Scott O’Connor, the son of Supreme Court Justice Sandra Day O'Connor, revealed in an interview last week that his father, John O'Connor, diagnosed with Alzheimer’s disease 17 years ago, had fallen in love with another woman. The woman lives with him in the same nursing home.

This happens frequently to people with Alzheimer’s. They develop close relationships with the people they live with; we call them “new attachments.” They adjust to the environment and attach themselves to others, just like all the rest of us. These attachments can be anyone, the same-sex, opposite sex, another patient, a caregiver, or even a beloved pet. It turns out that dementia can steal almost everything, but the desire for intimacy persists.

I didn’t like some of Justice O'Connor’s opinions, but I always respected her. That respect grew enormously when I read how she has let go of a person with whom she has spent most of her life. When Justice O’Connor retired from the Court, it was in part to care for her husband. She says she’s thrilled that that he is relaxed, happy, and comfortable living where he is and not complaining.

It is the ultimate act of love and caring to be able to say, “I want you to be happy and at peace as you spend your final days.” To be able to say goodbye to the relationship it was, to look at your love holding another’s hand and only wanting what’s best for them.

Love is the great mystery of human experience — it is brilliant, awe inspiring, sometimes tragic, but it’s a connection that is tenacious. As long as we live, we need this most basic human relationship. Young love is sparkling magic, and old love is richer and more precious. I see in Sandra Day O'Connor a moral exemplar who is helping us identify new ways of being in love when you’re older.


We are living longer, we are a generation that is more sexually liberated, and we are aging. Sandra Day O’Connor’s love for her husband who sees her only in memory has reframed for us all what love is all about.

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You may have heard of the celebrated case of Carl and Clarence Aguirre, Filipino twins conjoined at the top of their heads (craniopagus). This condition is so rare it happens once in 10 million births and there are no more than 60 who have undergone separation surgery. In the past they were separated in a single operation that often resulted in serious neurological setbacks for at least one of the children. The procedure is now done in multiple stages and was developed by surgeons at Montefiore Hospital in New York City.

Carl and Clarence had the surgery in 2003 and did pretty well; the success of the procedure was touted on Montefiore’s website as “the first ever separation of craniopagus twins where both twins survived with no neurological damage or deficit incurred from the surgery.” It generated headlines all over the world, and the surgeons were hailed as miracle doctors. The mother repeatedly expressed her gratitude for the medical care, attention and support she received.

Now four years, later Mrs. Aguirre is still in United States without her family, because the boys need more surgery. The Aguirre’s have been supported by the generosity of many Americans; Montefiore Hospital alone has provided multi-millions and is still providing medications and supplies. The townspeople where they live have provided them with food, non-profits have provided a home, and lawyers have set up trust funds and are dealing with their expiring visitors visas.

The boys are still in diapers at five years old; Carl can speak a few words but they are often unintelligible, and because of his impaired left side he crawls dragging his limp left limbs. Clarence can walk and talk although his speech is somewhat garbled. Neither boy eats well, so they are fed through feeding tubes at night.

The boys will require more surgery to close the holes in their heads; Mrs. Aguirre is anxious, depressed and has ulcers. Nobody planned for such a long haul, it is not the happy ending everyone hoped for and was led to believe.


There is a price for medical miracles; we can separate conjoined twins, even revive the dead, but it comes with a high price, physically, financially and emotionally. If we continue on the road to medical miracles, we can’t just do the miraculous interventions without also providing for long term care, because not all medical miracles have fairytale endings.

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I wasn’t planning on writing about my benign brain tumor, but it’s been four months since the diagnosis and things are good. It was after reading an article in the New England Journal of Medicine (Volume 357, No.18, Nov.1, 2007); I figured it was time to talk about it. It turns out that 1 in 60 people over the age of sixty are walking around with “incidental brain tumors” — they are benign and totally asymptomatic.

Sometimes, however, they do become symptomatic, as mine did this summer when I experienced pounding headaches and dizziness. Because it was Phoenix at the peak of summer heat, I thought I was dehydrated and drank lots of fluids which didn’t help. My wife insisted I have it checked-out before I left to work in Europe.

My doctor immediately ordered an MRI of the brain. When he called with the results, he said there was nothing keeping me from making the trip, but that there was something . . . “You have a brain tumor.” He went on to say that he was almost certain it was benign, sitting at the base of my skull and pressing on my auditory nerve, which explained the dizziness. But I didn’t hear much after the words “you have a brain tumor.”

My first reaction was maybe they misread the films or they belonged to somebody else. My doctor, an old friend, assured me he was 99% sure it was benign, but wanted me to see a neurosurgeon when I returned from Europe. It gave me time to reflect on life, the choices I’ve made (and those still to be made), fears, unfinished business, hopes, and to talk about it with my family and friends.

The neurosurgeon agreed the small mass was benign and did not recommend surgery. If anything had to be done, he suggested the new cyber-knife (highly focused, external beam radiation). He referred me to a Neuro-otologist, an ENT surgeon specializing only in the inner ear, who said I should do vestibular exercises. These exercises alleviate symptoms in at least half his patients; they retrain the brain to compensate for the confusing signals it is getting. I’m a strong believer in non-interventional medicine, but I had considerable skepticism that moving my eyes rapidly, rotating my head, neck and torso, turning, and balancing would cure my vertigo. There was also the nagging sense that even if it was benign and slow-growing, why not just get it out and over with.

I did the exercises twice a day, and asked my relatives to join me in a healing circle. I was prayed for, danced with, blessed by distant healers, and ate tumor-shrinking mushrooms that my daughter farms. Within weeks the dizziness disappeared, and I’ve been symptom free for three months. They’ll do another MRI in six months to see if the tumor is growing, but they think it’s been there for many years and won’t grow.


What I understand is this: whatever my afflictions, I only have to pay attention to them when they interfere with living. Then I have to decide it’s I who have it, and not it that has me and choose to do the work it takes to get better. Whether the work is a physical exercise, or a dietary, mental, surgical, or spiritual one, do it with commitment and the support of others.

Nobody makes it alone. I want to say thank you to all my relations and to my Uboontu. I am because you are.

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Dr. Vania Apkarian, a Professor of Physiology at Northwestern uses sophisticated MRI technology to study the brain in states of chronic pain. He just reported that chronic pain may stem from the emotional impact on the brain at the time of the original trauma (Pain, Vol.132, Nov. 2007). MRIs during chronic pain states reveal that the pre-frontal cortex — the site of emotional and cognitive learning and where such memories are stored — light up.

Apkarian theorized that if he could erase the painful memory, or at least desensitize the brain to it, the pain would lessen. He induced chronic pain in rats by cutting 2 of the 3 strands of their left sciatic nerve. After their injuries healed, he gave some of the rats Cycloserine, a drug that interferes with long-term memory. The rats that got the drug still felt painful stimuli, but they didn’t seem to mind anymore.

Admittedly, it’s hard to jump from rats to people. We aren’t that different in terms of our genetics, however, so maybe using drugs could be helpful in treating chronic pain syndromes in people. Apkarian says if we could turn off the memory of pain using similar medications in humans, we might offer relief to millions who are not helped by traditional painkillers or who become addicted to them.

Most research in treating chronic pain is focused on dulling the sensation of pain by blocking out the sensory input with narcotics like morphine, dilaudid, hydrocodone, and codeine. Much less attention has been paid to the emotional component of pain and the potential for treating it centrally.

What Dr. Apkarian learned in rats has long been known by healers throughout history. Old traumas, both emotional and physical, can linger for a long time and cripple us. We have now discovered drugs to dull the memory, but there are other ways to be desensitized from old traumas. Since ancient times, healers have used herbs, ceremony, trance induction, meditation, substances that expand consciousness rather than dull it, and all of them have worked.


The important principle in the no-pain brain game is to find a way to see the old landscape with new eyes. Any way that can get you to see beyond old, painful memories and experience a new reality will help you.

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