by Alan Brickman
Jerry left his doctor’s office in a daze.
When he went in for his annual check-up, he only had the usual aches and pains to report, nothing serious. The morning of his appointment, he was startled awake by the sensation of being short of breath. He didn’t think much of it.
But the doctor’s assistant called two days later to ask that he come in again to go over his lab results. This is a call you never want to get. You can beg them to tell you over the phone, but they won’t do it. What could this mean? Cancer? AIDS? Parkinson’s? ALS? Something else so serious they’re afraid to tell you for fear you’d hang up and throw yourself out a fifth-floor window? Or that you’d cry and cry, then faint and hit your head? Jerry wasn’t one to lose control like that, so it was annoying that he had to go in again.
Now that he was leaving the office after they explained his diagnosis, he felt overwhelmed.
“Jerry, sit down,” his doctor had said. Jerry looked up and saw a second doctor come into the exam room. He was tall and thin and was dressed in a white lab coat. All Jerry could make out from his laminated name tag were the words, “Restricted Access.” Jerry’s primary care doctor continued. “We’ve been working with the University’s Medical Research Center on a new project of theirs. After we looked at your lab results, we sent the data and the blood samples to the project team. Dr. Richard . . .” he pointed to the other doctor, “called us immediately and asked to speak with you. I’ll step out and let him explain.” He walked into the hallway and shut the door.
“Hello, Jerry,” Dr. Richards said as he extended his hand. “We ran the tests, twice to make sure, and then we consulted with two specialists, one in New York and one in Los Angeles, and also with the CDC in Washington. They all concur. I hate to be the one to tell you this, but you’ve been infected with a virus that medical researchers have just recently identified. They want us to incorporate your case into the studies already underway.”
“What are you saying?” Jerry asked. He felt a small jolt of panic.
“Well, Jerry. This virus doesn’t even have a name yet. They’re just calling it 909b for now. We’ve learned a lot in the past year, but there’s much more study that needs to be done. You won’t have any symptoms, or anything you’ll really notice. But . . .” Richards hesitated and pulled out a handkerchief and wiped his forehead. “It’s been fatal in nearly every case. Life expectancy from diagnosis, two years at most. There have been about two hundred cases, and you’re one of a handful still living.”
“What?!” said Jerry. “I don’t understand. How did you even think to test for it?”
“Dr. O’Leary, who runs the study in New York, is an old friend. He sent us a box of the testing kits they’ve just developed so he can collect more data. We’ve worked with the local hospitals and neighborhood clinics to randomly test some of their patients. They’ve all been negative. Until you.”
“Don’t you have to get my permission to do that, Doctor?” Jerry snapped, then softened. “Never mind, forget about it for now. Let’s get back to my condition. You’re telling me I have a virus, and that it’s fatal?!”
“I’m afraid so, Jerry. Let me share with you what we know. Like I said, no real symptoms, and when people,” he hesitated again. “When people die from it, it seems to happen when they’re asleep.”
Jerry felt his heart race. All he could think about in that moment was the old bedtime prayer from his childhood: “Now I lay me down to sleep/I pray the Lord my soul to keep/If I die before I wake/I pray the Lord my soul to take.”
“A-fucking-men,” he said out loud.
“What?” said Dr. Richards.
“Never mind. Explain it to me . . . slowly.”
Dr. Richards rubbed his eyes and slumped his shoulders. He appeared exhausted and tormented about what he was about to say. “I’m going to throw a lot of information at you. But time is of the essence with 909b, and once you decide what you want to do, we have to act fast.”
“I just want to understand,” said Jerry. “You can give it to me straight.”
“Of course,” Dr. Richards said. “Typically, when people sleep, especially deep REM-sleep, all bodily functions slow down, giving the sleeper a chance to rest and revitalize. We’ve known for many years just exactly how important sleep is. But with 909b, these same functions slow and slow, and it never stops. It’s as if the body simply runs out of gas. There are various specific C.O.D.s . . .”
“C-O-what?” Jerry said, feeling his anxiety rising.
“Sorry,” said Richards. “Cause of death. People with 909b die from any number of things. Cardiac arrest, respiratory failure, renal failure, sepsis . . . whatever is the weak link for that individual, if that makes sense.”
“None of this makes sense, Doctor,” Jerry snapped. “Should I get a second opinion?”
“We’ve already confirmed it with New York, Los Angeles, and DC. That’s three second opinions.”
Jerry slumped in his chair. “Why haven’t I heard anything about this? There’s been nothing in the news.”
“We’ve been keeping it quiet because we don’t want to start a panic. We haven’t identified the specific contagion, and we don’t yet have a large enough sample from which we can draw findings to inform any large-scale treatment or prevention protocols.” Richards exhaled and shook his head. “Look, I’m a medical researcher, not a politician or a communications expert. But these days, when new health information gets out, particularly something life threatening, the Internet is flooded with misinformation and conspiracy theories, which only makes my job harder. There are only a handful of people in the country, some medical personnel and some . . .” He hesitated, “. . . some patients who know any of this. And for now, we’re trying to keep it that way.”
“I get all that.” Jerry worked in the University’s Communications and Community Relations Office. He’d often had to make decisions about what information goes out, how to present it, and for what audiences. The doctor’s casual forthrightness was calming, even with the seriousness of Jerry’s situation. “So now what?”
“They’ve been experimenting with some sleep studies, monitoring people, and when a selected set of indicators start to fall, they wake people up, and everything’s fine. If only people didn’t have to sleep.” Dr. Richards looked at the floor. “We have something for you to try. It’s not great, but it’s the best we can do. Let’s see what happens over the next week or two, and then we can talk again.”
The rest of the time in the doctor’s office was a blur to Jerry. The rest of the day was a blur. Dr. Richards accompanied Jerry to the Medical Research Center a few blocks away. A clinical team implanted a device in Jerry’s arm and showed him how to plug it into the monitoring equipment they gave him for use when he went to sleep. This machinery would sound an alarm if the relevant indicators started to drop and hopefully wake him up. Dr. Richards said it would likely go off several times a night. They also gave him a box of epi-pens, each with a high dose of amphetamine, for when he found himself drifting off during the day. A home health aide was scheduled to see him each evening for the first week to make sure he was using the equipment correctly and that there were no other issues. The machine was set up to send his data to Dr. Richards who would put it together for the New York and Los Angeles teams conducting the studies.
Jerry had never been a particularly heavy sleeper, but with the troubling news about his diagnosis as well as the contraption set up by his bed, he couldn’t fall asleep at all that first night. He finally drifted off well after midnight, but when the alarm sounded, he saw it was just before three, after which he felt wide awake, buzzing and anxious. After that, there were several times he startled himself awake just realizing he’d closed his eyes. When the alarm on the monitor blared at five in the morning, and then again at seven, he sat up on the edge of his bed, exhausted. He dressed quickly, hit himself with one of the epi-pens, grabbed two more, and headed out, wondering what the day would be like.
He wandered aimlessly for an hour or so, then stepped into a neighborhood diner and had five or six cups of coffee sitting at the counter. He realized he totally forgot about work, so he called in sick, and apologized for the late notice. He wondered if he’d have to quit sooner or later, in order to deal with whatever this was.
He bought a newspaper and went to the park. He found a bench in a shady spot where he could look at the fountains and watch the moms with their kids, the couples holding hands. He felt angry and resentful about all the normal people who could probably sleep through the night without worrying if they would die.
It didn’t take very long. After a week of never getting more than an hour or two of sleep at a time, one morning, within minutes of waking, Jerry felt himself descend into a sobbing rage. He screamed, “What!” at anyone who approached him, and then felt guilty when those people scampered away. He went home and decided to try to sleep again. He fell asleep immediately, but only for another two hours before the alarm sounded.
Jerry went online to see what he could learn about the psychological effects of sleep deprivation. Anger, hopelessness, hallucinations, psychosis. He’d seen hints of each of these things, and certainly didn’t want that. He called the number Dr. Richards had given him to see if he could get an earlier follow-up appointment. He was told to come in the next morning.
“Do I have any options?” Jerry demanded without saying hello.
“Yes, Jerry,” Dr. Richards said. “But let’s talk about it.”
Jerry found a chair and sat. “I’ll do anything. I can’t go on like this.”
“At this point, there’s only one treatment alternative—if you can even call it treatment. We don’t talk to patients about it until they’ve tried the monitor for a few days and tell us they can’t continue. Let me put it into the context of all your options.” Jerry rolled his eyes and braced for a lecture. “You could do nothing, maintain the monitor, and become immobilized by the physical and psychological effects of sleep deprivation within weeks or less. Or . . . you could unhook the monitor, go to sleep and be dead within hours.”
“Not new information,” said Jerry. “You said there was a treatment option.”
“Yes. And here it is. After a two-day infusion, you get to live normally, sleeping and everything, but as far as we know, for only a limited period of time. Each subject is different, and we don’t know how long they’ve had the virus at the time of their diagnosis, but no one has lasted more than two years. We implant a monitoring device with a timer, and when it registers certain indicators, it could be weeks from now, or months, or more, an alarm goes off and . . . this is the hard part, you have forty-eight hours to decide where and when you want to lay down and die. You need to think about who you want to tell, who’ll be involved, family, friends . . . Do you live alone?” Jerry nodded. “Health emergencies like these can make people who live by themselves feel isolated and alone. It’s a good idea to think about your support network.” Dr. Richards took a deep breath. “In any case, this approach, based on everything we know, essentially buys you up to two years.”
“Has anyone not taken the two-year option?” asked Jerry. “I mean, three choices: sleep deprivation psychosis, die tonight in my sleep, or die in two years. Seems like a no-brainer.”
“You’d be surprised,” said Dr. Richards.
“Whatever. Where do I sign?”
“There’s one more thing you need to know,” said Dr. Richards. “After the infusion, we won’t know for a full week whether it will take effect.”
“What?! What does that mean?”
“It means,” Dr. Richards said, this time sounding more annoyed than he intended to. “It means . . . that your body may reject the infusion and we go back to the other two options.”
“So what you’re saying is that for the week after the infusion, either I don’t think about it—yeah right!—or I live in a state of ticking-time-bomb terror. Great. Just great.”
“I know this can be a lot to take in,” Dr. Richards said. “Do you want to sleep on it and let me know tomorrow?”
“Is that a joke?” said Jerry. “Sleep on it? Really?!”
“I’m sorry, Jerry. Poor choice of words.” Richards smiled. “Do you want to think it over and tell me tomorrow?”
Jerry had no idea how to process all this information in order to decide what to do. He thought back to that morning when he awoke with shortness of breath. Was that the first sign? There seemed to be no downside to the infusion, other than it wouldn’t work, and he’d already begun to experience the horrible effects of sleep deprivation. “No,” Jerry said. “I don’t need more time. I’ve decided. Let’s do the infusion. Can we go right now?”
After some paperwork, a few tests, and the implantation of the new monitor, Jerry was hustled into the infusion room. They knocked him out, and he woke up two days later with sore muscles and a slight headache.
He went home, sat on his back porch and wondered how all this would go. As soon as he felt tired, he figured he might as well try to sleep. He was a little nervous, so it took him a while to drift off, but he slept soundly for just under fourteen hours. He awoke with a start, and it took him a few seconds to realize that this was not the afterlife and that he wasn’t dead.
The week went by at a snail’s pace, and each day made Jerry more frantic. Dr. Richards hadn’t said anything about his diet during this period, but he decided to eat as healthfully as possible. Free-range chicken, whole grains, organic vegetables, kale smoothies. Within a few days, his urine was clear and his bowel movements soft and copious. He felt purified and exalted. He became hyper-aware of each bodily sensation: his sleeping patterns, of course, but also his aches or soreness, the fluttering twitches in his skin, any trembling or cramping in his muscles, his energy level, his focus and alertness, his strength and stamina. He was locked in and purposeful, his only project, one that took all his time and attention, was his own body, the creature in the mirror. This enabled Jerry to distract himself from the reality that he might be dead within days.
On the seventh day, he connected the monitor, took the readings, and consulted the manual he’d been given. His indicators were consistent with a successful infusion, so he was in the clear. He was jubilant at first, then realized that the countdown to his allotted two years had begun. He became obsessed with the eventual alarm and what would, at that point, be his last forty-eight hours. He rarely left his apartment, and when he did, he never ventured very far and was always ready to run home if necessary.
As the days and weeks went by, a strange thing happened. Jerry found that he was able to stay awake for longer and longer periods of time. One day, he was still awake past midnight without a hint of fatigue. It got to the point where he could stay up for a full twenty-four hours before he would fall asleep. At the same time, he was sleeping for longer periods of time as well, and he had lost almost all of his anxiety about 909b’s mysterious death sentence. Soon, his sleep schedule became twenty-four hours awake and active, twenty-four hours in some of the deepest sleep he’s ever had.
At first, his dreams were nothing out of the ordinary. Soothing, peaceful images of nature—swaying oceans, mountain streams, birds in flight. He would awake rested and relaxed. But after a few weeks, something odd happened. He would go through his waking hours—eating his healthy meals, running errands, puttering around the house. He wondered if he should try to get his old job back but decided against it. The odd part happened when he was sleeping. His dreams shifted from the nature scenes he’d found so pleasant to slightly askew versions of his waking activities, like some sort of off-kilter mirror image. If he enjoyed a tasty sandwich when he was awake, he dreamed of eating the same sandwich, but it tasted spoiled, rancid. If he picked up a few things from the hardware store or the grocery, in his dreams, he ran the same errands but the stores were out of the items he wanted. If he met a friend for a drink (something he had started to do, but cautiously, and he never talked about the virus), in his dreams their get-together erupted into a screaming fight. In all other respects, the dreams were as real as his waking life, just slightly sour and unpleasant, but otherwise indistinguishable.
Jerry’s existence of twenty-four-hours-awake, twenty-four-hours-asleep began to play tricks on his perception and sense of reality. At any one time, he could not be sure if what he was experiencing was the real world or his dream world. He became disoriented and confused. Was he making the best of his 909b-infection and only dreaming of an unpleasant and unsatisfying flip side, or had his life taken a turn for the worse where nothing good happened, while he dreamed of a better, happier alternative? As he relived each day by its cock-eyed flip side, he puzzled over the chicken-and-egg dilemma that defined his consciousness. Which came first, gliding pleasantly through life and managing his illness, followed by the darker mirror-images he dreamed, or was it the other way around where his real life had become so frustrating and difficult which then prompted him to dream of something better? He never felt over-tired or sleep-deprived, but it got to the point where he couldn’t tell when he was awake or when he was sleeping and dreaming. Was this a symptom of the virus or a side effect of the infusion?
He tried to call Dr. Richards to find out if any of this was typical of the 909b patients, but he was only able to leave a message and never got a call back. Finally, he went back to the Medical Research Center to see if he could get some answers. He didn’t recognize the woman at the registration desk. He gave her his name and date of birth.
“I’m sorry, sir,” she said. “We have no record of you as a patient.”
“That’s impossible! I was seeing Dr. Richards. I was part of the 909b study.”
“Hold tight for a moment while I check.” She tapped her computer keyboard. Jerry saw her cock her head and give a puzzled expression. “There is no record of a Dr. Richards ever having worked at the Center. And Room 909b, that’s across the parking lot in the other building.”
“Not Room 909b!” Jerry shouted. “The virus. The one where people die in their sleep. I’m part of the national study, and I got the infusion. Right here at the Center!” He stomped his foot on the shiny linoleum floor. “I’m having side effects, serious ones, and I need to see Dr. Richards.”
“Again, I’m sorry, but I don’t really know what you’re talking about. If you’ll have a seat, I’ll see if there’s someone who can straighten all this out.”
“I will not have a seat!” Jerry spat out through clenched teeth. “Look,” he said, trying to steady himself. “I’m not mad at you. Maybe they’re not sharing a lot of information about the virus or the study with everyone on staff. I just want to see Dr. Richards. So . . . where the fuck is Dr. Richards!”
“There is no need for that kind of language, sir. Now if you’ll just have a seat . . .”
“Fuck you!” Jerry bellowed. He banged his fist on her desk. “Thanks for nothing!” He stormed out of the waiting room, ran down the stairs, and out into the street in front of the Research Center. He paced up and down the sidewalk and rubbed his eyes. It occurred to him that this all might actually be an anxiety dream and that sooner or later, he’d wake up, get to see Dr. Richards, and find out if his side effects were typical, or treatable.
But it seemed equally possible that he was awake now, and that everything that had come before—Dr. Richards, Virus 909b, all of it—had never been real, had all been just a dream. What would happen now if he tried to sleep? Would he conjure his doctor, his illness, the study, his side effects? Or by falling asleep, would he in fact wake up, and if so, to what? Did he have two years left, or was 909b a figment of his imagination which meant he would just go on living? Was he awake or sleeping? Was he living or dying?
Jerry ripped off his shirt and threw it into the street. He looked at his shoulder where they put in the infusion port and saw nothing. He searched for the scar where the doctors had implanted the monitor and couldn’t find it. A man passed him on the sidewalk, and Jerry grabbed him by the sleeve. “I have to ask you something,” he said in a frantic rush of words. “Is all this real, I mean really real, or am I dreaming?” The man yanked his arm away and scurried around the corner.
Jerry held his arms out and looked up at the sky. “Will someone help me?!” he yelled. “Please! I need to know what’s real!” He fell to his knees, put his head in his hands, and sobbed.
The sidewalk filled with pedestrians. People stepped around Jerry as if he wasn’t there.
© 2025 Alan Brickman All rights reserved.
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