Friday, July 11, 2008

It May Not Be All In The Mind

In The Cockroach Catcher and in the Chapter with the same title:

“I have often wondered if it would be such a disservice to mankind if doctors were not so understanding of the psychological side of things.

The possibility of a serious illness being missed is of course a major concern when a patient seeks help for one reason or another. To put psychological conditions at the top of the list of possible diagnosis is dangerous.”

My good friend told me about a case that was first thought to be a psychiatric one. It was a severe case of Trichotillomania (hair pulling disorder) that had to be admitted to a mental institution compulsorily.

This is the same friend who alerted us to the radiation dose of some routine health checks.

Trichotillomania is not a condition that requires compulsory admission, so why in this case?

"The patient was sure someone was trying to harm her."

Oh! Acute paranoid psychosis. That makes sense. Anything else? I suppose she had to be on the most up-to-date anti-psychotic and anti-obsessional drugs.

No, before they could pump these drugs into her, her friend bailed her out, against medical advice, and got my friend to see her.

Great friend!

But what could have caused the hair loss?

Polonium?

No way, she was not a spy!

Yes, it was poisoning, not by Polonium, but by Thallium. That was what my friend’s investigation showed.

Thallium has been a noted poison favoured by Secret Services and one famous Graham Young in England. He poisoned his stepmother at the age of 14 and then other members of his family. He was caught and sent to Broadmoor, a maximum security mental hospital in England.

Miraculously he was declared “cured” and released. Nice justice as my friend’s patient was detained by being a victim and they let the perpetrator go despite his diary claiming he planned to kill one person for every year he spent in Broadmoor!

Young then proceeded to find employment as a shopkeeper at Bovingdon, Hertfordshire, where his co-workers were one by one struck by a mysterious illness nicknamed “the Bovingdon Bug”. One died but Young’s arrogance brought his downfall. He challenged the doctor dealing with the “Bug” in a public meeting as to why Thallium poisoning was not considered!

At one time, Thallium was used as a rat poison as even the rats could not detect it by taste. Now it has been banned in most countries but still poses a health risk.

As recently as 2007, two women, a mother and a daughter, who were both born in Russia but became American citizens, had Thallium poisoning on visiting Russia. They survived. The mother is a medical doctor.

It turned out that my friend’s patient was being poisoned by her partner. Prussian Blue was prescribed as the remedy and she survived, sort of, with residual neurological damage due to delay in diagnosis and appropriate treatment.

Paranoid psychosis indeed!

Just remember: it may not be all in the mind.


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