Administration and Leadership, Columns

Sleepwalking the Walk

Issue 2 and Volume 39.

“He seems OK now,” she said as she anxiously pointed toward the child’s room.

Indeed, our 9-year-old patient was sleeping cozily in his soft, warm bed with visions of videogames no doubt dancing in his head. His face portrayed a sweet smile of tranquility while his chest rose and fell effortlessly (a satisfactory homeostatic breathing rate linked harmoniously with his ventrolateral preoptic neurons). In other words, he was out like a light, and unbothered by the likes of us—two weary, grouchy, epi-deprived, medics toned out at 2 a.m. for a “child behaving strangely.”

Within minutes of concise medical questioning and the desire to get back to our own bedsteads, we determined the patient was sleepwalking. Unless, of course, it’s customary for a glassy-eyed child to walk with a zombie-like gait into his parent’s bedroom for the sole purpose of marking his territory within the boundaries of their wastebasket.

Following protocol, we asked such diagnostic questions as, “Has your child been previously diagnosed with sleep-disordered breathing?” No.

“Does your child have a history of migraines, seizures, head injury, recent fever/illness, RLS or recent Rx medications?” No.

“Is your child currently experiencing high anxiety or stress?” No.

“Is your child a raging alcoholic who finances his videogame habits by manufacturing and peddling crystal meth?” What?!

“Oops … Sorry. My bad. These are the kind of questions I’m used to asking at this hour of the day.”

After a quick set of vitals and mental/physical exam (of both the patient and ourselves), we left the little fella with his parents.

“What do you recommend we do at this point?” the somewhat now-relieved mother asked as we began our exit.

“I would have him admitted into a drug rehab program immediately … er, I mean, sleepwalking will only occur once a night,” I said through a reassuring smile. “He’ll outgrow sleepwalking by the time he reaches adolescence, but if you see more frequent sleepwalking habits, accompanied by other signs or symptoms, or that jeopardize his safety, you should consult with his pediatric doctor or sleep specialist.”

“How do you know so much about sleepwalking?” my partner asked.

“I’ve seen enough of these somnambulism cases in my career to enhance my intuitiveness for this particular phenomenon,” I yawned confidently. (OK, so I didn’t say “somnambulism.” Hell, I can’t even pronounce it, but that’s what it’s called—so says WebMD).

“This was my first sleepwalking call ever,” my perplexed partner replied.

“I’m not referring to any patients I’ve run on,” I guffawed sarcastically. “I’m referring specifically to prior partners I’ve worked with over the years. Jeez Louise,” I continued, “It’s no wonder we don’t see it more often considering the environment we work in. Sleeping in unfamiliar surroundings, chaotic sleeping schedules, sleep deprivation, high stress and chronic late-night Taco Bell indigestion infestation are all precursors for nocturnal aimless wandering in an unconscious state.”

There are only two times that I sleepwalked: once when I was 8, sickened with a blistering fever, and the other when I was working a sweltering 24-hour shift. My parents found me baptizing their wastebasket while mumbling incoherently. I guess all those intoxicated patients voiding their bladders in my ambulance are unjustifiable payback for having once experienced a fever void of Tylenol access.

As for the slumbering adventure I had subconsciously initiated while on duty 24 years earlier, it changed my life. My partner and I had been running nonstop calls from 8 a.m. to 3 a.m. the next morning. After only 20 minutes of finally hitting our beds at quarters (this is my partner talking now), I jumped out of my bed and walked purposely toward his. Unbeknownst to me, my startled partner awoke to find me hovering closely over his bed while smiling fiendishly down on him, not moving, not talking, and thankfully not looking for a wastebasket. Bewildered, he yelled, “What the hell are you doing?”

I said nothing and remained motionless as I continued to glare down on him. Reaching for his Maglite, he took a defensive supine stance. Minutes later I told him in a clear soft voice, “I’m going to become an EMS cartoonist,” at which point I turned around, snuggled back into my bed and peacefully fell asleep until wakeup tones went off four hours later. My partner didn’t fall back asleep, but did attempt to find the word “exorcist” in the yellow pages.

Needless to say I was surprised to hear of my comatose endeavor and didn’t believe a word of it, especially since I wasn’t an artist of any kind. But figuring it could be a sign from Satan and that I had nothing to lose, I went immediately to Wal-Mart. Bypassing the wastebasket section I found some art paper and tons of erasers to etch out what was inevitably to become a sick and twisted hobby of cartooning what we do day-to-day in EMS.

So, if you ever see me at a scene taking out a notepad, odds are I’m not writing down the patient’s vital signs. Heh heh.

Until next time, sweet dreams.