Then came a more radical change. Anne found herself in the back of “a 1950s Chinese bus on a propaganda tour of Chinese Christian churches.” She recalls watching a movie on religious freedom in China projected onto the rear window of the bus. But the viewpoint kept changing — both the movie and the bus suddenly tilted to odd angles, and it was unclear, at one point, whether a church spire she saw was “real,” outside the bus, or part of the movie. Her strange journey occupied the greater part of a feverish and insomniac night.

Anne’s hallucinations appeared only when she closed her eyes and would vanish as soon as she opened them.2 But other deliria may produce hallucinations that seem to be present in the real environment, seen with the eyes open.

In 1996, I was visiting Brazil when I started to have elaborate narrative dreams with extremely brilliant colors and an almost lithographic quality, which seemed to go on all night, every night. I had gastroenteritis with some fever, and I assumed that my strange dreams were a consequence of this, compounded, perhaps, by the excitement of traveling along the Amazon. I thought these delirious dreams would come to an end when I got over the fever and returned to New York. But, if anything, they increased and became more intense than ever. They had something of the character of a Jane Austen novel, or perhaps a Masterpiece Theatre version of one, unfolding in a leisurely way. These visions were very detailed, with all the characters dressed, behaving, and talking as they might in Sense and Sensibility. (This astonished me — for I have never had much social sense or sensibility, and my taste in novels inclines more to Dickens than Austen.) I would get up at intervals during the night, dab cold water on my face, empty my bladder, or make a cup of tea, but as soon as I returned to bed and closed my eyes again I was in my Jane Austen world. The dream had moved on while I was up, and when I rejoined it, it was as if the narrative had continued in my absence. A period of time had passed, events had transpired, some characters had disappeared or died, and other new ones were now on stage. These dreams, or deliria, or hallucinations, whatever they were, came every night, interfering with normal sleep, and I became increasingly exhausted from sleep deprivation. I would tell my analyst about these “dreams,” which I remembered in great detail, unlike normal dreams. He said, “What’s going on? You have produced more dreams in the past two weeks than in the previous twenty years. Are you on something?”

I said no — but then I remembered that I had been put on weekly doses of the antimalarial drug Lariam before my trip to the Amazon, and that I was supposed to take two or three further doses after my return.

I looked up the drug in the Physician’s Desk Reference — it mentioned excessively vivid or colorful dreams, nightmares, hallucinations, and psychoses as side effects, but with an incidence of less than 1 percent. When I contacted my friend Kevin Cahill, an expert in tropical medicine, he said that he would put the incidence of excessively vivid, colorful dreams closer to 30 percent — the full-blown hallucinations or psychoses were considerably rarer. I asked him how long the dreams would go on. A month or more, he said, because Lariam has a very long half-life and would take that long to be eliminated from the body. My nineteenth-century dreams gradually faded, though they took their time doing so.

Richard Howard, the poet, was thrown into a delirium for several days following back surgery. The day after the operation, lying in his hospital bed and looking up, he saw small animals all around the edges of the ceiling. They were the size of mice but had heads like those of deer; they were vivid: solid, animal-colored, with the movements of living creatures. “I knew they were real,” he said, and he was astonished when his partner, arriving at the hospital, could not see them. This did not shake Richard’s conviction; he was simply puzzled as to why his partner, an artist, could be so blind (after all, he was the one who was usually so good at seeing things). The thought that he might be hallucinating did not enter Richard’s mind. He found the phenomenon remarkable (“I’m not accustomed to things like a frieze of deer heads on mouse bodies”), but he accepted them as real.

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