I giggled because I am a child. However, Isidore Geoffroy Saint-Hilaireactually studied extensively abnormalities in physiological development and he actually looked at the congenital disordercyclopia. (Don’t click unless you want to see grotesque physical malformations.) Rhinencephala are those born with a specific form of cyclopia, rhinencephaly, which is characterized by a proboscis protruding from the head. (See previous click warning.) Rhinencephaly can be present with edocephaly, which roughly translates to genital-likehead, because the proboscis from either actually looks like a penis stitched on a head. But edocephaly is a type of otocephaly, which is a (lethal) cephalic disorder of the lower jaw, while rhinencephaly is a type of arhinencephaly, which is a (lethal) cephalic disorder of the nose.
The prefix rhin- means of the nose. (See also: Etymology of rhinoceros.) The proboscis in rhinencephaly is a nasal malformation. Arhinencephaly is the congenital absence of the olfactory system. And if you’re not confused enough, the rhinencephalon is now the part of the brain concerned with olfactory functions, arhinencephaly is now called holoprosencephaly, and cyclopia is a type of holoprosencephaly known as alobar holoprosencephaly.
But rhinencephaly is still rhinencephaly, so at least something consistent.
This was posted on Twitter but I wanted to post it here because I’m self-absorbed and self-advertising and I also can’t emphasize enough how arrogant and myopic someone must be to sneer at “social justice” and “social justice warriors” for overreacting, being too angry, and not doing “real” activism. My activism may not be your activism but if all you have for me is criticism about how I am so aggressive, then you are not engaging with what I am saying. You are the one polluting social justice with your dismissal. You are the one choosing to silence me.
Because this phenomenon often happens down the privilege hierarchy. A white person telling me that I am too angry is being racist. An abled person telling me that I am too angry is being ableist. A man telling me that I am too angry is being sexist. They are using their privilege to muzzle me. I don’t have the privilege to strike back. I won’t get the same result. It’s not the same thing.
Brosh’s experience with depression isn’t exactly like mine but there are some things that are exactly right. For example, this is every conversation I had with almost everyone who asked about the details of my depression:
This was me last week, minus the concerned questioning boyfriend:
I had the urge to cry continuously all last week. No matter where I had to be or what I had to do or who I was with, I was ready to burst into tears at any moment. It was so inexplicably frustrating. I had shit to do but all I wanted to do was cry. It took all my energy not to cry so I had no energy to do shit. Finally I got to the point where I did shit while crying. Still annoying and still not that effective but shit still got done, yo.
It’s hard facing a world where it’s acceptable for only certain illnesses to be seen. It’s even harder when the one of the symptoms of the illness is wanting to die. (Often you want to die as a result of symptoms from other diseases making your life a miserable hell but that is often more accepted because people can see how your life is a miserable hell.) Death is a severe subject and people often feel obligated to keep someone from dying. Depression is a bother for everyone, in one form or another.
For me, depression is the default state of life (unless I am hypomanic). Sometimes I’m lucky enough to enter remission. But when depressed, wanting to die is normal. I wake up expecting to want to die. I go to sleep expecting that I want to die the next morning. It’s a pleasant surprise when I don’t want to die (and not hypomanic). If there is anything I want people to understand about depression, it’s how wanting to die is normalized. No matter what face I show and no matter what I say, there is some part of me that doesn’t want to exist.
But that doesn’t mean that I don’t get shit done. It just takes longer because I am sick. Time and energy are used for basic survival, to just reach baseline for the healthy.
She told me that there are triggers for mania just as there are triggers for flashbacks. So of course there are triggers for depression. All the pieces fit: performance stress, sleep deprivation, major changes in living situation, losing a significant relationship, and just plain ol’ winter. Then she told me that I am being anti-social. No, I haven’t been the social butterfly I was, but November, December, and now January were unkind to my emotional stability. I could ask what I could have done differently, but those days have passed. Honestly, I am too tired to introspect. More, it’s too dangerous. I’ve been thinking about self-harm again.
She asked if I were okay. We’ll talk, she said, and I knew that something must have given it away. Maybe it was my face. Maybe it was my voice. Maybe it was both. I wouldn’t be surprised if our conversation went something like this:
In a major depressive episode, I have significantly less energy and significantly less interest in being nice to people. Unfortunately, both limit one of the best solutions to stop myself from killing myself. When you don’t have the energy, it’s hard to socialize. When you don’t have any patience, it’s hard to be someone people want to socialize with. More, it’s been hard to be honest. The simple question How are you? becomes complex. How do you easily and politely state that there is something terribly wrong and not make the conversation about you?
Then I realized that’s exactly what you do.
You say things like I’m not feeling that well or I’m a little under the weather. That is the truth. You are sick. If they ask, you sincerely say it’s depression and thanks for asking. Normalizing depression makes me feel less awkward talking about it, which makes other people feel less awkward facing it. The conversation moves on and everyone can have a good time.
I’ve been too tired to be social. Then I’ve been too afraid to be social. I said to her that there is a difference between staying in bed for self-care and staying in bed because you can’t leave. As tired and irritable and wanting to die as I am, I don’t want to be tired and irritable and wanting to die just because I don’t want this to be my life. More accurately, I don’t want this to be my death. No, I don’t want to die in bed. If I am going to go, I will do it some other fucking way and fuck me if I am going to expire before I finish goddamn school.
The non-sensical stubbornness that’s gotten me into so much trouble may be exactly what’s saving my life.
When people don’t understand why I am returning to academia’s heavy hand, I tell them that I was a precocious little shit. In a first-generation Taiwanese-American household, any interest in scholarly pursuits was encouraged and the resulting pain from pursuing such pursuits was normalized. Certainly some of that pain had external sources but some was self-inflicted. Many nights I would not sleep because I liked to read too much. Once, in a perverse combination of curiosity and stubbornness, I read until sunrise because I read about how the sky changes colors as the sun crosses the horizon and I wanted to see what that was like first-hand. Barely in second grade and already I was training my body for an irregular sleep schedule in the name of scholarship.
Some years later, my body decided it was time to sexually mature. Because I liked to read, I already knew all about menstruation, and immediately I went to my mother to ask for menstrual products. However, though I knew the biological mechanisms behind menses, I had no idea what the social norms were. At ten, I was still young enough to conduct bathroom activities in front of family members. Imagine my father’s surprise when he learned that his daughter has entered puberty.
The adults talked over breakfast. My father said something about how the timing seemed really early and my mother said something about how she didn’t know why but it was what it was. I said that though my menarche appeared to be early, it was still within the range of healthy ages of onset. I also noted that one of the factors contributing to menarche is body fat percentage, and I briefly displayed my pudgy midsection and limbs.
Then I pulled out the book. When I was a younger young thing, my parents gave me a book all about the body. I spent many late nights flipping through the pages, reviewing how we smell, the processes of the digestive system, why some people need vision correction. I knew exactly which page had the information to support my argument.
I was ten and I was citing my sources.
Say what you want about the dysfunctional relationship between Asia America and academia. Some of us, I think, have some natural talent for scholarship. We have the skills to learn quickly enough, the inclination to observe and explore, and the confidence to report and defend our results with enough supporting data. It just took another few years before I learned how to present with PowerPoint.
HE:Read your blog entry. If I had solutions I would share them. Best wishes to your own sleep schedule, as well as your emotional, hormonal, psychosomatic struggles, or whatever other label you prefer to place on them. But I will say this: we, individually, do learn more from experiencing a thing than from simply theorizing about it.
ME:Thanks! You are super sweet. But qualia are still not real.
Admitting that you are rebounding is admitting that something was there. It’s easy for me to be honest with myself, but to be honest with others is terrifying. I perform independence and nonchalance, so well I could almost believe myself. But to be honest is to admit that revealing heartbreak is revealing vulnerability. I would show my true face: I am an eager romantic. I have a heart to be broken. Out there, I would be eaten alive.
He is honest with me, but I wish he could be honest with himself. The mixed signals are confusing. His silence is disappointing. They all told me for months that it wasn’t fair to me, but I stayed because that’s no good reason to leave. Everything else was so good we could pretend that it was all good. But to be honest, I knew that he knew that there were problems.
And they are all his. We’ve all said it. They’re his problems, not mine.
Worse, there is nothing I can do. I can’t process his feelings for him. I can’t help him translate what he wants when he doesn’t know. I can’t will myself out of this sadness. I can’t do anything. No, there is nothing to do but for one more thing: Let it go.
To be honest, I don’t want to. But that’s no good reason to stay. They all say that I deserve better, and I know that they are all right. I just think it’s funny that just one thing is just that one thread that unravels everything else.
SHE:Clint and Tasha teaching Steve about sexual mores of the future? With kink occasionally going wrong? And then people being adults about it and working through it? I thought that might be something of interest to you.
I’ve started on Fox’s new neo-noir cyberpunk police procedural Almost Human, and I’ve been pleasantly surprised. (But then I didn’t start with high expectations. But then I generally don’t start with any.) J. H. Wyman may have been showrunner for Fringe, but Almost Human lacks its subtlety and atmosphere. The opening title cards and voiceover narration are ridiculously heavy-handed, seeming to belong to a second-rate production or one from an earlier time, and the setting is far too shiny, too sparkly, too sunny without any trace of self-awareness to be truly noir. Kevin McFarland at the A.V. Club dubs the show Blade Runner: The Procedural. I laugh in agreement because it’s clear that Almost Human is attempting to funnel the philosophy of tech-noir into the tone and execution of the procedural (except for the opening credits, which will eventually drive me up the wall because of the inconsistent visual language).
Even with those criticisms, Almost Human does very well centering the show around the relationship between its two protagonists, human Detective John Kennex and his android partner Dorian. The two men have good on-screen chemistry. Karl Urban, who plays Kennex, is a battle-weary but still genuinely warm cop, and Michael Ealy, who plays Dorian, is the talented and good-natured rookie. However, added to that classic cop buddy dynamic is the inherent class difference between being human and not quite human. Many times in the pilot episode Kennex calls Dorian “synthetic”. Dorian is not a “real” human being, even though he may look and act like one. It may also be an accident that Dorian is black while Kennex is white, but regardless of intention, one can’t ignore the implications behind the casting. As the show progresses, the relationship between Kennex and Dorian quickly falls comfortably into a partnership, so the message is not that Dorian and others like him are inferior, but there is great potential for Almost Human to explore the perception and embodiment of humanness through how the characters interact with each other.
And again, however overtly it came across, there’s an element of race at play in the interaction between androids and humans. Kennex keeps asking Vanessa [a black android] the wrong questions during an interrogation. He can’t get on the right mental wavelength to ask the right questions. As a fellow robot, and the black lead talking to the only black supporting character in the episode, Dorian knows what to say. I don’t think there’s some grand statement being made in these interactions, but there’s a pattern at play relating racial interaction in real life to how humans (or secret robots) interact with almost humans—Dorian’s robot with a soul, or the sex bots with human DNA in their skin—in the world of Almost Human. That is subtext I find most encouraging—that this show could have something complex to say.
Likewise, I am very interested in what this show could say about class or racial relations. (Already in the second episode, there is a strong statement about misogyny and sexual objectification: Even given safe and hyperrealistic alternatives to human women, men would still literally strip from women their bodies and turn them into sex toys.) I feel comfortable watching a show that is aware of societal power structures and the importance of on-screen personal relationships. I would even grit my teeth through the opening credits and elementary existentialist musings. Now if they would only strengthen the two female leads beyond romantic interest and boss, Almost Human could be a very good show.
Postscript - The amount of Blade Runner references is absolutely ridiculous. Blade Runner is set 37 years into the future of 2019; Almost Human is set 35 years ahead in 2048. In the second episode, Sebastian Jones, a man who creates sex androids, is found dead; in Blade Runner, J.F. Sebastian is geneticist who creates his own companions. Also in the second episode is a hotel called the Deckard Gardens Hotel, obviously named after Blade Runner protagonist Rick Deckard. I may have to grit my teeth about the heavy-handed homages, too.
The psycheval lasted five hours. Unsurprisingly, I was exhausted at the end of the exam. Surprisingly, I reported uninterrupted emotional security and stability for the previous two week period.
There is a first for everything. (Yes, I still feel stable and secure.)
I’ve been shuttered in and out of doctor’s offices, taking exams and giving medical histories, for over a decade. Beth Israel was new, but hospitals weren’t. I even took the WAIS twice before; many tests were instantly recognizable. Still, a few things:
Medical providers are forever grateful if you bring in related documents for them to keep. Makes their jobs so much easier. (I don’t expect to change provider teams anytime soon, but I anticipate reporting my medical history multiple times in the future, so I started to document the important events and people in my life. Going through my entire medical history quickly gets exhausting. Also, there are so many details, I always forget some the first go-around.)
Just as a counter-point, adult onset ADHD is a thing that happens sometimes without TBI. I mean, it’s a reasonable suspect, of course, just not necessarily the root cause.
As far as I know, there is no evidence for adult-onset ADHD without brain injury or disease. ADHD is a pediatric disorder that can go undiagnosed in childhood and then persist into adulthood. Though people are sometimes first diagnosed as adults, that is not considered adult-onset. However, there may be new literature in the past year I haven’t seen yet.
Still, whatever psychiatric disorder I have will be considered secondary to TBI because there was no diagnosis beforehand. Even bipolar affective, which typically has an age of onset in the early 20s, can’t be considered separately because mood disorders are common with TBI. Brain damage fucks with a lot.
This Wednesday, I will be getting the first psychological evaluation in ten years. The first was necessary after the TBI. The second was required by BU to receive disability accommodations. I am getting the third because my psychiatrist thinks it be good to have an updated profile (and I am curious to see how far I have come) and I need it to be diagnosed with ADHD.
I’ve strongly suspected the disorder for years, just as I strongly suspected bipolar when I noticed that my mood swings have a recognizable pattern. But before I could tackle any other disordered behavior, I had to manage the moods. I had to not want to die. I had to survive.
Now that I’m emotionally stable, I can explore the other ways the TBI affected me. I do think that the TBI caused attention deficiency, but there is no way to tell. I have no evaluation before the TBI. There is nothing from the past to compare with the present.
To prepare for the appointment, I made copies of my previous evaluation reports. Some lines caught my attention:
[Amber] was a straight A student until her TBI. Amber has always tended to become overcommitted with school work and extracurricular activities. She began at BU this Fall and is taking 20+ credits of intensive classes.
Overall cognitive functioning [after her TBI] within the very superior range—Currently Amber exhibits very strong intellectual capabilities that are likely commensurate with her premorbid intellectual capabilities. Given that her performance was at the very top end of the measure used at this time, it is difficult to assess if there is any decrement in general intellectual functioning.
As Amber is a high achiever, she is likely to want push herself beyond her current limits and beyond what might be healthy.
Despite these helpful supports and services [from family and the office for student disabilities at BU], Amber is not doing as well as might be expected given her strong intellectual ability, academic, background, and work ethic [two years after her TBI].
Reading this felt like reading about someone else. Though I recognize who I was before the TBI and that person struggling to understand her life after, these people feel so separate from who I am now. I do worry about my academic work but my performance is no longer tied to my identity. It’s just the career that I aim to have. Now I understand that I am something other than my intellect. I know that I am something more.
Though these people are not me, I recognize my self in them. As Amber is a high achiever, she is likely to want push herself beyond her current limits and beyond what might be healthy. I laugh because I remember dismissing that warning, believing that stubbornness could compensate for disability. I also remember learning that there are some battles you simply can’t win.
Now I know my limits, and more, I am happy to work within them. But that ambition was present before the TBI and it is what drove me to challenge myself after. Now I work at a much slower pace, but I am still that ambitious high achiever. I think that I always will be.
ME:We're starting with biscotte paired with goat cheese and honey. The wine is an Argentinian malbec whose light fruitiness brings out the sweetness of the honey in the cheese. The salad is romaine lettuce mixed with thinly sliced red onions soaked in red wine vinegar, avocado brushed with lime juice, and crumbled queso fresco. The salad dressing is handmade from dijon mustard, honey, and lime juice. Finally, the steak is gently cooked to a juicy medium-rare in a ketchup and honey sauce flavored with ground chipotle pepper.
Ever since I began lamotrigine, I’ve been having very vivid dreams. (It’s a known side effect of antiepileptic drugs.) Apparently this is where my creativity has been hiding. Entire stories play through my sleep, and often they end, completely resolved, right before I wake up. A sample of my dreams:
The family was vacationing in a foreign city, where my father accidentally crossed the mob and was captured. I tracked down a member and forced him to divulge information about the organization. Then I led the rescue mission through the city streets, ending with a chase through a bookstore, with others who wanted to take down the mob. In the end, the mob wasn’t dismantled but everyone was safe and my father was rescued (which was all I really cared about).
I was trapped in a gilded maze with dozens of other people. Some of us were looking to escape while others were content to stay. I wandered the halls and rooms, looking for a way to get out, when I met a charming man with sandy brown hair and a wry smile. He said he had a girlfriend but he still flirted. At first I was polite but he continued. Eventually I flirted back. Appalled, he retreated. Confused, I followed. After a chase through the maze, he disappeared through an open door. I stepped through and woke, heartbroken.
I was playing a computer game similar to SimCity and everything that happened in the game happened in the world around me. Eventually I was satisfied with my world and started to live in it. The house that I created, however, was a mess. After living there for a period, I started to clean, beginning with the dining table.
I was traveling in a car to a secret destination to meet a beautiful woman who wanted to have me join her secret society of beautiful women. To pass the time in the car, I was drawing some sketches, but there was a man sitting beside me, giving me unsolicited advice on my work. He was telling me how I should use texture and shading. I was so upset, I drew an excellent profile portrait and glared at him as I handed it over. I explained that I wasn’t sketching to create art but for an assignment for philosophy class.
Perhaps I was already primed by that confession by an anonymous neuroscientist about having Parkinson’s disease. His present is my future, except that I don’t have PD but TBI and I am already public about the subsequent mental illness and disability. Sometimes I wonder about what opportunities are open for me and how risky an investment I am seen to be, but most days, I just worry about memorizing the structures in the basal ganglia. The damage, neural and professional, has been done, and I have made peace with my new self.
But that stability crumbled during lecture last week. He was teaching the hippocampus and closed head injuries and memory loss, and I secretly and quietly lost it. I saw across the projector screen how the grey flesh curled like a tiny tail. I heard about lesions and defective declarative memory and contrecoup injury. My life was presented from a textbook, a lecture, a dissected three-pound mass, and I couldn’t look at my self displayed for the class to see. Suddenly I was sixteen again, vulnerable and shaken and seeing and understanding. But at twenty-nine, I know how to let the emotions pass and not overwhelm. Still, I floated, numbly. There was no cold November bite seeping under my scarf. There was no warmth behind the apartment door. There was only the haze and apprehension. Something will go wrong because something is wrong and what is wrong is me.
I am centered again, but like that anonymous scientist I wonder about the self—my self—and what it is like to be shackled by your brain. Though unlike him, I already know. For years, I lived within three-minute periods, learning to shape those disconnected moments into coherence. I saw my ability disappear with my memory. I was someone but who, I was unsure. I knew that I was different, that I could never be her again. Even in that mental miasma, I understood the injury, but in my youth, I couldn’t accept its consequences. So I fought. I have come far. But I learned that there are some truths you can’t fight.
We are bound, by biology, by the natural laws of this world. Whatever the nature of the relationship between our brains and minds, they are intrinsically linked, and no metaphysical speculation should deny that the atrophy of the brain is the atrophy of the self.