What is FFI? Exploring the rare and fatal disease showcased in Watson

Modified Jan 29, 2025 15:06 GMT

Watson, an American medical drama, premiered on CBS on January 26, 2025, created by Craig Sweeny. The series follows Dr. John Watson, a familiar character from Arthur Conan Doyle's Sherlock Holmes stories.

This series blends medical drama with detective elements and a unique twist on classic stories. One of the central cases that Dr. Watson tackles involves the rare and fatal disease known as Fatal Familial Insomnia (FFI).

Disclaimer: This article contains spoilers from the show.

In the story, Watson is asked to help Erika Filipello, who has strange symptoms similar to a condition called FFI. Erika has a serious case of insomnia, and her health is getting worse as she tries to manage her condition and prevent it from becoming deadly.

The disease is hereditary and leads to brain degeneration. The narrative centers on Watson as he investigates Erika’s family background, revealing a deeper connection to her condition.

In this episode, Dr. John uncovers that Erika's insomnia stems from a genetic disorder. However, he realizes that diagnosing and treating the disease, known as FFI, is quite difficult. As Dr. John navigates this obstacle, viewers gain insight into a rare and peculiar condition that serves as the episode's focal point.

More about FFI disease as shown in the series Watson

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As studies show, the main symptom of Fatal Familial Insomnia is the inability to sleep. It may get worse over time and eventually cause total sleep loss. Early symptoms include feeling anxious, paranoid, and having hallucinations. The quick decline in physical and mental abilities makes FFI a deadly illness.

The same study mentions,

"The disease course can last from 7 to 36 months, with an average duration of 18 months leading to eventual death. Patients with homozygous (Met-Met) mutation have a shorter mean survival time than heterozygous (Met-Val) patients."

Symptoms and progression

Fatal Familial Insomnia causes sleeplessness that worsens over time. Early symptoms include anxiety, paranoia, and hallucinations. The disease gets worse quickly, and most patients die within 18 months of starting to have symptoms.

As the disease gets worse, there might be difficulties with thinking and memory, problems with balance, and heart issues like high blood pressure and fast heart rate. Excessive sweating and problems regulating body temperature are additional symptoms.

Diagnosis and Treatment of FFI

Diagnosing FFI is difficult because it is rare and shares symptoms with other conditions. There is no specific test for FFI. Instead, doctors diagnose it by looking at the patient's medical history, including their family history, and doing a neurological exam.

Genetic testing can confirm if the PRNP gene mutation is present, but it isn't always definitive. Sadly, there is no treatment for Fatal Familial Insomnia. Medications can help with symptoms like trouble sleeping and anxiety.

What happened in the pilot episode?

In the first episode of Watson, Dr. John meets Erika Filipello, a woman who believes she has FFI because of her family's health history. She has serious problems like not being able to sleep, seeing things that aren't there, and feeling very anxious. She is urgently trying to find a way to stay alive long enough to have her baby.

After looking into it, Dr. John finds that her diagnosis may not be easy. At first, it seemed like Erika had FFI, but more tests showed that her problem might come from a rare genetic issue with biotinidase.

Even though Dr. John knows the truth, he has to trick Erika to calm her down. As stress increases, Watson's personal and work-related challenges become more complicated, making his emotional state even more unstable. The episode ends with Erika feeling better.

The show is available to watch on CBS.