Sunday, September 4, 2011

I read an article about the rap group Das Rascist today in New York magazine. Das Rascist is a group of three non-pure-white rappers who interject humor about race that is often intended to offend whites. Of course, it ends up working just the opposite and the group is gaining popularity. Their dilemna, is seems, is that they are striving to obliterate rascism, making race an inconsequential issue. Yet they are making a name for themselves by playing on rascism. So, it got me to thinking, is rascism passe? It is indeed becoming more difficult to identify those who are pure white, much to the anger of a few extemist psychopaths and sociopaths. But as "pure white" disappears, fear and anger will not. That is because there will always be "otherness" and it seems to be in the nature of humans to have to distinguish other from self. The more "other" someone appears to be, the more fear it evokes in some. So why is "other" so fear-inducing? It is because "other" challenges our sense of "self." Can an "other" devour us? Can we sustain our personal beliefs, our understanding of how we should behave, of how we should interact with others, who we allow ourselves to love, where we wish to live, how we wish to earn a living, if others approach all of these issues differently, especially if far differently? It is this fear that drives people to cruel acts, whether it is bullying a child in school or taken to the extreme, flying passenger-filled airplanes into occupied buildings. The question that has confounded humanity for millenia is how to erradicate this fear which leads to hatred and violence. The answer may be too simple for many to accept but it may be the answer, none-the-less, one that many great men and women have offered: to respect life above all else and to respect every individual's right to pursue their own happiness without infringing on other's equal right to the same. This is a challenge that requires understanding and compromise and above all, love. It is the foundation upon which every personal relationship is built and upon which this great country was built.

Saturday, July 23, 2011

Flora and Fauna

The cactus blossoms
From the parched desert earth
As the seedling stretches blue-ward
From the dank forest floor
In my hand I hold a tooth
Pushed out by the one behind it
A man must grow
Where he has been planted
His pain not penance
But a passing rain

Sunday, July 10, 2011

Casey Anthony and Belief

Apparently two thirds of Americans believe that Casey Anthony murdered her daughter. The jury did not believe this to be the case. That is because the jury understood that belief is not a basis on which to make decisions that profoundly affect another person's life. In order to make a judgement about another person, especially when it comes to imprisoning that person, restricting their freedom or even taking their life, belief is insufficient. Fact, or evidence is needed to make a determination as to the validity of a claim. As a matter of fact, no pun intended, this is what science is all about. People wish to believe a whole host of things especially when it is meant to make their life better in some way. When it remains purely personal, each individual can maintain their belief no matter how outlandish but when it comes to imposing it on others, we run into huge problems. The same is true in the healing arts. Lots of people offer remedies and treatments that they say is helpful and often may even try to benefit financially from offering these treatments but most often these are based on beliefs at best. Though it is true that experience may precede scientific proof and anecdotal experience may certainly be true for the one having the experience, offering it to others in a authoritative manner requires science and science is complicated and labor intensive and sometimes excruciatingly time-consuming but it will ultimately offer an answer that goes beyond belief. This is what, in effect, the Casey Anthony jury did in coming to it's verdict. It did not decide that she had not killed her daughter but rather that the evidence was not there to make a truthful determination that she had and it is what most of us would have concluded if we had gone through the same rigorous scientific process. It is a principle we should always apply to things that matter in our lives.

Monday, May 2, 2011

Osama Bin Laden Headshots

Yesterday American Forces found and killed Osama Bin Laden. Of course, throughout the world there are always skeptics, those who doubt that he was really found and that it was really he who was shot and killed. Well, apparently there are photographs taken after he was shot in the head that show his face recognizably but also show the bullet wound through or close to his eye that reveals blood and brain oozing out of the wound. Officials now question whether it would be too disturbing to the public to see these images. Even after years of having seen individuals with open head injuries with brain exposed, I am always disturbed by the sight. However, in my opinion it is less disturbing than the videos of beheadings, than the sight of young soldiers with dismembered limbs and life-long disfigurements, than the sight of innocent people having to jump to their certain death out of burning, collapsing buildings. We were forced to witness horrific carnage on September 11, 2001 and beyond. Seeing the mortal wounds of the mastermind behind all this demonic terror is far less disturbing than that which was witnessed by many millions on September 11, 2001. Those who do not want to see the image of Osama Bin Laden's mortal wounds don't have to look at them but for those who doubt and those who need confirmation to be able to move on with their lives, seeing is believing.

Sunday, February 20, 2011

Serena Branson and complex migraines

It turns out that after two days of extensive testing, Serena Branson's aphasia was diagnoses as a complex migraine. What she has stated in an interview is that she had not been feeling well with a sense of tiredness and the onset of a headache before the speech disturbance began. That was a big clue. Never-the-less a full work-up needed to be done, including MRI of the brain, MRA (MR angiography, looking at the blood vessels) of the neck and the brain, EKG and echocardiogram as well as blood tests. When it was found that all of these tests were normal than the symptoms could be utilized to make the final diagnosis.

So how could a migraine cause the symptome of speech dysfunction? First, the phenomenon of migraines needs to be understood. Fundamentaly, the arteries in the brain constrict in the first phase (prodromal phase) and then dilated. Though the constriction may cause some headache, the dilation phase is generally what causes the severe headache. When the blood vessels dilate, there can be a reduction in blood flow to the area of the brain most affected. Depending on which area is affected, symptoms related to that area develop. This is referred to as an aura. If it occurs in the occipital area which has to do with vision, then the aura will included symptoms such as seeing spots, flashing lights, zigzags or moving lines, like blades of a fan. This usually lasts minutes but can last up to almost an hour. If it affects the prefrontal gyrus which controls movement then there may be problems with movement of a limb or with the face. When it effects Broca's area in the base of the posterior frontal lobe, then, though the individual may know what they want to say, they can not get it out coherently. This is exactly what happened with Serena Branson. Many other symptoms may also occur such as tingling, confusion, even hallucinations. Following this aura, the migraine headache usually ensues but it may not always occur so when it is only the aura which is the significant symptom, it may be difficult to diagnose until other causes of the neurologic dysfunction are excluded. Rarely, the vasospasm and reduction in bloodflow can be so severe that a stroke can occur. When auras occur regularly and can be temporarily disabling then medication can be used such as inderal to limit these troubling events.

Those who suffer from these symptoms should meet with a neurologist to find the right treatment including avoiding triggers such as certain foods or even odors or scents.

Wednesday, February 16, 2011

Serena Branson's Speech Arrest

America witnessed a dramatic ezample of speech arrest or expressive aphasia when Serena Branson began speaking incoherently when reporting on the Grammies while on- air. According to news reports, her symptoms resolved within a few minutes at the most and she refused further medical assistance after the paramedics found her vital signs to be stable. There is great interest in knowing what could have caused a dramatic and sudden but thankfully brief loss of speech.

There are numerous possible causes of sudden aphasia that fully resolves. These include transient ischemic attacks, seizures, brain hemorrhages, low blood pressure, low blood sugar, multiple sclerosis and inflammatory conditions of the brain and blood vessels.

What comes to mind first is a transient ischemic attack (TIA). This is due to a brief reduction of blood flow to a portion of the brain but with resumption of adequate blood flow before damage to that area occurs. The reduction in blood flow can be due to a piece of "debris" breaking off a plaque in a narrowed, diseased artery in the neck or when there is such a high degree of narrowing of an artery in the neck or brain that briefly the blood flow through that artery is profoundly reduced. These events usually occur in individuals over the age of sixty. Another cause of TIA can be due to an abnormality in the heart such as an infection in the heart or an abnormal heart rhythm. In these instances a small piece of "debris" can be released from the heart into the blood stream and then into the brain. A TIA can also be caused by birth control pills, blood disorders and drugs such a cocaine. Inflammation of arteries, refered to as arteritis is another cause of TIAs.
TIAs are highly significant because they are often precurors of major strokes leading to permanent neurologic dysfunction. Therefore, it is important to diagnose the cause of a TIA and treat it appropriately and rapidly.

A focal seizure can present as a brief loss of neurologic dysfunction including a brief episode of aphasia as Serena Branson experienced. Again, there are numerous possible causes for the new onset of a seizure. A brain tumor, drug reaction, brain hemorrhage or low blood sugar are all possible causes of a focal seizure.

Even when someone recovers fully and feels well after an brief episode of aphasia, as apparently was the case with Serena Branson, the individual needs a full and careful medical evaluation. Not only do they need an MRI of the brain, which may, in fact, be normal but the arteries in the neck and the heart need to be fully evaluated. Additionally blood tests need to be performed. Without appropriate diagnosis and treatment, a permanent stroke could ensue or a minor hemorrhage in the brain could lead to a major hemorrhage. If a seizure has occured, a subsequent seizure might be more profound. The early stage of an infection such as encephalitis could become a life-threatening infection of the brain.

Certainly Ms. Branson will have a thorough medical evaluation and hopefully the cause of her episode of aphasia will be found to be readily treatable and she will not suffer future neurologic dysfunction.