flying elephants

Video from You Tube.

Everyone has their moments where you do something stupid in a spontaneous instant of thoughtlessness and realize immediately afterwards that it was a mistake. Ideally these events are swept under the rug, never to be thought of again; however in reality embarrassing moments tend to be resurrected when you least expect it. Take a lecture of the neuroanatomy of the midbrain for instance. Our brains are amazingly adapted to process the information from our environment and focusing on that which is important. Undoubtedly, circumstances in our environment change and what was once environmental noise becomes acutely salient. Imagine walking down a sidewalk chatting on a cell phone. You don't consciously think about moving one foot in front of the other, nor do you have to visually focus on the stop signs, mailboxes, trees, fire hydrants, and other features you pass. You're aware of them but they don't command attention. In this mental zone, you cross an intersection and suddenly your brain surges and you notice the semi truck charging towards you-immediately stealing your attention and causing you to speed out of harms way. The superior colliculi in the midbrain tectum is responsible for directing this visual attention (FYI the inferior colliculi are involved in auditory processes). To beat a dead horse, this is also the area often involved in the startle response in horror movies ---the dark, eerie mood music before something or someone jumps from off screen and says boo (or worse)!

I first learned about the colliculi six years ago when I was enrolled in Introduction to Cognitive Neuroscience course as a freshman at DU. During midterms, I was having a study group in my room in J-Mac with a neighbor also enrolled in the course while my roommate was on his bed, studying for a computer science test. In a moment of inspiration when we made it to the superior colliculi on the review guide, I picked up my stuffed elephant and chucked it unannounced at my roommate, intentionally aiming to miss his body and enter his peripheral vision to "demonstrate" the function of the superior colliculus. Unfortunately I miss judged my own strength and aim indeed missing Kevin's body instead making contact on his laptop sitting on the desk which proceeded to slide off the edge onto the floor with a loud crash. The unintended consequence of knocking off his laptop with my stuffed elephant did indeed direct the attention of everyone in the room in disbelief both at me and at the humpty dumpty laptop now on the floor. Flushed red I offered my sincerest apology stuttering something like, "i'm so sorry, I was just trying to test your superior colliculi response, I didn't mean to hit your computer, I was just aiming at you..."

Fortunately, my computer science roommate was able to repair his computer without lasting deficits and he even accepted my explanation for the vicious elephant-computer assault. Furthermore I passed my cognitive neuroscience midterm blocking out most recollection of the study session completely. That was of course until last week when I was in a group study session cramming for the Neuroscience Systems exam tracing tracts from the spinal cord through the hind and midbrain sections. Although we were focusing on the anatomical/histological regions of the sections, rather than the functional, I turned to my study partner and said, "you know, the superior colliculi is involved in the startle response...we should test it out!" A little voice in my mind started screaming-NO DON'T DO THAT!!! Do you remember the last time you tired that???


Image from Dr. Bales- G. Bales / Medical Neuroanatomy / Brainstem Topography 3/10/08

Lions in the classroom

I’m not one for horoscopes but this month can’t be high for love and medicine. Within a week three of my neighbors in close relationships have broken up with their significant other; including me. As some of these friendships ended mutually others ugly I am abruptly reminded about the advice given to us during orientation week by a firecracker clinician, “make an investment in your tools (stethoscope, ophthalmoscope, otoscope, and sphygmomanometer) I’ve kept mine longer than my wife.” I refuse to believe that in a career focused around people in need, it is impossible to support the needs of those closest to us, our friends and family. We first need to make an investment in each other to give purpose and meaning to anything else we value…everything else is relative.

Equally interesting is the observation of how we react to the emotional stress of ending or changing relationships with those we value--by running into retreat mode. For me it’s been hyper focusing on school extracurricular---Montclair clinic, Trends in Autism conference, and cramming for Neuro – anything but emotions and the future, only immediate survival. For others it has been an escape home away from the “drama” of campus, and for the third, it has been to hide literally, from his soon to be ex in order to study. I am sitting here learning about the catecholamine drugs--- Fight or flight response –and the impact these neurotransmitters have throughout the body. It is hard to believe that it is as simple as neurotransmitter soup that has made the last few days (and coming weekend) such a challenge. One amazing attribute is the brains ability to override its most basic reflexes— including pain. One of the first tenets we learn in Neuroscience is that pain is a perception of nociception from the pain receptors of the body. You can have the nociceptive response without the pain – we’ve all heard horrific accounts from war heroes who continue without pain-despite mortal wounds, or tales of professional athletes who perform despite broken or sprained extremities. The alternative process—pain without nociception is all too common—chronic pain which can be equally debilitating. In light of that…neglecting emotional distress is probably as pathologic as chronic pain but today feels as necessary as retreating from the heat of battle despite injury that might otherwise redirect all attention.

Homeostasis—the process of being in balance is controlled by parasympathetic’s predominance in the balance of life. This “feed and breed” pathway sets the tone while the "fight or flight" provides reserves when we are threatened and need to escape. It’s amazing that we have a system that can persist by the very fact of forcing you out of balance. It’s equally amazing how any alteration in our proverbial “feeding and breeding” desires automatically throws us into the turmoil of fight or flight, as if we were being attached by a lion, despite the fact it involves those we love.

This semester has emphasized two very important facts --- Exams are NOT LIONS that require a full blown sympathetic response; neither are friends, girlfriends, and family. As med school consumes my life in the process of molding me into a future physician I need to discover ways to remain in homeostasis with my body and my surroundings –not in attack mode. Until then, I hope the adrenaline lasts until spring break when I hope to experience true catharsis.


"...because you can't fight a bear when you're urinating[from the caption]."
Image from Dr. Wong's Introduction to Autonomic Pharmacology lecture 3/10/08.