Reaching Down the Rabbit Hole: Extraordinary Journeys into the Human Brain

by Allan H. Ropper

At about the same time, when I was an intern in San Francisco, we treated a farmer from the Sacramento area who had coccidioidomycosis meningitis, also known as valley fever. Stockton, California, was ground zero for the disease. It is carried by airborne dust particles that settle into the lungs, causing a pneumonia-like infection that can develop into an inflammation of the brain’s lining. The treatment involves a lumbar spinal tap that allows medicine to be injected into the spinal canal daily, a very invasive regimen requiring a long stay in the hospital. As serious as this was, the farmer had a more pressing problem. His wife was in the early stages of dementia, and she was alone on their farm with their two German shepherds. He desperately needed the treatment, and she desperately needed him. Every day, when the team dropped by on rounds, the senior resident, whose name was Chin, told the farmer he was doing better, that his lungs were getting better, and every day the farmer would reply by asking, “Can I go home today?” The first time this happened, Chin said: “You have to understand that you have a serious infection, and you have to get antibiotic injections for the next two weeks.” On rounds the following day, when the farmer again asked his one and only question: “Can I go home today?” Chin went through it all again, but less patiently: “Two weeks.” After several days of this routine we were all frustrated, but Chin, who saw the world and all the people in it in ...