Friday 26 June 2015

Rewalker

It's five years since Mark Pollock broke his back in a falling-from-a-height accident.  A more recent multiple ffh accident in Berkeley CA has been consuming the airwaves in Ireland as the remains are brought home for burial. Last October, the film Unbreakable was released to critical acclaim and damp handkerchiefs and a few days later I tribbed the female lead in this story.  While Mark struggled back to life, Simone started a new career in scientific research to find solutions to the manifold problems with which her bloke was beset.  One of the people she encountered was UCLA Professor of Integrative Biology & Physiology Reggie Edgerton who has spent 40 years teasing apart the complex relationships between nerves and skeletal muscle. I emphasise complex because, in my Human Physiology course at The Institute, I give a cartoonish overview [R above] of the neuro-muscular synapse and its neurotransmitter acetylcholine and move quickly on to bone marrow.  I know there's more to it than that.

This last week, Prof Edgerton has been in the Trinity College Institute for Neuroscience TCIN talking and setting up collaborative research projects.  Yesterday he gave a public lecture in the Science Gallery which should get people to think around the box of what everyone knows to be impossible.  All too often in science and elsewhere what everyone knows to be true turns out to be wholly unexamined and based on dogmatic assertions rather than any substantive evidence. Our own experience should give us pause to examine the assertion that spinal cord injury is irremediably final and that everything below the lesion is doomed to waste away through disuse. Edgerton maintains that the spine has a large degree of autonomy and can establish patterns of muscular flexion and extension without any external stimulus - they are called Central Pattern Generators CPGs. We know this could be true because we can walk without having to think about it. In UCLA they have induced rhythmic hind-leg pacing in cats and rats which have severed spinal cords.  It's a bit of a trick; you have to prime the system with electrical stimulation and/or judicious drugging of the other neurotransmitters - glycine and serotonin were mentioned - that I don't cover in teaching neuromuscular 101. The results are miraculous to behold. Another example is that the process of standing up - really important for self-esteem in the crippled so they aren't always talked down to - is largely reflexive: pressure on the heel starts the whole lurch forward and up that fit people do without thinking.  And which is an increasing ask for the elderly, the infirm and the spinally challenged.

One thing that Edgerton mentioned more than once is that a lot of the current cures for neuromuscular problems are worse that useless because the are directed at quelling the disturbing symptoms rather than channelling those symptoms into productive patterns. Spasticity, for example, has much more potential for amelioration than paralysis because you have some movement to work with.  As a metaphor, Mormons are required to spend a year of young adulthood spreading the word and they find it much easier to win converts in countries which already have a established belief systems, like catholic Ireland, than in more secular places like France and Britain. The gamma-aminobutyric acid GABA receptor agonist Baclofen is routinely used but maybe should be used less and more training implemented. Drugs are easier to administer than physiotherapy in the same way that they are easier to apply than psychotherapy. Megapharma is the only certain winner.

I'm well out of my depth here but in the questions at the end of Edgerton's talk the idea was floated that conscious thought might be counter-productive in the cocktail of drugs, electrical and physical stimulation that seems to have the potential to make people take up their beds and walk: "no longer conforming to the shape of the chair" as Simone put it.  In my years of drumming my head habitually got in the way - and I don't mean that I would accidentally drub my ears with the sticks. No it was that, if I let my hands do the work, I could perform presentably; but if I looked at the wangering hands they would say "whoa, brain taking over and kerFLUB".  Again, in my years as a not-very-good sambista we were required on parade to a) percuss [it was a chocalho and later a repinique for me], b) sway from side to side together and c) walk forward.  I could do any two of these: if things were going great and I decided to start the swaying then my feet would stop and I'd get rear-ended and heel-stepped by the woman behind me.

I have great hopes that someday Mark Pollock will walk into a room when I'm back drumming and we'll take up where we first met a dozen years ago in Sinead O'Brien's djembe class.

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