All in Your Head by Mara Buchbinder

Author:Mara Buchbinder
Language: eng
Format: epub
ISBN: 9780520285217
Publisher: University of California Press

THE JOFFE FAMILY

The patient who most captured the attention of the pain team for several months of my fieldwork was a fourteen-year-old girl named Claire Joffe, whom I followed closely over the course of her eight months of treatment in the West Clinic. Like many of the clinic’s patients, Claire displayed a mysterious set of symptoms that evaded a clear diagnostic explanation. The initial problem that drove Claire and her parents, Trish and Ricky, to a series of orthopedists, neurologists, and pain specialists before finally landing in the West Clinic was an agonizing pain, stretching from her lower back through her right hip and thigh, that had begun following a basketball injury. Yet it was a set of related, distressing symptoms that emerged much later that forced her to withdraw from school and to enter a home-schooling program for the duration of her ninth-grade year.

Several weeks before her first visit to the clinic, in March 2009, Claire began to experience a series of panic attacks that appeared as seizure-like episodes where her body shook uncontrollably. She also began to pass out up to twenty times per day, and she sometimes fell and hurt herself as she was losing consciousness. After several weeks, around the time of her first West Clinic appointment, the panic attacks progressed into night terrors, where Claire would, without awakening, stir from a prone position, rise, and thrash around violently, kicking and pushing her parents if they tried to restrain her. The episodes could last for fifteen or twenty minutes at a time, several times per night.

Ricky recorded several of these incidents on his home camcorder. Although to many of the clinicians it seemed somewhat perverse for him to have filmed his daughter at the height of her vulnerability, I later came to believe that he did so because he doubted that anyone would otherwise believe his account. The episodes were disturbing to watch. There was considerable struggling and wrestling while Trish and Ricky attempted to restrain Claire, and occasionally, she would escape her parents’ grasp and injure herself. Ricky and Trish were quite concerned that Claire would hurt herself seriously during these episodes. She often arched her neck backward, and they worried that it might snap. Ricky, a freelance designer who worked from home, maintained that someone needed to be close to Claire twenty-four hours a day, and since Trish worked for an architectural firm, he took on this role himself.

Claire began seeing Dr. Sterling a few weeks before her first appointment with Dr. Novak, because he had an opening in his schedule sooner, and Dr. Novak thought that he could help treat her psychiatric symptoms. By the time she arrived at the West Clinic, Claire had tried numerous medications, including Neurontin, Elavil, and Vicodin for pain; Ativan and clonazepam (both benzodiazepines) for anxiety; and Zoloft (an SSRI), which targeted both pain and anxiety. On at least one occasion, the Joffes had dialed 911 because they were so worried by Claire’s seizures and panic attacks. She

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