Dancing Upside Down

Dendrite Trails

This blog is almost a year old!  I have personally traveled a great distance during that time.  I started blogging soon after I had been told that I had Traumatic Brain Injury and long before I finally got concrete help.  The earlier posts especially chronicle my journey as I was finally diagnosed correctly and the early struggles I had to understand it and start healing.  I think any person dealing with a TBI will identify with many of the feelings and thoughts I had. 

I encourage anyone new to this blog to skim through the category on Brain Injury and Recovery.  Those posts are the foundation for many of the posts I will soon be writing.  I couldn't be where I am now were it not for the where I was back then! (And yes, I meant to write the sentence that way!!)

10,000 Hours

What does 10,000 hours get you?  It is an enormous amount of time.  It divides down to a little over 19 hours per week if you divide it evenly over 10 years. 

10,000 hours is the "magic number" of practice time to achieve mastery; mastery of anything. 

"The emerging picture from such studies is that ten thousand of hours of practice is required to achieve the level of mastery associated with being a world-class expert - in anything" writes the neurologist, Daniel Levitin.  "In study after study, of  composers, basketball players, fiction writers, ice skaters, concert pianists, chess players, master criminals, and what have you, this number comes up again and again.  Of course, this doesn't address why some people get more out of their practice sessions than others do.  But no one has yet found a case in which true world-class expertise was accomplished in less time.  It seems that it takes the brain this long to assimilate all that it needs to know to achieve true mastery."¹

The above excerpt is from Outliers² by Malcom Gladwell, however the part I quoted is actually Gladwell quoting Daniel Levitin from This is your Brain on Music: The Science of a Human Obsession³.

Gladwell goes on to discuss "prodigies" such as Mozart, Bobby Fisher (chess), Bill Joy (Java, etc.), Bill Gates, and others - all 10,000 hours!  And usually the minimum time to accrue the 10,000 hours is 10 years.  Bobby Fisher is the exception.  It took him only 9 years.

10,000 hours.  Even though that is a lot of time, it gives me hope. 

In the long run what we, the people with Mild Traumatic Brain Injuries, are hopefully doing is developing new pathways around damaged areas of the brain.  In the short run, we are developing compensatory strategies to manage our lives.  But if we work and work at something, for instance making detailed written plans to compensate for the lack of executive functions which include planning and sequencing, will we in time, in ten thousand hours, have developed mastery again?

I don't have the answer yet.  I recently sent an email to the nurse practitioner at the Harborview CORP-TBI clinic asking about about this very question.

... At my appointment on Wednesday with Dr. Zumsteg I asked about prognosis.  She told me that I have probably seen about as much improvement as I will see.  But on thinking about it later, that was not what I was asking.  I don’t think I clearly verbalized what my actual question was.  Therefore, I think my question still remains.  (At least when I do unclear things like this I know you people at CORP understand.) 

I think Dr. Zumsteg thought I was asking about actual healing of the brain tissue, but that is not what I meant.   I know and understand that the brain tissue that was injured is permanently damaged and that those specific areas that are still problematic will not heal. 

What I am trying to understand is what I can do to improve or grow other areas to compensate for or work around the damaged areas.  Or is there no way to do that?  For instance will my executive functions always be this handicapped or over time with working on them will they improve?  Will I forever be struggling this much with depression or over time can the brain chemistry become more normalized? 

I went on to explain how stubborn I am.  I gave an example of how, in my twenties, I had regained the use of my right hand after being told I would lose 75% of the use of it due to a major injury.  In the email I went on to say,

So that is where I am coming from in regards to these questions.  I am older this time around and I can feel that my body regenerates more slowly.  BUT I am still just as stubborn as I ever was!  I want to get more of me back.  I want to get my life to a more normal balance.  I desperately want to be able to work and earn a good wage so I can rebuild my retirement.

The idea of 10,000 hours to gain mastery is fascinating to me on many levels. This is the first of possibly a few posts on the topic.

Footnotes:

1. Daniel Levitin, as quoted by Malcolm Gladwell in Outliers, from This is your Brain on Music: The Science of a Human Obsession.
2. Outliers is Malcom Gladwell's third book.  In my opinion it his best book yet.  It is a quick "listen to" on CDs and a joy since Gladwell does the reading himself.  However, it is best to read the book in addition since Gladwell adds in a lot of side notes that are not in the audio version.
   
3. Daniel Levitin, This is your Brain on Music: The Science of a Human Obsession (Plume/Penguin,2007) This book sounds fascinating but I have not yet read it.

High IQ is over rated! Or is it?

Think about it.  

There are no negative or even neutral words to describe an IQ that is more than two standard deviations from the mean.  People have a High IQ, they are Gifted, Exceptional, Above Average, etc. 

The CIVIQ Society, which accepts people with an IQ of over 145, explains: 

"That high intelligence is a gift with only positive implications is a common misconception: it brings up facilities (talents, strengths and interests) on one hand, but often also specific difficulties and needs on the other."¹

IQ falls in a bell shaped curve with long tails on either end.

Two standard deviations below the mean is considered to be low IQ or mentally handicapped. We accept that people with low IQ fall outside the norm and may need additional assistance to adapt and be successful in society. 

Sadly, the same compassion and understanding does not often exist for people more than two standard deviations above the mean.  The existence of only "positive" words to describe IQ on the higher side is an example of that.

A big difficulty for people with high IQs is that they are sorely in the minority.  Though there is a long tale to the bell curve it is a narrow one.  96% of all people fall within 30 points of the mean IQ of 100.  For someone with an IQ of 146 they are 1 out of a 1000 or in other words for each person with an IQ of 146 there are about 999 people that have a lower IQ. Therefore "gifted" people are very much a minority. The world is not set up for them!  By the term "world" I mean school, the workplace, and even many social situations.  

Plus there is the additional burden of that it is not alright to talk about having a high IQ.  If you mention it you are thought to be boasting.  It cannot be discussed on any sort of equal, unemotional, and realistic footing. In fact, it is considered more politically correct to discuss hemorrhoids than IQ!  So a "gifted" person often struggles in silence; not understanding why they don't fit in and why their experience doesn't match what everyone else is telling them.

"After a particularly tough day of feeling "different", a 9-year-old, who is thinking of going underground with her abilities, says "I don't want to be a purple leaf, when the rest of the tree is green." ¹

And a child describes herself as a cube, "in a world of flat squares." ²

Things are slowly improving in the "Gifted" arena.  There is much more awareness in schools.  Children are tested at an early age for giftedness and there are many gifted programs even in public schools.  There are also many resources on the web for parents, educators, and kids to access.  (See the footnotes below for some links.)

So, back to the title of this post "High IQ is overrated! Or is it?"  I don't know if overrated is the right word.  "Koyaanisqatsi" is a Hopi word. It means "life out of balance".  (It is also the name of an avant-garde 1982 film about the frenetic speed of modern life.)  It is how I feel about the overrating of having a high IQ.  The rating is out of balance.  It exaggerates the positive aspects of the IQ without respecting the difficulties.

Footnotes:

1. The Civiq Society
2. The quotes come from the "You know you're the parent of a gifted child when . . ." page of Hoagies' Gifted Education Page.  Hoagie's is probably the very best site for parents of gifted kids and for the kids themselves.  It is a labor of love done by one couple.
3. The is cartoon by Jeff Gregory of Jagged Smile and is used with permission.  I love his blog and his cartoons!

Heads Up: A Tool Kit for Physicians

Well, this is cool in multiple ways!  First I just found out there is no copyright on Federal stuff.  The reasoning by the courts is that we already paid for it.  (I am not sure why the same reasoning does not apply to states, but it doesn't.)  Therefore I can put this CDC (Center for Dis-ease Control) notice in here verbatim!

The second way that it is "cool" is that this is so very needed.  The article explains it well, but I will add that I am one of the many people who got "missed".  You had better believe that I am sending this on to the Vashon Health Clinic and asking them to order this kit!!

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

An estimated 75%-90% of the 1.4 million traumatic brain injury-related deaths, hospitalizations, and emergency department visits that occur each year are concussions or mild traumatic brain injuries (MTBI).

Many individuals who sustain an MTBI are not hospitalized or receive no medical care at all. An unknown proportion of those who are not hospitalized may experience long-term problems such as persistent headache, pain, fatigue, vision or hearing problems, memory problems, confusion, sleep disturbances, or mood changes. Symptoms of MTBI or concussion may appear mild, but can lead to significant, life-long impairment affecting an individual's ability to function physically, cognitively, and psychologically.

Physicians can play a key role in helping to prevent MTBI or concussion and improve a patient's health outcomes through early diagnosis, management, and appropriate referral.

In response, CDC, in collaboration with an expert work group, has recently updated and revised the "Heads Up: Brain Injury in Your Practice" tool kit. This tool kit is available free-of-charge and contains practical, easy-to-use clinical information and tools, including:

• a booklet with information on diagnosis and management of MTBI;

• a patient assessment tool (Acute Concussion Evaluation or ACE);

• a care plan to help guide a patient's recovery;

• fact sheets in English and Spanish on preventing concussion;

• a palm card for the on-field management of sports-related concussion; and

• a CD-ROM with downloadable kit materials and additional MTBI resources.

To order a free tool kit, click here

View and download kit materials
(PDFs require Adobe Acrobat Reader)

Information for Physicians

• Introductory Letter [PDF 123 KB]
• Facts for Physicians booklet [PDF 4.58 MB]
• Acute Concussion Evaluation (ACE) form [PDF 79 KB]
• ACE Care Plan Work version [PDF 76 KB]
  School version [PDF 78 KB]
• Concussion in Sports palm card [PDF 38 KB]

Information for Patients

• Heads Up: Preventing Concussion fact sheetEnglish [PDF 239 KB]
  Spanish [PDF 219 KB]

MTBI Clinical Diagnosis Guidelines developed by CDC and the American College of Emergency Physicians

View the newly revised MTBI clinical diagnosis guidelines that can help improve diagnosis, treatment, and patient outcomes for the more than one million people who visit the emergency department every year for mild TBI or concussion.

The revised guidelines address the following four key questions and offers recommended courses of action:

• Which patients with MTBI should have a head CT scan in the ER?
• Is an MRI more useful than a CT scan when assessing a patient with acute MTBI?
• In MTBI patients, are brain specific blood serum biomarkers predictive of an acute traumatic intracranial injury?
• Should an MTBI patient with a normal neurologic evaluation and a negative CT scan be discharged from the ER?

CDC's National Center for Injury Prevention and Control-the Injury Center-invites your comments about the "Heads Up: Brain Injury in Your Practice" tool kit. We are especially interested in knowing which materials you found most useful and your recommendations for ways to improve the tool kit. To provide comments, please
e-mail us at ncipcdirinfo@cdc.gov.

Research shows Internet Searching is Good for the Brain

One of the fun (though time consuming) things about writing this blog is all the places it leads me to due to Internet searching. 

For instance in looking for a picture that made a visual statement for my metaphor I learned a lot about Sinkholes and saw some amazing photos of some huge ones. 

I also search to make sure I have facts straight, to check my use and spelling of words, get a quote, look up footnote formatting, etc. I therefore was happy to see that Internet searching may be good for us!

In the News from the Frontier section of the November-December 2008 issue of BrainWork there was a short article entitled "Being Internet savvy may have cognitive benefits". 

"Regularly searching the Internet activates regions of the brain that are known to be involved in decision making and complex reasoning, according to a new study led by UCLA neuroscientist Gary Small.

The study, currently in press at the American Journal of Geriatric Psychiatry, involved 24 participants between the ages of 55 and 76. Twelve had previous experience searching the Internet; 12 were self-described as “Net naïve.” The groups were matched for age, education, and gender. 

... Small and colleagues found that there was a significant difference in brain activity between the two groups during the Internet searching task. The “Net Savvy” subjects showed greater brain activation, particularly in the frontal lobe, which is known to be involved in decision making and complex reasoning. When the Net Naïve group searched the Internet, their brain activity resembled the activity during the reading task.¹

Of course, there is no real conclusion that can be drawn from this one small study but it does lead towards some interesting ideas and hypotheses.  However, I got a kick out of the only one that Small was willing to profess “Probably what you’re going to find from people who work out their brain searching the Internet is that they’re going to be better at searching the Internet.”

Footnotes:

1. "Being Internet savvy may have cognitive benefits" News from the Frontier BrainWork Vol.18, No.5  November 01, 2008  

Calling All Beatles' Fans

Today, February 9th is the 45th Anniversary of the Beatles' first appearance on the Ed Sullivan show.  I guess that is why the answer to the Cryptoqip was "Beatles hit about a street on which people congregate and create plays on words"  The answer was "Punny Lane".

For those of you who were Beatles fans the Magical Memory Tour needs you!  Well, at least they want your memories of the Beatles.  The Magical Memory Tour is actually a scientific study being done on memory.  Yes, this is for real.  

Follow the links to Magical Memory Tour to read more about it.  The research study is being done with support from the Economic and Social Research Council, the Dana Foundation, and (of course) the Beatles Story.

Journey to the Center of the Brain

This is an excellent talk by brain expert, Vilayanur Ramachandran.  He gets a standing ovation at the end for good reason!  He is a great speaker. 

In this talk he discusses the research being done using specific brain injuries to map the brain but also goes into some fascinating rehabilitation techniques that he has developed.  Especially amazing is the use of the mirror box for the treatment of phantom pain and also for use in stroke rehabilitation.

Vilayanur Ramachandran is the director of the Center for Brain and Cognition at the University of California, San Diego, and an adjunct professor at the Salk Institute. He is the author of Phantoms in the Brain, the basis for a Nova special, and A Brief Tour of Human Consciousness; his next book, due out in January 2008, is called The Man with the Phantom Twin: Adventures in the Neuroscience of the Human Brain.  Newsweek magazine named him one of the "hundred most prominent people to watch in the next century".

I am curious to hear about work using the mirror boxes for stroke patients.  If readers know about stroke rehab being done using mirror boxes, please post a comment.