Dreaming

We don’t have access to the moment of falling asleep but I imagine it to be a bit like dying; a gradual lapse into the void. After turning out the lights, you are alone with your thoughts. Initially these are rational, perhaps some unfinished business of the day you wish to chew over, but soon you are in a liminal zone where organised thoughts drift into illogical concepts and surreal images – followed by a blank.

“To die, to sleep – to sleep, perchance to dream – ay, there’s the rub, for in this sleep of death what dreams may come…”

Do you dream? In general I don’t – or rather I don’t remember my dreams. We all dream, but we only remember those dreams if we wake up during them. Even quite a vivid dream can fade rapidly when exposed to light. Dreaming mostly occurs during REM (rapid eye movement) sleep. REM sleep is shallow; muscle tone and blood pressure rise and we are more easily woken. It occurs later in the night and seems to be involved in memory and learning skills. Perhaps it is the brain preparing to become fully awake. We do a lot more REM sleeping when we are young. Being deprived of REM sleep results in a variety of symptoms including poor memory, loss of concentration and drowsiness. It fascinates me that other mammals dream. Dogs bark quietly and twitch their feet as they chase an imaginary quarry or confront some threat. What are they experiencing?

The non-sense of dreams is familiar. Despite this feeling that things are not quite right it is impossible to restore normality or wake yourself up. Most of the time we are caught within the illogicality of the dream, unable to identify it as non-sense. Various writers have described this experience. A philosopher woke believing he’d cracked the secret of everything. He grabbed a pencil and paper and wrote it down. In the morning he remembered the dream but not the actual thesis. He picked up the paper on the bedside table in eager anticipation only to find that he’d written, ‘The universe has no opposite’. Similarly, a comedian dreamt he’d invented the funniest joke in the world. His fortune was made. In the middle of the night he wrote it down, worried that he might forget it. In the morning he was dismayed to read the statement, ‘I am a hammer.’

If a dream becomes a nightmare, waking with a start can be involuntary – and a welcome relief. Your brain paralyses your muscles to stop you acting on these disturbing visions – unless, that is, you are a sleepwalker. I never walk in my sleep – although I know people who have, often performing complex, organised tasks in a type of ‘fugue state’. (I’m not sure I really believe in fugue states. I think sufferers are either sleepwalking or faking it.) Contrary to the popular myth, you should wake a sleepwalker to prevent them injuring themselves, or simply lead them back to bed.

The closest I’ve got to this sort of thing was as a teenager. One morning I found myself sitting upright in bed with no recollection of how I got there. Standing at the foot of the bed, looking quizzical, were my mother and younger brother.
‘Well, do you want some breakfast?’ asked my mother. I said that yes, I did and she left the room. My brother frowned at me.
‘What was all that about a vase?’
The word vase sounded oddly familiar to me, like déjà vu. ‘What do you mean?’ I asked.
‘You were sitting up in bed shouting, “I want my vase! I want my vase!” ‘
A vague memory of a dream involving this weird statement lurked in the back of my conscience – but it was quite beyond me to retrieve it.

Some of my recurring childhood dreams were completely abstract. One involved an image of a sheer orange curtain blowing in the wind. In front of it was some kind of dark, rounded but smoothly irregular wooden object. This was accompanied by vague feelings of unease. A recurrent nightmare means you have woken regularly from the same dream, and I wonder if this one reflected some kind of physical discomfort.

My mother suffered from a variety of anxiety dreams. In one she was desperately trying to prepare for a large dinner party but all the essential shops were closed, and the arrival of guests was imminent. Another involved needing to ‘spend a penny’ in Central Station in Glasgow but finding that all the toilets had a glass wall facing onto the busy concourse.

And then there are the exam dreams. You might dream that you’ve passed when in fact you haven’t even sat the damn thing. Joy turns back to anxiety as you surface from the illusion. More enjoyable are the ones where you dream your haven’t yet sat the exam – or even failed it – then wake to the colossal relief of finding it’s all behind you.

I spent university holidays working on the farm. Sometimes while I was seated on a noisy tractor turning endless rows of cut hay my father would come to the end of the field to divert me to another activity. Standing by the Hillman Hunter estate, he would use his loud whistle to get my attention above the din. After he died, there were a couple of occasions when I thought I had heard him whistle above the drone of the engine and I would look to the end of the field only to see that there was no one there. Until very recently, I have had the occasional dream that he has been found alive. Joy is mixed with outrage: ‘We’ve been so worried about you! We thought you were dead! Why didn’t you let us know?’

Profoundly disturbed sleep was a constant feature of my junior doctor years. As a house officer in the 1980s a normal working day could be followed by a night of on-call when you might not get to bed at all. This was followed by another ‘normal’ working day. Similarly, if you’d been on-call over an entire weekend you nevertheless had to work a full day on Monday. Once, after a particularly busy weekend with only two hours of broken sleep out of the 48 worked, I found I had five routine admissions to ‘clerk in’ on the Monday. Exhausted, by five pm I still had two patients left to do. Clerking a patient is time-consuming and involves taking a comprehensive history then performing a full physical examination. It was a neurology ward and neurological examinations are particularly demanding. You committed all this to paper in the notes and would often get challenged on your findings by the consultant on subsequent ward rounds.

As he left for home my registrar breezily said, ‘You’re tired Allan. Don’t stay too late.’ That evening, while sitting in a chair by the bedside taking a history from my last patient I lapsed into unconsciousness. I woke to find my patient reading his paper. Glancing at my notes I saw that the last sentence I’d written was gibberish and the pen had trailed right down to the bottom of the page. I apologised to the gentleman who said, ‘That’s OK doctor, you looked like you needed a rest. What time did you start work today?’
‘Saturday,’ I said.

As a defence I developed the ability to fall asleep instantly any time there was an opportunity. I could sleep upright in chairs or with my forehead resting on the desk in the duty room. I was once woken from a desk-nap by a motherly auxiliary who had brought me tea and toast. It was bliss. Exhaustion while on-call results in an instant deep ‘sleep of death’ when you eventually made it to the on-call room. Then the phone would ring after what seemed like hours of insensibility – only to find it was just ten minutes later.

A cheerful and attractive telephonist ran the overnight switchboard at the hospital I worked in as a medical registrar in Fife. Originally from the South East of England, this lady had a mellifluous estuarine accent. She lived in happy symbiosis with the local emergency services and had a sideline in alarm calls to various firemen and policemen around the town. In the middle of the night one or two bored policemen might be encountered hanging around reception chatting to her. Even middle-graders like me had to be resident in the hospital when on-call, and instantly available for any crisis. We admitted a variety of these including many heart attacks and self-poisonings. When a nocturnal emergency arose you would pick up the phone to a tenderly apologetic, ‘I’m sorry, love. Cardiac arrest, Ward 2.’

As an adult I have had two recurring dreams. I regularly dream that I can fly. It seems so easy; you simply think yourself into the air and soar over the landscape wondering why on earth you have never exploited this fantastic talent before. The other one involves finding a secret room in your house that you never suspected was there; perhaps under the stairs or through a cupboard. Sometimes it’s a secret part of the garden that you stumble upon. I usually feel annoyed at these discoveries, frustrated that I could have enjoyed these assets for years – if only I’d known they were there.