The Hypochondriac's Guide to Life. and Death. (15 page)

And now, some important commonly asked scientific questions about the brain and central nervous system.

During the Reign of Terror, when someone was guillotined and his head plopped off into a wicker basket, and some French revolutionary, drunk on power and revenge, held the head up by the hair in front of a ravening crowd of semiliterate blood-thirsty keening yeehaws with bad teeth, might there have been a few horrifying seconds when the head was still conscious and saw this happen?

Yes. In 1988, scientists published the results of a study called
Neocortical and Hippocampal Electrical Activity Following Decapitation in Rats,
in which persons in white lab coats with advanced degrees took a bunch of rats and chopped their heads off. Then they measured the severed brains for the persistence of electrical impulses suggesting consciousness. Electrical activity continued for thirteen to fourteen seconds after decapitation. This is long enough to hum the first eight bars of “La Marseillaise.”

What's the story with that slashing karate chop to the back of the neck that lets the hero temporarily incapacitate the villain in old TV shows like the original
Mission: Impossible?
And wasn't Peter Lupus the worst actor of all time?

The unconsciousness-inducing karate chop is a clumsy plot device to effectuate sudden, improbable escapes. It would not work in real life; neurologists say a vicious blow to the back of the neck could conceivably cause paralysis but probably not unconsciousness, unless it also killed you. Peter Lupus is the third-worst actor of all time, after Victor Mature and the guy who played the Professor on
Gilligan's Island.
The worst acting
performance
of all time was by Shelley Duvall in
The Shining.

Is there any neurological disease that can turn you into a sex machine? How do I get it?

Herpes simplex encephalitis is a serious infection that can attack the temporal lobes of the brain. With proper treatment you can recover, though sometimes there is irreversible damage done to the brain tissue, and permanent memory loss. One rare but possible complication from herpes simplex encephalitis is Kluver-Bucy syndrome, in which you become “hyperoral.” You try to put everything in your mouth. You show symptoms of pica, which is a desire to eat bizarre things, such as dirt or hair or cigarettes. You also have indiscriminate sexual urges. You become a voracious, sex-crazed, humping lunatic. Cats with Kluver-Bucy syndrome will rape chickens. Humans get wildly horny. They suck and lick at your face. They squeeze and probe your body. They rub their privates against you. They have no idea that there is anything wrong with this.

Shouldn't a book on hypochondria deal with psychiatric disorders?

It should. Except psychiatry is in disorganized retreat these days, with mounting evidence that the hallowed tenets and principles of psychotherapy, long considered the glorious apex of modern medical achievement, are about as valid as the theory that the earth sits on a big turtle. Sigmund Freud, the brilliant brainmaster who became the model for a thousand fictional shrinks with ludicrous Teutonic accents, is now widely regarded as Daffy the Quack. People who spent twenty years weeping out their family secrets to psychotherapists are now cured by a pill. Psychotherapists are going to work for Wal-Mart, leaving behind a pile of grease-stained inkblots.

Are Rorschach tests discredited, too?

Not really. They remain a reasonably reliable diagnostic tool to identify delusional or pathological thinking. The key is that the blots themselves are randomly generated and therefore meaningless. The patient must supply the interpretation, drawing from within; most of us offer benign scenarios. It is here that pathologies sometimes reveal themselves. On the following page is a typical set of random Rorschach blots. Try it yourself.

1
At one point, I was planning to identify myself on the cover of this book as “Gene Weingarten, MD,” revealing in very fine print that the “MD” meant that I lived in Maryland. I was persuaded not to do this by my publisher, who was concerned that it might be considered somewhat misleading, causing misunderstandings, legal actions by regulatory agencies, prison terms for all concerned, and so forth.

2
Eyelid twitching: amyotrophic lateral sclerosis, which is Lou Gehrig's disease. You waste away and then die. Also, Huntington's chorea, in which you become irritable and obnoxious, and
then
you waste away and die.

3
Heart attack. See
Chapter 11
, “Infarction—Isn't That a Funny Word? Hahahahaha Thud.”

4
G
et
O
ut of
M
y
E
mergency
R
oom.

5
Get it?

6
In medical school, students learn an ancient mnemonic device to remember the names of the twelve cranial nerves: “On old Olympus's towering tops, a Finn and German viewed a hops” (olfactory, optic, oculomotor, trochlear, etc.). Because this basically makes no sense at all, in recent years smart-ass male medical students corrupted it to “Oh, oh, oh, to touch and feel a girl's vagina and hymen!”—which, not surprisingly, has stuck. Some of these male medical students have gone on to become pillars of their communities. In general, medical books love mnemonic devices. The best one I found summarizes the causes of urinary incontinence:
D
ehydration,
R
etention,
I
nfection,
P
sychologic.

Infarction—Isn't That a Funny Word? Hahahahaha Thud.

She was the kind
of dame who gets your attention if you are the kind of guy who doesn't know the difference between ecru and puce, if you get my drift. She was brainy but not mouthy. She walked last but fine, like a woman who knows how a woman is supposed to walk but doesn't give a damn. Not that she walked like a man. A goat can't impersonate a fish.

She took my hands in hers. Her hands felt good. Mine felt clammy, like a clam. That's the thing about me. When I'm nervous, I can't think of good analogies. She took the tips of my fingers in hers and pressed on them, not enough to hurt but enough to let me know she could hurt me if she wanted to. She had hurt men, you could tell.

We were alone in a small room with a bed. I took off my tie. I took off my shirt. She reached for me. We had sex.

OK, we didn't have sex, because Dr. Karen Stark is a cardiologist and it would have been totally inappropriate for us to have sex in her office, plus I was wearing one of those paper gowns that expose your behind, and I am certain Dr. Stark would have been laughing too hard to properly enjoy the experience.

I was in her Washington office to get my heart listened to. I
didn't have a heart problem, so far as I knew. In twenty years of active, aggressive hypochondria, my heart was the only organ that I never once suspected of betraying me. When I decided to get a medical exam as part of my research, I chose a cardiologist, because I felt reasonably secure. So here I was in Dr. Stark's office, practically
daring
her to find something wrong.

She put a stethoscope on my chest. She frowned. She listened again. She said: “You have an extra heart—”

I knew it! Suddenly, all became clear: The racing pulse in times of stress! The pounding in my ears when I climbed that pyramid in Mexico! I had an extra heart! But wait. Was this good, or bad? Maybe it is like having a dual carburetor or, holy cow, a second penis. You could be a superman, the
Übermensch
Nietzsche dreamed of. But what if …

“—beat.”

“Pardon me?”

“You have an extra heartbeat. Everyone has a few extra heartbeats.”

“Oh. So it is no problem?”

“Right,” she said.

But she wasn't really listening. Sometimes you can tell that with a woman, particularly if she has a stethoscope on your chest and she is saying “shhh.”

“Squat down,” she commanded.

(Oboy.)

“You have a midsystolic click,” Dr. Stark said at last, pleased. I had asked her to find something wrong, and she did. It is called a mitral valve prolapse. Basically, the valve between my left atrium and left ventricle is a little squishy, and when it opens and contracts, part of it squeegies through the hole and makes a click, and a lot of people have it: it is sort of a benign hernia
1
of the heart, and there is probably nothing to worry about, and
there is certainly no reason to run home and throw open your two hundred medical books and read everything ever written about valves, including Chilton automotive manuals.

According to
The Cecil Textbook of Medicine
(twentieth edition), a mitral valve prolapse is no big deal, except for the possible development of infectious endocarditis, which is basically a rampaging infection of the heart that deposits what is known, euphemistically, as “Vegetation” inside the organ and can kill you. But—and this is a big but
2
—“if ventricular irritability is present, the extent of the murmur of hypertrophic cardiomyopathy with obstruction is much louder in the post extrasystolic beat.” I have no idea what this means, but it doesn't sound good. Fortunately, at this point my attention was distracted by a picture of a woman who has no thumb as a result of congenital heart disease. A problem with the heart can make your thumb fall off!

I have to stop reading these books.

A few days after my chest exam, I was leafing through a health magazine, noticing endless lists of support groups for persons with, shall we say, cutting-edge medical conditions. There were support groups for victims of anxiety disorders and eating disorders and “pet grief” and attention deficit disorders and obsessive-compulsive obsessive-compulsive obsessive-compulsive disorders, and something called “trichotillomania,” which is defined as chronic hair pulling. And there in the middle of these listings was a support group for victims of … mitral valve prolapse! So I called the phone number that was listed and I told the woman who answered that I had a mitral valve prolapse, and she said—and I am quoting here—“I'm so sorry.” I said the cardiologist told me it was nothing to worry about, and there was a full five seconds of pregnant, patronizing silence. Finally, she spoke.

“I faint all the time,” she said.

See, that's the problem for hypochondriacs. Sometimes you
just don't know whom to believe—a qualified professional like Dr. Stark or some anonymous whack job on the telephone. Fortunately, at that point I had already been cured of my hypochondria in a miracle of modern science that I will disclose a few chapters from now. So I felt faint only for a few minutes, and then it passed.

Although cardiologists have an arsenal of sophisticated tests, such as echocardiograms, many initial diagnoses are made simply by listening to your chest, taking your blood pressure, observing your breathing, evaluating your skin tone, checking whether you have any thumbs, etc. And so it is that you can sometimes play cardiologist in your own bathroom, without the formality of eight years of higher education, sucking up to professors, gobbling amphetamines like Tic Tacs, and so forth.