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The New Yorker
Annals of Medicine
June 30, 2008 Issue

The Itch

Its mysterious power may be a clue to a new theory about brains and
bodies.
[gawande-at]

By Atul Gawande

June 23, 2008

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It was still shocking to M. how much a few wrong turns could change
your life. She had graduated from Boston College with a degree in
psychology, married at twenty-five, and had two children, a son and a
daughter. She and her family settled in a town on Massachusetts'
southern shore. She worked for thirteen years in health care,
becoming the director of a residence program for men who'd suffered
severe head injuries. But she and her husband began fighting. There
were betrayals. By the time she was thirty-two, her marriage had
disintegrated. In the divorce, she lost possession of their home,
and, amid her financial and psychological struggles, she saw that she
was losing her children, too. Within a few years, she was drinking.
She began dating someone, and they drank together. After a while, he
brought some drugs home, and she tried them. The drugs got harder.
Eventually, they were doing heroin, which turned out to be readily
available from a street dealer a block away from her apartment.

Someone scratching their head
Scientists once saw itching as a form of pain. They now believe it to
be a different order of sensation.Photograph by Gerald Slota

One day, she went to see a doctor because she wasn't feeling well,
and learned that she had contracted H.I.V. from a contaminated
needle. She had to leave her job. She lost visiting rights with her
children. And she developed complications from the H.I.V., including
shingles, which caused painful, blistering sores across her scalp and
forehead. With treatment, though, her H.I.V. was brought under
control. At thirty-six, she entered rehab, dropped the boyfriend, and
kicked the drugs. She had two good, quiet years in which she began
rebuilding her life. Then she got the itch.

Published in the print edition of the June 30, 2008, issue.
[gawande-at]
Atul Gawande, a surgeon and a public-health researcher, has been a
staff writer at The New Yorker since 1998. His books include "Being
Mortal" and "The Checklist Manifesto."
More:AmputeesBerkeleyBrainGeorgeGregoryH.I.V.Massachusetts General
HospitalNeurologistsNeurologyNeuroscientistsPerceptionPsychology
Richard

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