>March 05 2002

>

I am trying to maintain some study momentum this week heading into Spring Break. It will be my first spring break since 1989 and I can’t wait!

This week in Psychiatry we are studying psychotic disorders such as schizophrenia. This is a disease that really sort of gives me the willies. It just seems so eerie to think that problems in the nervous system can manifest themselves in such bizarre ways. Even though it seems laughable in today’s more enlightened times, it is easy for me to understand how ancient cultures could attribute mental disorders to supernatural causes such as demon possession. I mean what else could you have thought when someone was seeing and hearing voices that no one else did?

We saw some video taped interviews with some patients that exhibited symptoms. One guy, who was a handsome young black man, was convinced that he had been horribly disfigured by surgery. He would furrow his brow and tell the doctor that all of the wrinkle marks across his forehead were the scars from where his face had been taken off and replaced. He was also convinced that both of his hands had been surgically removed and reattached.
Then there was also a video that tried to put you in the shoes of a delusional schizophrenic and show you what he was experiencing. This was a guy who, when he was not having a psychotic episode, could look back and methodically analyze and describe his experience. He related a time when voices in his head convinced him to go up on his roof and jump off. While he was describing this, the video put you in his head and you could hear the voices and see what he perceived. It was as scary as any horror movie to me! Of course many of the interviews would elicit laughs from the class, and I too would find them amusing. But I think somewhere down deep, the humor is just our way of dealing with something pretty terrifying – the idea that sometimes, things go terribly wrong with the real substance of what makes you “you.”

In neurobiology we are learning the anatomy of the central nervous system. I came into this course thinking about how much of the brain’s function is still a mystery but am finding out that even if that is the case there is a HUGE amount of stuff that we do know, and they expect me to learn it all!

In kind of a tie-in to our neuro studies, we are looking into having an implant called a Vagus Nerve Stimulator put in Manning. This is a device that is similar to a pacemaker. You implant it on the chest wall, and then a wire leads up into the neck and wraps around cranial nerve X – the Vagus nerve. The implant is programmed to deliver small electrical stimuli every 20 minutes or so. In some patients this has proven to reduce seizure activity through some still mysterious mechanism. You can tinker with the timing of the shocks with a computer and magnet tool. You can even pass a magnetic device over the implant at the onset of a seizure and sometimes abort the seizure. Hopefully we will know more about this in a week or so.

Now if I can just keep my nose to the grindstone for another 72 hours or so …

About Marcus Lee

Child Neurologist
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