Assignment #1: The Frame...and meeting K.J.!

In a slightly belated post, I will post the top three images I edited and produced with the point-and-shoot digital camera for the Photography as Language class.
This was the first time I attempted using photoshop, but after the prints and critique, I was very happy with the results.

These two images I chose plainly for their aesthetic value. The deep and bright greens and the overwhelming cyan-blue truly shined from the original images. After a brief tweaking of highlights and shadows then playing with color balance produced images that I am proud of.

Of course, I decided not to show my patient these, instead, ever attempting to be the amateur neuropsychologist, provided this picture of my girlfriend on the beach. I told her "go run at those birds so I can take a picture!" to which she happily obliged. I felt the image provided a story and a plethora of descriptive words to review for an aphasic patient. Sand, clouds/cloudy, birds, flight/flying, running, beach, smile/smiling, and various nouns, verbs, and adverbs. I had just read a paper for neuropsychology outlining the double disassociation of noun/verb duality. Patients often have trouble with either words related to imagery or trouble with more nebulous concepts. It's easier to imagine a bird in your head, but the imagery of "flying" requires one to create a mental scenario with an object to partake in flight.

Of course, I got what was coming for me. My client, K.J., is extremely feisty, extraordinarily smart and quick-witted. Well, she took one look at my picture, frowned, and pointed to Diego's photograph of beautifully composed and vibrant marker heads, creating a rainbow pattern of random colors. K.J. used to be a painter before her stroke, and of course was attracted to the superior and more interesting image. 

This is a great lesson in the attempt of a scientific intent and the subsequent realization of its absolute absurdity. I just might have to rethink this whole case-study idea...K.J. is much too entertaining, engaging, and hilarious to drone on about dry clinical facts. Oh, but I'm not abandoning that aspect totally. Something I noticed quite early on was K.J.'s immediate verbalization of what I'll call "frustration words." The first words I heard her speak were a "What the hell?!" pointing to her speech therapy scheduling, jotted confusingly on a sticky note. 

She presents with anomia, telegraphic speech, and other non-fluent presentations. Right-side hemipelegia is apparent as she lost the majority of fine motor control of her right hand, which must be extraordinarily frustrating to a former painter. She is acutely aware of her language deficits, and quickly inserts a frustrated "crap!!" in place of an unknown word. We took her outside to show her how to use the camera, and joked about the dismal scenery outside of the building. "What do I do!?"gesturing with her camera, "picture of dead bush?!" 

Pre-Patient Preconceptions

For the past week, I've been extremely excited about meeting my client, known to me at this point as K.G. (And due to HIPA, she will henceforth be referred to by her initials on this blog.) I'm paired up with a speech pathology graduate student, Kaitlin, in her third year of the Masters program at the Communicative Disorders program at the University of Central Florida. Speech therapists perform a variety of roles ranging to clinical rehabilitation after injury to helping children develop stronger speech patterns to even training actors how to perfect accents. 

At this point, I have only a brief clinical presentation with a few behavioral anecdotes. K.G. is currently in her early fifties and suffered a stroke in 2003. She is extraordinarily independent, and cohabitants with and cares for her blind father in his mid-eighties. K.G. was, and is, an extraordinarily intelligent woman, a member of Mensa (meaning she scored above the 98th percentile on a standardized IQ test) and fiercely self-determining. Coronary and cerebral artery disease caused a piece of atherosclerotic plaque to dislodge from her carotid artery, common etiology for an ischemic stroke. Her stroke six years ago left major non-fluent language deficits (Broca's), minor cognitive reasoning difficulties, and minor right-side hemipelegia, all consistent with left anterior frontal cortex damage. She is able to communicate with labored telegraphic speech and successfully utilizes verb networking and external clue sheets to facilitate communication. Due to her intelligence, apparently largely intact, she becomes extremely frustrated at her inability to succeed at simple tasks. Until I have HIPA clearance and get ahold of the medical records, this is the furthest I can speculate on the clinical presentation. 

This is an MRI of an individual that has suffered an ischemic stroke presenting with Broca's aphasia. Each stroke and each patient's neuroanatomy varies, but Broca's and Wernicke's areas of the brain are correlated strongest with language production/motor control and logistics/comprehension, respectively. Broca's aphasia, known as "non-fluent" aphasia, creates labored speech production or an inability to produce speech. Comprehension is usually intact, adding to the frustrating nature of the condition. Telegraphic speech, usually one or two words denoting the gist of the thought, tends to be the average level of communication most Broca's patients can muster. Hemiplegia, or one sided-paralysis, is common because Broca's area is so close to the pre- and primary motor cortex. 

Broca's is the most common aphasia, with over 70% of aphasic patients falling under major non-fluent categories. This is because of the complicated vascularization pattern of the brain--Broca's area happens to lie adjacent to a major cerebral artery branching off the carotid artery in the neck. The carotid, like many arteries surrounding the heart, becomes covered in sticky plaque that can attract blood clots. High blood pressure usually causes one of these clots to break off from the diseased artery and cause ischemic damage to the two most vulnerable tissues--the heart and brain. 

Science tends to be impersonal, detached, and uncaring. I reject this outright, and it's one of the reasons I love the field of neuropsychology so much. Case-studies, detailed and personal accounts of patients, have little choice but to include emotional developments between a clinician and patient. While I understand the need for double-blind pharmacologic studies, assessing individual therapies on a patient-to-patient basis gives neuropsychology an entirely different aesthetic from other descriptive sciences. I'm looking forward to interacting with K.G. and participating in her therapy. Six years after her stroke, it's highly unlikely that she will regain any major language or motor functions lost from the stroke, but the brain is phenomenally malleable. I know she is an incredibly intellugent person, and her drive in relation to these specific photographic therapies, I can safely assume, will literally rewire parts of her brain. I will be recording as many observations I can throughout this process with the hopes of writing a case-study, but I won't let that devalue the patient herself. This is an amazing opportunity not only for an amateur neuropsychologist, but hopefully for KG as well. 

The Art of Neuroscience

When one thinks of neurology, neuropsychology, or neurology, sterile images of MRI scans and disembodied heads of CT radiographs come to mind. Personally, I think angiography is a truly beautiful, if not slightly morbid, test performed thousands of times a day by interventional neuroradiologists. A radioactive dye, injected directly into a major cerebral artery, can highlight specific areas of potential ischemia through diseased arteries, locations of aneurysms and other neurovascular areas of concern. 

I'd consider applied neuroscience one of the most artistic and creative sciences left in the medical field, mainly because there is so much left to be discovered. The aesthetics of neuroscience are apparent from its inception. Arguably one of the first great works of neurobiology, Spanish physician, histologist, and and pathologist Santiago Ramón y Cajal used his artistic skills and ingenuity to highlight the cellular structure and interconnection of neurons. Staining individual cells first showed the massive interconnectivity of the neural network. 

A century later, researchers used genetic engineering techniques to breed a rat brain with florescent proteins that would glow bright colors under certain lights. The research is still providing breakthroughs for understanding exactly how neurons develop, organize, and connect with one another, but the micrographs are truly beautiful. 

Ischemic Imagery: Introduction

Ischemia is a technical term for lack of oxygenated tissue due to an obstruction in blood flow. Two of the body's most vital organs most commonly fail due to ischemia. Myocardial infarctions, heart attacks, occur when a small blood clot interrupts and clogs an artery that supplies blood to heart tissue itself. Within minutes, heart tissue dies and cardiac arrest may occur. Most strokes occur in a similar manner. A blood clot may detach from an artery (commonly the carotid artery in the neck) and block blood flow to the brain, catastrophically starving fragile neurons of oxygen. Sometimes a blocked artery will swell up or even rupture, applying deadly pressure to surrounding neurons. The brain is the most essential organ, but its fragility is a terrifying reminder of our own mortality and tenuousness of consciousness. 

I intend to do undergraduate, graduate, and post graduate research on strokes and resulting neurological deficit, focusing on pharmacological treatments to reduce neuron cell death and promote neuron compensation and growth after traumatic injury or ischemia. The brain, despite its fragility, has a phenomenal ability to change itself, to rewire its connections, to cope with otherwise devastating loss. This is called plasticity, and it is this constant evolution that makes the brain the greatest scientific frontier to ponder. Neuroscience is an interdisciplinary academic amalgam including biology, psychology, philosophy, medicine, and, yes, even art. 

Written for an art class by a psychology student intending to go into medicine and research, I expect I'll provide more emphasis on empirics over aesthetics--but it's easy to overlook the aesthetics inherent in the empirics. I may come off as a left-brained and coldly analytical scientist, but that couldn't be further from the truth. I want to go into medicine for patient interaction and creative pharmacological problem-solving. This is a neuropsychological art therapy course, and I couldn't be more excited. 

I think I can sum it up:

This blog will attempt to highlight the relationship between the visual arts and underlying neurological deficit.