Reaching Down the Rabbit Hole: A Renowned Neurologist Explains the Mystery and Drama of Brain Disease

Reaching Down the Rabbit Hole: A Renowned Neurologist Explains the Mystery and Drama of Brain Disease

Allan H. Ropper

Language: English

Pages: 272

ISBN: 1250034981

Format: PDF / Kindle (mobi) / ePub

"Tell the doctor where it hurts." It sounds simple enough, unless the problem affects the very organ that produces awareness and generates speech. What is it like to try to heal the body when the mind is under attack? In this book, Dr. Allan Ropper and Brian Burrell take the reader behind the scenes at Harvard Medical School's neurology unit to show how a seasoned diagnostician faces down bizarre, life-altering afflictions. Like Alice in Wonderland, Dr. Ropper inhabits a world where absurdities abound:

• A figure skater whose body has become a ticking time-bomb
• A salesman who drives around and around a traffic rotary, unable to get off
• A college quarterback who can't stop calling the same play
• A child molester who, after falling on the ice, is left with a brain that is very much dead inside a body that is very much alive
• A mother of two young girls, diagnosed with ALS, who has to decide whether a life locked inside her own head is worth living

How does one begin to treat such cases, to counsel people whose lives may be changed forever? How does one train the next generation of clinicians to deal with the moral and medical aspects of brain disease? Dr. Ropper and his colleague answer these questions by taking the reader into a rarified world where lives and minds hang in the balance.


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again over to the desk nurse, and Hannah went to help her get it. Mannitol, a drug administered by IV, is a sugar alcohol used to pull fluid out of the brain in order to reduce the internal pressure. In this case it was just a stopgap. Mrs. G was going to need more than mannitol. A code is a highly choreographed performance executed in a small space measuring approximately eight by twelve feet. Among the dozen people who rushed into the room in the next few minutes, each one had a specific part

that his equanimity was sustained by two extracurricular passions: watching professional football, and the television show Car 54, Where Are You? It was Fisher, along with one of my other mentors, Raymond Adams, who had given transient global amnesia its name. On a Sunday afternoon in November, Dr. Fisher had just settled into his favorite easy chair to watch the New York Giants play the Cleveland Browns when the telephone rang. On the line was an apologetic junior resident who had drawn the

tell her roommate why. Alternately anxious and distracted, uncharacteristically morose and sullen, she spent the day in bed. That evening she refused to eat, and her roommate made the second call, this one to Cindy’s mother, a first-generation Korean immigrant. Despite the language difficulty, there was no mistaking the concern in the roommate’s voice. Cindy’s mother took the next commuter train from Framingham, exited at Yawkey Station, took the Green Line out to Chestnut Hill, walked up the

11:45 p.m. on the third day of his crisis. Stanley, the first-year resident who was handling admissions, called me at home to say that he had just examined a sixty-eight-year-old man who had lost his reflexes. He said nothing about sensory levels, a standard neurological exam finding that tests for numbness along the spine. A specific transition point from normal sensation to numbness is a characteristic indicator for spinal cord problems. Stanley did mention a fever and high white count, but I

spinal cord irrevocably. So we need to drain the pus. The abscess needs to come out or he’ll be paralyzed, and wither away, and die. I can’t promise you that he’s not going to be paralyzed, even with an operation.” It was 7:30 that evening when I called around to my neurosurgical colleagues. At the Brigham, the responsibility for taking care of spine problems alternates between the neurosurgeons and the orthopedists, both of whom are extremely capable. I called my go-to guy first, a

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