Tacking on the Styx

The trail had no features where he’d left it, running straight and flat in both directions. When he re-entered it, which way he had come from, only ninety seconds ago, slipped beneath his consciousness. By chance, he continued further in the right direction, but the river looped back close to the trail where its increasing noise confused him. He forgot that he’d come a long ways from where they had earlier crossed it, hence its renewed noise must be coming from a second, altogether different location on it. That simple calculation didn’t materialize for him. Now he reversed course and backtracked a hundred feet in the wrong direction. His thoughts continued failing to fully complete themselves. He sat down on the trail, fished his tranquilizers out of his bag and placed one under his tongue. He continued sitting and began to feel panicked. Suddenly a small, sharp pinching sensation arose from his left calf muscle followed by another, and a third higher on his thigh. Looking at the ground, he saw a thin reconnaissance stream of safari ants running alongside of his foot and only some seven ants wide. Like their Amazonian cousins, the army ants, the safari ants spread out in thin columns, attempting to eat anything that moved while sending news back to the main mass of the nomadic colony. He quickly shifted his leg to the side, stood up, and strode forward six paces, all the while struggling to think articulated thoughts as well as keep his balance. Seeing no more ants beneath him, he stood still and tried to remove his pants without first removing his shoes. He fell over onto his knees. Then he sat back onto the ground and removed both shoes and pants in proper order. He brushed six ants off of his calf. He pulled off two which had clamped onto his upper thigh and one off of the right leg band of his briefs. Pulling the waistband away from his body, he looked in and saw only his own belongings. They could have belonged to somebody else for as connected as he felt to his entire body now. While still struggling to complete a thought, he inspected his pants with shaking hands. After killing five more marauders, he lay his pants over his knees and sat still for what felt like several minutes breathing alternately deeply and weakly. What would the renowned wildlife spokesman, Marlin Perkins, think of a man sitting alone on the damp forest ground, trembling in his underwear, pants in his lap, shoes to the side, and feeling beyond incoherent in an African woodland? His eyes watered, and he barely suppressed the sudden urge to cry. Remembering Marlin Perkins was a benchmark of returning normality in his brain - a break in the mutism. The tranquilizer had begun pushing his thoughts back together. “Safari ants?” the man who was Geoff asked now standing over him. He had finally backtracked, confused by Tom’s failure to catch up. “Yeah,” Tom mumbled with a sniff, just now finding his speech. “I did the strip search routine yesterday when you weren’t around. I can’t stand those damn things,” Geoff replied. ------- “In college psychology class, I remember seeing a chart with a map of all these different body functions mapped out on the brain,” Tom continued. “It was all anatomical stuff. It doesn’t seem too hard to think that if somebody removes a part of your brain where an arm maps to, then you might have permanent difficulties using the arm after surgery. So where is the emotional stuff? Does that map someplace on our brains somehow? Do I go into surgery wanting a wife and come out wanting to join a monastery? Do I get some inappropriate interest in children? Do I just stop giving a darn about everything? My doctor has never talked about that sort of thing. If an arm maps rigidly onto a brain, how do we know that an emotion isn’t just as rigid? Where does psychology fit into all of this? Do you think that maybe any psych doctor has bothered to counsel me in any of this? No! Like what the hell is their problem? Are shrinks really that useless? If a doctor doesn’t have the balls to talk to you about the psychology of having part of your brain carved out, then they should find another damn career! I want to know how much of our brains are some sort of mosaic that can fraction into pieces, and nobody will tell me. Do my likes and dislikes change a little, or do whole parts of me go missing? I’m not about to die - at least not very quickly! This whole operation stuff is still a judgement call, and I’m still in charge of making the call... more or less. But discretion without education stresses a man... stretches a man pretty thin!” ------- Children of women with epilepsy have an increased risk of having a major congenital malformation, i.e. a birth defect, that is roughly twice that of the general population. Epilepsy, in and of itself, does not appear to increase the risk of major congenital malformations. Rather, risks for birth defects appear to stem from a mother’s drug therapy regimen. Multiple studies have found that one drug, in particular, imposes a risk of birth defects when taken by the mother. That drug is valproate, and it has been associated with increased risks of spina bifida, cleft palate, polydactyly, autism and several other problems. Reviews of medical research have found the overall risk of an abnormality in a newborn with prenatal exposure to valproate to be between 7.5% and 10.7%. Case reports have also linked it to autism. Multiple studies of children with prenatal exposure to valproate found them to have a lower IQ than those having exposure to other anticonvulsant drugs. It should not be used as a first choice drug for women who are reproductively active. Carbamazepine also has some risk to it both for deformities and low birth weight. Multi-drug treatments in certain combinations can have an increased risk of malformations in offspring as well. Therefore it is essential to strike a balance between the risks to both a mother and her unborn child of seizures in pregnancy and the risks of taking anticonvulsants, and women need to be counseled accordingly. ------- Today epilepsy is generally associated with hyposexuality or a day-to-day decrease in sexual drive and activity. One operational definition that has been used is becoming sexually aroused no more than once a month. However, the view of epilepsy’s correlation to hyposexuality has not always been pervasive, and even recently some people think that hyposexuality is overstated. The relationship between sex and epilepsy exists at several levels - behavioral and anatomical events occurring during or close to a seizure itself, complex hormonal effects caused by seizure activity or the effects of medications, and also social factors relating to stigma, self esteem, unemployment, inability to drive, and any number of other non-physical factors which complicate relationships. Hyposexuality may arise primarily by the effects of hormonal imbalances in epilepsy caused, in part, by medication and also by seizures themselves. As such, hormonal effects on behavior will not have been understood or appreciated prior to a 20th century understanding of neurophysiology and endocrinology. Furthermore, hyposexuality often manifests within statistics (e.g. how much ordinary sex is the average patient having?) and, thus, it will chiefly be revealed by surveys and record keeping. For a patient to report that they are having less sex than they once did will not likely inspire a case study. On the other hand, hypersexuality, often inclusive of bizarre behaviors and physical responses, can be more attention grabbing. Hypersexuality might not require a statistical sample to discern to the same extent that hyposexuality does - a case study of one or several individuals will readily get reported in a medical journal (and in this book as well). However this circumstance leaves it’s occurrence open to exaggeration even within the medical community itself.