Sunday, November 11, 2018

The Woman who Sniffed Jasmine

The Woman who Sniffed Jasmine

 Each patient carries his own doctor inside him. They come to us not knowing that truth. are at our best when we give the doctor who resides within each patient a chance to go to work. —Albert Schweitzer, M.D.'
 when I awoke with a piercing headache and began vomiting, my husband, Jim, told me that something had happened in the night. I had cried out, tossed about, and then lay still without waking up. Neither of us knew why or what had caused this strange occurrence, and since I was seven months pregnant, he wondered if he should leave me to go to work. I assured him that I would be all right, and he left. All was well until mid-morning. My three-year-old son was laying near me on the living room rug when I felt a strange sensation beginning. I was stricken with panic. What was happening? What was I going to do? My husband was now thirty minutes away by car. We had recently moved to this midwestern city, and I didn't know my neighbors. If these sensations were a repetition of what had happened in the night, I did not want to go through that experience before the eyes of my little son who was completely dependent on me. The strange feelings increased. I picked up a toy or two and said, "Let's play in the bedroom. Mommy wants to take a little rest." My son followed me into the bedroom and settled onto the rug beside the bed. 
I lay down, hoping he would see nothing, and stared hard at the ceiling. If kept my eyes open, perhaps I could prevent this thing from overwhelming me. The strange sensations grew more powerful, and so did my terror. I stared hard at the ceiling, stared and stared, as the sensations increased. Then, to my astonishment, the feelings seemed to peak, stop, and then recede until they vanished. My heart slowed down, and I dared to blink my eyes. Exhausted, I propped myself on the pillows and spoke with my little son. He had noticed nothing. The rest of the day went without incident. I was bewildered and tired, but there were no further episodes. That evening, however, with my husband at home and our son in bed, I was struck by another massive seizure. The next thing I knew it was morning and I was in a hospital bed. A strange doctor standing beside me was saying that he thought it was epilepsy. Epilepsy? I stared at him in disbelief. He wanted to do a few tests, he said, some x-rays of the head. A day later he was sure of his diagnosis. It was epilepsy. Again I stared at him. I had epilepsy? Epilepsy! A small voice inside me told me that I must never tell anyone. 
This disease was not socially acceptable. When my husband came to the hospital and learned of the diagnosis, we simply looked at each Other, both of us agreeing without words that we must keep it a secret. Another, weaker voice also spoke, telling me that epilepsy was unusual, rather interesting, but it was silenced by the stronger voice of fear. The doctor said he was going to put me on phenobarbital and Dilantin, two medications that should take care of the problem. Luckily for me and my unborn son, my pregnancy was into the third trimester and the fetus was not affected by these powerful drugs. It was not until three decades later that these drugs were recognized as potentially damaging to the fetus, especially in the first trimester. From that time on, I took the medication compliantly, trusting that it would work, and it did, Several years passed. I then decided on my own that I no longer needed the drugs and dropped them. A massive seizure occurred a few
months later, and I returned to the medication. I consulted eminent neurologists and went through diagnostic tests that became over time more sophisticated and more dependent on increasingly higher technology. I learned a little about my case—that the discharging lesion lay in the left temporal lobe of my brain and what the seizure spikes looked like on an electroencephalogram the diagnosis never changed nor did the treatment. When I was able to reflect on the initial diagnosis, I realized that the episode was not my first seizure but the first one to be observed by someone else. I had been aware of these feelings previously, but since they were minor episodes, I had not realized they were actually epileptic seizures. I had blamed these "feelings" on everything from fatigue to nerves. Now, thinking back over those early seizures, I am astonished to see their similarity. The seizure pattern over the years was always the same. They were all massive seizures with unconsciousness and some convulsion, the grand mal seizures that are synonymous with epilepsy. "Garden-variety epilepsy" one neurologist called it. In addition, I seem to have had the ability, when the seizures threatened during waking hours, to recognize the advance warning, the "aura" of fear and panic, even though  I did not know such signals could occur. When I recognized the aura, I was able to exert control over the oncoming seizure. Nevertheless, it took me decades to learn that I could use this awareness of the aura systematically and consciously to stop a seizure from developing. What astonishes me most now is that I immediately knew that I must never tell anyone about this affliction. If I did, I would be ostracized from normal social functioning. Although I was and am habitually curious and inquiring, I asked few questions, even of my neurologists. I sealed off my epilepsy in a secret compartment deep inside me. Only my husband, my parents, and my brothers knew. Epilepsy was a degrading thing to have. How did I know this so instinctively at the instant of diagnosis? I had never thought about epilepsy before or been around it. Was it some buried residue from high school

English class where we read Silas Marner, the story of the linen weaver whose spells of epileptic unconsciousness brought false accusations and ostracism? I doubt it. I did not know then that the fear of epilepsy and the social stigma it continues to carry deeply affect everyone who has it. The very word seems to activate the most human of terrors, the fear of losing control, of losing the self, the shame of making a degrading public spectacle of yourself, the fear of death. It did not occur to me until years later that seeing epilepsy as "bad" was a perception, and one not held by all other cultures in the world, or even by all persons within our own culture. The medication controlled my seizures. For a long time I swallowed it and was silent. I took anticonvulsants for two decades and had complete control over my epilepsy. Then, twenty years ago, I became aware of new approaches to health and healing, and I decided again to take the risk of going without medication. Over the course of a year or so I eased off the Dilantin and phenobarbital I had taken for twenty years. Abrupt cessation of anticonvulsants can precipitate seizures, but I didn't know this at the time. I was simply afraid to stop. At the same time my diet and life-style had changed. I learned yoga primarily to relax and strengthen my back fatigued by long

same time my diet and life-style had changed. I learned yoga primarily to relax and strengthen my back fatigued by long hours at the typewriter. But in the process, I discovered the astonishing benefits in relaxation, in deep breathing, and in the practice of meditation. Osteopathic treatments helped me with the tension in my neck and shoulders. Over the past twenty years only two grand mal seizures have occurred. There have been some lesser episodes but nothing major. Eventually I began to wonder, what was I doing—or not doing—that accounted for this dramatic reduction in seizure activity? One day I was talking with my neurologist about seizure reduction, and he said, "You know, you should read Robert Efron's work. You'll find it in the neurological journal Brain for 1957, maybe 1956." I went to the closest medical school library, found the journal, and under the unlikely title of "The Conditioned Inhibition of Uncinate I read a story about a woman who sniffed jasmine. Dr. Efron's patient was a concert singer whose seizures kept her from pursuing her career. Each seizure was preceded by a warning signal, an "aura," that manifested itself as the halluci- nation of a disagreeable smell. Dr. Efron gave his patient a small vial of essence of jasmine to sniff whenever she hallucinated this bad smell. It enabled her to stop her seizures before they went full course. Later he taught her through a process of conditioning how to imagine the odor of jasmine and stop her seizures by doing so. When I read this account, I was astonished. Once again I looked at my own case and wondered. I remembered my experience of holding off a seizure as my three-year-old played on the rug beside me. In the opening paragraph of his article Dr. Efron noted: "Seizures spontaneously arrested during the aura are reported by almost every epileptic from time to time. "3 As I read this, years after that episode took place, my personal experience of epilepsy was validated for the first time. Had I unwittingly found a way to arrest a seizure? Did the diet and life-style changes I had now made constitute my own version of a sniff of jasmine? Since then I have talked with many people who have epilepsy, and almost everyone has a similar story to tell of how he or she stopped a developing seizure. This curious experience of having some built-in control over a terrifying event—the sudden discharge of excessive electrical activity somewhere in the brain—opened my mind to new possibilities. Now I began to read more and more research studies that revealed we have much greater control over the unconscious processes of the body than we had formerly believed possible. Soon after I read Dr. Efron's case study, I learned of the Mind/Body Workshops, an innovative program in self-care then being held at Beth Israel Hospital in Boston, and I wondered if the techniques taught there by Joan Borysenko and Steve Maurer would have an effect on seizures. I spoke with them, and in their next group I became part of an informal research project to investigate that very question. There were two of us: a man of about thirty whose seizures began after a construction accident and myself. One

of the techniques we learned during the ten weeks of the course was deep meditative breathing. Unknown to each other, we were both beset by seizures. When my colleague's massive grand mal seizure began with an aura of fear, he was able to use the deep breathing, dispel the fear, and stop the seizure from developing. My seizure or seizures involved a series of sensations of something taking me over like the ones I described at the opening of this book. This time, however, I was able to keep my body relaxed by closing my eyes, instead of staring hard at the ceiling, and breathing deeply. Just as they had years ago, the sensations peaked and receded. This time, however, I was able to dispel the fear. The episode was strange but pleasant, rather interesting, and not frightening at all. After this experience, I was filled with great excitement. What else might reduce or control seizures? I had learned of biofeedback in the Mind/Body Workshop, and now I went to the Menninger Foundation in Topeka, Kansas, for training in its laboratory for the Voluntary Control of Internal Processes. There, under Elmer and Alyce Green' and Dale Walters, I learned methods of biofeedback that enabled me to control the temperature of my body, warming it at will. I learned how to relax my muscles and how to recognize the emotional effect of words, phrases, and tasks that increase or decrease the body's tensions. Particularly important for epi- Iepsy were the brief experiments done with electrodes at- tached to my head to pick up the brain's electrical dis- charges. These showed me that even with a modicum of training the brain's electrical discharge could be altered voluntarily. I came home to investigate diet and found by reading the research that certain diets and certain nutrients helped to make the brain function normally. Of greatest interest to me were the many techniques available to arrest a seizure. Some were the simplest of behavioral methods. Others were like the smell of jasmine and involved sensory input, while still others depended on visualizations and complex mental images. I will describe all of these techniques later in this book. What I have come to call my education through epilepsy led me into the long history of this disease,'disorder and into the ways in which other cultures regard and treat it. It was illuminating to discover how our current biomedical view has appeared only recently. As medicine has changed, so has epilepsy. As historical and cultural contexts have shifted, epilepsy has been seen in a different light. I searched through the anthropological literature and discovered that our western view of an epileptic seizure was not held by every society. Some cultures saw epileptic seizures as an evil, as the peoples of western Europe did a century and more ago, but others saw the seizures as the potential for great spiritual healing and divination. In those societies, people with epileptic seizures were not medically treated but trained for these great callings. This cross-cultural and historical view opened my mind to a broader perspective on epilepsy than the one I had before. What's more, I discovered that there are neurologists within biomedicine, such as David Bear, M.D„s who have taken into account the many historical personages who have had epilepsy or whose behavior suggests that they did. Would these people and their contributions in the realms of art, literature, religion, and politics be lost if epilepsy or the neurological conditions that underlie it did not exist? The question remains unanswered.

All of this material I found for myself by reading through the literature of neurology, psychology, medicine, and anthropology. Why had no neurologist ever mentioned any of it to me? I can only answer that question by citing Dr. Efron 's introduction to this book. The education of the patient, and even more, the training of the patient in personal health care, has been neglected by modern medicine. The constraints of medical training, and a doctor's work load and fee schedule, limit what a physician is able to do and what a patient can afford. Once my. initial doubts were allayed, I grew more confident that the methods of self-care that I had stumbled upon could indeed be applied to seizures. Although I knew that they worked for me, I wondered if they would help others. The more I talked with people with epilepsy (I was really out in the open now) the more I realized that these methods would help many others as well.

My conviction was confirmed when I met a young neu- rologist in the Boston area who was also interested in a more broad-spectrum approach to epilepsy than simply the diag- nosis and the treatment by anticonvulsants. With him and a psychiatrist, I began to give workshops for persons with seizures. The object of the workshops was to educate people about epilepsy and teach self-care skills and practices that would reduce the need for medication and help to control epileptic outbreaks. The experience of teaching these workshops has been particularly gratifying to me. Almost everyone has been helped in some way. People learn about the neurology of epilepsy, information that had not been available to them previously. They learn and practice self-care methods that improve general good health and reduce exacerbating con- ditions. Most come to recognize the debilitating effects of stress and tension and the remarkably restorative powers of deep relaxed breathing. When anyone reports the astonishing experience of blocking a seizure, it's always the highlight of that session. Particularly valuable, I believe, are the moments when someone says, "I can't believe I'm saying this to a group of people," or ' 'I've never mentioned this to anybody but my  doctor." Then I know that the secret compartment deep within has broken open. I have followed a number of participants in these workshops over several years. They continue to use the techniques with success in reducing their seizures. You will hear from them throughout this book. Primarily, however, I am a writer, and my research and experiences from the workshops began to take shape as journal and magazine articles. As I was preparing my article, "Self-Help for Seizures," for the magazine, Medical Self- Care, the editor. Michael Castleman, sent me a workbook put out by the Andrews/Reiter Epilepsy Research Program in Santa Rosa, California. To my amazement, I found many of the methods and techniques that I had come to on my own being used by a neurologist and an epilepsy counselor who worked with him. They, too, had found the new approach to epilepsy.

In the course of writing my article I talked with Dr. Joel Reiter on the telephone, and he expressed his concerns, long-standing since his days as a resident in neurology, about the toxicity of the medications used to treat epilepsy and the ineffectual treatment for some kinds of epilepsy. Since then we have met, become friends, and it is my pleasure to have Joel Reiter as collaborator on this book. The years of study, research, and experience that have led to this book have been full of surprises and astonish- ments for me. Not the least of them is how one whiff of jasmine opened and altered my life. It awoke the "doctor inside" me, to use Dr. Schweitzer's words, broke the seal on the hidden compartment marked "unacceptable affliction, " and stimulated my curiosity and inquiry in many new directions. One sniff and I set off on the healing journey that led to this book.

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