Staring at the Sun (Part 2)
There was a total solar eclipse in North America on Monday, August 21, 2017.
The last time I wrote about a solar eclipse, it was really a story about migraine aura.
Again, the dates don’t really line up quite right, but this time they are a bit closer. The last time I experienced a truly unusual migraine aura was on Tuesday, August 22, 2017 at 9am. Six months ago today.
If you asked me about the way that I think, I would start out by telling you that there is a running commentary, in English, in my head. Or, if you had asked me this roughly six months ago, that is what I would have opened with, and it would have taken a lot of follow-up questions to push me away from that idea. Sometimes when I think about math, it is in some sort of indescribable way; it only turns into words when I start to think about writing down the proof. Maybe this is why it is so hard for me to do math or other technical things when people around me are speaking English (but not around other sounds). Maybe I only remember the thoughts that are streams of English words because I am using that mode of thinking to prepare for some future interaction with people.
On Saturday, August 5, 2017, I stopped at Trader Joe’s after knitting group (same shopping plaza), and as I was heading back to my car, the part of the sky in the upper right corner of my vision flickered just a little bit. A few pulses that reminded me of some sort of digital artifact. Like you might imagine a glitch in the matrix. I drove home, although in retrospect, I probably should have gone back into Panera and asked someone from knitting group to call 911. But I thought that this was some minor variant of the flashing rainbow crystal, the unusual (but harmless) migraine aura that I had befriended over several weeks in the spring of 2015.
By the time I got home, the upper right corner of my visual field was flickering and refracted. It was as if someone had drawn a diagonal line and had applied some dynamic version of the photoshop clone tool to everything above it in a somewhat haphazard way. When I got home, I saw a neighbor in the alley and had a weird conversation. I just could not find the words to say any of the things that I was thinking. It was similar to the feeling when you are speaking a foreign language that you aren’t very good at and you know what you want to say, but you don’t know what the words are. But I didn’t have access to words in English, and there was no fall-back language. I had thoughts, but there were hardly any words; all I had were some well-practiced stock phrases. The neighbor clearly knew that something was wrong; she blamed it on the hot day and suggested that I should drink some water and rest. I knew that it was far worse than that.
When you lose your ability to speak, you can’t call 911.
Fortunately, I live in North Park, and it was the early afternoon on a sunny Saturday. North Park is filled with crazy homeless people and very popular and crowded hipster brunch places with plenty of outdoor seating. I walked half a block to the nearest brunch restaurant and harrangued the hostess: CALL 911! CALL 911! I NEED HELP! I couldn’t explain what was wrong, but it was pretty clear that I was upset and something was wrong. I needed to get to a hospital. The hostess wanted me to stop causing a scene in front of her restaurant. It was in both of our best interests for her to call 911.
Even though I did not have the words to express complex thoughts, I still knew that both the ability to speak and the right part of my visual field are controlled by the left side of my brain. I also knew that people with a history of migraines are statistically more likely to have a stroke than the general population. I had all these thoughts without having any access to words like “brain” or “blood” or “probability” or “stroke.”
A few hours later, still in the emergency department, words started to return. While I was in the MRI machine, the word “localizer” was one of the first to come back to me. They did a bunch of test: CT, CT-A, MRI, EEG. No signs of stroke. No signs of seizure. A perfusion study that was consistent with migraine. An EEG pattern that was consistent with migraine. A vascular feature that is probably nothing but they wanted to get a better look at just to be sure (it has either been there since I was born or else is a result of that time I was hit by a car in October 2002). I have a history of migraine. I have such a history of migraine that when I could speak again one of the first things I volunteered to the neurologists is that one of the photo albums on my phone is a CT-A of my brain from about ten years ago. Diagnosis: Migraine with aura, not intractable: G43.10. I spent the night in the hospital.
Everything is performance. I wanted nothing more than to be declared to be better so that I could go home. When the herd of neurologists came by on rounds on Sunday, I was sitting up in bed doing the New York Times crossword puzzle. I explained that I was still having trouble with visual processing. In order to do the crossword puzzle, I had to put a finger from my left hand on the clue and a finger from my right hand on the box because otherwise I could not look back and forth between them correctly. I was also having trouble with my phone; it was really hard for me to read anything that was on a phone or a computer screen. (And, yet, the newspaper was fine.) I had to stay another day just in case and also because of the way that imaging resources are allocated in our current health care system. The MRI venogram got me some pretty cool images. One of my friends helped me section the images into an STL file so that I could 3D print the vascular tree. Sadly, 3D printing something so complicated is above my skill level.
You can feel remarkably good when you are sitting around a hospital bed, and you don’t even realize what you can’t do until you are home. Or until you try to go back to work. Visual system was definitely still off. I was much more aware of the work that my brain was putting in to resolve figure vs. ground. Reading screens was still quite challenging. Every now and then, the upper right part of my visual field would start flashing, and things would feel slightly off. For example, during the time that the flashing was going on, it would be really hard for me to do subtraction in my head.
So, um, yeah, a few days later I went back to work. I told my colleagues about the hospital and showed them the MRI images. I told them about the weird flashing—which was taking place rougly once every 20 minutes, as much like clockwork as you might expect from an organic process in the human brain. 7:10am, 7:33am, 8:04am, 10:10am, 10:32am, 10:52am, 11:39am, 12:10pm, 3:21pm, 3:43pm, 4:31pm, 4:50pm, 5:24pm. My colleagues are fascinating people, so they told me that the next time one of these flashing events happened they would see if I could draw.
Do you remember how some people were not impressed by the president’s ability to draw a clock? My colleagues told me to draw a clock. Ignore the curve in the lower left; it is part of a different drawing. The “clock” is the arc in the upper right and the diagonal line segment.
Could I draw a compass? (Not in the Euclidean geometry sense. In the orienteering sense.)
OK, so I couldn’t draw. But could I copy a drawing? The next time I saw the flashing, a colleague drew a picture of a cat (while I watched), and then I tried to copy it.
(I am such a good neurology patient. I come to appointments with complete logs of the times and duration of my symptoms as well as DVDs full of imaging studies and drawings like these. One of the doctors I saw is also a neurology professor. He made a copy of my notes and drawings to use in his class.)
Eventually these weird migraine auras stopped happening. (The day after the eclipse. If you make the movie version of my life, we can change the dates.) I can now draw clocks and cats and other simple figures whenever I want.
One of these days I want to take all of my migraine drawings, my MRI images, and my EEG data and sew it into a quilt. There will, of course, also be eclipse imagery.