
The Itch (2008) - Dove
http://www.newyorker.com/magazine/2008/06/30/the-itch
======
terminado

      She worked for thirteen years in health 
      care, becoming the director of a residence 
      program for men who’d suffered severe head 
      injuries. But she and her husband began 
      fighting. There were betrayals. By the time 
      she was thirty-two, her marriage had 
      disintegrated. In the divorce, she lost 
      possession of their home, and, amid her 
      financial and psychological struggles, she 
      saw that she was losing her children, too. 
    
      Within a few years, she was drinking. She 
      began dating someone, and they drank together. 
      After a while, he brought some drugs home, 
      and she tried them. The drugs got harder. 
      Eventually, they were doing heroin, which 
      turned out to be readily available from a 
      street dealer a block away from her apartment.
    
      One day, she went to see a doctor because 
      she wasn’t feeling well, and learned that 
      she had contracted H.I.V. from a contaminated 
      needle. She had to leave her job. She lost 
      visiting rights with her children.
    

God, that is _hellishly_ brutal. I'm assuming she's dead now, and a de-
identified version of the story can be told.

~~~
danso
The article is 8 years old. So she'd be only 56 years old now.

> _I met M. seven years after she’d been discharged from the rehabilitation
> hospital. She is forty-eight now. She lives in a three-room apartment, with
> a crucifix and a bust of Jesus on the wall and the low yellow light of table
> lamps strung with beads over their shades. Stacked in a wicker basket next
> to her coffee table were Rick Warren’s “The Purpose Driven Life,” People,
> and the latest issue of Neurology Now, a magazine for patients. Together,
> they summed up her struggles, for she is still fighting the meaninglessness,
> the isolation, and the physiology of her predicament._

------
gfody
Pretty unexpected that it turned out to be a literal itch and not
metaphorical.

------
yawaramin
Great article, but I really wanted to read M's story as a contiguous block.
The interruptions to explain the historical context and research detracted
from the immediacy of her (and H's) situation. In fact, the most important
theory in the article seemed to be the sensor treatment theory using mirrors.
All the other explanatory text may as well have been cut.

I wonder if it worked for M.

------
Bromskloss
> She had scratched through her skull during the night—and all the way into
> her brain.

What?! Is this even possible?

~~~
sp332
I suspect that she got an infection which weakened the material, and got
through her skull by basically growing its way in instead of scratching. Just
a guess since it doesn't give any details.

------
tomcam
Western medicine is fantastic for injuries, and utterly medieval when it comes
to chronic problems. It was agonizing to read this.

------
bahro
> Researchers at the University of Manchester, in England, have gone a step
> beyond mirrors and fashioned an immersive virtual-reality system for
> treating patients with phantom-limb pain. Detectors transpose movement of
> real limbs into a virtual world where patients feel they are actually
> moving, stretching, even playing a ballgame. So far, five patients have
> tried the system, and they have all experienced a reduction in pain.

Could be a pretty killer future VR/EEG (or are they using physical motion
sensors configured to the "good" side of the body?) app.

------
dmurray
> In one study, a German professor of psychosomatics gave a lecture that
> included, in the first half, a series of what might be called itchy slides,
> showing fleas, lice, people scratching, and the like, and, in the second
> half, more benign slides, with pictures of soft down, baby skin, bathers.
> Video cameras recorded the audience. Sure enough, the frequency of
> scratching among people in the audience increased markedly during the first
> half and decreased during the second. Thoughts made them itch.

I itched while and after reading the article. At various times I scratched my
head, my nose, my lip. I don't normally have a problem with itching, and none
of them were extreme.

Writing this comment made it way worse! I've scratched my arm, my leg, my
back, my eye socket all since I went to copy and paste the quote above. Anyone
else find the same?

------
gboone42
I loved reading this in 2008, was my first encounter with Atul Gawande and
caused me to seek out other medical writers like Oliver Sacks. Thanks to @dove
for reposting this incredible piece of writing.

~~~
bonniemuffin
I hadn't noticed this was from Atul Gawande -- I loved his book Being Mortal.
Neat to see what he was writing about in 2008.

------
devy
Can someone provide a tl;dr version? :)

~~~
lukas099
When the brain gets incomplete signals from its peripheral nerves, it does its
best job to "fill in the gaps" with its best guess of what that information
should be.

Unfortunately, this mechanism can lead to symptoms like phantom pain or
itching. As the author puts it, sometimes the check engine light is really
nothing wrong with the engine but a faulty light itself.

One promising solution to these medical problems is to fill in the missing
data in a different way. For example, phantom limb sufferers can look in a
mirror image of their good limb, pretend it's their missing limb, and feel
immediate and lasting relief. This may help with things like phantom itching,
too.

