Saturday, August 22, 2009

Disorderly conduct

Isn’t life strange? The whole continuum unfolds one decision at a time. Each day, each hour and minute we take the fork in the road and what follows is life. Change is continuous always clamoring to add that delicate spice to make the whole better. Parallel universes aside the linearity of events dictate the outcome, from each cell to the entire organism.  Origins are the possibilities of endless quests and endless desires. The road to these quests, collapse the possibilities into realities. It is as if sitting in your living room you decide to take a walk instead of fill the empty bowl with ice cream and resume watching television. One probability collapses while another one becomes real. A living cell continues on the same path of probabilities, constantly being barraged by a slew of inputs. The greatest input or the largest collections of similar inputs force the cell to proceed in its course of action. Does the cell have memory? A question you can only ask if you have one too. Of course the cell has memory. It resides in the matrix of a complex interior. Like the Immune modulatory cell remembers the vulgar attacks of an allergen, stimulated, it releases its cast of characters in the blood stream for the body to fight off the offending agent. Sometimes the cell is forced by external or internal inflicted damages to commit suicide to save the rest of the body.  And other times the body cannot tolerate this selfless act and the whole body goes into a dangerous state of flux. The brain functions on a similar plane. Weeding out the tall grass to keep the surface smooth and even.

Life takes turns from roads well traveled to those less traveled and vice versa. Decisions manufactured in the mind create the impetus for the direction. These decisions arise as a consequence of the entire brain at play. The pre-frontal cortex is the arbiter of such directives. The question being mulled in the brain continues to swirl between the temporal lobes (located under the temples) and the frontal lobes, coursing the highway between the to two sides of the brain called the corpus collusum. After such contemplative issues have been hashed the pros and cons weighed then the judgment comes down from the pre-frontal cortex. The weighing of such decisions are balanced with the fears and anger, hopes and desires, submission and extroversion, past and the potential future information residing in various niches of the brain, before the pre-frontal cortex visits the decision well. In spite of such a collective force of thought, the decisions are not always perfect. The fudge factors are always at play, for knowledge and information is never complete. That is what makes us humans. This imperfection of sorts, this final turn of the roulette wheel is how we become who we are. Perfection is only in the mind. Actions reek of imperfection. Overall though a properly functioning mind will see the road of it's desire and plunge headlong. Yet sometimes these desires are drowned by elements out of human control.

It was a Monday, the day that awakens with much hope and desire. The morning had slowly slipped into finding the sun fully ablaze overhead. The usual bustle of the day-shift nurses mulling in the cafeteria to discuss their personal problems or that of their wards in the hospital made quite a buzz. Cell phones on mute vibrated their owners of incoming calls making them leave the table amidst juicy conversation. The culture of this environment feeds on its participants. The stories, some exaggerated, some real, some perceived all blended are those that finally make it out of the environment for further mixing and churning outside. The constant obsession by the outside over this environment within remains a subject of journals, newspapers, books, television and the big screen, challenges the mind. To the outside it is a microcosm of the world itself. Life, death and all in between hashed out on paper or digital 1 and 0. This coveted sanctuary is the hospital.

A sudden crash of silverware silenced the cacophony. All eyes diverted to the direction of the sound. A pile of scrubs lay on the floor covered with the remains of her lunch. Some spaghetti strewn across the floor made the housekeepers scamper to this person’s aid.

After much ado and deliberation the stricken woman got up with bewildered unfocused eyes. She stumbled but managed to keep her station intact. After a moment of sway she seemed to conquer her sudden loss of stride. Her gait now steadied she continued to walk with her soiled tray and placed it in front of the cashier, who looked at her with confusion. The lady stood there as confusion mounted on both sides. The cashier asked politely, “Can I help you?”

“Yes. I’ll pay.”

“But you have nothing on this tray.” Cried the cashier.

“I do. See all this." the lady said and pointed to her tray. "I don’t want to jip you.” 

“But there is nothing on this tray, except some left over sauce covered spaghetti?”

“Oh. Oh. I, I can’t think... I have a head...” With that she collapsed under her own weight. She could not concentrate on the act of concentration. The smooth graph lines of her brain function had suddenly turned chaotic. Order had morphed into disorder. While this riot of the mind continued to unfold the outside world, efficiently and quickly, marshaled it’s collective insight to help her. A slew of barked orders and someone had taken charge.

There were many witnesses to the event. The diagnostician, a neurologist determined after an MRI that the lady had suffered a cerebral bleed –a stroke. The cause was a small berry aneurysm located near the parieto-temporal region on the right side. In those few minutes was manifested a complete picture of the brain in a state of disarray. Confusion preceded indecision, which was followed by a disaffected action. Was confusion the driving force or was it the warbled messaging that entered the pre-frontal cortical cells. Her confusion and the resulting actions were disproportionate to the moment. The brain cells (neurons) inundated with a flood of blood fired, misfired or simply quit and the highways of orderly flow in the axonal (neuronal fibers) bundles sent misguided messages adding to the disorderly state. Confusion therefore had followed disorder.

The lady, a nurse, recovered fully. She was lucky to have been in an environment suited to care for such an occurrence. Medicine had subsumed another calamity. Another life had been helped. And another mind was cleansed to make real decision based on life-lived experiences.


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