FINDING ANSWERS

(Above) Margherita and Al Atwell

Clear Lake resident sees research  done decades ago put into use today

by Marianne Gasaway

You never know when, or how, you might inspire others.  Just ask Margherita Atwell.

Today, Marg and her husband, Al, live in the Bayside area on the south side of Clear Lake, but back in the 1960s, Des Moines was home.  Al was a Master Sergeant for the U.S. Air Force Recruiting Detachment in Des Moines and Marg was employed outside of the home.  Al often promoted furthering education as a benefit of enlisting in the service.  Ultimately, he also became the inspiration for his wife to pursue her education.

Marg said she was a bit reluctant to enroll, but with Al’s support— and his offer to also sign up for classes too, the pair became students at Drake University.  A successful undergraduate experience sparked even more study for Marg.  Her college advisor pushed for her to consider graduate studies, and with Al’s continued strong support, she embarked on the quest for a graduate degree in psychology.

The idea for Marg’s thesis was born of real life experience.

“Fear of the unknown has always motivated man to search for understanding,” she wrote in the summation of her thesis.  “For centuries, man attributed an epileptic attack to an omen, an evil curse which overpowered the victim… Today man fears sudden death and many theories attempt to explain it.”

Al’s first wife died suddenly at age 32 and the autopsy offered no clear conclusion as to the cause.  She had begun having epileptic seizures with no known record of disease or accident.  Her medical history had included several complete physical exams and no irregularities were found.  After her death, which was witnessed by her physician, doctors could not explain, or fully understand, the seizures or her death.

“As I read the autopsy, I just thought ‘that can’t be right,’” said Marg.  “That’s how the idea for the thesis evolved,” explained Marg.  “I wanted to look for answers.”

The problem identified in her 1974 thesis was “to ascertain whether epileptic seizures develop as a result of a laboratory produced lesion of the nodes ganglia of the vagus nerve, to condition to inhibition of seizures, and to theorize on sudden death.”

For her study, Marg would need 11 Squirrel monkeys and would surgically implant them with depth electrodes.  She was required to obtain and pay for the monkeys herself, as well as find a location where she could keep them and conduct her studies.   Cages with feeders and bottle holders, a restraining chair, wall board heater, humidifier and electrodes to perform the research, valued at more than $3,000 were also Marg’s responsibility to purchase.  The monkeys were shipped from Peru by an import company in New York.  Two of the 11 died in transit, leaving nine for the study.

The couple built the cages and were fortunate to be able to house the study in a space available in the lower level of the Veterans Administration

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Hospital in Des Moines.  A sterile field was needed for Marg to conduct her studies.  With little help or experience, she controlled their environment, performed surgery on the monkeys, implanting each with stainless steel depth electrodes and screws, then running a variety of tests and Electroencephalographic (EEG) recordings.  She charted behavior and kept thousands of pages of detailed records— all in the days of having no computers to help process the information.

“She was way ahead of her time,” says Al, who assisted his wife as much as possible.

“I kept hearing ‘you’re wasting the animals,’ or ‘they’ll never use this on humans’,” said Marg.  “But I knew it was important work.  Sudden deaths occur and leave people with so many questions.  I was just trying to explore a possible answer.”

Those in the scientific community began to realize the importance and impact of Marg’s work and her discoveries were shared.  A photographer from the VA filmed her work and those at the University of Iowa, where she sometimes utilized the medical library, and Veterans Hospital took note.  One VA physican even took her research to his new post in California for use as a teaching tool.

The results of Marg’s studies significantly indicated that a lesion of the vagus nerve created epileptic seizures.

“There appears to be a similarity between the sudden death of persons diagnosed as epileptics, persons who have not been diagnosed as epileptic but who have disruptions of cardiac or respiratory functions or both, and young babies classified as crib deaths, who have the same cardiac and respiratory failures,” Marg’s thesis stated.

The finding of the thesis provided a measure of satisfaction to the Atwells— providing a level of understanding about the sudden death of Al’s first wife.  However, 42 years later, the study is still impacting lives.

Ten years ago Drake University sent Marg a letter and contract, asking her permission to make her thesis available worldwide using the Internet.  As computer novices, Marg and Al said they really had no expectation of how the thesis could be shared.  Then, just over a year ago the Atwell’s were reviewing The Mayo Clinic Magazine, which is delivered monthly to their home.  One particular article caught their eye.  It discussed stimulation of the vagus nerve in humans today to control epilepsy.

“Her Way Back” was the story of Sheri Finstad.  Sheri is among the 1 million persons in the United States who finds no relief from her epilepsy with existing medications.  Five years ago, with her seizures becoming more severe, she spent a week at the Mayo Clinic’s Epilepsy Monitoring Unit in Rochester, Minn. under evaluation.  Her team suggested she might be a candidate for epilepsy surgery to stimulate the vagus nerve.  The procedure would require an implant of intracranial electrodes directly into her brain to record electrical activity.  The experimental device implanted in Sheri is called the Active PC+S.  In can analyze brain activity patterns to detect seizures and in the future may be able to detect seizures before they happen and use that information to deliver an electrical charge to stop them.

“I saw it right there.  It was amazing,” said Marg.  “They were using the same procedures I had used in my study on humans and they are finding the link between lesions on the vagus nerve and epileptic seizures.”

Marg said she takes pride in knowing that her early research and conclusion that the vagus nerve plays a vital role in seizures is continuing to be explored.

“During my own visits to the Mayo Clinic I have followed up on the Epilepsy Clinic and discussed my experience with physicians there,” said Marg.  “That people can be inspired and learn from what I studied is a great satisfaction.”

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