frontal lobe

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After less than a week in second year medical school, I had survived the elimination contest exam, coming in 38th of the 650 examinees. Thus I earned my place in the amphitheater that held only 110 people, including the spare chairs wedged into the stairwell.

The cornerstone on the building — the original cornerstone — said clearly, “1568.” It was not a museum, but a living medical school building. I suppose some monks had practiced here in the building at the outset when medicines were mostly tinctures, maybe marijuana if they were lucky. 
In the ancient dissection room, were four slate tables for cadavers. They were not easy to obtain, for it was said very few wanted their bodies dissected after death. The slate tables had rivulets carefully carved into them. The floor around the tables had buckets to catch various bodily fluids.

During my dissection, the master who supervised pointed a finger at me and the three other students at our table. Tradition said that “Sylvius, of the “Sylvian Fissure” had dissected at that very table. Sylvius,” meaning “from the woods” in Latin is “DuBois.” a common name in French. This fissure, that separates the frontal and temporal lobes, is so named in all the language in which medical terminology is known to me. He is sometimes claimed by Germany and sometimes by Holland.

I have looked into it enough to know he had a couple of “teaching voyages” around Europe, and his dates of activity would have made his presence in my dissection room very possible, indeed. The first day I was in this amphitheater, my physiology professor, from an ancient French family which alleged lineage dating back to 18th century pre-revolutionary French nobility, sidled up to my table and rapped on it, as if to focus his attention on me — before starting his lecture. “Mademoiselle,” he said, “you should be ashamed of yourself. You have taken a seat in this class away from a deserving Frenchman, who could earn a salary and raise a family.” The amphitheater could not have been more silent since 1568. I heard my own voice tremble. “With all due respect, Monsieur, I am here according to the Napoleonic Code of 1802, which opened the Universities of France to people coming from all nations who are capable of speaking the French language, so that they return with French culture to their nations of origin. I am pleased to be so honored. Vive la France!”

Pretty much any time you say “Vive la France!” in am amphitheater of students it is fairly certain that the whole amphitheater will end up cheering and shouting “Vive la France,” which they did. My poor professor was silenced, and shook his head. Nobody else said anything derogatory about my origins to me for the remainder of my education.

Later that week was my first lecture in neuroanatomy. I had loved the brain and its mystery and majesty long before starting the study of medicine. In first year medicine we were focused primarily on learning the limbs, with the brain and the head, neck thorax, and abdomen saved for the second year. Strangely I cannot remember the professor’s name. He was ancient and had to be helped up to the master’s lectern, One of the students told me he had been teaching before World War II. He had an essential tremor — head and neck, and sometimes the whole of his body. His voice seemed feeble, even with the microphone of the lectern. He wore a vest and trousers beneath his white coat.

“Mesdames, Mesdemoiselles, Messieurs … To me, falls the responsibility of teaching you the brain. When I address you, I speak to your brain. Assiduously studied, for hundreds of years, we knew little about it before World War I. The brave “poilus,” the French soldiers who protected this great nation in WWI , gave their lives — and all too often, gave us their brains. From knowing what part of their brain was missing and what they were unable to do in their twilight of their young lives, we learned what part of the brain did what. From this, we have evolved into a people whose knowledge of the brain we share with the world.”

He stared at me, and I felt as if his eyes burned holes in my flesh. “This organ is so complex, I do not teach with the pathologists’ photographs or drawings, but with simple circles of colored chalk to show you their bunches and bundles in cross-section. Learn them well, for they were learned from people’s lives and memories.” The other students told me later, when I talked to them that they were suppressing giggles. Me, I was suppressing tears. I have heard many complaints about nearly everything about medical education. But I have never heard anybody tell me about a deeper contact with being part of the research and education tradition than I did at that moment.

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Natural treatment of obsessionality. “Estelle, you’re such a little worrier.  Yes you are.” When I was little, I never understood why my Auntie Charlotte always addressed me this way.  I did know that my family had “adopted” her which seemed to give her the right to “adopt” me.  Her orthodox Jewish family had rejected her because she wanted to marry a guy who had been married before, even though he was very Jewish. I was not supposed to know or care about such things.  But I did know she was the first person in my life to tell me I worried too much about things that didn’t need worrying about.

Read more on Obsessions…

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I was a 2nd year resident in neurological surgery when there was news that a single neuron could link with a single computer wire and messages could travel from the one to the other. Nobody in my doctors’ lounge seemed to care.

Brain In A JarI remember seeking out a psychologist who had a fairly high tech research background, to see if he was anywhere nearly as excited as I was. To say “no” is a gross understatement.

He told me about an idea which long before that had been both funded and forgotten.  The idea had been one of a prosthetic frontal lobe.  Frontal lobe of the brain, among other things, tells people what is “appropriate” socially. The one example I will never forget is the physician who (inappropriately) peed in his pants on rounds, and ended up having a frontal lobe tumor. So the idea was that somebody who had a hunk of frontal lobe excised to get rid of the tumor, or presumably some other kind of illness, could have a teency-tiny computer to hold in their hand that would do some frontal lobe kinds of things that they no longer could.

The attempt to develop this happened on the east coast, presumably sometime after Noah’s flood, and the funding dried up just like that great flood did.

Of course, another possibility is that men do not much care where and when they pee.  I doubt this, since I had a patient in Oklahoma who had purchased a fair amount of real estate in his life and thought it necessary and appropriate to “mark” it in the same way a dog marks his territory.  Yes, it involved peeing in public, but the fellow had no known frontal lobe pathology at the time.

Ah, those Oklahoma men. Read more on Maybe Those People Who Annoy Can Get A Prosthetic Brain…

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