News & Notes from Larry's Laptop

The other day I overheard two people talking about neuroplasticity while waiting in line at Peets Coffee & Tea in San Jose. Talk about coming a long way!

When I was studying Psychobiology—aka, the neurological basis of behavior—at UC Santa Cruz back in the early 1980s, the structure of the brain was understood to be given and unchangeable. The homunculus—the representation of the physical body on the sensory and motor cortices based on Wilder Penfield's research—provided a physical basis for Feldenkrais' idea of the self-image. However, the homunculus was taken to be fixed, like a map that was hardwired into the brain at birth.

This presented a problem. If Feldenkrais was right—that we move according to our self-image and not our structure AND that our self image changed—that implied that the sensory homuculus, at least, would have changed as we learned. This idea was unacceptable to the orthodoxy at the time, which lead to some pointed conversations with some of my professors and fellow students.

At one point, I remember reading an article about research into the development of the nervous system of dogs done by Russian neurophysiologists. Following Penfield, they stimulated the motor cortex of puppies through the first days of life and they were able to show that the projection of the body onto the brain (since they were canines, does that mean we'd have called it the "canunculus?") changed over time. This was a breakthrough: the first evidence that the brain changed with learning that I had stumbled upon.

At our first appointment my orthopedic surgeon, Christian Heywood, compared the X-rays taken that day with the ones taken a few weeks earlier in Australia (immediately after my accident). He showed me that the 5mm gap was not closing and explained that, even with my arm in the sling, the extensor muscles of my forearm were engaging— pulling the bone away from the shaft.

Dr. Heywood showed me how these muscles attach outside where the bone was cracked, and demonstrated how they work. For instance, when making a fist the extensors contract to prevent bending the wrist. Because they would keep pulling on the bone there was a great danger that the bone would not heal. Though he was clear that is was an option, he strongly recommended surgery.

Truth be told, I wasn't so sure. Was this a necessary operation or not? I did my own research, talked to my primary care physician and other members of my medical team, and consulted a few trusted Feldenkrais colleagues who are doctors and physical therapists.

They all agreed: the risk of non-un ion was too great. It was a serious complication that would leave my upper arm bone fragile, unstable, and prone to pain and deformation. What's worse is that non-un ion would make weight-bearing difficult and dangerous. Not only wouldn't I be able to exercise, but my beloved bike-riding could be too risky and using my arm at work could become severely limited.

That made it clear: despite my trepidation, the operation was indispensable. Dr. Heywood would insert two metal screws to bring the small piece of bone back into contact with the shaft and hold it there to allow the bone to knit together. A few months of recovery and rehabilitation would make my arm strong and reliable once again.