680 --> 00:20:10,720 Speaker 1: is this gap in their recollection of what happens during 361 00:20:10,720 --> 00:20:13,639 Speaker 1: these micro sleeps. So that's just a little different thing 362 00:20:13,640 --> 00:20:16,520 Speaker 1: that I wanted to point out. Ailor's condition also caused 363 00:20:16,600 --> 00:20:18,840 Speaker 1: him a little bit of trouble on occasion. There was 364 00:20:18,880 --> 00:20:21,280 Speaker 1: one point where he was mistaken for being drunk while 365 00:20:21,280 --> 00:20:23,919 Speaker 1: he was working as a porter and a policeman was called, 366 00:20:24,440 --> 00:20:27,240 Speaker 1: and when he recovered from his attack, he of course 367 00:20:27,280 --> 00:20:31,320 Speaker 1: became his normal self. He was completely uh cogent and aware, 368 00:20:31,359 --> 00:20:33,720 Speaker 1: and he was able to explain that no, no, in fact, 369 00:20:33,720 --> 00:20:38,520 Speaker 1: he had a medical condition. When Ailert had an attack, 370 00:20:38,640 --> 00:20:41,919 Speaker 1: his eyes closed in voluntarily. They could only be opened 371 00:20:41,960 --> 00:20:44,439 Speaker 1: with great effort if he was able to do so. 372 00:20:44,520 --> 00:20:47,840 Speaker 1: He only saw bright light. He also reported not feeling 373 00:20:47,880 --> 00:20:50,639 Speaker 1: tired before these attacks and described the pre event mental 374 00:20:50,720 --> 00:20:54,960 Speaker 1: state as his mind being empty or wandering completely. No 375 00:20:55,200 --> 00:20:59,720 Speaker 1: dizziness accompanied them. So remember west Ball is describing cataplexy 376 00:20:59,760 --> 00:21:01,680 Speaker 1: at this point, and then he goes on to say 377 00:21:01,680 --> 00:21:04,960 Speaker 1: that alert instances of sleep are an extension of the 378 00:21:05,040 --> 00:21:09,160 Speaker 1: muscular condition. And while Westpall did not use the terms 379 00:21:09,200 --> 00:21:12,240 Speaker 1: catoplexy or an ecilepsy in his presentation or in the 380 00:21:12,359 --> 00:21:15,720 Speaker 1: related writings that he worked on afterwards, he was clearly 381 00:21:15,760 --> 00:21:19,120 Speaker 1: describing the same symptoms. And as we said, his work 382 00:21:19,160 --> 00:21:21,760 Speaker 1: also focused so much more on the cataplexy than the 383 00:21:21,840 --> 00:21:25,200 Speaker 1: narcileptic sleep attacks. So while he was clearly onto the disorder, 384 00:21:25,680 --> 00:21:28,679 Speaker 1: he didn't identify it as one unique condition unto itself 385 00:21:28,760 --> 00:21:31,600 Speaker 1: quite yet. As for the lack of a name for 386 00:21:31,680 --> 00:21:34,480 Speaker 1: what he had witnessed in his patient alert, Westpall wrote, 387 00:21:34,960 --> 00:21:37,720 Speaker 1: one is faced with a predicament in attempting to attribute 388 00:21:37,760 --> 00:21:40,680 Speaker 1: a name to the illness described above. It would be 389 00:21:40,720 --> 00:21:44,320 Speaker 1: a simple matter to call these episodes epileptoid attacks as well, 390 00:21:44,359 --> 00:21:46,520 Speaker 1: and I cannot object to the term if one wishes 391 00:21:46,560 --> 00:21:50,760 Speaker 1: to lengthen the list of very varied conditions commonly called 392 00:21:50,760 --> 00:21:54,320 Speaker 1: by that name. This does not advance our understanding it all, however, 393 00:21:54,680 --> 00:21:57,080 Speaker 1: and the peculiarity of the attacks to which I need 394 00:21:57,119 --> 00:22:00,439 Speaker 1: not add any further detail given the exhaustive description and above, 395 00:22:00,880 --> 00:22:07,000 Speaker 1: persists nonetheless. And then, almost as a footnote, Westfall mentions 396 00:22:07,040 --> 00:22:09,800 Speaker 1: another case he consulted on several years earlier, and it 397 00:22:09,840 --> 00:22:11,520 Speaker 1: really is like a footnote. He goes on and on 398 00:22:11,560 --> 00:22:13,800 Speaker 1: and on about Tailor, and then it's like two paragraphs 399 00:22:13,800 --> 00:22:16,320 Speaker 1: on this one. And this is our trigger warning section. 400 00:22:16,680 --> 00:22:18,119 Speaker 1: This is the case that we mentioned at the top 401 00:22:18,160 --> 00:22:21,159 Speaker 1: of the episode that involves some unsettling content. We're not 402 00:22:21,200 --> 00:22:23,320 Speaker 1: going into any details, and it will take us less 403 00:22:23,320 --> 00:22:24,840 Speaker 1: than a minute to talk about it. So if you 404 00:22:24,840 --> 00:22:28,480 Speaker 1: want to hop ahead, now is the time. So several 405 00:22:28,560 --> 00:22:31,480 Speaker 1: years prior to his work with Ailort, Westball had been 406 00:22:31,480 --> 00:22:34,080 Speaker 1: asked to collaborate in determining the mental state of a 407 00:22:34,200 --> 00:22:38,720 Speaker 1: recently arrested criminal. The man who was named von Zastrow 408 00:22:38,880 --> 00:22:42,440 Speaker 1: had raped and attempted to murder a young boy. Westwall 409 00:22:42,520 --> 00:22:45,160 Speaker 1: had expected, based on the information that he had been given, 410 00:22:45,320 --> 00:22:49,919 Speaker 1: to find that von Sastrow had epilepsy. None was indicated, 411 00:22:49,960 --> 00:22:52,320 Speaker 1: but the prisoner did relay that he would often fall 412 00:22:52,320 --> 00:22:54,960 Speaker 1: asleep in social situation, so that he had been mocked 413 00:22:55,000 --> 00:22:59,520 Speaker 1: for doing so. Von Zastrows suspected that this constant drowsiness 414 00:22:59,640 --> 00:23:03,440 Speaker 1: might be the result of his addiction to masturbation. Yeah, 415 00:23:03,480 --> 00:23:07,440 Speaker 1: this caused some confusion, uh, you know about sort of 416 00:23:07,640 --> 00:23:11,720 Speaker 1: being associated with uh, sexual deviance or something like that. 417 00:23:11,920 --> 00:23:15,080 Speaker 1: But Westfall concludes his paper by talking about this tale, 418 00:23:15,320 --> 00:23:17,160 Speaker 1: and he says that he was reminded of this case 419 00:23:17,160 --> 00:23:21,000 Speaker 1: while working on the instance of you know, putting together 420 00:23:21,040 --> 00:23:23,760 Speaker 1: his notes to relay alert's condition, and he writes, quote, 421 00:23:24,040 --> 00:23:27,479 Speaker 1: one cannot deny that if additional observation should uncover a 422 00:23:27,480 --> 00:23:30,800 Speaker 1: fairly common occurrence of such sleep attacks, then we are 423 00:23:30,840 --> 00:23:35,000 Speaker 1: in the presence of a pathological manifestation of the nervous system, which, 424 00:23:35,080 --> 00:23:38,000 Speaker 1: in the exploration of the mental condition of certain categories 425 00:23:38,000 --> 00:23:42,680 Speaker 1: of criminals deserves no less consideration than epileptic or epileptoid attacks. 426 00:23:43,160 --> 00:23:45,680 Speaker 1: It is evident that for the time being, nothing less 427 00:23:45,680 --> 00:23:48,520 Speaker 1: than a disease of the central nervous system can be concluded, 428 00:23:48,880 --> 00:23:51,440 Speaker 1: and that the question of responsibility in and of itself 429 00:23:51,520 --> 00:23:56,600 Speaker 1: is not involved. So at this point, the medical community 430 00:23:56,680 --> 00:23:59,320 Speaker 1: is really on the cusp of recognizing narcolepsy as an 431 00:23:59,359 --> 00:24:02,320 Speaker 1: actual met cold condition, and that is where we're going 432 00:24:02,400 --> 00:24:05,639 Speaker 1: to stop. Yeah, so we can get to part two, 433 00:24:05,680 --> 00:24:10,280 Speaker 1: which is where the next big, uh huge part of 434 00:24:11,119 --> 00:24:15,320 Speaker 1: identification and research comes in. Uh So hopefully you will not. 435 00:24:15,440 --> 00:24:17,640 Speaker 1: I had to chuckle to myself as I was doing 436 00:24:17,680 --> 00:24:19,280 Speaker 1: some of this research because I was thinking, I hope 437 00:24:19,280 --> 00:24:21,119 Speaker 1: none of our listeners start hearing these symptoms and go, 438 00:24:21,160 --> 00:24:24,520 Speaker 1: maybe I have not gilepsy the way that first year 439 00:24:24,520 --> 00:24:28,320 Speaker 1: med students always do. I'm more when uh at the start, 440 00:24:28,320 --> 00:24:29,919 Speaker 1: when we were talking about symptoms, I was like, this 441 00:24:29,960 --> 00:24:32,280 Speaker 1: sounds a lot like sleep sleep apnia, And then we 442 00:24:32,320 --> 00:24:33,879 Speaker 1: got to the part where we talked about sleep apnia 443 00:24:33,880 --> 00:24:36,520 Speaker 1: and I was like, yeah, yeah, that's like we said, 444 00:24:36,560 --> 00:24:40,280 Speaker 1: there are so many commonalities amongst different sleep disorders that 445 00:24:40,720 --> 00:24:43,520 Speaker 1: it really does cost some trickiness in terms of identifying 446 00:24:43,560 --> 00:24:46,679 Speaker 1: some of them. Particularly at this point in time, and 447 00:24:46,760 --> 00:24:49,040 Speaker 1: even up until like the mid twentieth century when they 448 00:24:49,040 --> 00:24:55,000 Speaker 1: were really developing identifying test procedures, it was easy for 449 00:24:55,040 --> 00:24:57,320 Speaker 1: people to kind of get written off or misdiagnosed. And 450 00:24:57,640 --> 00:25:00,960 Speaker 1: we'll talk about that some more in episode two. Now 451 00:25:01,000 --> 00:25:05,840 Speaker 1: I have listener mail. Uh, this is a correction on 452 00:25:05,880 --> 00:25:08,359 Speaker 1: our Gouty episode. We got a couple of these, and 453 00:25:08,400 --> 00:25:11,160 Speaker 1: I will talk about it a little bit, uh, and 454 00:25:11,320 --> 00:25:14,159 Speaker 1: I will laugh at myself. So, uh, this is from 455 00:25:14,200 --> 00:25:16,520 Speaker 1: our listener, Kevin. He says, I wanted to provide you 456 00:25:16,560 --> 00:25:18,840 Speaker 1: with a small but important to me correction regarding your 457 00:25:18,840 --> 00:25:22,639 Speaker 1: comment comments on Gouty's podification. One of you mentioned that 458 00:25:22,680 --> 00:25:26,639 Speaker 1: members of the society promoting Gouty's beatification quote already believed 459 00:25:26,640 --> 00:25:29,400 Speaker 1: in Gouty's divinity. That was mine. It was a misspeak 460 00:25:29,440 --> 00:25:31,159 Speaker 1: on my part. I made a quick search for this 461 00:25:31,200 --> 00:25:33,000 Speaker 1: group and found what I believed is your website, but 462 00:25:33,040 --> 00:25:36,320 Speaker 1: it was in Spanish, but I cannot read. I'm gonna 463 00:25:36,440 --> 00:25:40,320 Speaker 1: jump ahead, uh. She he says. Furthermore, if they are Catholic, 464 00:25:40,400 --> 00:25:42,359 Speaker 1: familiar with their faith, which I presume to be true, 465 00:25:42,400 --> 00:25:45,560 Speaker 1: they would not believe that Gouty was divine. Individuals named 466 00:25:45,560 --> 00:25:47,439 Speaker 1: a saint by the Catholic Church are considered to have 467 00:25:47,480 --> 00:25:50,240 Speaker 1: had lives of heroic virtue and are to be considered 468 00:25:50,240 --> 00:25:52,240 Speaker 1: examples of how to live a good life in accordance 469 00:25:52,280 --> 00:25:54,960 Speaker 1: with God's will. The Holy Spirit of God is considered 470 00:25:55,000 --> 00:25:58,919 Speaker 1: to have acted within these individuals. However, these individuals are 471 00:25:58,960 --> 00:26:01,200 Speaker 1: not considered to be mine in the sense that they 472 00:26:01,400 --> 00:26:03,800 Speaker 1: themselves are a God, are directly part of God, rather 473 00:26:03,840 --> 00:26:07,480 Speaker 1: than the Holy Spirit inspired these individuals. We got a 474 00:26:07,520 --> 00:26:10,359 Speaker 1: couple of these, one of which kind of accused me 475 00:26:10,400 --> 00:26:13,320 Speaker 1: of having been raised with some sort of anti Catholic sentiment, 476 00:26:13,359 --> 00:26:15,600 Speaker 1: and I had to chuckle a little bit. Not that 477 00:26:15,680 --> 00:26:18,320 Speaker 1: it's not a valid comment and a valid correction to make, 478 00:26:18,600 --> 00:26:22,159 Speaker 1: but because uh, I have a lot of relatives who 479 00:26:22,200 --> 00:26:24,399 Speaker 1: I would have to apologize to if that were the case, 480 00:26:24,720 --> 00:26:26,800 Speaker 1: because my mother Shute of the family is very devout 481 00:26:26,880 --> 00:26:29,439 Speaker 1: Roman Catholic, and I was raised Catholic. This is just 482 00:26:29,480 --> 00:26:32,240 Speaker 1: a case where I misspoke, you know, sometimes notes are 483 00:26:32,240 --> 00:26:34,199 Speaker 1: getting written in the middle of the night. I certainly 484 00:26:34,200 --> 00:26:38,520 Speaker 1: would not mean to um uh in any way mock 485 00:26:38,640 --> 00:26:42,280 Speaker 1: or misrepresent anybody's religion, but it did strike me as 486 00:26:42,280 --> 00:26:44,560 Speaker 1: funny that people thought I might be anti Catholic because 487 00:26:44,720 --> 00:26:47,679 Speaker 1: I grew up very very well. I'm just I'm just 488 00:26:47,760 --> 00:26:50,800 Speaker 1: forgetful and sometimes I just speak extemporariously and it's not 489 00:26:50,800 --> 00:26:54,360 Speaker 1: always correct. Yeah, well, and sometimes always came to uh. 490 00:26:54,400 --> 00:26:56,320 Speaker 1: They were worded in such a way that they sort 491 00:26:56,320 --> 00:26:59,200 Speaker 1: of sounded like maybe you had never heard of Catholicism, 492 00:27:00,960 --> 00:27:02,679 Speaker 1: which really did make me laugh, because I mean, I 493 00:27:02,680 --> 00:27:05,480 Speaker 1: have like clergy in my family, like there's so it 494 00:27:05,520 --> 00:27:07,159 Speaker 1: was a chuckle. And again, I don't mean to in 495 00:27:07,200 --> 00:27:10,159 Speaker 1: any way downplay the import of their their feelings on 496 00:27:10,280 --> 00:27:14,840 Speaker 1: the matter, but it's just the juxtaposition between what they 497 00:27:14,840 --> 00:27:16,960 Speaker 1: thought might be going on and what my actual upbringing 498 00:27:17,040 --> 00:27:19,480 Speaker 1: was was so completely at odds that it was a 499 00:27:19,520 --> 00:27:22,520 Speaker 1: little bit comedic to me. That's all so apologies. If 500 00:27:22,520 --> 00:27:26,800 Speaker 1: anybody was confused or dismayed by those comments, I'm telling 501 00:27:26,840 --> 00:27:28,479 Speaker 1: you you can be raised Catholic and still say their 502 00:27:28,520 --> 00:27:30,879 Speaker 1: own thing. If you would like to write to us 503 00:27:31,040 --> 00:27:33,880 Speaker 1: about today's episode or anything else that pops to your mind, 504 00:27:33,920 --> 00:27:35,840 Speaker 1: you can do so at History Podcast at how stuff 505 00:27:35,840 --> 00:27:38,120 Speaker 1: Works dot com. 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