Or: The brain uses the virtual body to tell you where your actual body is in danger.
When you are hitch-hiking, getting out of a capital city is usually a breeze. Unless the capital city is Adelaide, in which case it is almost impossible. My average wait getting out of Adelaide is about three hours. On this occasion, it was a little over six hours since my brother had dropped me off and done his best to wish me well. He was in no state to wish me well, being rather suffocated by an irrational conviction that I was bound for death. He had told me that hitch-hikers were being organ-napped. He reckoned I would end up with my liver in Prince Myanmat of Burma and my pancreas in the son of a Vietnamese rubber mogul.
Six hours after his farewell, my rock-juggling was disrupted by the sound of a reversing car. I could tell it was reversing because it had that strained whirring noise that cars get when they reverse. The back end of a Toyota Corona was coming down the dirt strip that separated the two lanes of the highway. It zig-zagged through the dust as though it was smelling its way, like a beagle might. It dragged along a cloud of dust that looked like a sandy plumage. When the car was in line with where I stood, it stopped abruptly with a little skid and was immediately swallowed by the dustcloud. From somewhere inside the dustcloud came a vaguely frightening voice:
Man inside dust cloud: Hey hitch-hiker, Hey Mr hitch-hiker, do yer wanna lift north? Do yer?
I had no way of sizing up my potential lift because he was still hidden inside the cloud of dust. However, I have a policy that any lift is a good lift so I grabbed my pack, my clarinet and my hat and I ran across the road to join him. When the dust settled a fraction, I found the door, threw in my gear and jumped in the front seat. The driver of the car introduced himself:
Driver: Simon Jeffery or Jeffery Simon – can’t remember which. Been a long time since anyone knew. Got an Aunty Grace Simon ‘n’ an Uncle Bill Jeffery so I’m nip the wiser. Most people call me Twonames. Want some apple?
LM: G’day Twonames. Lorimer. Sure
Twonames freaked me out. Twice. First time was when he was cutting up the apple with a fishing knife that was as long as my foot and well capable, I imagined, of skinning more than just a fish. He offered me the half of the apple that was pierced atop his awfully big knife and then, as soon as I plucked the apple off the top, Twonames stabbed himself in the top of his knee. The knife made a deep thudding noise as it entered his flesh and then it just sat there, about two centimetres in, just at the top of his knee-cap, where the big leg muscles come together in a big tendon. The knife wobbled back and forth like a javelin for a second or so. I was seriously spooked. Here was this guy, in charge of a vehicle that was about to take me into the South Australian outback; straight through Snowtown, a village made famous by the Snowtown murders19; beyond the coverage of the telephone network. A guy who has reversed his car a hundred metres to pick me up and has now stabbed himself, voluntarily, in his own leg with little more than a wimper?!?! Curiously there was no blood coming from the wound. He looked up at the knife, then at me, apple juice dripping down his chin.
Twonames: Still gets me, that. Dunnit 50 times since the Royal and it still makes me wince. Crazy as a dog eatin’ peanut butter. Every time. You better take care of this cause it just gets in me way.
With that, Twonames lifted up his shorts and unclipped a couple of suspenders that were holding his prosthetic leg onto his thigh. He yanked the prosthesis off and threw it onto my lap. The thing I was to take care of was his artificial leg. Then he laughed. Well, cackled really:
Twonames: You thought I’d stabbed meself didn’t yer?
LM: Well, yes I did Twonames. You got me with that one.
Twonames: Hook line and friggin’ sinker I would say Warren.
LM: Lorimer.
Twonames: Borrow one? What for?
LM: (it was about now I realised that Twonames’ hearing loss was about the same as his leg loss) No no, I don’t want to borrow one - my name’s Lorimer.
Twonames: I know I know. You introduced yourself when you got in Warren.
I left it at that. Twonames was probably pushing 50. He had a bad hair-piece, a gaunt face and sunken eyes. His skin was thin. Veins across his thighs looked like river deltas. He smelt like a pub on Sunday morning just after the Glen2020 has been sprayed in the toilets. We took off with a jolt. Twonames explained that he had just been at the Royal Adelaide Hospital to have his stump revised21, but had discharged himself because they wouldn’t let him drink. He was on the way to The Snout and Trotter, a small pub in the middle of prime pig land 80km north of Adelaide. Twonames had been hit by a beer truck out the front of The Snout and Trotter when he was 18. An out-of- court settlement seemed to involve little more than medical expenses and free beer for the rest of his life.
We jerked and jumped up the road until Twonames had forced the unwilling Corona to get into 4th gear. It did seem odd that Twonames would own a manual and not an automatic. Three pedals, one leg. Didn’t seem like great planning. We chatted, which was fun because Twonames heard about 50% of what I said and I understood about 50% of what he said. According to probability, this means that the conversation was actually four times as interesting as it appeared to be22, and, as it was, it appeared to be quite interesting.
I did pick up that Twonames’ favourite subject of discussion was his sister, of whom he was obviously proud. Unlike Twonames, she had made it right through school and now worked as a nurse at Townsville Base Hospital. “She got all the brains, I just got my mum’s ears”. Granted - they were absolute radar dishes (which made his hearing loss even more astounding), but they didn’t seem all that out of place on the side of his head, which looked as though it could only have been plonked on top of his torso as a sort of after-thought: “Jeepers George, we need a head here – what’ve you got?” His face looked like it belonged on something far bigger than his body. A bonsai head. No neck to speak of and a tiny mouth that seemed to sit too low on his face. Despite the confronting nature of his appearance, he was as friendly a man as you could hope to meet, especially if you were hitch-hiking. Twonames spoke mainly in take-home messages, moral of the story’s and tiny tit-bit’s, the meaning of them was never obvious:
“The moral of the story is don’t swim with stingers unless you’re a pack of salt & vinegar crisps”
or
“If you’re goin’ to sleep around, make sure you pack a few mozzie coils”.
I was lucky enough to receive many tiny tit-bits during the time we had, none more impressive than the rationale behind keeping a bottle of beer in one’s crotch. I had noticed early on that a six-pack of XXXX23 that sat between the seats was missing one bottle. Not long in, he reached one hand up his faded blue shorts and pulled out the missing bottle. Needless to say I was interested in this. I asked him why he kept a beer up his shorts. It so happened that his sister, the nurse (who got all the brains), rang him excitedly in the middle of studying for her biology exam because she had just learnt that the whole reason men have scrotums in which to store their testicles is that it keeps the testicles cool and thereby ensures the health of the sperm. Twonames was noticeably impressed even as he recounted the fact:
“That’s it! No other reason! Here’s a tiny tit-bit for yer – it’s not just for looks!”
Having done Human Systems 101 myself I was well aware of the need to keep the testicles below 40°C and that to keep them outside of our abdomen in a purpose-built sack seemed an ingenious way to do it. Twonames was on a roll and made me a generous offer:
“The take home message is that you can use my scrotum to keep all sorts of things cool.”
Mental note: do not share his egg sandwich.
I couldn’t tell him that his sister had misunderstood the whole scrotum-testicles thing, I didn’t have the heart. The other reason is that we arrived at The Snout and Trotter. Violently.
It was a pretty unimpressive pub, although it had a brand new car park. In fact, they had redesigned their carpark while Twonames was in
hospital, which meant that when he drove in, at the same spot at which he would always drive in, we bounced up the gutter and crashed through a small hedge to stop in the bay between two big smelly waste bins. Twonames cursed something I couldn’t quite understand, turned off the engine and sat shaking his head as though someone had just died. It was then that he freaked me out a second time.
Without any warning, a brutal look of raw and unadulterated fear took hold of his face. He swore and jumped back, clutching the cloth of the seat with rapidly-whitening knuckles. His eyes seemed to be locked on the clutch pedal. He was screaming blue murder and yelling at me:
Twonames: Me leg! Get me leg! Stick me leg on! Holy Mother of Jamie Wilson! Get me fuckin’ leg! I gotta have me leg on!
Despite the clear sentiment of what he was saying, it took me a little while to get the message. He wanted me to put his prosthetic leg back where it should be. A bit perplexed and still unconvinced that Twonames hadn’t seen the Ghost of Jamie Wilson’s mother, I put his leg down on top of the clutch pedal, rested its top end at his stump and adjusted it a bit so it looked to be on the right angle. However, that wasn’t enough, Twonames was still writhing, now grabbing his prosthetic knee and looking at the foot.
Twonames: Take off me sock! Take off me bloody sock! Holy Mother of Jamie Wilson!! Me sock! Me sock!
This Jamie Wilson fellow must have a really bad mother. Now Twonames was holding a screwdriver toward me and as I took the sock off I realised what the screwdriver was for and that neither Jamie Wilson, nor his mother, were relevant. There, on the outside of the top of his prosthetic foot was a little circle, about a centimetre in diameter, drawn in green marker. Next to the circle was the word “here” and an arrow pointing into the middle of the circle.
Twonames: Press me foot! Diggit into me foot! Move your arm you idiot – I gotta see it! I gotta see it!!
No sooner had I dug the screwdriver into the well-worn spot on the top of his prosthetic foot than Twonames let out a moan of relief. The blood returned to his face and he loosened his grip on his prosthetic knee.
Obviously, I was intrigued by this. Half of me was thinking ‘what a complete joker’ and half of me was thinking ‘how amazing is that?!’ It was like his rubber foot was actually hurting.’ I asked him:
LM: What on earth was going on there?
Twonames: That has been happening ever since I lost the leg. Twenny years. I get this sudden, burning, white hot, shooting pain in me foot, travels up the front of me shin where it digs into me knee and feels like it will blow me whole leg into a million pieces. It is murder. Bloody murder. They used to have to strap me down when I was younger. Knock me out. Everyone thought I was going crazy – ‘specially me – I thought I was going completely nuts. Only discovered by accident that if I have me rubber leg on, I could turn the pain clear off by pressing something really hard into that spot on the top. That’s the spot where I was pinned down when the truck hit me. Dunno why that matters, but apparently it does. I don’t know why digging a screwdriver into it turns the pain off ‘n’ it doesn’t work if I can’t see it, but if I can see it, it’s just like a switch. A magic bloody button. Beautiful.
With that, Twonames threw me back the leg and said:
“Coming in for a lager? It’s on them. I’d rather hop – will yer bring me leg?”
so, what has Twonames and his magic button got to do with pain?
The one sentence take home message: It hurts where your brain thinks the problem is, not necessarily where the problem really is.
There are a couple of things that Ithink are groovy about this story:
Twonames had no leg, but he still got pain in his leg. What’s more, he still got pain in his leg 20 years after his leg had been removed. What’s more, the worst pain he had, that burning ‘white-hot’ pain, was felt in the same place that he had been pinned down all those years ago. Pain in an amputated or missing body part is known as phantom limb pain and it is reasonably common. It can be associated with any missing body part. In fact, you don’t even have to have ever had the body part for it to hurt. That the brain is able to make a missing limb hurt, and make the pain as intense, as bad and as real as it does when the leg is actually there, shows me that it is the brain that makes things hurt.
Phantom limb pain also shows me that despite the fact that Twonames knew for a fact that he had no leg – there is not an ounce of doubt about it – his brain still made his leg hurt. In order to do this, the brain must have a map of the body that it uses to give us bodily feelings, including pain. We know that this is the case and there are ways to measure where in the brain different body maps are held. We know that every single bodily feeling we ever had is constructed by the brain and ‘projected’ onto a virtual body. Thus, it is the virtual body, or the maps of the real body, that determine where things hurt. This doesn’t always coincide with what is actually happening in the body. That is obvious for Twonames, but there are other examples that are less drastic, like leg pain related to danger messages coming from the back. The brain mistakenly ‘projects’ the pain onto the virtual leg. Try telling someone with burning leg pain that their pain isn’t real and they will more than likely biff you one. The leg pain is 100%, completely, undeniably, real, even though there is nothing at all wrong with the leg.
The way that Twonames could eliminate his pain, very quickly, was by digging a screwdriver into a spot on his rubber leg that felt like the source of his pain, so long as he could see it happen. I have no idea why digging a screwdriver in made the pain stop, but there is a bunch of stuff that shows how the brain can use visual information to modify bodily feelings. It was crucial that the brain saw the leg and saw that something had been done. That shows me that the virtual body part can still be modified even though the real body part is missing. That, I reckon, is superb.
scratchy & the boring talker (the snake bite stories)
Or: Pain depends on the answer to the question “how dangerous is the really?”
Or: Pain depends on the experience
1. Scratchy
About two hours south of Sydney, in the superb southern tablelands, is Wollondilly River. Our mates PC and Kaz have a little block of land there. They call their block of land Rivendell. It is indeed God’s Country – yellow box and river gums, tough granite outcrops and knee high bush grass. Not a sound aside from the natural inhabitants. Kookaburras, Whoopee birds24, Koalas. Koalas do not sound nearly as cute as they look. They actually sound a bit like a neglected Skoda SuperSport 110 (see chapter called Nigel’s skoda) – a throaty, almost raspy, growl. It is a noise, not a call. Furthermore it is a noise that is not nice. It is a little frightening if you don’t know what it is and only slightly less frightening if you do, because you can’t believe such a devilish groan can emerge from such a cute cuddly sleepy animal.
As the crow flies, Rivendell is not too far from civilisation. As the four wheel drive drives, it is. PC and Kaz spend most weekends there and love to have visitors. PC is one of those blokes who just loves to be nude. In fact he loves to be nooode. What’s more, he loves his nooode-ness in that jiggly-wiggly kind of way. Apparently he takes off his gear as soon as their 4WD crosses the boundary into their land and doesn’t put it back on until their 4WD crosses the boundary back out. The exception to the jiggly-wiggly nooode policy is when he has visitors who might be less comfortable than he is with jiggly- wiggly, or nooode, or both. Visitors, for example, like us.
We visited PC and Kaz one weekend in May. It was a glorious time of year – a chill coming into the air, but crisp sunny mornings and calm cool evenings. We had a lovely evening chatting about stuff. With PC and Kaz, a Cab Sav conversation was always around the corner and a surprisingly refreshing aspect was that it was always PC talking. About himself, primarily, but in an interesting and reflective way. We all enjoyed the genuine wonder he got when he contemplated himself.
Next morning I got up with the sun and donned my sarong. Very groovy indeed. PC and Kaz and TMBA25 were s
till asleep, so I tiptoed outside and strolled down toward the river, which was more of a creek really. It was a splendid morning. I love dawn. Everything is still. The birds are active but the koalas are not. I love knowing that most people are asleep, as though all this magnificent beauty is there for just me to enjoy. I shuffled down the slope, just in my sarong and a t-shirt. I could feel the soft sand squeezing up between my toes and the crunchy dry grass and shrubs prickling my ankles. I remember, vaguely, a sharper prickling slightly beyond my ankle – sharp enough to make me flick my foot, let out a tiny ‘ooh’ and squint my eyes a fraction. That was it. Let me tell you, by way of a very bad picture and some lines, what I think happened in that moment, from a biological perspective. Make sure you start at the bottom box, numbered 1.
figure 3 snake bite version 1
2. The boring-talker
You have probably guessed that the dangerous thing that happened was a snake bite. No ordinary snake mind you – an Eastern Brown. Eastern Brown snakes are notoriously good. At killing. This is what Wikipedia (www.wikipedia.com) says about the Eastern Brown:
The Eastern Brown Snake is the second most venomous land snake in the world after the Inland Taipan. Although an Eastern Brown will seek to avoid a confrontation, it has a very toxic venom,… (they) have been known to cause fatalities in humans. The venom contains both neurotoxins and blood coagulants.
My mate Chris Jackson was incredulous that something with a brain the size of a pea could knock off a human. I wonder what he thought about box jellyfish26. I think he would take issue with Wikipedia’s conservation classification of the Eastern Brown as an animal of ‘least concern’27.
Painful Yarns Page 4