Phantoms in the Brain: Probing the Mysteries of the Human Mind by V. S. Ramachandran, Sandra Blakeslee
Authors: V. S. Ramachandran, Sandra Blakeslee
Ads: Link
proclaim that his phantom was "direct evidence for the existence of the soul." For if an arm can exist after it is removed, why can't the whole person survive physical annihilation of the body? It is proof, Lord Nelson claimed, for the existence of the spirit long after it has cast off its attire.
The eminent Philadelphia physician Silas Weir Mitchell2 first coined the phrase "phantom limb" after the Civil War. In those preantibiotic days, gangrene was a common result of injuries and surgeons sawed infected limbs off thousands of wounded soldiers. They returned home with the phantoms, setting off new rounds of speculation about what might be causing them. Weir Mitchell himself was so surprised by the phenomenon that he published the first article on the subject under a pseudonym in a popular magazine called Lippincott's Journal rather than risk facing the ridicule from his colleagues that might have ensued had he published in a professional medical journal. Phantoms, when you think about it, are a rather spooky phenomenon.
Since Weir Mitchell's time there have been all kinds of speculations about phantoms, ranging from the sublime to the ridiculous. As recently as fifteen years ago, a paper in the Canadian Journal of Psychiatry stated that phantom limbs are merely the result of wishful thinking. The authors argued that the patient desperately wants his arm back and therefore experiences a phantom—in much the same way that a person may have recurring dreams or may even see "ghosts" of a recently deceased parent. This argument, as we 22
shall see, is utter nonsense.
A second, more popular explanation for phantoms is that the frayed and curled−up nerve endings in the stump (neuromas) that originally supplied the hand tend to become inflamed and irritated, thereby fooling higher brain centers into thinking that the missing limb is still there. Though there are far too many problems with this nerve irritation theory, because it's a simple and convenient explanation, most physicians still cling to it.
There are literally hundreds of fascinating case studies, which appear in the older medical journals. Some of the described phenomena have been confirmed repeatedly and still cry out for an explanation, whereas others seem like far−fetched products of the writer's own imagination. One of my favorites is about a patient who started experiencing a vivid phantom arm soon after amputation—nothing unusual so far—but after a few weeks developed a peculiar, gnawing sensation in his phantom. Naturally he was quite puzzled by the sudden emergence of these new sensations, but when he asked his physician why this was happening, the doctor didn't know and couldn't help. Finally, out of curiosity, the fellow asked, "Whatever happened to my arm after you removed it?" "Good question," replied the doctor, "you need to ask the surgeon." So the fellow called the surgeon, who said, "Oh, we usually send the limbs to the morgue." So the man called the morgue and asked, "What do you do with amputated arms?" They replied, "We send them either to the incinerator or to pathology. Usually we incinerate them."
"Well, what did you do with this particular arm? With my arm?" They looked at their records and said, "You know, it's funny. We didn't incinerate it. We sent it to pathology."
The man called the pathology lab. "Where is my arm?" he asked again. They said, "Well, we had too many arms, so we just buried it in the garden, out behind the hospital."
They took him to the garden and showed him where the arm was buried. When he exhumed it, he found it was crawling with maggots and exclaimed, "Well, maybe that's why I'm feeling these bizarre sensations in my arm." So he took the limb and incinerated it. And from that day on, his phantom pain disappeared.
Such stories are fun to tell, especially around a campfire at night, but they do very little to dispel the real mystery of phantom limbs. Although patients with this syndrome have been studied
The eminent Philadelphia physician Silas Weir Mitchell2 first coined the phrase "phantom limb" after the Civil War. In those preantibiotic days, gangrene was a common result of injuries and surgeons sawed infected limbs off thousands of wounded soldiers. They returned home with the phantoms, setting off new rounds of speculation about what might be causing them. Weir Mitchell himself was so surprised by the phenomenon that he published the first article on the subject under a pseudonym in a popular magazine called Lippincott's Journal rather than risk facing the ridicule from his colleagues that might have ensued had he published in a professional medical journal. Phantoms, when you think about it, are a rather spooky phenomenon.
Since Weir Mitchell's time there have been all kinds of speculations about phantoms, ranging from the sublime to the ridiculous. As recently as fifteen years ago, a paper in the Canadian Journal of Psychiatry stated that phantom limbs are merely the result of wishful thinking. The authors argued that the patient desperately wants his arm back and therefore experiences a phantom—in much the same way that a person may have recurring dreams or may even see "ghosts" of a recently deceased parent. This argument, as we 22
shall see, is utter nonsense.
A second, more popular explanation for phantoms is that the frayed and curled−up nerve endings in the stump (neuromas) that originally supplied the hand tend to become inflamed and irritated, thereby fooling higher brain centers into thinking that the missing limb is still there. Though there are far too many problems with this nerve irritation theory, because it's a simple and convenient explanation, most physicians still cling to it.
There are literally hundreds of fascinating case studies, which appear in the older medical journals. Some of the described phenomena have been confirmed repeatedly and still cry out for an explanation, whereas others seem like far−fetched products of the writer's own imagination. One of my favorites is about a patient who started experiencing a vivid phantom arm soon after amputation—nothing unusual so far—but after a few weeks developed a peculiar, gnawing sensation in his phantom. Naturally he was quite puzzled by the sudden emergence of these new sensations, but when he asked his physician why this was happening, the doctor didn't know and couldn't help. Finally, out of curiosity, the fellow asked, "Whatever happened to my arm after you removed it?" "Good question," replied the doctor, "you need to ask the surgeon." So the fellow called the surgeon, who said, "Oh, we usually send the limbs to the morgue." So the man called the morgue and asked, "What do you do with amputated arms?" They replied, "We send them either to the incinerator or to pathology. Usually we incinerate them."
"Well, what did you do with this particular arm? With my arm?" They looked at their records and said, "You know, it's funny. We didn't incinerate it. We sent it to pathology."
The man called the pathology lab. "Where is my arm?" he asked again. They said, "Well, we had too many arms, so we just buried it in the garden, out behind the hospital."
They took him to the garden and showed him where the arm was buried. When he exhumed it, he found it was crawling with maggots and exclaimed, "Well, maybe that's why I'm feeling these bizarre sensations in my arm." So he took the limb and incinerated it. And from that day on, his phantom pain disappeared.
Such stories are fun to tell, especially around a campfire at night, but they do very little to dispel the real mystery of phantom limbs. Although patients with this syndrome have been studied
Similar Books
