I’M IN A SCENE FROM STAR TREK—IN THE HIGH-TECH, sterile setting of the flight deck. At least, that’s what it looks like from where I sit overlooking the darkened laboratory, where a computerized column rising from the center of the room flashes ominously with multicolored lights.
The door opens, and a stream of gurneys is rolled in one by one by nurses wearing light blue uniforms. The weird lighting casts their faces in shadow.
I pinch myself for the nth time for proof that this is real. I, a mere premed student, am sitting here in the world’s leading sleep technology clinic, about to witness a cutting-edge experiment.
Okay, maybe it helped a bit that I’m at the top of my class at Yale. And it didn’t hurt that my mom is the personal assistant for one of the clinic’s biggest donors. But I count everything I get in life as a gift. There is nothing I take for granted.
Focusing on what is happening below me, I sketch the room’s layout in my notebook. The nurses are carefully transferring their seven wards onto beds arranged around the column like spokes on a wheel. The column flashes like a psychotic Christmas tree and sends out a whirring electrical hum. Stenciled numbers are painted on the concrete floor next to the beds—one to seven.
The nurses bustle around prepping the patients for the doctors’ arrival by attaching sensors taped all over the subjects’ bodies to cords spewing from the column. As each one connects, a light changes from flashing red to stable green, until there are only a few pulsing diodes left, scattered around the pillar.
It’s slightly chilly in the room. The subjects are wearing hospital-issued socks and are draped with those metallic insulated blankets designed to trap body heat. I don’t realize they’re conscious until one lifts her hand to drowsily scratch her nose. Then I notice small movements from the others: wiggling toes, shifting heads, a nod from one boy when a nurse whispers something to him. Their movements are slow, drugged.
I pull my gaze away from the scene taking place below and acquaint myself with the area I’ve been assigned. The “monitoring station” I’m seated at is on a platform raised a couple of feet above the test area, allowing me and the researchers a clear view of all seven subjects.
The thick three-ring binder in front of me bears the mouthful of a title: “Continuous Low-Current Electroconvulsive REM Inducement Therapy: Test File.” I flip it open to a page headed “Trial Parameters” and begin reading.
I’m going to have to write this all up into a paper describing my six hours of field experience, so I start taking notes:
• seven subjects, ages thirteen to nineteen
• all suffer from chronic insomnia
• new electroconvulsive technology will be used to try to cure them
• trial will last five hours, fifty minutes
That, of course, reduces a whole page of scientific explanations to four simple bullet points, but the paper is supposed to be more about my experience than explaining the experiment to my professor.
I turn the page to the in-depth explanation of the thinking behind the experiment, precedents, and a whole lot more. Holy crap, this stuff is dense. I wish I had been given access to the information before today. It would have been nice to memorize the whole file and be better prepared. But Dr. Zhu and Dr. Vesper delayed my introductory meeting until yesterday (“for security purposes”), and, even then, only gave me the barest of descriptions of the trial.
A large flat-screen monitor takes up most of my work space, and in front of it, there’s an expensive-looking computer. I’m not sure what it’s for, since the doctors specified that any notes I want to take with me must be written in the notebook I bought last night. I was told not to bring my laptop, and was actually asked to leave my phone at the front desk. Again “for security purposes.” Which I’m guessing means they’re worried I might upload this stuff to YouTube when they aren’t looking.
Although I basically had to sign my life over in the confidentiality contract, I’m not complaining. Zhu and Vesper are rock stars in the sleep research world, working on cutting-edge brain studies. This trial is going to shoot them into the stratosphere of medical-world fame. Like Nobel-quality material.
The nurses are now placing IV bags on poles next to the subjects’ beds and plugging the tubes into the central column. I wonder what they’re for. I look under the heading “Pretrial Preparations,” and note:
• subjects received mild sedation before they were brought to lab
• they must remain aware until researchers speak with them individually before the trial starts
• IVs provide the anesthesia that will knock them out
I note which drug they’re using and read on. One of the machines they’re being hooked up to is a polysomnograph. I studied up on those last night, following Dr. Zhu and Dr. Vesper’s vague explanation, in my scramble to cram as much as I could. PSGs are typical equipment used in sleep studies, which monitor the subject’s brain function, eye movement, muscle activity, and heart rhythm. What’s not typical in this case is that this PSG will be monitoring seven subjects at the same time. This is where the high-tech column comes in.
There is a whole section for “The Tower,” as it is called, which is basically the brain of the experiment. It manages the anesthesia, the electrical current, the feedback—making sure everything is equal and simultaneous.
With a computer treating the seven subjects identically, the researchers will be able to say that the conditions were the same for all of the subjects when they report their findings. Something this groundbreaking will be picked apart by critics . . . especially since it’s an invasive treatment. Electroconvulsive therapy for children and teenagers is a hotly debated topic. It’s even illegal in some states. Until its efficacy is confirmed, this could kick up a shit storm in the medical world, so everything about the test has to be perfect.
The door opens and in walk Dr. Zhu and Dr. Vesper. They glance around the room, their eyes flitting up to where I sit at the monitoring station. They approach the beds—Vesper hunching over as he moves; Zhu walking ramrod straight—double-checking the placement of the electrodes being attached to each subject’s temples, inserting the IV needles into the backs of their hands, speaking a few words of encouragement, and giving them a squeeze of the hand and a reassuring smile.
When they finish, Dr. Vesper climbs the steps up to the monitoring station and takes his seat in front of a pair of screens. Dr. Zhu makes her way to me and leans over to switch on my giant monitor. “Good morning, Jaime,” she says. I say good morning back as my screen springs to life. It is divided into seven windows with bird’s-eye views of the subjects in black and white.
Three green lights glow in the upper right corner of each window. “Since you’re just observing, we’ve put you in front of the screen that monitors each subjects’ video, audio, and power feed.” She gives me a slight smile. “As we explained yesterday, there’s nothing really for you to do per se, but feel free to read the general file. If it seems like a quiet moment, you are welcome to ask Dr. Vesper and me questions. And, though you may take all the notes you want for your project report, you aren’t to show them to anyone except your supervising professor—who we’ve spoken with—until our results have been published.”
“You made that clear yesterday,” I reassure her.
Zhu nods efficiently and takes her chair next to Vesper. “Ready to go?” she asks, and then taps on the microphone positioned next to her screen. “It is March thirty-first, and the time is seven thirteen a.m. Administering general anesthetic . . .” She types a key, and a clicking sound starts up from the Tower. “. . . now.”
A couple of minutes later, Vesper announces that the subjects are unconscious and starts the electroconvulsive current.
I turn to watch the scene behind me. The only sign that anything is happening to the subjects is a slight flexing of their fingers and toes each time the current flows, which is signaled by a crackling sound . . . like static.
This happens five times before the innovative part of the test begins. In regular ECT, the electrical current is shut off after the last pulse is given. But now it is left flowing through the subjects’ brains at low levels. The static continues, but quieter, becoming a background noise.
According to Zhu’s running commentary, the subjects begin dropping into REM sleep . . . all except for one. After exchanging several worried looks with Vesper, Zhu walks down into the test area and watches the boy in bed seven like he’s a bomb about to go off. A second later, Vesper announces, “Subject seven has entered REM.”
Zhu relaxes. “Thank the gods for that,” she murmurs, and, casting an appraising glance across the sleepers, returns to her chair. The researchers busy themselves staring at the screens and talking into their microphones.
In my binder, the methodology section says we have twenty minutes to go before the next phase begins, but for now, the sensors indicate that everyone is dreaming.