Keep Myself Awake

It's three o'clock in the morning, but I can't sleep. I've decided that I might as well try to get all my thoughts down about the whole Courtney Styles mess, see where I went wrong and...alright, I'll admit it, I know exactly where I went wrong. But I'm hoping that when I recount it all, something will occur to me that didn't at the time.

Obviously, this isn't an official case file. That's already on record at the hospital. No, I'm dictating this for my own personal use. Still protected by therapist/patient privilege, though, so if you're listening to this, you probably shouldn't be. Unless I give it to you. If I've given this to you, I probably did so for a very good reason. So fuck therapist/client privilege and give it a listen.

*****

Courtney's parents checked her into St. Mary's about four days ago, claiming that she'd become irrational and paranoid after a trip to Greece. They'd gotten back a week before we admitted her to the hospital, and at first, she'd seemed fine. Perhaps a little more jet-lagged than usual, seemed to be practically dragging herself out of bed every morning, but everyone feels like that the first few days back from Europe, and anyway, she's seventeen. When I was that age, I felt like I had to drag myself out of bed every morning. (yawn) Excuse me. Just the word "bed" is kind of a taboo subject right now.

Anyhow, her mom said that after about five days, the problem hadn't cleared up, and she'd begun to worry about her daughter. Courtney looked more tired than ever--dark circles under the eyes, the whole package. That evening, she decided to look in on her daughter to see how she was sleeping. She found out that, well, she wasn't. Courtney was sitting up in her room with a pot of black coffee and her headphones on, blasting music as loud as she possibly could while surfing the web. Mom tried to get her to go to sleep. Courtney got snappish, then moved to panicky, and finally to near-violent. She kept insisting that she mustn't sleep, that "he'd get her" if she went to sleep.

Yeah, I know. You can start singing, "One, two, Freddy's coming for you," any time now. But the thing is, that was based on a real case. Not the knives or the child killer or anything, that was all just Hollywood slasher-movie crap. But I looked it up last night, and there really was a bunch of kids, refugees from Cambodia, who were having nightmares so bad they were convinced they'd die if they went back to sleep. Well-meaning psychiatrists convinced them that they were just paranoid, that there was no way that sleeping could kill them no matter how bad the dreams were.

So the kids went to sleep. And they all died.

That's kind of haunting me right now. I mean, I'm a psychiatrist, I know just how real psychosomatic illnesses can be. But when a case is staring you in the face, when it's so outside of your normal experience that you just can't imagine it to be anything other than crazy, well...sometimes you make the wrong decisions. Nobody can make a medical judgment based on a horror movie they saw when they were a kid.

But making a bad decision in our profession has serious consequences. Those people who were working with those Cambodian kids, they were just trying to help. I was just trying to help Courtney. Fuck. Fuck fuck fuck!

*****

OK, I'm back now. I put down the tape recorder for a bit to collect my thoughts. I'm not at my best right now, sorry. Anyhow, Courtney's parents spent a couple of days trying to get their daughter to go to sleep, doing things like hiding the coffee, giving her warm milk--they tried to slip a couple of Unisom pills into it, but that just backfired, she started refusing any food or drink she didn't make herself. When they found her at three AM standing under a cold shower to keep from falling asleep, they decided to seek professional help. That's where I came in.

I got to work that morning to find Courtney's mom and dad, looking like they hadn't gotten very much sleep themselves. They tried to tell me what a bright, bubbly young girl Courtney was, how she was an honors student as well as a cheerleader, how she volunteered down at the homeless shelter, all sorts of things about how well-adjusted and likeable she was...and how, in the span of a week, she'd become a burned-out paranoid wreck.

I played the good doctor with them for a few minutes, reassured them that all kids went through rough patches, but inside I was wondering what the hell I'd stepped into. They didn't have a clue as to why Courtney was freaking out so bad. All they could tell me was that she was worried "he'd get her". I figured maybe she'd seen one too many horror movies, had a few nightmares and built it up into something worse than it was, but I knew I needed to see Courtney to find out.

I walked into her room, and she was pacing back and forth next to her bed. I remembered my reading on sleep deprivation, back in school. The parents had said she'd slept a little, just in short stretches, but Courtney still hadn't had significant sleep in seven days. By this point, her demand for sleep would have gone beyond simply 'insistent' into 'compulsive'. She'd be suffering paranoia, hallucinations, and more importantly, she wouldn't be able to relax without falling asleep. That was why she was walking. She must have done the same reading I had, probably looked it up on the Web, and known that the only way to keep awake was to keep active and moving.

"Hello, Courtney," I said. "I'm Doctor Christine Linders." I used my usual tone, the soft, friendly 'I'm on your side' voice. That voice works wonders. Ninety percent of people I see just need someone sympathetic to talk to.

She turned and looked at me. Her face was...I've never seen anything like it, that wary, exhausted, terrified look. "Hi," she said. "I'm Courtney. Bring a needle anywhere near me and I'll scratch your fucking eyes out."

Courtney was one of the other ten percent.

"It's alright, Courtney," I said. "I don't have a needle. But you're right in thinking that we have sedatives here. We've also got orderlies that can make sure you get them, even if you don't want them. So if you don't want me to sedate you, you're going to need to give me a good reason to let you keep staying up." It was a risk, but only a small one. Courtney had threatened to get violent with anyone suggesting sedation, but she was also a teenage girl who'd been pretty much normal until a week ago. She probably wanted someone to talk to. I just hoped she'd want to talk to me.

"I..." She looked uncertain, even more scared than before. "You won't believe me. I know you won't believe me, nobody will believe me, oh, God, he's going to take me into the dream forever and there's nothing I can do!" She dug her fingernails into her arm, hard. I wasn't sure if she was really trying to hurt herself, or if she was just trying to stay awake.

"Courtney," I said, "I can't promise I'll believe you. But I can promise that I'll listen. You're right, I might not believe you. But if you don't say anything, I'm going to have to sedate you. So you might as well tell me about it, and see what I say."

She said...hold on, I'm going to go get my notes. I want to make sure I get this right, it turned out to be important.

*****

She said, "We went to Greece for a week during Spring Break. Dad had gotten into a big 'Greek History' phase after seeing '300', and he talked Mom into going and seeing the sights. I wasn't sure, because I kind of wanted to go someplace more touristy, but I gotta admit, it was nice. Real nice. Pretty country, nice beaches, not too crowded, and cute boys."

She slapped the back of her neck a little, trying to keep alert. "We didn't spend a ton of family time while we were there, because Dad kept wanting to see big historical sites, and Mom and I were more interested in the beaches. But on the last day, we all took a ferry out to see some ruins of a temple dedicated to Hypnos. He's the God of Sleep." She looked over into the corner. I didn't know what she was seeing, but like I said before, she was probably experiencing hallucinations by this point.

"So we took the ferry over, and I'll be honest, it was kind of dull. Just, y'know, piles of rock. Old buildings. And the tour guide was kind of boring, and he wasn't even that cute, so I kind of wandered off to take a look around on my own. That was when I found this." She pulled up her sleeve to reveal a copper armband on her right arm, worn just a few inches below her shoulder. I wondered why the orderlies hadn't taken it off her when she checked in. Not that it really looked like she could use it as a weapon, but it might serve as improvised brass knuckles or something. It wasn't the sort of thing she should have.

"I thought it was pretty, but I figured that I couldn't just take it with me. It was probably, you know, a historical artifact or something. So I took it back to the tour guide, told him I'd found it." She smiled wearily. "I think I thought maybe they'd put it in a museum and name it after me or something."

The smile vanished. "He told me it wasn't old. Not even a little old, because copper turns green if you don't keep it polished, and..." She gestured to the armband. It shone as if newly made. "He said some tourist must have dropped it. So Mom and Dad said I could keep it." She tugged absently at the band. "I was actually happy when I put it on, you know that? I thought it was cool. Souvenir of the trip."

Her eyes closed for a moment in a slow, lazy blink, and then opened again in wide alarm. She started pacing again. "That night, on the flight back, I fell asleep. And I was back on the island, back at the temple. Only it wasn't, you know, wrecked. It was new. Brand new. Decorated in black marble, with little red flowers planted all around the entrance." She giggled hysterically. "I looked it up later. They were poppies, just like in 'The Wizard of Oz'." She screeched out an impression of Margaret Hamilton. "'Poppies will make her sleep!'" I recognized that as another sign of sleep deprivation. Wild mood swings, uncontrollable laughter.

"These women came out, all naked...except they all wore armbands just like mine. They looked at me, but their eyes were...blank. Empty. Like they were sleepwalking. No, not 'like'. They were sleepwalking. They were sleepwalking towards me. I turned around to go back to the ferry, but there was no dock. It hadn't been built yet. The water was churning like a storm, I knew that I'd drown if I tried to swim. I mean, I'm a pretty good swimmer, but...I knew. The way you know things in dreams."

She shuddered. "And the girls surrounded me, and one of them said, 'Lord Hypnos is waiting,' and they reached out, and...and then I woke up. I think Mom noticed I'd had a bad dream, but she didn't say anything. I just figured it was, y'know, a bad dream.

"But then we got home," she continued, "and I went to bed that night. For real, in my own bed. And as soon as I fell asleep, I was right back on the island. Not even in a different place, or starting over. I was right back where I'd been when I woke up. Like the dream was on pause, and going to sleep unpaused it. The girls grabbed me, and I felt it. That was another thing. It wasn't like a normal dream, where you can't really feel or taste or smell things. I could feel wind on me, I could smell flowers, and I could feel it when those girls grabbed me and started pulling off my clothes. One of them said, 'Lord Hypnos...'" She pounded her own leg, hard, and shook her head to clear it. "'Lord Hypnos desires you naked, that your beauty might serve Him all the better.' I swear, I could feel every bit of it."

I started thinking this might be Freudian, at that point. Freud's gotten a bit of a bashing over the last few decades, but a seventeen-year-old girl having dreams about being stripped naked and taken into a temple to make love to a dark god, well, it doesn't take a Freudian to think that might be connected to anxieties about sex.

Courtney must have seen the look on my face, because she stomped over to me and held out her right arm. "Okay, then," she shouted, "if I'm so fucking crazy, try to take the armband off! Go ahead, just try!"

And I did. I gave it an experimental tug, just to see what would happen. Sure enough, it was stuck fast. Her arm was red and irritated around it, and I remembered the way she'd tugged at it earlier. It had probably become a nervous habit over the last week, pulling at the thing that had become the focus of her neurosis. It was a little weird, but I had a ring that swelled up on me so bad I couldn't even remove it with soap. Took me about a week to get that sucker off.

So I just nodded, and said, "I don't think you're crazy, Courtney." Which I didn't. We don't use that word in our profession. I thought she was suffering from a neurosis. "Please, go on."

"Sorry, where was I?" she asked.

"You were dreaming about the girls taking your clothes off." I paused. "Courtney, is there perhaps something you've wanted to tell your parents, but couldn't? Something about your sexual orientation?"

Courtney rolled her eyes. "Ick, no!" she said. "Anyway, it wasn't like that. In the dream, I mean. The girls weren't, you know, getting off on it or anything. They were just doing what they were told. They'd been touched by Hypnos. They were His, now." She put her finger into her mouth and bit down hard on the knuckle.

"Sorry," she said. "He's getting to me. I keep getting..." She shifted a little, embarrassed. Normal teenage girl embarrassed. "I keep getting horny, just thinking about becoming one of those slave girls. I don't want to be His slave, but He's getting into my head and making me want it. Even when I'm awake, now. I'm hallucinating, I know I am, but I can see him. He's watching me right now, with those black eyes. He's just waiting for me to sleep, so he can take me forever."

I nodded. "Alright, Courtney, that's enough for now. I'm afraid I have other patients to see. I'll be back to talk to you some more, though, tomorrow."

She was suddenly frantic. "You're not going to sedate me?" she asked desperately. "Please, just...I know it sounds crazy, I'll explain more tomorrow, but you can't sedate me, please please please!"

I put up a hand. "It's alright, Courtney. I'm not going to sedate you tonight, but I am sending in someone to put some electrodes on you. I want to run an EEG--you know what that is?"

She nodded. "Sorta. It's that thing they always do in the movies to test your brain waves."

"Basically, yes. We've got some newer equipment here, and so we don't need any wires--it's just going to be some little sticky dots on your head, is all. Won't keep you from moving around, I promise." I was already beginning to believe that she just needed sleep, but I knew the clinical data well enough to know that sleep deprivation didn't do any damage that a good night's sleep wouldn't cure. Not to mention, nobody had ever managed to stay awake longer than a couple of weeks straight. The problem would probably cure itself. Still, I wanted EEGs to back me up.

And I just went on with my day from there, while Courtney fought for her life to stay awake.

*****

I went back the next morning, and Courtney was still awake. "Hi, Doc," she said, her words slightly slurred. "I've got sticky dots on me." She giggled, pointing to her scalp. Wireless EEGs. Thank Christ for those. Keeping a patient still enough to make sure all the connections stayed in place was a non-stop pain in the ass.

"Yes, Courtney, I can see. I've been looking at some of the data, and it's very interesting." Actually, it was. Most sleep deprivation patients couldn't stay hooked up to an EEG while they tried to stay awake, but the wireless EEG let Courtney do whatever she had to. Her brain patterns were a mess, though. You could see patterns associated with stage one sleep almost throughout the recording, alpha waves disappearing and theta waves popping up, then her brain 'snapping back' to wakefulness. "Now, why don't we finish talking about these dreams you've been having?"

"Uh-huh." She sounded really groggy, now. I didn't think she'd be up more than another day or two, tops. "After I woke up from the dream where the girls grabbed me, I didn't sleep at all that night. I just stayed up all night, and then went to school the next day tired. But by bed-time, I'd convinced myself it was all just a weird dream." Her eyes went glazed for a moment. I looked over at the one-way mirror set into the wall. Behind it, I knew, was a video camera recording the session. Later, I'd be able to synch it up with her EEGs and get a real time picture of how the conversation was affecting her.

Arrogant bitch that I was, I was already thinking of writing this up as a paper.

"I went back to sleep again, and I just...unpaused. The girls had finished pulling my clothes off, they were dragging me up the stairs to the temple. I tried to struggle, but there were too many of them, and they were stronger than I was. Because they were His. Their whole desire was to take me to Him, because it was His will." Her head bobbed down slowly as her eyes slipped shut, then shot back up.

"And I woke up again. And now I knew I couldn't sleep anymore, because every time I slept, I'd be right back on the island. So I stayed up that whole night, and...and I nodded off at school, just for a minute, but they carried me up three steps while I was sleeping. You understand, Doc? Every time I sleep, I get closer to Him."

I nodded. "What do you think is going to happen when you get into the temple, Courtney?" I asked.

"I'm already in the temple." Her eyes looked blank for a moment, like the girls she'd described in her dream. "It's so hard to stay awake like this. I keep nodding off--just for a minute here and there, but every time I sleep, they take me closer to Lord Hypnos. I can't be more than five feet away from Him now. And when I fall asleep, He'll look into me with His black eyes and touch me and I'll...I'll be His. Like the other girls. I won't wake up, not really. I'll open my eyes, and I'll walk and talk like I'm awake, but I'll still be dreaming. I won't ever wake up ever again. I'll be in the temple with Him forever, until even my dream-self sleeps in His will.

"He'll fuck me, you know. He fucks all the girls, and they're so deep in His dream that even when He isn't fucking him, they feel like He is. There's no difference to them anymore, because what could be the difference between sex with a dream and a dream of sex? They're trapped by His pleasure, and they can't help but serve Him because He makes them feel so good and helpless and used..." She sounded half-terrified, half-aroused by the idea. This was a Freudian psychologist's dream girl. So to speak.

"It's alright, Courtney," I said. "You don't have to be afraid. We're going to help you." I was blatantly bullshitting, and she knew it.

"How?" she shouted. "How the fuck are you going to help me with this?" She slapped her own face, hard. "You can't keep me awake forever! He's watching me from the corner, He's watching me with His black eyes! Oh, God, please, just cut my arm off! Cut it off above the armband, it's how He holds me in His will! Please, I'd rather live my life with one arm than sleep in His will forever!" She was screaming now, rampantly hysterical and hallucinating and all the other fun things that'll happen if you go nine solid days without sleeping at all.

"Courtney," I said, "if you can't control yourself, I'll sedate you."

She stopped screaming instantly. "Please don't," she said in a little girl's voice.

"We'll see," I said. "I'm just going to look at some of the EEGs. I'll be back later, I promise."

I went in the next room, then, and synched up the EEGs to the video recordings. It was interesting stuff. Every time she talked about 'Lord Hypnos', her theta waves spiked. That means she was falling asleep, but in post-pubescent subjects, theta waves are also associated with sexual arousal. So she was either getting sleepy or getting horny every time she thought about this "dream god" of hers...or possibly both.