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THE CELTENCEPHALON* R. W. CHILDERS, M.D. ^ When I review the names of the speakers who have stood at this lectern for previous Foundation dinners, I am not filled with humility, nervousness, or blind terror. You will probably insist that I provide a descriptive word. I can: paralysis. This sense of awe is fortified by the nature of the goals of this particularly august Foundation. Ever since I was a medical student I have been fascinated with the great neurologic names. Some of them, like Sir Henry Head and Sir Russell Brain, are immediately unbelievable: they remind us of the children's books in which the surnames announce the occupation—Mr. Ballcock the plumber and so forth. When you are finally accustomed to this plethora ofcoincidence, you are then struck by the unremittingly powerful sonority of the other great names in neurology and neurosurgery. There is almost an excess of substantiality in Sherrington, Hewlings Jackson, McDonald Critchley, Kinnear Wilson, Wylie McKissock, and Harvey Cushing. If the names themselves can create a sense of awe, it is dwarfed by that which I, as a physician, feel when contemplating the intrepid and marvelous work of brain surgeons. In case any of you have the slightest doubt about the delicacy of their task, I am going to quote a few lines from a practical tract on the anatomic dissection of the brain. "Delicately pull off as much as you easily can of the filament which encloses the tissue, but without tearing it. This is a rather slow process." The next sentence rings with mortally intolerable truth. "Brains must be handled carefully or they will fall apart." When I first read these words ofJulia Child, they gave me a sense ofcomplete surgical terror. Ofcourse, brain surgery is a success story, nowhere more so than at the University of Chicago. The creative support given by this Foundation has, I am sure, contributed to this success. The surgeons themselves have probably helped also. We often hear of the silent majority. The late poet W. H. Auden once spoke of the "Invisible College of the Humble." I would like to address some words on behalf of another silent, confused section of the body *Address given at the annual dinner of the Brain Research Foundation, Drake Hotel, Chicago, December 12, 1973. tDepartment of Medicine, University of Chicago. 58 I R. W. Childers · The Celtencephalon politic. It is a group of sufferers who communicate with each other over the telephone to form mostly strong bonds. I call them the Fellowship of the Slipped Disk. Curiously, you will not find the same camaraderie in the case of coronary disease, or hypertension, or stroke, or any form of cancer, so one is forced to inquire what it is that feeds this externally silent but internally loquacious minority. It is the perpetual state of anticipation in which they live as they learn from each new disk sufferer ofyet another form oftreatment, the superiority ofwhich is vehemently proclaimed not by the patient but by his or her medical adviser. I cannot be more specific about the latter because everyone has his fingers in the discoid pie: internists, arthrologists, neurologists, orthopedists, neurosurgeons, chiropractors, and osteopaths. Thus, you can have traction, manipulation, bed rest, board rest, back brace, spinal fusion, arthrodesis, laminectomy, enucleation, alcohol injections, or enzyme dissolution , or even be recommended to swim most of the day. There is no condition that conjures up so much visual imagery. When I first read of the rare situation in which multiple disks decide to extrude, I visualized lifting the lid of an upright piano and watching the cushions hammer out during an arpeggio. I have devoted time to the slipped disk because there is no neurologic condition which has received less research attention . In County Clare in Ireland, broken bones, dislocations, slipped disks, and other diseases of what Julia Child calls gristle were treated free of charge for 25 years by Burke the Bonesetter. He was a perpetual embarrassment to Prime Minister de Valera, whose constituency was Clare, because Burke was a fellow congressman. No election promises have ever been more habitually fulfilled. Burke asked his constituents only for a legislator's salary—in return for...


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