The Pause-and-Nod

So, it’s the holidays and I travel a lot around the holidays.  Recently, I sat next to a woman on a short hour-long flight.  We did the little awkward half-smile when she sat down, then I promptly fell asleep before the plane took off.  

About half way through the flight, I awoke and somehow got chatting with my neighbor. Only a few sentences in, “it” came up. She’d asked a simple question, but the answer would disclose that I have narcolepsy. Should I divert the conversation or tell her?
I decided to go for it. I told her I have narcolepsy and knew exactly what was coming next — she paused for a split-second and nodded her head “yes,” in apparent recognition of narcolepsy.
I used to cringe at the pause-and-nod, fearing where the convo would go from there, as it could take one of many directions.  The person could ask, “So could you fall asleep right this second?” or they might offer an anecdote about a time they fell asleep in an odd place.  I used to smile and nod back politely, realizing we weren’t on the same page.
Worst of all, the pause-and-nod could be followed by nothing at all.  During the first two years following my narcolepsy diagnosis, I dreaded this nonchalant conversation drifter the most.   It was not uncommon that after saying I have narcolepsy, a person simply paused, nodded and moved on to another topic, as if I’d just reported a random tid-bit like tomorrow’s weather or the score of a sports game.  Time after time, I watched in disbelief as a major part of my life fizzled and disappeared in the empty space between others and myself. 
After collecting a handful of distasteful exchanges, I stopped telling people about my narcolepsy as freely.  I told superiors only to explain particular behavior or actions.  I kept the information private from casual friends and acquaintances.  I even hid narcolepsy from a guy I liked until our fourth date when I panicked and awkwardly busted it out with full-blown tears as if I’d been holding back top-secret classified government secrets from him for years.
All this changed after I graduated from law school and moved to Washington DC to begin working on a memoir about my experience with narcolepsy.  In DC, people strike up conversation with the question “What do you do?” This took me off-guard, as work status was a third or fourth layer conversation topic in Boston.  And what would I respond? I was working full-time on a memoir about narcolepsy
Ready or not, I began talking about narcolepsy quite a bit. I’ve told countless acquaintances, strangers at bars, fellow passengers on flights, store employees and nail technicians.  I’ve perfected my “talking points”  – and depending on circumstances, I can steer the conversation in many different directions.  I wait for follow-up questions and always maintain control over the tone and direction of the conversation (At the bottom of this post, I’ve drafted a few general guidelines and sample responses to common questions.)
On this particular plane ride, the woman next to me was very fascinated to hear my story.  Like many other people, she enjoyed learning about something she’d “heard of” before but didn’t know much about.
I now see these interactions as opportunities to raise awareness.  Maybe someday one of the people I’ve told will think of narcolepsy when someone they know has issues with sleepiness or experiences muscle weakness with emotions.  Putting narcolepsy on people’s radars has become a fulfilling part of my life.  I no longer dread these conversations, instead looking forward to them – relishing in the pauses and inquisitive looks. I expect the odd-ball questions and I am caught off guard when someone has a cousin or friend with narcolepsy and already knows what it’s really about. 
Most importantly, I no longer let others’ misperceptions or lack of knowledge about narcolepsy control the conversation or shape my self-image.   I still encounter conversation-drifters.  Some people aren’t interested in learning about narcolepsy.  Like sports or ballet, health and science aren’t everyone’s cup of tea. I accept this and move on. Yet strangely, it is often the people I least expect who are moved by my story.  
In closing, wishing everyone safe travels and abundant happiness this holiday season! Thank you for reading my blog and supporting my experience this past year.  Sharing my story here has given me the strength and courage to raise my voice in other spaces.
A few general guidelines for conducting conversations about narcolepsy:
  1. Keep an upbeat tone. The information I am imparting may be serious, but I try to keep a positive demeanor.
  2. Leave out the big “science-y” words – they’re distracting.
  3. Less is more – I try to limit myself to one or two sentence responses and let people follow-up if they are interested.
A few of my favorite responses to general questions about narcolepsy:
Q: So that’s the thing where you fall asleep all the time?
A: Sleepiness is an aspect of narcolepsy, but it’s a much more complicated disorder. 
Q: Could you fall asleep right now?
A: Probably not. I experience episodes of extreme sleepiness, but it’s generally brought on by situations that would make anyone tired (like dark rooms, hot rooms, and jet-lag), but these situations make me 100 times more tired than a normal person.
Q: So how does that work – were you born with it?
A: No, people aren’t born with narcolepsy. It’s an autoimmune disorder in which a particular group of cells in the brain deteriorate. Scientists are still figuring out what causes the autoimmune attack on these particular brain cells.
Q: Is there treatment? 
A: I manage my symptoms by taking medication twice a day and twice a night. I also nap twice everyday. The best medications improve my symptoms somewhat, but make me sick in other ways.  It’s a give and take situation.
Q: Is there a cure?
There is currently no cure and better treatments are needed, but scientists are working towards one, so hopefully someday! 


  1. The Dreamer on December 23, 2010 at 2:40 pm

    Hmmm, I always get hit with extreme sleepiness during or before take off and usually just succumb to it and sleep until landing or just after, or more recently (since I've been on CPAP) long enough to miss out on in-flight beverage service.

    I haven't yet figured out how to properly occupy the time that I'm awake during a flight….though I know I used stay awake during flights.

  2. Kim on December 23, 2010 at 3:06 pm

    Great post Julie. What an awesome outlook and one that I hope more people share so as to raise awareness for narcolepsy. I too am very taken off guard when someone truly understands narcolepsy. Then I begin to understand how important it is for people to know about it:) Merry Christmas and let the training start!

  3. Saraiah on December 24, 2010 at 9:49 am

    Though I'm not in the position of having to deal with the conundrum myself, the various complications of dating with narcolepsy are sure topics I see and hear discussed a great deal within our community. And yay for the narcolepsy elevator speech for strangers! What a good idea.

  4. Guy McBearfly on December 24, 2010 at 1:22 pm

    Great post! You are a great example for how to deal with the topic of N in everyday interactions. I'm going to give this a try. Also, I know dating issues regarding N can be tough for PWN. I wonder if PWN ever look to other PWN for romance? It seems like there has gotta be two PWN out there who are perfect for each other, and who could be mutually understanding and supportive?

  5. The Dreamer on December 25, 2010 at 12:10 pm

    Actually, the list would've come in handy recently…guess I should've paid more attention in that session.

    My boss was asking if he should be worried about me falling asleep at work. Of course I don't have all the answers yet, I'm still waiting to see my sleep doctor (Jan 13) following my recent PSG/MSLT (Dec 2/3). But, it was complaining that it was starting to happen too frequently, and out of my control, that finally prompted my doctor to start me on this journey (of 2 years so far).

  6. Anonymous on January 18, 2012 at 9:07 pm

    Awesome Blog!

    Every time my Sleep Physician starts a new medication for me, my partner asks "So how long will you be taking this for?"…

    …Grrrr! "I don't know! Till they find a cure?" LOL

  7. The F Word on May 1, 2012 at 7:14 pm

    […] a previous post, I offer a few basic communication guidelines:1. Keep an upbeat tone2. Leave out big science-y […]

  8. […] more communication techniques: I am a Person With Narcolepsy and I’m Proud, The Pause and Nod and The F-word. Please read more about AWAKEN in the Press […]

  9. […] Have other creative ideas for raising awareness this season? Post a comment! For tips on communicating about narcolepsy during the Holidays, read: The Pause and Nod.  […]

  10. Jill on December 20, 2012 at 6:07 pm

    I can’t stay awake in a car. But can’t seem to sleep on a plane. Weird.
    Thanks for the tips on how to talk about narcolepsy. I am always at a loss!
    Merry Christmas!

    • julie on December 20, 2012 at 6:09 pm

      Thanks for your comment, Jill! Merry Christmas to you too!

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