Pria Anand > Quotes

“Medical students are taught to imagine a binary: doctor and patient, science and faith, objective truth and superstitious fallacy, us and them. Our morning rounds are an exercise in telling and retelling patients’ stories in a way that explains their illnesses, cloaked in the sense of objectivity offered by a white coat. But the stories told on these rounds are just as prone to false truths as the reports of an amnesia patient, subconsciously shaped by our priors, our communities, our own narratives. On rounds, a woman’s pain might be recast as anxiety, for instance, while a vitamin deficiency born of alcohol use might be regarded as a deserved punishment.”
― Pria Anand, The Mind Electric: A Neurologist on the Strangeness and Wonder of Our Brains

“In 2016, a group of doctors surveyed 222 white medical students and residents on their beliefs about their patients’ bodies, asking them to judge the veracity of statements such as “Black people’s blood coagulates more quickly than whites’ ” and “Blacks’ nerve endings are less sensitive than whites’.” Half of the students and residents ascribed to at least one of these false beliefs. Like the doctor who brutalized John Brown, 40 percent of the first-year medical students and 25 percent of the residents agreed with the statement “Blacks’ skin is thicker than whites’.” These beliefs had real-world consequences: when given two mock medical scenarios, one featuring a Black patient and one featuring a white patient, the students and residents who endorsed more of the false beliefs assumed that the Black patient felt less pain than her white counterpart. Worse, they were less likely to adequately treat the Black patient’s pain than they were the white patient’s. Even now, medicine seems in thrall to Mitchell’s assertion that not all pain is equal, disbelieves the essential truth that the “capacity to suffer” is a human universal.”
― Pria Anand, The Mind Electric: A Neurologist on the Strangeness and Wonder of Our Brains

“In his wonderful TED talk “A Doctor’s Touch,” physician and author Abraham Verghese relates a story in which Bell divines the shortcut a woman took to travel to the clinic from the color of the clay on the soles of her feet and her job—as a linoleum-factory worker—from a rash on the fingers of her right hand.”
― Pria Anand, The Mind Electric: A Neurologist on the Strangeness and Wonder of Our Brains

“In the Salpêtrière, medical care was a quid pro quo, given in exchange for a performance of one’s illness. In modern emergency departments and hospital rooms, I have seen quieter ways we ask our patients to perform their illness in exchange for their care. A woman arrives in the emergency department three times in as many weeks, first with hazy vision in one eye, then with a heaviness that weights her right foot like a winter boot. Each time, she is perfunctorily examined and sent home with no explanation for her symptoms; in the chaos of an emergency department flooded with overdoses and heart attacks, her symptoms are too subtle to merit attention. The third time she is examined, she says that she cannot move her right leg at all, refuses to lift it when the doctor asks. This time, she cannot walk out of the emergency room to return home. An MRI shows the unmistakable white lesions of multiple sclerosis, unfurling like flames from the center of her brain. Given a name for her disease, a reason for her symptoms, she will later walk to the bathroom, bearing weight on her right leg. The weakness has retreated to just her foot. This sort of unconscious exaggeration is common enough that it has a name: medicine calls it elaboration, the inadvertent performance of a weak leg to receive care for a weak foot that would otherwise be overlooked.”
― Pria Anand, The Mind Electric: A Neurologist on the Strangeness and Wonder of Our Brains

“there exists a vast liminal expanse that stretches between wellness and illness.”
― Pria Anand, The Mind Electric: A Neurologist on the Strangeness and Wonder of Our Brains

“Even though Charcot described sclérose en plaque disseminée as a disease primarily of women, such as his wards in the Salpêtrière, his successors were convinced until the early twentieth century that it was an affliction of men: men who reported sudden, transient blindness or paralysis were given a diagnosis of multiple sclerosis, their symptoms assumed to be the result of a physical malady, a lesion of the brain or spinal cord, while women with the same fluctuating symptoms were dismissed as hysterical. Until even more recently, for perhaps the same reasons, multiple sclerosis was deemed an affliction of white women. We now understand that it affects Black and brown women just as often. Black women are still diagnosed much later in the course of their illness than white women, often with worse symptoms by the time a diagnosis is made. Centuries after Charcot died, I would read the paper “Multiple Sclerosis and Hysteria,” published in 1980. “Multiple sclerosis,” the authors explained, “shares with hysteria a common epidemiology (young patients and preponderantly women), prevalence, and frequency of equivocal, difficult-to-verify abnormal neurological signs.”
― Pria Anand, The Mind Electric: A Neurologist on the Strangeness and Wonder of Our Brains

“As a medical student, I read the lore of Joseph Bell, the Scottish surgeon on whom Sherlock Holmes was based. Bell, who taught Arthur Conan Doyle during his medical training at a hospital in Edinburgh, was famously observant, with an “eerie trick of spotting details.” From sailors’ tattoos he could know where they had traveled; from the lilt of a man’s accent, the calluses of his hands, the uneven way the legs of his trousers or the breast pocket of his jacket had faded, he could deduce the man’s hometown, his profession, his vices. “Most men have a head, two arms, a nose, a mouth and a certain number of teeth. It is the little differences—the ‘trifles’—such as the droop of an eyelid, which differentiates men,” Bell told his students. “Use your eyes.”II For his students, he would demonstrate the importance of “trifles,” meeting a patient for the first time and deciphering a sort of autobiography from their body in a theatrical performance. From one man’s elephantiasis—a parasitic infection that clogs the lymphatics and swells the legs—and military habit of never taking off his hat, Bell deduced that he was a Highland regiment officer who had been stationed in Barbados. From another’s military swagger and short stature—too short for a soldier—Bell deduced that he had played in a Highland regiment band. When the man replied that he was a cobbler and had never been in the army, Bell had two particularly burly trainees restrain and undress the man to find the tiny blue D, “deserter,” branded on his skin, the truth written indelibly on his body and his fears exposed, the doctor unmasking the denial.”
― Pria Anand, The Mind Electric: A Neurologist on the Strangeness and Wonder of Our Brains

“The drugs we use to treat Parkinson’s disease are indiscriminate, flooding the brain with dopamine without consideration to the delicate balance of the basal ganglia. A side effect of some of these dopaminergic drugs is a sort of hedonism, a compulsion to engage in addictive behaviors—sex, eating, gambling, shopping. The patients described in early reports on this phenomenon were nurses and pastors, computer programmers and car dealers. They were middle-aged and happily married before they began treating their Parkinson’s disease. Like the rats who learned to pull a lever for a rush of dopamine, they favored slot machines for the immediate payoff. After starting a dopaminergic medication, one patient reported that he felt an “incredible compulsion” to gamble, even when he “logically knew it was time to quit.” One sixty-eight-year-old man lost hundreds of thousands of dollars at casinos over six months, gambling for days at a time; his compulsion to gamble stopped entirely six months after stopping his medication. Another man gained fifty pounds and developed an addiction to pornography that stopped a month after he stopped his medications.”
― Pria Anand, The Mind Electric: A Neurologist on the Strangeness and Wonder of Our Brains

“Incidentally, Manàsseina was also perhaps the first female biochemist. Another set of groundbreaking experiments on yeast fermentation was ignored by the scientific establishment during her lifetime. In 1907, four years after her death, a man replicated her experiments without acknowledging her work and was awarded the Nobel Prize.”
― Pria Anand, The Mind Electric: A Neurologist on the Strangeness and Wonder of Our Brains