Inkwell: Authors and Artists

    
"In her room in Columbia-Presbyterian Hospital, located in a slummy corner
of north Manhattan, [von Bulow] is dressed daily by round-the-clock
attendants who also see to her hair, makeup and nails. A small stereo
radio fills the room with her favorite music. At no time during this
period [1982-96] has Sunny von Bulow ever given any sign of
self-awareness. She cannot respond to stimuli -- sights, sounds, touch.
She is nourished via a food tube.  Neurological experts declare that her
loss of consciousness is irreversible. And yet:  she is capable of
breathing on her own, without a respirator. Her brain-waves show
sleep-wake sequences. Now and then her lips curl into a smile. Her eyes
open periodically and are said to tear when she is visited by her children
Ala and Alexander Auersperg."

        -- from a 1996 University of Toronto classroom case study on the 
ethics of death

http://www.quahog.org/attractions/index.php?id=43
  

    
When I was talking to doctors in the U.S., I was horrified at the ease
with which they dismissed the possibility that something was going on
inside teh people in pvs or other brain-devastated states. It was
enough to make you agree with the right-to-lifers that they were all a
bunch of Kevorkians, although what was fairer to say is that they held,
nearly without self-criticism, a view of human life that equated it to
the life of the brain. That's not an implausible view, certainly more
plausible than equating it to, say, the liver, but it's still a view
and not a fact. And like all views, it has an ideology behind it. The
absolute refusal of most doctors even to grant this possibility, let
alone to explore and critique the ideology, was quite stunning. And
when I was in Cuba at the Brain Death and Coma Conference, where the
main attraction was a neurologist showing video of a boy who'd been
brain dead for more than a decade, but was still breathing, etc., their
unwillingness to grant the guy's irrefutable point--that that state of
being might be many things, but dead didn't seem to fit the bill--was
striking and, in its own way, horrifying.


When I was in Japan, on the other hand, I was equally horrified at the
way the women tending the brain-devastated (I met exclusively mothers)
seemed unaware of how they were animating their children, attributing
a conscious life to them that seemed more their fantasy than anything
else, and which, if it did exist, would itself be horrible--to be aware
of yourself in that condition would have to be some kind of
unimaginable hell. Still, even though it was impossible to avoid the
feeling that they were playing dolls with their boys, it was also
impossible not to be moved by their devotion, and aware of the
possibility that they knew something that I didn't, that didn't show up
on the  MRIs.

I should add that I had a cousin who was in a persistent vegetative
state for more than thirty years. He was the bright and shining boy of
my mother's generation, a devastatingly handsome, bright man who was
going to be a navy flier and then who knows what, until he crashed his
convertible, got ejected, and landed on his head. His mother, my
great-aunt, refused to give up on him. She built a hospital room in her
house, and every week brought him home from the VA Hospital, where she
tended him with the aid of a nurse. The rest of my family thought that
my aunt was buts--and truth to tell, she was a little nuts--but you
couldn't be around her and not understand that she really loved her
son. Was her devotion merely an attempt to accept reality or to
forestall her grief? I once thought so, but now I think that's a really
inadequate response. AFter all, she re-visited her grief every
weekend. 

In the presence of horror, it's easy to see just how puny our
categories are, and how little we really know. 
  

    
Is Claus von Bulow still alive?
  

    
I mean that in the conventional sense.
  

    
wikipedia thinks he's alive and living in London.
  

    
Weirdly, Sunny's first husband, a prince, also ended up in a lengthy coma 
after a car accident.
  

    
Gary, a group of scientists writing in Nature have created a brouhaha by
suggesting that even healthy people be allowed to take stimulants like
Ritalin and Adderal as "brain boosters" comparable to a cup of coffee or a
good night's sleep.

http://www.nature.com/nature/journal/vaop/ncurrent/full/456702a.html

"Human ingenuity has given us means of enhancing our brains through 
inventions such as written language, printing and the Internet. Most 
authors of this Commentary are teachers and strive to enhance the minds of 
their students, both by adding substantive information and by showing them 
new and better ways to process that information. And we are all aware of 
the abilities to enhance our brains with adequate exercise, nutrition and 
sleep. The drugs just reviewed, along with newer technologies such as 
brain stimulation and prosthetic brain chips, should be viewed in the same 
general category as education, good health habits, and information 
technology -- ways that our uniquely innovative species tries to improve 
itself."


While obviously this has been going on since long before the first 
undergrad popped a white cross to pull an all-nighter, bringing this 
discussion out into the open makes some assumptions about 
health and disease discomfitingly clear, along the lines of your book.
  

    
And more Greenbergiana in the news... a French doctor has raised a ruckus 
by claiming that he has found a "cure" for alcoholism -- a muscle relaxant 
called baclofen.


http://www.independent.co.uk/life-style/health-and-wellbeing/health-news/has-t
his-doctor-discovered-a-cure-for-alcoholism-1056645.html
  

    
I'm really glad they wrote that article. But the fact that it is
controversial to advance the idea that people can use drugs responsibly
is highly annoying.

Back in 1969 or so, a psychiatrist named Gerald Klerman, who was
otherwise, as near as I can make out, a pretty undistinguished
psychopharmacologist, always ready to shill for a drug company, came up
with the term Pharmacological Calvinism, which he contrasted to
psychotropic hedonism. (I am not sure why he picked Calvinism, since
what it really is is Puritanism, Calvin's major contribution being the
notion of predestination, and puritanism being the strain of
Christianity that is fundamentally appalled at the body's capacity for
pleasure, but whatever.) This question of whether we should use "smart
drugs" is like the steroid debate in baseball. It's full of nostalgia
for a time that never was, a prelapsarian condition in which we just
function with what God gave us and are happy with that.

The best way to counter this stupidity, to me, is to ask the question
of whether or not it's okay to eat a diet that, in the case of
baseball, increases availability of protein for muscle building, or in
the case of cognitive activity increases overall health and alertness
and lifespan. Or should we just go back to a hunter-gatherer diet, eat
ourselves stupid and die before we can develop an opus?

Even the side effects argument doesn't sway me. Of course amphetamines
have side effects. But so does our protein-rich diet, and those side
effects aren't just limited to our bodies. Consider  what our reliance
on animal protein does to the enconomy and the environment, not to
mention to the animals. 

Jay Hughes, the guy who has written most cogently on enhancement
technologies (a book called Citizen Cyborg, in which he forgoes these
ontological/philosohpical arguments in favor of political and economic
ones) calls this attitude "bioconservatism," and if you read the guys
who advance it (the Nature article cites them--Leon Kass, Francis
Fukuyama, et al.) you will see the parallels to the neocon movement. If
you want to read more about what I think about this response to
biotechnology, I suggest After Nature, an essay in Harper's. 
http://www.harpers.org/archive/2004/03/0079963

Use gxgre as your login and harpers as your passcode, and I'll leave
that combo up for a week.
  

    
I'm gonna be on Angie Coiro's show on Green 960 (KQKE) tonight at 8
Pacific for an hour. I will try to be coherent, but that's way past my
east coast bedtime. Don't know if it's a call-in, but if so, call away.
  

    
excellent!  chip some ritalin to beat that timezone fatigue.
  

    
Great news.  I'll be provigilant about listening.  ;-)
  

    
Coffee up!
  

    
Heh! 

Yes, Gary, it's a call-in show. But we're only in our fourth show in a
new slot. This time window has been occupied by pre-taped shows for so
long the audience is only now catching on that they can really
participate. Usually that's a downside, but there's so much to cover in
your book I want you as much to myself as possible!
  

    
Alas, after a meeting at work this morning, I will not be able to listen.  
But <coiro> is a fabulous interviewer, Gary is a wonderful subject, and I 
can't wait to hear the reports.
  

    
Should be awesome!
  

    
Yes, I'm looking forward to it. Unfortunately, I can't take any
stimulants before, because I need to go to sleep right afterwards. When
they make a time-sensitive version of Provigil, you know, where you
can take a two-hour version or a twelve-hour version, I am so there.
  

    

My very best short term wake-me-up technique I discovered years ago driving
across the Arizona desert in the summer at night, super tired but not
wanting to have coffee.  

I stopped at a gas station convenience store, impulsively bought a 
jar of salsa from the chips and dips rack, and set it beside me on 
the passenger seat.  Every time my eyes got heavy I'd have another 
big spoonful of the hot stuff, and I'd be wide awake again for 
another stretch of dark highway.

Your milage may vary, as always.

Best luck with the show!
  

    

And the Angie Coiro Show is available after the fact for those who aren't
able to listen online.
  

    

Angie, tell folks how to tune in!
  

    

Assuming, that is, that's also streaming live.
  

    

Live AND archived:

<http://www.green960.com/pages/tgs.html>
  

    
A tragic story from the UK this morning, of a mother arrested for 
murdering her daughter who had been bedridden, paralyzed, mute, unable to 
eat, in pain, and requiring 24 hour care, for 17 years. Weirdly enough, 
the disease mentioned in the news stories is described as "myalgic 
encephalopathy, also known as ME or chronic fatigue syndrome." I've known 
people with chronic fatigue syndrome, and it certainly wasn't as 
devastating as this.  This article goes on to quote the ME Association as 
saying that 250,000 people in the UK have it.

Kay Gilderdale, the mother, said in 2006:

She added that she felt her daughter was in limbo between life and death. 
"If someone dies, you mourn them, then you get to a stage where you know 
that person is gone and you move on. But Lynn is neither one nor the 
other. She is stuck in that room, not dead, but not alive properly."

http://www.timesonline.co.uk/tol/news/uk/health/article5309918.ece
  

    
Killing a hopelessly ill child is the problem that the movie I've
Loved You For So Long pivots on. 

I had a good time on Angie's show last night. And she dropped your
name and that of this conf. That was nice.
  

    
That's great.