Stroke Patient Quotes

An algorithm that expedites care to a stroke patient in a chaotic emergency room (ER) has a good chance of adoption. An algorithm that reads a routine scan and provides some quantification of what the physicians can already estimate won’t be in as much demand. There are good reasons for algorithms to parse patient records to look for signs of rare diseases, but there are fewer good reasons for using them to evaluate clinical symptoms. It’s cool that AI tools can make diagnoses from scratch, but for most clinical encounters doctors are already pretty good at it.

What would you call this patient – schizophrenic or schizoaffective?" He paused and stroked his chin, apparently in deep thought. "I think I'd call him Michael McIntyre," he replied.

Narcissistic Supply You get discarded as supply for one of two reason: They find you too outspoken about their abuse. They prefer someone that will keep stroking their ego and remain their silent doormat. Or, they found new narcissistic supply. Either way, you can count on the fact that they planned your devaluation phase and smear campaign in advance, so they could get one more ego stroke with your reaction. Narcissists are angry, spiteful takers that don't have empathy, remorse or conscience. They are incapable of unconditional love. Love to them is giving only when it serves them. They gaslight their victims by minimizing the trauma they have caused by blaming others or stating you are too sensitive. They never feel responsible or will admit to what they did to you. They have disordered thinking that is concerned with their needs and ego. It is not uncommon for them to hack their targets, in order to gain information about them. They enjoy mind games and control. This is their dopamine high. The sooner you distance yourself the healthier you will become. Narcissism can't be cured or prayed away. It is a mental disorder that turns the victims of its abuse into mental patients because it causes so much psychological manipulation.

Individuality is deeply imbued in us from the very start, at the neuronal level. Even at a motor level, researchers have shown, an infant does not follow a set pattern of learning to walk or how to reach for something. Each baby experiments with different ways of reaching for objects and over the course of several months discovers or selects his own motor solutions. When we try to envisage the neural basis of such individual learning, we might imagine a "population" of movements (and their neural correlates) being strengthened or pruned away by experience. Similar considerations arise with regard to recover and rehabilitation after strokes and other injuries. There are no rules; there is no prescribed path of recovery; every patient must discover or create his own motor and perceptual patterns, his own solutions to the challenges that face him; and it is the function of a sensitive therapist to help him in this. And in its broadest sense, neural Darwinism implies that we are destined, whether we wish it or not, to a life of particularity and self-development, to make our own individual paths through life.

A very different study, in which robots interacted with stroke patients during physical rehabilitation exercises, yielded strikingly similar results. Introverted patients responded better and interacted longer with robots that were designed to speak in a soothing, gentle manner: “I know it is hard, but remember that it’s for your own good,” and, “Very nice, keep up the good work.” Extroverts, on the other hand, worked harder for robots that used more bracing, aggressive language: “You can do more than that, I know it!” and “Concentrate on your exercise!

Alexander the Magnus was once called to solve the following challenge in the Phrygian city of Gordium (as usual with Greek stories, in modern-day Turkey). When he entered Gordium, he found an old wagon, its yoke tied with a multitude of knots, all so tightly entangled that it was impossible to figure out how they were fastened. An oracle had declared that he who would untie the knot would rule all of what was then called “Asia,” that is, Asia Minor, the Levant, and the Middle East. After wrestling with the knot, the Magnus drew back from the lump of gnarled ropes, then made a proclamation that it didn’t matter for the prophecy how the tangle was to be unraveled. He then drew his sword and, with a single stroke, cut the knot in half. No “successful” academic could ever afford to follow such a policy. And no Intellectual Yet Idiot. It took medicine a long time to realize that when a patient shows up with a headache, it is much better to give him aspirin or recommend a good night’s sleep than do brain surgery, although the latter appears to be more “scientific.” But most “consultants” and others paid by the hour are not there yet.

Oh God how subtle he would have to be, how cunning... No paragraph, no phrase even of the thousands the book must contain could strike a discordant note, be less than fully imagined, an entire novel's worth of thought would have to be expended on each one. His attention had only to lapse for a moment, between preposition and object, colophon and chapter heading, for dead spots to appear like gangrene that would rot the whole. Silkworms didn't work as finely or as patiently as he must, and yet boldness was all, the large stroke, the end contained in and prophesied by the beginning, the stains of his clouds infinitely various but all signifying sunrise. Unity in diversity, all that guff. An enormous weariness flew over him. The trouble with drink, he had long known, wasn't that it started up these large things but that it belittled the awful difficulties of their execution. ("Novelty")

When my sadness finally lifted, I found my head on Josh’s shoulder. He stroked my hair slowly, patiently. “Josh?” “Mmm?” he said. “Can we get married?” His breath caught, and then I felt his smile against my forehead. “You do mean to each other, right?” I squeezed his knee. “Yes. Would you do that for me?” “I would like that very much,” he said in a small voice.

Callahan found that the common first reaction to news of cancer, strokes, heart attacks, or the failure of some major organ was one of betrayal. The patient was astounded to find that such a close (and, up to now at least, fully understood) friend as one’s own body could be so sluggard as to lie down on the job. The reaction which followed close on the heels of the first was the thought that a friend who would let one down so cruelly was not worth having. The conclusion that followed these reactions was that it didn’t matter if this friend was worth having or not. One could not refuse to speak to one’s traitorous body, or get up a petition against it, or pretend that one was not at home when it called. The final thought in this hospital-bed train of reasoning was the hideous possibility that one’s body might not be a friend at all, but an enemy implacably dedicated to destroying the superior force that had used it and abused it ever since the disease of reason set in.

We desire that God would give us the death-stroke; but we long to die without pain; we would die to our own will by the power of the will itself; we want to lose all and still hold all. Ah! what agony, what distress, when God has brought us to the end of our strength! We faint like a patient under a painful surgical operation. But the comparison is nought, for the object of the surgeon is to give us life -- that of God to make us die.

Our most surprising finding was a white spot in the left frontal lobe of the cortex, in a region called Broca’s area. In this case the change in color meant that there was a significant decrease in that part of the brain. Broca’s area is one of the speech centers of the brain, which is often affected in stroke patients when the blood supply to that region is cut off. Without a functioning Broca’s area, you cannot put your thoughts and feelings into words.

But the heavy stroke which most of all distresses me is my dear Mother. I cannot overcome my too selfish sorrow, all her tenderness towards me, her care and anxiety for my welfare at all times, her watchfulness over my infant years, her advice and instruction in maturer age; all, all indear her memory to me, and highten my sorrow for her loss. At the same time I know a patient submission is my Duty. I will strive to obtain it! But the lenient hand of time alone can blunt the keen Edg of Sorrow. He who deignd to weep over a departed Friend, will surely forgive a sorrow which at all times desires to be bounded and restrained, by a firm Belief that a Being of infinite wisdom and unbounded Goodness, will carve out my portion in tender mercy towards me! Yea tho he slay me I will trust in him said holy Job. What tho his corrective Hand hath been streached against me; I will not murmer. Tho earthly comforts are taken away I will not repine, he who gave them has surely a right to limit their Duration, and has continued them to me much longer than deserved. I might have been striped of my children as many others have been. I might o! forbid it Heaven, I might have been left a solitary widow. Still I have many blessing left, many comforts to be thankfull for, and rejoice in. I am not left to mourn as one without hope. My dear parent knew in whom she had Believed...The violence of her disease soon weakned her so that she was unable to converse, but whenever she could speak, she testified her willingness to leave the world and an intire resignation to the Divine Will. She retaind her Senses to the last moment of her Existance, and departed the world with an easy tranquility, trusting in the merrits of a Redeamer," (p. 81 & 82).

(...) I'm my very best self when I'm with him, but every day, I want him more than I need him. He taught me that love is patient, love is kind, love is calm and quiet. It's not a music video of big hair, big tears and erotic, electrical storms. It's two people pottering about a small flat making each other coffee. It's waking up every morning and feeling quietly delighted as you smell the sleep on his skin and observe the the way his tufty hair is framed by the pillow. It's sly hands sneaking up jumpers to stroke the silky skin underneath and wanting to share all your big news, bad news and pictures of especially adorable dogs. It's knowing that there's nothing that can't be talked over and solved by a walk to the park or a trip to the pub.

Right above my head, on the shelf made out of sockets and switches, is the hospital’s kind reminder of my impermanence. A whiteboard that says Lenni Pettersson in red marker with a smudge near the final n. The thing about whiteboards is that they’re so easily wiped clean. They’re designed to be used again and again and again for the names of the unlucky few who find themselves in the May Ward. One day, in just the briefest stroke of a dry whiteboard eraser, I’ll be gone. A new patient with skinny arms and big eyes will take my place.

I encourage my patients to do what it takes to normalize their blood pressure so they do not require medication. Prescribing medications for high blood pressure has the effect of giving someone a permission slip. Medication has a minimal effect in reducing heart attack occurrence in patients with high blood pressure because it does not remove the underlying problem (atherosclerosis), it just treats the symptom. Patients given medication now falsely believe they are protected, and they continue to follow the same disease-causing lifestyle that led to the problem to begin with, until the inevitable occurs—their first heart attack or stroke. Maybe if high blood pressure medications had never been invented, doctors would have been forced to teach healthful living and nutritional disease causation to their patients. It is possible that many more lives could have been saved.

Cam paused, staring down at her with dilated eyes, the irises bright gold rims around circles of fathomless midnight. “Amelia, love…” His kiss tasted of salt and intimacy. “Can you take a little more of me?” She fought to think above the confusion of pleasure, and shook her head jerkily. The corners of his lips deepened with a smile. He whispered, “I think you can.” His hands played over her, solicitous fingertips sliding to the place they were joined. He pressed inside her, a low rhythmic movement, and his fingers were astonishingly gentle, almost delicate, as they stroked in time to the patient thrusts. Gasping, she arched to take him deeper, and deeper still. Every time he pushed, his body rubbed hers in exactly the right way. She began to lift eagerly, anticipating each invasion, panting for it, sensation building on sensation until it culminated in a blinding swell of delight … and another … another … she felt him begin to withdraw and she moaned and twined her legs around his hips. “Amelia,” he gasped, “no, let me … I’ve got to…” Shuddering, he spent helplessly inside her, while her body gripped and stroked the hard length of him. Still locked together, Cam rolled Amelia to her side. He muttered something in Romany. Although she didn’t understand a word, it sounded highly complimentary. Limp with pleasure and exhaustion, Amelia rested her head on the solid curve of his biceps, her breath catching as she felt the occasional twitch and pulse of him in the depths of her body.

Certain brain areas are considered near-inviolable, like the primary motor cortex, damage to which results in paralysis of affected body parts. But the most sacrosanct regions of the cortex are those that control language. Usually located on the left side, they are called Wernicke's & Broca's areas; one is for understanding language & the other for producing it. […]If both areas are damaged, the patient becomes an isolate, something central to her humanity stolen forever. After someone suffers a head trauma or stroke, the destruction of these areas restrains the surgeon's impulse to save a life: what kind of life exists without language?

Our most surprising finding was a white spot in the left frontal lobe of the cortex, in a region called Broca’s area. In this case the change in color meant that there was a significant decrease in that part of the brain. Broca’s area is one of the speech centers of the brain, which is often affected in stroke patients when the blood supply to that region is cut off. Without a functioning Broca’s area, you cannot put your thoughts and feelings into words. Our scans showed that Broca’s area went offline whenever a flashback was triggered. In other words, we had visual proof that the effects of trauma are not necessarily different from—and can overlap with—the effects of physical lesions like strokes. All trauma is preverbal.

You taste so sweet." The whispered words sent a shiver down her spine. Somehow, whenever she had imagined this intimacy with a man, she had thought of darkness and urgency and groping. She had not expected firelight and heat and this patient courting of her body. Jack's lips wandered in a velvet path from her throat to the sensitive opening of her ear, played lightly, and then Amanda jerked in surprise as she felt the tip of his tongue stroke along a tiny inner crevice. "Jack," she whispered. "You don't have to play the lover for me. Truly... you are kind to pretend that I'm desirable, and you-" She felt him smile against her ear. "You are an innocent, mhuirnin, if you think that a man's body reacts this way out of kindness.

EKGs frequently have normal or inconclusive findings in heart attack patients, particularly in women, so you should insist on having your levels of cardiac enzymes measured, using a blood test called high-sensitivity troponin, which checks for elevated levels of proteins that are released when muscle cells in the heart are damaged, as occurs during a heart attack.22

The concept of “brain plasticity” refers to the ongoing capacity of the brain and the nervous system to change itself. Everything that we do, think, feel, and experience changes our brain. A stroke or a traumatic brain injury can affect brain plasticity, and plasticity may also be associated with such developmental disorders as autism. Increased brain plasticity may also potentially endow a person with unanticipated new abilities, as John appears to have experienced in this book. TMS, or transcranial magnetic stimulation, the intervention that John undergoes, provides a unique opportunity for us to learn about the mechanisms of plasticity, and to identify alterations in the brain’s networks that may be responsible for a patient’s problematic symptoms, and also for recovery.

I’m going to take some much-needed time with your mouth right now. While I do, you’re going to continue stroking me until I’m so close to coming, I’ll be ready to die just to drill you against this wall. But I won’t. I’m going to stop you just before I bust. Then I’m going to lick the sweet pussy that’s been waiting so patiently for me.” He surged into her hand. “Come on, baby. Make me suffer.

And there were other neural implants being developed back then, including retinal implants, chips that enable a stroke patient to control his computer from his brain, an artificial hippocampus for boosting short-term memory, and many others. If you apply the approximately 30 million–fold increase in capability and over 100,000-fold shrinking in size that has occurred in the past quarter century, we now have much more capable devices that are the size of blood cells. Reader: Still, it’s hard to imagine building something the size of a blood cell that can perform a useful function. Terry2034: Actually, there was a first generation of blood cell–size devices back in your day. One scientist cured type 1 diabetes in rats with a blood cell–size device. It was an excellent example of nanotechnology from

in 1972 Governor Ronald Reagan with one bold, brilliant stroke abolished mental illness in California by not only closing the large state psychiatric hospitals but also eradicating most of the public aftercare programs. As a result hospital staffs were forced, day after day, to go through the charade of treating patients and discharging them back into the same noxious setting that had necessitated their hospitalization.

Quietly he read, restraining himself, the first column and, yielding but resisting, began the second. Midway, his last resistance yielding, he allowed his bowels to ease themselves quietly as he read, reading still patiently, that slight constipation of yesterday quite gone. Hope it's not too big bring on piles again. No, just right. So. Ah! Costive one tabloid of cascara sagrada. Life might be so. It did not move or touch him but it was something quick and neat. Print anything now. Silly season. He read on, seated calm above his own rising smell. Neat certainly. Matcham often thinks of the master-stroke by which he won the laughing witch who now. Begins and ends morally. Hand in hand. Smart. He glanced back through what he had read and, while feeling his water flow quietly, he envied kindly Mr Beaufoy who had written it and received payment of three pounds thirteen and six.

What these older physicians exhibited is termed clinical curiosity. They stroke to understand their patients in order to elucidate the underlying medical conditions. This thoroughness, patience, and dogged curiosity may have been ingrained in them because they trained at a time when they were no rapid CTs or MRIs. But even now, when these diagnostic tools are at their fingertips, these physicians maintain this approach to patients, one that serves to appreciate the dignity and uniqueness of each patient and his or her illness.

The enemy of my soul didn't want me painting that day. To create meant that I would look a little bit like my Creator. To overcome the terrifying angst of the blank canvas meant I would forever have more compassion for other artists. You better believe as I placed the first blue and gray strokes onto the white emptiness before me, the "not good enough" statement was pulsing through my head in almost deafening tones... This parlaying lie is one of his favorite tactics to keep you disillusioned by disappointments. Walls go up, emotions run high, we get guarded, defensive, demotivated, and paralyzed by the endless ways we feel doomed to fail. This is when we quit. This is when we settle for the ease of facebook.... This is when we get a job to simply make money instead of pursuing our calling to make a difference. This is when we put the paintbrush down and don't even try. So there I was. Standing before my painted blue boat, making a choice of which voice to listen to. I'm convinced God was smiling. Pleased. Asking me to find delight in what is right. Wanting me to have compassion for myself by focusing on that part of my painting that expressed something beautiful. To just be eager to give that beauty to whoever dared to look at my boat. To create to love others. Not to beg them for validation. But the enemy was perverting all that. Perfection mocked my boat. The bow was too high, the details too elementary, the reflection on the water too abrupt, and the back of the boat too off-center. Disappointment demanded I hyper-focused on what didn't look quite right. It was my choice which narrative to hold on to: "Not good enough" or "Find delight in what is right." Each perspective swirled, begging me to declare it as truth. I was struggling to make peace with my painting creation, because I was struggling to make make peace with myself as God's creation. Anytime we feel not good enough we deny the powerful truth that we are a glorious work of God in progress. We are imperfect because we are unfinished. So, as unfinished creations, of course everything we attempt will have imperfections. Everything we accomplish will have imperfections. And that's when it hit me: I expect a perfection in me and in others that not even God Himself expects. If God is patient with the process, why can't I be? How many times have I let imperfections cause me to be too hard on myself and too harsh with others? I force myself to send a picture of my boat to at least 20 friends. I was determined to not not be held back by the enemy's accusations that my artwork wasn't good enough to be considered "real art". This wasn't for validation but rather confirmation that I could see the imperfections in my painting but not deem it worthless. I could see the imperfections in me and not deem myself worthless. It was an act of self-compassion. I now knew to stand before each painting with nothing but love, amazement, and delight. I refused to demand anything more from the artist. I just wanted to show up for every single piece she was so brave to put on display.. Might I just be courageous enough to stand before her work and require myself to find everything about it I love? Release my clenched fist and pouty disappointments, and trade my "live up" mentality for a "show up" one? It is so much more freeing to simply show up and be a finder of the good. Break from the secret disappointments. Let my brain venture down the tiny little opening of love.. And I realized what makes paintings so delightful. It's there imperfections. That's what makes it art. It's been touched by a human. It's been created by someone whose hands sweat and who can't possibly transfer divine perfection from what her eyes see to what her fingertips can create. It will be flawed.

Marissa,” he mumbled, taking her hand. “Don’t want to see you drink so much.” Wait, not really what he’d been going for. “Ah . . . don’t want you to see me drink so much . . . want.” Whatever. God . . . he was so confused. V smiled a little, but it was the kind of falsey number doctors gave to patients who were about to throw up. “He’s going to need something with sugar in it. Rhage, you got a lollipop on you?” Butch looked over as a wicked handsome blond guy knelt down. “I know you,” Butch said. “Hey . . . buddy.” “Hey, my man.” Rhage reached into the pocket of his fleece and pulled out a Tootsie Pop. After ripping the wrapper off, he put the thing into Butch’s mouth. Butch groaned. Goddamn, that was the best thing he’d ever tasted in his whole life. Grape. Sweet. Ahhhh . . . “Is he seizing again?” Marissa asked. “I think he likes it,” Rhage murmured. “That right, cop?” Butch nodded and nearly lost the lollipop, so Rhage took control of the stick, holding it in place. Man, they were so good to him. Marissa stroking his hair and holding his hand. V’s palm a warm weight on his leg. Rhage making sure the Toosie Pop stayed where it needed to be—

When his count reached thirty children he stopped. Five more hours at six children per hour would take him to eight o’clock. He crouched down before a two-year-old girl. Lily was her name if he remembered correctly. He said, “Hello Beautiful,” and stroked her hot cheek with the back of his hand. He took the cap off the iodine and wet the tip of his index finger. He drew a semicircle on her forehead and added two dots. To him it was a smiley face, but if asked he would say it was a moon and two stars. Turning to the mother he said, “Your daughter will be the last patient of the day.

So should patients born under Libra and Gemini be deprived of treatment? You would say no, of course, and that would make you wiser than many in the medical profession: the CCSG trial found that aspirin was effective at preventing stroke and death in men, but not in women;30 as a result, women were undertreated for a decade, until further trials and overviews showed a benefit. That is just one of many subgroup analyses that have misled us in medicine, often incorrectly identifying subgroups of people who wouldn’t benefit from a treatment that was usually effective. So, for example, we thought the hormone-blocking drug tamoxifen was no good for treating breast cancer in women if they were younger than fifty (we were wrong). We thought clotbusting drugs were ineffective, or even harmful, when treating heart attacks in people who’d already had a heart attack (we were wrong). We thought drugs called ‘ACE inhibitors’ stopped reducing the death rate in heart failure patients if they were also on aspirin (we were wrong). Unusually, none of these findings was driven by financial avarice: they were driven by ambition, perhaps; excitement at new findings, certainly; ignorance of the risks of subgroup analysis; and, of course, chance.

What if conscious experience is managed by each module? Lose a module to injury or stroke, and the consciousness that accompanies that module is gone, too. Remember: patients with hemi-neglect aren’t conscious of one-half of space because the module that processes that information is no longer working. Or, if the modules responsible for locating oneself in space are not being integrated properly, conscious experience is deeply affected, and one ends up with the feeling that someone else is there just over your shoulder. Or, take people with Urbach-Wiethe disease, which leads to deterioration of the amygdalae: they no longer experience the emotion of fear. One

Shocked, she uttered a hoarse protest and shifted beneath him, but he soothed her with his hands, stroking her legs and hips, resettling her on the mattress. "Lie still. You don't have to do anything, my love. Let me take care of you. Yes. You can touch me if you... mmm, yes..." He purred as he felt her trembling fingers touch his glistening hair, the back of his neck, the hard slope of his shoulders. He moved lower, his hair-roughened legs sliding along the insides of hers, and she realized that his face was just above the triangle of fiery red curls. Flooded with embarrassment, she automatically reached down to cover the private area with her hand. St. Vincent's erotic mouth lowered to her hip, and she felt him smile against her tender skin. "You shouldn't do that," he whispered. "When you hide something from me, I want it all the more. I'm afraid you're filling my head with the most lascivious ideas... you'd better take your hand away, sweet, or I might do something really depraved." As her shaking hand withdrew, he let one fingertip wander into the springy hair, delicately searching the cushiony softness. "That's right... obey your husband," he whispered wickedly, stroking farther, deeper, until he had separated the cluster of curls. "Especially in bed. How beautiful you are. Open your legs, my love. I'm going to touch inside you. No, don't be afraid. Will it help if I kiss you here? Be still for me..." Evie sobbed as his mouth searched through the triangle of brilliant red hair. His warm, ruthlessly patient tongue found the little peak half concealed beneath the vulnerable hood. His long, agile finger probed the entrance of her body, but he was momentarily dislodged as she jerked in surprise. Whispering reassurances against her swollen flesh, St. Vincent slid his finger inside her again, deeper this time. "Innocent darling," came his soft murmur, and his tongue tickled a place so excruciatingly sensitive that she quivered and moaned. At the same time, his finger stroked her inner softness with a languid rhythm.

The researchers tried a clever tactic to overcome this problem. They created a number of recipes for common foods including muffins and pasta in which they could disguise placebo ingredients like bran and molasses to match the texture and color of the flax-laden foods. This way, they could randomize people into two groups and secretly introduce tablespoons of daily ground flaxseeds into the diets of half the participants to see if it made any difference. After six months, those who ate the placebo foods started out hypertensive and stayed hypertensive, despite the fact that many of them were on a variety of blood pressure pills. On average, they started the study at 155/81 and ended it at 158/81. What about the hypertensives who were unknowingly eating flaxseeds every day? Their blood pressure dropped from 158/82 down to 143/75. A seven-point drop in diastolic blood pressure may not sound like a lot, but that would be expected to result in 46 percent fewer strokes and 29 percent less heart disease over time.125 How does that result compare with taking drugs? The flaxseeds managed to drop subjects’ systolic and diastolic blood pressure by up to fifteen and seven points, respectively. Compare that result to the effect of powerful antihypertensive drugs, such as calcium-channel blockers (for example, Norvasc, Cardizem, Procardia), which have been found to reduce blood pressure by only eight and three points, respectively, or to ACE inhibitors (such as Vasotec, Lotensin, Zestril, Altace), which drop patients’ blood pressure by only five and two points, respectively.126 Ground flaxseeds may work two to three times better than these medicines, and they have only good side effects. In addition to their anticancer properties, flaxseeds have been demonstrated in clinical studies to help control cholesterol, triglyceride, and blood sugar levels; reduce inflammation, and successfully treat constipation.127 Hibiscus Tea for Hypertension Hibiscus tea, derived from the flower of the same name, is also known as roselle, sorrel, jamaica, or sour tea. With

How often are people told they’ve brought a condition like depression upon themselves? It’s all part of mercury’s blame-the-victim game. Those depressive symptoms are the mercury speaking for the patient without her or his consent. Sometimes mercury moves past the hostage phase and takes someone out, resulting in death by Alzheimer’s, Parkinson’s, dementia, or stroke. It’s that serious. Mercury has injured or killed well over a billion people. No one likes Alzheimer’s; it’s a frightening, terrible disease. Yet it’s rapidly becoming common—and it’s 100 percent mercury-caused. You heard that here first: Mercury is 100 percent responsible for Alzheimer’s disease. You will never in your lifetime hear the truth about that anywhere else.

This tragic sequence helps explain the fearful loss of cognition in coronary artery bypass patients.3 But neuroradiologists also report that using magnetic resonance imaging, they can detect little white spots in the brains of Americans starting at about age fifty. These spots represent small, asymptomatic strokes (see Figures 18 and 19 in insert). The brain has so much reserve capacity that at first these tiny strokes cause no trouble. But, if they continue, they begin to cause memory loss and, ultimately, crippling dementia. In fact, one recently reported study found that the presence of these “silent brain infarcts” more than doubles the risk of dementia.4 We now believe, in fact, that at least half of all senile mental impairment is caused by vascular injury to the brain.

More than anything else a dying person needs to have someone with them. This used to be recognised in hospitals, and when I trained, no one every died alone. However busy the wards, or however short the staff, a nurse was always assigned to sit with a dying person to hold their hand, stroke their forehead, or whisper a few words. Peace and quietness, even reverence for the dying, were expected and assured. I disagree wholly with the notion that there is no point in staying with an unconscious patient because he or she does not know you are there. I am perfectly certain, though years of experience and observation, that unconsciousness, as we define it, is not a state of knowing. Rather, it is a state of knowing and understanding on a different level that is beyond our immediate experience.

The most sacrosanct regions of the cortex are those that control language. Usually located on the left side, they are called Wernicke’s and Broca’s areas; one is for understanding language and the other for producing it. Damage to Broca’s area results in an inability to speak or write, though the patient can easily understand language. Damage to Wernicke’s area results in an inability to understand language; though the patient can still speak, the language she produces is a stream of unconnected words, phrases, and images, a grammar without semantics. If both areas are damaged, the patient becomes an isolate, something central to her humanity stolen forever. After someone suffers a head trauma or a stroke, the destruction of these areas often restrains the surgeon’s impulse to save a life: What kind of life exists without language?

He concluded the speech with an irritated motion of his hands. Unfortunately, Evie had been conditioned by too many encounters with Uncle Peregrine to discern between angry gestures and the beginnings of a physical attack. She flinched instinctively, her own arms flying up to shield her head. When the expected pain of a blow did not come, she let out a breath and tentatively lowered her arms to find Sebastian staring at her with blank astonishment. Then his face went dark. “Evie,” he said, his voice containing a bladelike ferocity that frightened her. “Did you think I was about to…Christ. Someone hit you. Someone hit you in the past—who the hell was it?” He reached for her suddenly—too suddenly—and she stumbled backward, coming up hard against the wall. Sebastian went very still. “Goddamn,” he whispered. Appearing to struggle with some powerful emotion, he stared at her intently. After a long moment, he spoke softly. “I would never strike a woman. I would never harm you. You know that, don’t you?” Transfixed by the light, glittering eyes that held hers with such intensity, Evie couldn’t move or make a sound. She started as he approached her slowly. “It’s all right,” he murmured. “Let me come to you. It’s all right. Easy.” One of his arms slid around her, while he used his free hand to smooth her hair, and then she was breathing, sighing, as relief flowed through her. Sebastian brought her closer against him, his mouth brushing her temple. “Who was it?” he asked. “M-my uncle,” she managed to say. The motion of his hand on her back paused as he heard her stammer. “Maybrick?” he asked patiently. “No, th-the other one.” “Stubbins.” “Yes.” Evie closed her eyes in pleasure as his other arm slid around her. Clasped against Sebastian’s hard chest, with her cheek tucked against his shoulder, she inhaled the scent of clean male skin, and the subtle touch of sandalwood cologne. “How often?” she heard him ask. “More than once?” “I…i-it’s not important now.” “How often, Evie?” Realizing that he was going to persist until she answered, Evie muttered, “Not t-terribly often, but…sometimes when I displeased him, or Aunt Fl-Florence, he would lose his temper. The l-last time I tr-tried to run away, he blackened my eye and spl-split my lip.” “Did he?” Sebastian was silent for a long moment, and then he spoke with chilling softness. “I’m going to tear him limb from limb.” “I don’t want that,” Evie said earnestly. “I-I just want to be safe from him. From all of them.” Sebastian drew his head back to look down into her flushed face. “You are safe,” he said in a low voice. He lifted one of his hands to her face, caressing the plane of her cheekbone, letting his fingertip follow the trail of pale golden freckles across the bridge of her nose. As her lashes fluttered downward, he stroked the slender arcs of her brows, and cradled the side of her face in his palm. “Evie,” he murmured. “I swear on my life, you will never feel pain from my hands. I may prove a devil of a husband in every other regard…but I wouldn’t hurt you that way. You must believe that.

Cursing himself, he glided his fingertips from her shoulder inward along the elegant line of her collarbone. She responded to him with a sigh of intoxicated pleasure, arching her head back, lifting her breasts slightly as her body rose to his touch. His eyes glazed over as he realized then that she was awake enough to know what she wanted. He leaned down at once and kissed her shoulder softly, whispering her name. "Wake to me." She touched his head in answer, draping her arm weakly over his neck. He moved onto the bed with her, his heart pounding. He lay beside her, close enough to consume with his lips the small, heady sigh that escaped hers. He watched the dreamy smile that curved her lips as he began caressing her with seductive reassurance, letting her get accustomed to his touch. "That's right. You just relax," he breathed. He skimmed his palm down her arm, but at her elbow, he diverted his explorations to her slender waist. From there, he ran his hand down lower, to her hip. She stretched a little like a pampered cat under his patient stroking. He bent his head at length and pressed a kiss to the white line of her tender neck. He was rewarded with another enticing undulation of her body, drawing him closer. As his lips worked his way higher, Kate turned her mouth to his invitingly. She met his gaze for a fleeting instant before he kissed her; her glittering, heavy-lidded eyes teemed with feverish desire. "Hullo there," he whispered, then he bent his head and claimed her mouth. Her low moan passed from her lips to his. Rohan answered in kind as he deepened the kiss, capturing her chin between his finger and thumb. She clutched two fistfuls of his shirt for a passing instant. Her mouth tasted of red wine. He drank deeper. As she opened her mouth to his hungry kiss, he skimmed his fingertips down her throat to her chest. He slipped his hand into her gown and cupped her breast. With tingling hands, he took her nipple between his finger and thumb and held it lightly as he kissed her. Her approving groan asked wordlessly for more. She touched his shoulders, arms, and chest as he moved downward over her body to indulge himself in sampling her breasts. She made no move to stop him, no longer cold or shivering as she had been in the great hall, but panting, her skin aglow with newfound heat as he undid the bodice of her skimpy gown and bared her lovely breasts. Closing his eyes, he took her nipple into his mouth and sucked until it swelled to glorious fullness against his tongue. The kiss went on and on, for she was even sweeter than he had already fantasized in the great hall. Now that he had her nipple in his mouth, he could not get enough of her. But when she began to writhe hungrily beneath him, her moans climbing, he obliged her, taking his hand down slowly over her quivering stomach through her gown. She was wanton, but he stoked her fire by keeping a leisurely pace for now. He put his hand between her legs, giving her a taste of what she craved. She began rubbing restlessly against the snug hold of his hand cupping her mound. He was rock hard, and enjoyed pleasuring her for a while further, feeling the dampness of her core permeating the thin cloth of her gown

One year later the society claimed victory in another case which again did not fit within the parameters of the syndrome, nor did the court find on the issue. Fiona Reay, a 33 year old care assistant, accused her father of systematic sexual abuse during her childhood. The facts of her childhood were not in dispute: she had run away from home on a number of occasions and there was evidence that she had never been enrolled in secondary school. Her father said it was because she was ‘young and stupid’. He had physically assaulted Fiona on a number of occasions, one of which occurred when she was sixteen. The police had been called to the house by her boyfriend; after he had dropped her home, he heard her screaming as her father beat her with a dog chain. As before there was no evidence of repression of memory in this case. Fiona Reay had been telling the same story to different health professionals for years. Her medical records document her consistent reference to family problems from the age of 14. She finally made a clear statement in 1982 when she asked a gynaecologist if her need for a hysterectomy could be related to the fact that she had been sexually abused by her father. Five years later she was admitted to psychiatric hospital stating that one of the precipitant factors causing her breakdown had been an unexpected visit from her father. She found him stroking her daughter. There had been no therapy, no regression and no hypnosis prior to the allegations being made public. The jury took 27 minutes to find Fiona Reay’s father not guilty of rape and indecent assault. As before, the court did not hear evidence from expert witnesses stating that Fiona was suffering from false memory syndrome. The only suggestion of this was by the defence counsel, Toby Hed­worth. In his closing remarks he referred to the ‘worrying phenomenon of people coming to believe in phantom memories’. The next case which was claimed as a triumph for false memory was heard in March 1995. A father was aquitted of raping his daughter. The claims of the BFMS followed the familiar pattern of not fitting within the parameters of false memory at all. The daughter made the allegations to staff members whom she had befriended during her stay in psychiatric hospital. As before there was no evidence of memory repression or recovery during therapy and again the case failed due to lack of corrobo­rating evidence. Yet the society picked up on the defence solicitor’s statements that the daughter was a prone to ‘fantasise’ about sexual matters and had been sexually promiscuous with other patients in the hospital. ~ Trouble and Strife, Issues 37-43

Eight Bells: Robert J. Kane ‘55D died June 3, 2017, in Palm Harbor, Florida. He came to MMA by way of Boston College. Bob or “Killer,” as he was affectionately known, was an independent and eccentric soul, enjoying the freedom of life. After a career at sea as an Officer in the U.S. Navy and in the Merchant Marine he retired to an adventurous single life living with his two dogs in a mobile home, which had originally been a “Yellow School Bus.” He loved watching the races at Daytona, Florida, telling stories about his interesting deeds about flying groceries to exotic Caribbean Islands, and misdeeds with mysterious ladies he had known. For years he spent his summers touring Canada and his winters appreciating the more temperate weather at Fort De Soto in St. Petersburg, Florida…. Enjoying life in the shadow of the Sunshine Bridge, Bob had an artistic flare, a positive attitude and a quick sense of humor. Not having a family, few people were aware that he became crippled by a hip replacement operation gone bad at the Bay Pines VA Hospital. His condition became so bad that he could hardly get around, but he remained in good spirits until he suffered a totally debilitating stroke. For the past 6 years Bob spent his time at various Florida Assisted Living Facilities, Nursing Homes and Palliative Care Hospitals. His end came when he finally wound up as a terminal patient at the Hospice Facility in Palm Harbor, Florida. Bob was 86 years old when he passed. He will be missed….

From WIP 'Behind The Fan' *** “Come with me.” His warm breath caresses her ear, giving her a delicious tingle. This seduction is no accident. “Baby we can be anywhere; we’ll start a new life. Dottie, all I need is you.” She opens her eyes, he turns when he feels the flutter of her lashes. She expects another plea instead; he kisses her. Soft and slow his lips pulling her down deeper into a sweet chasm. This assault on her proprieties will be slow and subdued. He has after all proven that he is a patient man. Those musicians’ finger will first trail on the column of her neck. The touch is soft but deliberate. Do the top buttons of her blouse come undone on their own accord or has he banished them? She is never sure but before she can register the affect, he lightly strokes the swell of her breast. It is sinful; despite her confessions to the priest regarding this weakness, she is never stronger. Her body willingly betrays her; she will roam her hands down his back, beyond the tapered waist to the hard orbs. She knows that she is no innocent; she revels in his plea for her touch. Convinced that she is going to hell she wished she cared for her soul. “Honey leap with me, we will land safely I promise you.” “Oh God, Nicky you know it is never this simple.” Nick leans back far enough to bore into her eyes; staring to the depth of her soul. She prays he will stay but knows her appeal is futile. He feels colder already, it doesn’t matter how she tries to hold on he is already leaving; leaving her behind. ***

From my new WIP, Behind the Fan. “Come with me.” His breath is warm; his lips lightly touch her ear, it gives her a delicious tingle. This seduction is no accident. “Baby we can be anywhere, we will start new. Dottie, all I need is you.” She opens her eyes, he turns when he feels the flutter of her lashes. She expects another plea instead; he kisses her. Soft and slow his lips pulling her down deeper into a sweet chasm. This assault on her proprieties will be slow and subdued. He has after all proven that he is a patient man. Those musicians’ finger will trail on the column of her neck first. The touch is warm, soft nevertheless deliberate. Do the top buttons of her blouse come undone on their own accord or has he banished them? She is never sure but before she can register the affect, he lightly strokes the swell of her breast. It is sinful; no matter how often she confesses her weakness to the priest, she is never stronger. Her body willingly betrays her; she will roam her hands down his back, beyond the tapered waist to the hard orbs of his backside. She herself is no innocent, she revels in his plead for more. She is going to hell she wished she cared for her soul. “Honey leap with me, we will land safely I promise you.” “Oh God, Nicky you know it is never this simple.” Nick leans back enough to look into her eyes; she feels he can see damn near to her soul. She prays he will stay but knows her appeal is futile. He feels colder already, it does not matter how she tries to hold on he is already leaving. Leaving her behind.

For instance, emotional memories are stored in the amygdala, but words are recorded in the temporal lobe. Meanwhile, colors and other visual information are collected in the occipital lobe, and the sense of touch and movement reside in the parietal lobe. So far, scientists have identified more than twenty categories of memories that are stored in different parts of the brain, including fruits and vegetables, plants, animals, body parts, colors, numbers, letters, nouns, verbs, proper names, faces, facial expressions, and various emotions and sounds. Figure 11. This shows the path taken to create memories. Impulses from the senses pass through the brain stem, to the thalamus, out to the various cortices, and then to the prefrontal cortex. They then pass to the hippocampus to form long-term memories. (illustration credit 5.1) A single memory—for instance, a walk in the park—involves information that is broken down and stored in various regions of the brain, but reliving just one aspect of the memory (e.g., the smell of freshly cut grass) can suddenly send the brain racing to pull the fragments together to form a cohesive recollection. The ultimate goal of memory research is, then, to figure out how these scattered fragments are somehow reassembled when we recall an experience. This is called the “binding problem,” and a solution could potentially explain many puzzling aspects of memory. For instance, Dr. Antonio Damasio has analyzed stroke patients who are incapable of identifying a single category, even though they are able to recall everything else. This is because the stroke has affected just one particular area of the brain, where that certain category was stored. The binding problem is further complicated because all our memories and experiences are highly personal. Memories might be customized for the individual, so that the categories of memories for one person may not correlate with the categories of memories for another. Wine tasters, for example, may have many categories for labeling subtle variations in taste, while physicists may have other categories for certain equations. Categories, after all, are by-products of experience, and different people may therefore have different categories. One novel solution to the binding problem uses the fact that there are electromagnetic vibrations oscillating across the entire brain at roughly forty cycles per second, which can be picked up by EEG scans. One fragment of memory might vibrate at a very precise frequency and stimulate another fragment of memory stored in a distant part of the brain. Previously it was thought that memories might be stored physically close to one another, but this new theory says that memories are not linked spatially but rather temporally, by vibrating in unison. If this theory holds up, it means that there are electromagnetic vibrations constantly flowing through the entire brain, linking up different regions and thereby re-creating entire memories. Hence the constant flow of information between the hippocampus, the prefrontal cortex, the thalamus, and the different cortices might not be entirely neural after all. Some of this flow may be in the form of resonance across different brain structures.

Miss Sydney, there is just one more thing." Sophia paused before leaving. "Yes, sir?" He reached for her, his hand sliding around the back of her neck. Sophia was too startled to move or breathe, her entire body stiffening as his head lowered to hers. He touched her only with his lips and with his hand at her nape, but she was as helpless as if she had been bound to him with iron chains. There had been no time to prepare herself... she was defenseless and stunned, unable to withhold her response. At first his lips were gentle, exquisitely careful, as if he feared bruising her. Then he coaxed her to give him more, his mouth settling more firmly on hers. The taste of him, his intimate flavor laced with the hint of coffee, affected her like a drug. The tip of his tongue slid past her teeth in silken exploration. He tasted the interior of her mouth, stroked the slick insides of her cheeks. Anthony had never kissed her like this, feeding her rising passion as if he were layering kindling on a blaze. Devastated by his skill, Sophia swayed dizzily and clutched his hard neck. Oh, if only he would hold her tightly and lock her full length against his... but he still touched her only with that one hand, and consumed her mouth with patient hunger. Sensing the force of his passion, held so securely in check, Sophia instinctively sought a way to release it. Her hands fluttered to the sides of his face, stroking the bristle of his cheeks and jaw. Ross made a quiet sound in his throat. Suddenly he took hold of her shoulders and eased her away from his body, ignoring her whimpering protest. Sophia's gaze locked with his in a moment of searing wonder. The stillness was broken only by their panting breaths. No man had ever looked at Sophia that way, as if he could eat her with his gaze, as if he wanted to possess every inch of her body and every flicker of her soul. She was frightened by the power of her response to him, the unmentionable desires that shocked her.

He leaned back on his hands. And then idly turned to her. She inhaled, and exhaled an almost long-suffering sigh. And he began in a patient, almost leisurely fashion, in a voice fashioned from dark velvet, a voice that stroked over her senses until they were lulled, to lecture directly to her as if she was a girl in the schoolroom. "A proper kiss, Miss Eversea, should turn you inside out. It should... touch places in you that you didn't know existed, set them ablaze, until your entire being is hungry and wild. It should... hold a moment, I want to explain this as clearly as possible..." He tipped his head back and paused to consider, as though he were envisioning this and wanted to relate every detail correctly. "It should slice right down through you like a cutlass with a pleasure so devastating it's very nearly pain." He waited, watching her face, allowing her to accommodate the potent words. Her mouth was parted. Her breathing short. She couldn't look away. His eyes and voice held her as fast as if he'd cradled her face with his hands. And as he said them, an echo of sensation sounded in her, like a remembered dream, an instinct awakened. She thought about Mars getting ready to give Venus a good pleasuring. Stop, she should say. "And...?" she whispered. "It should make you do battle for control of your senses and your will. It should make you want to do things you'd never dreamed you'd want to do, and in that moment all of those things will make perfect sense. And it should herald, or at least promise, the most intense physical pleasure you've ever known, regardless of whether that promise is ever, ever fulfilled. It should, in fact..." he paused for effect "haunt you for the rest of your life." She sat wordlessly when he was done. As though waiting for the last notes of a stormy, discordant symphony to echo into silence. 'The most intense physical pleasure.' His words reverberated in her. As if her body contained the ancient wisdom of what that meant, and now, having been reminded, craved it.

his hands moved busily among the puppets, choosing, discarding, until they pounced finally on the moon with her crystal eyes and her hands shaped like stars. 'I will be the moon,' Kyel said. 'You must make a wish to me.' Lydea slid her fingers into the fox's head, with its sly smile and fiery velvet pelt. 'I wish,' she said, 'that you would take your nap.' 'No,' the prince said patiently, 'you must make a true wish. And I will grant it because I am the moon.' 'Then I must make a fox's wish. I wish for an open door to every hen house, and the ability to jump into trees.' The moon sank onto the blue hillock of Kyel's knee. 'Why?' 'So that I can escape the farmer's dogs when they run after me.' 'Then you should wish,' the prince said promptly, 'that you could jump as high as the moon.' 'A good wish. But there are no hens on the moon, and how would I get back to Ombria?' The moon rose again, lifted a golden hand. 'On a star.' The governess smiled. The fox stroked the prince's hair while he shook away the moon and replaced it with the sorceress, who had one amethyst eye and one emerald, and who wore a black cloak that shimmered with ribbons of faint, changing colors. 'I am the sorceress who lives underground,' the prince said. 'Is there really a sorceress who lives underground?' 'So they --' Lydea checked herself, let the fox speak. 'So they say, my lord.' 'How does she live? Does she have a house?' She paused again, glimpsing a barely remembered tale. 'I think she does. Maybe even her own city beneath Ombria. Some say that she has an ancient enemy, who appears during harsh and perilous times in Ombria's history. Then and only then does the sorceress make her way out of her underground world to fight the evil and restore hope to Ombria.' ... The sorceress descended, long nose down on the silk. Kyel picked another puppet up, looked at it silently a moment. The queen of pirates, whose black nails curved like scimitars, whose hair was a rigid knoll in which she kept her weapons, stared back at him out of glittering onyx eyes.

Once, I was doing a late-night case with one of the neurosurgery attendings, a suboccipital craniectomy for a brain-stem malformation. It’s one of the most elegant surgeries, in perhaps the most difficult part of the body—just getting there is tricky, no matter how experienced you are. But that night, I felt fluid: the instruments were like extensions of my fingers; the skin, muscle, and bone seemed to unzip themselves; and there I was, staring at a yellow, glistening bulge, a mass deep in the brain stem. Suddenly, the attending stopped me. “Paul, what happens if you cut two millimeters deeper right here?” He pointed. Neuroanatomy slides whirred through my head. “Double vision?” “No,” he said. “Locked-in syndrome.” Another two millimeters, and the patient would be completely paralyzed, save for the ability to blink. He didn’t look up from the microscope. “And I know this because the third time I did this operation, that’s exactly what happened.” Neurosurgery requires a commitment to one’s own excellence and a commitment to another’s identity. The decision to operate at all involves an appraisal of one’s own abilities, as well as a deep sense of who the patient is and what she holds dear. Certain brain areas are considered near-inviolable, like the primary motor cortex, damage to which results in paralysis of affected body parts. But the most sacrosanct regions of the cortex are those that control language. Usually located on the left side, they are called Wernicke’s and Broca’s areas; one is for understanding language and the other for producing it. Damage to Broca’s area results in an inability to speak or write, though the patient can easily understand language. Damage to Wernicke’s area results in an inability to understand language; though the patient can still speak, the language she produces is a stream of unconnected words, phrases, and images, a grammar without semantics. If both areas are damaged, the patient becomes an isolate, something central to her humanity stolen forever. After someone suffers a head trauma or a stroke, the destruction of these areas often restrains the surgeon’s impulse to save a life: What kind of life exists without language? When I was a med student,

My fingers grazed his. Warm and sturdy- patient, as if waiting to see what else I might do. Maybe it was the wind, but I stroked a finger down his. And as I turned to him more fully, something blinding and tinkling slammed into my face. I reeled back, crying out as I bent over, shielding my face against the light that I could still see against my shut eyes. Rhys let out a startled laugh. A laugh. And when I realised that my eyes hadn't been singed out of their sockets, I whirled on him. 'I could have been blinded!' I hissed, shoving him. He took a look at my face and burst out laughing again. Real laughter, open and delighted and lovely. I wiped at my face, and when I pulled my hands down, I gasped. Pale green light- like drops of paint- glowed in flecks on my hand. Splattered star-spirit. I didn't know if I should be horrified or amused. Or disgusted. When I went to rub it off, Rhys caught my hand. 'Don't,' he said, still laughing. 'It looks like your freckles are glowing.' My nostrils flared, and I went to shove him again, not caring if my new strength knocked him off the balcony. He could summon wings; he could deal with it. He sidestepped me, veering toward the balcony rail, but not fast enough to avoid the careening star that collided with the side of his face. He leaped back with a curse. I laughed, the sound rasping out of me. Not a chuckle or snort, but a cackling laugh. And I laughed again, and again, as he lowered his hands from his eyes. The entire left side of his face had been hit. Like heavenly war paint, that's what it looked like. I could see why he didn't want me to wipe mine away. Rhys was examining his hands, covered in the dust, and I stepped toward him, peering at the way it glowed and glittered. He went still as death as I took one of his hands in my own and traced a star shape on the top of his palm, playing with the glimmer and shadows, until it looked like one of the stars that had hit us. His fingers tightened on mine, and I looked up. He was smiling at me. And looked so un-High-Lord-like with the glowing dust on the side of his face that I grinned back. I hadn't even realised what I'd done until his own smile faded,, and his mouth partly slightly. 'Smile again,' he whispered. I hadn't smiled for him. Ever. Or laughed. Under the Mountain, I had never grinned, never chuckled. And afterward... And this male before me... my friend... For all that he had done, I had never given him either. Even when I had just... I had just painted something. On him. For him. I'd- painted again. So I smiled at him, broad and without restraint. 'You're exquisite,' he breathed.

Tell me, Princess Olivia... why do you have to stay in your tower?" The soft entreaty made Livia feel as if she were melting inside. She laughed unsteadily, wishing for a moment that she dared to trust him. But the habit of independence was too strong. Shaking her head, Livia approached him, expecting him to back away from the doorway. He retreated half a step, his hands still grasping the edges of the doorway, so that she couldn't help but walk into an open-armed embrace. The bonnet ribbons slipped from her fingers. "Mr. Shaw-" she began, making the mistake of looking up at him. "Gideon," he whispered. "I want to know your secrets, Olivia." A bitter half smile touched her lips. "You'll hear them sooner or later from other people." "I want to hear them from you." As Livia began to retreat into the glasshouse, Shaw deftly caught the little cloth belt of her walking dress. His long fingers hooked beneath the reinforced fabric. Unable to back away from him, Livia clamped her hand over his, while a hectic blush flooded her face. She knew that he was toying with her, and that she once might have been able to manage this situation with relative ease. But not now. When she spoke, her voice was husky. "I can't do this, Mr. Shaw." To her amazement, he seemed to understand exactly what she meant. "You don't have to do anything," he said softly. "Just let me come closer... and stay right there..." His head bent, and he found her mouth easily. The coaxing pressure of his lips made Livia sway dizzily, and he caught her firmly against him. She was being kissed by Gideon Shaw, the self-indulgent, debauched scoundrel her brother had warned her about. And oh, he was good at it. She had thought nothing would ever be as pleasurable as Amberley's kisses... but this man's mouth was warm and patient, and there was something wickedly erotic about his complete lack of urgency. He teased her gently, nudging her lips apart, the tip of his tongue barely brushing hers before it withdrew. Wanting more of those silken strokes, Livia began to strain against him, her breath quickening. He nurtured her excitement with such subtle skill that she was utterly helpless to defend against it. To her astonishment, she found herself winding her arms around his neck and pressing her breasts against the hard plane of his chest. His hand slid behind her neck, tilting her head back to expose her throat more fully. Still gentle and controlled, he kissed the fragile skin, working his way down to the hollow at the base of her throat. She felt his tongue swirl in the warm depression, and a moan of pleasure escaped her. Shaw lifted his head to nuzzle the side of her cheek, while his hand smoothed over her back. Their breaths mingled in swift puffs of heat, his hard chest moving against hers in an erratic rhythm.

Then, decades later, in the 1970s, a hard-assed U.S. swim coach named James Counsilman rediscovered it. Counsilman was notorious for his “hurt, pain, and agony”–based training techniques, and hypoventilation fit right in. Competitive swimmers usually take two or three strokes before they flip their heads to the side and inhale. Counsilman trained his team to hold their breath for as many as nine strokes. He believed that, over time, the swimmers would utilize oxygen more efficiently and swim faster. In a sense, it was Buteyko’s Voluntary Elimination of Deep Breathing and Zátopek hypoventilation—underwater. Counsilman used it to train the U.S. Men’s Swimming team for the Montreal Olympics. They won 13 gold medals, 14 silver, and 7 bronze, and they set world records in 11 events. It was the greatest performance by a U.S. Olympic swim team in history. Hypoventilation training fell back into obscurity after several studies in the 1980s and 1990s argued that it had little to no impact on performance and endurance. Whatever these athletes were gaining, the researchers reported, must have been based on a strong placebo effect. In the early 2000s, Dr. Xavier Woorons, a French physiologist at Paris 13 University, found a flaw in these studies. The scientists critical of the technique had measured it all wrong. They’d been looking at athletes holding their breath with full lungs, and all that extra air in the lungs made it difficult for the athletes to enter into a deep state of hypoventilation. Woorons repeated the tests, but this time subjects practiced the half-full technique, which is how Buteyko trained his patients, and likely how Counsilman trained his swimmers. Breathing less offered huge benefits. If athletes kept at it for several weeks, their muscles adapted to tolerate more lactate accumulation, which allowed their bodies to pull more energy during states of heavy anaerobic stress, and, as a result, train harder and longer. Other reports showed hypoventilation training provided a boost in red blood cells, allowing athletes to carry more oxygen and produce more energy with each breath. Breathing way less delivered the benefits of high-altitude training at 6,500 feet, but it could be used at sea level, or anywhere. Over the years, this style of breath restriction has been given many names—hypoventilation, hypoxic training, Buteyko technique, and the pointlessly technical “normobaric hypoxia training.” The outcomes were the same: a profound boost in performance.* Not just for elite athletes, but for everyone. Just a few weeks of the training significantly increased endurance, reduced more “trunk fat,” improved cardiovascular function, and boosted muscle mass compared to normal-breathing exercise. This list goes on. The takeaway is that hypoventilation works. It helps train the body to do more with less. But that doesn’t mean it’s pleasant.

He gripped the sides of her body carefully, keeping her in place as he parted her with his tongue and stroked the sides of the soft furrow. Entranced by the vulnerable shaper of her, he lapped at the edges of softly unfurled lips and tickled them lightly. The delicate flesh was unbelievably hot, almost steaming. He blew a stream of cooling air over it, and relished the sound of her moan. Gently he licked up through the center, a long glide through silk and salty female dampness. She squirmed, her thighs spreading as he explored her with flicks and soft jabs. The slower he went, the more agitated she became. He paused to rest the flat of his tongue on the little pearl of her clitoris to feel its frantic throbbing, and she jerked and struggled to a half-sitting position. Pausing, Keir lifted his head. "What is it, muirninn?" Red-faced, gasping, she tried to pull him over her. "Make love to me." "'Tis what I'm doing," he said, and dove back down. "No- Keir- I meant now, right now-" She quivered as he chuckled into the dark patch of curls. "What are you laughing at?" she asked. "At you, my wee impatient bully." She looked torn between indignation and begging. "But I'm ready," she said plaintively. Keir tried to enter her with two fingers, but the tight, tender muscle resisted. "You're no' ready," he mocked gently. "Weesht now, and lie back. 'Tis one time you won't be having your way." He nuzzled between her thighs and sank his tongue deep into the heat and honey of her. She jerked at the feel of it, but he made a soothing sound and took more of the intimate flavor he needed, had to have, would never stop wanting. Moving back up to the little bud where all sensation centered, he sucked at it lightly until she was gasping and shaking all over. He tried to work two fingers inside her again, and this time they were accepted, her depths clenching and relaxing repeatedly. As he stroked her with his tongue, he found a rhythm that sent a hard quiver through her. He kept the pace steady and unhurried, making her work for it, making her writhe and arch and beg, and it was even better than he'd imagined, having her so wild beneath him, hearing her sweet little wanton noises. There was a suspended moment as it all caught up to her... she arched as taut as a drawn bow... caught her breath... and began to shudder endlessly. A deep and primal satisfaction filled him at the sounds of her pleasure, and the sweet pulsing around his fingers. He drew out the feeling, patiently licking every twitch and tremor until at last she subsided and went limp beneath him. Even then, he couldn't stop. It felt too good. He kept lapping gently, loving the salty, silky wetness of her. Her weak voice floated down to him... "Oh, God... I don't think... Keir, I can't..." He nibbled and teased, breathing hotly against the tender core. "Put your legs over my shoulders," he whispered. In a moment, she obeyed. He could feel the trembling in her thighs. A satisfied smile flicked across his mouth, and he pressed her hips upward to a new angle. Soon he'd have her begging again, he thought, and lowered his head with a soft growl of enjoyment.

He concluded the speech with an irritated motion of his hands. Unfortunately, Evie had been conditioned by too many encounters with Uncle Peregrine to discern between angry gestures and the beginnings of a physical attack. She flinched instinctively, her own arms flying up to shield her head. When the expected pain of a blow did not come, she let out a breath and tentatively lowered her arms to find Sebastian staring at her with blank astonishment. Then his face went dark. "Evie," he said, his voice containing a bladelike ferocity that frightened her. "Did you think I was about to... Christ. Someone hit you. Someone hit you in the past---who the hell was it?" He reached for her suddenly---too suddenly---and she stumbled backward, coming up hard against the wall. Sebastian went very still. "Goddamn," he whispered. Appearing to struggle with some powerful emotion, he stared at her intently. After a long moment, he spoke softly. "I would never strike a woman. I would never harm you. You know that, don't you?" Transfixed by the light, glittering eyes that held hers with such intensity, Evie couldn't move or make a sound. She started as he approached her slowly. "It's all right," he murmured. "Let me come to you. It's all right. Easy." One of his arms slid around her, while he used his free hand to smooth her hair, and then she was breathing, sighing, as relief flowed through her. Sebastian brought her closer against him, his mouth brushing her temple. "Who was it?" he asked. "M-my uncle," she managed to say. The motion of his hand on her back paused as he heard her stammer. "Maybrick?" he asked patiently. "No, th-the other one." "Stubbins." "Yes." Evie closed her eyes in pleasure as his other arm slid around her. Clasped against Sebastian's hard chest, with her cheek tucked against his shoulder, she inhaled the scent of clean male skin, and the subtle touch of sandalwood cologne. "How often?" she heard him ask. "More than once?" "I... i-it's not important now." "How often, Evie?" Realizing that he was going to persist until she answered, Evie muttered, "Not t-terribly often, but... sometimes when I displeased him, or Aunt Fl-Florence, he would lose his temper. The l-last time I tr-tried to run away, he blackened my eye and spl-split my lip." "Did he?" Sebastian was silent for a long moment, and then he spoke with chilling softness. "I'm going to tear him limb from limb." "I don't want that," Evie said earnestly. "I-I just want to be safe from him. From all of them." Sebastian drew his head back to look down into her flushed face. "You are safe," he said in a low voice. He lifted one of his hands to her face, caressing the plane of her cheekbone, letting his fingertip follow the trail of pale golden freckles across the bridge of her nose. As her lashes fluttered downward, he stroked the slender arcs of her brows, and cradled the side of her face with his palm. "Evie," he murmured. "I swear on my life, you will never feel pain from my hands. I may prove a devil of a husband in every other regard... but I wouldn't hurt you that way. You must believe that." The delicate nerves of her skin drank in sensations thirstily... his touch, the erotic waft of his breath against her lips. Evie was afraid to open her eyes, or to do anything that might interrupt the moment. "Yes," she managed to whisper. "Yes... I---" There was the sweet shock of a probing kiss against her lips... another... She opened to him with a slight gasp. His mouth was hot silk and tender fire, invading her with gently questing pressure. His fingertips traced over her face, tenderly adjusting the angle between them.

If one loses half the visual field from a stroke or other injury, one may or may not be aware of the loss. Monroe Cole, a neurologist, became aware of his own field loss only by doing a neurological exam on himself after his coronary bypass surgery. He was so surprised by his lack of awareness of this deficit that he published a paper about it. “Even intelligent patients,” he wrote, “often are surprised when a hemianopia is demonstrated, despite the fact that it has been demonstrated on numerous examinations.

APOLIPOPROTEIN A1 (Apo A1) Apo A1 is the major protein of HDL (good) cholesterol. Low levels of Apo A1 is associated with increased risk of early cardiovascular disease, and may be seen more often in patients with a high-fat diet, inactivity, and central obesity.

GLOBAL RISK SCORE (GRS) An answer based test score that looks at a person’s risk factors. The GRS weighs risk factors in importance and then gives a percentage risk of the patient developing heart disease or having a heart attack within the next 10 years. Goal values Less than 10% = low risk 10% to 20% = intermediate risk Greater than 20% = high risk GRS information is important to develop a plan to improve your cardiovascular health. Call the Preventive Cardiology and Rehabilitation Program at 216-444-9353 or toll-free 800-2232273, ext. 49353 to be evaluated and get started … Monday thru Friday, Eastern Standard Time.

Ultra-Sensitive C-Reactive Protein Blood (HS-CRP) C-reactive protein measures an inflammatory response in the body and has been shown to play a role in atherosclerosis and blood clot formation.  Patients should ask their doctor specifically about HS-CRP, as this test helps determine heart disease risk. Elevated HS-CRP is related to increased risk for heart attack, restenosis of coronary arteries after angioplasty, stroke, and peripheral vascular disease (PVD). While elevated cholesterol, LDL, and triglycerides plus low HDL are independent risk factors for heart disease and cholesterol build-up, HS-CRP provides added information about inflammation in the arteries. This cannot be determined by lipid testing alone. Results Less than 1.0 mg/L = Low Risk for Cardio Vascular Disease (CVD) 1.0 – 2.9 mg/L = Intermediate Risk for CVD Greater than 3.0 mg/L High Risk for CVD

the question of why some individuals learn motor skills faster than others; perhaps they have a better system of reflexes. More important, perhaps the motor deficits that accompany various movement disorders, such as stroke and cerebellar ataxia, are in part caused by patients’ inability to execute appropriate corrections to their movements, thus depriving their brains of an extremely knowledgeable teacher. This research suggests that encouraging patients to make mistakes while moving and reinforcing patient-driven feedback corrections to their movement errors may be one path toward neurorehabilitation. In other words, as neuroscientists, we hope that the fundamental insights we make concerning the brain will be translated into methods for improving human life.

To test this they gave mice a first stroke in motor cortex and then waited a week before beginning retraining. As expected, the mice recovered only minimally because too much time had been allowed to pass before training was initiated. They then gave these same mice a second stroke in an area near to the original stroke, and, not surprisingly, the animals developed an even worse impairment. The surprising result was that with retraining the mice returned to normal levels of performance. In essence a previous stroke was treated with a new stroke. It should be made clear that this experiment was done to prove definitively that there is a sensitive period after stroke that allows training to promote full recovery at the level of impairment. It is clearly not a viable therapeutic option to induce a second stroke in patients after a first stroke. Other means will need to be found to have the same desired effect without causing more damage to the brain. One promising option is to combine drugs, such as the serotonin reuptake inhibitor Fluoxetine (Prozac), with training early after stroke.25 Another is to drastically increase the intensity and dosage of behavioral training that patients receive early after stroke. At the current time in the first weeks after stroke patients spend about 60 percent of their time alone and 85 percent of the time immobile.26 We know from basic science that hundreds, if not thousands, of movement repetitions are needed to induce detectable changes in motor cortex in animal models.27 Current therapy offers only about thirty!28

SAMPLING OF SOME OF THE MAJOR TRIAL RESULTS WITH EDTA CHELATION A 1993analysis of 19 studies of 22,765 patients receiving EDTA chelation therapy for vascular disease found measurable improvement in 87%. A study of 2,870 patients with various degrees of degenerative diseases, especially vascular disease, almost 90% of the patients showed excellent improvement. The study measured walking distance, ECG, and Doppler blood flow changes. A small, blinded, crossover study of patients with peripheral vascular disease found significant improvements in walking distance and ankle/brachial blood flow. In 30 patients with carotid artery stenosis, there was a 30% improvement in blood flow after EDTA treatment. EDTA chelation treatment was evaluated in patients with carotid and coronary disease using technetium 99 isotope techniques. Significant improvement in arterial blood flow and ejection fraction (a measure of heart pumping ability) was reported. 65 patients on the waiting list for CABG surgery for an average of 6 months were treated with EDTA chelation therapy. The symptoms in 89% (58) improved so much they were able to cancel their surgery. In the same study, of 27 patients recommended for limb amputation due to poor peripheral circulation, EDTA chelation saved 24 limbs.

Visual agnosia is the inability of the brain to make sense of or make use of some part of an otherwise normal visual stimulus and is typified by the inability to recognize familiar objects or faces. This is distinct from blindness, which is a lack of sensory input to the brain due to damage to the eye, optic nerve, or the primary visual cortex. Visual agnosia is often due to stroke affecting the posterior occipital and/or temporal lobe(s) in the brain. The specific dysfunctions vary depending on the type of agnosia. Some sufferers are unable to copy drawings but are able to manipulate objects with good dexterity. Commonly, patients can name the object, here a tea cup, categorize it, but cannot describe its function; or the reverse, be able to drink from it appropriately but not know its name or describe its uses. Lesion studies clearly demonstrate that even crystallized objects, your left foot, or here a tea cup, are not “things” in long-term memory but are concepts constructed from multiple brain modules at the moment of perception (Farah, 1999).

His muscled thighs and lean hips felt like warm steel under her hands as she caressed him on her knees, kissing his chiseled belly, while his large, gentle hands stroked her shoulders and her hair. She felt the mystery of his rock-hard manhood brush her throat. He was swollen solid behind the barrier of his tight black breeches. He needed her, she knew, and it pleased her.' There was no sound in her dream but his urgent whisper, 'Give it to me. Give it all to me.' 'Yes,' she thought, her body arching, 'yes.' She was naked beneath the brown robe and painfully aroused, acutely aware of the feel of coarse wool against her tender flesh. She wanted to be rid of it, but she waited patiently, weaving a wreath of careful, rosy kisses around his navel, for she knew he would sate her.

In 1992, a forty-six-year-old woman whom I’ll call Hannah underwent a neurological examination at a hospital in Vienna, Austria. The neurologist, Georg Goldenberg, began by asking Hannah to describe his own face. It was an odd question, but Hannah complied. The doctor had short hair and was clean shaven, she said; he wasn’t wearing glasses, and he looked like he had a bit of a tan. Goldenberg next asked Hannah about an object in front of her. It was a notebook, she answered, like the kind schoolchildren use, with a brown cover and some writing in Latin script that she couldn’t quite make out. And where exactly was the book located, the doctor asked her. He was holding it up in his left hand, Hannah replied, at just about eye level. The trouble was this: Goldenberg’s face was concealed behind a screen, the object in front of his patient was a comb, and before asking about its location, he’d hidden it beneath the table in front of him. Hannah was blind. One month earlier, she had suffered a stroke that destroyed virtually her entire visual cortex and left her all but unable to move, owing to loss of muscle coordination and chronic, epilepsy-like contractions, especially on the left side of her body. All that was bad enough. But Hannah was also left with a rarer and stranger problem: she didn’t know that she was blind.

In constraint-induced movement therapy, stroke patients wear a sling on their good arm for approximately 90 percent of waking hours for fourteen straight days. On ten of those days, they receive six hours of therapy, using their seemingly useless arm: they eat lunch, throw a ball, play dominoes or cards or Chinese checkers, write, push a broom, and use standard rehab equipment called dexterity boards. “It is fairly contrary to what is typically done with stroke patients,” says Taub, “which is to do some rehabilitation with the affected arm and then, after three or four months, train the unaffected arm to do the work of both arms.” Instead, for an intense six hours daily, the patient works closely with therapists to master basic but crucial movements with the affected arm. Sitting across a pegboard from the rehab specialist, for instance, the patient grasps a peg and labors to put it into a hole. It is excruciating to watch, the patient struggling with an arm that seems deaf to the brain’s commands to extend far enough to pick up the peg; to hold it tightly enough to keep it from falling back; to retract toward the target hole; and to aim precisely enough to get the peg in. The therapist offers encouragement at every step, tailoring the task to make it more attainable if a patient is failing, then more challenging once the patient makes progress. The reward for inserting a peg is, of course, doing it again—and again and again. If the patient cannot perform a movement at first, the therapist literally takes him by the hand, guiding the arm to the peg, to the hole—and always offering verbal kudos and encouragement for the slightest achievement. Taub explicitly told the patients, all of whose strokes were a year or more in the past, that they had the capacity for much greater use of their arm than they thought. He moved it for them and told them over and over that they would soon do the same. In just two weeks of constraint-induced movement therapy with training of the affected arm, Taub reported in 1993, patients regained significant use of a limb they thought would forever hang uselessly at their side. The patients outperformed control patients on such motor tasks as donning a sweater, unscrewing a jar cap, and picking up a bean on a spoon and lifting it to the mouth. The number of daily-living activities they could carry out one month after the start of therapy soared 97 percent. That was encouraging enough. Even more tantalizing was that these were patients who had long passed the period when the conventional rehab wisdom held that maximal recovery takes place. That, in fact, was why Taub chose to work with chronic stroke patients in the first place. According to the textbooks, whatever function a patient has regained one year after stroke is all he ever will: his range of motion will not improve for the rest of his life.

Ed Taub had shown that the more stroke patients concentrated on their tasks—the more they paid attention—the greater their functional reorganization and recovery. In stroke patients who sustain damage to the prefrontal cortex, and whose attention systems are therefore impaired, recovery is much less likely. Two months after the stroke, a simple measure of attention, such as the patient’s ability to count tones presented through headphones, predicts almost uncannily how well the patient will recover motor function. The power of attention, that is, determines whether a stroke patient will remain incapacitated or not. Ian Robertson’s research group at Trinity College found much the same thing: “How well people can pay attention just after a right-brain stroke predicts how well they can use their left hands two years later.” If the attention circuits in the frontal lobes are damaged by the stroke, the patient recovers less well from injury to other regions of the brain than if the frontal lobes are spared.

For the stroke victim, the OCD patient, and the depressive, intense effort is required to bring about the requisite Refocusing of attention—a refocusing that will, in turn, sculpt anew the ever-changing brain. The patient generates the mental energy necessary to sustain mindfulness and so activate, strengthen, and stabilize the healthy circuitry through the exertion of willful effort. This effort generates mental force. This force, in its turn, produces plastic and enduring changes in the brain and hence the mind. Intention is made causally efficacious through attention.

The discovery that the mind can change the brain, momentous as it is both for our image of ourselves and for such practical matters as helping stroke patients, is only the beginning. Finally, after a generation or more in which biological materialism has had neuroscience—indeed, all the life sciences—in a chokehold, we may at last be breaking free. It is said that philosophy is an esoteric, ivory-tower pursuit with no relevance to the world we live in or the way we live. Would that that had been so for the prejudice in favor of biological materialism and its central image, Man the Machine. But biological materialism did, and does, have real-world consequences. We feel its reach every time a pharmaceutical company tells us that, to cure shyness (or “social phobia”), we need only reach for a little pill; every time we fall prey to depression, or anxiety, or inability to sustain attention, and are soothed with the advice that we merely have to get our neurochemicals back into balance to enjoy full mental health. Biological materialism is nothing if not appealing. We need not address the emotional or spiritual causes of our sadness to have the cloud of depression lift; we need not question the way we teach our children before we can rid them of attention deficit disorder. I do not disparage the astounding advances in our understanding of the biochemical and even genetic roots of behavior and illness. Some of those discoveries have been made by my closest friends. But those findings are not the whole story.

Dr Todd Feinberg writes of a patient, Lizzy, who suffered strokes in her occipital lobes. As can happen in such cases, her brain didn’t immediately process the fact she’d gone ‘suddenly and totally’ blind, so it continued projecting its hallucinated model of the world. Visiting her hospital bed, Feinberg enquired if she was having trouble with her vision in any way. ‘No,’ she said. When he asked her to take a look around and tell him what she saw, she moved her head accordingly. ‘It’s good to see friends and family, you know,’ she said. ‘It makes me feel like I’m in good hands.’ But there was nobody else there. ‘Tell me their names,’ said Feinberg. ‘I don’t know everybody. They’re my brother’s friends.’ ‘Look at me. What am I wearing?’ ‘A casual outfit. You know, a jacket and pants. Mostly navy blue and maroon.’ Feinberg was in his hospital whites. Lizzy continued their chat smiling and acting ‘as if she had not a care in the world’.

The prince jumped up from the chair in new fright. When Rogozhin quieted down (and he did suddenly quiet down), the prince quietly bent over him, sat down beside him, and with a pounding heart, breathing heavily, began to examine him. Rogozhin did not turn his head to him and seemed to forget about him. The prince watched and waited; time passed, it began to grow light. Now and then Rogozhin sometimes suddenly began to mutter, loudly, abruptly, and incoherently; began to exclaim and laugh; then the prince would reach out his trembling hand to him and quietly touch his head, his hair, stroke it and stroke his cheeks there was nothing more he could do! He was beginning to tremble again himself, and again he suddenly lost the use of his legs. Some completely new feeling wrung his heart with infinite anguish. Meanwhile it had grown quite light; he finally lay down on the pillows, as if quite strengthless now and in despair, and pressed his face to the pale and motionless face of Rogozhin; tears flowed from his eyes onto Rogozhin's cheeks, but perhaps by then he no longer felt his own tears and knew nothing about them … In any case, when, after many hours, the door opened and people came in, they found the murderer totally unconscious and delirious. The prince was sitting motionless on the bed beside him, and each time the sick man had a burst of shouting or raving, he quietly hastened to pass his trembling hand over his hair and cheeks, as if caressing and soothing him. But he no longer understood anything of what they asked him about, and did not recognise the people who came in and surrounded him. And if Schneider himself had come now from Switzerland to have a look at his former pupil and patient, he, too, recalling the state the prince had sometimes been in during the first year of his treatment in Switzerland, would have waved his hand now and said, as he did then: "An idiot!

It is fair to say that, though the main deficits incurred by damage to the left hemisphere are in the twin important areas of the use of language and of the right hand, the world itself usually remains recognisable, and mainly, though not always wholly, undisturbed. That is because the right hemisphere is functioning as normal. Things are very different when the damage is in the right hemisphere, and the subject is more – or wholly – dependent on the left. When those who care for left hemisphere stroke patients were asked to specify the most important problem encountered, they named difficulty writing or spelling; by contrast, when those who care for right hemisphere stroke patients were asked, it was loss of empathy. Almost half of carers for those with right hemisphere stroke reported as among the most important problems a whole range of cognitive and emotional impairments, as well as alterations to personality. Not one of the carers for left hemisphere stroke sufferers did so.4 For those with right hemisphere damage, they and their world had changed. For those with left hemisphere damage, they and their world were recognisably the same: it was their ability to handle it, to make use of it, that had altered. As we have seen, the foundational difference between the hemispheres lies in the way they attend – and how you attend changes the world. It also changes you, the one who is doing the attending. Since it is of such consummate importance, let’s take a closer look at attention from a hemisphere point of view.

I remember asking him once: “What would you call this patient—schizophrenic or schizoaffective?” He paused and stroked his chin, apparently in deep thought. “I think I’d call him Michael McIntyre,” he replied.

A testable prediction emerged: if I could lower the levels of noradrenaline in the brains of PTSD patients during sleep, thereby reinstating the right chemical conditions for sleep to do its trauma therapy work, then I should be able to restore healthier quality REM sleep. With that restored REM-sleep quality should come an improvement in the clinical symptoms of PTSD, and further, a decrease in the frequency of painful repetitive nightmares. It was a scientific theory in search of clinical evidence. Then came the wonderful stroke of serendipity.

Music can dampen pain. Consequently, it is, therefore, already used therapeutically in medicine in a wide variety of areas. It is particularly useful in psychiatry and pain therapy. However, it can also be a valuable aid in the rehabilitation of stroke patients and geriatrics, because making music can be like a fountain of youth for the brain because it creates new nerve connections.

First, I am thrilled that paramedics are finally getting the respect they deserve for being the professionals they can be. The scope of practice is expanding, and patient care modalities are improving, seemingly by the minute. Patient outcomes are also improving as a result, and EMS is passing through puberty and forging into adulthood. On the other hand, autonomy in the hands of the “lesser-motivated,” can be a very dangerous thing. You know as well as I do that there are still plenty of providers who operate from a subjective, complacent, and downright lazy place. Combined with the ever-expanding autonomy, that provider just became more dangerous than he or she ever has been – to the patients and to you. Autonomy in patient care places more pressure for excellence on the provider charged with delivering it, and also on the partner and crew members on scene. Since the base hospital is not involved like it once was, they are likewise less responsible for the errors and omissions of the medics on the scene. Now more than ever, crew members are being held to answer for the mistakes and follies of their coworkers; now more than ever, EMS providers are working without a net. What’s next? I predict (and hope) emergency medical Darwinism is going to force some painful and necessary changes. First, increasing autonomy is going to result in the better and best providing superior patient care. More personal ownership of the results is going to manifest in outcomes such as increased cardiac arrest survival rates, faster and more complete stroke recovery, and significantly better outcomes for STEMI patients, all leading to the brass ring: EMS as a profession, not just a job. On the flip side of that coin, you will see consequences for the not-so-good and completely awful providers. There will be higher instances of licensure action, internal discipline, and wash-out. Unfortunately, all those things will stem from generally preventable negative patient outcomes. The danger for the better provider will be in the penumbra; the murky, gray area of time when providers are self-categorizing. Specifically, the better provider who is aware of the dangerously poor provider but does nothing to fix or flush him or her, is almost certain to be caught up in a bad situation caused by sloppy, complacent, or ultimately negligent patient care that should have been corrected or stopped. The answer is as simple as it is difficult. If you are reading this, it is more likely because you are one of the better, more committed, more professional providers. This transition is up to you. You must dig deep and find the strength necessary to face the issue and force the change; you have to demand more from yourself and from those around you. You must have the willingness to help those providers who want it – and respond to those who need it, but don’t want it – with tough love by showing them the door. In the end, EMS will only ever be as good as you make it. If you lay silent through its evolution, you forfeit the right to complain when it crumbles around you.

When Richard Cooper went to medical school at the University of Arkansas in the late 1960s, he was stunned at how many of his black patients were suffering from high blood pressure. He would encounter people in their forties and fifties felled by strokes that left them institutionalized. When Cooper did some research on the problem, he learned that American doctors had first noted the high rate of hypertension in American blacks decades earlier. Cardiologists concluded it must be the result of genetic differences between blacks and whites. Paul Dudley White, the preeminent American cardiologist of the early 1900s, called it a “racial predisposition,” speculating that the relatives of American blacks in West Africa must suffer from high blood pressure as well. Cooper went on to become a cardiologist himself, conducting a series of epidemiological studies on heart disease. In the 1990s, he finally got the opportunity to put the racial predisposition hypothesis to the test. Collaborating with an international network of doctors, Cooper measured the blood pressure of eleven thousand people. Paul Dudley White, it turned out, was wrong. Farmers in rural Nigeria and Cameroon actually had substantially lower blood pressure than American blacks, Cooper found. In fact, they had lower blood pressure than white Americans, too. Most surprisingly of all, Cooper found that people in Finland, Germany, and Spain had higher blood pressure than American blacks. Cooper’s findings don’t challenge the fact that genetic variants can increase people’s risk of developing high blood pressure. In fact, Cooper himself has helped run studies that have revealed some variants in African Americans and Nigerians that can raise that risk. But this genetic inheritance does not, on its own, explain the experiences of African and European Americans. To understand their differences, doctors need to examine the experiences of blacks and whites in the United States—the stress of life in high-crime neighborhoods and the difficulty of getting good health care, for example. These are powerful inheritances, too, but they’re not inscribed in DNA. For scientists carrying out the hard work of disentangling these influences, an outmoded biological concept of race offers no help. In the words of the geneticists Noah Rosenberg and Michael Edge, it has become “a sideshow and a distraction.

Patients are taught that there is no correct way to bend or lift, one doesn't need to avoid soft chairs or mattresses, corsets and collars are unnecessary, and in general the great number of admonitions and prohibitions that have become part of back pain folklore are simply without foundation, because TMS is a harmless condition, and there is nothing structurally wrong with the back. Running is not bad for the spine; weak abdominal muscles do not cause back pain; strong back muscles do not prevent back pain; it is perfectly all right to arch the back, swim the crawl or breast stroke; man was meant to walk upright (Homo sapiens and his ancestors have been doing so for somewhere between 3 and 4 million years); a short leg does not cause back pain. One could go on and on. (page 110)

His voice is a seductive grit of palpable hunger that has my ribbons twisting on the floor and my own want surging. My eyes flutter closed as his words stroke my ear and slip inside to settle beneath my ribs like they carry their own heart. “It’s fucking torture to have you stand there and tell me you want me, and not be able to do anything about it. But I’m a patient male, and as soon as I’m able, I’m going to touch and taste every inch of you. I’m going to have you writhing and begging, and I’ll give you every bit of pleasure I can wring from your delectable body,” he murmurs in a wicked promise. “The moment that sun dips, Goldfinch, you’re mine.

attack, and stroke among 17,800 patients randomly assigned to receive either Rosuvastatin or placebo for over four years. Source: P. M. Ridker, “Rosuvastatin to Prevent Vascular Events in Men and Women with Elevated C-Reactive Protein,” New England Journal of Medicine 359 (2008): 2195–207.

If you want me, love,” he whispered, “tell me in Romany. Please.” Blindly Amelia turned her head and kissed the curve of his biceps. “What should I say?” He murmured soft lyrical words, waiting patiently as she repeated them, helping her when she faltered. All the while he positioned himself against her, lower, tighter, and just as the last syllable left her lips, he thrust strongly inside her. Amelia flinched and cried out in pain, and Cam was torn between acute regret at having hurt her, and the devastating pleasure of being inside her. Her innocent flesh cinched around the unfamiliar invasion, her hips lifting as if to throw him off, but every movement only drew him deeper. He tried to soothe away the hurt, stroking her, kissing her throat and breasts. Taking a rosy crest into his mouth, he sucked lightly, ran his tongue over it, until she relaxed beneath him and began to moan. Cam couldn’t stop from moving then, forgetting everything but the need to push deeper into the gently gripping flesh, the warm limbs curving around him, the sweet panting mouth beneath his. He whispered compulsively against her lips … one word, over and over, the ecstasy crowning higher every time. “Mandis … mandis…” Mine.

When the researchers performed brain scans on these patients, they found noticeable changes in the white matter that could easily be confused with multiple sclerosis or even small strokes. This is the reason I always check for gluten sensitivity in patients referred to me with a diagnosis of multiple sclerosis; on many occasions I’ve found patients whose brain changes were in fact not related to multiple sclerosis at all and were likely due to gluten sensitivity. And lucky for them, a gluten-free diet reversed their condition.

I’m sorry,” she said again, turning to stand beside him, laying a hand on his back. He heard her sharp intake of breath as she realized her error—his shirt was still off. He didn’t move off, though, but waited to see how she’d manage. Her hand was comforting, and without him willing it, his own slid along her waist and drew her against his side. She remained facing the gardens, her expression impassive, her breath moving in a measured rhythm, her hand resting on his back as if it had arrived there despite her complete indifference to him as a person. Slowly, he relaxed, sensing her innate decency had, for just a few moments, trumped her notions of propriety, class distinction, and personal rectitude. She offered comfort, he decided. Just comfort, for him, upon his recounting some very dark moments and his frustration and helplessness in those moments. But what about for her? He turned her to face him, brought her slowly against his body, and rested his cheek against her temple. Just that, but it changed the tenor of the moment from gestures of comfort to the embrace of a man and a woman. His arms draped over her shoulders while hers looped at his naked waist, even as he told himself to end this folly immediately, or she’d have grounds for believing he trifled with the help after all. She didn’t end it. She stood in the loose circle of his arms, letting him positively wallow in the clean summery scent of her, the soft curves fitting him in all the right places. He urged her with patient strokes of his hands on her back to rest more fully against him, to give him her weight. He wasn’t even aroused, he realized, he was just… consoled. When

AMPUTATION  (AMPUTA'TION)   n.s.[amputatio, Lat.] The operation of cutting off a limb, or other part of the body, with an instrument of steel. The usual method of performing it, in the instance of a leg, is as follows. The proper part for the operation being four or five inches below the knee, the skin and flesh are first to be drawn very tight upwards, and secured from returning by a ligature two or three fingers broad: above this liagure another loose one is passed, for the gripe; which being twisted by means of a stick, may be straitened to any degree at pleasure. Then the patient being conveniently situated, and the operator placed to the inside of the limb, which is to be held by one assistant above, and another below the part designed for the operation, and the gripe sufficiently twisted, to prevent too large an hæmorrhage, the flesh is, with a stroke or two, to be separated from the bone with

She could feel Cameron move up behind her; the warmth of his body was right there, though he didn’t touch her. Then one hand caressed her upper arm while the other pulled her hair away from her ear. “This is the first time I’ve ever driven two hundred miles to see a woman I’ve barely met, Vanessa,” he whispered. Vanni bit on her lower lip. She’d been sleepless last night, thinking. She knew Cameron was interested in her, but that wasn’t enough. Her mind was on Paul. She turned around. “I’m very vulnerable, Cameron,” she said by way of warning. “I know. I’ll treat you carefully.” “You’re going to have to treat me patiently,” she said. “I’m not prepared to be any more than friends right now.” He laughed and shook his head. “I’d sure like to see where this could go.” “Friends,” she said. “Or nothing at all.” He cocked his head and smiled. “Do friends kiss? Just to see if there’s…chemistry?” She shook her head. “They do not. Not yet.” “Yet is a much more encouraging response than nothing at all. I guess friends kiss when they’ve gotten to know each other and there’s trust. Do I have that right?” She sighed deeply. If not for Paul, she might be attracted to Cameron. He was handsome, sexy, sweet. “It’s too soon. My mother-in-law jumped the gun, introducing us and—” “Nah, it’s not Carol’s fault. I’m jumping the gun because…” He shrugged. “Because you’re beautiful and fun. So shoot me.” She smiled at him. “I don’t think your life is in danger for calling me beautiful and fun. That’s very nice. But I’m not getting involved with you right now.” “You said we’d be friends,” he argued. And he reached out to stroke her hair. “Behave like a friend, Cameron. Like a Boy Scout.” He laughed at her. “You’re asking way too much. I’ll behave, but let’s keep this in perspective. I’m a man. You’re a damn sexy woman.” “Do I have to worry you won’t mind your manners?” she asked, lifting a brow. “Absolutely not,” he promised. “You’re in charge.” “Then no touching until… No touching.” He put his hands in his pockets. “Whatever you want, Vanessa. I’m just going to—” At that very moment, Plenty whinnied, backed away from the stream and bolted. “Shoot!” Vanni said. “That little troublemaker.” She pushed Cameron away, grabbed the reins of the gelding, leaped into the saddle and said, “I’ll be back.” She directed her horse after Plenty. “Don’t go away,” she yelled, laughing, as if he could go anywhere, stranded as he was.

Similar considerations arise with regard to recovery and rehabilitation after strokes and other injuries. There are no rules; there is no prescribed path of recovery; every patient must discover or create his own motor and perceptual patterns, his own solutions to the challenges that face him; and it is the function of a sensitive therapist to help him in this. And

This cannot be happening, Damon.  Someone, somewhere, made a mistake, you cannot be the Black Wolf!" "Gwyneth."  His hand was stroking her hair, calming her as he might a frightened young child.  "Dear, loyal Gwyneth.  Do you not remember what creatures guard the Marquesses of Morninghall as they sleep?  Do you not remember what creatures stand watch from the very gates of Morninghall Abbey?"  His voice was patient, resolute, resigned.  "Think, dearest wife — and then think upon my surname." "Wolves," she whispered brokenly.  "Oh, dear God . . .

a stroke is only a stroke after 50 of D50—a

April 30 MORNING “And all the children of Israel murmured.” — Numbers 14:2 THERE are murmurers amongst Christians now, as there were in the camp of Israel of old. There are those who, when the rod falls, cry out against the afflictive dispensation. They ask, “Why am I thus afflicted? What have I done to be chastened in this manner?” A word with thee, O murmurer! Why shouldst thou murmur against the dispensations of thy heavenly Father? Can He treat thee more hardly than thou deservest? Consider what a rebel thou wast once, but He has pardoned thee! Surely, if He in His wisdom sees fit now to chasten thee, thou shouldst not complain. After all, art thou smitten as hardly as thy sins deserve? Consider the corruption which is in thy breast, and then wilt thou wonder that there needs so much of the rod to fetch it out? Weigh thyself, and discern how much dross is mingled with thy gold; and dost thou think the fire too hot to purge away so much dross as thou hast? Does not that proud rebellious spirit of thine prove that thy heart is not thoroughly sanctified? Are not those murmuring words contrary to the holy submissive nature of God’s children? Is not the correction needed? But if thou wilt murmur against the chastening, take heed, for it will go hard with murmurers. God always chastises His children twice, if they do not bear the first stroke patiently. But know one thing — “He doth not afflict willingly, nor grieve the children of men.” All His corrections are sent in love, to purify thee, and to draw thee nearer to Himself. Surely it must help thee to bear the chastening with resignation if thou art able to recognize thy Father’s hand. For “whom the Lord loveth He chasteneth, and scourgeth every son whom He receiveth. If ye endure chastening, God dealeth with you as with sons.” “Murmur not as some of them also murmured and were destroyed of the destroyer.

Abstract: We have found that when patients with cancer are pushed off a high cliff this reduces mortality from cancer deaths by 100%. This represents an unprecedented reduction in cancer mortality, and we suggest this technique might be used to reduce cancer deaths around the world. I would follow this with my seminal study on ‘Removing the human brain to prevent strokes.

Febrile patients with head trauma, subarachnoid hemorrhage, or stroke should receive antipyretics to prevent temperature-related increases in cerebral oxygen utilization.

The relationship between BP and mortality in patients with stroke may be “U-shaped.” According to this notion, systolic BP (SBP) values above or below 140 to 180 mm Hg are associated with increased mortality. In the International Stroke Trial, SBP above 200 mm Hg was associated with an increased risk of recurrent ischemic stroke (50% greater risk of recurrence), while low BP (particularly <120 mm Hg) was associated with an excess number of deaths from coronary heart disease.

According to a large study from Kaiser Permanente, for every 0.05 increase above 4.72, patients had an additional 6 percent increased risk of developing diabetes in the next ten years (4.82 = 12 percent increased risk, etc.) Above 5 indicates that vascular damage has already occurred and a patient is at risk for having damage to the kidneys and eyes. Why is high fasting blood sugar a problem? High blood sugar causes vascular problems throughout your whole body, including your brain. Over time, it causes blood vessels to become brittle and vulnerable to breakage. It leads not only to diabetes but also to heart disease, strokes, visual impairment, impaired wound healing, wrinkled skin, and cognitive problems. Diabetes doubles the risk for Alzheimer’s disease.

One more item I’d like to point out from this study: When the researchers performed brain scans on these patients, they found noticeable changes in the white matter that could easily be confused with multiple sclerosis or even small strokes. This is the reason I always check for gluten sensitivity in patients referred to me with a diagnosis of multiple sclerosis; on many occasions I’ve found patients whose brain changes were in fact not related to multiple sclerosis at all and were likely due to gluten sensitivity. And lucky for them, a gluten-free diet reversed their condition.

The brain can be divided roughly into two hemispheres of unequal function, and patients can get strokes in either. The hemispheres contain separate “spotlights” for visual attention. The left hemisphere’s spotlight is small, capable of paying attention only to items on the right side of the visual field.

...Yes, now the roads themselves are shattered As though they had fallen from a height, and the sky Is cracked like varnish. Hard to believe, Our family tree Seems to be making its mark everywhere. I carry my head high On a pike that shall be nameless. Even so, we had to give up honor entirely, But I do what I can. I am patient With the woes of the cupboards, and God knows― I keep the good word close to hand like a ticket. I feed the wounded lights in their cages. I wake up at night on the penultimate stroke, and with My eyes still shut I remember to turn the thorn In the breast of the bird of darkness. I listen to the painful song Dropping away into sleep...

Pomegranates inhibit breast cancer, prostate cancer, colon cancer, and leukemia, and prevent vascular changes that promote tumor growth in lab animals.55 2. Pomegranates inhibit angiotensin-converting enzymes and naturally lower blood pressure. (Angiotensin, as you may recall, is a hormone that promotes angiogenesis.)56 3. The potent antioxidative compounds in pomegranates reverse atherosclerosis and reduce excessive blood clotting and platelet clumping, factors that can lead to heart attacks and strokes.57 4. Pomegranates have estrogen-like compounds that stimulate serotonin and estrogen receptors, improving symptoms of depression and helping build bone mass in lab animals.58 5. Pomegranates reduce tissue damage in those with kidney problems, reduce the incidence of infections, and prevent serious infections.59 6. Lastly but impressively, pomegranates improve heart health. Heart patients with severe carotid artery blockages were given a daily dose of less than an ounce of pomegranate juice for a year. Not only did their blood pressure decrease by over 20 percent, but there was a 30 percent reduction in atherosclerotic plaque.60

Humphrey had lost his hand in the first Gulf War and now had a phantom hand. As is true in other patients, whenever he was touched on his face, he felt sensations in his missing hand. No surprises so far. But with ideas about mirror neurons brewing in my mind, I decided to try a new experiment. I simply had him watch another person—my student Julie—while I stroked and tapped her hand. Imagine our amazement when he exclaimed with considerable surprise that he could not merely see but actually feel the things being done to Julie’s hand on his phantom. I suggest this happens because his mirror neurons were being activated in the normal fashion but there was no longer a null signal from the hand to veto them. Humphrey’s mirror neuron activity was emerging fully into conscious experience. Imagine: The only thing separating your consciousnesses from another’s might be your skin! After seeing this phenomenon in Humphrey we tested three other patients and found the same effect, which we dubbed “acquired hyperempathy.” Amazingly, it turns out that some of these patients get relief from phantom limb pain by merely watching another person being massaged. This might prove useful clinically because, obviously, you can’t directly massage a phantom.

One unexpected hint comes from patients with a strange disorder called anosognosia, a condition in which people seem unaware of or deny their disability. Most patients with a right-hemisphere stroke have complete paralysis of the left side of their body and, as you might expect, complain about it. But about one in twenty of them will vehemently deny their paralysis even though they are mentally otherwise lucid and intelligent. For example, President Woodrow Wilson, whose left side was paralyzed by a stroke in 1919, insisted that he was perfectly fine. Despite the clouding of his thought processes and against all advice, he remained in office, making elaborate travel plans and major decisions pertaining to American involvement in the League of Nations. In 1996 some colleagues and I made our own little investigation of anosognosia and noticed something new and amazing: Some of these patients not only denied their own paralysis, but also denied the paralysis of another patient—and let me assure you, the second patient’s inability to move was as clear as day. Denying one’s own paralysis is odd enough, but why deny another patient’s paralysis? We suggest that this bizarre observation is best understood in terms of damage to Rizzolatti’s mirror neurons. It’s as if anytime you want to make a judgment about someone else’s movements, you have to run a virtual-reality simulation of the corresponding movements in your own brain. And without mirror neurons you cannot do this.

Meanwhile,” adds Dr. Brownstein, “we’ve seen lots of really bad vaccine side effects in our patients. We’ve had seven strokes—some ending in severe paralysis. We had three cases of pulmonary embolism, two blood clots, two cases of Graves’ disease, and one death.

Sometimes you spend hours contemplating a tree, describing it, dissecting it: the roots, the trunk, the branches, the leaves, every leaf, every rib of every leaf, every branch again, and the unending play of the indifferent shapes that your eager gaze solicits or conjures up: a face, a town, a maze or a path, coats of arms and cavalcades. As your perception gets sharper, more patient and more versatile, the tree shatters and then reforms, a thousand shades of green, a thousand leaves, identical and yet all different. You think that you could spend your whole life in front of a tree, never exhausting it and never understanding it, because there is nothing for you to understand, just something to look at: when all is said and done, all you can say about this tree is that it is a tree; all this tree can say to you is that it is a tree, a root, then a trunk, then branches, then leaves. You can't expect to extract any other truth from it. The tree has no moral to offer you, no message to impart. Its strength, its majesty, its life - if you still hope to draw some meaning, some courage, from these outworn metaphors - are only ever images, neat illustrations, as useless as the tranquillity of the fields, as the still waters which, reputedly, run deep, or the courage of the little paths that don't climb very high but do so all alone, or the smiling hillsides upon which bunches of grapes ripen in the sun. And that is why the tree fascinates you, or astounds you, or calms you: because of the unsuspected and unimpeachable obviousness of the bark, the branches and the leaves. That is why, perhaps, you never go walking with a dog, because the dog looks at you, pleads with you, speaks to you. Its eyes brimming with tears of gratitude, its servile expression, its canine frolicking, constantly force you to confer on it the ignoble status of pet. You cannot remain neutral in the company of a dog any more than in the company of a man. But you will never hold a conversation with a tree. You cannot live in the company of a dog, because the dog is constantly calling upon you to make it live, to feed it, to stroke it, to be a man for it, to be its master, to be the god roaring the name - dog - that will make it instantly grovel on the ground. But the tree asks nothing of you. You can be the God of the dogs, God of the cats, God of the poor, all you need is a leash, a little tenderness, a little money, but you will never be master of the tree. All you can ever wish for is to become a tree in your turn.

You’ll meet the brilliant Dr. Mary Lou Jepsen, whose company, Openwater, is using red laser light and holography to measure the brain blood flow of a patient, in the ambulance, during that first critical three- to four-hour window to determine if tPA therapy is required and to diagnose every stroke.