The itch you can't scratch

For a hemi-demi-semi-Monk-like compulsive like me, Atul Gawande's much-discussed New Yorker piece on the science of itching is ultrafreaky. Consider this passage, about a woman who had shingles on her forehead, which left her skin numb ... except for an overwhelming, inexplicable itch:

M. was willing to consider such possibilities. Her life had been a mess, after all. But the antidepressant medications often prescribed for O.C.D. made no difference. And she didn't actually feel a compulsion to pull out her hair. She simply felt itchy, on the area of her scalp that was left numb from the shingles. Although she could sometimes distract herself from it--by watching television or talking with a friend--the itch did not fluctuate with her mood or level of stress. The only thing that came close to offering relief was to scratch.

"Scratching is one of the sweetest gratifications of nature, and as ready at hand as any," Montaigne wrote. "But repentance follows too annoyingly close at its heels." For M., certainly, it did: the itching was so torturous, and the area so numb, that her scratching began to go through the skin. At a later office visit, her doctor found a silver-dollar-size patch of scalp where skin had been replaced by scab. M. tried bandaging her head, wearing caps to bed. But her fingernails would always find a way to her flesh, especially while she slept.

One morning, after she was awakened by her bedside alarm, she sat up and, she recalled, "this fluid came down my face, this greenish liquid." She pressed a square of gauze to her head and went to see her doctor again. M. showed the doctor the fluid on the dressing. The doctor looked closely at the wound. She shined a light on it and in M.'s eyes. Then she walked out of the room and called an ambulance. Only in the Emergency Department at Massachusetts General Hospital, after the doctors started swarming, and one told her she needed surgery now, did M. learn what had happened. She had scratched through her skull during the night--and all the way into her brain.

Aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaugh!