Tag: neurology
Weekend Reader: ‘On The Move: A Life’

Weekend Reader: ‘On The Move: A Life’

In a February op-ed published in The New York Times, Oliver Sacks, the eminent neurologist and cultural luminary, revealed to the world that he was dying of terminal cancer.

Sacks discussed his new resolve to live life free of inessentials, and his gratefulness for being able to participate in what he called “the special intercourse of writers and readers.” It’s a relationship that Sacks has built and maintained over the decades through his myriad essays and books, such asAwakeningsandThe Man Who Mistook His Wife For A Hat, which meld his extensive knowledge of the biology of the brain with a generous, inquiring spirit, and shine a light on what he dubbed “the suffering, afflicted, fighting human subject.”

In his latest book, On the Move: A Life, the “human subject” is Sacks himself. Picking up where his previous memoir, Uncle Tungsten, left off, On the Moveis a chronicle of unmoored youth, capturing young Sacks’ detours, setbacks, and flashes of early brilliant discovery.

You can read an excerpt below. The book is available for purchase here.

Muscle Beach

When I finally made it to New York in June of 1961, I borrowed money from a cousin and bought a new bike, a BMW R60 — the trustiest of all the BMW models. I wanted no more to do with used bikes, like the R69 which some idiot or criminal had fitted with the wrong pistons, the pistons that had seized up in Alabama.

I spent a few days in New York, and then the open road beckoned me. I covered thousands of miles in my slow, erratic return to California. The roads were wonderfully empty, and going across South Dakota and Wyoming, I would scarcely see another soul for hours. The silence of the bike, the effortlessness of riding, lent a magical, dreamlike quality to my motion.

There is a direct union of oneself with a motorcycle, for it is so geared to one’s proprioception, one’s movements and postures, that it responds almost like part of one’s own body. Bike and rider become a single, indivisible entity; it is very much like riding a horse. A car cannot become part of one in quite the same way.

I arrived back in San Francisco at the end of June, just in time to exchange my bike leathers for the white coat of an intern in Mount Zion Hospital.

During my long road trip, with snatched meals here and there, I had lost weight, but I had also worked out when possible at gyms, so I was in trim shape, under two hundred pounds, when I showed off my new bike and my new body in New York in June. But when I returned to San Francisco, I decided to “bulk up” (as weight lifters say) and have a go at a weight- lifting record, one which I thought might be just within my reach. Putting on weight was particularly easy to do at Mount Zion, because its coffee shop offered double cheeseburgers and huge milk shakes, and these were free to residents and interns. Rationing myself to five double cheeseburgers and half a dozen milkshakes per evening and training hard, I bulked up swiftly, moving from the mid-heavy category (up to 198 pounds) to the heavy (up to 240 pounds) to the superheavy (no limit). I told my parents about this — as I told them almost everything — and they were a bit disturbed, which surprised me, because my father was no lightweight and weighed around 250 himself.

I had done some weight lifting as a medical student in London in the 1950s. I belonged to a Jewish sports club, the Maccabi, and we would have power-lifting contests with other sports clubs, the three competition lifts being the curl, the bench press, and the squat, or deep knee bend.

Very different from these were the three Olympic lifts — the press, the snatch, and the clean and jerk — and here we had world-class lifters in our little gym. One of them, Ben Helfgott, had captained the British weight-lifting team in the 1956 Olympic Games. He became a good friend (and even now, in his eighties, he is still extraordinarily strong and agile).  I tried the Olympic lifts, but I was too clumsy. My snatches, in particular, were dangerous to those around me, and I was told in no uncertain terms to get off the Olympic lifting platform and go back to power lifting.

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The Central YMCA in San Francisco had particularly good weight-lifting facilities. The first time I went there, my eye was caught by a bench-press bar loaded with nearly 400 pounds. No one at the Maccabi could bench-press anything like this, and when I looked around, I saw no one in the Y who looked up to such a weight. No one, at least, until a short but hugely broad and thick-chested man, a white-haired gorilla, hobbled into the gym — he was slightly bowlegged — lay down on the bench, and, by way of warmup, did a dozen easy reps with the bench-press bar. He added weights for subsequent sets, going to nearly 500 pounds. I had a Polaroid camera with me and took a picture as he rested between sets. I got talking to him later; he was very genial. He told me that his name was Karl Norberg, that he was Swedish, that he had worked all his life as a longshoreman, and that he was now seventy years old. His phenomenal strength had come to him naturally; his only exercise had been hefting boxes and barrels at the docks, often one on each shoulder, boxes and barrels which no “normal” person could even lift off the ground.

I felt inspired by Karl and determined to lift greater poundages myself, to work on the one lift I was already fairly good at — the squat. Training intensively, even obsessively, at a small gym in San Rafael, I worked up to doing five sets of five reps with 555 pounds every fifth day. The symmetry of this pleased me but caused amusement at the gym — “Sacks and his fives.” I didn’t realize how exceptional this was until another lifter encouraged me to have a go at the California squat record. I did so, diffidently, and to my delight was able to set a new record, a squat with a 600-pound bar on my shoulders. This was to serve as my introduction to the power-lifting world; a weight-lifting record is equivalent, in these circles, to publishing a scientific paper or a book in academia.

Excerpted from On The Move by Oliver Sacks. Copyright © 2015 by Oliver Sacks. Excerpted by permission of Knopf, a division of Random House, Inc. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

If you enjoyed this excerpt, purchase the full book here.

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Neurologist Oliver Sacks Describes His Fascinating Life In ‘On The Move’

Neurologist Oliver Sacks Describes His Fascinating Life In ‘On The Move’

By Jim Higgins, Milwaukee Journal Sentinel (TNS)

On The Move: A Life by Oliver Sacks; Knopf (416 pages, $27.95)
___

Hold on a minute: The young stud straddling the BMW motorcycle on the cover of On the Move is Oliver Sacks, the genial neurologist of Awakenings?

As this memoir makes clear, the Whitmanesque Sacks truly contains multitudes: The compassionate scientist who writes beautifully and travels to Mexico to look at ferns has also been a motorbike buff, competitive weightlifter, and, in the past, a drug abuser.

In February, the 81-year-old Sacks revealed in a New York Times op-ed that he has terminal cancer.

In reacting to the mild-mannered way in which philosopher David Hume described his own terminal condition, Sacks wrote, “I am a man of vehement disposition, with violent enthusiasms, and extreme immoderation in all my passions.”

Indeed, On the Move is a memoir of a man who lived the advice of Ms. Frizzle: Sacks has taken chances, made mistakes, and gotten messy.

On the Move picks up where Uncle Tungsten, Sacks’ childhood memoir, ended. He grew up in London in a brilliant, loving Jewish family, with his father a doctor and his mother a surgeon. Unfortunately, mother’s love and support did not extend to her teenage son’s attraction to other males. “You are an abomination,” he reports her once saying. “I wish you had never been born.”

“I have needed to remind myself, repeatedly, that my mother was born in the 1890s and had an Orthodox upbringing and that in England in the 1950s homosexual behavior was treated not only as a perversion but as a criminal offense,” Sacks writes.

He understands now that his mother spoke those words when she felt overwhelmed and probably regretted them.

But he also admits that “her words haunted me for much of my life and played a major part in inhibiting and injecting with guilt what should have been a free and joyous express of sexuality.”

In college at Oxford, Sacks won 50 pounds for an essay on anatomy, then spent 44 pounds on “the most coveted and desirable book in the world” — the 12-volume Oxford English Dictionary, presaging his future as the man who would revive the art of the literary medical case study.

Feeling that London already contained too many Dr. Sackses, he sought his medical destiny in the United States. While pursing advanced training, he rode his motorcycle around California, at least once making the unexpected acquaintance of Hell’s Angels. He pushed himself relentlessly in weightlifting, at one point setting a California state record.

But while he became strong, Sacks writes, that physical strength did nothing for what he calls his “timid, diffident, insecure, submissive” character. He also became addicted to amphetamines. “A rash drug taker in the 1960s, I was prepared to try almost anything,” he confesses.

Freaking out more than once, he was helped back to earth and sanity by a calm friend, a black physician improbably named Carol Burnett. Sacks may have struggled with sexual and romantic relationships, as he relates in his book, but he has clearly been both gifted and fortunate in his friendships.

Giving up the laboratory, where he often fumbled, Sacks turned to clinical work with patients, and found his calling.

His work with postencephalitics at the Beth Abraham Hospital in the Bronx led to his book Awakenings (1973) and the subsequent movie. The Man Who Mistook His Wife for a Hat (1985), a collection of case studies, became a best-seller and made him famous — a mixed blessing for a man who loves solitude.

Sacksologists will find many nuggets to chew on in this memoir, including details on his clinical work, memories of Robin Williams and Robert De Niro, thoughts about autism and deaf culture, and hints about books he has not yet published.

I see the roots of his compassion in family relationships, including his Auntie Birdie (who played a role in his world similar to Sook in young Truman Capote’s life) and his brother Michael, who was given insulin shock treatment after a psychotic break as a teenager, and never developed the ability to live a normal independent life.

Once, after a fall from a Norwegian mountain path led to a horrific leg injury, Sacks considered that he might be dying. “A line from an Auden poem, ‘Let your last thinks all be thanks,’ kept going through my mind.” That sense of gratitude permeates On the Move.

(c)2015 Milwaukee Journal Sentinel, Distributed by Tribune Content Agency, LLC.

On The Front Lines Of PTSD Research

On The Front Lines Of PTSD Research

By Bill Glauber, Milwaukee Journal Sentinel (TNS)

MILWAUKEE — Picture a trauma victim, someone who has endured a gunshot wound, a car crash or an industrial accident, a person whose body is broken and is rushed into surgery to be mended by physicians racing against the clock.

But what happens during recovery, when thoughts ricochet through the mind of the victim? What happens if symptoms of post-traumatic stress disorder take hold?

This is where clinical psychologist Terri deRoon-Cassini steps in.

Working alongside surgeons at Froedtert & the Medical College of Wisconsin, deRoon-Cassini is deeply engaged in research that identifies neurological, biological, and psychosocial markers for PTSD. She also provides psychological care to injured trauma patients.

It’s not just soldiers in combat who can suffer from PTSD. Civilians who encounter trauma in their daily lives also can get PTSD, which can lead to severe mental health problems.

DeRoon-Cassini said PTSD is the biggest predictor of quality of life in trauma patients. A 2010 study conducted at Froedtert showed that up to 40 percent of civilian survivors developed PTSD.

“Why is PTSD important? It’s important because if people can no longer engage in their everyday lives, they can’t support themselves, be there for family and loved ones,” she said.

Ultimately, she said, untreated PTSD “creates a large health burden on society.”

Froedtert is among only a few hospitals in the country that routinely screens trauma patients for PTSD symptoms. It also is unique for having a clinical psychologist like deRoon-Cassini working in the surgical department.

The American College of Surgeons Committee on Trauma recommends PTSD and depression screening at Level I trauma centers like Froedtert. According to deRoon-Cassini, the hope is that in five years such screening treatment will be mandated and more psychologists will be embedded in trauma centers.

The hospital also has started a trauma mentoring program. Four former patients who have been through the system, and then received training, volunteer their time to talk with new patients about recovering from a traumatic event.

“Our psychological intervention is targeted to people at risk,” deRoon-Cassini said. “PTSD can’t be diagnosed until 30 days after a trauma. We want to prevent that diagnosis.”

Stephen Hargarten, chief of the Emergency Department at Froedtert Hospital, said deRoon-Cassini plays a vital role.

“She’s an expert at understanding how a traumatic event affects an individual and she is an expert at recognizing and intervening before debilitating post-traumatic stress takes over,” Hargarten said.

“People generally associate PTSD with military engagement but they don’t often associate this with day-to-day events that are similar in quality, a kinetic energy exchange from a car crash or a bullet,” Hargarten said.

At 36, deRoon-Cassini is deep into a career centered on detecting and treating PTSD.

Born and raised in California, she attended the University of Wyoming, where she studied zoology and physiology. While in college, she got an internship at a domestic violence shelter.

She recalled helping one client, a woman who suffered abuse at the hands of her husband, a member of the military. The woman, a mother of four, had cuts on her face. She needed dental care because several teeth had been knocked out. But before she could get her teeth fixed, she had to undergo a magnetic resonance imaging test to see if there were any fractures.

The clicking sound of the MRI triggered a flashback for the woman. DeRoon-Cassini later learned why. The woman told her that one weekend she had been kept in a box in the basement of her home, and anytime she made a noise her husband hit the box with a baseball bat.

DeRoon-Cassini said that woman’s story pushed her toward her life’s work.

She earned her master’s and doctorate degrees in clinical psychology at Marquette University. During an internship at the Zablocki Veterans Affairs Medical Center, she focused on health psychology and PTSD after combat trauma.

DeRoon-Cassini completed postdoctoral work at the Medical College of Wisconsin, where she is now assistant professor in the Department of Surgery, Division of Trauma & Critical Care.

She and her colleagues are involved in several studies that she hopes “can give us a more complete picture of risk for PTSD.”

“Can we look at the biology of a person at risk? Can we look at their neurological state?” she said.

Just as important, she is in the trenches, trying to help patients cope with trauma. Others are, too.

The Trauma Peer Mentor Program was unveiled at Froedtert in October. Former patients talk with current patients, imparting advice and listening. The initiative grew out of the Trauma Survivors Network, which works to connect patients and families after serious injury.

“We visit patients who are newly injured,” said Chris Prange-Morgan, who fell 30 feet at a local climbing gym in 2011. Three years later, her right leg was amputated just below the knee.

“One of the things I’ve found in connecting with people is there is a great network of very old souls out there who know what it’s like to suffer,” she said.

Prange-Morgan did not suffer PTSD after her injury, but said she knows what to look for in patients who might be in distress.

“I think it can help people to know there is hope, particularly when faced with not just a physical injury but the emotional scarring of knowing they have been violated in their home or a victim of a serious car accident outside their control,” she said. “Having someone come and help you feel you can get control back is pretty important.”

(c)2015 Milwaukee Journal Sentinel, Distributed by Tribune Content Agency, LLC

Photo: Joe Shlabotnik via Flickr

Kill Your Snooze Button Before It Kills You

Kill Your Snooze Button Before It Kills You

Keeping up to date with health studies can be a hellish experience, especially when every third report informs you that some everyday habit or seemingly innocuous simple pleasure can kill you (sitting down, anyone?). Well, if you’re easily unnerved by this sort of thing, stop reading now. It turns out that oversleeping is bad for you. Who knew?

It has been well established for years now that not getting enough sleep correlates to higher risks of obesity, high blood pressure, and diabetes. But a recent study indicates that, among older adults, getting more than the requisite eight hours is linked with an increased likelihood of having a stroke.

The findings come from a decade-long study conducted by researchers at Cambridge University, published in an article that recently appeared in the journal Neurology. The study concludes that if adults older than 65 get more than their nightly quota, they run a higher risk of stroke.

Study participants were drawn from the middle- and older-age adult population of Norfolk, UK, and screened for pre-existing health problems. The participants in the study were between 42 and 81 years old. The sleep patterns of these 9,692 people were measured in two-year batches, from 1998-2000 and 2002-2004. Researchers then tracked the incidence of strokes among the test subjects until mid-2009.

When older adults fell outside the six- to eight-hour sweet spot, that’s when problems began to arise. Those who reported sleeping for more than eight hours a day were 46 percent more likely to have a stroke; those who slept less than six hours were 18 percent more likely to have one. Of the 9,692 sample set, there were 346 strokes.

However, it remains unclear whether sleeping too long is the cause of the cardiovascular problems that lead to stroke, or whether it’s a symptom of the underlying issues.

The National Sleep Foundation, an organization of researchers and clinicians that promotes healthy sleep habits through advocacy and education, recently updated its guidelines for the recommended amounts of sleep. While both younger and middle-aged adults are encouraged to get seven to nine hours per day, adults older than 65 are encouraged to cut that off at eight hours.

The Cambridge study into the correlation between oversleeping and strokes joins a body of other research indicating that a horror house of health issues can arise from oversleeping, including obesity, headaches, depression, back pain, and heart disease.

At least until the next batch of research comes out, perhaps the best course of action is to kill your snooze button before it kills you.

Photo: Jonathan Bliss via Flickr