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Journal of General Internal Medicine

22-09-2023 | Narcolepsy | Medicine Then and Now

Harriet Tubman’s Hypersomnia: Insights from Historical and Medical Perspectives

Authors: Evan A. Balmuth, BS, Thomas E. Scammell, MD

Published in: Journal of General Internal Medicine

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Abstract

Harriet Tubman, a hero of the abolitionist movement and early civil rights advocate, suffered a head injury in childhood and subsequently developed sleep attacks associated with visions that were extensively documented in historical accounts. Her contemporaries perceived these visions together with unpredictable and unavoidable urges to sleep as manifestations of her deep faith, rather than as symptoms of an illness. While religious perspectives remain crucial to understanding Tubman’s sleep-related experiences, some may consider them insufficient in view of modern medical advances. We propose the parallel explanation that her sleep attacks, usually attributed to temporal lobe epilepsy, actually represent a hypersomnia that is most consistent with the modern diagnosis of post-traumatic narcolepsy. Using historical analysis as well as current understandings of sleep medicine, we aim to shed light on this under-recognized aspect of Tubman’s life. In addition, this case study allows us to review the potential long-term effects of severe traumatic brain injuries; consider a differential for excessive daytime sleepiness and hypnagogic hallucinations; and familiarize readers with the pathophysiology, diagnosis, and treatment of narcolepsy. Whether her symptoms are viewed through the lens of the past or measured against current biomedical standards, Tubman demonstrated an inspiring ability to persevere despite intrusive sleep episodes and to realize her dreams for the betterment of others.
Footnotes
1
Excerpts in italicized text are from the Tubman biography by K.C. Larson, who compiled quotations from primary sources that we have independently reviewed and cited. Citations of italicized material reflect where the authors cross-checked the information in other sources.
 
2
During an interview in her later years, Tubman recounted that she pursued surgical treatment in Boston for debilitating headaches: the surgeon “sawed open my skull, and raised it up, and now it feels more comfortable.”6 Historians have postulated that the headaches were related to her childhood head injury, and that the surgery likely occurred in the late 1890s at Massachusetts General Hospital.3 However, we and others have been unable to find any documentation of the clinical encounter. Notably, Tubman did not cite sleep attacks as part of her reason for seeking this treatment.
 
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Metadata
Title
Harriet Tubman’s Hypersomnia: Insights from Historical and Medical Perspectives
Authors
Evan A. Balmuth, BS
Thomas E. Scammell, MD
Publication date
22-09-2023
Publisher
Springer International Publishing
Published in
Journal of General Internal Medicine
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-023-08414-x
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