Archive for the ‘NEUROLOGY WRITING (NOT TECHNICAL!)’ Category


May 12, 2019

A while back, my computer flooded when a cat jumped on my arm, which was controlled by my brain to hold a cup of coffee, and not a landing cat.  The arm jerked, the coffee flew (along with the cat), much of the former landing on the keyboard.  I don’t remember where the cat landed.

After replacing the computer (keeping the cat), I loaded from my back up disk and noted that I had different emails.  I had three different computers storing data on the backup disk, and two were almost the same regarding information.  Some of the emails, however, I hadn’t seen in 15 years.  I had written a piece “A Wise Owl,” which with the help of the late Dr. David Goldblatt, a neurologist, writer, fellow Rochesterian, gentleman,  critic, and friend, brought back memories I had long forgotten.  I miss David, who died in 2007 from ureteral cancer.  His editing brought out the best in my writing.  He hated it when I confused “as” and “like,” and he once said he read one of my eclipse articles completely only, “because I was committed to doing it,” which unequivocally stated his opinion.  

“A Wise Owl” was about the night my widowed father asked to come to view a total lunar eclipse with me and others at Sabino Canyon, a reasonably dark sky site in Tucson with ample parking.  Dad was having a difficult time being alone after 63 years, and his memory suffered.  But that night, under the eclipsed Moon, he explained the phenomenon to two young women in a way that left me agape, and I was a local astronomy columnist who knew a great deal about eclipses.  

I wrote the article in response to a request for submissions to Nisus, a section in the journal Neurology dealing with the human condition and neurology.  This section wasn’t about research but rather neurological conditions with their effect on individuals, society, and humanity.  My mother had a rapidly progressive dementia and my father had a pseudodementia as a result of depression.  Once I knew clearly my mother’s diagnosis, and she stopped eating and drinking, we put her in hospice and she died five days later.  She had once made me promise never to put her in a nursing home and I didn’t“A Wise Owl” was about my relationship with my father shortly before and after her death.

David saw promise in my article and made important suggestions. I rewrote the piece, and it appeared in Neurology in late 2003.  That December, David called me (referring to me as Admiral Byrd, since I had just returned from an eclipse flight over a good portion of Antarctica), telling me that I had won the Creative Expression Award for Humanity in Neurology, and it would be presented at the Academy’s annual meeting in 2004.  I was stunned.  I was a real writer.

The next spring, I flew to Oakland and took the BART to San Francisco, where the meeting was held.  That evening, I was guest of honor at a small gathering where past winners of the CEA and interested others were present.  The award came with a $1500 check, which was donated to the charity of the winner’s choice.  I said a few words, saying that I chose MSF (Doctors Without Borders), and talked briefly with some there, until people trickled away to dinner with other neurologists at the meeting.  David finally left, saying that I would probably want to spend some time with neurologists from Arizona.  

I knew there were no Tucson neurologists there.  And if there had been, I would have been hard pressed to name more than two with whom I would have wanted to have dinner and who would have wanted to eat with me. I returned to my hotel.

The next noon was the Academy luncheon honoring award recipients, and my table was way in back labeled “Guests.”  My name was on the back of the program as a recipient of a Level Two Award. There was a short blurb about me and an ezine I wrote about hearing wolves howl in the wilderness that had recently been published.  Nobody at the table knew me, my name tag didn’t say anything special, and I don’t remember if I got to stand with the other award winners, which included some non-neurologists.  In short, I didn’t really need to be there; it didn’t matter.  Level One awardees were feted.    

I later expressed surprise to David about the luncheon.  He had had another commitment that day and couldn’t attend.  I learned that he long had difficulty convincing the leaders of the Academy to allow articles such as mine in the journal, that humanity was an important part of neurology, not just research into neurological conditions.  When I read his emails on my computer, I was astounded at his passion for Nisus, how well he expressed himself, how much I missed his wisdom over the years, and that he was one of the true elders in the field.  David copied me on many letters over the ensuing two years, trying to ensure that never again would a CEA winner be treated as anything other than an “true” award winner at the annual meeting.  During that time, I left the Academy, because I was moving further from neurology and medicine and the Academy was no longer relevant in my life.  The letters I read from David reminded me that the Academy’s feeling was mutual.  

I wrote one more article that appeared in Nisus.  David and I wrote with very different styles; he was a far better writer.  He had exchanges with The New Yorker about his letters to the editor, none of which was ever published. Having one published was an unfulfilled goal of his.  I wish I could have told him I got one published in the magazine several years ago.  He would have laughed and said he was jealous.

The day I looked at the letters written long ago, I sent a comment to the New York Times about an article detailing what social media has brought us.*  I wrote it quickly, on my phone, while eating a small breakfast at the Portland airport.  It became a Times pick.  At the other end of the day in Ely, Minnesota, I wrote a second comment that became another Times pick.^  David would have been pleased, but I bet he would have found a way to have made both better.  He made so many things better.  

Deep in a closet upstairs in my house is a box that contains a folder of handwritten thank you notes I received as a neurologist.  For many years, when I felt really down, I would read them.  I saved most of these letters. Technology makes it more and more difficult to open and read ancient emails.  I was fortunate enough that the ones I had still could be opened, for they reminded me of a man who helped me write the best article I will ever write.

*“I’d gladly trade my right to comment here for no comments and no social media. The world was better without the online hatred, false conspiracies, ignorance, poor spelling and grammar that we got in return for doctored videos and digital narcissism.”

^On Jacinda Ardern, Prime Minister of New Zealand: “As a yank who loves both countries and probably should stay quiet, I appreciated Ardern’s neither mentioning the name of the perpetrator nor allowing his face to be shown. As a result, he has disappeared from the media (although probably not from the Dark Web). When there is a mass shooting here, the perpetrator has his name blabbed for days and his picture stays on the screen for 30 seconds at a time. This may not be a minor point: a lot of copycats want to end their existence making big headlines and having everybody know their names.”


May 16, 2010

In early March, a young woman was thrown from her dressage horse during a routine schooling ride.  She was rendered comatose and two months later in a rehab facility with a mild hemiparesis but finally able to swallow.

The woman was a member of the US Equestrian Olympic Team, one of only two sports where men and women compete equally.  I say “was,” because we both know it is unlikely that she will ever be able to compete again at a high level in dressage, one of the most demanding partnerships between man and animal.  She has recovered remarkably well and hopes to teach riding; unfortunately, even her young age was not young enough for better recovery.  She is at higher risk for epilepsy, personality and emotional residuals as well.  In short, she suffered a catastrophe.  Fortunately, she didn’t end up vegetative, especially since the accident occurred in Florida, where adults with 600 gram brains are felt by cardiac surgeons to be conscious and doing well, because they smile even if they can’t comprehend 15 years after the insult.

Florida and the 109th Congress aside, what is finally occurring is a helmet debate in the equestrian community, similar to the helmet debate seven years ago in the cycling community, where 9 years earlier, almost to the day, Andrei Kivilev, a superb Kazakh rider, collided with two other riders on the Paris-Nice race.  The other two were fine; Kivilev, 29, hit his head and died the next day, leaving behind his widow and six month old daughter.  His death was a catalyst for mandatory helmets in major cycling races, which first did not mandate helmets for mountain top finishes, but now do.  Every cyclist in every major event wears a helmet.  Something good came out of Kivilev’s death; hopefully the equestrian community will do the same.  Already, several equestrian riders have stated publicly that they were saved by a helmet they began wearing.

But there is still no mandate.  Dressage riders must dress formally; indeed, proper riding attire is considered appropriate dress anywhere, something I often kid my wife about.  Helmets are not part of dressage riding.  Well, the judges need to get over it and deduct points should someone not be wearing a helmet.  Better yet, it should be cause for immediate disqualification if any rider on a horse at any time at a horse event is not wearing a helmet.

In 1976, Arizona allowed motorcyclists not to wear helmets.  I remember the demonstrations at the Capitol.  I wonder how many have since died or been permanently maimed as a result of not wearing a helmet.  It is time for a helmet debate in this country.  At what point do an individual’s rights conflict with the rights of his loved ones to have him (usually a him) around and whole, and society’s rights to pay for the extra care that going without a helmet and having an accident causes?  It’s a fair debate.  I know where I am on this issue.  I, like many of my former colleagues, bitterly remember coming into an ED at 2 a.m. to take care of another drunken biker who wasn’t wearing a helmet.  In my case, the lack of payment was a minor annoyance.  The sleep I lost was not so minor.  We live in a republic.  We have a government, and by definition, that government has some control over us, even in the hinterlands of Alaska.  We need an honest, factual debate on regulation, without Rush, Bill, Glenn, Sarah, Keith, Jon, Rachel or Steven.  In my view, failure to regulate almost took down the world’s economy and has given us wireless service that is worse than many third world countries.  There is an imperfect but better middle ground out there that we need to find; otherwise, Zappa’s Law about universality has a third part:   hypocrisy, in addition to hydrogen and stupidity.

Growing up, I didn’t know about seat belts; today, even in Arizona, 75% wear them.  I skied for 40 years without wearing a helmet; I didn’t know better.  Or didn’t want to know better.  I knew that ½mv2 =mgh, and a fall at 25 mph was like falling off the roof.  I would wear a helmet today if I skied.  In my three major bicycling accidents, my helmet was significantly damaged, damage my skull didn’t have.  I was not knocked out, even when I could hear the back of the helmet go WHACK! on Moore Road, the day I broke my clavicle.

Physicians need to frame the helmet issue and lead the debate.  And after we deal with helmets, we will have to deal with a hot, extremely difficult issue:  the long term side effects of playing football as the game is currently played, for the data show that the sport is far more dangerous than anybody ever realized.

For now, the equestrian community must recognize the dangers of being 10 feet off the ground on an unpredictable animal, and where a head might hit if the animal bucks.  It won’t be the only buck in the equation.

We will never drive trauma centers out of existence, but every physician should want to.  I hope most trauma physicians would be among the first to agree.


September 16, 2009





September 11, 2009