“Scleroderma,” the rheumatologist said after examining my stiff swollen arms and legs. “Unfortunately, given your biomarkers, it’s likely to get worse before it gets better, but you never know.” She gave a quick rundown of what I might expect—rapidly progressive skin and joint tightening, GI symptoms, high likelihood of multi-organ involvement…. “Let’s hope for the best.” She paused, then asked if I had any questions.

A middle-aged woman had a massive stroke and would be dead within hours. The husband was in the ER waiting room. I took him aside and explained the grim prognosis. He paused, his expression blank, his lips searching for something to say. Finally, he blurted out, “I think I’ll go home and take a shower.”.

Symptoms of ConsciousnessIn this series of short essays, stories, poems, and personal observations, Robert A. Burton, neurologist and writer, uses both fiction and nonfiction to explore many paradoxes and contradictions inherent in scientific inquiry. A novelist as well as author of On Being Certain and A Skeptic’s Guide to the Mind, Burton brings story to science and science to story.

While window-shopping for his wife’s birthday, a businessman was struck by a speeding taxi that jumped the curb at 55th and Madison. In the few minutes it took the ambulance to reach the University emergency room, he had lapsed into a coma. Brain imaging revealed a large blood clot compressing the brain. The only hope for his survival was immediate drainage of the clot.

Given a strong family history of early heart attacks, the future has always been an iffy proposition. Miraculously, I have bypassed the early off-ramps and find myself approaching 80, stents in place, considering the very real but previously unimaginable possibility of still more. But what kind of more? With dopamine on the wane and no longer supercharged by the push and shove of unbridled ambition and pride, bigger and grander are out of the question. Tired clichés poke through the widening (...) cracks in my thinking to become uninvited bulletins of compromise and consolation. Be grateful. Relax, reminisce, enjoy sunsets, learn the backyard birds’ names, maybe even sing to them, and count blessings. (shrink)

The cardiac rehab nurse calls out each of our group’s blood pressures and pulse rates. It is my first posthospitalization class and I am relieved to be in the middle of the pack. Although fully aware that numbers are not fate, I cannot help wondering if the worst performers will fully satisfy the dark needs of heart disease statistics. I presume that others are making similar calculations, yet wince at the ugly direction of my mind. Maybe it is not necessary (...) to do better than another; if we take our meds, eat wisely, and exercise to the max, it is possible that our entire group will do well. (shrink)