Carole,

    You can't.  Its not published yet.  haven't got a publisher yet.

Bill
-----Original Message-----
From: Carole Hercun <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Date: Monday, September 06, 1999 8:07 AM
Subject: Re: Surgery for rigidiity


>Hi William: What a fascinating chapter, both of your
>life and of your book. Where can I get a copy of "My
>Second Life"?           Carole H.
>
>--- William Harshaw <[log in to unmask]> wrote:
>> Debbie,
>>
>>     When I had my pallidotomy in Dec '93, as Dr.
>> Ronald Tasker, my
>> neurosurgeon, made the lesion in my right globus
>> pallidus, I could feel the
>> rigidity leave the left side of my body.  It has not
>> returned.
>>
>>     I attach Chapter Eight of my book: My Second
>> Life.
>>
>> copyright 1999 The Harfolk Press
>> may not be reprodced without permission
>> Monday, November 30, 1998 revise
>>
>>  Chapter Eight
>>
>>  NEUROSURGERY
>>
>>   ... the brain is the most interesting, complex and
>> wonderful thing in the
>> universe ... and it's a wonderfully exciting thing
>> to study and be in
>> contact with. ... The brain is you, it's not just
>> biologically or
>> genetically, it has all your experience, it's you.
>>   -Oliver Sacks
>>
>>
>>
>> When I returned to the hospital on Tuesday, December
>> 7, 1993, I was ready
>> for surgery, eagerly looking forward to the
>> operation even though I was
>> apprehensive. Other than my overnight doing the
>> pre-op testing I hadn't
>> stayed in a hospital since I was twelve years old
>> having my tonsils out, and
>> I enjoyed the novelty. I brought a good supply of
>> books and music tapes.
>> Because the operation was unusual, everyone seemed
>> to want to know about me
>> and I was being paid a lot of attention. I felt
>> quite important.
>>  I was sharing a room with a man from Huntsville who
>> had an inoperable brain
>> tumour. His wife was with him constantly, and I
>> sensed, from overhearing the
>> doctors and nurses, that he did not have long to
>> live. Even so, there was a
>> sense of calm surrounding the couple as they
>> prepared for his inevitable
>> death.
>>  For the first few hours after I was admitted, I was
>> too busy having my
>> medical history taken, for what seemed the nth time
>> by a nurse and then
>> again by a surgical resident, and then being visited
>> by Jan Duff, Dr. Lang
>> and Esther and Howard to take in the reality of what
>> was going on beside me.
>> I dimly recognized that this couple were preparing
>> for the husband's death,
>> but there was no weeping and gnashing of teeth;
>> rather, there was hope. As
>> the wife left that Tuesday evening, she turned to me
>> and said, "You will be
>> in my prayers tonight. God bless you."
>>  She had enough room in her heart for me, when I
>> would have thought her
>> whole being would be focused on her husband, on her
>> family. I was touched
>> and inspired by her generosity of spirit.
>>  Later in the evening, Dr. Lozano and Dr.Tasker, the
>> neurosurgeons, came to
>> see me and discuss the operation. Dr. Andres Lozano
>> is tall, with
>> close-cropped black hair and wears plain wire-rimmed
>> glasses. If anything,
>> they made him look younger than his thirty-six
>> years. He had the aura of an
>> ascetic about him. He was the expert in
>> pallidotomys, having done thirteen
>> previous ones at the hospital. Dr. Tasker, known
>> behind his back as "The
>> Lone Ranger", and with a reputation for iconoclastic
>> brilliance, was
>> Lozano's mentor, having pioneered the thalamotomy,
>> where lesions are made in
>> the thalamus, another procedure used to reliving
>> Parkinson's tremors. In my
>> operation Dr. Tasker, although the senior, would be
>> the number two surgeon,
>> learning the pallidotomy procedure from Dr. Lozano.
>> With me they were a
>> "good guy, bad guy" team as they discussed the risks
>> and potential benefits
>> of the operation. Tasker spelled out the negatives,
>> while Lozano emphasised
>> the potential benefits.
>>  The operation I would be having was a stereotaxic
>> pallidotomy. Stereotaxic
>> refers to the finely calibrated metal frame that
>> would be fixed to my skull
>> for the operation. It fulfils two functions: it
>> provides precise three
>> dimensional co-ordinates for the positioning of
>> surgical instruments within
>> the brain; and it is bolted to the operating table,
>> immobilizing the frame,
>> and, therefore the head. Pallidotomy refers to the
>> globus pallidus,
>> literally "pale globe", a part of the basal ganglia
>> which is the deepest in
>> the skull. The pallidus regulates the braking action
>> of the brain; in
>> Parkinson's patients the brakes are being applied
>> too heavily, causing
>> poverty of movement and clumsiness. (Parkinson
>> himself had noted that
>> sometimes, if patients of "his" disease had a
>> stroke, the characteristic
>> Parkinsonian tremor was less evident, although
>> muscle weakness more than
>> made up for the eased tremor.) In the pallidotomy,
>> the neurosurgeons make
>> some lesions on the pallidus which would result in
>> scarring. When properly
>> placed, the scars relieve the patient's symptoms.
>>  Stereotaxic surgery dates back to the nineteenth
>> century when its use was
>> pioneered by veterinary surgeons. It was not until
>> the 1930s that the frame
>> was used for surgery on Parkinson's patients. By
>> today's standards, these
>> early procedures were crude, even barbaric. The
>> procedure was little more
>> than trial and error and the results were often less
>> than satisfactory. In
>> one American case reported in 1951, first the motor
>> cortex was disconnected,
>> then other connecting fibres were cut and finally
>> the head of the caudate
>> was severed, which finally relieved the Parkinson's
>> symptoms. It is hard to
>> imagine that there was much brain function left.
>>  Meanwhile, in the 1960s, the potency of L-dopa
>> medications became
>> recognized as far superior to herbal extracts and
>> their synthetic clones,
>> and to some extent replaced surgery as a treatment
>> for Parkinson's. But
>> L-dopa has its limitations. In my case and many
>> others, it produces
>> dyskinesia as a side-effect. As these limitations
>> became recognized,
>> stereotaxic surgery was undergoing a revolution in
>> technique resulting from
>> the application of computer technology and
>> miniaturization of surgical
>> instrumentation. Technology assisted as well in
>> understanding the geography
>> of the brain and the specific function of many of
>> the parts of the human
>> brain.
>>  As the two neurosurgeons discussed the operation
>> with me, I realized for
>> the first time how much responsibility for its
>> success would fall on my
>> shoulders. I would have no aesthetic because there
>> would be no pain. I
>> needed to be alert and mentally clear so I could
>> give timely and accurate
>> responses to the surgeons' questions, particularly
>> about the location of the
>> optic tract, a scant one millimetre from the globus
>> pallidus, and itself
>> only one millimetre in diameter. Should the probe
>> damage the optic tract, my
>> vision could be impaired. If the procedure resulted
>> in bleeding, a stroke
>> could result, with all the complications that come
>> with it, including the
>> possibility of death.
>>  Somehow, all the cautions and potential problems
>> that Dr. Tasker discussed
>> were insignificant when Dr. Lozano described the
>> potential benefits of the
>> operation: moderation of dyskinesia, easing of
>> muscular rigidity on my left
>> side (the operation was going to be on the right
>> side of my brain ) and a
>> lessening of the reptilian appearance my
>> Parkinsonian mask had given me. Dr.
>> Lozano had estimated the risk of something going
>> seriously wrong at between
>> two and three per cent. The two surgeons were
>> putting benefits and possible
>> hazards of the operation clearly so that so that I
>> would be able to sign a
>>
>=== message truncated ===
>
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