Cormoran Strike and the Itch That Cannot Be Scratched

Before you read this post, please review my earlier one on this topic, JK Rowling and the Phantoms in the Brain. It will explain my hypothesis that “Robert Galbraith” consulted neuroscientist V.S. Ramanchandran’s popular books for information about amputated limbs and phantom pain in her research for the Cormoran Strike books. While she was at it, she incorporated a few of the other conditions described in the Ramachandran’s books, as well.

At the time, I left out what I think is the best Easter Egg in the series, at least for neuroscientists. It seemed a little adult for a site that was still predominantly Harry Potter-themed. But, as more and more of our posts concern Cormoran Strike, our discussions have become more mature, so this seems a good time. After the jump, tune in for a close reading of Strike and Ciara’s encounter in the limo, in Cuckoo’s Calling. Images include some “naughty bits.”

 

As noted in the comments of the original post (which pre-dated Lethal White), Ramachandran’s model of phantom limb pain involves the re-wiring of the somatosensory cortex, the area of the brain that processes our sense of touch, as indicated in light blue in the diagram below. As you can see from the illustration, the cortex is laid out, for the most part, in a topographical map of the body, with the areas serving adjacent parts (such as leg and hip) located next to each other in the brain. However, the parts are not in proportion to the actual size of the body. Our most sensitive parts(lips and fingers) get way more than their fair share of brain space.

There are two exceptions to this orderly mapping. First, the face is not found near the head, but below the fingers. In Phantoms in the Brain, Ramachandran describes “Tom,” a young arm amputee who had an uncomfortable phantom limb. Specifically, his phantom fingers frequently itched:

Even though he was distressed by ‘itching’ and painful sensations in his phantom fingers, he was cheerful, apparently pleased to have survived the accident.

Strike describes a similar issue in Lethal White:

The last time he had endured such a long stretch of sleeplessness had been his first week of consciousness after his leg had been borne off by the IED in Afghanistan. Then he had been kept awake by a tormenting itch impossible to scratch, because he felt it on his missing foot.

Ramachandran discovered that Tom’s phantom limb was the result of his somatosensory cortex rewiring itself. With no input from the now-missing arm, the neighboring parts of the brain expanded and took over the area that originally received touch sensations from the hand and fingers. Movement or touch in these areas, therefore, activated brain cells that had previously served the hand. Tom therefore misinterpreted these signals as coming from the amputated hand, giving him a “phantom limb.”

Using a highly scientific instrument known as a Q-tip, Ramachandran found that stroking either the shoulder or the cheek on the side of the amputation resulted in Tom feeling the cotton swab not just in those places, but also on his phantom hand. Eventually, Ramachadran was able to map out the precise areas that corresponded to Tom’s hand and fingers on his shoulder and face. And, happily, Tom discovered he could relieve the persistent itching in his missing hand by scratching his cheek.

The second mapping exception is the genitals, which are found not near the hips, but below the toes. So, you would expect, with an amputation like Strike’s, the remapping would occur at the knee stump and….  yes, there. After Ramachandran announced his findings, two foot amputees contacted him, independently. Both reported an odd symptom they had been too embarrassed to mention to anyone; they felt sensations in their phantom foot every time they had sex; including, at least for one, a full orgasm that he felt both in his foot and genitals. Ramachandran was jokingly advised to title his book, The Man Who Mistook His Foot for a Penis.

Knowing this, let’s join Ciara and Cormoran in the Cuckoo’s Calling limo, when Strike realizes he needs to warn the gorgeous supermodel that his leg would come off with his trousers.

Ten minutes later, a lucid voice in his head urging him not to let desire lead on to humiliation, he surfaced for air to mutter:

“I’ve only got one leg.”

“Don’t be silly…”

“I’m not being silly…it got blown off in Afghanistan.”

“Poor baby…” she whispered. “I’ll rub it better.”

“Yeah—that’s not my leg…It’s helping, though….

Strike may have been even more truthful than we realized. If he was like the amputee Ramachandran described, he was indeed feeling Ciara’s, ahem, “ministrations” on his amputated leg. And, if Rowling did consult Phantoms in the Brain for information about amputees, I guarantee she remembered that.

Comments

  1. Ramachandran made a box with a mirror for a chap who’d lost his left hand but who still had pain in it. when he put his right hand into the box it reflected off the mirror and tricked his vision into seeing he had two hands moving around and the pain stopped.. after a few sessions it stopped completely so visual neural input can affect outcomes drastically too.

  2. Louise Freeman says

    That’s right, if you look at the earlier post, there is a link to a video of a patient with an amputation like Strikes using one. I fully expect Strike to eventually remember getting mirror therapy at Shelly Oak.

  3. I think I’m one of many who expect Cormoran to learn something unexpected about his past, so I like your idea he’ll remember his own mirror therapy. It would be an interesting development for Cormoran, a man who considers himself to be a realist, discovering what he thinks (or perhaps wants) to be true is a figment of his imagination.

  4. Louise Freeman says

    Karol, Can you explain a bit more about what you mean? Phantom limbs, and phantom pain are certainly not figments of the imagination; the sensations are absolutely real and there is a neurological explanation for them. By “remember” I just meant he’d think about, or tell Robin, that he had that type of therapy.

    He certainly could discover that something he has always believed, or even a memory he has is false. We have seen, for instance, that he likely misremembers the “blood test” that made Rokeby accept paternity when he was five as a “DNA test” –which wasn’t available until he was 12 or so. (See https://www.hogwartsprofessor.com/science-in-cormoran-strike-narrative-misdirection-or-plain-old-error-part-i-dna-and-paternity-testing/) But that’s not quite the same as a figment of the imagination.

  5. Robin is strikes’ mirror therapy.

  6. I have no doubt the pain is real, it’s the limb that no longer exists, that’s the figment. It’s fascinating that the brain can be tricked into a kind of healing by seeing what isn’t really there. It feels a bit like the mirror in HP to me because healing involves a vision of what a person wants, and in HP there was danger in being consumed by the vision at the expense of reality.

    Cormoran considers himself to be entirely rational and a person who sees things as they really are. But has he actually been as clear sighted as he thinks? When he examines events in his life, a figurative look in the mirror, has his wants and needs colored what he believes to be true? Or perhaps when he takes that figurative look he sees himself, or a situation, in a way that he didn’t before.

    Mick, I love the idea of Robin as mirror therapy.

  7. I laughed when I realized there is a real possibility for “smoke and mirrors” in the series. The possibility of mirrors and/or mirroring appearing in a future book, along with the significance of smoking for Cormoran and it’s potential for obscuring one’s vision, well, it feels appropriate for mysteries.

    And I couldn’t get the concept of Robin as a mirror out of my mind and thought about how she differs from Charlotte in that sense. In the case of Charlotte, what was reflected back to him was dysfunction, pain, and chaos. She didn’t add anything to his life. With Robin as his mirror, what was empty might be filled by other possibilities. I’m still intrigued by the idea.

  8. Louise Freeman says

    https://www.youtube.com/watch?v=6Vkb2iz5Ue0

    That really is a cool idea– we could expand it and think of Charlotte as the phantom limb: absent but still hurting. For at least some patients, mirror therapy first relieves the pain, then makes the phantom limb disappear entirely— Ramanchandran referred to it in his first book as “amputating” the phantom limb.

    And Robin did give Orlando a gift of a mirror in the Silkworm, after Orlando gave her the robin picture. i

  9. In the video it said that to be effective the patient needs to be emotionally ready to try. That sounds about right for Cormoran.

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