Sleepless Nights Research Articles

Trading likes for sleepless nights: A lifespan investigation of social media and sleep

ObjectivesThe present study sought to examine the association between social media use and sleep and whether the association differed by age. MethodsTotal 3,284 adults (M age = 42.74, SD = 16.72; 48.5% female; 80.8% White) participated in an online study of sleep and health across the lifespan. Sleep quality and duration were assessed using the Pittsburg Sleep Quality Index (PSQI). Participants reported the total time they spent using social media daily. ResultsGreater social media use was associated with poorer sleep quality (P < .001) and shorter sleep duration (P= .002). Age moderated the relationship between social media use and sleep quality (P= .006), as well as duration (P= .001). The strength of the associations between social media and sleep increased with age. ConclusionThe findings highlight potential adverse sleep outcomes associated with social media use. They also provide preliminary evidence suggesting the need for further exploration of age-related processes involved in social media use and sleep.

Genocide Never Sleeps. Living Law at the International Criminal Tribunal for Rwanda

International tribunals come and go. By the 2020s, it became clear that the international community had less appetite for international justice than in the early 1990s. Against the background of the permanent International Criminal Court (ICC), the United Nations’ (UN) International Criminal Tribunal for Rwanda (ICTR) — one of the only ever two fully powered UN tribunals — was a unique past phenomenon. Its unfinished business lives on in the UN’s International Residual Mechanism for Criminal Tribunals (IRMCT). Following the arrest, in mid-2020, of the ICTR’s main fugitive, Felicien Kabuga, its Arusha branch will convene the last major international trial. While awaiting the proceedings, and to get a taste of what the ICTR was about, one ought to read Nigel Eltringham’s latest book, with the eye-catching and distressing title Genocide Never Sleeps. It stems from a lawyer who joked, at 1 O’clock in the night over drinks at the ICTR’s popular hangout Via Via, ‘genocide never sleeps and neither should we’.1 It alludes to both what has become a trope for the mass murder of Rwandan Tutsi – proverbially carried out when ‘God was sleeping in Rwanda’ — and to sleepless nights working on complex and haunting cases. No matter how provocative, unsettling and confusing, this utterance illustrates how some lawyers were ‘living the law’.

Postpartum Cranial Diabetes Insipidus

Cranial Diabetes Insipidus is a rare diagnosis and rarer still postpartum. We present the case of 24-year-old woman who developed CDI following pregnancy. The patient had developed persistent polydipsia and polyuria 5 months following her first pregnancy. The pregnancy had been complicated by Gestational Diabetes Mellitus, Obstetric Cholestasis and a Postpartum Haemorrhage which had required a 3 unit transfusion of blood. The patient reported feeling fatigued and lightheaded and stated that she had needed to drink water frequently: around 8 litres throughout the day and 4 litres overnight. She reported that she had been unable to breastfeed but the rest of her systemic enquiry was unremarkable. The patient had attributed her symptoms of lethargy to sleepless nights with her new born baby and the polyuria as a consequence of labour and as such had presented for review at her primary care Physician 18 months following delivery.Initial investigations revealed a fasting blood glucose of 4.9 mmol/l, an Adj. Calcium of 2.23 mmol/l and a fasting urine osmolality of 85 mmol/kg. A diagnosis of DI was suspected and was confirmed by water deprivation test: the patient had an inappropriately dilute urine osmolality of 111 mmol/kg when compared to the serum osmolality of 301 mOsm/Kg at the start of the test and her urine failed to concentrate as water was withheld. Administration of DDAVP resulted in appropriate concentration of urine and therefore confirmed the diagnosis specifically as Cranial Diabetes Insipidus.Blood tests revealed normal anterior pituitary function: TSH was 2.78 mU/L, Prolactin was 361 mU/l, LH and FSH were 23.6 U/L and 5.3 U/L, IGF and GH were 197 ug/L and 0.1 ug/l and ACTH was 10 mU/L. Her basal cortisol was 392 nmol/l and was stimulated to 593 nmol/l by SST. MRI Pituitary revealed an unusually flat and broad pituitary gland with a possible tiny lesion in the posterior pituitary suggestive of an adenoma. The patient was established on DDAVP replacement therapy and her quality of life improved: she enjoyed restful sleep and reported less exhaustion. There was no anterior pituitary hormone deficiency 28 months following delivery. DI is a rare diagnosis with an estimated prevalence of 1 in 25000 people. CDI has been commonly reported as being caused by infiltrative or inflammatory pituitary disease, as an iatrogenic sequelae of pituitary surgery or as a result of a congenital defect in the production of vasopressin. We suspect that in this case the patient’s PPH may have resulted in isolated cranial diabetes insipidus though the significance of the MRI scan findings remains unclear. The learning points highlighted by this case are that CDI can occur following pregnancy in an isolated form without anterior pituitary hormone deficiency. We also highlight that patients may misattribute significant symptoms and signs of DI as being a normal part of the postpartum period resulting in a delayed diagnosis.

Assessment of sleep quality and its predictors among newly diagnosed psychiatric patients.

Poor sleep is a vital symptom observed in many psychiatric conditions and is the most neglected and underdiagnosed. The current study aims at assessment of sleep quality among psychiatric patients using the Pittsburgh Sleep Quality Index (PSQI) scale and to identify the predictors of sleep quality. A hospital-based cross-sectional observational study conducted in the Psychiatry department with a sample size of 256 patients for six months. PSQI scale was used to assess sleep quality and multiple logistic regression was used (to identify) the predictors for poor sleep quality. The mean age of the study population was 37.95±14.11 years, with 148 (58%) male study participants. 192 (75%) of the study population had poor sleep quality with respect to PSQI scale with a mean score of 9.05±4.65 that was well above the expected range (0-5) suggestive of compromised quality of sleep (p=0.001). Poor sleep satisfaction, waking up after the sleep onset, anorexia, day time drowsiness and at least one completely sleepless night in the past one week of admission were identified as good predictors for poor sleep quality. Our study addresses the importance of assessing sleep quality regardless of the psychiatric conditions. We recommend screening patients if they have Poor sleep satisfaction, waking up after the sleep onset, anorexia, day time drowsiness or at least one completely sleepless night in the past one week of admission predictors for comorbid sleep disorders.

A snapshot of emotional harms caused by the litigation process – Qualitative data from Ghana

BackgroundVery few studies have investigated the effect of the process of litigation on the mental health of litigants. In Ghana, not much is known about the stress that litigants encounter and how they cope during the process of litigation. MethodsThis study used a mixed-method sequential explanatory design to explore the stressors people litigating as individuals encounter in Ghana and how they cope in the process of litigation. As the second phase following the quantitative stage, interviews were conducted with seventeen (male = 13, female = 4) litigants (defendants = 4, plaintiffs = 13) who were selected (using criterion sampling) from the Law Court Complex in Accra, Ghana. Their average age and the average duration of the case was 50.13 (SD = 12.55), and 26.7 months respectively. Results and discussionTo explain the results found in the quantitative phase, three themes with subthemes were extracted from the data set: challenges in the court process, emotional consequences of the litigation process, and coping mechanisms. The frequent adjournments of cases, delays on court days, deliberate dragging of cases, financial strain, and opportunity cost, were the challenges encountered by litigants in the court process. These led to emotional outcomes such as stress, overstraining, sleepless nights, numbness, and the acceptance of court proceedings as part of life. To help them cope with these emotional outcomes, litigants looked for a light at the end of the tunnel and reliance on their faith. The stressful nature of the court process and how litigants cope with the process of litigation is discussed. Consequently, we recommend that people be educated about Bar etiquette and court procedures. Additionally, we suggest that lawyers should provide some form of scientifically-derived estimation of how long a case might last. It is also recommended that law firms consider providing counselling sessions for their clients.

Starp pagātni un tagadni: Gunara Janovska prozas šķautnes

The Latvian writer Gunars Janovskis (1916–2000) lived a long life, becoming the most productive Latvian exile prose writer not only in Great Britain but the whole Latvian exile community. Everything he saw, experienced, observed, and noticed in some way, was echoed in his literary work. Janovskis’ voluminous work offers diverse interpretation and analysis opportunities for a researcher of literature. The present article focuses on two of Janovskis’ prose texts – his novels “Sōla” (1963) and “Pilsēta pie upes” (‘A Town by the River’, 1992), belonging to different stages of the writer’s activity, as well as his life. For the literary characters depicted by Janovskis, it is vital to remember, avoid losing the past while they attempt to live in the present, though this may be rather hard at times. It has been commented regarding the works of Janovskis that in his books, people only are really living when they are remembering. The present article aims to view the aforementioned novels by Janovskis within the model of the relationship between the past and the present, mainly concentrating on the relationship of the main characters with the time. The novel “Sōla” is the first novel by Janovskis ever published in a book. The main protagonist is Arturs Skuja, returning to some past impressions alongside the present from time to time. The landscape and elements of nature bring back his memories, inviting comparisons with the things once seen in Bolderāja or Daugavgrīva. There is a second and much heavier layer of the past in the protagonist’s dramatic and even tragic experiences during the war, which haunt him during sleepless nights or even return like a ghost. The main tense of the story within this novel is the present. But the novel “Pilsēta pie upes”, written much later, shows a shift of accent. The story starts in the present reality – at the old people’s home “Straumēni”. The urge of the author to tell the life story of Ansis Klētnieks is obvious, but in this story, one can unmistakably recognise the reflections of the author himself, through the location depicted (there are clear parallels between the course of life of Ansis from Krustpils and that of the author). The urge to tell, testify, not remain silent is much more pronounced in the story. The author has become less ambiguously involved in documenting a dramatic era, being its eyewitness. The novels chosen for the present article mark the changes in the relationship of the Janovskis’ literary characters with the present and the past. While the narrative in the present basically dominates in the novel “Sōla”, the other novel, “Pilsēta pie upes”, shows the past events and narrative dominating over the present. In both works, the plot takes place in both Great Britain and Latvia, though with changing intensity. It can be concluded that for Gunars, Janovskis writing was a kind of therapy aimed at overcoming the past while still securing the memories from being lost.

Effect of Pregnancy on Sleep

Getting a good sleep is important to mother and child health, for pregnant women getting sleepless night lead to fatigue, day time sleeping, leading to change in sleep cycle and effecting maternal and fetal health mentally. Sleep plays important role in health of baby like memory, appetite, and learning. Now a day’s sleep duration has been declining in women priority list. Sleep deprivation have shown adverse effect on birth results like preterm delivery and mental issues like postpartum illness and depression. Pregnancy deals with different physical, hormonal and physiological changes effecting sleep, most of the women experience sleep disturbances during pregnancy. Insomnia, leg cramps, obstructive sleep Apnea, restless leg syndrome, gastro oesophageal reflux disorder majorly occurring problems during pregnancy. Lifestyle and prevention of things are considered

Sleep problems in children and adolescents following traumatic life events.

Rates of childhood trauma exposure are extremely high, with approximately 70% of children and adolescents experiencing at least one traumatic event. Among the most common non-specific consequences of stress and trauma are disruptions of sleep. Sleep problems, such as shorter sleep duration, difficulty falling asleep, frequent awakenings, nightmares, sleepless nights, and early-morning wakefulness appear to have a higher prevalence among children and adolescents following traumatic events. This review will illustrate the role of sleep problems in traumatized children and adolescents, and emphasize the need to consider a wide range of etiological mechanisms for these symptoms. However, the relationship of trauma exposure to sleep problems among children and adolescents needs further investigation in future research. Moreover, in view of the adverse consequences of long-term disrupted sleep on mental health outcomes following trauma, the need to effectively address sleep disturbances in traumatized children and adolescents is crucial.

Working memory from pregnancy to postpartum: Do women really change?

Studies indicate that pregnancy is associated with declines in working memory (WM), potentially due to intense pregnancy hormonal fluctuations. These declines extend into the postpartum period and may even be worsened due to sleepless nights and continued hormonal changes. However, previous studies finding WM stability from pregnancy to postpartum have not used a control group to examine practice effects on WM tests. The current study used a well-matched control group, fathers, to examine a) whether mothers and fathers differ on tests of WM during pregnancy and postpartum, and b) whether mothers show a postpartum WM decline, taking into account the practice effects of fathers. Results revealed that mothers (N = 75) and fathers (N = 44) performed equally well on a WM task at both time points and improved across time at a statistically equivalent rate. Use of a Reliable Change Index and a regression-based sensitivity analysis bolstered these results, indicating that taking practice effects into account, the majority of women did not improve or decline in WM from pre- to postpartum. These findings add to the literature on pregnancy-related changes in cognition and raise new questions about potential cognitive changes in men during the same period.

Stuck in companionless days, end up in sleepless nights: relationships between ostracism, rumination, insomnia, and subjective well-being

The current research aimed to investigate the relationship between ostracism and insomnia and whether the relationship is mediated by rumination and has implications on subjective well-being. A cross-sectional design was adopted. A sample of 219 undergraduate students from a public university in Hong Kong participated in this study. Participants completed a series of well-validated measures to assess their dispositional ostracism, rumination, insomnia, and subjective well-being. As predicted, the results revealed that ostracism was positively associated with rumination and insomnia and negatively associated with subjective well-being. Moreover, the relationship between ostracism and insomnia was mediated by increased rumination, and such an ostracism–rumination–insomnia link was associated with reduced subjective well-being. These findings have implications for advancing current theories about negative outcomes of ostracism and the underlying psychological mechanisms. They also emphasize the significant role that interpersonal relationships play in easing insomnia and enhancing subjective well-being.

COVID-19: The Unprecedented Malady- A Holistic Review

Background: Coronavirus disease (COVID-19) is spreading rapidly at an unprecedented scale across continents and has emerged as the single biggest risk the world has faced in modern times. Some scientists are comparing it to Spanish flu that created havoc around a century ago. The fear of death by COVID-19 looms large in the world today. The disease has reached devastating proportions since its first reports in December 2019. Doctors are having a difficult time dealing with this challenge and the microbiologists are having sleepless nights to bring about an effective vaccine for this disease. Methods: A number of research and review articles have been exhaustively reviewed. The collected data has been meticulously analyzed and documented. Conclusion: This paper reviews the different types of coronaviruses, the structure of SARS-CoV-2 responsible for COVID-19, its transmission, and virulence. Further, the article discusses the diagnosis, signs and symptoms like fever, breathlessness, cough, potential loss of taste or smell, sneezing, runny nose, fatigue, headache, sore throat and different treatment approaches including drug repurposing being tried by doctors around the globe that may come handy in the management of disease symptoms. The article describes the use of remdesivir, ribavarin, lopinavir, favipiravir, hydoxychloroquine, chloroquine, and tocilizumab among others in treating COVID-19.

How effective and cost-effective is water fluoridation for adults? Protocol for a 10-year retrospective cohort study

BackgroundTooth decay can cause pain, sleepless nights and loss of productive workdays. Fluoridation of drinking water was identified in the 1940s as a cost-effective method of prevention. In the mid-1970s, fluoride toothpastes became widely available. Since then, in high-income countries the prevalence of tooth decay in children has reduced whilst natural tooth retention in older age groups has increased. Most water fluoridation research was carried out before these dramatic changes in fluoride availability and oral health. Furthermore, there is a paucity of evidence in adults. The aim of this study is to assess the clinical and cost-effectiveness of water fluoridation in preventing invasive dental treatment in adults and adolescents aged over 12.Methods/designRetrospective cohort study using 10 years of routinely available dental treatment data. Individuals exposed to water fluoridation will be identified by sampled water fluoride concentration linked to place of residence. Outcomes will be based on the number of invasive dental treatments received per participant (fillings, extractions, root canal treatments). A generalised linear model with clustering by local authority area will be used for analysis. The model will include area level propensity scores and individual-level covariates. The economic evaluation will focus on (1) cost-effectiveness as assessed by the water fluoridation mean cost per invasive treatment avoided and (2) a return on investment from the public sector perspective, capturing the change in cost of dental service utilisation resulting from investment in water fluoridation.DiscussionsThere is a well-recognised need for contemporary evidence regarding the effectiveness and cost-effectiveness of water fluoridation, particularly for adults. The absence of such evidence for all age groups may lead to an underestimation of the potential benefits of a population-wide, rather than targeted, fluoride delivery programme. This study will utilise a pragmatic design to address the information needs of policy makers in a timely manner.

“But He Was Good for Israel, Wasn’t He?” A Reassessment of the Jewish State’s Embrace of Donald Trump

After a sleepless night wishing that the frightening scenes from the US Capitol were just a grotesque nightmare, the morning of January 7, 2021, brought some initial comic relief. Israeli politicia...

La Nuit Épuisée: poïétique d’une insomnie collective

La Nuit Épuisée, poietic of a collective insomnia La Nuit Épuisée (2018), project on the initiative of Antoine d’Agata and Lea Bismuth, comes from a collective writing experience which tooks place during a sleepless night; consequently, it allows us to see the visual and textual marks left by the night on this photoliteracy silkscreened book. By analysing this work and each of his twelve leporelli, we can, like its authors, see what it’s only perceptible into the night. As much as poietic is, according to René Passeron, the science of the dynamic relationship between an artist and its artwork while he is struggling with it, this article analyses the context of creation of this book (a collective insomnia in a nightclub) and how it affects the plasticity and the writing of a book which intends to propose us a reading experience.

Do caffeine-containing combination analgesics cause sleepless nights?

No relevant effects on the sleep quality of subjects were found in two studies in which ibuprofen combined with 100 mg caffeine was taken three times daily. Of a total of 538 patients, medication-induced sleep problems occurred in only one to two in 100 participants. In one of the studies, only 0.8% of participants reported sleep disorders – exactly the same percentage as in the placebo arm.

Sleepless

Sleepless Andrew Porter (bio) Sometimes I wake at night to the sound of my son wandering around the house. He doesn’t sleep anymore, and we’ve tried everything. We’ve tried reading to him, giving him a long warm bath before bedtime, letting him listen to music, watch tv. He’s six years old this spring and full of all sorts of complex emotions. My wife and I live in a small Mission-style home on the south side of San Antonio, and I often hear my son wandering out to the courtyard in the middle of the night, standing at the stone fountain and staring at it pensively, or other times, sitting down on one of the benches in the middle of the garden, looking at the bougainvillea along the wall, the Mexican bush sage and hibiscus. Once last week I caught him standing at the parapet on the second-floor balcony, overlooking the courtyard, and I thought for a moment he might jump. I don’t know why I thought such a thing. I don’t see him as a particularly despondent child, just mysterious. He’s not what I imagined when I imagined having a son. He’s nothing at all like my daughter. He’s exactly like you, my wife once told me, and I wondered what she could possibly mean. He’s restless, she said, sensitive, lost. You see me as lost? More than you realize. Later that night, after my wife had fallen asleep, I followed my son out to the moonlit courtyard and sat next to him, as he sat there quietly, staring out at the yucca plants, the old wrought iron table and chairs where we often had dinner. I knew in a couple years we’d be gone from this place. It was a wonderful house for parties, and it was perfect for an unmarried couple, or maybe even a married couple with one child, but it wasn’t a place to raise a family. It was too old, and there were too many problems with it. It was beautiful, yes, but not in a practical way. That evening, though, I wasn’t thinking about this. I was thinking about what my wife had said. [End Page 116] He’s just like you, she said, restless, sensitive, lost. I took my son’s hand and I squeezed it, hoping he wouldn’t hate me too much when he was older, hoping he wouldn’t resent me for all of the things I hadn’t given him, hoping that within those long silences, there were positive things, hopeful things, hoping he was just saving these thoughts up for a time when he might need them, hoping these long nights would pass, these sleepless nights when he sat there so quietly, stoic in the moonlight, waiting for something, or someone, to release him. [End Page 117] Andrew Porter Andrew Porter is the author of three books, including the forthcoming short story collection The Disappeared (Alfred A. Knopf); the short story collection The Theory of Light and Matter (Vintage/Penguin Random House), which won the Flannery O’Connor Award for Short Fiction; and the novel In Between Days (Alfred A. Knopf), which was a Barnes & Noble Discover Great New Writers selection. Currently, Porter directs the creative writing program and teaches fiction writing at Trinity University in San Antonio. Copyright © 2021 University of Nebraska Press

Plus sombre la nuit, plus claire la journée: « la beauté des nuits du monde » de Marguerite Duras

The darker the night, the brighter the day: “the beauty of the world’s nights” by Marguerite Duras Night-time, the favorite time of awakening for Marguerite Duras, has an ambivalent status. In a colorful game, the sleepless night changes from white to black, from bright to dark. Rather than a standstill or loss of time, the night without sleep offers a spectacular acceleration and intensification. Since the night acts as a catalyst, insomnia confronts the characters to their inescapable fate. Staying awake becomes an act of resistance, for both, characters and author. Therefore, insomnia emphasizes emptiness and inaction, and transforms loss into creation and fulfillment. Which means that insomnia is more than a physical phenomenon: it acquires a metaphysical dimension in Marguerite Duras’s work.

Do caffeine-containing combination analgesics cause sleepless nights?

No relevant effects on the sleep quality of subjects were found in two studies in which ibuprofen combined with 100 mg caffeine was taken three times daily. Of a total of 538 patients, medication-induced sleep problems occurred in only one to two in 100 participants. In one of the studies, only 0.8% of participants reported sleep disorders – exactly the same percentage as in the placebo arm.

The Pleasure Marriage by Tahar Ben Jelloun

BOOKS IN REVIEW Alonso Cueto The Wind Traveler Trans. Frank Wynne & Jessie Méndez Sayer. Austin. University of Texas Press. 2020. 232 pages. THE WIND TRAVELER is the latest novel to appear in English by Alonso Cueto, an author known for his Redención trilogy about the war between the Peruvian State and the Shining Path in the 1980s and 1990s. The first volume of Cueto’s trilogy, The Blue Hour (2005), considered one of the best novels on the subject, received high critical praise upon its publication in English in 2012. The Wind Traveler tells the story of Angel Serpa, former soldier in the Peruvian army who, after fighting in Ayacucho, has retired in the 1990s and now leads a lonely, monotonous life in Lima selling housewares. Haunted by his war memories , Angel refuses to collect his pension from the army. One day, a woman named Eliana, whom he was ordered to execute in the war, walks into Angel’s store to buy glasses. Angel recognizes his victim and thus begins his painful journey to find atonement for the suffering he has caused her. Guilt-ridden and in shock, but hoping to receive Eliana’s forgiveness, Angel follows her and is eventually confronted by Señor Huarón, a man claiming to be her father. Later, he finds an opportunity to redeem himself when he witnesses a struggle between Eliana and Señor Huar ón, who we learn has enslaved the woman. The result is that Angel is charged with the murder of Huarón and spends three years in prison, although he is not responsible for his death. Nevertheless, he sees his time in jail as a way to pay for his war sins. Cueto’s magnificent storytelling ably portrays the brutality of Peru’s armed conflict and, more importantly, the many personal scars it left behind. Because the narrative is centered on Angel’s personal trauma, it allows us to carefully explore a wide array of feelings, including the protagonist ’s sense of sorrow, pain, guilt, and reparation. In the end, the lesson to be learned resonates loud and clear: It will be impossible for Angel to fully come to terms with the ghosts of his painful past. The Wind Traveler is a fast-paced, psychologically charged novel that quickly grabs the reader’s attention. Translators Frank Wynne and Jessie Méndez Sayer should be commended for their excellent rendition of this gripping narrative. The Wind Traveler will allow English-speaking audiences to learn about Peru’s recent painful past, as well as discover the many talents of one of its best storytellers. César Ferreira University of Wisconsin–Milwaukee Tahar Ben Jelloun The Pleasure Marriage Trans. Rita Nezami. Evanston, Illinois. Curbstone Books. 2021. 133 pages. BENEATH ITS BUSTLING marketplace and wondrous architecture, Fez, Morocco, is no less susceptible to hatred. Tahar Ben Jelloun’s generational saga, The Pleasure Marriage, traces the consequences of the dream of two lovers against the prejudice of reality. Amir, a successful and white merchant, graduates a temporary union—the novel’s namesake—in Senegal between himself and Nabou, into a second marriage. After a surreal journey across the desert with Nabou and Amir’s son, Karim, fantasy and passion is ensnared by intolerance and racism. Ben Jelloun’s tale possesses the voice of a fairy tale yet never relents in examining Nabou and ultimately her children’s plight. Amir and Nabou’s story is framed à la One Thousand and One Nights; appropriately , an excerpt of the classic text prefaces the novel. A renowned, begging storyteller introduces the narrative with a tinge of whimsy and curiosity, despite its severity . Though the early movement of The Pleasure Marriage feels magical and even timeless, Ben Jelloun’s voice does not inappropriately stifle the injustice that later transpires. Passion is ample throughout the novel even when tempered by the flames of scrutiny. Ben Jelloun is careful to illustrate every consequence of Amir and Nabou’s relationship. In doing so, however, some seemingly key events in the novel pass quickly and without much contempla86 WLT AUTUMN 2021 0 tion. The novel’s pace is thus jarring at times: whereas one character’s sleepless night encapsulates the...

For a Friend

For a Friend R. M. Cooper (bio) Isabelle had been dead for six months before I read her obituary on Twitter. Six weeks later, I still wasn’t sleeping well, so Dave suggested I try a cleanse. Juice/herbs/kelp/whatever. I told Dave what I thought of it, and he dropped the subject. The next week, I started having Isabelle flashbacks. I wish there was a better word for them. They weren’t “flashbacks” in the Vietnam or acid sense. It’d be more like I’m watching Netflix when all of a sudden: isabelle flashback We’re eight and Isabelle has a cast on her left leg. We sit around her kitchen table and Isabelle’s mom is talking about how her bones might grow back uneven. Like, Isabelle’s healed femur would probably be shorter than the other the rest of her life. Not even an inch. Fractions. Less even. “Isn’t that interesting?” Her mom smiles when she says it. Then her mom frowns. “No. Izzy won’t limp.” I don’t remember asking the questions. Just her mom’s answers. I don’t know why. Other flashbacks are different. I don’t make the rules. “No. No one will even notice.” “Of course they won’t think something’s wrong with her.” “No. She won’t be ugly. No. No, don’t cry, Izzy. Why would you ever ask that?” After every flashback, I spend the next forty-eight hours obsessing over it until Dave tells me the same thing for the thousandth time: “You don’t have to feel this way, Sarah. Nobody has to feel this way.” Dave sent me a bunch of links about the way our bodies react to stress, about toxins and cell memory. Dave promised I’ll feel better after the cleanse. He said in ten years they’ll be the norm. No different than sitting [End Page 143] shiva. No more uncomfortable silences. No moping. No depression. It’s all chemicals and hormones. The body doesn’t require misery any more than it does refined sugar. Let that shit go. So I ordered one of those forty-eight-hour all-natural boxes online. I downloaded a bunch of movies onto my phone and read articles about how to keep your legs from falling asleep on the toilet. I bought a box of Pedialyte. Hydration is very important during the first twenty-four hours. I read and I read. I figured I was ready. important note on cleanse instructions: “48 hours” doesn’t necessarily begin when you swallow the first capsule. “48 hours” can mean “begins after 48 hours” or “lasts for 48 hours” or whatever the hell else they want. Cleanses aren’t monitored by the fda or the cdc or whoever is supposed to ensure that children’s Tylenol won’t give you a stroke. It says so right in the small print. Remember those stories of synthetic weed from the 2010s? It’s like that. Nobody knows anything. There’s no one to hold responsible. It’s unregulated. The Wild West. I mean, I’m sure Gwyneth Paltrow is a fantastic human being. But that’s not really the point. Because when you think about it, should you really be buying laxative from actors? Fact: I knew none of this at the time. I took the first cleanse capsule on Friday. Saturday. Sunday. Nothing happened. I assumed I’d ordered a dud. I was mildly annoyed but not surprised. I cursed the hippie industrial complex and wrote an angry review on Amazon and moved on with my life. Thought maybe I’d use the Pedialyte as an excuse to train for a marathon. That seemed more productive. I had another sleepless night Sunday and went to work Monday. Then it happened. Happens. Is still happening. ________ The cold sweats hit during an hr meeting. 10:15 am. By 10:17, I’m doing ninety on the interstate for home, doing that Lamaze breathing which for some reason becomes instinctual when you’re trying not to crap your pants. I know saying “crap your pants” isn’t very ladylike. You know what’s less ladylike? Literally crapping...