Despite Alzheimer's, She Is "Still Alice"

"Still Alice", a novel by Lisa Genova is "a poignant portrait of Alzheimer's ... Not a book you will forget." USA Today.

The book starts out with Alice Howland as a fifty-year-old cognitive psychology professor at Harvard. She is a world-renowned expert in linguistics with a likewise successful husband and three grown children. Unfortunately, she suddenly begins to become radically disoriented, forgetful, tongue-tied and is soon diagnosed with early onset Alzheimers. Her career, her family, her very world are rocked! The book is an astute psychological study of an Alzheimer-victim's perspective of what the disease is and how it shakes the very core of her existence. Brilliantly written!

September 2003

Alice is dumbfounded. She has always had near-perfect recall of scientific articles she has read. She has performed with excellence as a dynamic speaker, giving in-depth analytical comments in forums, raising mind-boggling questions and dispelling disputes. She has thrived on a brisk jog after work to maintain her physical capabilities. In September, however, Alice no longer has perfect recall ... she can no longer remember favorite scientific authors, she forgets specific psychological jargon and hears herself using the empty word "things" in her presentations and classes, she even becomes so disoriented while jogging a few blocks from home that she struggles to find her own way home. She is of course stressed and goes in for testing.

As a psychologist she is well aware of why certain neurological tests are given ... the Stroop, Raven's Colored Progressive Matrices, Luria Mental Rotation, Boston Naming, WAIS-R Picture Arrangement, Benton Visual Retention, NYU Story Recall ... all designed to tease out any subtle weakness in integrity of language fluency, recent memory, and reasoning processes. She had given many of the tests before to her students, when she was in control. But today, she is no longer in control. She is the subject being tested.

The outcome ... Alzheimer's .... brain atrophy!

With her surface knowledge of Alzheimer's, she knows that the brain of an Alzheimer's patient has reduced levels of acetylcholine, a neurotransmitter important in memory and learning. She likewise knows the hippocampus, a seahorse-shaped structure in the brain critical for information of new memories, becomes mired in plaques and tangles, and that anomia, a pathological tip of the tongue, is another hallmark symptom. And she knows that someday, she will look at her husband and her children, her colleagues, and faces she's known and loved for forever, and she won't recognize them. And she knows that before that time comes she can expect delusions, hallucinations, agitation, depression, anxiety, euphoria, apathy, disinhibition, irritability, repetitive motor disturbances, sleep disruptions, changes in eating habits to name but a few. Alice chooses denial, denial that she has any problem and doubles her efforts in her work.

June 2004

Alice is back in a tiny testing room with Sarah Something. Oops, she has promptly forgotten the name after being introduced. In the Memory Disorders Unit at Mass General Hospital she is asked many questions about her present circumstances, her family, her visual orientation, words that begin with particular letters, and more. After a bit she is given a paper with an NYU story, a test of declarative memory performance:

"On Tuesday, July second, in Santa Ana, California, a wildfire shut down John Wayne Airport, stranding thirty travelers, including six children and two firemen."

She is asked to repeat the key details of the NYU story, which she does, and the testing continues. On to a Boston Naming Exam. She is asked to name a four-legged animal. "Racquet." And her stumbling of word recall becomes noticeable with the progression of pictures shown. "Oh, wait, I know what it is, it's a ladder for plants, a lattice? No. A trellis!" "Accordion, pretzel, rattle." "Oh, wait again. We have one in our yard at the Cape. It's between the trees, you lie on it. It's not a hangar. It's a ... halyard? No. Oh, god, it begins with H, but I can't get it." Sarah Something makes a notation on her score sheet. She sails through the WAIS-R Picture Arrangement test, Raven's Colored Progressive Matrices, the Luria Mental Rotation test, the Stroop test, and copying and remembering geometric figures. She has been in the testing room for over an hour, and then Sarah Something drops the bomb and asks her about the short story she read earlier.

Oops! "I don't really remember that much."
"That's okay. Tell me what you remember."
"Well, it was about an airport, I think."
"Did the story take place on a Sunday, Monday, Tuesday, or Wednesday?"
"I don't remember."
"Just take a guess then."
"Monday."
"Was there a hurricane, a flood, a wildfire, or an avalanche?"
"A wildfire."
"Did the story take place in April, May, June or July?"
"July."
"Which airport was shut down: John Wayne, Dulles, or LAX?"
"LAX."
"How many travelers were stranded: 30, 40, 50, or 60?"
"I don't know, 60."
"How many children were stranded: 2, 4, 6, or 8?"
"8."
"Who else became stranded: 2 firemen, 2 policemen, 2 businessmen, or 2 teachers?"
"2 firemen."
"Great, you're all done here. I'll walk you over to Dr. Davis."
Great? Was it possible that she remembered the story but didn't know she knew it?

October 2004

After jogging one day she enters her house. Her house? The refrigerator is in a different place. Well, maybe not, but it does seem different. The microwave? Hmm, some other things seem a bit odd, and then there is Lauren her next door neighbor suddenly standing behind her politely asking why she is in her kitchen. HER kitchen? Just whose kitchen is this? After that, whenever she returns from jogging she makes sure that she has the right house, the one with the note in bold black letters on the fridge saying:

ALICE,
DO NOT GO RUNNING WITHOUT ME.
MY CELL: 617-555-1122
ANNA: 617-555-1123
TOM: 617-555-1124

John made her promise not to go running without him. Recently her spatial perception has been off. Objects sometimes frequently appear closer or farther away than they actually are. She's had her eyes checked. They are fine. The problem isn't corneas, lenses or retina. The glitch is somewhere in the processing of visual information, somewhere in her occipital cortex. She evidently has the eyes of a college student but the occipital cortex of an octogenarian. She calls John in her impatience and anger at her life changes. John is in a meeting, but answers the phone anyway. He can't promise when or if they can jog today. He is busy, he has to go. Blazing anger overtakes her! Each time he doesn't take her she is consumed with the thought of losing more invaluable and irreplaceable neurons. She calls him back.

"I need to run today."
"I don't know yet when my day's going to end."
"So?"
"This is why I think we should get you a treadmill."
"Oh, fuck you," she said, hanging up.

She supposes that wasn't very understanding. She's had a lot of anger lately, but she couldn't say if this was a symptom of her disease advancing.

Summer 2005

She sat in a white wooden chair on a deck drinking tea when the man of the house [John] approaches her with a butterfly necklace [hers].
"That's not my necklace, that's my mother's. And it's special, so you'd better put it back, we're not supposed to play with it."
"I talked to your mom, and she said you could have it."
She studied his eyes and mouth for motive, but before she could decipher his sincerity, the beauty of the sparkling blue butterfly seduced her, overriding her concerns. "She said I could have it?"
"Uh-huh."
............................................

She sat on the floor in front of the full-length mirror in the bedroom she slept in and examines her reflection. The girl in the mirror has sunken, darkened circles under her eyes. Her skin looks loose and spotty all over and wrinkled at the corners of her eyes. Thick scraggly eyebrows need to be tweezed. Her curly black hair, wait, the girl's hair isn't black but is very shot with gray. The girl in the mirror looks ugly and old. Running her hands along her own cheeks and forehead she comes to a startling realization, "That can't be me. What's wrong with my face?" The girl in the mirror sickens her. "What's wrong with these mirrors?" The bathroom doesn't smell right either. There is a bucket on the floor offending her nose. She pries off the lid. Something white and sticky. She dips a brush in, and watches a creamy white paint dribble down. She knows each of the mirrors is defective, the one in the bathroom, the one in the bedroom where she slept. She found four more before she finished and had painted them all white.
............................................

She sat in a big white chair, and the man of the house [John] is in another one. He is reading a thick book and drinking a drink that is yellowish brown with ice in it. She picks up an even bigger book and thumbs through it. Her eyes pause on diagrams of words and letters. Her eyes land on individual words ... disinhibition, phosphorylation, genes, acetylcholine, priming, transience, demons, morphemes, phonological.
"I think I've read this book before."
The man looks over and nods. "You've done more than that. You wrote it. You and I wrote that book together."
Hesitant to take his word, she closes the book and reads the shiny blue cover, "From Molecules to Mind" by John Howland, PhD and Alice Howland, PhD. She looks up at the man. He's John. "John..."
"Yes." He draws closer.
"I wrote this book with you."
"Yes."
"I remember. I remember you. I remember I used to be very smart."
"Yes, you were, you were the smartest person I've ever known."

Useful Internet Sites for Teaching

This collection of Internet sites was gathered at one of our teaching seminars at Korea University. I have my colleagues to thank for such a great list of teaching resources to escape the monotony of the traditional textbook!

Voxopop:    

http://www.voxopop.com/      

(Username: XXXXX             Password: XXXXX)

• Use this site to create a class group to store all recorded files in one place.
• Useful for speeches, anecdotes or speaking practice for individuals.

Wordpress:

http://wordpress.com/               

(Username: XXXXX             Password: XXXXX)

• Use this site to create a class blog for social or academic purposes.
• Can also be used to post entries on a forum.

Moodle:       

https://moodle.org/

Usename: XXXXX                Password: XXXXX)

• Create an e-learning platform (similar to EKU or an educational portal)
• Use for discussion forums, assignment submission, projects and chats

Wikispaces:

http://www.wikispaces.com/

(Username: XXXXX             Password: XXXXX)

• Create an e-learning platform with a focus on writing and assessment
• Create spaces for social writing, project submissions and grading

Check My Words:

http://mws.ust.hk/cmw/index.php

• A useful site for students to use with Microsoft Word
• Users download a toolbar which explains common errors, reads the words written and links to online dictionaries.

Mark My Words:    

http://mws.ust.hk/mmw/index.php

• A useful site for teachers to use with Microsoft Word.
• Using documents online, insert automatic comments onto work
• Link essay points to suggested links for research

The Corpus of Contemporary American English:

http://corpus.byu.edu/coca/

• A free corpus with a variety of search options
• Shows different genres of words
• Users can also be sent a new academic word list

FLAX Interactive Language Learning:

http://flax.nzdl.org/greenstone3/flax

• Written texts and tools to work with them
• Contains a collection of essays written by university students in English universities from BAWE collection (British Academic Written English Collections)
• Essays classified by subject or genre

Citation Machine:

www.citationmachine.net

• Quick and easy citation generator for APA, MLA, Chicago and Turabian documentation
• Gives properly formatted citations for references pages and in-text citations for a variety of print and virtually all non-print options
• Fill-in-the blank and copy and paste

Google Drive for Making Surveys:

http://www.youtube.com/watch?v=22eVYplSJQ8

https://drive.google.com/

• The YouTube video explains how to create a survey with GoogleDrive

Purpose of Class

• To teach students to become independent learners by using online resources
• To provide students with a method to attain primary sources

Ted Ed:

http://ed.ted.com

• Use this site to create your own ready-to-use TED class lessons.
• Can also use lessons created by other educators.

World Teacher:

http://worldteacher-andrea.blogspot.kr

• Though primarily an ELT site, she has some great ideas for academic class projects and also gives comprehensive links to other educational aspects.

Learning English Online:

http://www.englisch-hilfen.de/en

• Extremely useful site for specific vocabulary-related and grammar-related points.
• Has a host of cultural information useful for various aspects of teaching.
• Can also be used as a good point of reference for students wishing to do self-study.

 

Tumblr:

http://tumblr.com

• Using a very simple blog interface to host files, use for in-class lessons, and post homework assignments

 

English Central:

http://englishcentral.com

• Use this site to allow your students to learn the 570 most common Academic English words.

The Hearts of Horses

The Hearts of Horses by Molly Gloss is a nostalgia novel mostly about the winter of 1917 and 1918. The story is as meandering as a winding trail up a mountain, and like a winding trail that suddenly ends at the top, the story culminates with a written view of where the heroine, Martha Lessen, 19, female horse-whisperer and bronco-buster has been and experienced in her youth as well as giving a verbal glimpse of her future life in the west as it was further tamed.

In the meandering story Molly Gloss shared fascinating lost horse-sense on horse markings and pigmentation:

• a white-faced horse's eyes will weep
• a horse with white feet is prone to split hooves
• palominos, claybacks, skewbalds, piebalds, some strawberry roans have amber hooves that are brittle and prone to cracks
• white hides will scald and chaff from sweat and heat
• some paint horses—the ones with mostly white on them—and blue eyes are not right in the head
• a pure black horse will sunburn in hot weather and fade out under the saddle and harness
• but horses seem to know that those of them that are the plain-colored ones are the lucky ones (p. 115)

Molly Gloss also wove little known knowledge of the 1910s, a time when cars were replacing horses, and other era-specific tidbits into her narrative. For example, some young kids collected the shed antlers of bulk elk and bull deer to be sold for a few cents a pound at a hardware store. Or cars were driven backwards up hills to keep fuel going into the carburetors. Or ptomaine poisoning, from improperly canned foods, was a very serious matter. She shared the time-era social gossips of the time too. As the war picked up (1917), women gathering at the many functions debated over whether Americans should get involved in Europe's war, whether Margaret Sanger in Brooklyn ought to have been arrested for handing out birth control information and whether Jeannette Rankin over in Montana would cause a riot when she arrived in Washington DC as the first woman elected to Congress.

Molly did later add some insightful humor on Margaret Sanger later in her book:  Although Margaret Sanger in Brooklyn was arrested for just passing out birth control information, condoms did in fact already exist. Evidently it was as illegal to share birth control information publicly just as it was illegal to ship condoms across state lines and in some/many counties, buying and selling them was also illegal.

Other social dynamics in the books concerned entertainment, which primarily centered around theaters. Back in the 1910s the plots of movies were the near equivalent of dime novels. "Stories of Mounties and Texan Rangers abounded, frontiersmen in coon caps, heroes with swords and plumed hats, Kit Carson-style scouts; titillating stories of girls dressed in breeches and pith helmets, cave girls in fur tunics, brown-skinned girls in grass or leather skirts, innocent girls in jeopardy from mustache-twirling villains. Quite a few movies made a point of the barbaric and the unusual—Eskimos in the far North, for example, building their igloos. The movies brought a lot of people their first glimpse of a seaside bathing beach, a woman smoking, colored people in a jazz band, men in swallow-tailed tuxedos, a woman in a negligé. Charlie Chaplain was popular, and Buster Keaton, an unlucky young many coping with the mysteries of modern life; it was from these picture shows that most people in the West had their first images of electric streetcars, ocean liners, airplanes. And in the war years there rained down a storm of movies about boys in uniform, boys who were the pride of their fathers and the envy of their younger brothers" (p. 261).

During the movie real changes, Four-Minute Men, community volunteers who spoke for encouraging enlistments or making communities aware of other wartime needs, delivered speeches. They might incite members in their communities to look for spies among their neighbors, expound on the evil of extravagance (eating sugar, wheat, pork chops when soldier boys get stale bread and cold meat), laud the virtues of wearing half-soled shoes and mended trousers and of signing food pledge cards to eat less, and of course to extol the wearing of Liberty Badges to confirm their patriotism. This was the era when Germans were hated, and even those German families with children born in America and fighting against the Germans overseas were hated. Such were the social dynamics of the times.

Patriotism ran wild. Conscientious objectors were jailed, war protesters were to be kicked out of the country, as well as pacifist ministers and journalists who wrote anti-war editorials, soldiers who complained of bad conditions in the army, and teachers who spoke out in favor of German literature.

The spirit of ruthless intolerance and repression continued after the war. The Ku Klux Klan became strong and put ads in the paper calling for "Patriots Who Hold This Country Dear" to conceal their identities in robes and hoods and come for public initiations. Negroes and Chinese were not as yet in Elwha country where Martha Lessen had her riding ring for breaking horses, and the KKK was determined to keep them out as well as plan their attacks on the "unwanted" Jewish family, some Basques, Mexicans and Catholics already there.

The Heart of Horses was not focused on the political or social currents but rather on the mundane riding circle of Martha Lessen and her gentle-taming of horses who were owned by seven separate households. Written in the first person, Martha rides her ring daily, breaking and loving the horses. Her thoughts are shared on the horses she rides as well as their owners, for as Martha says, knowing the owners is primary to knowing the horse itself.

Coyote Medicine

Lewis Mehl-Madrona, MD, Phd, is a half-breed Native American who took years becoming a medical doctor. In his early attempts at residency he voiced his idealistic views about how medicine is institutionalized but has little to do with the patients' mental or emotional sufferings while their physical symptoms are measured by numbers on medical tests and treatments correspond to the test-documented area of illness, not considering the human under treatment at all. Lewis as an intern was startled into the awareness of the human when four formerly healthy men were suddenly dying of kidney failure because doctors felt the men, because of slightly high counts of proteinura, were given biopsies ... and all four healthy men from the biopsies had kidney failure. And thus Lewis began to question allopathic medicine. For several years Lewis postponed his internship and explored various aspects of  Native American cultural health heritage in his search for complimentary holistic medicine that considers the whole person — the physical, mental and spiritual.

Below are some of his astute comments on the allopathic-complimentary medicine spectrum that he made in his book Coyote Medicine (1997):

"The academic world had met my thirst for knowledge but it had proven to be as spiritually barren as it was as intellectually bracing." (p. 33) 

"Native American religion was illegal at that time [1970s, until 1975], having been outlawed by an act of Congress in 1895. Although school children learn that the Constitution protects freedom of religion, Native Americans were long denied the right to practice theirs." (p. 36) 

"Eddie continued to explain the [Kiowa] sweat lodge to me, how it was built, what would happen. 'It's supposed to symbolize the whole world,' he said. 'Also the womb of Mother Earth. Even though it's a half sphere above ground, you're supposed to think of it as a whole sphere going doing into the earth as far as it stand above the earth. The pit in the middle of the lodge is where you put the stones. Think of those as your placenta. You're returning to the womb of Mother Earth. The placenta is then to doctor you and to take away the wastes and the toxins that you no longer need. You're going to sweat them out. The stones get filled up with the energy of the sun when the wood is burned. Then they give that energy back to you. That is the medicine.'" (p. 40) 

"The song 'Amazing Grace' is the national anthem of the Cherokee people. It was made famous from being sung on the Trail of Tears, from Tennessee to Oklahoma." (p. 67) 

"Medicine for the most part is generated numbers and statistics, t-tests and chi-squares, distributors and product moments — objective results that can be disputed and defended ... quantitative studies. Qualitative studies by recording stasis such as the method Lewis Mehl-Madrona used had its own merits, and the use of the deconstructionists view of reality, which has become mainstream thinking in behavioral medicine." (p. 145-6)

On psychiatric medicine:

"'We prescribe Thorazine of Haldol or lithium for bizarre behavior as casually as we prescribe antibiotics for bacterial infections,' Luke, chief of the psychiatric ward, would say. "Isn't chaining yourself to City Hall and reciting passages of Howl a more complicated problem than strep throat?" (p. 151) 

"The psychiatrists' tool kit includes four major categories of drugs — anti-anxiety drugs called benezodiazepines, antidepressants, antipsychotics, and mood stabilizers," e.g. Klonopin, Valium, Xanax, Librium, Antivan, Loxapine, Haldol, Mellaril, Pamelor, Lithium, valproic acid, Tegretol, Elavil, Zoloft, Parnate, and Nardil. (p. 163).

Other books similar to Coyote Medicine are located at Native American Healing.

Ben Carson, "THINK BIG!"

The biography of Ben Carson is very impressive, but when a person has a glimpse at some of his motivation to help others, one can understand why he is so successful--in the modern terms of being famous, well-known, a big contributor to society--but he is also successful to himself. He has dreams that are as yet unfulfilled, one being to create a scholarship program that recognizes pure talent in any field, and to give those individuals who deserve a chance of success the necessary tuition funding to help them achieve their dreams.

 

For Ben to be a high achiever, he has put a THINK BIG policy into his own life. When people ask him what made him so successful, he says, "Think big." He wants to share his THINK BIG concept with others so they can dream large and be large at life. The following THINK BIG excerpt is lifted from Chapter 22, pages 216-218 in Gifted Hands by Ben Carson.

 

THINK BIG

T = TALENT

Learn to recognize and accept your God-given talents (and we all have them). Develop those talents and use them in the career you choose. Remembering T for talent puts you far ahead of the game if you take advantage of what God gives you.

 

T also = TIME

Learn the importance of time. When you are always on time, people can depend on you. You prove your trustworthiness. Learn not to waste time, because time is money and time is effort. Time usage is also a talent. God gives some people the ability to manage them. The rest of us have to learn how. And we can!

 

H = HOPE

Dont' go around with a long face,expecting something bad to happen. Anticipate good things; watch for them.

 

H also = HONESTY

When you do anything dishonest, you must do something else dishonest to cover up, and your life becomes hopelessly complex. The same with telling lies. If you're honest, you don't have to remember what you said the last time. Speaking the truth each time makes life amazingly simple.

 

I = INSIGHT

Listen and learn from people who have already been where you want to go. Benefit from their mistakes instead of repeating them. Read good books like the Bible because they open up new world of understanding.

 

N = NICE

Be nice to people - all people If you're nice to people, they'll be nice to you. It takes much less energy to be nice than it does to be mean. Being kind, friendly, and helpful takes less energy and relieves much of the pressure.

 

K = KNOWLEDGE

Knowledge is the key to independent living, the key to all your dreams, hopes, and aspirations. If you are knowledgeable, particularly more knowledgeable than anybody else in a field, y become invaluable and write your own ticket.

 

B = BOOKS

I emphasize that active learning from reading is better than passive learning such as listening to lectures or watching television. When you read, your mind must work by taking in letters and connecting them to form words. Words make themselves into thoughts and concepts. Developing good reading habits is something like being a champion weightlifter. The champion didn't go into the gym one day and start lifting 500 pounds. He toned his muscles, beginning with lighter weights, always building up, preparing for more. It's the same thing with intellectual feats. We develop our minds by reading, by thinking, by figuring out things for ourselves.

 

I = IN-DEPTH LEARNING

Superficial learners cram for exams but know nothing two weeks later. In-depth learners find that the acquired knowledge becomes a part of them. They understand more about themselves and their world. They keep building on prior understanding by piling on new information.

 

G = GOD

Never get too big for God. Never drop God out of your life.

Hyponatremia

"For a long time it was thought that dehydration was a potential danger for people engaged in extended vigorous activity Thus, athletes were encouraged to drink lots of water while engaged in active sport. The trend toward extensive hydration has spread throughout society; many people carry water bottles everywhere and dutifully keep well hydrated.



To help prevent overhydration, the number of water stations
such as this one has been reduced in many marathon events.
Source

"It turns out, though, that in some circumstances, drinking too much water is a greater danger than not drinking enough. Excess water consumption can lead to hyponatremia, a condition in which the concentration of sodium ion in the blood is too low. In the past decade at least four marathon runners have died from hyponatremia-related trauma, and dozens more have become seriously ill. For example, a first-time marathon runner named Hillary Bellamy, running in the Marine Corps marathon in 2003, collapsed near mile 22 and died the next day. One physician who treated her said that she died from hyponatremia-induced swelling, the result of drinking too much water before and during the race.

"The normal blood sodium level is 135 - 145 mM (millimolar). When that level drops to as low as 125 mM, dizziness and confusion set in. A concentration below 120 mM can be critical. Low sodium level in the blood causes brain tissue to swell. Dangerously low levels can occur in a marathon runner or other active athlete who is sweating out salt at the same time that excessive salt-free water is being drunk to compensate for water loss. The condition affects women more than men because of their generally different body composition and patterns of metabolism. Drinking a sport drink, such as Gatorade, which contains some electrolytes, helps to prevent hyponatremia.

"Contrary to popular belief, dehydration is not as likely as overhydration to present a life-threatening situation, though it can contribute to heat stroke when the temperature is high. Athletes frequently lose several pounds in the course of extreme workouts, all in the form or water loss, with no lasting adverse effects. When, for instance, Amby Burfoot ran in the Boston Marathon in 1968, his body weight went from 138 to 129 pounds during the race. He lost 6.5% of his body weight while winning the men's competition that year. Weight losses of this magnitude are typical of elite marathon runners, who produce tremendous amounts of heat and sweat and cannot afford to slow down for much drinking."

Passage taken from Brown, et al. (1009). "Drinking Too Much Water Can Kill You" in

"Chapter 4: Aqueous Reactions and Solution Stoichiometry". Chemistry: The Central Science, 11ed.

Upper Saddle River, NJ: Pearson Prentice Hall. p. 147.

Tuol Seng - Genocide Museum

Tuol Seng, the former Khmer Rouge S-21 prison, is a genocide museum reminding the world of the disaster that befell Cambodia starting in 1975 when the Khmer Rouge came in droves into the cities with the intent of taking absolute control of the country. The Khmer Rouge were for the most part young kids who had been so brainwashed by a twisted ideology, and they were given control, these young, little tutored half-adults governed by a remorseless regime to eradicate those educated, their elders who they should have respected, the people who were the foundation and grit of the country ... and so a senseless, brutal genocide programs swept the country. It is suggested that as many as 1/3 of the Cambodians were senselessly eradicated by out-of-control Khmer Rouge. Tuol Seng, otherwise known as S-21 prison, was the Khmer Rouge headquarters and the location of the most brutal tortures that have been recorded in our modern day.

Tuol Sleng as a Prison

In English, the word "Tuol Sleng" is recognized as the location where the Democratic Kampuchea (DK) regime, more commonly known as the Khmer Rouge (KR) regime, set up a prison to detain individuals accused of opposing Angkar. However, in the Khmer language, the word "Tuol Sleng" connotes a terrible meaning in itself. It is perhaps only a strange coincidence that the KR regime used this specific location as a prison.

According to the Khmer dictionary published by the Khmer Buddhist Institute in 1967, the word "Tuol" is a noun. It means the ground that is higher in level than that around it. The world "Sleng" can be a noun and also an adjective. When the world "Sleng" functions as an adjective, it means, "supplying guilt" (del aoy tos) or "bearing poison" (del noam aoy mean toas) or "enemy of disease" (del chea sat-trov ning rok). As a noun, "Sleng" means the two kinds of indigenous Khmer poisonous trees. The first kind is "Sleng Thom" or Big Sleng that has a big trunk, leaves, and fruit. The second type is "Sleng Vour" or Sleng Vine which is shaped almost like a vine with small fruit. They are both poisonous. Therefore, from the above translation we can see that Toul Sleng literally means a poisonous hill or a place on a mound to keep those who bear or supply guilt (toward Angkar).

According to documents discovered by the Documentation Center of Cambodia, S-21 was established at Tuol Sleng in May 1976.

S-21 or Tuol Sleng was the most secret organ of the KR regime. S-21 stands for "Security Office 21." S-21 was Angkar's premier security institution, specifically designed for the interrogation and extermination of anti-Angkar elements.

In 1962, S-21 was a high school called "Ponhea Yet" High School, named after a royal ancestor of King Norodom Sihanouk. During the Lon Nol regime, a republican regime backed by the US government in the 1970s, the name was changed to Tuol Svay Prey High School. Behind the school fence, there were two wooden buildings with thatched roofs. These buildings were constructed before 1970 as a primary school. Today all of these buildings are called "Tuol Sleng" and form part of the museum of genocidal crimes.

S-21, located in Tuol Svay Prey sub-district, south of Phnom Penh, covers an area of 600 x 400 meters. During the KR regime it was enclosed by two folds of corrugated iron sheets, all covered with dense, electrified barbed wire, to prevent anyone from escaping the prison. Houses around the four school buildings were used as administration, interrogation and torture offices.

Other branches of S-21 were located elsewhere. One was S-21 (kor), which was located in Ta Khmao provincial town in Kandal province south of Phnom Pehn; another was S-21 (khor) located at Prey Sar (a colonial era prison), west of Phnom Penh, in Dang Kore District, Kandal province. S-21 (khor) was also known as Office 24 and was used as a re-education camp not only for KR military Division 170, but also for all kinds of people including staff members of S-21, who were accused of minor crimes. S-21 (khor) was responsible for producing agricultural supplies for the S-21 complex.

All the classrooms of Tuol Sleng high school were converted into prison cells. All the windows were enclosed by iron bars, and covered with tangled barbed wire to prevent possible escape by prisoners. The classrooms on the ground floor were divided into small cells, 0.8 x 2 meters each, designed for single prisoners. The rooms on the top floors of the four buildings, each measuring 8 x 6 meters, were used as mass prison cells. On the middle floors of these buildings, cells were built to hold female prisoners.

At first, the interrogations were conducted in the houses around the prison. However, because women taken to the interrogation rooms were often raped by the interrogators, in 1978 the chief of the S-21, a former teacher named Kang Kek Ieu alias Comrade Duch, decided to convert Building B for use as an interrogation office, as this made it easier to control the interrogation process.

The Security office and its branches were under the authority of the Central Committee and the KR Minister of Defense, Comrade Son Sen alias Khieu, who appointed Comrade Duch to head the S-21 system. Comrade Duch was born as Kang Kek Ieu in Sho Yok village, Chine Thbong sub-district, Kampong Thom province. He was a mathematics teacher before he joined the Khmer Rouge.

According to Cambodia Scholar, David Chandler, Kang Kek Ieu won a scholarship to Lycee Sisowath in the late 1950s, and taught briefly in his specialty: mathematics in Kampong Thom province with Comrade Mom Nay alias Chan before going to Pedagogique, where he fell under the spell of some Chinese students sent from China to learn Khmer. Kang Kek Ieu also taught his speciality in Kampong Cham province briefly before being arrested as a Communist in 1965. After being released, he seemed to have disappeared into the woods.

The Research Committee on Genocide of the People's Republic of Kampuchea (PRK) reported in 1983 that in order to maintain security and to manage all the activities in S-21 prison and its branches, in 1976 the KR regime employed a large staff divided into 4 units responsible for S-21, S-21 (ka), S-21 (kor) and S-21 (khor). The units were:

A. Internal workforce ..........141

B. Office personnel ..........1,148

C. Interrogation units ............54

D. General workers ..........1,377

The number of workers in the S-21 complex totaled 1,720. Most of the "general workers" were under confinement at Prey Sar.

Within each unit, there were several sub-units composed of male and female children ranging from 10-15 years of age. These young children were trained and selected by the KR regime to work as guards at S-21. Most of them started out as normal before growing increasingly evil. They were exceptionally cruel and disrespectful toward the prisoners and their elders.

There were two management offices. One was Duch's office and the other was his office for interrogation, documentation and general administration. Ill or injured prisoners were treated by paramedics in their respective cells. Treatment was available three times per day. There were no hospital services inside the prison. The medical personnel were untrained and mostly children.

The victims in the prion were taken from all parts of the country and from all walks of life. They were of different nationalities and included Vietnamese, Laotians, Thai, Indians, Pakistanis, British, Americans, Canadians, new Zealanders, and Australians, but the vast majority were Cambodians. The civilian prisoners composed of workers, farmers, engineers, technicians, intellectuals, professors, teachers, students, and even ministers and diplomats. Moreover, whole families of the prisoners, from the bottom on up, including their newly born babies, were taken there en masse to be exterminated.

According to the KR reports found at Tuol Sleng Archive, the influx and outflux of prisoners from 1975 - June 1978 were recorded on lists. Some documents have disappeared. One report estimated the number of prisons as follows:

1975 .........................154 prisoners

1976 ......................2,250 prisoners

1977 ......................2,330 prisoners

1978 ......................5,765 prisoners



The guide, a baby of 3 when the Khmer first rolled into the capitol, points to a board of the Khmer Rouge youth
who were responsible for carrying out the torture in Tuol Sleng S-21.
 

These figures, totaling 10,499, do not include the number of children killed by the KR regime at S-21, which was estimated by the same report at 2,000.

The reports show that in 1977 and 1978, the prison on average held between 1,200 and 1,500 prisoners at any time. The duration of imprisonment ranged from 2-4 months, although some important political prisoners were held between 6-7 months.

The prisoners were kept in their respective small cells and shackled with chains fixed to the walls or the concrete floors. Prisoners held in the large mass cells had one or both of their legs shackled to short or long pieces of iron bar. The short iron bar was about 0.8 meters up to 1 meter long and was designed for 4 prisoners. Prisoners were fixed to the iron bar on alternative sides, so they had to sleep with their heads in opposite directions.

Before the prisoners were placed in the cells they were photographed, and detailed biographies of their childhood up to the dates of their arrests were recorded. Then they were stripped to their underwear. Everything was taken away from them. The prisoners slept directly on the floors without any mats, mosquito nets or blankets.

Every morning at 4:30am, all prisoners were told to removed their shorts, down to the ankles, for inspection by prison staff. Then they were told to do some physical exercise just by moving their hands and legs up and down for half an hour, even though their legs remained restrained by the iron bars. The prison staff inspected the prisoners 4 times per day; sometimes the inspection unit from the security office made a special check over the prisoners. During each inspection, the prisoners had to put their arms behind their backs and at the same time raise their legs so that the guards could check wither or not the shackles were loose. If loose, the shackles were replaced. The prisoners had to defecate into small iron buckets and urinate into small plastic buckets kept in their cells. They were required to ask for permission from the prison guards in advance of relieving themselves; otherwise, they were beaten or they received 20-60 strokes with a whip as punishment. In each cell, the regulations were posted on small pieces of black board. The regulations read as follows"

1. You must answer accordingly to my questions. Do not turn them away.
2. Do not try to hide the facts by making pretexts of this and that. You are strictly prohibited to contest me.
3. Do not be a fool for you are a chap who dares to thwart the revolution.
4. You must immediately answer my questions without wasting time to reflect.
5. Do not tell me either about your immoralities or the revolution.
6. While getting lashes or electrification, you must not cry at all.
7. Do nothing. Sit still and wait for my orders. If there is no order, keep quiet. When I ask you to do something, you must do it right away without protesting.
8. Do not make pretexts about Kampuchea Krom in order to hide your jaw of traitor [sic].
9. If you do not follow all the above rules, you shall get many lashes of electric wire.
10. If you disobey any point of my regulations, you shall get ten lashes or five shocks of electric discharge.

When I heard my camera click on this picture, I suddenly felt sick and wondered what kind of a person I am to take such a picture of horror. In the commemorative stupa is a large collection of skulls - from the victims of Tuol Sleng. In the barbed-wire enclosed compound, people walking around will see bones jutting from the ground from mass burials. The museum curators do not collect the bones that people find but leave them there, and when a very large number has washed up, they are collected and interred somewhere. The bones keep washing up ... and it's eery to know that you are walking on bones that you're not seeing ...

... or to see chickens scratching among the sufacing bones ....

The prisoners were required to abide by all the regulations. To do anything, even to alter their positions while trying to sleep, the inmates had first to ask permission from the prison guards. Anyone breaching these rules was severely beaten. Prisoners were bathed by being rounded up into a collective room where a tube of running water was placed through the window to splash water on them for a short time. Bathing was irregular, allowed only once very two or three days, and sometimes once a fortnight. Unhygienic living conditions caused the prisoners to become infected with diseases like skin rashes and various other diseases. There was no medicine for treatment.

Tuol Sleng as a Museum

In the wake of the renovation following the fall of the Khmer Rouge regime, Tuol Sleng, opened as a museum of the atrocities of the genocide. In the 1980s, most visitors were local people, whereas foreign visitors were principally from certain socialist countries like Vietnam, the Soviet Union, Laos, Hungary, Poland and others from the Eastern bloc. Since the 1993 election and the establishment of the Kingdom of Cambodia, most of the visitors to Tuol Sleng Museum have come mainly from Taiwan, Japan, Germany, Korea, the United States, and other non-communist countries. About 50 people (statistics from the early 2000s) visit the museum a day to witness the horrors or a regime without humanism or conscience.

Ghengis Khan and the Making of the Modern World

Weatherford, Jack. Ghengis Khan and the making of the modern world.  xxxv, 312 pp., illus., bibliogr. New York: Crown Publishers, 2004. $25.00 (hard), $14.95 (paper)

(book review - by Cheryl Magnant)

This historical ethnography of the Mongol people as hunters growing into the powerful nation of destroyers, conquerors and shapers of history under the leadership of Ghengis Khan is a carefully researched piece of scholarship divided historically into three parts.  For introduction, the author relates his personal research endeavors in the Mongolian steppes and gives a broad overview of how Mongols are perceived in the present age and how and from where commonly known perceptions and misconceptions of the Mongols have arisen.  The first part of the narrative tells of Ghengis Khan’s birth in 1162, his rise to power and his charisma as a leader and unifier of the steppe tribes into a founded nation in 1206, and then recounts many of his successes at expansionism until his death over twenty years later. The second part relates the further expansions of his immediate heirs and their entering the Mongol World War, which lasted five decades until his grandsons went to war with one another; the war was the beginning of the end of the great nation which ruled nearly half of the world from the Mongol steppes north to the dense forests of Russia, south to Vietnam and westward to the edges of modern western Europe, and deeply southward into India. The third part examines Mongolia’s century of peace and the effects the Global Awakening had on modern society in terms of political, commercial and military institutions. 

 

Following the three narratives is an epilogue giving a culturally emotional tribute to a newly discovered site located by the author and his scholarly companions; it is the location of Ghengis Khan’s wife’s kidnapping, the pivotal event which ignited Ghengis Khan into ingeniously changing a tribe into a nation.  Extensive chapter notes provide cross-referencing in English, when available, and other languages if not; all referenced foreign scripts have been Anglicized.  For Anglicizations within the narrative, Jack Weatherford provides a note on transliteration of the Mongol language and a glossary of Mongolian names and places appearing in the text.  His selected biography is replete with no less than one hundred and ninety-five references, followed by acknowledgments to the diversity of people in Mongolia, Russia, China and the United States, ranging from herders to parliament members, who assisted him in his years of research.  Throughout the ethnography, intermittent drawings depicting historical moments reflective of Mongolian art and culture appear by Dr. S. Badral of Chinggis Khaan University.  Finally, a several-paged index culminates this ethnography. 

Jack Weatherford’s premise in writing Ghengis Khan and the Making of the Modern World is that through the influence of Ghengis Khan, contrary to popular belief, the world was not only threatened by his warring ingeniousness and revolutionary tactics but was also positively transformed.  Jack Weatherford writes about the ancient struggle between the hunter and the herder and portrays the triumph of the hunter in a revisionist history of Ghengis Khan reshaping civilization worldwide by conquering peoples but not destroying cultures.  Ironically, Ghengis Khan, an illiterate hunter who became Great Khan in his early forties, surrounded himself with scholars and skilled artisans of the conquered peoples and amalgamated their knowledge into his growing Mongol kingdom; thus, through his military thrusts primarily west and southward, he redistributed his newly gained knowledge and learned skills, and as a result, impacted world history by reshaping literature, language, art, music, erudition itself, methods of war, politics and diplomacy, commerce, philosophies, and, in fact, he was the first conqueror and ruler to successfully practice religious tolerance.  Ghengis Khan was a humanitarian who abolished torture, avidly sought out new technologies and forms of expertise, and as Great Khan, head of the Mongols, was representative architect of history.  His four male offspring were the dynasty founders of the Golden Horde in Russia, the Moghul Empire in India, the Ilkhanate in Persia and Iraq, and the Yuan Dynasty in China.  His blood legacy lasted for seven hundred thirty-one years until the last descendent, Alim Khan, was deposed as emir of Bukhara.  Yet, the legacy he gave the world was the foundation of modern civilization:  international paper currency, a postal system, technologies such as printing, the compass and abacus, as well as the spread of merchandises.  Namely, the legacy he bestowed on civilization was the beginning of the homogenization of our present global village.

 

Mediaeval Commerce Asia - source

Ghengis Khan and the Making of the Modern World is a theoretical narrative of historical events which took place eight centuries previous.  Extensive passage of time and translation concerns of The Secret History of the Mongol raise some questions as to the exactness of the events reconstructed in this ethnology, especially as The Secret History of the Mogols was written for the royal Mongol family significantly after Ghengis Khan’s death.  Over a period of five years Jack Weatherford researched and took cultural journeys through the “Great Taboo,” Ghengis Khan’s homeland and forbidden burial site.  Through careful readings of the more than a dozen language translations of The Secret History of the Mongols, Jack Weatherford, self-confessed as lacking proficiency in the Mongol language, along with two renowned Mongolian scholars, Professor Kh. Lkhagvasuren, archeologist, and Professor O. Sukhbaater, geographer, retraced the steps of Ghengis Khan in the same inclement weather as was presented in The Secret History of the Mongols.  Vast discrepancies between the translations became apparent as well as the difficulty in deciphering the context of relocating non-geographically named sites.  Other names appear to be in code or allude to places and events of common knowledge at the time but about which have been lost in the intervening centuries.  Due to harsh weather, the steppes are ever-changing and topographical landmarks have been erased or defaced, making positive identification difficult.  Transliterations of names into English alone also inhibit the preciseness demanded of empirical research; however, Jack Weatherford presents several names of controversial spelling and, explaining his choice in selecting one, systematically uses it throughout his narrative. 

 

The Secret History of the Mongols is a cultural tool, describing even the weepings of the Great Khan; nevertheless, there exists one cultural aspect that leaves gaps in the understanding of peoples of non-Mongolian backgrounds:  the topic of death, which is still not culturally discussed in Mongolia today.  As a result, a mystical vagueness surrounds the death and burial of Ghengis Khan, and no matter how scholarly or technical the searching may become, the steppes will never bring to light his disguised-by-trampling burial site.  Jack Weatherford, already holding a Ph.D. in anthropology from the University of California, yet, owing to his five years of extensive research with the steppe scholars and an additional year of literary research on Mongolia at Macalester College in St. Paul, Minnesota where he is the Dewitt Wallace Professor, was awarded an honorary Doctorate of Humanities from the Chinggis Khaan College in Mongolia for his scholarly research on Mongolia and Ghengis Khan.  His most recent ethnography, Ghengis Khan and the Making of the Modern World, is imbued with Jack Weatherford’s insightful steppe-life cultural experiences which clarify presupposed cultural knowledge in the recently corrected and translated The History of the Mongols: The Life and Times of Chinggis Khan (2001) by Urgunge Onon.  The books counterbalance each other.  The History of the Mongols focuses on the past and is a cultural translation from the original Uighur script into English, whereas Genghis Khan and the Making of the Modern World not only explores Mongolia’s ancient history but also ties in the ancient past with the modern present. 

 

Cheryl Magnant