In the universe of Neil Gaiman's "Sandman" comic books, Delirium is the youngest of the seven Endless. She used to be Delight, until something occurred which not even her oldest brother Destiny knows that caused her to change.

Delirium has one blue eye and one green eye, typically. She's given to talking in a complete stream of consciousness and has great difficulty holding on to two different thoughts at the same time. Her appearance changes regularly, except of course for her eyes, and her realm is one of disorder and madness. Indeed, all mad people are of her realm.

She has a talking dog named Barnabas, who was a gift from her favorite brother Destruction. It's a matter of opinion which one keeps the other as a pet.

Well, there was this doggy. He was a very clever doggy. He said things"I would feel infinitely more comfortable in your presence if you would agree to treat gravity as a law, rather than one of a number of suggested options." He said that. I only remembered it. In my head.
Delirium, in The Kindly Ones

One of The Endless from Neil Gaiman's The Sandman series of graphic storytelling publications.

Dream went with her on a search for their brother Destruction once, but when they found him he didn't want to be found, and the chocolate people were all sticky. She got to keep Barnabus though, though the dog has a tendency of keeping her instead. He can talk. Just like all talking dogs can talk. Desire dislikes her fashion statements but Delirium just tells her its not the clothes that do the talking. It's the dog. Despair is a good sister and a good friend but makes people sad which is sad. She would like to call one of them DeeDee, but that would just confuse people.

She got to drive once. She was very good. She only hit a few pedestrians but it was her first try. She would like to drive again but people are always taking the keys away. Delirium thinks Destiny, the oldest sibling of the Endless, is stuck up. She likes to put him in his places. Delirium is the youngest of the Endless and used to be Delight but something happened, that is not even written in Destiny's book, which changed her. Every once in awhile she reminds her oldest brother of that, just because she can.

"Delirium is the youngest of the endless. She smells of sweat, sour wines, late nights, old leather. Her realm is close and can be visited; however human minds were not made to comprehend her domain, and those few who have made the journey have been incapable of reporting back more than the tiniest fragments. The poet Coleridge claimed to have known her intimately, but the man was an inveterate liar and in this, as in so much, we must doubt his word. Her appearance is the most variable of all the Endless, who, at best, are ideas cloaked in the semblace of flesh. her shadow's shape and outline has no relationship to that of any body she wears, and it is tangible like old velvet. Some say the tragedy of Delirium is her knowlede that, despite being older than suns, older than gods, she is forever the youngest of the Endless, who do not measure time as we measure time, or see the worlds through mortal eyes. Others deny this, and say that Delirium has no tragedy, but here they speak without reflection. For Delirium was once Delight. And although that was long ago now, even today her eyes are badly matched: one eye is a vivid emerald green, spattered with silver flecks that move. The other eye is vein blue. Who knows what Delirium sees, through her mismatched eyes?"
Neil Gaiman Season of Mists

One of her eyes is now a different color than the other and she has uneven hair that keeps changing colors, but she likes it better now, especially when the goldfish fly in it. Oh, and she is always smiling, except for when she isn't. Thinking is not a plate of fruit for Delirium because her dragonflies get all taxidermy, and if too many pieces of eight begin to fill her coxcomb then the wrong window burnings will come out of her fireplace, causing penguin dancers to misinform their ears in her face. She tries though. She's smart but not in the backwards way that teachers teach and students learn. She's smart like mermaids walk and blindfolds see.

There are no traditions that she upholds, except for the ones that she attends, or those age old rituals in which she makes them up as she goes. Though she may be sitting with you playing checkers with a deck of cards, she is also in the infirmary observing the sick, in the poor houses attending to the downtrooden. She's over there at the bar suggesting maybe he should get a taxi and not go home. And she's in Ohio telling that girl's reflection in the mirror she isn't really so fat that's just jello, and she should put the gun down. Someone wants to jump, and she recommends he miss the ground. She tries to be helpful but things don't always go as planned. It might help if she planned ahead, but that means thinking backwards and it hurts her ankles when she does that. She helped them when it was cold and wet once. She convinced the players to keep on playing, because music would make it easier for them to wait for her sister to come. Death was a little late to the Titanic but that's okay. Delirium was there. Then decades later they made a movie about it but forgot to write her in which made her sad.

You know the best thing about aeroplanes? Apart from the peanuts in the little silver bags, I mean. It's looking out of the windows at the clouds, and thinking, maybe I could go walking in there. Maybe it's a special place where everything's okay. Sometimes I do go walking in the clouds. But it's just cold and wet and empty, but when you look out of a plane it's a special world...
Delirium, in Brief Lives

Hers is the realm of madness and disorder, and those who lose their grip on reality are welcome to her care. Others visit for brief periods. Most come and go as they please. All know her whether they want to admit it or not, for even the smallest inchworm loses it every once in awhile. There is more to say about her, but Delirium is pancakes to the logging chipmunks. So I will have to distill the water colors for the pastel chicken later.

Neil Gaiman, upon becoming good friends with Tori Amos, modeled Delerium after her. Tori can be found singing about the author of The Sandman comics in her song "Horses" from Boys for Pele:

...and if there is a way to find you i will find you
but will you find me if Neil
makes me a tree...

Neil soon made the tree for her:

That happened in a new bookseries by Neil Gaiman and Charles Vess called Stardust. The first part of this 4-part series came out in October 1997. The Tori tree appears in issue #3 that came out in early 1998 in a special illustrated version.


Interesting side note:
At first I thought that she was saying "Neil makes me a dream", but I read the lyrics and got really disappointed as I started to node this. I did some more research, specifically at and found a reference to this lyric. I felt redeemed :). Major props to the page... it has LOTS of tori & gaiman info.

From an on line medical dictionary: Delirium: A disorder characterized by Confusion; inattentiveness; disorientation; Illusions; Hallucinations; agitation; and in some instances Autonomic Nervous System overactivity. It may result from toxic/metabolic conditions or structural Brain lesions. (From Adams et al., Principles of Neurology, 6th ed, pp411-2)

I have now had three people tell me recently that I was "scary" when I was sick.

It is an interesting perspective and I was surprised. Because as a physician I know that when people are systemically ill, they are often delirious. We are taught to watch for ICU psychosis. Just being sick enough to be in the ICU, people are bats. They will pull out ventilator tubes, intravenous lines and foley catheters (without lowering the balloon, ouch).

I had gone to the ER four times in 2012 and was at last hospitalized for observation. For 24 hours. But the docs were so sure that I was bananas from my sister's death that they ignored the labs. To the point that the discharging physician wrote in her note that I had two blood tests positive for strep A and she was giving me a penicillin shot, but she "didn't believe that it had anything to do with the hospitalization." They ignored the potassium and magnesium levels low enough to make my muscles cramp when I arrived. They ignored the "ins and outs". The nurse wrote down how much I got iv for the 24 hours and how much liquid I drank. Those are the "ins". The outs is how much you urinate. Normal output is up to 3000cc in 24 hours. When I was sent home, my ins were at 4200cc. My outs were at 10400 cc. This means that I was 6200 cc behind. Fluid "third spacing" is common in sepsis, where the fluid leaks from the arteries and veins into the tissues. I did not run a fever, I did not have a high white blood cell count, but I was septic as shit. However, I had been drinking fluid to keep up until I was hospitalized. I just had not kept up on potassium and magnesium.

So I had to drink 6 liters when I got home. Adding electrolytes.

Why, then, did I go home? Two reasons: my fellow doctors were so locked in to thinking me psychotic or manic from my sister's death that I was afraid of them. And secondly, I had figured out how to reduce the fluid shifts.

It took me another week to realize that a penicillin shot treats strep throat. For strep A sepsis you are supposed to give 1.2 million units of iv penicillin every 6 hours and iv clindamycin every 6 hours. A bit difficult at home. And I'd been told not to treat myself. What to do? I wrote a letter to the psychiatrist who they'd required me to see and got high dose oral clindamycin and penicillin.... four times a day.

Seems to have worked.

But.... in the hospital I thought, I am sick as shit and technically septic and borderline delirious and I am STILL the only one who is thinking straight about my labs and the "medical case". I think doctors are terrified of thinking that a doctor could go nuts. So their brains shut down. I was really trying hard not to die. Also, septic people looked whacked out, they can be anxious as hell. A lot of adrenaline as the body is screaming at the brain, "HELP HELP HELP HELP!!!"

I can understand that I scared friends. I was not scared about being delirious because that is normal with sepsis. Normal from a doctor perspective. I was scared that I could very well die or if I let my blood pressure drop too far, I could damage brain/heart/kidneys/extremities. So I drank to keep up and tried to balance the damned electrolytes at home. Guesswork.

They were worried that I WAS crazy. I wasn't worried about it. But after a friend told me I scared him too, I felt very very sad for the last two days. Because I was so alone. I had the medical knowledge and skills to survive, but the medical community labelled and refused to listen, and my friends probably thought about calling the people with white coats.... was scary. Sepsis is on the rise, it gets missed and once you have had it you are at higher risk to get it again. I have had it twice. My infectious disease specialist said cheerfully "You can take twice a day Penicillin 250mg, but we have no idea if that will work." I am NOT reading the "life after sepsis" link for patients today.

De*lir"i*um (?), n. [L., fr. delirare to rave, to wander in mind, prop., to go out of the furrow in plowing; de- + lira furrow, track; perh. akin to G. geleise track, rut, and E. last to endure.]

1. Med.

A state in which the thoughts, expressions, and actions are wild, irregular, and incoherent; mental aberration; a roving or wandering of the mind, -- usually dependent on a fever or some other disease, and so distinguished from mania, or madness.


Strong excitement; wild enthusiasm; madness.

The popular delirium [of the French Revolution] at first caught his enthusiastic mind. W. Irving.

The delirium of the preceding session (of Parliament). Motley.

Delirium tremens (). [L., trembling delirium] Med., a violent delirium induced by the excessive and prolonged use of intoxicating liquors. -- Traumatic delirium Med., a variety of delirium following injury.

Syn. -- Insanity; frenzy; madness; derangement; aberration; mania; lunacy; fury. See Insanity.


© Webster 1913.

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