We expect a lot of our doctors, but they don’t always have the best tools or knowledge to treat us. In this podcast, TED speakers Elliot Krane, Dorothy Roberts, Jennifer Brea, and Paula Johnson explore new ways to think about disease, diagnosis, and the delicate art of healing.
Dorothy Roberts talks about how our ancestry and where we come from effects the way that we react to medical treatments, and that we all respond in different ways to them. Jennifer Brea talks about illness from a neurological perspective. She goes into detail about her journey with doctors and their hard time finding out why she was receiving the symptoms that she was. She was eventually diagnosed with myalgic encephalomyelitis (ME), or Chronic Fatigue Syndrome, and she talks about how it affected her life and changed her goals. Paula Johnson gives a lecture about how the two sexes affect the way people react to specific treatments in areas such as the cardiovascular system and respiratory system.
But…
Elliot Krane had the most fascinating part of this podcast. He is a pediatrician and an anesthesiologist. In his piece, he burrows into the world of pain. What is pain? Is it a symptom? Is it a disease? What is it? Dr. Krane thinks of this reaction to stimuli as a mixture of both disease and just a response in general. He goes on to say that 99% of physical pain in patients usually comes from an illness or injury, which is what most people think and agree upon. Once that patient has recovered from a medical problem, the pain goes away in about 90% of all people. The concern that Dr. Krane brings up is that other 10% continue to experience the same pain if not more excruciating for months to years after the injury/illness has healed.
It is his job to help this other 10% of people get rid of the pain that is occurring so that his patients can return to normal life. What his patients have is what is called Chronic Pain. He gives us an analogy, and he describes our bodies nervous system is structured like a house of sorts. In the house, wires run in the wall, from the light switch to a junction box in the ceiling and from the junction box to the light bulb. And when you turn the switch on, the light goes on. And when you turn the switch off, the light goes off. If you hit your thumb with a hammer accidentally, these wires in your arm that we call nerves and begin to transmit the information into the junction box, which is the spinal cord where the wires or nerves, take the information up to the brain where you become aware that your thumb is now hurt.
But it is not that simple. One nerve doesn’t connect with the next nerve by releasing packets of chemical information that are called neurotransmitters in a line to the next nerve. What happens is the neurotransmitters spill out in all directions in the spinal cord, and the adjacent cells to the nerves interact with the neurotransmitters. These cells are called glial cells. They were thought to be just structural cells in the spinal cord to hold the spine together. It turns out that glial cells have a vital role in the regulation, amplification, and the distortion of our sensory experiences. These glial cells become activated during our experience with our surrounding. Their DNA starts to synthesize new proteins, which spill out and interact with adjacent nerves, and they start releasing their neurotransmitters, and those neurotransmitters spill out and activate adjacent glial cells, and so on until what we have is a positive feedback loop.
Think of it like someone coming to your home and rewired your walls so that when you turn on the light switch, the toilet starts to flush the next door down. This is what happens with chronic pain. And that’s why pain becomes a disease. The nervous system is flexible and adaptable. It changes, and it transforms in response to stimuli.
Well, what is done to prevent this?
Patients are usually treated with symptom modifying drugs such as painkillers which are not very useful for this pain. They take nerves that are active which should be quiet and put them to sleep with anesthetics. There is also very rigorous and painful physical therapy to retrain the nerves to respond in a normal fashion to the sensory experiences that are part of everyday life.
This podcast was very intriguing and did an outstanding job at giving a strong walk away thought. I really suggest you give this podcast a listen it is very educational but also keeps you interested along the way.
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