Thursday, May 18, 2006

Lost



Well, I found that amusing.

Now where was I?

Ah yes. Standing in an underground room, with a Japanese girl, desecrating a corpse.

I have decided to invent a new word or phrase. Adextrosinisterism. Chiral blindness. Amanugnosia. I don't know what the exact word is, but I can come out now and confess before the world that I've got it. I have great difficulty in telling my right hand from... the other one.

You suspect I jest. I do not. When I was a child I was okay - I had a wart on my right knee. It healed, but then I was able to rely on some kind of bump thing on my wrist. But eventually that too went away, and it took with it my last real hope of finding my way around the world.

I (almost) can't tell left from right. It started in primary school, where I confused b, d, p and q, R and 5, and 7, T and Y - but never 0 (zero) and o (oh). I wrote the numeral two backward until at least the age of fifteen (I found my old tape of "Ziggy Stardust and the Spiders From Mars" in the garage the other day - side one, side five). And I couldn't tie my shoelaces until an embarrassingly late age, and still tie them in this weird macrame way.

And I still have to wiggle my hand in a writing way to tell which direction is left, and I am still almost legendarily bad at navigating. I get lost five or six times a year, ending up in unknown valleys, or exotic harbours where surly men load crates bearing unitelligible writing onto boats bound for foreign places, or isolated hamlets in lost valleys, places where the locals eye me warily and everyone wears unusual ethnic clothing with big hats.

I don't mean lost trying to drive to Sydney. I mean when going to the local shop it takes me a lot longer than other people because I miss turns, go via unusual suburbs, lose the car in the carpark and then can't find my way home.

I think this is due to a lot of things. Part of it is I don't tend to pay attention to stuff. I go into screensaver when permitted, and can work up Adult Male With Head Injuries, Appears Intoxicated in alpha wave sleep.

Part of it is finding it really difficult to stay interested in boring stuff, and how to get home when you've got the wrong side of town, have only three litres of petrol and don't remember there being an amphetamine kitchen on that street before before is only really really important, it's not interesting.

And some of it is something more - there are times, at least once a month, where I will fail to recognise familiar places, and be for a moment utterly disorientated (which means literally "unable to find east"). The French have a phrase for it - jamais vu, which is the counterpart of deja vu. Deja vu is "I've been here before" in what should be unfamiliar surroundings, jamais vu is "I've never seen this before", in surroundings that should by rights be familiar.

Both of these occur in epilepsy, by the way.

But part of it is left and right. Never understood it, never got it, never grokked it, never will. When patients describe pain that I suspect may be appendicitis, I surruptitiously superimpose my body on theirs (as in I imagine it, I don't leap in the bed and start spooning), line everything up, press on my body precisely where they are pressing when they show where the pain is on them , wiggle my left hand as if writing something, and if it's on the same side as my writing hand, it's left sided pain. And unlikely to be appendicitis.

And yes, I am an emergency doctor. And no, no-one's ever died as a result of me getting this wrong, because I don't, I just take longer - and I've always found oter people's bodies easier to navigate than mine. And no, I have no plans to go into surgery.

But the desecration. Me and Masako down in the freezing basement, the smell of formalin, the thick surgical gowns that gradually became sticky and stiff with un-named fluids. Me and her and an elderly man who had given his body to science. Whittling - preserved flesh is a strange texture, slightly springy but unyielding for the connective tissue, greasy and brittle for the fat, and colours that suggest but do not evoke life - greys and tans and faint russets, pale yellows and diluted browns. More of autumn, life with death in it, while the bright red blood and golden yellow fat of living people are summer.

Masako and I were dissecting Mr E, whom, it became apparent, had died of advanced pancreatic cancer. He was thin when we got him, and after we'd scraped back the meagre curtain of abdominal fat he was almost skeletally thin - a ribbon of abdominal muscles, pectoral and shoulder muscles clearly outlined, looking like some discomforting parody of a bodybuilder, an aged superman.

Surface anatomy was easy. But it was when we reached the viscera - thankfully after the face and hands had been dissected, and I was able to concentrate less on the person and more on what we were meant to be learning about - by the second day of visceral anatomy Masako was starting to lose patience.

"The left lobe of the liver" she repeated.

"That's it there."

"That can't be it there. That's the right."

"How can that be the left lobe?" I said. "Then what's that over there?"

"The right lobe, perhaps?"

"How can that be the right lobe?"

"I sortof thought on account of it being on the right hand side."

"Then what about his pancreas? Why has he got it way over there?" I stared at his jumbled abdomen, with the organs we'd recoved and put back like a jigsaw puzzle. "Do you reckon he's some kind of freak?"

"No, not him" said Masako. "When I go home I'm getting a tattoo. It's going to have pictures of all of my internal organs on it where they are, so if you ever operate on me..."

This went on for another day or so, but eventually my brain put together the facts that I was standing in a room with an irritable Japanese girl who was holding a very sharp scalpel. And the morgue was a long way away from the rest of the hospital, certainly too far for anyone to hear me scream. And it was already full of dead bodies. One more would't be noticed, especially since they were in short supply ...

So I did it. Carved a little "L" on the pectoralis major muscle, just under the left nipple. It worked fine. As the dissection continued I was more at ease - that big heart-looking thing was on the left, the red-brown livery thing with the consistency of cold rubber was on the right. It all worked out in the end. But that first signpost was the crucial thing.

I like to imagine he wouldn't have minded. His face suggested a decent, if deeply tired, fellow.

Anyway. Haven't looked at anatomy for years, and am unlikely to, unless I manage to whip up the enthusiasm for the exam again. Which I will, once the moods and the chaos and the rest of everything settle up. It may be some time.

Thanks for listening,
John

4 Comments:

Blogger Prom said...

"preserved flesh is a strange texture, slightly springy but unyielding for the connective tissue, greasy and brittle for the fat, and colours that suggest but do not evoke life - greys and tans and faint russets, pale yellows and diluted browns. More of autumn, life with death in it, while the bright red blood and golden yellow fat of living people are summer."

Superb imagery!

7:23 PM  
Anonymous Anonymous said...

Yes, superb imagery indeed, but rather uncomfortably reminiscent of my single and unlikely-to-be-repeated experience with a practical human anatomy class. My reaction to the part about greasy and brittle for the fat explains why I will never be a doctor.

Funny, I never used to be so squeamish.

10:59 PM  
Blogger Benedict 16th said...

I have tears running down my face from laughter,
do you ever share those memories with Masako?
I never knew about the threat of tattoos. I have seen
you hold out your hands (when you think no one is looking)
and look for the "L" that the index finger and thumb form
on the left hand....

So instead of a frontal lobe syndrome you have a parietal lobe syndrome?

also here is some list of things to help diagnose dyslexia (buggered if I can remember where I got this list)
I think it was some new age left brain right brain paper....

Signs that your child is dyslexic:

Difficulty distinguishing between left and right
Difficulty mastering the technique of tying shoe laces or buttoning shirts
Learning anything in sequence eg: days of the week; periodic table, order of the planets; the alphabet.
Writing d instead of b, writing pan instead of nap etc...
Short term memory problems due to anxiety

Thanks
Benedict

11:58 PM  
Blogger Foilwoman said...

Here's a simple trick to learn left from right -- taught to my daughter by those eminent Ozzies, the Wiggles: hold your hands up in front of you so the palm and fingers are perpendicular to the ground. Hold your thumbs out at right angles tot he fingers. The hand in which the fingers and thumb make an "L" is the left hand. See how easy?

And, sweetie-pie, you carved the guy up, how is making a little "L" desecration?

10:57 AM  

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