The_Invention_of_Surgery

again. “Her left or right?” I ask. “The right side—not the one she had
fixed,” my assistant Kristy replies.
Relieved that her operatively repaired left shoulder is still doing well, I
knock on her exam room door and enter, finding Miranda sitting on an
exam table, and I’m struck by how nervous she is. We know each other
pretty well, but she’s anxious, even fidgety.
“Miranda, how are you doing?”
“I had another seizure ... I’m sorry,” she blurts out.
I have seen this kind of apologetic reaction in patients who are subject
to migraines, seizures, inflammatory bowel disease, and other episodic
illnesses where the sufferer has little-to-no control over the disease. The
self-reflection on causality, I think, makes them explore whether or not
they are to blame for their infirmities.
“This last seizure was a really bad one. Normally I have a pretty strong
sense it’s coming on, but I had almost no warning this time. My boyfriend
had never seen me have a seizure, and it was really tough for him to see
my face so screwed up during the convulsions. You know, my friend videoed
me once during a seizure and I couldn’t believe how scary I looked. Now,
he saw me look that way ...” and she trails away with her eyes welling up
with tears.
My hand on her shoulder, I console her, “You know it’s not your fault,
right, Miranda?”
“I just feel so bad about it. I also wet my pants and had to leave the
restaurant with pee all over my jeans. I just don’t know why I have to have
all these damn seizures.”
“Miranda, I cannot imagine how frustrating that must be. I feel so sorry
that you suffer from these seizures. It simply isn’t fair. I’m hoping that you
and your neurologist can tweak your meds and get your seizures under
control, and this I swear to you: I will do everything in my power to make
both of your shoulders stable and pain free, so that even if you have
another seizure your shoulders will be okay.”
When treating a chronic dislocator who suffers from seizures, I often
think about patients in antiquity, who were castigated for their epileptic
fits, abused for their “demon possession,” or suspected of witchcraft. The
writhing and grimacing of a paroxysm, and the apoplexy that followed a
seizure, lead the ancients to conclude that some supernatural power was
governing the bodily temple of the victim. And just when the patient’s