April 1, 2013

Babinski's and Other Signs of the Foot

“Our brains are dulled by the incurable mania of wanting to make the unknown known, classifiable...” Andre Breton

My reading of the works of Balzac have taken a back seat to my informal study of neurology. I recalled from my previous experience with a serious illness that it took twenty years to get an appropriate diagnosis. This came only after studying the illness through medical texts, then finding a practitioner who understood the symptoms as well as the appropriate diagnostic tests. So I’ve signed up for battle number two through careful study but wishing that this time I had the stamina to go a little faster.

The text I am reading, Brain’s Diseases of the Nervous System, by Donaghy, is a classic text now in its twelfth edition. I’m finding it fascinating and almost as worthy reading as Balzac. The history section is especially intriguing and features many illustrious neurologists with apt names like Dr. Russel Brain.

I’ve finally reached the section on reflexes. Reflexes, as it appears in Donaghy’s text, are legion, with each one registering an affect from a specific part of the brain or spinal chord. These long distance messages carry the clues of wellness or disease. What was disconcerting about this chapter was that many of the clinical evidence of illness through reflexes often did not dovetail with my own experience. I am guessing that much of this is due to the dependence on increasingly sensitive technological advances that may be making reading reflex signs something of a lost art form.

To give an example, I recall a clinician scraping the bottom of my foot in a center line from the heel and stopping abruptly at the ball of the foot. Later, I read in the Donaghy text a description of a test for Babinski’s Sign. This test is performed by moving a stick along the soul of the foot but almost at the outside edge, then quickly moving this stick horizontally across the ball of the foot in a shape like an upside down and backwards “L.” “So that was what the doctor was trying to do,” I thought.  Far be it for me to go back to the man and tell him "Backwards upside down L, not lower case l."

Babinski’s sign is so named for Joseph Babinski, a French neurologist of Polish descent active in the latter part of the nineteenth century and early twentieth. The name Babinski reminded me of the name of a friend of my Ukranian grandmother’s, Anna Babinka. Babinski’s sign is a reflex in response to the above mentioned stimulus which causes the small toe to spread outward and the large toe to go upwards. (A normal reflex is to point downward). This reflex is not to be confused, then, with Babinka’s sign, which would involve lifting both hands suddenly upwards at the elbow, palms outward, and exclaiming “Oi!.”

I’ve illustrated my readings about reflexes in the foot with my mixed media mosaic of a footprint filled with prints of “signs.” I made this by stepping into wet clay, then pushing stone seals with ancient writing on them into the footprint. Very clever, I thought, except that the words are in such an ancient language that all but a few historians will be able to read them. I’ll translate the most hopeful sign; “Long life and eternal joy,” it says. The others signs make reference to health and wellness. Let us all hope that there are more neurologists out there who know how to read reflexes accurately than there are historians who can read these prints of ancient language on my footprint.

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