This Hitchcock classic is one of the great achievements in the horror genre. It is certainly one of the most talked about. There are no literal monsters or aliens that are usually attributed to films of the same time period, instead the film favors the world of a psychologically based approach to terror. Director Alfred Hitchcock took the familiar horror movie clichés and reused them in a new, contemporary setting. Although a realistic tale (loosely—very loosely—inspired by actual events), the approach to filming is full-blown Gothic. The lonely road and the rain the drives a victim to seek shelter where there is only danger—this is the stuff of classic horror movies, as is the spooky house, a fine 20th Century stand-in for Dracula’s castle. And of course, the lurking menace hiding in the attic or the basement—what more could you ask of a horror movie?

The film begins with Marion Crane (Janet Leigh) shacking up with her boyfriend Sam (John Gavin) in a hotel during a lunch break. Unable to marry because of financial circumstances, Marion succumbs to temptation and steals money from the bank where she works. Her escape route leads her to an old hotel, where she finds the friendly nervous proprietor Norman Bates (Anthony Perkins) trapped in his own cage, forever tied to his ailing mother. Seeing her own plight reflected in his pathetic condition, Marion decides to give the money back, but before she can a silhouetted maternal figure sneaks into her hotel room and stabs her to death. Horrified, Norman cleans up the mess and hides the body, to protect his mother from the police. A private investigator searching for (Martin Balsam) is stabbed to death on the stairs of the Bates mansion. Marion’s boyfriend and her sister Lila (Vera Miles) come searching for her, but they learn one inexplicable fact: Norman’s mother died years ago. While Sam distracts Norman down at the motel, Lila sneaks into the mansion to find the truth about his mother. Norman knocks out Sam and heads up to the house. Lila searches in the basement, where she finds Mrs. Bates: a mummified corpse. Suddenly, the figure of “Mother” appears behind Lila – it’s Norman, dressed in his mother’s clothes. Fortunately, Sam arrives in time to stop her from killing Lila. In the police station, a psychiatrist (Simon Oakland) explains that Norman murdered his mother in a jealous rage, but his guilt-obsessed mind blocked out the memory, and the only way to keep her alive was to take her place. The film ends with Norman in his isolated cell, his own personality completely submerged, his mother’s voice echoing in his head.

Decades have passed, yet this story still works – even though the shock has worn off and we all know the ending. (Much credit for that must go to the direction by Hitchcock, since director Gus Van Zant’s word-for-word remake proved to be a total bore.) Robert Bloch’s novel supplied a great structure, including the shocking death of the lead character midway through the story, plus an unguessable twist ending. Screenwriter Joseph Stefano reworked much of the dialogue and characterizations, making Norman Bates more sympathetic and less suspicious, at least in his early scenes. Anthony Perkins’ performance is perfect: it works whether or not you know the truth about his character. And of course, Alfred Hitchcock’s masterful direction brings the proceedings to life in visually arresting ways, most memorably in the notorious shower sequence, but also in more subtle moments, as when we last see Norman, now fully transformed into his alter ego, Perkins’ sly expression glaring out at us from against an almost blank background, and then briefly, almost subliminally, there comes the superimposed image of Mother’s corpse, her features briefly lining up with those of her son.

The impact of this movie changed the genre forever, relocating the source of horror from the far off hills of Transylvania and internalizing it in the most cherished of relationships, the one between mother and son. Previous films had used contemporary settings and emphasized psychological explanations (e.g., Val Lewton productions like The Cat People), and stories like Dr. Jekyll and Mr. Hyde had featured characters with split personalities, but these were diversions that still retained elements like European superstition and mad science to explain the etiology of horror. Yes, Irena thought she would turn into a cat if sexually aroused – but only because she’d been brought up to believe this in Serbia. Yes, the respectable Dr. Jekyll turned into the monstrous Mr. Hyde – but only because he indulged in misguided experiments.

Psycho managed to overthrow even these tenuous links when it came to the “blame game” – this is, identifying the cause that turned Norman Bates into a maniac. By making his mother out to be the real monster – the one whose psychological domination drove her son to murder and madness – Hitchcock’s film manages to be truly subversive and disturbing. The monstrous “Other” is no longer out there somewhere at a distance, threatening a normal, safe, and comfortable homestead; the monster now resides within the very heart of the home, where the innocent have no defense.

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Excellent – A Must See Film.

Time travel and story telling has been a device since the earliest stories. People always want to go back in time and change something or go forward in time to see what time has produced. Of course it is one thing writing about time, rather sticking it into a story for the sake of bringing point A to point B and it is quite another to tell a time story well. Going beyond the story and actually making the time lines logical and adhering to logic when it comes to traveling through time is very difficult and most stories find themselves in a time paradox. Most films do not bother working through the paradox. There are some basic themes when in comes to time travel: taking technology to the past, trying to guard the past against evil changes, and lastly the unintentional change that has to be corrected.

The time travel motif also has an ideological function because it literally provides the necessary distancing effect that science fiction needs to be able to metaphorically address the most pressing issues and themes that concern people in the present. If the modern world is one where the individuals feel alienated and powerless in the face of bureaucratic structures and corporate monopolies, then time travel suggests that Everyman and Everybody is important to shaping history, to making a real and quantifiable difference to the way the world turns out]].
        —Sean Redmond, Liquid Metal: the science fiction film reader (2004)

The following is a list of films that handle time travel pretty well. Of course it is impossible to handle time travel without flaws or outright paradoxes but this list of films handles the time issue to the best possible logic. There are temporal anomalies in all time travel movies, even the best of them. This list tries to examine the good and the bad of these films. As with all of my lists they are listed by year as to not assign excellence to one over another. These are all good films and you should see them all.

It’s A Wonderful Life (Frank Capra, 1946)
In this timeless Christmas classic, George Bailey (James Stewart) finds himself at his wits ends as his world falls apart around him. Despondent George contemplates suicide and wishes “he had never been born”. Observing George’s desparate plea, Clarence Oddbody a guardian angel comes to his aid and granting his wish shows him what Bedford Falls would be like had he never been born. The saving grace of any anomalies of this film is that George is returned to the beginning of where he was supposedly erased and so no time travel occurred. This can also be explained away as a dream sequence since the timeline was returned and restored with no change but George’s own dream about his own existence.

The Time Machine (Pal George, 1960)
Scientist Alexander Hartdegen (Rod Taylor) invents a time machine in an effort to change the past and finds himself transported 800,000 years into the future. The Time Machine (also known as H.G. Wells’ The Time Machine) is based on H. G. Wells’s 1895 novel. The film was produced by George Pál, who also filmed a 1953 version of Wells’ The War of the Worlds. Pál always wanted to make a sequel to his 1960 film, but it was not remade until 2002 when Wells’ great-grandson Simon Wells directed a film with the same title.

HG Wells was certainly not the first to consider time travel but his view of a time travel device and his imagination of the future is fascinating. He avoids many of the trappings of time travel by only going forward thus foregoing time shift anomalies

Planet of the Apes (Franklin Schaffner, 1968)
In the year 3978A.D. a spaceship with a crew of 4 crashes down on a distant planet. One of the crew members had died in space and the other 3 head out to explore the planet. They soon learn that the planet is much like their own. They then find the planet is inhabited by intelligent apes. One of the men is shot and killed and the others are taken to the apes’ city. There, one undergoes brain surgery and is put into a state of living death. The other befriends some of the apes but is feared by most. After being put through ape trial he escapes with a female human native to the planet. After helping his ape friends escape a religious heresy trial he escapes out into the wilderness with the female. There he learns the planet might not be so distant after all. In this original film, two astronauts are thrown forward thousands of years and land on Earth; sequels confused this but let’s just worry about this original 1968 film on it’s own merit. Time travel in this story is accomplished by accident. We see that there is only a single event that goes forward, which for time travel is the best scenario and one with the least possibility for confusion or divergent time lines.

Time After Time (Nicholas Meyer, 1979)
H.G. Wells has just invented a time machine but hasn’t tried it out yet. When he discovers that one of his friends is actually Jack the Ripper, Jack makes his escape using the time machine. Herbert follows Jack into the late 1970’s where he meets Amy, a bank clerk, who teaches Herbert about life in 1970’s while they pursue Jack, who is enjoying the more violent society in which he continues his murderous activities.

Of particular interest in this film is the treatment of the time machine, which is seen as existing in every moment of time at once.  The traveler gets into it, and moves through time; but if someone physically moves the time machine, the traveler arrives in the place to which the machine has been moved.  This seems most consistent with Wells’ original story.  However, time within the machine is confusing, and can’t withstand much scrutiny. There is an inherent problem with Wells being in the future; that is that his presence in the future temporarily removes him from the past.  On his journey forward, there will be no H. G. Wells museum, no books he wrote, no history about him, as he has not done any of those things before leaving the past.  He goes back, in the end, to do them, which would restore his place in history in the CD timeline, but the AB timeline is very difficult to reconstruct due to his absence from it.

Somewhere in Time (Jeannot Swarc, 1980)
The movie opens with college student Richard Collier gathering rave reviews for his new play. At the party, he comes face to face with an old woman who presses something in his hand and whispers, “Come back to me.” He opens his hand to find an old pocket watch. Cut to several years later. Playwright Collier is in the midst of a break-up and writers block. He leaves the city for awhile to think things out and finds himself near his alma mater at the Grand Hotel. While wandering around the hotel, he finds a photograph of a beautiful young woman. Richard is entranced, and tries to find out all he can about her. During the course of his research he learns she was Elise McKenna, an actress from the turn of the century. He also discovers that she was the mysterious old woman who gave him the watch. He purchases antique coins and an old suit, clears his hotel room of everything, and using a tape recorder under his bed and extreme exertion, he wills himself back to June 27th, 1912.  Here he begins the rather difficult project of attempting to meet Miss McKenna, completely out of touch with the social realities of the day.  But gradually he manages to win her heart.

One theory is that this story only works in a fixed time concept.  Richard Collier and Elise McKenna were fated to be together; they were together because they were together, and time itself bent to bring them together.  But that is not the only way to solve the anomaly. Obviously, Richard Collier goes back in time, and this causes a change in history.  He eventually comes forward in time, and we find that whatever he changed has resolved into that which was known to have happened anyway.  This seems perfectly reasonable.  He went back in time with the sole purpose of meeting someone, and he met her; having met her, he returned to his own time–but he has not changed history in a way that would make it so that he would not have wanted to travel back in time to meet her. But when he goes back in time, he takes with him several objects, and one of these he does not bring back.  Watch the watch.  It is critical to the analysis. It would appear that we have an uncaused cause in this film, a story in which everything happens because it happens.  The watch has no creation; it has always been.  Richard Collier finds McKenna because she finds him; she finds him because he found her.  Everything depends on everything else; nothing can be said to have happened first and so caused all else. In the original history, there must have been another young man.  He was tall, with dark hair, and a name similar to Richard Collier.  He, too, had an interest in Miss McKenna, and he undoubtedly interfered with her life and made promises.  We cannot fully guess what he promised, but he gave her his pocket watch, left from the hotel and never returned–and she waited a lifetime for him.  Then, when she was near death, she heard of a young man producing a play just up the road whose name was Richard Collier.  Could it be him?  She went to see him, and he was tall, dark-haired–it could well be him.  It must be him, she thought.  She gave him the watch, and made her cryptic comment – this resolves our historical dilemma

Watch for part II which includes Time Bandits, The Terminator, Back To The Future, Star Trek IV – The Voyage Home, Back To The Future, Part 2, Bill & Ted’s Excellent Adventure and more…

The second cervical spinal nerves are unduly vulnerable to forcible approximation of the arches of the atlas and axis and to excessive rotation of the atlas on the axis. Sequelae of such injury include sensory aberrations ranging from loss of feeling to severe neuralgia and disorders of balance. Diagnosis of second cervical neuropathy may be difficult when there are multiple injuries to the cervical spine, but most cases clear up spontaneously within one to three years.

Occipital neuralgia was recognized in the nineteenth century and descriptions of the condition are found in contemporary textbooks. It was Charles Downing that observed “cervico-occipital neuralgia” was due to damage to the second cervical nerve. A century later Dr. Hunter and Dr. Mayfield provided anatomical explanation why the second cervical nerves are particularly susceptible to trauma. Unlike the other spinal nerves, they are not protected by bony pedicles and facets. Their ganglia lie on the vertebral arch of the axis to the soft tissues in the neck. Hence they are clearly vulnerable and may be crushed when the two bony surfaces are approximated by forced hyperextension of the head. They may also be injured when excessive rotation occurs in one direction and the arches of the atlas and axis excert a scissor like action on the ipsilateral nerve. Thus hyperextension and excessive rotation may result in injury to one or both of the second cervical nerves. Wrenching movements of the head are particularly dangerous since they combine both movements.

Injury to the second cervical spinal nerve is associated with sensory aberrations usually associated with disturbances of equilibrium. The sensory aberrations range from loss of sensation to severe neuralgia, and the pain is often burning or stabbing. It tends to be intermittent, and associated with superficial tenderness of the scalp. In some cases the area continues to around the ear or at the angle of the jaw.

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Clinicians often think in terms of “syndromes.” A syndrome is a pattern of symptoms (what the patient complains about) and signs (what the physician finds) which suggest the location of a disease process and occasionally its nature.  The consequence of nerve root damage (from any cause) is known as a radiculopathy (L. radicula = little root; pathos = disease), whereas the syndrome of “myelopathy” (Gr. myelos = marrow, pertaining to the spinal cord, pathos = disease) results from spinal cord damage. 

Compression of nerve roots or the meninges covering the spinal cord usually presents with back or neck pain.  Back pain is a very common symptom and results in costs up to $50 billion annually for medical care and disability payments.  Back or neck pain may be caused by a variety of musculoskeletal mechanisms and the physician needs to be able to examine the nervous system to determine if there is compression of nerve roots or the spinal cord.  The anatomy you are learning is essential for understanding exam findings and symptoms of root or spinal cord compression. 

The peripheral nervous system begins at the nerve roots.  Each segment of the spinal cord gives rise to a ventral or anterior motor and a dorsal or posterior sensory nerve root.  The spinal nerve roots can be damaged as they traverse the spinal (vertebral) canal, but are especially vulnerable in the intervertebral foramina, where the ventral and dorsal spinal roots join to form the spinal nerves. 

Because there are only 7 cervical vertebrae despite 8 cervical roots, the root number exiting between two vertebrae is always the number of the lower vertebra.  For example, the C5 root exits between the C4-C5 vertebrae and would be effected by a C4/5 disc herniation; the C8 root exits between C7-T1 vertebrae and would be compressed by a C7/T1 disc.

Pain due to a C6 and C7 radiculopathy radiates from the neck and from around the shoulder into outer aspect of the arm and forearm.  C6 radiculopathy may cause pain and numbness along the dorsal aspect of the thumb and index finger, C7 pain and paresthesia may radiate into the middle finger.

In the cervical and thoracic spine, intraspinal tumors, of which herniated discs are the most common, may cause not only a radiculopathy, but may also compress the spinal cord and the resulting syndrome is a myeloradiculopathy.  Compression of the spinal cord needs to be recognized and treated promptly.  Upper motor neuron (spasticity, Babinski sign) signs are often present with spinal cord compression.

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Back to the Future Part II is a 1989 film and a sequel to the 1985 film Back to the Future. Like the previous film, it was directed by Robert Zemeckis and written by Zemeckis and Bob Gale. Part II and the third installment of the trilogy, Back to the Future Part III, were filmed back-to-back, with some of the scenes of Parts II and III filmed concurrently, and released six months apart. Although released in 1989 and 1990, both films continued to portray 1985 as the present, due to them directly following the events of the first film.

No sooner has Marty McFly (Michael J. Fox) returned to 1985, than Doc Brown (Christopher Lloyd) turns up to whisk him and perfunctory romantic interest Jennifer (Elizabeth Shue) off to 2015, in order to prevent grown-up Marty’s kids going to jail. Meanwhile, mean old man Biff Tannen (Thomas F. Wilson) picks up an almanac of sports results, borrows the DeLorean, and heads back to the ’50s to make himself rich and turn Hill valley into hell on earth. With Bob Gale, Zemeckis has fashioned a script whose complex twists, ironies and paradoxes amply compensate for the somewhat juvenile nature of the action itself. Of course this is light fare time travel fans or shall we say geeks. There is a lot of entertainment for your buck here and Part II will certainly whet your appetite for Part III. Best of all, it never degenerates into Spielbergian sentimentality: you can laugh, be thrilled and think without feeling embarrassed.

I have to talk for a moment about tiime. When Doc takes Marty and Jennifer out of 1985 and brings them to the future, the Marty and Jennifer from the future couldn’t possibly exist since their disappearance from 1985 instantaneously erased their future. This rather large plot hole was admitted by writers Robert Zemeckis and Bob Gale as something they had noticed while filming. They decided to leave it, however, since they had already set up Marty and Jennifer to meet their future kids by having Doc say, “Something’s got to be done about your kids” at the end of the first movie. Having them travel to the future only to find out they didn’t exist would have been a bigger disappointment to the audience. Although they could still exist in the future having already left the present as long as they return to the present.

The Back to the Future franchise is thoroughly entertaining and believable. There is no doubt that the audience cares about these characters and circumstances. The film is ever-aware of the need to explain the complications of geometric time and space travel, and attempts to do so chiefly through Lloyd’s frenetic ramblings and often-unintelligible discourses. But the film works best through its magnificent technical achievements (the visual effects received an Oscar nomination) and the inherent charm of Michael J. Fox as the lovable Marty McFly. Christopher Lloyd as the professor is dead on Lloyd. As the spotlight and glue of the film is the delightfully menacing Thomas F. Wilson, reprising his role as the awful Biff Tannen. In light of the comically rich performance turned in by this deceptively facile actor, perhaps the alternate title for Back to the Future Part II should have been Biff’s Story.

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Excellent – A Must See Film.

Is there anything worse than neck pain? If you ask someone who suffers with chronic neck pain, the chances are their reply is a resounding “No”! Neck pain often radiates into the shoulders and upper back and may be accompanied by other symptoms such as headaches and extremity tingling and numbness.

Chronic neck pain sufferers may wonder, “What causes neck pain and how can this aggravating pain be stopped?” One cause is dysfunction or disease affecting the cervical facet joints. The cause, combined with a treatment is called Pulsed Radiofrequency Neurotomy (PRFN) (or Pulsed Radiofrequency Rhizotomy).

Facets are the spine’s system of joints that enable movement. Another term for the facet joints are Zygapophyseal or Apophyseal Joints. At the back of each vertebra are two sets of facet joints. One pair faces upward and one downward; with one joint on the left and right sides of each vertebra. Facet joints allow flexion (bend forward), extension (bend backward), and twisting motion. In general, the spine is made more stable due to the interlocking nature of the facet joints to the adjacent vertebrae.

The cervical facet is a cartilaginous joint that can be a major source of pain. The most commomly injured facet  joints are the C4/5 and C5/6 and even C6/7. Therapy for cervical facets include stem cell therapy with regeneration of the damaged cartilage.  Regenexx enables a patient to use their own stem cell to regenerate damaged tendons, ligament and cartilage. See figure 2.

Similar to other joints in the body, each facet joint is surrounded by a capsule of connective tissue and produces fluid to nourish and lubricate the joint (synovial fluid). The joint surfaces are coated with a thick spongy material termed articular cartilage that enables the bones of each joint to smoothly move against the other.

Osteoarthritis is probably the most common cause of cervical facet joint pain. This degenerative disease causes progressive cartilage deterioration. Without the spongy cartilaginous cushion, joint bones begin to rub against each other when at rest and during movement.

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Pulsed Radiofrequency Neurotomy (PRFN) is a minimally invasive procedure that disables and prevents a specific spinal nerve from transmitting pain signals. PRFN is a modified version of a procedure termed Radiofrequency Therapy (RT), a procedure developed more than 30 years ago. PRFN is still fairly new, but more and more pain management specialists are performing this procedure to treat painful facet joints.

Like its predecessor, PRFN applies a precisely targeted electrical field to change the function of nerves – in this case, a specific branch of a spinal nerve rendering it incapable of transmitting pain signals. However, PRFN is different! A primary difference between the original technique (RT) and PRFN is that ‘pulsed’ radiofrequency applies an electrical field to the target nerve for short intervals at a lower temperature, which does not destroy nerve tissue, but rather “stuns” the nerve.

For many patients who suffer chronic neck pain, PRFN is an effective treatment that may provide relief for months or longer. Even when normal function returns to the target, pain relief may continue. If the patient responded well to the first PRFN, a second may be considered if pain resumes. Of course, each patient is unique and it must be remembered that what works well for one person, may not work well or at all for another.

Medicine to relax the patient is administered through an IV (intravenous line) and the patient is positioned on a padded x-ray table. The skin over the injection site is thoroughly cleaned and then numbed using an anesthetic. The entire PRFN is performed using fluoroscopic guidance. Fluoroscopy is similar to a real-time x-ray and allows the physician to see the patient’s anatomy while guiding and positioning a special needle (pulsed radiofrequency electrode) into place.

Using gentle electric pulses through the needle, the physician can cause muscle twitches or tingling sensations that confirm that the needle is properly and precisely positioned next to the targeted spinal nerve branch. Electric energy is then applied for the next 2 to 4 minutes to “stun” the nerve. Unlike the more traditional radiofrequency “burn”, the pulsed technique is so gentle that it does not even require that the target nerve be numbed. This procedure is repeated for each targeted nerve root. In general, there is minimal pain with this procedure. Patients feel a mild pulsating feeling in the area during the “stunning.”