I was at the Opthomologist with my daughter for her to get an exam. Next to me was a sweet older woman who noticed my daughter, and commented on her beauty. She also noted that daughters are precious, and in the next 15 minutes, I came to learn that she had lost her daughter in the Polio epidemics in the mid-nineteenth century. She lost her husband 6 months later from cancer, and had been alone ever since. She told me her daughter had stayed for a year at Shriners of her day, was placed in an iron lunch, and that they were only aloud to see her for 1 hour every Sunday. They would bring her a gift every week and talk with her. She didn’t live more than a year.
I would never have known this by just looking at her. But I learned a lot about a condition I had just learned the day before had revolutionized what we knew about ventilating patients. It was the beginning of what we cal l ICUs, and started us into intensivist medicine(medicine for the seriously ill and in need of ventilation management and multi-organ treatments). Also, it was a time when medical philanthropy was started to blossom, as it was expensive to have an Iron lung and harder to get to them.
It was a disease that has been recorded for millenia, and that when we started to become a more sanatized society, we actually decreased the exposure for children, and made them more succesptible to the disease’s devestating effects. Hence the need for immunizations.
Poliowas a devastating disease and it killed a lot of people. It affected millions and killed thousands. If you contracted the disease, you were most likely to get better, but many had debilitation limb issues, and few lost the ability to breath or move. Amazing how such a small thing could cause so much change-societal and personal.
Two different patients. Two different stories. But a shared delusion. Each is convinced that someone they love dearly is not that person, but an impostor. A curious disorder known as Capgras delusion involves the distinct feeling that the people around you have been replaced.
NPR did story on this delusion disorder. One of the experts they interviews is an interesting neuroscientist who spoke at a TED conference about interesting brain paradoxes, his name is Dr. Ramachandran. Really this story came from Radio Lab, a blog/radio/podcast pair of men who speak on insteresting subjects. All in all, I was impressed with this rare, rare, delusion that can effect people.
As is mentioned in the piece, Capgras delusion, is named after a French psychiatrist. He gave the first case report on a woman who had this issue.
Imagine you look at someone, and you see that they look like someone you know and you know what their name is, and you know a history with this face, but there is no emotional backing to your image. So, you don’t think it’s them because it doesn’t “feel” like them! If they walked out of the room and called you, you’d know them and tell them someone stole their body and impersonated them. Interesting and sad.
“A common error in thinking about primary care is to see it as entry-level medicine…and, because of this, rudimentary medicine — for mostly (say) the common cold and imaginary illnesses. This is a false notion. Everyone knows, however, that knowing when you don’t know require sophisticated knowledge…From the perspective of training physicians and the knowledge bases required for adequate performance, the higher we go on the scale of a specialist training, the less complex medical problems become.” Eric J. Cassell, MD
It is very humbling to feed a young woman her breakfast because she is too autistic to tell you she’s hungry, but functional enough to sometimes be able to use a spoon. It is humbling to watch a spirit, “trapped” in a body that wont allow her to communicate all she feels, so only pure emotion and frustration surface. When she is not understood, or cannot get her needs met, she strikes her own head–her ears bearing years of scars and healing in the form of large keloid scars.
It is humbing to think, that something as simple as telling another human, I think I am tired, do you mind letting me rest? or I am very sad, and I cannot seem to be comforted, will you love me? Can never be said by some who need it most. A very humbling thing to watch.
I’m planning on being a Family Doctor who also have a board certification in Osteopathic Manipulative Medicine. Most people have the idea that it’s like Chiropractics, and it is, because Chiropractics came FROM the original osteopath, Dr. Andrew Still in Missouri. This is a little blip on what OMM is: