44 Scotland Street: Interesting somnambulism cases Dr MACGREGOR would not normally have allowed himself such an excursus with a patient, but he felt an essential rapport with Angus and so he spoke quite freely. "The first thing I should say is this," he began. The overwhelming majority of cases of somnambulistic activity give no cause for alarm. Sleepwalking is, in fact, quite common in childhood and it's something that people grow out of - rather like an appreciation of pop music - Abba, for instance - or any other childish aberration. But sometimes somnambulism continues into later life, or indeed first appears later on - as I suspect is the case with you. But whenever it first manifests itself, it tends to be pretty insignificant, and nothing needs to be done. However..." He looked at Angus cautiously. However, there are cases - and I'm not sure if I should be bringing these up, as I don't want to alarm you. "Too late," said Angus. Yes, perhaps it is. Well, let me tell you about a couple of cases I know about - one of which I've had some personal involvement with. A couple of these cases are Scottish, interestingly enough - one of them quite a well-known one among the lawyers. That was the Simon Fraser case, back in the nineteenth century. The psychiatrist picked up his pen and doodled with it as he spoke, describing small arcs and circles on the pad in front of him. Simon Fraser killed his young son while he was, by all accounts, fast asleep. Fortunately for him, he did this just at the time that forensic psychiatry was getting going in Scotland - we were pretty much at the vanguard of it in those days - and there was some enlightened medical opinion available at his trial. He was dealt with humanely and allowed off as long as he promised to sleep in a locked room from then on - which he did. The alternative, of course, in those days would have been the end of a rope - so poor Mr Fraser was indeed fortunate. Then, much more recently - only a few decades ago - there was a curious case written up in the medical literature. A teenage boy in Edinburgh attacked his cousin at night with a knife and injured her. Fortunately, not too badly, but it was a knife attack and the authorities had to do something about it. The boy had a perfectly good relationship with the cousin - there was no reason for him to do what he did, and it was out of character too. It looked as if he had done it in his sleep. Again a humane result was achieved, as he was not convicted. Which goes to show that the law can be sympathetic when there's good supporting medical evidence. Angus shifted in his seat. There but for the grace of God, he thought... "But listen to this," Dr MacGregor went on. The really astonishing case is a Canadian one. I had some involvement in that as I was one of the experts to whom the papers in the case were sent by the defence for comment. They consulted psychiatrists in a number of countries, as it was a rather important case. A man in Toronto was sitting about in his apartment. He had a couple of beers - nothing much - and then dropped off to sleep on the couch. Later that night he got up, went down to his car and drove quite a few miles - over twelve, I think - to his parent-in-laws" place, negotiating, on the way, quite a few traffic lights. All of this, we were told, was done while he was sound asleep. Then he got out of the car, went into the parental-in-law flat apartment, and proceeded to attack his mother-in-law with a tyre lever. Psychiatric evidence was produced at the trial to the effect that all this was somnambulistic. The result was that he was acquitted. Angus raised an eyebrow. "I suppose they had no alternative," he said. The things you do in your sleep aren't voluntary, are they? You can't be blamed for things you don't intend to do. "Indeed you can't," agreed Dr MacGregor. If you tap my knee and in reflex action my foot comes up and kicks you, that's automatism. I shouldn't be held responsible for the kick. "No, you shouldn't," said Angus firmly. As a somnambulist, he felt that perhaps he had an interest in asserting the principle of non-responsibility for such acts. "However, there is a public safety issue," said Dr MacGegor, "and that means that the law must have one or two tricks up its sleeve to ensure that dangerous somnambulists don't go round attacking their mothers-in-law. And there's another thing. There was a fascinating study in Montreal some years back that shows that even when we are asleep there are certain inhibitory mechanisms operating in the brain. So things done in the sleeping state might just be the object of moral evaluation. Angus looked at him expectantly. "There was a woman in Montreal," Dr MacGregor said, "who was obese. Now there are undoubtedly many women in Montreal who are obese, but this woman had an additional problem: she was a somnambulistic fridge-raider. She used to sleep-walk down to the fridge and tuck into various fattening snacks. And she had another problem - fear of snakes - ophidiophobia, to give it its full name. And this gave the doctors a chance to do a rather interesting experiment. Angus sat at the edge of his seat. "What happened?" he asked. "They got her each night to put a large rubber snake on the fridge," he said. She did this just before she went to bed at night, and, would you believe it, it stopped her somnambulistic snacking - she was too frightened to go near the fridge. Although she was asleep? So she was frightened in her sleep? "Yes," said Dr MacGregor. But then one night she forgot to put the snake in position - and she somnambulistically snacked that particular night. So that shows... That we are aware of things while we are asleep? And it means that somnambulistic acts are influenced by thoughts of consequences and implications. "Heavens!" said Angus, and thought: michty me!