Reaching Down the Rabbit Hole: Extraordinary Journeys into the Human Brain

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You may also opt to downgrade to Standard Digital, a robust journalistic offering that fulfils many user’s needs. Compare Standard and Premium Digital here. She called their primary care physician, who told her to get him to the emergency room immediately.

I liked Dr Ropper, he came across nicely and informally, but his ego can get a bit wearisome after a while. I am trying not to hold the whole ego thing against him, after all he is a neurologist and fair enough he does an amazing job that very few people can or would choose to do. Holy cow!" I said. "It's an ovarian teratoma. You'd better send her over." It was a snap diagnosis, possibly wrong, but there was no harm in raising on a pair of aces. I had a pretty good idea what the other cards would be: memory deficits, gooseflesh, a high heart rate, and no family history of psychosis. The drooling alone was a tip-off. He had a bad headache from the beginning," she told me, "and a fever." The residents had neglected to mention this, but it was important. Like all universities, Boston College has a health center that provides minimal services overnight, on holidays, on weekends, and during the summer, relying on referrals to local emergency rooms for anything serious. The after-hours nurse, who was used to such things, assumed that Cindy had been using recreational drugs and was "just flipping out." Nothing unusual as far as the nurse was concerned, but Cindy's mother was outraged. Convinced simply from cultural experience that there were no drugs involved, she would not let that stand. Cindy was so jittery and sweaty that the nurse gave in and called an ambulance to take her to the Brookline Hospital emergency room. Once there, Cindy remained agitated, stopped responding to questions, and started thrashing, as though reacting to hallucinated visions. This prompted a round of phone calls to the eight local psychiatric hospitals to see if there was a bed for an acutely psychotic young woman. Such beds are hard to come by, and it took a hard sell by the emergency room doctor to secure the promise of one by the next afternoon, "if you could just hang onto her and give her Haldol in the meantime." Is she salivating like she has rabies?" That was my first question, and would turn out to be my only one.Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.

Yes, good, good, fine," Vincent replied. He was sitting up in bed, watching television with a smile of bemused innocence. Vincent Talma was a picture of contentment. His room on the tenth floor of the hospital tower commanded an outstanding view of Fort Hill Park in Boston's Roxbury section, but Vincent took no notice. Along with twenty-nine of our other patients, he had been waiting for a visit from the neurology team on their morning speed rounds. What Burrell and Ropper produce is a portrait of an immensely talented neurologist and teacher who is always the smartest man in the room. Almost every anecdote ends with Ropper emerging the hero of the moment. It’s too carefully written to be crassly boastful, but it’s not exactly an essay in professional humility. But where ultimately do these journeys lead? What lies at the other end of the rabbit hole except the uncomfortable knowledge that who we are and all that we hold certain is precariously contingent? This book never engaged me entirely. It was supposed to be anecdotal--stories about neurology. I found the stories too brief, but that was largely because the author never had a chance to follow up on long-term outcomes. Once he had solved the problem, the patient either died or went home. PDF / EPUB File Name: Reaching_Down_the_Rabbit_Hole_-_Allan_Ropper.pdf, Reaching_Down_the_Rabbit_Hole_-_Allan_Ropper.epubNevertheless, there are some wonderful accounts of rare cases, such as the young Asian Korean woman who was fuming like she has rabies. That definitely requires an experienced eye to make an accurate and prompt diagnosis, and to prevent further damage to the patient's physical functioning and quality of life.

By the time Vincent Talma and Cindy Song had settled in at the Brigham, Arwen Cleary had been there for four days. She came by ambulance on the morning of July 1, and was admitted to neurological intensive care from the Emergency Department later that evening. Of the three cases, hers was the least clear-cut, the most troubling, and one that had the potential to become an absolute shambles. According to her medical records, her problems had begun two years earlier, when she showed up at a central Massachusetts hospital with disabling nausea, difficulty walking, and vomiting. We treat people with seemingly implausible ailments all of the time. Each day they show up in a predictable parade of signs, symptoms, and diseases: an embolus, a glioma, a hydrocephalus; a bleed, a seizure, a hemiplegia. That's how the residents refer to the cases, as in: "Let's go see the basilar thrombosis on 10 East." When viewed in terms of actual patients, however, no day is quite like any other. After the bedside visit, the thrombosis suddenly has a name, the glioma has a wife and children, the hydrocephalus writes a column for a well-known business journal. Our coed suffering from psychosis turned out to be a Rhodes Scholarship candidate, the case of multiple strokes became a charming woman who had competed in the Junior Olympics, and the man for whom a smile was a troubling symptom owned a personal empire of six Verizon wireless stores.

Apropos of nothing really, but this reminds me of British game shows. It is very alien to the British to applaud oneself or one's accomplishments, whereas Americans jump up and down and shout out how proud they are of themselves, this makes British people cringe. However, it makes much more exciting television, so the producers now have got the British to run around arms in the air shouting out and generally looking awkard and embarrassed. Everyone feels the same inside, it's just a difference in expression and probably the one people prefer is the one of the culture they were brought up in. What they hope, what they expect, what they deserve, is that we take the time to listen, because the act of listening is therapeutic in itself. When we do it right, we learn details that make us better doctors for the next patient. The residents may not get this yet. They are focused on diagnosis and treatment, on technology, on scales, titers, doses, ratios, elevations, and deficiencies. All well and good, I tell them, but don’t forget to listen.” A moderately interesting story of the life of a neurologist, marred by the gigantic ego of the author. I'm sure you need a gigantic ego to do the job and there are plenty of stories where he gets stuff wrong (at first, before getting it right obv) but the overall impression is of being sat next to someone at a dinner party who starts off seeming an absolutely fascinating and enthralling raconteur and by the third course you're wondering who you ought to stab in the eye with a dessert fork: yourself or him. Reading this is like being a fly on the wall in a neurology ward. There are some real characters, and some real highs and lows. It’s in part an eye opening education and part like watching a car crash.

This starts out strong, with an introduction into various complex and interesting neurology patients. We have hydrocephalus, subarachnoid haemorrhage, strokes and even ovarian teratomas. It's fascinating stuff, told in a way that feels accessible and not too weighed down by medical jargon. However, I did find the stories petered out somewhat towards the end, and I also really didn't like the way Allan Ropper describes some of his patients. Is 'blonde, very attractive, a little on the plump side, but very lovely' really appropriate? No, I think not.I could see that over the course of the previous week, Hannah had begun the transition from resident to full-fledged physician. I could see it in her bearing, in the assertive physicality with which she carried out her examinations, in the firmness of her tone with some of the more difficult patients, and in the controlled sympathy she adopted in family meetings when she had to deliver bad news. She had turned out to be one of our strongest clinicians. Told in a breezy style through a series of real-life case studies, Ropper's book offers a fascinating glimpse of the ways in which our brain can go wrong. * Financial Times * We started him on acyclovir, an antiviral medication, and he soon improved. Five days later, Vince was discharged, talking normally again, and, for better or worse, just like his old self.