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I heard about this case and was more than a bit distrubed…..

A 35-year-old woman with bipolar disorder was found wandering on a highway screaming and crying, with disorganized speech. She was evaluated in the emergency department, and computed tomography of the head revealed a hypodense area. The patient reported that she had a nail in her uterus. In the context of the presentation, this was deemed to be unlikely. However, before magnetic resonance imaging was performed for further evaluation, radiography of the abdomen showed a large nail, which was localized to the bladder on ultrasonography, and an intrauterine device in the uterus. Surgery was scheduled to remove the nail, but on the morning before surgery, the patient painlessly passed a 10-penny 8.3-cm steel nail while voiding. After resolution of this psychotic episode, the patient revealed that her intention was to place the nail in her uterus as a means of protection against being raped, which had occurred in the recent past. She was subsequently admitted to a psychiatric facility.

Source:NEJM

Nurse worked 18 years with no license

Spring Hill woman was arrested Wednesday afternoon, after deputies discovered she'd worked for 18 years as a nurse with no license.

New Port Richey, Florida — For the last 18 years, she'd been training students for medical certifications at Pasco-Hernando Community College. But she never had a nursing license, according to deputies.

Sandra Wilbanks, 59, was arrested Wednesday afternoon.

Since August of 1990, she'd worked at PHCC as a registered nurse as the instructor of technical health programs. When she was hired, deputies say Wilbanks provided forged documents to the human resources department to prove she was a nurse. The documents showed Wilbanks had a valid license to practice nursing in Florida.

State law did not require Wilbanks to be a registered nurse in order to be an instructor at PHCC, but the college did.

"The copy of the license she submitted seemed genuine," said PHCC spokesperson Lucy Miller. "Every several years, registered nurses are required to update their licenses, and she provided us with copies through the years."

But the school did not double-check with the Florida Department of Health until this year.

In May, PHCC requested updated licensing information from Wilbanks as the school was in a credential review process for state accreditation. Wilbanks eventually told the school that she "might have let her licensing expire," according to the Pasco County Sheriff's Office. She then submitted her letter of retirement.

"I'm shocked, to be honest with you," said Terri Buell, who earned her certification of Phlebotomy under Wilbanks' instruction. They're also neighbors and have been friends for more than a decade.

"She's a wonderful person, inside and out. She was a good teacher."

Deputies say Wilbanks' nurse status was revoked by the North Carolina Board of Nursing in 1974.

During her time at PHCC, Wilbanks worked as a full-time employee, which included all salary and benefits, including enrollment in the Florida Retirement System. In her 18 years at the college, administrators say all reviews were exemplary.

Wilbanks has bonded out of jail and did not respond to Tampa Bay's 10's request for comment. She is charged with forgery and scheming to defraud.

The Florida Department of Health has an online tool that searches for medical licensing information on anyone in the state. All you need is the person's first or last name.

Click here for PHCC's Statement

Click here for Sheriff's Statement
Janie Porter, Tampa Bay's 10 News

Stroke of Insight: A Window Inside the Brain

Scientist Jill Bolte Taylor Given an 'Incredible Education' When She Suffered a Stroke

By KATIE ESCHERICH

June 24, 2008—

Jill Bolte Taylor has always been fascinated by the brain.

"I've always been thinking about who am I as a brain, as a mind," Taylor told "Nightline" co-anchor Terry Moran. "To me, it's absolutely phenomenal that this collection of cells is capable of creating for us a perception of the world that seems real and that feels safe. To me that is just a mind-blowing concept."

Taylor's own perception of the world was shattered in an instant on Dec. 10, 1996, when the then 37-year-old suffered a left hemisphere stroke. As a scientist, the stroke offered a Taylor a rare opportunity to experience what she studied.

She has since shared that experience with the world in a best-selling book, "My Stroke of Insight: A Brain Scientist's Personal Journey," and a presentation she gave at the Technology, Entertainment, Design conference in February that has caught on like wildfire on the Internet.

The stroke was the moment that "everything changed," Taylor now says.

"In the course of four hours I watched my mind completely deteriorate in its ability to process all information coming in through my sensory systems," she said. "I had no ability to connect what was going on inside of my nervous system with the external world. I shifted away from being the person I was before."

A Beautiful Mind

Who Taylor was before the stroke was a Harvard-trained and published neuroanatomist who devoted her life to studying the brain at the cellular level. Her experience growing up with a sibling who suffered from mental illness shaped her future profession.

"Eventually [my brother] was diagnosed with chronic schizophrenia," Taylor said. "So his brain was organizing information very differently than mine, was and that fascinated me."

She chose to study the brain because, she says, "I knew I would never be bored." Still fascinated by her subject matter, Taylor calls the space inside our heads "the great frontier."

Most people would expect a stroke to be a frightening, even painful experience, but Taylor describes it differently, using words such as "bliss" and "euphoria" and adding that she didn't initially realize what was happening.

"There was no fear," she said. "I'm observing myself feeling detached from my normal perception of reality."

She calls it an "incredible education" for a scientist, because the stroke allowed her to live what she had learned about how the left and right hemispheres of the brain function.

Taylor's stroke occurred in the left hemisphere of her brain, where the language center is primarily located. The left hemisphere controls the ability to create sound and to understand words; it controls the internal organization of every detail of your life. The right hemisphere controls what Taylor calls "the big picture."

"The right hemisphere is the big contextual landscape of your life," she said. "You're not focusing on all the details. You're experiencing the whole context & So you have both of these beautiful hemispheres. One is designed to do the big picture. The other is designed to take the detail out of that, and then you walk into the world and you have both."

Taylor says her stroke of insight, her epiphany, occurred when her right hemisphere took over.

"You have this brain that brings you to the present moment, and in this present moment you are experiencing a collage of sensory & You can feel the temperature of the air. You can feet the slight breeze in your hair. You can see the world. You can smell scents about you. There is this magnificent present moment."

The Balanced Brain

But there are also downsides to living only in the present moment.

"The disadvantage of just living in the right hemisphere is as soon as I would turn my back on you, I would have a new present moment and you don't exist for me anymore," she explained. "Imagine what that would be like & we require so much information that we have learned in the past to teach us how to appropriately act with the present moment. So, it takes both. I am an advocate of the balanced brain where you have both."

According to Taylor, the world we live in doesn't emphasize a balance of the left and right sides of the brain.

"We are in a very left hemisphere dominated society," she said. "We reward our children for their left hemisphere skills."

The right hemisphere, she says, is "an experience of deep internal peace that is just phenomenal, and to think that we all have that right there, right there in the consciousness of the right mind. To me that was the insight, it was I can have this experience of nirvana and bliss& And we are all perfect and whole and beautiful simply because we are."

Taylor says anyone can consciously go to that part of the brain, comparing it to how everyone detaches and relaxes while on vacation. "It's an awareness," she said. "First, I think, it's an awareness and then a practice and a discipline."

"You can always take yourself back to that perception. Does that mean you're going to spend you life on vacation? No, because you want to be a productive human being in the world. But it does mean you're sitting in that board meeting and you're bored to death and you're feeling all this stress and you're late for home and your tension is rising and you have that choice to picture I'm going back to bliss."

Taylor says this is easier than meditation, because there is "no destination."

"That doesn't in any way negate the validity of where meditation will take you if you want to go through that kind of a practice and you enjoy that. For me, I just want to go there. I just go there."

'Stroke Survivor'

After her stroke, Taylor says that she was no longer a "normal human being," and the person who had achieved so much professionally disappeared. She says that her values, interests and abilities all shifted.

"I did lose my mind," she said.

"When that language center, when that left hemisphere died, I had no recollection of her life," she explained. "That person and her capacities, she died. And I was real clear that I was no longer that person because I didn't share anything about her other than this form. I was going to look like her, I was going to speak like her, but I didn't have any of her memory& So, it was never my goal to recover. So we grieved her, we mourned her, we let her go. And we celebrated, 'OK, now who am I going to become?'"

Taylor resented the anxiety, anger and pity of those around her at the hospital, and doesn't believe people who have suffered brain injuries should be categorized as damaged.

"I was not a victim. I was a stroke survivor. It's an attitude. It's an attitude of how do we look at people that are different than we are," she said.

Learning to Speak, Return to Research

Her recovery was a "moment-by-moment experience," she said.

Three weeks after the stroke Taylor underwent brain surgery at Massachusetts General Hospital, and as she began her long road to recovery, Taylor says her first priority was regaining language capacity.

"It didn't matter if I couldn't do any math, it wouldn't matter if I didn't learn about the brain or any of my science," she said. "But I did need to be able to speak."

It took eight years for Taylor to fully recover and return to her professional life, and the changes in her life have shifted her area of research.

"This has set me free," she said. "This experience has set me free from the doctrine of hardcore science that I was brought up to believe, into looking at the bigger picture of what is really going on inside the portions of the brain that left hemisphere tools cannot measure or understand."

Freedom and Faith

Taylor says that the experience has also transformed her as a person; she says she's friendlier, more compassionate, more loving, more connected to fellow human beings.

"I consider all my life since Dec. 10, 1996, as gravy time," she said. "Gravy is just this bonus. So, in this bonus time, how can I help us think differently& in order to help decrease the amount of suffering that we are engaged in and that hostility and pain and to project more peace from what we are as a living being? So my intention is completely different. "

Taylor is also giving a number of speeches each month and is in discussions to turn her book into a feature film.

She thinks her story has generated so much interest because it "has an appeal to anyone that has a brain," adding that the response from people who have seen the video has been overwhelming.

"I'm getting these beautiful stories from people that have a sibling or a family member with a severe mental illness or who have had a stroke, and they're desperate to know that these people are still in there. 'How do I find them? What do I do?'"

Taylor doesn't know why she was given this window into a different world.

"This experience happened," she said. "It just happened to someone who had this biological background who then got to observe it and walk away with a different kind of perception."

Taylor doesn't equate that different perception with a transformative religious experience. As a scientist, she says, she doesn't believe in "an external entity sitting on a cloud somewhere& But is there something beyond me, is there something much greater than what I am? Oh, absolutely."

For Taylor, different religions are just different stories, different paths to the same place.

"[Different religions] are ultimately getting to the same consciousness, which would be that right hemisphere, a celebration of what we are. & So, it's the left hemisphere story that gets you to that place. I am not attached to the story, I am not attached to anyone's story. I think whatever story it is, great, if it gets you to the same final destiny then that's a beautiful thing."

Helpful Bacteria May Hide in Appendix

Everyone is born with one, but no one knows what it’s for. The human appendix is a small dead-end tube connected to the cecum, or ascending colon, one section of the large intestine. Everyone lives happily with it until it becomes painfully inflamed, when the only treatment is to remove it surgically.

Then everyone lives happily without it. So why is it there in the first place?

Some experts have guessed that it is a vestige of the evolutionary development of some other organ, but there is little evidence for an appendix in our evolutionary ancestors. Few mammals have any appendix at all, and the appendices of those that do bears little resemblance to the human one.

Last December, researchers published a novel explanation in The Journal of Theoretical Biology. The appendix, they suggest, is a “safe house” for commensal bacteria, the symbiotic germs that aid digestion and help protect against disease-causing germs.

Structurally, the appendix is isolated from the rest of the gut, with an opening smaller than a pencil lead, protected from the fecal stream that might be carrying pathogens. In times of trouble like a diarrheal infection that flushes the system, these commensal bacteria could hide out there, ready to repopulate the gut when the coast is clear.

William Parker, the senior author of the study and an assistant professor of surgery at Duke, emphasized that this was a hypothesis, not experimental proof. “At this point,” Dr. Parker said, “this is a deduction based on a lot of information that we’ve had for many years and some key pieces of information that have only been uncovered recently by our lab and others. It does make sense.

“But an experiment to prove this theory would be very expensive. And in any case, why would you want to spend money to find out something that is not likely to help cure a disease?”

Rebecca E. Fisher, an assistant professor of anatomy at the University of Arizona College of Medicine, said that although the appendix was “likely to be a derived feature, selected for a purpose, the enigma is that we didn’t know what that purpose might be.”

“I think Parker’s study offers an interesting solution,” Professor Fisher said.

Recent studies have found that biofilms, colonies of beneficial microbes that live outside cells, form in the large intestine, where they are dependent on the mucus that lines the bowel. There, they aid digestion and protect against infection, while enjoying the protection and nutrition of the human host.

The researchers, examining tissue from uninfected human appendices removed in kidney-pancreas transplants, found biofilms on the epithelial lining of the appendix, as well. Under their theory, it is in these biofilms in the appendix, well positioned to avoid pathogens in the rest of the gut, that commensal bacteria take refuge.

If that is true, why is it that removing the appendix apparently does not have negative side effects? The scientists contend that in industrialized countries with modern medical care and sanitation, maintaining a reserve of helpful bacteria has become unnecessary. Widespread outbreaks of intestinal disease are so rare that the commensal bacteria face little danger of extermination.

Dr. Parker wants to know whether biofilms function in the same way in other animals. “We already have an idea that the cecum in some animals works the same way,” he said. “But how, for example, do biofilms work in frogs and other species with no cecum and no appendix?”

Whether the human appendix has the function Dr. Parker thinks it has or whether it has no function at all, it is clear, he said, that “if your appendix gets inflamed, forget about the fact that it might have some function.”

“You have to get it out,” he added. “Appendicitis can be life threatening, and the earlier you treat it, the less likely it is that you will die from it.”

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