Thursday, April 10, 2008

A visit to Beth Israel Deaconess Medical Center

I know that many of my readers are in big cities with access to state of the art medical facilities. You readers may want to skip this post, because you see Famous Medical Centers around every corner. You take places like BIDMC for granted; just another example of Your Health Care Dollars at Work. For country bumpkins like me, though, it’s an experience to be savored. A trip to the big city. Boston.

BIDMC is in the middle of a huge medical-industrial complex on Brookline Avenue. The whole thing - hospital buildings, parking garages, and a small park - is part of the Harvard Medical School. It’s almost like a Mall of America for medicine. With some trepidation, I drove to the end of the street, and turned into the entrance. That’s where I encountered my first test.

I knew that behavioral psychologists did their experiments inside, but I did not realize they’d had a hand in the design of the building. It hit me as I sat in the entrance to the parking structure, looking forward into the roof. I was stuck. The diabolically designed curbs and curves prevented a reverse-gear escape. And the entrance ahead was an inch lower than the roof of my car. Cars were lining up behind me and the pressure was on. Resigned, I pressed the button and lowered my Range Rover to its lowest position, and then pushed the button three more times for effect.

At the lowest possible speed, I crawled the Rover into the structure.

I opened the sunroof, and reached my hand up to feel the passing of each concrete support, a scant two inches above my car. The satellite antenna is two inches tall, too, I thought. As I penetrated the building, I noted the total absence of vehicles like mine, and I remembered the advertisements for public transportation on the street. Luckily, I found a space to park.

Ducking my head, I walked out of the garage and into the crowded lobby. Scanning the people, I was struck by their overall appearance of health, or at least the non-appearance of visible disease and decay. They must market this place to an upscale crowd, I thought. Or else this lobby is where the fixed specimens hang out.

A receptionist gave me directions to the Brain Study area, and I headed up the stairs and into a corridor. I must have walked half a mile, and everyone I passed looked ambulatory and healthy. Impressive, I thought.

Finally, I reached my destination. The Center for Non Invasive Brain Stimulation. I opened the door and went inside. It was a quiet but impressive place, led by Dr. Alvaro Pascual-Leone. You could almost smell the intelligence in the air. Sort of perfume-like, with a hint of ear-smoke. The walls were lined with magazine articles describing the work they’d done, and the patents they’d been awarded. Some places would have put that stuff up with thumb tacks, but these folks have class. They used frames.

Looking around some more, I was reassured by the absence of operating room equipment, large knives, or saws. Sharp-edged power tools in the hands of medical people have always worried me.

Two post doctoral fellows (though Lindsay and Shirley are not fellows at all) rounded me up and herded me into a room for some “testing.” I wasn’t sure what they had in mind, but I went along. They sat me down at a computer, which proceeded to ask me questions. For each question, I had to push one button if the question made sense and another if it did not.

At first, the questions seemed obvious. I don’t want to give up their secrets, so I will show what they did with my own sample questions:

“Eat the cake.” Makes sense.

“Drink the highway” Nonsense.

But after a few minutes, I began to wonder . . . Did the questioners do acid? Maybe they did drink highways. I remembered my experiences with mushrooms, and suddenly the questions seemed a lot more ambiguous. And shrinks often ask weird questions.

“Choke me.” OK, makes sense. I’ll choke you if you want.

“Throw me out the window.” I paused for a second. How far can I go with these answers before they sneak up behind me with restraints?

Finally the questions came to an end. I was sure there was some deep purpose, and I hoped I passed. It was, after all, a long ride in the car followed by a tense encounter with a parking structure.

The next stop was the TMS machine, which is one of the main things they experiment with out there. I sat in a chair with electrodes attached to my fingers, while they fired bolts of magnetism into my head. And that was the strangest thing. I could hear each pulse, and I could feel a twitch in my head. But at 25% power, nothing at all showed in the fingertip electrodes. At 40%, there was still nothing. We went up slowly. 41%, then 42%. All of a sudden, a blip appeared from my fingers. 43%, and my fingers jumped like frog legs off a dinner plate.

It was very curious. During a break, I called a friend, who said, “Great! Now you can re-magnetize the strip on my credit card.” I know that I sometimes insult people whose technical knowledge is less than mine by pointing out their ignorance, so I said nothing.

And that is just the tip of the iceberg, or brainberg, as it were. Neuroscientists are now using cutting-edge technology to reach deep into the hidden recesses of the mind, to measure and even change our very thought processes. I’ll be writing a lot more about this in the future, so stay tuned . . .

It sounds strange, but these folks have achieved remarkable results using magnetic energy to help stroke survivors, people with depression, and people with other strange neurological conditions. Now, they’ve set their sights on autism.

After reading about their work, and talking to them, I decided to join their effort. And that’s what started me on the journey to the experimental parking garage.

With that, we headed over to the MRI center, where we made 168 images of my brain. Afterward, the technician provided me with a viewer. Later, when I showed it to my son, he animated it, and I now have a dancing brain. On Youtube.

And after all that, I headed home. I’ll return next week. Check back for more on the TMS program. For those who can’t wait, here’s the lab’s official site http://www.tmslab.org/

10 comments:

Kim Stagliano said...

Wow. Wow. Wow. I can't wait to learn more.

John Elder Robison said...

Hey, Kim, are you coming up to Wallingford this evening?

bookfreak53 said...

I look forward to reading your book. My nephew has been diagnosed with ASD. He's 3 and getting help now. So lucky! I wish you'd had the same benefit.

I grew up in a dysfunctional nightmare myself and can relate to you in that way. To quote a movie I once saw, "If I'd had a happy childhood I'd have nothing to write about".

I read that one application of TMS is treating depression. Do you know anything that might reference that for me? I've struggled with depression for much of my life - which seemed logical since my childhood was the kind you survive not benefit from.

I appreciate what you contribute. It seems to me that Autism is rapidly growing in awareness and hopefully treatment options. I look forward to the possibility that someday my nephew and I may develop some kind of a connection.

Mariah

John Elder Robison said...

Bookfreak, here are some links to stories in the Boston Globe on the BIDMC/Harvard TMS program and depression. You have to subscribe to download them. I've read them, and I can tell you the patients talk of remarkable success in the story.

The lab’s official site
http://www.tmslab.org/

Old brain, new tricks New research on the blind is revealing the brain's ability to adapt - and may lead to new therapies for everything from strokes to chronic pain

Published in the Boston Globe, January 15, 2006

Zap!
Published in the Boston Globe, January 14, 2003

For the above articles, go to their site, www.boston.com and use the search function.

Also read:
Magnetic Pulse Seen as Boon for Brain Research

Morning Edition, NPR, January 25, 2007

http://www.npr.org/templates/story/story.php?storyId=7015109

Kim Stagliano said...

Hi, Sorry! I was speaking in NYC at the JCC event. But I asked the group if they'd read your book and MANY of them had. I suggested they rest run out and buy it! I blogged the event today. See you Sunday at Elms. I'll prepare a bit more this time! :)

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Brownie said...

My son was identified as having Asperger's at age FOUR. I suppose like most parents, I view him through a filter...he is so amazing, smart, funny...has such a unique outlook on the world...His AS just adds a little "flavor" to our otherwise "normal" existence. Your book is fabulous. I gave a copy to his incredibly understanding preschool director for Christmas. Thanks for your view into our future...

ChristineEldin said...

This is truly fascinating!!!
And really very noble of you to partipate in research that helps so many causes.
I'm glad I read this post. Thanks for sharing.

Doreen Orion said...

John,
This is fascinating! I look forward to next week (and wonder if you are, too???).

Danni said...

Hello John. This is Danielle Gorczyca. Jack and I were best friends when we were little. I read "Running With Scissors" two years ago, and it wasn't until I talked to Mariel Adams that I discovered you and Augusten were brothers.

When I was in 8th grade I accidentally discovered one of my best friends had Aspergers. I was reading into the disorder and I noticed my friend displayed similar attributes. We dug through his medical records and found it to be true. He was diagnosed with ASD as a toddler and his parents never told him.
He was relieved because his "odd" characteristics began to make sense to him. I've been helping him with social interaction ever since we found out. He goes to UMASS Amherst now and hes actually extremely popular for his unique qualities. His friends call him "Burgers" and he loves it.
Shortly after we discovered his diagnosis he told me that he was cursed for having ASD because he felt like it was detrimental to his relationships and future. I told him I could never love him in the same way if he didn't have ASD.

In his case, I wouldn't even call it a "disorder" because it seems to brighten his social life in a different way and allows him to conceptualize things most people cannot. Sometimes its all about what society finds acceptable and what society deems unacceptable.

Anyway, my family (Mike, Vivian, and I) enjoyed your book tremendously.

Could you perhaps give me Jack's e-mail or some way to contact him? I would love to talk to him. I will be going to Mount Holyoke College in September and I heard he is going to UMASS Amherst. We are going to be close. :)