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Light of my life
The American Journal of Medicine (2005) 118, 1454
MEDICAL HUMANITIES PERSPECTIVES Helle Mathiasen, Cand. mag., PhD, Section Editor
Light of my life David Goldblatt, MD Professor Emeritus of Neurology and the Medical Humanities, University of Rochester School of Medicine and Dentistry, Rochester, NY. “I can do that!” Ann says, rummaging in her purse. Ann has had multiple sclerosis (MS) for nearly 20 years. I am a neurologist, presenting her case to second-year medical students. She has told the students about her Lhermitte’s phenomenon: an electrical sensation down her back that is brought on by flexing her head forward. In the early years of her illness, she would experience it when she washed her long red hair in the kitchen sink. She and her late husband used to joke about it, not knowing what it meant. For fun, I have just read to the class the proceedings of a remarkable meeting of the New York Neurological Society in 1927, at which a prominent neurologist presented an electrician who had been one of Lhermitte’s patients in Paris. Notable among his symptoms was “a peculiar electrical sensation going down the spine and lower extremities. [He gave] a more or less spectacular performance, which the patient attributes to the electric sensations on which he harps so much, namely his ability to obtain a glow from an ordinary incandescent lamp.” Members of the society disagreed as to whether it was the filament or only the frosted exterior of the bulb that glowed. That it glowed appears not to have been in doubt.1,2 “What do you mean?” I ask Ann, feigning perplexity. “I can make a bulb light up,” she says, pulling out a small white plastic ball. “Turn out the lights.” She puts the ball in the palm of her hand and bends her neck—an unnecessary maneuver, added for effect. The ball begins to glow brightly. (The “Energy Ball,” a toy made in Hong Kong, has two contacts on its surface and contains a small bulb and battery. A moist palm completes the electrical circuit.) We have the students’ attention. Over the years, I sometimes saw students dozing. My challenge was to wake them up and make them learn. I improved my delivery. I drew cross-sections of the brain stem on the blackboard with both hands at once. In Ann, I had found a person who wanted to help me teach effectively. We became a team. Initially, I was her doctor. When prophylactic treatment became available I referred her to a subspecialist in MS, but we remained friends. She
0002-9343/$ -see front matter © 2005 Elsevier Inc. All rights reserved. doi:10.1016/j.amjmed.2005.09.043
regularly attended a poetry group I had organized. She brought flowers or fruit from her home in the country for me to take to Sally, my seriously ill wife, whom she hadn’t met. After Sally’s death, our friendship grew into love. Although Ann has had 3 bouts of optic neuritis and, at times, various sensory and motor deficits, she usually has nothing to show for her years of illness but a Babinski sign. If I scratch the bottom of her foot, her big toe goes up. After 5 years of doing our annual clinical correlation seminar on MS, we add another attention-getting element to our presentation, one based on this reflex. It will become a school legend. I make a point of telling the class that I am not Ann’s doctor. The Energy Ball creates its usual hum among the students. Then I demonstrate her normal eye movements and gait. I seat her, kneel in front of her, and scratch the bottom of her foot. Calling her attention to my kneeling position, I ask, “What does this remind you of?” “It’s the way a man used to propose to a woman.” “Well, will you marry me?” A pause, then, “Yes.” It is our first announcement of our plan. We stand and embrace. We kiss. The students go wild. Some cheer; some cry. We certainly have their full attention. Ann and I have been married 9 years and live in the house from which she used to travel to see me at the medical center. I have retired from practice and regular teaching, but memories of the classroom still glow in my mind. My memory of the Energy Ball is one of the brightest.
References 1. Wechsler IS. A case of multiple sclerosis with an unusual symptom. Arch Neurol Psychiatry. 1928;19:364-365. 2. Goldblatt D, Levy L. The electric sign and the incandescent lamp. Jacques Jean Lhermitte (1877-1959). Semin Neurol. 1985;5:191-193.
MEDICAL HUMANITIES PERSPECTIVES Helle Mathiasen, Cand. mag., PhD, Section Editor
Light of my life David Goldblatt, MD Professor Emeritus of Neurology and the Medical Humanities, University of Rochester School of Medicine and Dentistry, Rochester, NY. “I can do that!” Ann says, rummaging in her purse. Ann has had multiple sclerosis (MS) for nearly 20 years. I am a neurologist, presenting her case to second-year medical students. She has told the students about her Lhermitte’s phenomenon: an electrical sensation down her back that is brought on by flexing her head forward. In the early years of her illness, she would experience it when she washed her long red hair in the kitchen sink. She and her late husband used to joke about it, not knowing what it meant. For fun, I have just read to the class the proceedings of a remarkable meeting of the New York Neurological Society in 1927, at which a prominent neurologist presented an electrician who had been one of Lhermitte’s patients in Paris. Notable among his symptoms was “a peculiar electrical sensation going down the spine and lower extremities. [He gave] a more or less spectacular performance, which the patient attributes to the electric sensations on which he harps so much, namely his ability to obtain a glow from an ordinary incandescent lamp.” Members of the society disagreed as to whether it was the filament or only the frosted exterior of the bulb that glowed. That it glowed appears not to have been in doubt.1,2 “What do you mean?” I ask Ann, feigning perplexity. “I can make a bulb light up,” she says, pulling out a small white plastic ball. “Turn out the lights.” She puts the ball in the palm of her hand and bends her neck—an unnecessary maneuver, added for effect. The ball begins to glow brightly. (The “Energy Ball,” a toy made in Hong Kong, has two contacts on its surface and contains a small bulb and battery. A moist palm completes the electrical circuit.) We have the students’ attention. Over the years, I sometimes saw students dozing. My challenge was to wake them up and make them learn. I improved my delivery. I drew cross-sections of the brain stem on the blackboard with both hands at once. In Ann, I had found a person who wanted to help me teach effectively. We became a team. Initially, I was her doctor. When prophylactic treatment became available I referred her to a subspecialist in MS, but we remained friends. She
0002-9343/$ -see front matter © 2005 Elsevier Inc. All rights reserved. doi:10.1016/j.amjmed.2005.09.043
regularly attended a poetry group I had organized. She brought flowers or fruit from her home in the country for me to take to Sally, my seriously ill wife, whom she hadn’t met. After Sally’s death, our friendship grew into love. Although Ann has had 3 bouts of optic neuritis and, at times, various sensory and motor deficits, she usually has nothing to show for her years of illness but a Babinski sign. If I scratch the bottom of her foot, her big toe goes up. After 5 years of doing our annual clinical correlation seminar on MS, we add another attention-getting element to our presentation, one based on this reflex. It will become a school legend. I make a point of telling the class that I am not Ann’s doctor. The Energy Ball creates its usual hum among the students. Then I demonstrate her normal eye movements and gait. I seat her, kneel in front of her, and scratch the bottom of her foot. Calling her attention to my kneeling position, I ask, “What does this remind you of?” “It’s the way a man used to propose to a woman.” “Well, will you marry me?” A pause, then, “Yes.” It is our first announcement of our plan. We stand and embrace. We kiss. The students go wild. Some cheer; some cry. We certainly have their full attention. Ann and I have been married 9 years and live in the house from which she used to travel to see me at the medical center. I have retired from practice and regular teaching, but memories of the classroom still glow in my mind. My memory of the Energy Ball is one of the brightest.
References 1. Wechsler IS. A case of multiple sclerosis with an unusual symptom. Arch Neurol Psychiatry. 1928;19:364-365. 2. Goldblatt D, Levy L. The electric sign and the incandescent lamp. Jacques Jean Lhermitte (1877-1959). Semin Neurol. 1985;5:191-193.