PHANTOM DEATH

This should come as no news to most people who know they are afflicted with OSA.

However, I doubt that many people in the general population realize this fact; I fear that the ranks of the uninformed include most of the 19+ million Americans with sleep apnea who don’t know they have OSA. . .yet.

Of course, OSA doesn’t usually kill directly, as it might by stopping the sleeper’s breathing once and for all. It kills mainly by its complications—heart disease, strokes, accidents, lack of oxygen to vital organs, etc. In this it resembles many chronic diseases that shorten life expectancy: high blood pressure, atherosclerosis, diabetes, obesity, alcoholism, nicotine addiction.

Unfortunately, such “indirectly” lethal effects don’t grab attention with the same immediacy as a disease that often kills without needing an intermediary, like metastatic cancer. To take this point a step further, nicotine addiction leads to death by a myriad of causes, including lung cancer, but also including other types of cancer, emphysema, heart disease, etc. As agents of death, cigarettes cast a much greater shadow over our lives than lung cancer, yet fail to evoke anything like the same degree of terror. Although animals given free access to nicotine will abuse it to the point of death by overdose (one of the very few substances of abuse for which this holds true), human beings don’t drop dead from an excess of nicotine. If they did, the danger of smoking might have much more impact on the still widespread use of cigarettes.

Consider this hypothesis: the perception of a disease as a single-handed, serial killer, capable of murder without need for accomplices, makes a distinctive impression, more powerful than volumes of irrefutable statistics demonstrating that a condition indirectly leads to the death of millions. The plausibility of the hypothesis has encouraged me to offer a single example of how sleep apnea can kill in a very direct and immediate way.

The case I have in mind is that of John Merrick (1862-1890), the "Elephant Man." Despite his having been the subject of books, websites, play and movie, his name probably means nothing to a lot of people. Long thought to represent a severe case of neurofibromatosis, he has recently come to be viewed as a victim of a rare disease called Proteus syndrome.

Regardless of precise diagnosis, Mr. Merrick suffered from a dreadful condition, starting at about age five, which caused overgrowths of skin and bone. It resulted in numerous deformities, including those of his face and jaws. Before his admission to London Hospital for the last four years of his life, he had been emprisoned in a work house, then escaped into slavery as a carnival freak. After hospitalization, he received much kinder treatment, and even gained a certain celebrity for his high intelligence and admirable character.

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