"The Family That Couldn't Sleep"

Read more about D.T. Max's investigation of killer insomnia in the following interview and excerpt.

By Salon staff

Read more: Books

Dec. 14, 2006 | How did you first learn of fatal familial insomnia, the illness that afflicts the Italian family in your book?

We had an issue planned at the New York Times Magazine, where I was a frequent contributor, on diseases and cures that cross borders. I was on the phone with a Chicago neurologist who I knew had interesting cases and he said he had had a patient who had died of fatal insomnia. I said, that's impossible, no one ever died from lack of sleep. He laughed that knowing chuckle of the neurologist confronted with the naiveté of the journalist (how I learned to dread that laugh!) and said, "That's what you think." I said, "I've got to come see you," and he said, "Wait, I've got something even stranger. I know a family in Italy -- rich, cultured, established -- who have had the same disease for over 200 years, 200 years of fatal insomnia." I paused: "Where in Italy?" He said Venice. So I thought to myself, "Death in Chicago"? "Death in Venice"? Soon I was looking for my passport.

The incredible resilience of prions -- the fact that they can lie dormant in soil for years, for example -- makes them truly terrifying disease agents. How significant a threat to public health are they?

They are a major threat because we still don't understand the most basic things about them -- we don't understand how they are transmitted in the wild or what their species range is -- i.e., can chronic wasting disease, a wildly spreading prion disease in domestic deer, infect cows, humans, groundwater?

You write about both literature and science, two subjects that people often see as radically different. Do you?

I embody the question because "dtmax" in chemistry means the maximum change (delta) in temperature. Try Googling it. Actually the glory of words is that they are powerful enough to bridge the gap between speech and science. It's not reversible: Science can't substitute for words, but words can substitute for science. Put another way, when it comes to explaining, all science bows down before rhetoric -- and rhetoric is what writers should be good at.

Do you have any rules of thumb for how to write accessibly about complex scientific subjects, like the quest to figure out what exactly prions are?

This one: After I've mastered a scientific fact, I write it as if I was learning it again for the first time. Another way to state the rule is: I don't pull up the ladder after I've climbed the wall.

"The Family That Couldn't Sleep" is a pretty scary book! Do you have any tendency to hypochondria, and if so how did you fend it off while working on this book?

Well, I already had an undiagnosed neurological disease when I started working on the book, so I didn't have too much room for hypochondria. I spent this rather unsettling afternoon outside of Mount Horeb, Wis., watching hunters drop off possibly infected deer carcasses as part of the state's eradication effort. The Wisconsin DNR [Department of Natural Resources] people would then saw off their heads and throw them in a truck to be tested. Some guy was splashing some sort of bleaching agent around to disinfect, but I didn't see his graduate degree in prion sciences. He just sort of threw it wherever he wanted. So I've told my wife if I start falling apart in my 60s from a mysterious condition that resembles chronic wasting disease in deer, she should call the lawyers.

Do you have a favorite book from 2006?

I thought Matt Ridley's book on Crick, "Francis Crick: Discoverer of the Genetic Code," was very good. I always wondered about Crick. All we ever hear about over here is [James] Watson.

Next page: Read an excerpt from "The Family That Couldn't Sleep"