User talk:Tz6984451

The last tape
The bustle of the hospital was a welcome distraction as I opened my new patient's chart and headed for her room. My son, Eric, had just brought home a disappointing report card, and my daughter, Shannon, and I had argued again about her getting a driver's license. For the next eight hours I wanted to throw myself into helping people who I knew had much more to worry about than I did. (收集整理:www.159love.com) Rebekah was only 32, admitted for chemotherapy after breast-cancer surgery, When I entered her room it took me a moment to spot her amid the bouncing forms of three giggling little girls. (收集整理:www.159love.com) I told Rebekah I would be her nurse and she introduced her husband, Warren; six-year-old Ruthie; four-year-old Hannah; and two-year-old Molly. Warren coaxed the girls away from their mother with a promise of ice cream and assured Rebekah they would return the next day. (www.159love.com收集整理) As I rubbed alcohol on her arm to prepare it for the intravenous line, Rebekah laughed nervously. "I have to tell you I'm terrified of needles." "It'll be over before you know it," I said. "I'll give you a count of three." (www.159love.com收集整理) Rebekah shut her eyes tightly and murmured a prayer until it was over. Then she smiled and squeezed my hand. "Before you go, could you get my Bible from the table?" I handed her the worn book. "Do you have a favorite Bible verse?" she asked. "Jesus wept. John 11: 35." "Such a sad one," she said. "Why?" (http://www.159love.com收集整理) "It makes me feel closer to Jesus, knowing he also experienced human sorrow." (收集整理:www.159love.com) Rebekah nodded thoughtfully and started flipping through her Bible as I shut the door quietly behind me. (http://www.159love.com收集整理) During the following months I watched Rebekah struggle with the ravages of chemotherapy. Her hospital stays became frequent and she worried about her children. Meanwhile I continued to contend with raising my own kids. They always seemed either out or holed up in their rooms. I missed the days when they were as attached to me as Rebekah's little girls were to her. For a time it had seemed Rebekah's chemotherapy was working. Then doctors discovered another malignant lump. Two months later, a chest X-ray revealed the cancer had spread to her lungs. It was terminal. Help me to help her through this, I prayed. (www.159love.com收集整理) One day when I entered her room, I found her talking into a tape recorder. She picked up a yellow legal pad and held it out to me. "I'm making a tape for my daughters, " she said. (收集整理:www.159love.com) I read the list on her pad: starting school, confirmation, turning 16, first date, graduation. While I worried how to help her deal with death, she was planning for her children's future. (www.159love.com收集整理) She usually waited until the early hours of the morning to record the tapes so she could be free from interruptions. She filled them with family stories and advice?trying to cram a lifetime of love into a few precious hours. Finally, every item in her notes had been checked off and she entrusted the tapes to her husband. (www.159love.com收集整理) I often wondered what I would say in her place. My kids joked that I was like an FBI agent, with my constant questions about where they'd been and who they'd been with. Where, I thought, are my words of encouragement and love? (收集:http://www.159love.com) It was three o'clock one afternoon when I got an urgent call from the hospital. Rebekah wanted me to come immediately with a blank tape. What topic has she forgotten? I wondered. (http://www.159love.com整理收集) She was flushed and breathing hard when I entered her room. I slipped the tape into the recorder and held the microphone to her lips. "Ruthie, Hannah, Molly?this is the most important tape." She held my hand and closed her eyes. "Someday your daddy will bring home a new mommy. Please make her feel special. Show her how to take care of you. Ruthie, honey, help her get your Brownie uniform ready each Tuesday. Hannah, tell her you don't want meat sauce on your spaghetti. She won't know you like it separate. Molly, don't get mad if there's no apple juice. Drink something else. It's okay to be sad, sweeties. Jesus cried too. He knows about sadness and will help you to be happy again. Remember, I'll always love you. (http://www.159love.com整理收集) I shut off the recorder and Rebekah sighed deeply. "Thank you, Nan," she said with a weak smile. "You'll give this one to them, won't you?" she murmured as she slid into sleep. (收集整理:www.159love.com) A time would come when the tape would be played for Rebekah's children, but right then, after I smoothed Rebekah's blanket, I got in my car and hurried home. I thought of how my Shannon also liked her sauce on the side and suddenly that quirk, which had annoyed me so many times, seemed to make her so much more precious. That night the kids didn't go out; they sat with me long after the spaghetti sauce had dried onto the dishes. And we talked ? without interrogations, without complaints?late into the night.

想睡好觉？别做梦了
It is 11.30pm on a Sunday night and a 26-year-old worker has checked into the London Clinic on Harley Street. His private room is plush and spacious but he is not comfortable.

Several dozen electrodes are glued to his head, chest and limbs; elasticated belts circle his torso; and a blood oxygen monitor is clipped to his right index finger.

Alex Webb (not his real name) is here because, according to his girlfriend, he has been behaving oddly in his sleep. He thrashes around as if fighting the bedclothes. He punches the wall or knocks things off the bedside table. Sometimes he'll speak to her angrily before drifting off again. He wakes up with no recollection of these things, exhausted.

“It's bad enough that my id is having conversations with my girlfriend without my knowledge,” he says. “But what concerns me most is that I might harm her.”

Hence the test, a polysomnogram or “sleep study”. It was arranged by Gaby Badre, a consultant at the London Clinic and professor at Gothenburg University, Sweden. He has a hypothesis about Mr Webb's condition, but he needs to prove it. He wants to record the patient's brain activity and analyse the way he dreams. (www.159love.com收集整理)

Polysomnograms have become more widely used in recent years. The number of sleep complaints in western countries is rising sharply, says Dr Louise Reyner, senior lecturer at Loughborough University's sleep research centre, though it is unclear how much of this is down to greater awareness and better diagnostics.

“There's not a lot of evidence to show that sleep quality and quantity is declining,” she says. “What we are finding is that people are doing more complex tasks than they used to, and that sleepiness is affecting their lives adversely to a greater extent.”

Prof Badre believes modern working habits are pushing human physiology to its limits. “For 1,000 years we had a biphasic existence: working in the day, sleeping at night,” he says. “Now we're in a 24/7 culture in which we feel we have to be ‘connected' – to the office, to our family and to our friends – at all times.”

He has treated numerous City workers who are “completely burned out” because they have chosen to sleep less in order to fit other things into their lives, and so have accumulated a massive “sleep debt”. (www.159love.com收集整理)

“We see more young people with chronic sleep debt developing problems such as hormonal defects, decreased immunological function, high blood pressure and cardiovascular problems, increased weight and type-II diabetes,” he says.

Many of these symptoms are linked to a disorder called obstructive sleep apnoea. OSA causes severe breathing difficulties during the night and sleepiness during the day. The higher your bodyweight, the more likely you are to have OSA, which typically causes loud snoring and choking during sleep.

Marianne Davey, a co-founder of the British Snoring and Sleep Apnoea Association, says levels of OSA in the west have risen in line with increased obesity, as well as improved awareness and diagnosis. In the UK an estimated four in 1,000 people now suffer from OSA in comparison with one in 1,000 in 1991, although some surveys suggest the incidence is much higher.

“Being overweight, smoking and drinking are the three main reasons why people snore, so lifestyle is the biggest contributing factor,” she says.

Yet the worst lifestyle choice is to lose sleep deliberately, Prof Badre says. He has seen a small but growing number of clients who abuse drugs in order to stay awake and alert for unhealthy periods of time.

He recently treated a young investment banker who could apparently work for three to five days to complete a deal, before taking a long weekend to recover. He kept himself awake with a drug called modafinil and then put himself to sleep with a hypnotic agent called zopiclone. Both are available only by prescription, but he had ordered them on the internet.

City high-flyers are being lulled into a false sense of security, Prof Badre says. If you keep yourself awake all night, by any method, and work the following day, you will suffer at least from some cognitive dysfunction.

“This could lead to a small injury. Or it could lead you to miss a traffic light. Or it could lead you to make an error in a million-dollar contract,” he says.

Three days after his sleep test, Mr Webb meets Prof Badre for the results. As suspected, the smoking gun is in his brain activity. A healthy sleeper will experience four or five “sleep cycles” a night, between the troughs of deep sleep, when tissue repair takes place, and the peaks of rapid eye movement, when dreaming takes place. (www.159love.com收集整理)

Mr Webb is in REM more than half the night, having feature-length dreams. What is more, he acts out those dreams because, unlike a normal sleeper, his brain is failing to paralyse his body.

The diagnosis is REM behaviour disorder, a condition that can lead sleepers to injure themselves and partners. It is a neurological problem, so his lifestyle is not to blame, but stress can trigger its worst effects.

He is prescribed a mild dose of a sedative called clonazepam to relax his muscles at night so his body can “unlearn” its misbehaviour. He is also taught to restore his “Circadian rhythms”, the daily physiological cyclesthat regulate our sleep patterns. In weeks he is sleeping like a baby.

Mr Webb was lucky. His health insurance covered him for the sleep test – many UK policies do not. He also responded well to treatment. Most importantly, he was alerted to the problem and acted. According to specialists, many of the sleepless are either too embarrassed or unaware to take even these simple steps.