Purple Crayon

“So should we not call it a ‘seizure’ when the infant has a seizure? What should we say?” In this talk for some of Yerevan’s neonatologists, I am doing my best to shatter the notion of a neonatal seizure as something you can diagnose by eye. These are fine, conscientious physicians who believe in science, who voyage to the Marzes (outlying regions) to improve neonatal resuscitation; and who, like many US neonatologists, mistakenly treat all seizure-like newborn behaviors as epileptic.

I loved Harold and the Purple Crayon, the way he divided up space so freely.

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Now, here in this Soviet-era lecture hall, I am dividing up seizures with little more than a purple crayon. “You can call it a seizure, as long as everybody knows that behind that word are 2 possibilities–epileptic and non-epileptic.” I feel the neuro-epistemology of seizures rounding a hairpin turn in the room.

A great many of us begin life with a paroxysm that you might call a seizure: we extend, we twitch, we contort, we ride imaginary bicycles, we roll our eyes. The ink runneth over in the world’s neonatal units, as we prescribe medicines for these events, even though a seizure is not always a seizure. To neglect would be a sin, seems to be the thinking; better be safe than sorry. The answer: do an EEG, and see whether the brain’s electromagnetic halo is pulsing along with those movements. But there’s no EEG at this hospital; I can’t just draw one.

Academics sub-divide as avidly as real estate developers; see, over here, I have split apart what you thought was whole! Sometimes, the academic’s intellectual avarice takes us on a frenzy of sub-division. You can imagine the sophisti-confusion. But today, I’m solid with my fission; until they get an EEG, I advise them which movements can more reliably be diagnosed as seizures, and which are the common masqueraders.

Clinic Maria, a 15 month old, former premature infant with motor delay, retinopathy. “Inke zhbtume?” Does she smile? The parents smile. It’s nice to know that, in all cultures of this planet, a smile is a smile is a smile, an indissoluble unit of behavior. And Maria has an ethereal smile. We trade waves as the discussion closes.

Matenadaran Museum; a lamb appears to be suspended amidst the branches. Look lower, there must be some misunderstanding: Abraham, his cutlass poised at his son Isaac’s throat, is looking upwards. I think he is about to change his mind. God drew a terrible line, and now is erasing it, ending this trial of faith, with the toss of a lamb.

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Recently I found myself configured in an on-line spat. O purple crayon! Symbols, and a sense of fairness–these must be the most dangerous tools God ever put in our hands. “Put it on my list of sins” was the last, despairing rejoinder. But would I call it a sin?

Song: “Put it on My List of Sins

 

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2 thoughts on “Purple Crayon

  1. Dear Peter,
    Paint on with your purple crayon and sing us your songs into the night. Change is so complicated, borders so borderly. Humble and brave, humble and brave – bet that’s true where ever you are. Maybe when you return to Vermont it will feel like a new experience in need of continuing bloggery. Hoping so.
    Best here is the view from our duckboat kayaks in the mouth of the La Platte River off Shelburne Bay among great blue heron, great egrets and six goslings swimming in line between their Canada Goose parents times three. No borders in the river bends or the emails in Spanish between Mireya in México DF and me in VT.
    Love to you and Dana,
    Sharyl

    Reply

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