boring sensation in the bones of the index finger. The feeling seemed to start at the tip of the finger, but then it rose to the shoulder, and the stump would begin to have clonic contractions.
The carpenter reported he was frequently nauseated when the pain was at its extreme. As the pain at last faded, the tenseness in the hand seemed to ease a bit, but never enough to permit it to be moved.
Amfortas asked the carpenter a question. “Your greatest concern seems to be the tenseness in your hand. Would you tell me why?”
The carpenter asked him to clench his fingers, over his thumb, flex his wrist, and then raise his arm into a hammerlock position and hold it there. The neurologist complied. But after some minutes the pain proved too severe, and Amfortas ended the experiment.
The carpenter nodded his head. He said, “Right. But you can take your hand down. I can’t.”
They left the room silently
Walking down the hallway, the resident shrugged. “I don’t know. Can we help him?”
Amfortas recommended a Novocain injection in the upper thoracic sympathetic ganglia. “That should relieve it for a while. A few months.” But no longer than that. He knew of no cure for the phantom limb.
Or the broken heart.
424 was a housewife. From the age of sixteen, she’d complained of abdominal pain so persistently that over the years she’d acquired a history of fourteen abdominal operations. After these came a minor head injury that had her complaining of pain in the head so severe that subtemporal decompression was performed. Now her complaint was of agonizing pain in her limbs and back. At first she had refused to give her history. And now she lay constantly on her left side and cried out when the resident made an effort to turn her over on her back. When Amfortas leaned over and gently stroked the region of her sacrum, she screamed and trembled violently.
When they left her, Amfortas agreed with the resident that she ought to be referred to Psychiatric with a finding of probable addiction to surgery.
And to pain.
425 , another housewife, aged thirty, complained of chronic, throbbing headache, with attendant anorexia and vomiting. The worst possibility was a lesion, but the pain was confined to one side of the head, as was also teichopsia, a temporary blindness caused by the appearance in the visual field of a luminous area that was bounded by zigzag lines. Ordinarily, teichopsia symptomized migraine. Moreover, the patient came from a family that emphasized attainment and had rigid standards of behavior that denied or punished any expression of aggressive feelings. That was usually the history of a classic migraine patient. The repressed hostility gradually built to unconscious rage, and the rage attacked the patient in the form of the disorder.
Another referral to Psychiatric.
427 was the last, a man of thirty - eight, with a possible lesion of the temporal lobe. He was one of the janitors of the hospital, and only the day before had been discovered in a basement storage room where he had placed a dozen or so electric light bulbs in a bucket of water and was rapidly bobbing them up and down. Afterward, he couldn’t remember what he’d done. This was an automatism, a so–called “automatic action’’ characteristic of a psychomotor seizure. Such attacks could be seriously destructive, depending on the patient’s unconscious emotions, though most often they were harmless and simply inappropriate. Always bizarre, such fugues were normally brief in duration, although in rare cases they had lasted many hours and were considered to be totally inexplicable, like the baffling case of a man who had flown a light aircraft from an airport in Virginia to Chicago, yet had never learned how to fly a plane and had no recollection of the event. Sometimes, violent assaults took place. One man, later found to have a scarred temporal lobe in association with hemangioma, killed his wife while in a state of epileptic furor.
The
The carpenter reported he was frequently nauseated when the pain was at its extreme. As the pain at last faded, the tenseness in the hand seemed to ease a bit, but never enough to permit it to be moved.
Amfortas asked the carpenter a question. “Your greatest concern seems to be the tenseness in your hand. Would you tell me why?”
The carpenter asked him to clench his fingers, over his thumb, flex his wrist, and then raise his arm into a hammerlock position and hold it there. The neurologist complied. But after some minutes the pain proved too severe, and Amfortas ended the experiment.
The carpenter nodded his head. He said, “Right. But you can take your hand down. I can’t.”
They left the room silently
Walking down the hallway, the resident shrugged. “I don’t know. Can we help him?”
Amfortas recommended a Novocain injection in the upper thoracic sympathetic ganglia. “That should relieve it for a while. A few months.” But no longer than that. He knew of no cure for the phantom limb.
Or the broken heart.
424 was a housewife. From the age of sixteen, she’d complained of abdominal pain so persistently that over the years she’d acquired a history of fourteen abdominal operations. After these came a minor head injury that had her complaining of pain in the head so severe that subtemporal decompression was performed. Now her complaint was of agonizing pain in her limbs and back. At first she had refused to give her history. And now she lay constantly on her left side and cried out when the resident made an effort to turn her over on her back. When Amfortas leaned over and gently stroked the region of her sacrum, she screamed and trembled violently.
When they left her, Amfortas agreed with the resident that she ought to be referred to Psychiatric with a finding of probable addiction to surgery.
And to pain.
425 , another housewife, aged thirty, complained of chronic, throbbing headache, with attendant anorexia and vomiting. The worst possibility was a lesion, but the pain was confined to one side of the head, as was also teichopsia, a temporary blindness caused by the appearance in the visual field of a luminous area that was bounded by zigzag lines. Ordinarily, teichopsia symptomized migraine. Moreover, the patient came from a family that emphasized attainment and had rigid standards of behavior that denied or punished any expression of aggressive feelings. That was usually the history of a classic migraine patient. The repressed hostility gradually built to unconscious rage, and the rage attacked the patient in the form of the disorder.
Another referral to Psychiatric.
427 was the last, a man of thirty - eight, with a possible lesion of the temporal lobe. He was one of the janitors of the hospital, and only the day before had been discovered in a basement storage room where he had placed a dozen or so electric light bulbs in a bucket of water and was rapidly bobbing them up and down. Afterward, he couldn’t remember what he’d done. This was an automatism, a so–called “automatic action’’ characteristic of a psychomotor seizure. Such attacks could be seriously destructive, depending on the patient’s unconscious emotions, though most often they were harmless and simply inappropriate. Always bizarre, such fugues were normally brief in duration, although in rare cases they had lasted many hours and were considered to be totally inexplicable, like the baffling case of a man who had flown a light aircraft from an airport in Virginia to Chicago, yet had never learned how to fly a plane and had no recollection of the event. Sometimes, violent assaults took place. One man, later found to have a scarred temporal lobe in association with hemangioma, killed his wife while in a state of epileptic furor.
The
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