Dream-like State Research Articles

Mary's Guide to Divination and Fortune-Telling

Mary's Guide to Divination and Fortune-Telling Hannah Dow (bio) [YOU WILL MAKE HEADS TURN] Perplexing that you walk at allwithout seeing the cavernous mouthsof the people who feel themselvespass by, if not through, you. [LIFE IS TOO SHORT TO HOLD GRUDGES] I ran away from home when I was six years old, angryat my mother. I packed my baby doll and saltines to avoidhunger. When baby began to cry, I went home. If God had leta bitter child die, what kind of God would this be? [ONE IS NOT SLEEPING, DOES NOT MEAN THEY ARE AWAKE] You have stopped sleeping because there is too much else—you fold laundry and watch zombie movies on TV and I stay upwith you because I'm afraid you are asleep behind your eyesand in a dream-like state you'll rememberyou are human, turn on the stove, burn yourself. [WHEN THE MOMENT COMES, TAKE THE TOP ONE] In the middle of the night, a camp counselor woke meto ask if the boy who wet his bed could share my bunk.In the morning, I saw his drooling face there, rememberedwhat mom once said about sleeping with boys.When she picked me up from camp, I cried the whole way home. [BIRDS ARE ENTANGLED BY THEIR FEET AND MEN BY THEIR TONGUES] I cracked open a cookie that looked likea vagina or a bird's beak, ate onehalf of it, postponed the lectureI had come to give you. [End Page 44] [YOU WILL KISS YOUR CRUSH OHHH LALAHH] Standing sideways before my bedroom mirrorI sucked in my stomach and became a sheetof paper. I thought about kissing on the mouth,forced my lips into some shape a boy might find suitable. [YOU CREATE ENTHUSIASM AROUND YOU] Your face might be made of plaster. You might bea floppy little doll, a doll that bends in halfat the waist. This is my interpretationof what the people whisper as they look away. [SOON, A VISITOR SHALL DELIGHT YOU] I convinced myself I was pregnant and told no one.I asked myself several questions, notably, ifI had had sex. I thought I was a virgin but my stomachgrowled and ached in unordinary ways such thatI knew there was someone else inside me. [LET THE DEEDS SPEAK] If a child is anything other than parasiteI would ask my mother to speak now. As the un-intended consequence of a deed, product of a uterus, I feelI must not use my mouth for anything other than apologies. [OLD FRIENDS MAKE BEST FRIENDS] When your body is forced to invent creative waysof feeding itself, it ages. Only months sinceI last saw you, but you have aged years. A fetus,too, grows wrinkled in a matter of only months. [End Page 45] [OUT OF CONFUSION COMES NEW PATTERNS] Standing sideways before my bedroom mirror Isucked in my stomach and wondered whether the raisedknoll had been conceived through my imagination,God, man, or eating for two: myself, and you. [WHEN HUNGRY, ORDER MORE FOOD] The beauty of a fork is its willingnessto bend and not break. No matter howmany times I allow food to pass through me I worryit will get stuck along the way, take hold, growinto something God herself could not digest. [End Page 46] Hannah Dow Hannah Dow is the author of Rosarium (Acre Books, 2018). Her poems have recently appeared in The Cincinnati Review, North American Review, and Ninth Letter. She reads poetry for Ploughshares and Memorious. Copyright © 2019 Pleiades and Pleiades Press

City Profile: Amsterdam

A msterdam is much more than first meets the eye. From afar, Amsterdam seems to consist of only the scandalous Red Light District and the somber Anne Frank House. But up close, this often-underestimated Dutch haven presents art and experience in spades. Arriving in this near-cartoon metropolis puts travelers in a dreamlike state: in a bustling capital where cars aren’t allowed, the tringtringing of bikes fills your ears as they whiz past multicolored pastel houses, down cobblestone streets running parallel to the canals. At first, the patternless layout of these narrow streets is disorienting, but, as you adjust to the sensory overload, you find you don’t mind; in fact, you surrender to it willingly. Literature thrives here. Secondhand bookstores line the canals in the “9 Straatjes” (Nine little streets), like the Boekie Woekie, which specializes in selfpublished and small-press books. Every Friday, Squi puts on an outside book market , where shoppers find novels, poetry, and nonfiction written in dozens of languages . Just around the corner stands the American Book Center, a four-floor library and store with wall-to-ceiling bookshelves, Beauty and the Beast style. As if that’s not enough to fill your dreamy days, every year in May, the city puts on the Amsterdam Literary Festival, which accepts submissions from all genres and proffers the world’s largest book market, with over one thousand stalls. It’s impossible not to acknowledge the ghost of Anne Frank and both the museum and statue erected in her memory. Her legacy has given birth to a rich literary scene: dozens of writing workshops meet monthly , like the Amsterdam Writers Guild, full of creatives from different backgrounds and cultures. Artists here mingle easily; most speak two or three languages. The Van Gogh Museum alone brings in hundreds of people daily from around the world. Open since 1973, it holds the largest collection of paintings and drawings by Vincent Van Gogh and his contemporaries; though Starry Night resides in the MoMA in New York City, you can still see Self-Portrait, Sunflowers, and Almond Blossoms. For those equally interested in writing as well as reading, there’s the Perdu, the center for Dutch poetry. It boasts creative workshops, exhibits, a theater, and a small publishing house. The Mezrab Storytelling School hosts a three-day introduction course to allow you to get a feel for what the professional courses might be like, should you seek a more permanent relationship with the city. The inhabitants welcome international influence, and because of this, the town has become a melting pot of perspectives, preserved by an easygoing nature and inviting aura. Amsterdam offers something for everyone, from the traveling student to the serious artist. Its door is open to all—you only have to knock. A WLT intern, Taylor Hickney has a degree in English writing from the University of Oklahoma and will begin pursuing an MFA in fiction at the New School in August. Commas are important, and she hates surprises. A big thanks to Amy Poehler for getting her this far in life. Notebook city profile Amsterdam by Taylor Hickney WHAT TO READ BY THE CANAL David Hewson The House of Dolls Pan Books Hendrik Marsman Three Dutch Poems Trans. Jacquelyn Pope WLT website Richard Milazzo “Artaud in Amsterdam” and other poems in Prayer in a Wolf’s Mouth: Poems 2013–2014 Lower Canal Books Deborah Moggach Tulip Fever Dial Press Dubravka Ugrešić The Ministry of Pain Trans. Michael Henry Heim Ecco PHOTO: KIRK FISHER/PIXABAY WORLDLIT.ORG 5 ...

City Profile: Amsterdam

A msterdam is much more than first meets the eye. From afar, Amsterdam seems to consist of only the scandalous Red Light District and the somber Anne Frank House. But up close, this often-underestimated Dutch haven presents art and experience in spades. Arriving in this near-cartoon metropolis puts travelers in a dreamlike state: in a bustling capital where cars aren’t allowed, the tringtringing of bikes fills your ears as they whiz past multicolored pastel houses, down cobblestone streets running parallel to the canals. At first, the patternless layout of these narrow streets is disorienting, but, as you adjust to the sensory overload, you find you don’t mind; in fact, you surrender to it willingly. Literature thrives here. Secondhand bookstores line the canals in the “9 Straatjes” (Nine little streets), like the Boekie Woekie, which specializes in selfpublished and small-press books. Every Friday, Squi puts on an outside book market , where shoppers find novels, poetry, and nonfiction written in dozens of languages . Just around the corner stands the American Book Center, a four-floor library and store with wall-to-ceiling bookshelves, Beauty and the Beast style. As if that’s not enough to fill your dreamy days, every year in May, the city puts on the Amsterdam Literary Festival, which accepts submissions from all genres and proffers the world’s largest book market, with over one thousand stalls. It’s impossible not to acknowledge the ghost of Anne Frank and both the museum and statue erected in her memory. Her legacy has given birth to a rich literary scene: dozens of writing workshops meet monthly , like the Amsterdam Writers Guild, full of creatives from different backgrounds and cultures. Artists here mingle easily; most speak two or three languages. The Van Gogh Museum alone brings in hundreds of people daily from around the world. Open since 1973, it holds the largest collection of paintings and drawings by Vincent Van Gogh and his contemporaries; though Starry Night resides in the MoMA in New York City, you can still see Self-Portrait, Sunflowers, and Almond Blossoms. For those equally interested in writing as well as reading, there’s the Perdu, the center for Dutch poetry. It boasts creative workshops, exhibits, a theater, and a small publishing house. The Mezrab Storytelling School hosts a three-day introduction course to allow you to get a feel for what the professional courses might be like, should you seek a more permanent relationship with the city. The inhabitants welcome international influence, and because of this, the town has become a melting pot of perspectives, preserved by an easygoing nature and inviting aura. Amsterdam offers something for everyone, from the traveling student to the serious artist. Its door is open to all—you only have to knock. A WLT intern, Taylor Hickney has a degree in English writing from the University of Oklahoma and will begin pursuing an MFA in fiction at the New School in August. Commas are important, and she hates surprises. A big thanks to Amy Poehler for getting her this far in life. Notebook city profile Amsterdam by Taylor Hickney WHAT TO READ BY THE CANAL David Hewson The House of Dolls Pan Books Hendrik Marsman Three Dutch Poems Trans. Jacquelyn Pope WLT website Richard Milazzo “Artaud in Amsterdam” and other poems in Prayer in a Wolf’s Mouth: Poems 2013–2014 Lower Canal Books Deborah Moggach Tulip Fever Dial Press Dubravka Ugrešić The Ministry of Pain Trans. Michael Henry Heim Ecco PHOTO: KIRK FISHER/PIXABAY WORLDLIT.ORG 5 ...

Denouement: teacher education and the persistence of memory

Salvador Dali’s famous 1931 work ‘The Persistence of Memory’ is said to have been painted following an hallucinatory episode or dreamlike state which Dali deliberately induced in order for him to a...

The Ethics of Reading J. M. Coetzee

The presentation scene itself we skip. It is not a good idea to interrupt the narrative too often, since storytelling works by lulling the reader or listener into a dreamlike state in which the time and space of the real world fade away, superseded by the time and space of the fiction. Breaking into the dream draws attention to the constructedness of the story, and plays havoc with the realist illusion. However, unless certain scenes are skipped over, we will be here all afternoon. The skips are not part of the text, they are part of the performance. J. M. Coetzee, Elizabeth Costello Introduction Moral and aesthetic theorists have long relied on examples from literature. Indeed, an ongoing conversation between a cluster of contemporary philosophers and writers seems to indicate a modern lifting of the millennia-old ban, sanctioned by Plato, on the inclusion of poets in the just republic. Relatively recent endeavors in philosophy and literature alike would seem to suggest that the two traditions have finally initiated a process of reconciliation. As philosophers, though, we call for further support for this claim, as well as further clarification on how this reconciliation might be achieved. Hence the importance of tracking the moves of a new circle of writers who transition between the two strands of this dialogue--from philosophy to literature, and then back again. Work in both fields illustrates the point: Stephen Mulhall's The Wounded Animal (2009) discusses both J. M. Coetzee's and (the fictional) Elizabeth Costello's projects, describing them as manifestations of long-standing modernistic reflection on the conditions of literary formal realism; Coetzee's The Childhood of Jesus (2013) neatly returns to the ancient philosophical dispute over the existence of universals. The intrinsic value of the dialogical form itself--a formal device Plato seems less willing to do without--has been further reassessed and rendered more nuanced in recent philosophical work that uses dialogue as a means of resuming the interrupted conversation. In his response to Coetzee's lectures in The Lives of Animals, for example, Peter Singer produces a philosophical dialogue, held between a philosopher called Peter and his daughter Naomi, while Paola Cavalieri uses dialogue to discuss animal rights and to refute a form of moral perfectionism according to which moral status depends on the extent to which a being possesses certain hierarchically ordered perfections (e.g., consciousness, rationality, conceptual-linguistic abilities). Cavalieri uses dialogue both to reveal and challenge the way in which nonhuman animals, supposedly lacking these relevant perfections and thus characterized neither as moral agents nor moral subjects, are excluded from the moral realm altogether. What, then, is fueling this conversation? This essay will try to answer this question by entering the dialogue, and it will do so on different fronts. I begin by tracing the main steps of an approach to reading Coetzee developed by Derek Attridge in J. M. Coetzee and the Ethics of Reading. As the title suggests, Attridge argues at length that there is a strong ethical core at the heart of the aesthetics of Coetzee's novels. Following Attridge's lead, and engaging heavily with Jonathan Lear's essay on Diary of a Bad Year, I focus my analysis on the alleged ethical motives behind Coetzee's experimental upending of canonical literary conventions in Diary. In particular, I explore the motives behind Coetzee's departure from standard novelistic form in this text and his use of the split page. I then closely consider Stephen Mulhall's main thesis on the ethical import of Coetzee's work, which I compare with an alternative explanatory model developed by Terry Eagleton. A provisional last word is then handed to Coetzee himself. Entering the age-old conversation from multiple angles, I aim to consider the implications of this reassessment for the practice of philosophical writing more generally. …

Metaphoric Recurrences of Dreamlike Imagery in M. Khvylovy’s “My Self (Romantica)” and N. Gogol’s “Diary of a Madman”

Delusional states such as madness and hallucination are traditionally viewed as mental disorders characterized by a chaotic activity or as an experience in which something is perceived as true but is not real. In a literary discourse, madness and hallucination can be viewed as analogous to metaphoric perception of reality. Primarily, due to the fact that the way protagonists think and see things shifts from accepted societal norms to unaccountable patterns of behavior.In this article I approach madness and hallucination as dreamlike states of mind and follow George Lakoff’s belief that everyday abstract concepts like time, change, causation, and purpose appear to be metaphorical (1). From this point, I explore the narrative of madness and hallucination through the metaphoric recurrences of dreamlike imagery in Nikolai Gogol’s “Diary of a Madman” and Mykola Khvylovy’s “My Self (Romantica).”I suggest that both stories present situations of crisis, in which the characters appear on the edge of mental breakdown and thus experience the dreamlike states. Symbolically, the recurrent images that appear in the stories are connected to the idea of nationhood and social pressures within imperial Russia (1835) in “Diary of a Madman” and to the Communist Party ideology during its early rule in Ukraine (approximately 1920s-1930s) in “Myself (Romantica).” Therefore, by depicting the progression of their protagonists’ mental disorders, the writers reveal the truth about social and political struggles of their times

Mum’s story – refocusing on the human dimension of quality healthcare

Quality in healthcare comes in many guises; these may be adherence to national best practice guidelines, use of cutting edge technology or the delivery of evidence-based medicine. However, one must not overlook the fundamental human basis of healthcare and always acknowledge that the delivery of a compassionate and caring service, to both patients and their carers, is at the core of delivering a quality service. The story below is that of my beloved mum, at the end of her life; a life that was filled with kindness and compassion to others. Unfortunately, the care she received in her final days lacked compassion and care; the effect of this lack of empathy for her and my family has left an indelible scar. This article is not meant to be persecutory; however, it is honest and may be uncomfortable to read. Its purpose is to highlight the human face of quality and I share it with you to encourage you to reflect on the impact of delivering high-quality technical care without due consideration of the personal human domain, which is essential in quality improvement. As I walked through the hospital car park my mind raced, my heart was heavy and I was filled with sadness and anxiety. I felt totally alone and helpless, despite the crowds of people in the hospital. The intensive care unit (ICU) bustled with an array of medical professionals attending to the patients who had tubes and wires connected to a plethora of bleeping monitors and ventilators. In a dream-like state, I edged slowly towards my mum in bed 3 as sheer panic welled up inside me. I felt nauseated and light headed and froze just short of the bed, trying to gather my thoughts and compose myself. I was frantic and distraught, trying to rationalise the enormity …

A Case of Possible Iatrogenic Ketamine-Induced Mania in a Patient Being Treated for Postoperative Pain

Ketamine is an N-methyl-D-aspartate (NMDA) antagonist that has become increasingly recognized and utilized in the treatment of post-operative pain as a way to reduce opioid use. Overall ketamine is generally well tolerated, however it is associated with transient hypertension and neurologic “emergence phenomena” manifesting as dream-like states, irrational behavior, and delirium. From a psychiatric perspective, ketamine is known to cause mania in animal models, but evidence in humans is lacking. This report adds a fourth case of possible ketamine-induced mania to the literature, however this is the first case report of mania in a patient with no previously documented family or personal history of Bipolar Disorder. Decreased need for sleep occurred within hours of the initiation of the ketamine infusion and the symptoms of mania progressed throughout the next 3 days culminating on day 4 of ketamine therapy in a full manic episode. Well-known, post-anesthetic “emergence phenomena” after ketamine use differs from our case in that patients are generally somnolent, whereas our patient developed a manic state which took weeks to resolve with olanzapine and lorazepam treatment. This patient was off treatment and symptom free for more than a year before developing a second manic episode and subsequently being diagnosed with Bipolar Disorder. As ketamine is being increasingly used in psychiatric and non psychiatric populations, all providers should be aware of the possibility of an affective switch with the use of ketamine. It is unclear if ketamine can induce mania in susceptible individuals, though this case suggests that it may.

Psychedelic medicines

While studying alkaloid natural products and their derivatives, Sandoz chemist Albert Hofmann had to leave the lab early one day in 1943 because he’d accidentally been exposed to one of his products, lysergic acid diethylamide (LSD). As he wrote in his memoir, “ LSD—My Problem Child,” he later reported to his department director: “I was forced to interrupt my work in the laboratory in the middle of the afternoon and proceed home, being affected by a remarkable restlessness, combined with a slight dizziness. At home I lay down and sank into a not unpleasant intoxicated-like condition, characterized by an extremely stimulated imagination. In a dreamlike state, with eyes closed … I perceived an uninterrupted stream of fantastic pictures, extraordinary shapes with intense, kaleidoscopic play of colors. After some two hours this condition faded away.” In the decades that followed, various researchers pursued LSD and other psychoactive compounds for medical uses,

Representations of epilepsy on the stage: From the Greeks to the 20th century.

Epilepsy is a disorder that has been used by dramatists in various ways over the ages and therefore highlights the views of the disorder as people saw it at the time the plays were written and performed. In the 6th century BC, links between tragedy and epilepsy were developed by Greek playwrights, especially Euripides, in Iphigenia among the Taureans and Heracles where epilepsy and madness associated with extreme violence occur together. Both Heracles and Orestes have episodes after a long period of physical exhaustion and nutritional deprivation. During the Renaissance, Shakespeare wrote plays featuring different neurological disorders, including epilepsy. Epilepsy plays a crucial part in the stories of Julius Caesar and Othello. Julius Caesar is a play about politics, and Caesar's epilepsy is used to illustrate his weakness and vulnerability which stigmatizes him and leads to his assassination. Othello is a play about jealousy, and Othello, an outsider, is stigmatized by his color, his weakness, and his 'seizures' as a form of demonic possession. In modern times, Night Mother portrays the hard life of Jessie, who lives with her mother. Jessie has no friends, her father has abandoned the family, and she has no privacy and is ashamed. Stigma and social pressures lead her to commit suicide. Henry James' novella, The Turn of the Screw, portrays a governess with dream-like states, déjà vu, and loss of temporal awareness who has been sent to the country to look after two small children and ends up killing one. This novella was turned into an opera by Benjamin Britten. Most recently, performance art has been portraying epilepsy as the reality of a personally provoked seizure. Both Allan Sutherland and Rita Marcalo have purposely provoked themselves to have a seizure in front of an audience. They do this to show that seizures are just one disability. Whether this provokes stigma in audiences is unknown. Whether the performance artists understand the potential for status epilepticus has not been discussed. This article is part of a Special Issue entitled "Epilepsy, Art, and Creativity".

Examining signs of driver sleepiness, usage of sleepiness countermeasures and the associations with sleepy driving behaviours and individual factors

The impairing effect from sleepiness is a major contributor to road crashes. The ability of a sleepy driver to perceive their level of sleepiness is an important consideration for road safety as well as the type of sleepiness countermeasure used by drivers as some sleepiness countermeasures are more effective than others. The aims of the current study were to determine the extent that the signs of driver sleepiness were associated with sleepy driving behaviours, as well as determining which individual factors (demographic, work, driving, and sleep-related factors) were associated with using a roadside or in-vehicle sleepiness countermeasure. A sample of 1518 Australian drivers from the Australian State of New South Wales and the neighbouring Australian Capital Territory took part in the study. The participants’ experiences with the signs of sleepiness were reasonably extensive. A number of the early signs of sleepiness (e.g., yawning, frequent eye blinks) were related with continuing to drive while sleepy, with the more advanced signs of sleepiness (e.g., difficulty keeping eyes open, dreamlike state of consciousness) associated with having a sleep-related close call. The individual factors associated with using a roadside sleepiness countermeasure included age (being older), education (tertiary level), difficulties getting to sleep, not continuing to drive while sleepy, and having experienced many signs of sleepiness. The results suggest that these participants have a reasonable awareness and experience with the signs of driver sleepiness. Factors related to previous experiences with sleepiness were associated with implementing a roadside countermeasure. Nonetheless, the high proportions of drivers performing sleepy driving behaviours suggest that concerted efforts are needed with road safety campaigns regarding the dangers of driving while sleepy.

Snow and Shadow by Dorothy Tse

70 WLT JANUARY/ FEBRUARY 2015 of the Bercea family, as other tales tell other families, “who we are.” They are—the narrator, Trajan, and his sister Miruna—the great-grandchildren of Constantine Bercea, who fought in the Romanian war of independence in the late nineteenth century and earned, through his service, the first land to be owned by anyone in his family. He also brought the first clock to the village of Evil Vale, paid for the first newspaper subscription, and imposed his will on land and beasts, ignoring the other villagers who lived “in thrall to the forest,” dependent on spells to protect them and on stories of fays to explain madness and disorientation. Although Constantine is clearly a transitional figure from the unchanging past to a world caught in print and technology, he also becomes a kind of mythic figure in the stories told by his son, Niculae, who does not soften events or endings the way that storytellers for children often do. Niculae’s granddaughter, Miruna, absorbs both the content and the spirit of the tales, while her brother narrates—from the point of view of a child but in the language of an adult—in ways that bridge the gap between traditional and modern. Later in the book, the stories turn to Niculae’s life, less mythic but very much in the spirit of the stories about Constantine. As the young siblings listen, they come to understand intuitively the way in which, as Suceavă writes in the afterword, “facts tend to become transformed into either rumors or ballads or legends.” When the grandfather dies, the children feel that they have been banished from paradise, that “the real world began, that we took our first steps on the earth.” Yet all is not lost. Miruna has a dream in which “the Angel of the Story” fends off “the Angel of Silence,” or Death, allowing her to encounter her grandfather in imagination. There is loss, but all is not lost, for as the narrator says in the last lines, “if the tale were not true, I wouldn’t have told it to you.” Robert Murray Davis University of Oklahoma Dorothy Tse. Snow and Shadow. Nicky Harman, tr. Hong Kong. Muse. 2014. isbn 9789881604606 Dorothy Tse’s collection of short stories transports the reader through a series of shocks and revelations into a complex realm pendulating between the known, the obscure, and the horrific. Many of the stories seem to twist together several layers of both temporal and spatial dimensions. The reader is lost and confused, sliding between the surreal and grotesque. There is no thread connecting us to the emotive response. Even so, the characters seem ready to withstand whatever comes their way; they are out of compass guidance yet not out of flexibility. In “Woman Fish,” the feminine character undergoes a Kafkaesque metamorphosis . The husband witnesses his wife’s transformation into a fish and seems to make the necessary changes to accept their new relationship until delivering her to the river. A similar dual tension can be found in “Leaf and Knife,” where a couple’s coordinated dance steps turn into an amputation contest. In all of Tse’s stories, there is always the possibility of global destruction as death breaks into our dimension: “the overcast sky opened its toothless mouth, spattering faces with rain.” Another common theme in Tse’s writing is confused states of mind, the constant shift between reality and dreamlike states. Several stories refer to the subconscious world of dreaming. In “Black Cat City,” people are slaves of their own imagination. The characters named Recall and Memoria seem to get either closer or separated, based on what they remember or forget about their life together; they experience revelations of the absurd and a disintegration of their conscience. The same disorientation brings characters to states of imprisonment. In “Bed,” a girl leaves her small house in search of a place to rest; eventually, somebody takes advantage of her primordial need for sleep and takes away her virginity. Yet, separating two worlds, the bed becomes the point of transformation from a temporary resting place of sleep into death and entering the cycle of life. world...

Shelley’s Antimasques of Life: Re-Visioning The Triumph

Shelley’s The Triumph of Life has its roots in the English masque tradition, an organic whole combining the distortions and chaos of the often grotesque antimasque with the metamorphosis in the masque proper, unwritten in this fragment but a requisite element because of the very nature of the genre. The “masked” narrator exists in a dream-like state traversing the past and present in déjà vu sequences, simulating the mind in dialogue with itself to “pierce the sphere / Of all that is, has been, or will be done.” Using the genre itself, passages from A Defence of Poetry , and the complex images and themes in the work itself, the image of the Moon emblematic in combining the ghost of its “dead mother,” the antimasque, with the new phase--the transformation in the unwritten masque proper, I argue that the answer to the final question, “Then, what is Life?” would have been revealed in the unwritten masque proper in which the narrator would have defeated the Proteus villain, the Shape, the source of delusion and loss of imagination.

Water for thought: is there a role for aquaporin channels in delirium?

C. G. Jung believed that water was a symbol for the unconscious mind, the background from where our conscious thoughts emerge, and also the sea where they melt into the dream-like state of primary processes (1). Water comprises about 80% of the brain volume and water homeostasis is inextricably coupled to the CNS function. In this regard, neuroscience describes an inverse relationship between the intensity of the neuropil function and the amount of water it contains. For example, during high neuronal activity (such as information processing), water is transported away from the neuropil, shrinking the extracellular matrix (ECM). Conversely, during times of lower brain activity (such as during sleep), water is shifted back to the neuropil, expanding the ECM (2, 3). The movement of water in and out of the neuropil occurs with the help of the glymphatic system via special molecular pumps, aquaporin water channels (AQP 4) located in astrocyte end-feet. Water circulation is enabled by the exchange between the cerebrospinal fluid (CSF) and interstitial fluid (ISF). The pressure gradient for this exchange is probably provided by pericytes’ contraction and arterial pulsations along with the suction, pump-like action of AQP 4 channels (4–6). This movement of water in and out of the neuropil enables both, clearance of molecular waste and volume transmission (VT) of chemical signals (7). Conversely, delayed water movement (glymphatic stasis) may predispose to the accumulation of misfolded proteins (4) and ultimately to neuroinflammation (8). The relationship between water and delirium is complex. Both, brain edema and dehydration may predispose to delirium (9). Up-regulation of AQP 4 water channels seems to occur in both situations. In fact, a biphasic up-regulation was described in edema build-up and the resolution phase (10). Interestingly, AQP 4 receptors seem to be the common denominator between the neuropil water movement and neuroinflammation (10). Moreover, animal studies demonstrated that peripheral dehydration triggers central up-regulation of AQP 4 receptors (11–13). This in turn causes swelling and priming of astrocytes and microglia, predisposing to neuroinflammation (14). According to a recent study, two key factors, systemic inflammation and central cholinergic impairment must interact in order to produce delirium (15). The goal of this article is not to discuss VT or the relationship between AQP 4 channels and inflammation since extensive literature exists on these subjects. Instead, we attempt to answer three questions: Can an inefficient glymphatic clearance lead to impairment of central cholinergic transmission? Does glymphatic stasis contribute to microglia and astrocytes’ priming, the precursor of neuroinflammation? Do aquaporin blockers have a place in delirium? We hypothesize that failure of glymphatic clearance leads to impairment of acetylcholine volume transmission (AChVT), contributing to impaired arousal, attention, memory, and sleep as seen in delirium. We hypothesize further, that glymphatic failure is pro-inflammatory in nature, leading to up-regulation of AQP 4 channels, which in turn trigger astrocyte swelling and gliosis with the end result being microglial and astrocytic priming. The above phenomena may reconcile two theories of delirium: central cholinergic deficit and neuroinflammation.

Case Report of Transient Global Amnesia

A 62 y/o female with no significant past medical history, presented with confusion, disorientation and short- term memory loss for approximately one hour prior to arrival in the Emergency Department (ED). She recalled driving to work and then suddenly felt like she was in a “dream-like state”, and could not recall any events since that time. She arrived at work, where a security guard found her wandering around confused and 911 was called. EMS arrived to find patient on the bathroom floor, disoriented. On arrival to the ED, she was alert but oriented only to self. She kept repeating the same questions: “Am I having a dream?”, and “How did I get here?” She was feeling well and acting appropriate the night before, according to her husband. She could, with some effort and concentration, remember the names of her husband and children. She took no medications, and family history was negative for stroke or seizure.

Waiting for the Turnover of Time: Reading the Narrative Strategy of Awakening in Walter Benjamin's One-Way Street

What literary project can be deciphered from the non-mimetic representation of urban space in Walter Benjamin's One-Way Street? The book can be read as a course that attempts to make speak dialectical images found among the signs and sites of daily urban life in the first third of the twentieth century. The prominence of dreams already in the early pages of One-Way Street, together with dialectical images whose speech brings historical truth to consciousness, shows that Benjamin's city tour is a (hi)story of awakening. Within this context, the images of public places represent signs of a collective unconscious that are to be deciphered in order to overcome the dream-like state in which they are perceived. By aiming to overcome a state in which images regulate daily life and apperception in public space, Benjamin's project remains irreducibly political. Instead of following a mimetic approach, Benjamin undermines the authority of unconscious images within a writing process that describes the trajectory of awakening. This essay uncovers Benjamin's narrative strategy for pursuing the dynamic of literary imagination for an ultimately iconoclastic effect.

Ketamine-induced Biliary Dilatation

Ketamine is a popular drug of abuse in China, especially for young adults between the 18 and 30 years. It produces desirable short-term sensations of excitement, dream-like states, hallucinations, and vivid imagery, but is also responsible for untoward effects of the gastrointestinal and urinary tracts. Abusers often present with severe abdominal pain and dysuria. In addition to its excretion in urine, ketamine is also excreted in bile and can lead to biliary dilatation. Sixteen reports of this phenomenon have been described in the literature, mostly in China. To date, this phenomenon has not been described in the United States. We present 2 cases of ketamine-induced biliary dilatation in young adult Asian patients. It is a new entity in the United States but should be recognized early, as it may prevent unnecessary investigation with blood work, imaging, therapeutic endoscopy, or even surgery.

The neurological manifestations of trauma: lessons from World War I.

Changes in the clinical presentation of functional disorders and the influence of social and cultural factors can be investigated through the historical case notes from mental hospitals. World War I (WWI) was a potent trigger of functional disorders with neurological or psychiatric symptoms. We analysed 100 randomly selected case files of German servicemen admitted to the Department of Psychiatry of the Charité Medical School of Berlin University during WWI and classified them according to contemporaneous and retrospective modern diagnoses. We compared the clinical presentations with accounts in the German and British medical literature of the time. Most patients obtained the contemporaneous diagnosis of ‘psychopathic constitution’ or hysteria reflecting the general view of German psychiatrists that not the war but an individual predisposition was the basis for the development of symptoms. The clinical picture was dominated by pseudoneurological motor or sensory symptoms as well as pseudoseizures. Some soldiers relived combat experiences in dream-like dissociative states that partly resemble modern-day post-traumatic stress disorder. Most servicemen were classified as unfit for military service but very few of them were granted compensation. Severe functional disorders of a neurological character could develop even without traumatic exposure in combat, which is of interest for the current debate on triggers of stress disorders. The high incidence of pseudoseizures accords with the psychiatric literature of the time and contrasts with accounts of war-related disorders in Britain. The tendency of German psychiatrists not to send traumatised servicemen back to active duty also distinguished between German and British practice. Our data contribute to the debate on the changing patterns of human responses to traumatic experience and their historical and social context.

Perske's List: False Confessions From 75 Persons With Intellectual Disability

N 65 have been exonerated. N 29 have been exonerated by DNA tests N 5 of them (Jerome Bowden, Earl Correll, Girvies Davis, Barry Fairchild, and Cornelius Singleton) were convicted before many investigation techniques (including DNA testing and the videotaping or police interrogations) were developed and applied to such cases. N 1 person (Joe Arridy), in a very old case, received a posthumous pardon from a governor. His action may inspire others to seek posthumous pardons for individuals who were wrongly executed in the distant past.

Salome and: Painted Dolls of Martinique and: Letters from Madinina and: Address to the War Council

Salome and: Painted Dolls of Martinique and: Letters from Madinina and: Address to the War Council Lindsay Walker (bio) Salome —After Adrienne Kennedy X who is Salome who is the Bedwetter who is Josephine. Twin-bed & plastic sheet as ice cream sandwich & paper wrap. Other children portrayed as sunflowers. Act I: Mattress propped on artist’s easel faces audience. White sheet stained with urine. Think bulls-eye, think square egg. X in dreamlike state contorts around spot, spelling with body, in any order: IRIS, FOLD, & BATHE Act II: Mother pulls sheets from under X. Continues to pull sheets throughout the next seventeen years. X opens many books during the interval. X cuts off legs, pulls self on hands through doors left open. Act III: X paces her high school in inscrutable blue jeans. Columns of sunflowers follow her progress with slow yellow heads. X laughs continuously. X cannot stop laughing. Act IV: Family, dressed in black, sits down to dinner. Sings happy birthday to the tune of “Let Me Call You Sweetheart.” Iris centerpiece sways. X inhales for seventeen candles. X blows all the water glasses over. Act V: Exit family. Taper candles perform the dance of seven veils. (Mandolins fade.) X uses her hands to gut the cake. Painted Dolls of Martinique Island girls have their mouths sewn shut early. It is not pleasant to be able to speak. So the lead stitch is cast. So a knot begets the garland. By the time we are twelve our first mouths are sealed white. We replace them with wax lips [End Page 505] from the drug store, we paint our eye flowers, we learn other mouths. Letters from Madinina stra ‘ ta n. pl. of STRATUM and then the clouds come I hang a hammock from bamboo stalks that crack like line breaks, and curl in the comma’s nook. Dream the first T is a palm r leans against rubs up and down like a sun bear on the pineappled trunk working an itch between the cuff of shoulder blades. a’s become artichokes r scoops and juggles. Their green rubber petals bloom like fingers’ hands lobbing lime colored fists. The pencil snaps (snap n. 1. a sound of pencils [one of five] 2. a species of cookie 3. the song of cane) clouds gone. Tomorrow: I’ll find an eyelash (like a scythe) has closed the parentheses and cradles the postscript. Address to the War Council We’re all fools stumbling around in hospital gowns. Grasping at ties. Looking for walls to press up against. Fearing those doctors, real or imagined, always behind us, shaking their heads. Sadly, there is no cure for this. Or perhaps, we’re the doctors, gasping at our own heads, pressing ourselves into cures, and our gowns, lost, stumble around in search of patients. No, here it is. The ghost of some cure ties us to walls. Shakes a finger at what we doctor. In the background our hospital gowns tremble, fearing us fools. Curiously, this is no imagined sickness. [End Page 506] Lindsay Walker Lindsay Walker recently earned her Ph.D. in English at the University of Southern Mississippi and is an instructor of English at Auburn University. Winner of the Center for Writers 2009 Joan Johnson Award for Fiction, she served as poetry editor for the literary journal Juked from 2005 to 2010. Her manuscript, “The Josephine Letters,” was a finalist for the 2009 Walt Whitman Award, and her poetry has appeared recently, or is forthcoming, in West Branch, The Southeast Review, Gulf Stream, The Southern Quarterly, and The Southern Poetry Anthology. Copyright © 2011 Lindsay Walker