dermatomes            I was stopped at a red light.  Through my rear view mirror I saw the car speeding toward me.  The driver was looking down operating a cell phone in his lap.  I considered putting my car in park because the rapid acceleration in a crash is what damages, but I did not want to limit my options.  As the car barreled toward me at full speed I applied my brakes hard with both feet and braced for impact.  The driver never looked up.  His car slammed into mine, collapsing my seat with the explosive force of the rear-end collision.  Sharp pain stabbed my neck and shot down my shoulder, upper back, lancing down my arm and making my middle and ring fingers suddenly go numb and tingly as if I had hit my funny bone.  Two weeks later the pain has decreased to a constant annoyance, but my fingers are still numb, my neck hurts, and the tingling has spread to include my little finger.

                The MRI confirmed what I already knew from tracing the sharp demarcations of dermatomes on my arm.  I have studied these patterns so many times in anatomical figures, but now the territories of the body’s nerve endings are mapped out on my own body tattooed in prickly patches of pain.  The intervertebral disk separating two vertebrae in my neck is smashed and displaced from its proper position padding the neck bones where my C7 and C8 spinal nerves exit my spinal cord.  The critical function of this disk is to keep these neck bones from crushing the nerves as they squeeze between them, traveling out to my arm and hand. 

                But I will get better in time.  I can expect a full recovery.   

                If you ever feel sorry for yourself, visit a neurologist’s waiting room.  A young woman dressed in fashionable athletic clothes is wheeled in by a muscular male companion.  Her torso is encased in a blue hard plastic body brace holding her upright in the wheelchair.  Another woman in her 50’s with graying hair awkwardly struggles to unzip her coat without success.  Encouraged, in a role reversal at this stage of life, by her elderly mother caring for her like the young child her daughter once was.  She speaks encouragingly in simple monosyllabic baby talk to her adult child who struggles with the zipper, her left arm withered and a goofy expression on her face.  Indifferent to staring eyes, the two are enveloped in a cocoon of love, coping together with the reality of the situation. 

                So that’s how it happens.  Suddenly your life is ripped from its track and it will never be the same.  Mere chance separates the able bodied and intellectually capable from the wheel chair bound or cognitively disabled.  Disability, restricted opportunity, and dependency now frame your future. 

                If you ever feel sorry for yourself visit a neurologist’s waiting room, or talk with a psychiatrist, as I once did.   Crestfallen the doctor told me that this morning Peter, his patient with schizophrenia, had completed.  “We never say successful,” his colleague explained to me in referring to suicide.   He related the details of Peter’s life from a healthy young man in college to becoming ill, isolated, unable to maintain a relationship or hold a job, losing his home, becoming ensnarled in the prison system, cut off from reality by the hallucinations in his own mind and cut off in reality–utterly isolated by a society fearful of mental illness.

                Setting aside for a moment the usual article announcing the latest marvel in the field of neuroscience, I wish to make one point.  All areas of science have potential to improve the lives of people, but some more than others.  Neuroscience as a field of study has enormous potential to relieve human suffering.  Whether you are a basic scientist or a clinician, the need for a better understanding of the brain is profound.  All diseases are tragic and disabling, but nervous system disease and injury are profoundly life altering and current treatments are inadequate.  Physicians, who comfort and heal people with injuries to the spinal cord, brain, and mind, provide heroic service to people in need, but they are operating with too little biological understanding to empower them. 

                Neuroscience is one of the most intellectually challenging and rewarding areas of modern science, but even for basic research scientists, neuroscience research also offers the opportunity to relieve human disability and suffering.  That is not the case for all areas of basic research.  

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