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This posthumously published collection of essays by Dr. Klawans, an eminent neurologist and writer, explores the interactions between patient, family and neurologist and the implications of specific neurologic diseases. Klawans's special interest in neurology is movement disorders, such as Huntington's chorea and Parkinson's disease, but his outside interests range from evolutionary biology to classical music. His essays, therefore, focus on single patients or families, but the author weaves thoughts about his other interests into each "case."
The book is divided into two sections, "The Ascent of Cognitive Function" and "The Brain's Soft Spots: Programmed Cell Death, Prions, and Pain." In a brief preface, Klawans declares that this book is "more than just a set of clinical tales about interesting and at times downright peculiar patients" from his 35 years of practice, but rather it "humbly grapples with the 'whys' of our brain, not the 'hows.'" (pp. 9-10) In the preface, as well as in one essay, Klawans acknowledges the work and impact of fellow neurologist-writer Oliver Sacks ("Oliver is truly the father of us all." p 12).
The title essay concerns a six-year-old girl who was found, locked and completely speech-deprived, in a closet. Because she is still within the window of opportunity for language acquisition, "Lacey" quickly learns to speak, unlike Victor, the Wild Boy of Aveyron, whose story was immortalized in the François Truffaut film, L'enfant Sauvage. Klawans uses these stories as a launch pad to discuss the evolution of language, including a proposal that the cavewoman, not the man, was responsible for development of the human species as she taught her offspring language.
Other chapters focus on patients with epilepsy, Parkinson's disease, localized and hemispheric stroke, "painful-foot-and-toe syndrome, " and Creutzfeldt-Jakob disease. Two particularly memorable chapters concern Huntington's chorea and Refsum's disease. The chapter, "Anticipation," explores the profound ethical concerns of genetic testing for Huntington's chorea as applied to three generations of one particular family. In the chapter, "The Hermit of Thief River Falls," Klawans recollects his first year as a neurology resident, and his care of a reclusive patient with a rare eponymous illness, Refsum's disease--just in time for a visit by Refsum himself, a famous Norwegian neurologist.
The book concludes with a speculative "afterthought" about genetics, evolution, and the importance of extended "juvenilization" --the protracted post-natal development of Homo sapiens. This essay intertwines some of the threads regarding speech development and evolutionary biology, particularly brain development, that were introduced earlier in the text.
The narrator was ridiculed during adolescence because he was fat and socially inept at school. He had one friend, Marion, "a slender girl who came up on holidays from the city / to my cousin's farm." He liked to show-off to others, but couldn't express his feelings, especially to Marion, who he only now realizes was "my first love." At the age of 19, during her nursing training, "she had a fatal accident / alone, at night, they said, with a lethal injection / and was spared from seeing what my school did to the world." [28 lines]
Consider the possibility of a man whose sense of hearing is so enhanced that he can discern the noise of the entire world and also mimic all the sounds made by men and beasts. Imagine a human being who can SEE sounds as well as hear them. It is little wonder that he would have an affinity and talent for music.
Johannes Elias Alder is such a musical genius born in 1803 with a preternatural gift of hearing. The illegitimate son of the village curate, Elias experiences a physical metamorphosis as a child and by the age of ten is already a man. He effortlessly composes magnificent music that he plays on the organ.
Although Elias falls in love with his cousin, Elsbeth, she marries another man. After this loss, he becomes tired of life. Elias commits suicide at the age of 22 by refusing to sleep and succumbing to starvation and an overdose of belladonna.
Fred McCann is an energetic man in his thirties, something of a playboy, when the Second World War breaks out. He becomes a soldier, and in an Italian village one day he goes to a pump for a drink of water. The pump is booby-trapped and explodes. He is blinded and loses all four limbs. The story traces the development of a relationship between Fred and Alice, his nurse in the military hospital.
As he learns to submit to being entirely helpless, reliant on Alice for all his needs, he gradually begins to adapt to his new condition. Then Alice changes everything by having sex with him. At first their new and obsessive relationship makes him happy, restoring some of his old sense of himself as a man. When Alice is moved to another duty and replaced by a sadistic male nurse, Fred is so devastated and makes such a scene that he gets Alice back.
To celebrate her return, Alice sneaks some whiskey into his room and they get drunk. She then says something that appalls him: she calls him her "thing" and confides that she has always hated men, who look at her and touch her and have power. Fred is nauseated, seeing himself reduced to nothing more than a "a phallus on its small pedestal of flesh." He realizes now that he is no longer a man, and later that night he manages to drag himself out into the garden, where there is a small pool in which he drowns himself.
Summary:Dividing the background expanse of red from yellow, and surrounded by a halo, three apples--green, red, and purple, four yellow papyrus blossoms, and a snake held between the fingers of the artist's hand, a disembodied head appears caricature-like in this self-portrait.
In 371 E. C. (Efican Calendar) a woman named Felicity Smith gives birth to Tristan, a child with such severe congenital defects that the doctors advise her to let him die. Felicity is an actress and the head of a theater troupe in Chemin Rouge, the capital of a small fictional country called Efica. Instead of getting rid of her son, Felicity takes him to live in the tower of her theater.
The boy actually has three fathers (Bill, Wally, and Vincent), each of whom in his own way accepts responsibility for the horribly deformed child. The boy grows up with the ambition to become an actor, even though he is only three and a half feet tall, his speech is almost unintelligible, and he inspires revulsion in almost everyone that he meets for the first time. Nonetheless, he thrives in the close-knit theatrical community.
When Tristan is eleven, agents from Voorstand murder his mother, who has entered politics and become a "persona non grata" in Voorstand. Tristan also fears for his life, but nonetheless avenges his mother's death by writing subversive pamphlets. Many years later, at the ripe old age of 23, Tristan and Wally (one of his fathers) travel illegally to Voorstand where they encounter many adventures before the novel comes to a satisfactory conclusion.
This novel is the fictionalized account of author Thomas Moran's real-life experience as a patient with disseminated chicken pox. During his five months in hospital, much of that time on a ventilator, Moran experienced "coma visions" and near death which he retells here through his alter ego, James Blatchely, a man who struggles to remain emotionally alive in spite of the virus's physical assault. Blatchely does this by observing, befriending, and then fantasizing a life for his two Irish nurses--Brigit who, he discovers, uses drugs to endure the pain she witnesses daily in Intensive Care, and Nuala, with whom he falls in love.
Through the depiction of Blatchely's erratic, inching descent toward death, readers gain visceral insight into a patient's encounter with critical illness--but the real heroes of this book are the nurses. We observe them through Blatchely's eyes, and they are the force that enables him to survive, if not in body, at least in mind. This beautifully written novel creates a world in which both patients and caregivers are fully human, bound together by their shared experience of the patient's illness and by the life the imagination enjoys when the body cannot.
The first-person narrative of Catherine who is desperate for her seemingly indifferent mother’s love. Raised from infancy by grandparents following her parents’ divorce, Catherine seeks her indifferent but devout mother’s affection by emulating her saintly namesake. She mortifies her flesh in the pursuit of thinness based on an ideal of purity as self-denial and on her mother’s esthetic expectations.
The obsessive behavior extends from anorexia to willful insomnia and severe illness. At college she recovers by discovery of a happier, more direct faith. The essay begins and ends in the narrator’s later life, as she contemplates her own revulsion and pain in caring for her mother who lies dying of breast cancer.
The story covers the months from early diagnosis of a retinal disorder through stages of treatment and loss of vision to a six-month stay at a residential facility to train the newly blind in life skills, including Braille. Sally Hobart was a 24-year-old elementary school teacher when she began suddenly and rapidly to lose her vision.
In the months that followed, she went through several surgeries and other treatments that are sometimes successful in restoring vision, but all efforts failed. She was left with very cloudy partial vision--only enough to distinguish colors, light and dark in the lower half of the vision field.
She tells about the fear, the frustrations of partial information and false hope, the tension between herself and her fiancé (they finally called off the engagement), the support (and also confusion and pain) of friends and family, and the emotional adaptation to a whole new life while learning to become independent as a blind person.
This work touches upon a wide range of issues, more or less closely related to the trauma surrounding, the management of, and the aftermath of sustaining a serious burn. Divided into three sections, the work first defines burns not only on a biological basis, but as distinguished psychologically and historically from other forms of physical trauma.
In Part II the authors explore ancient myths and then images from modern culture that they contend define social perceptions about the meaning of being a burn victim. The final section poses problems that remain in the technique of burn management in its most holistic sense. An extensive bibliography/filmography completes the book.