Tacking on the Styx: An epileptic sails the facts, fiction and philosophy of a mental illness300
Tacking on the Styx: An epileptic sails the facts, fiction and philosophy of a mental illness300
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Tacking on the Styx
An Epileptic Sails the Facts, Fiction, and Philosophy of a Mental Illness
By Jeffrey L. Hatcher
AuthorHouseCopyright © 2014 Jeffrey L. Hatcher, Ph.D.
All rights reserved.
What is the hardest task in the world? To think.
Ralph Waldo Emerson Intellect
He knew that the woman at his bedside was his mother. What he did not realize immediately was that he truly did not care. He did not care that she was his mother, nor did he care that she was here with him.
Oddly, the bed was buttressed on the left and right sides with crib-like metal rails. Metal meets mattress under fluorescent lights. Not his own room but a hospital room. Little else penetrated the dull static.
He politely fixed his eyes on the woman (whom he knew was his mother), but his narrow thought ran only to his most peculiar pains. A strong yet dull pain permeated his head. Its Intensity never wavered but was never sharp either. Inside his skull, he felt like the Pillsbury Dough Boy caught in a slow-working trash compactor. Quite surprisingly, the muscles even within his eye sockets ached. Could you pull a muscle in an eye socket?
His tongue had swollen half again its normal size. Later examination in a mirror would reveal three separate, bloody, puncture wounds — two on top, one below. One canine was left unsatisfied. No vamplrlc aspirations apparently. All of his back teeth floated on a palette of embers. Clamped like wood in a vice by jaw muscles who had a point to prove, the roots of his teeth had bruised the tissues and the very bone of his jaw. A hot nest of pain cupped each and every molar.
Very oddly, his other greatly noticeable pain — his greatest pain, actually — traced up from his groin. With some effort he felt perplexed. The family jewels felt just fine. No, this was an Inside-out ache running the length of his penis. Like what a balloon might feel, If a balloon could feel, that was Inflated just past the bursting point before fluttering out intact but helplessly over extended.
It must have been a hell of a show he thought as he lay in a hospital gown which some unknown person had put on him. Why the seizures stimulated what must have been a personal record of an erection he hadn't a clue. In its own phallic manner, self-disgust began pushing its way into the cramped space of his mind, displacing confusion with a determined rhythm. He fought it, the image that was forming in his head — the revolting and entirely public image.
He knew some EMT's as neighbors. They probably brought him here. Seen everything. Maybe even helped to remove his unforgiving pants. He tried to venture into another realm of thought, but the images kept pushing back like matter into a vacuum filmed in slow motion. He felt violated as if he had been raped ... somehow raped by himself. Despite whatever feeble extent he resisted, a large chunk of disgust intruded further into his mind while he lay weakly like a limp rag caught on the edge of a receding surf. He had not thought that a man could rape himself, but somehow he had found a way.
The woman was speaking clearly to him, talking about how the string of seizures had lasted almost an hour. She held him by the hand, neither Interesting him nor annoying him. After some time she vanished, for a while at least. Maybe it was for some hours. He hadn't noticed for missing her. Nurses came and went, easily taking his attention away from her to no particular end. As they exited the room, they ceased to exist. Upon reentry, each had a brand new face of no special interest to him.
He asked the woman whether or not his father had returned home from abroad. In a carefully reassuring voice she told him that he had only just driven his father to the airport for several weeks of business travel. Then she talked ofsomethlng else. Or maybe not. She was definitely gone by sundown.
Returning from a stupor some hours after she left, he felt about in his mind for anything familiar. He recognized the woman who had been with him earlier. She seemed familiar with the hospital that he was in, but he could not think of any reason why he thought so. He didn't think that the room had changed. The man in the next bed appeared to be the same as earlier. He remembered his head having the same, invariable, pressured ache before as it did now. His dick didn't seem to hurt as much as before, but he couldn't remember the intensity of the pain clearly. He had not yet even noticed that a catheter ran out of it to a bag under the bed. His teeth were now the most painful part of his body ... or at least the less curious. He had little room for anything more in his head.
Beyond the shock of waking up hospitalized, in a bed walled in by metal, beyond the bizarre bodily pains, beyond the forgetting of some indeterminate amount of recent life, something else lurked. It lurked alongside the woman whom he knew was his mother. It tiptoed from her side to his back to pull on his head or chest with a marionette string to keep him unengaged from her. Unengaged but not unaware, at least not entirely. When she left, it remained behind, unidentified. Paying it little heed, he crept back to sleep, to a dreamless, black field of non-existence.
* * *
The man standing at his walled-ln bedside was his neurologist. "Edgar Thomas, you put up quite a fight," he said with enough gentle sarcasm to show that he meant unconsciously sparring with hospital personnel as much as fighting to recover. Glancing up at the man, Tom saw him with a more lucid mind. The extent of the memory loss grew clearer — perhaps not days but months. Tom grew more troubled as he grew more aware. His doctor kept the talk light and brief. It left Tom's mind as quickly as it registered. The words slipped in and out of focus like items in a grocery checkout line slipping through a cashier's hands.
His doctor understood that there was no point to much talk. Tom still lacked the stamina for much stimulation. He was too exhausted to even take comfort in his complete recognition of his doctor. However, he had forgotten that his doctor was specifically a neurologist. He had forgotten why he might have ever needed a neurologist.
When Rogers stepped out, he walked just across the corridor to a nurse's station. "Keep an eye on Edgar," he said to a nurse while pointing to the room. "He's the man with temporal lobe epilepsy who went status for forty-five minutes a short time ago. He's to be checked frequently, and I want regular updates throughout today. Tonight's attending physician needs the same." Rogers then walked to another patient's room down the hallway.
Numerous nurses, blood-seekers, and food trays entered and left Tom's room. Tom thought he might know the proper name for a blood-seeker, but it remained not behind a cape but behind a veil. The light from the window slipped in and faded out. His mother, now accompanied by his sister, seemed to appear and disappear at random. He couldn't keep track of how many times they visited in a day (or what he supposed was a day).
Two days into his stay, when everyone was gone except his room-mate, he remained alert for his longest time yet. In this time, that alien feeling he had in the presence of his mother returned to identify itself unaccompanied by her. That over-present feeling was proper emotion lost in a shuffle. The connection to family or friend that provides a hook to attach our positive emotions to. The autopilot that lets us relax and enjoy that sense of security found only in unromantic love. Fraternal, paternal, maternal, or sometimes vintage spousal. Tethered. Unquestioning. Unassuming.
Though he had always been intensely religious, charismatic fundamentalism inspired mild contempt. The world took more than six days to create, there were too many animal species alive on Earth to have fit into a gopherwood boat. Seas, even red ones, don't split open on command. No special respect for the divine came from believing otherwise. Still, understanding the symbolism found in scripture held the keys to what and who we are. There was more to humanness than some sort of highly sophisticated, gigantic blob of neurons. Something unifying rose above the biology — above the evolution. It had to be that way.
He had embraced spirituality and prayer just as he embraced family and friend, but now all that changed. The earlier disconnect from his mother brought a mean-spirited revelation. That uniquely odd feeling he had had upon regaining consciousness metamorphosed into the realization that spirituality was nonsense — pure distilled. He had just experienced the greatest trauma of his life, when anybody would most hold onto a family bond for comfort and to draw strength from. He hadn't given a monkey's crap that his mother had been there at all. Not in some mentally articulated sense, but just in some background feeling.
His mind recognized her just as his mind recognized the janitor at his old high school. The horror was that his mind connected to both people with similar levels of emotion. Something in his brain — in his mind — felt vacant in a way that had never happened when he was around her before.
If she had been rudely displaced from his bedside by some cold, inconsiderate hospital employee, he would have taken no offense at all on her behalf. None. Complete objective recognition. Complete emotional estrangement. All a function of neural connections. A fragmented state of his very being arising from a mind using distinct, multiple brain parts to different ends. The caring part of him, the defensive part of him, and his recognition circuits had all had a trial separation at the seizures' orders. Who was he to care about her presence just for knowing who she was?
However one may conceive a soul, Tom thought, it tests credibility to think of it as some mosaic of components blinking on or off without regard to an overall unity. If an ability to care blinks out permanently, is the soul reduced accordingly? Not likely Tom thought. Salvationist theology had to be an all-or-nothing proposition. Nothing felt more likely than that.
Reality supplanted the fantasy of spiritualism in the span of only a few hours. "We are nothing aside from neural connections", he thought. Ironically, he thought that if he had completely failed to recognize her as his mother, he probably would not be feeling as he did. It was the half-forgetting that was worse — so much worse. Feeling his being broken up into components of a sort. Had he completely forgotten her, but only temporarily, all of his faculties might have been up, running, and reintegrated by the time recognition firmly reestablished itself. Maybe the reverse epiphany would not have happened. He was coming unhinged from every angle.
"What did some Greek say? I think therefore I am? That fucking sucks!" he thought completely.
Losing the memory of his most recent life was frightening, but it did not frighten him the worst. After all, at an objective level and an emotional level that was recovering minute by minute, he knew he had a supportive group of family and friends. He knew that the pains and weakness were temporary. Saturday morning cartoons had taught him that amnesia was similarly temporary. People lost details over time normally. However, the spontaneous loss of religion threw him into a twirl that led up to the worst fear which his mind could harbor in one day (or was it now two or three?). If the most hallowed parts of his identity could break apart within hours, what assurance did he have that subsequent attacks wouldn't leave the darker sides of him more intact than any other? Were the seizures brewing a Jekyll-or-Hyde cocktail for the drinking? Could he cast aside moral predispositions and act only upon the darker emotions of a moment without any conscious inhibitions at all? Unable to handle another sinister epiphany, he shut down, but not before pushing his face into the pillow to muffle the sobs. Now, at least, he was knitted back together well enough to cry.
* * *
He turned back on before sun-up feeling both more lucid and still more morose. He recalled little of the previous day except the essence of his epiphany and his disgusting humiliation, enough to promptly jump-start the self-loathing. Now, though, his doctor was finishing night rounds and standing bedside. He carried out a routine examination during which he said little and nothing that Tom would ultimately remember. Before he left, taking his lead from ancient healing rituals and Tom's demeanor, he took Tom's hand in one of his and placed his other hand on Tom's shoulder. He stood in this laying-on of hands for some minutes without speaking a single word. Transfusing a sense of human stability. Then he vanished. Tom flipped back into the abyss of sleep. This laying on of hands by his doctor would come to be the sharpest positive image retained from his hospital stay, if only for its simplicity.CHAPTER 2
THE DEVILS THAT WE KNOW
Epilepsy is mostly about seizures, so what is one? The Commission on Epidemiology and Prognosis of the International League Against Epilepsy defines a seizure as "a clinical manifestation presumed to result from an abnormal and excessive discharge of a set of neurons in the brain." In other words, a seizure is the observable physical or cognitive response of the body to these neural discharges. They may be observable by the patient alone, medical personnel, or both. Some of these responses may include muscle twitching, convulsions, loss of consciousness, or odd perceptions by the person. They can also include more complex and frequently repetitive behaviors called 'automatisms' such as scratching, vocalizing, or kicking. Automatisms, as will be discussed, can become quite elaborate.
Often times, seizure activity does not lend itself to easy description when the patient suffers some activity and yet shows no or scant clinical symptoms. A light-headedness can alert a patient to a forgotten dose of medication, as can a myriad of other sensations or minor moments of mental inabilities all of which a patient might recognize while nobody else would be aware of them. Some brain activity can impede focus and disrupt a train of thought but come to little more than that. When a patient suffers a significant amount of such activity, epileptic drugs that have little impact on the frequency of overt seizures may still have a significant therapeutic effect on such unobservable seizure activity. Though discussed in medicine, subclinical seizure activity is a phenomenon that needs recognition more generally as it may be patterned in a dispersed manner over multiple hours. As will be further discussed, family, friends, and employers need to learn to accommodate it, but to do so, the person must feel comfortable being open about it. We do not care to betray our hard-fought-for sense of competence.
Manifesting in the most complex organ in the human body, seizures don't lend themselves to easy categorization. The boundaries between categories can overlap, creating grey zones rather than hard lines. Part of this obscurity comes from the fact that seizures can be defined around different parameters — the state of the body during a seizure, the cause of the seizure, its duration, and the affected part of the brain especially in reference to the seizure's starting point. My terminology will be discussed in greater detail momentarily, but as an example, an absence seizure, a generalized seizure, or a tonic-clonic seizure are labels that apply to the state of a person's body in the moment. An externally caused seizure is a provoked seizure. Status epilepticus is historically a time-based label. A frontal lobe seizure refers to the part of the brain a seizure starts in.
* * *
What I refer to as 'state-of-the-body' simply refers to what is happening to the body physically in the moment, inclusive of brainwaves, cognition, bodily movements, and other physical manifestations.
A generalized seizure is thought to involve the whole cerebral cortex (the calculating, dynamic surface of the cerebrum) in a manner that cannot, in the moment, be traced to any particular locale on the brain (reviewed in Blumenfeld et al.). Some researchers now believe that aberrant activity still has some anatomical structuring to it even in a generalized state of activity. Of greater importance to the reader, however, is the fact that a generalized seizure typically entails loss of consciousness.
A 'partial' seizure is one having a starting site that can be traced to a focal point or small region of the brain using an EEG. Much like a seismograph can trace the 'epicenter' of an earthquake, the EEG can help trace the site of a seizure's origin, the site of 'epileptogenesis'. A partial seizure can generalize to where its spike patterns on an EEG (its exaggerated brain waves) show no traceable origin, however it will still be referred to as a partial seizure. If an individual retains most mental faculties and memories during and after the event, the seizure is called 'simple'. Where consciousness is lost and there is amnesia, a seizure is 'complex'.
Excerpted from Tacking on the Styx by Jeffrey L. Hatcher. Copyright © 2014 Jeffrey L. Hatcher, Ph.D.. Excerpted by permission of AuthorHouse.
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Table of Contents
Chapter 1 Awakening, 1,
Chapter 2 The Devils That We Know, 5,
Chapter 3 Surreal Interpretations, 12,
Chapter 4 Homecoming, 20,
Chapter 5 Superstitions and Psychoses, 30,
Chapter 6 New Life, 37,
Chapter 7 Calling Cards, 43,
Chapter 8 Points of View, 45,
Chapter 9 Shortcomings, 53,
Chapter 10 A Mind in Tune, 60,
Chapter 11 New Beginnings, 62,
Chapter 12 Not So Fun Facts, 68,
Chapter 13 Student Disorientation, 77,
Chapter 14 Anxieties Real and Imagined, 80,
Chapter 15 Whose Objectives?, 89,
Chapter 16 Independent Thinking, 91,
Chapter 17 Can't Live With 'em, Can't Live Without 'em, 103,
Chapter 18 Emergence, 107,
Chapter 19 Oh Bother, 112,
Chapter 20 New Places and New Spaces, 114,
Chapter 21 Misery, Mortality, and Mortification, 125,
Chapter 22 The Unthinkable, 147,
Chapter 23 Of Progress and Paranoia, 151,
Chapter 24 Hidden Triggers, 175,
Chapter 25 Eye to Eye, 182,
Chapter 26 Morbid Amnesia, 185,
Chapter 27 An Intermission, 198,
Chapter 28 Model Thoughts for Model People, 202,
Chapter 29 Friendly and Not-So-Friendly Agendas, 219,
Chapter 30 Up Close and Personal, 222,
Chapter 31 Headaches and Helpers, 236,
Chapter 32 Melting Down, 248,
Literature Cited, 266,
Nonfiction Index, 287,