When I was little, my dad explained my seizures to me using the vocabulary of electrical circuits.
“Your brain is like a light,” he said. “Most of the time it is on. Sometimes it turns off.” I was 6 and just tall enough to reach the switch plate by the bathroom door. “Those times when it is off,” he continued, “those are the seizures.”
I liked this explanation. Over coloring books and crayons, this became the way I described what a seizure was to my friends. My brain had a light switch, unambiguous and predictable. And cool. Something about having a brain that worked differently felt very cool.
As a child, I learned from my dad’s analogy that my seizures were not something to be afraid of. Lights were normal. They were everywhere. Once you learn how to operate a lamp, you never need to worry about getting lost in the dark. And so I approached the seizures with curiosity rather than fear.
As I think about that comparison 20 years later, I wonder if it wasn’t just for me. As an electrical engineer, my dad understood the flow of current. He could control it, redirect it, and increase the charge if necessary. On the rare occasions when he brought his work computer home, I looked over his shoulder to discover intricate diagrams of black lines far more complicated than the circuitry running through the walls of our house.
When something did not work, Dad would pull out his voltmeter with confidence. Despite all of his knowledge, the unpredictable electrical patterns in my brain were something he could not touch. When my eyelashes fluttered and my pupils rolled backward, the only thing anyone could do was wait for the moment to pass. I don’t have children now, but I imagine that if you are a parent, those feelings of helplessness are overwhelming.
Still, there is truth to his teaching. When you break down a seizure to its minute components, when you remove the complex topography of the skull and sift out supporting glial cells, all you are left with is an “aberrant conduction pathway” — an outlet with haphazard wiring. And for an electrical engineer, who creates layered circuits with thousands of components, a broken light switch is an easy fix. So I wonder if the comparison also made him feel as though he had some control.
Now, as a medical student, I still hold on to the light-switch metaphor. I think it says something about how to explain illness to children. Start with something simple, because when things are easy to understand, we are less afraid. Then add something common, because as much as patients are exceptional, it is not their illness that makes them so. It is their character.
As time passed, my seizures resolved and I learned more about the spectrum of epilepsies. I now know that the disorder I had existed at the mildest end of the scale. I came to understand that seizures are more analogous to a violent flash of lightning than to the sudden darkness of a blackout. I learned that while my medicine worked, not everyone’s does. And I learned that while seizure physiology is complex, epilepsy carries a social stigma that drugs will never touch.
The memory of that long-ago conversation — a parent assuring a child that light follows darkness and that moments of fear are transient — reminds me of where I have been and of the people who accompanied me through so many challenges, both real and perceived. They are neurologists, patients, and, always, my mom and dad. My most important gifts came from the landscape architect who taught me how to see the natural beauty in the world and the electrical engineer who taught me how to understand it.
Hillary Mullan is a fourth-year medical student at the University of Massachusetts. Send comments to firstname.lastname@example.org.