Itchy McItchy

June 24, 2008 2:26 PM

The Itch: The New Yorker's suprisingly interesting Annals of Medicine article which includes the story of a woman whose scalp itched so badly she scratched through it. And then through her skull.
posted by nevercalm (88 comments total)

Good stuff. Those who enjoyed this might check out Dr. Gawande's two collections of essays from The New Yorker, Complications and Better.
posted by inoculatedcities at 2:40 PM on June 24, 2008 [2 favorites]

*reads article*

*screams, runs out of thread*
posted by Unicorn on the cob at 2:42 PM on June 24, 2008 [1 favorite]

It seems too much like an urban legend to be true.
posted by Dave Faris at 2:42 PM on June 24, 2008

suprisingly interesting

Hardly surprising, considering that it is written by Atul Gawande. That man could write a book about paint drying, and I would read it. Twice.

Seconding inoculatedcities' recommendations of his essay collections.
posted by the littlest brussels sprout at 2:47 PM on June 24, 2008

Horrifying. But not as horrifying as people who transpose the words "itch" and "scratch."

"Will you itch my back for a moment?"

No I won't. I will hit you with a 2X4 instead.
posted by Astro Zombie at 2:47 PM on June 24, 2008 [20 favorites]

Thanks for the rec, inoculatedcities, and for the seconding as well. I hadn't heard of him (?) before, but will definitely check out his stuff.
posted by nevercalm at 2:51 PM on June 24, 2008

And then she scratched through her husband's skull, and then her neighbor's skull. The police arrived, and she scratched through their skulls too. But the neighborhood kids, those skulls she left alone.
posted by davejay at 2:51 PM on June 24, 2008 [9 favorites]

“I felt like my inner self, like my brain itself, was itching,” she says.

Jesus that freaks me out.
posted by itchylick at 2:51 PM on June 24, 2008

Horrifying. But not as horrifying as people who transpose the words "itch" and "scratch."

"Will you itch my back for a moment?"

No I won't. I will hit you with a 2X4 instead.
posted by Astro Zombie

Can we page languagehat? I'd love to know the backstory of that transposition. I'd google it, but I suspect I'll get a better answer here....
posted by nevercalm at 2:52 PM on June 24, 2008

Well, at least she has a face.
posted by Artw at 2:53 PM on June 24, 2008 [6 favorites]

—and all the way into her brain.

Is there a paragraph in existence that cannot be improved by appending this text to the end of it?
posted by davejay at 2:55 PM on June 24, 2008 [9 favorites]

*itches Astro Zombie's name off Synonymy Party guest list*
posted by cortex at 2:55 PM on June 24, 2008 [2 favorites]

Believe it, Dave. I have nerve damage in my right leg that goes through cycles seemingly on a whim. Sometimes it burns; sometimes it freezes; sometimes it feels wet; sometimes its just alive with pure pain. But the absolute worst is when it itches. Because it's a phantom itch. Pure sensation deep inside the flesh where the nerve lives. It's the worst itch imaginable, but there's nothing really to scratch. So I don't. Instead, I just beat on the nerve with my fist until it switches over to pain. Ah, sweet, sweet endurable pain. Don't ever leave me, pain.
posted by It's Raining Florence Henderson at 2:57 PM on June 24, 2008 [11 favorites]

Allow me to be the first to say:

AAUUUUAAAAAAAAAIIIIIIAAAAAUGH!!!!!
posted by mwhybark at 2:58 PM on June 24, 2008 [1 favorite]

After a few minutes of reading famous first paragraphs of books, I can safely say I am wrong, and it is unlikely I will find any paragraphs that can be improved by that sentence.

and I am repentant
posted by davejay at 2:59 PM on June 24, 2008 [1 favorite]

This is now on my top ten list of things that scare the shit out of me - itching so badly that I can't keep my own hands from scratching through my flesh and bone while I sleep.
posted by Joey Michaels at 3:01 PM on June 24, 2008

Reading this makes me feel itchy. in my brain. shudder.
posted by Solon and Thanks at 3:02 PM on June 24, 2008

Have you tried the mirror thing the author was writing about, It's Raining Florence Henderson? It sounds to me from the article that it was revelatory for a few people who didn't think it would work.
posted by nevercalm at 3:05 PM on June 24, 2008

Well, did she try the mirror thing? What do they want me to do, wait for the sequel?
posted by Rock Steady at 3:07 PM on June 24, 2008 [1 favorite]

Is there a paragraph in existence that cannot be improved by appending this text to the end of it?

Testing . . .

Elfriede B., a 72-year-old grandmother, supplemented her pension with a modest sideline in marijuana. "Oma's grass" became cool in Karlsruhe -- and led police to her door, and all the way into her brain.

He pleaded guilty yesterday to having sex with the North Side girl and then fleeing with her on a bus back to his base, and all the way into her brain.

Sue Shellenbarger has written about what the law says on the issue of letting kids stay home alone, and Sara posted recently about letting children walk home alone from school, and all the way into her brain.

Preliminary conclusion: no.
posted by the littlest brussels sprout at 3:12 PM on June 24, 2008 [11 favorites]

—and all the way into her brain ...with a beehive!
posted by Artw at 3:15 PM on June 24, 2008 [5 favorites]

Sitting here with some irresistibly itchy bug bites, the result of a foolish decision to hike off trail through brush, I am not enjoying this article.
posted by zippy at 3:25 PM on June 24, 2008

Can we page languagehat? I'd love to know the backstory of that transposition.

I don't know the history of that particular usage, but it's an example of a common sort of confusion between terms for tightly intertwined activities/roles; borrow/lend is another ("Can you borrow me five bucks?"). Try not to let it drive you to distraction (or to scratching through your skull and all the way into your brain).

That man could write a book about paint drying, and I would read it.

Same here.
posted by languagehat at 3:27 PM on June 24, 2008

Haven't tried it, nevercalm. I'd be surprised if it worked in my case because the sensations aren't constant, so resetting the brain doesn't seem like the issue. I'll give it a try the next time I have a flare-up, though (assuming I'm somewhere that's possible), and a few times after that. If I get any relief, I'll be sure to give you a shout out.
posted by It's Raining Florence Henderson at 3:30 PM on June 24, 2008

Same here.

Oh, you're not that good of a writer.
posted by cortex at 3:34 PM on June 24, 2008 [2 favorites]

I had a friend whose social anxiety manifested as twitchy, repetitive scratching at his scalp. We always joked that he was trying to drill through his skull and manually stimulate the pleasure centers in his brain.

Now that I've read this article I will never make that joke again.
posted by BitterOldPunk at 3:39 PM on June 24, 2008

Fascinating. I wonder if the woman had some self destructive streak or mental illness. (besides the itch) I'd figure if you were scratching yourself down to the bone in your sleep you'd figure out a helmet or binding or some other protective technique before the doctors made you do that and before you went through to the brain.

He has tried all sorts of treatments—medications, acupuncture, herbal remedies, lidocaine injections, electrical-stimulation therapy. But nothing really worked, and the condition forced him to retire in 2001.
...
When I mentioned that he might want to try the mirror-box treatment, he agreed. “I have a mirror upstairs,” he said.
...
After a moment or two, I noticed that he had stopped moving his left arm. Yet he reported that he still felt as if it were moving. What’s more, the sensations in it had changed dramatically. For the first time in eleven years, he felt his left hand “snap” back to normal size. He felt the burning pain in his arm diminish. And the itch, too, was dulled.

An illustrative fable for the Ask Metafilter commenters who always shout DOCTOR DOCTOR DOCTOR. Doctors didn't help this guy, a magazine writer channeling a neuroscientist did.
posted by TheOnlyCoolTim at 3:43 PM on June 24, 2008

Doctors didn't help this guy, a magazine writer channeling a neuroscientist did.

To be fair, Atul Gawande IS a doctor.
posted by prefpara at 3:47 PM on June 24, 2008 [1 favorite]

"When I was alive, I often received advice from my own big brain which, in terms of my own survival, or the survival of the human race, for that matter, can be charitably described as questionable."

--Kurt Vonnegut, Galapagos
posted by gottabefunky at 3:48 PM on June 24, 2008 [5 favorites]

An illustrative fable for the Ask Metafilter commenters who always shout DOCTOR DOCTOR DOCTOR. Doctors didn't help this guy, a magazine writer channeling a neuroscientist did.

Yeah, really. I await the usual shouts of "alternative medicine doesn't work! Ergo, it can't be the mirror that helped him, it's just the placebo effect, yadda yadda etc!" All this from people who do not know (and hopefully never will) how maddening and life-destroying chronic sensations can be.

Also, I'm with Rock Steady -- I got to the end of the article and thought, "and...? AND...?" Hopefully my frustration at the incomplete narrative won't cause me to scratch all the way into my brain...
posted by vorfeed at 3:55 PM on June 24, 2008

wow - amazing article.

thanks for this!
posted by jammy at 3:56 PM on June 24, 2008

To be fair, Atul Gawande IS a doctor.

Ouch, some FAIL on me, though still he was acting at this time as a writer not as a doctor you'd visit.
posted by TheOnlyCoolTim at 3:57 PM on June 24, 2008

he was acting at this time as a writer not as a doctor you'd visit.

Take that, science!
posted by Artw at 3:58 PM on June 24, 2008 [1 favorite]

it can't be the mirror that helped him, it's just the placebo effect

"Just"? The placebo effect is actually kind of interesting.
posted by Artw at 4:04 PM on June 24, 2008 [1 favorite]

I think that, in defense of modern medicine, most doctors don't deal on a regular basis with the kind of patient who scratches through their scalp and all the way into her brain.
posted by infinitywaltz at 4:06 PM on June 24, 2008

The placebo effect is actually kind of interesting.

I agree wholeheartedly! Unfortunately, it's not all that interesting when it's the fiftieth time someone has used it as a catch-all to deny that anybody ever gets relief from chronic symptoms without the help of Mainstream Science(tm).

The placebo effect is great, but it seems that many people mistake it for the Neener Effect: "nuh-uh, nuh-uh! You just think you feel better! No tag-backs!"
posted by vorfeed at 4:13 PM on June 24, 2008 [3 favorites]

Ironically, I also have chronic tag-backs.
posted by It's Raining Florence Henderson at 4:16 PM on June 24, 2008 [2 favorites]

TBH I’m not entirely clear why interesting perceptual tricks with mirrors are considered outside of the realm of conventional science.
posted by Artw at 4:24 PM on June 24, 2008

Oh jeez oh jeez oh jeez!
posted by katillathehun at 4:26 PM on June 24, 2008

(also: I am now really fucking itchy. I think I need to go home and take a shower before people start thinking I have fleas.)
posted by Artw at 4:29 PM on June 24, 2008 [1 favorite]

“Who knows?” he said.

It seemed worth a try. ♦

ACK! You bastard, I demand resolution!
posted by MiltonRandKalman at 4:29 PM on June 24, 2008

This sounds like the kind of thing you'd scare your kid with, doesn't it? "Honey, don't scratch your head like that. Your brains will come out."
posted by danb at 4:36 PM on June 24, 2008

Now my scalp itches.

My arm too.
posted by zia at 4:37 PM on June 24, 2008

I have phantom existing limbs!
posted by Artw at 4:38 PM on June 24, 2008

—and all the way into her brain ...with a beehive!

Later, he fights a yeti.
posted by stet at 5:02 PM on June 24, 2008 [2 favorites]

How does one scratch through bone?
posted by m0nm0n at 5:10 PM on June 24, 2008

Sick and strange, yet I can understand and relate. I had a cut that took forever to heal, because once the scab solidified it would itch like mad. I would just start scratching and scratching it until the scab was scratched off, but the scratching felt so good that I would continue until my nails had gone through another few layers of epidermis and the blood became too messy.

I don't think I've ever scratched through bone, though. That's crazy.
posted by Civil_Disobedient at 5:16 PM on June 24, 2008 [1 favorite]

Is there a paragraph in existence that cannot be improved by appending this text to the end of it?

When, in the course of human events, it becomes necessary for one people to dissolve the political bonds which have connected them with another, and to assume among the powers of the earth, the separate and equal station to which the laws of nature and of nature's God entitle them, a decent respect to the opinions of mankind requires that they should declare the causes which impel them to the separation, and all the way into her brain.

I like big butts and I can not lie
You other brothers can't deny
That when a girl walks in with an itty bitty waist
And a round thing in your face
You get sprung, wanna pull out your tough
'Cause you notice that butt was stuffed
All the way into her brain.
posted by ROU_Xenophobe at 6:16 PM on June 24, 2008 [11 favorites]

How could the mirror effect be considered placebo: a beneficial effect that cannot be attributed to the properties of the placebo itself, and must therefore be due to the patient's belief in that treatment.

The property of a mirror is that it allows one to see oneself. Pretending to move both arms in with the same motion, the mirror provides the illusion that one has two arms. This visual confirmation is relieving to the brain. It feels that the body is complete and normal.

I simply don't see how this is a placebo effect. It's tricking the brain, yes, but it's less to do with "belief in the treatment" and more to do with feedback mechanisms.
posted by five fresh fish at 6:25 PM on June 24, 2008 [1 favorite]

Contemplating what it’s like to hold your finger in a flame won’t make your finger hurt.

Huh? It can for me. I can make any part of my body hurt at will, too, though not much more than a dull ache. And I often get mild sympathy pains from reading about injuries. I'm sure I'm not the only one.
posted by Citizen Premier at 6:35 PM on June 24, 2008 [1 favorite]

Great. Just great. Now I have to throw out my new New Yorker when it arrives. With a pair of tongs. And aaaaa-all the way into her brain.
posted by steef at 6:48 PM on June 24, 2008 [1 favorite]

Great, I already have formication from walking face first into a spiderweb today, and now this.

Still, cool article.

Oh, and Citizen Premier, you are the only one... freak. just kidding.
posted by BrotherCaine at 7:14 PM on June 24, 2008

How does one scratch through bone?

Consider that your fingernails grow much faster than your bones do. Apparently, faster enough that any difference in hardness doesn't much matter.
posted by dhartung at 7:40 PM on June 24, 2008

Wow, I got a little itchy reading the article, but reading the comments is fucking agony.

p.s. there is a bug on your elbow
posted by fantabulous timewaster at 7:44 PM on June 24, 2008

i guess i believe the article because it's in a reputable publication, but really? into her BRAIN? honestly, how does that happen?

i've had chronic hives, and scratched some pretty deep troughs into myself, but i never fucking hit bone.
posted by misanthropicsarah at 8:28 PM on June 24, 2008

This reminds me of the opening scene in A Scanner Darkly, which leads inexorably to the thought that the same is probably happening to Amy Winehouse.
posted by lukemeister at 8:31 PM on June 24, 2008

I have nerve damage in my right leg that goes through cycles seemingly on a whim.

Fear not. Is your twue sezuality!
posted by dobbs at 8:32 PM on June 24, 2008

Huh? It can for me. I can make any part of my body hurt at will, too, though not much more than a dull ache. And I often get mild sympathy pains from reading about injuries. I'm sure I'm not the only one.

Probably not the only one, but this does seem to me to be an interesting and rare ability.
posted by TheOnlyCoolTim at 8:46 PM on June 24, 2008

My god - that poor woman, hadn't she suffered enough before the infernal itching?

All the way into her brain.
posted by Space Kitty at 9:16 PM on June 24, 2008

Great article! I am now browsing through his other New Yorker articles...thanks for turning me on to Dr. Gawande!
posted by radioamy at 9:17 PM on June 24, 2008

Poor Amy Winehouse. First the emphysema, and now this, all the way into her brain!

And may I say again:

AUUUGHIIIAIIIGH!
posted by mwhybark at 10:22 PM on June 24, 2008

It's hard to understand. What could have caused this? Reading about her condition truly leaves me scratching my head.

Oh shit.
posted by Anything at 10:46 PM on June 24, 2008 [1 favorite]

*reads article*
*itches all over*
...Fuck.
posted by SilverTail at 12:01 AM on June 25, 2008

My partner gets itchy scalp, due to having too much hair. He sometimes seems to get a bit of a buzz going, scratching his scalp. I shall enjoy directing his attention to the article.
posted by Goofyy at 12:49 AM on June 25, 2008

For those more interested in V. S. Ramachandran's mirror therapy, I highly recommend watching his TED talk he did a little while ago (sorry for no direct link, but you can find it easily on their web site). It will be an absolutely fascinating 15 minutes of your life, and Ramachandran is quite a character.
posted by blindcarboncopy at 1:14 AM on June 25, 2008

I loved the article, and the author seems very good, but "scratched through her skull"? Really? isn't the skull a very hard object that brain surgeons have to use power tools to get through when they need access to the brain? And aren't fingernails relatively brittle? I've broken nails opening cardboard boxes, is there a way to get my nails so strong they'll dig right through bone?

And if fingernails really can drill right through a skull, why didn't the doctors remove her fingernails? She'd look a bit strange and have a new itch for a week or two, but it would greatly reduce her ability to harm herself without tools.

Fascinating brain research, but it did leave me wondering about her amazing fingernails.

Also, I itch now. Thanks.
posted by mmoncur at 1:20 AM on June 25, 2008

Continuing to attack an unimportant plate of beans within this otherwise very good article:

1. “this fluid came down my face, this greenish liquid.”

Cerebrospinal fluid is supposed to be colorless, not green.

2. ...a neurosurgeon washed out and debrided M.’s wound, which had become infected.

Discharge from an infected wound could be green.

3. Later, a plastic surgeon covered it with a graft of skin from her thigh.

Wouldn't a damaged skull require more reconstruction than a mere skin graft?

All of this makes it sound like there was an exaggeration, until this:

4. She met me at the door in a wheelchair; the injury to her brain had left her partially paralyzed on the left side of her body.

Now I'm really confused. All the way through to my brain.
posted by mmoncur at 1:31 AM on June 25, 2008 [2 favorites]

Cerebrospinal fluid is supposed to be colorless, not green.

Only if you remember to change it every 50,000 miles.
posted by zippy at 3:49 AM on June 25, 2008 [5 favorites]

They're Pinky and The Brain
Yes, Pinky and The Brain
One is a genius
The other's insane.
They're laboratory mice
Their genes have been spliced
They're dinky
They're Pinky and The Brain, Brain, Brain, Brain
Brain, Brain, Brain, Brain
Brain.
All the way into the brain.

Hmmm. Kinky dinky Pinky.
posted by Sparx at 4:10 AM on June 25, 2008

No I won't. I will hit you with a 2X4 instead.

After you're done with it, will you borrow me that 2x4?
posted by fusinski at 5:27 AM on June 25, 2008

I started reading the article this morning, my one-year-old grabbed the magazine off the couch and tore the first page before I grabbed it and subbed in a toy truck. Brought it to the kitchen and taped the page back together, where it now sits after I forgot to throw it in my bag for the commute, something I am so, so, so thankful for...all the way into her brain.

(scratch scratch)
posted by jalexei at 7:15 AM on June 25, 2008

To be fair, Atul Gawande IS a doctor.

Moreover, Gawande is an endocrine surgeon at one of the best-performing hospitals in the world, Brigham & Women's here in Boston. He's a former senior health policy advisor to Clinton and an associate professor at Harvard Medical School. Oh, and an Aimee Mann fan to boot.
posted by inoculatedcities at 8:12 AM on June 25, 2008

Personally, I think appending "Hilarity ensue[s/d]." onto the end of a paragraph yields greater results, but that has admittedly little to do with the post. All the way into her brain.
posted by owtytrof at 8:27 AM on June 25, 2008

Moreover, Gawande is an endocrine surgeon at one of the best-performing hospitals in the world, Brigham & Women's here in Boston. He's a former senior health policy advisor to Clinton and an associate professor at Harvard Medical School. Oh, and an Aimee Mann fan to boot.

He's no DaShiv, though :-)

If you like Gawande, try Jerome Groopman, an older, and perhaps even wiser, professor at Harvard Medical School who also writes for The New Yorker.
posted by lukemeister at 9:15 AM on June 25, 2008 [1 favorite]

I was actually more struck by the implication that the majority of what we perceive comes from memory. That is a serious statement.

But then again, "and all the way into her brain" became my new favorite meme the moment I laid eyes on it.
posted by iamkimiam at 9:17 AM on June 25, 2008

MetaFilter: The best of the web ... all the way into [you]r brain.
posted by spaceman_spiff at 1:25 PM on June 25, 2008

In Xanadu did Kubla Khan
A stately pleasure-dome decree :
Where Alph, the sacred river, ran
Through caverns measureless to man
Down to a sunless sea,
And all the way into his brain.

posted by eritain at 1:28 PM on June 25, 2008

imakimiam, here's another interesting discussion of the interplay between perception and memory.

there is still a bug on your elbow
posted by fantabulous timewaster at 3:17 PM on June 25, 2008

More fool you: I itched my elbow right off hours ago.
posted by cortex at 3:24 PM on June 25, 2008 [1 favorite]

cortex, check your remaining elbow
posted by fantabulous timewaster at 3:27 PM on June 25, 2008 [1 favorite]

I itched it off with my free stump. Are you going to keep pestering me, or are you going to do something about that faint eggy smell and the high, distant ringing noise?
posted by cortex at 3:36 PM on June 25, 2008

Yeah, I know what phantom anatomy is all about. I'm so convinced that my penis is much larger than it really is that I find myself telling girls about it on the phone. It's not that I'm lying exactly, it just feels so real.

Also: *scritch scritch scritch*.
posted by turgid dahlia at 3:37 PM on June 25, 2008

I got unhappy when I read that the doctor "shined" a light. And his shoes too presumably.
posted by A189Nut at 4:46 PM on June 25, 2008

SOOOOO ITTCHHHHYYYY

I literally have not stopped scratching myself in various places since reading this article. I need to go bathe in thumbtacks AAAGGGHHHH
posted by tehloki at 6:21 PM on June 25, 2008

I've heard of phantom limb syndrome. And I've heard of the mirror treatment for it. But I've never heard of someone having phantom limb syndrome who isn't missing any limbs. How wild is that? What causes that sort of thing? The body is a freaky place.
posted by fungible at 7:18 PM on June 25, 2008

Ah, this is where I get to step in and mention V. S. Ramachandran's book Phantoms in the Brain. He turns the phantom limb phenomenon into an epistemological question, one that has never really left me since putting down the book. Highly recommended.
posted by hecho de la basura at 6:28 AM on June 26, 2008

I've had psoriasis as long as I can remember, and as long as that's been, it seems longer that I've been told "Just don't scratch!"

Gawande mentions psoriasis in this piece, but what's wonderful for this psoriatic to read in his article, is this: Itch has been ranked, by scientific and artistic observers alike, among the most distressing physical sensations one can experience.

Ignoring it is impossible. Either you scratch, or you're so concentrated on not scratching that you can't concentrate on anything else.
posted by goofyfoot at 9:56 PM on June 27, 2008

See, I was going along just fine until he talks about how researchers "inserted ultra-thin metal electrodes into the skin of paid volunteers" and I jumped. But I composed myself. And then: "an experiment in which he put ice-cold water in people’s ears."

OH GOD OH GOD OH GOD OH GOD OH GOD.
posted by kittyprecious at 11:51 AM on July 1, 2008