Showing posts with label 4 Medicine. Show all posts

Friday, May 22, 2026

Madness & Modernity: BOBBY BAKER

In The Cockroach Catcher is a Chapter called “The Peril of Diagnosis”, in which I highlighted three cases where a definitive psychiatric diagnosis was in the end more a hindrance than an aid, as that focused all attention on the cure of the symptoms and little else on the resolution of the underlying psychiatric problems.
........In one of the letters from my contacts at the clinic, I was told that Jane had to be admitted to a hospital in London. Her weight was so low that she was on tube feeding.

News of a famous heiress just flashed through this morning’s news and the psychodynamics of Jane’s Anorexia Nervosa suddenly became clearer. The heiress witnessed her uncle’s murder and was anorectic ever since. Jane was home when her father died in mother’s arms with a massive haemoptysis (coughing up of blood, a rare but not unknown effect of lung cancer, generally a massive bleed). It must have been very traumatic.

How dim of me. That was bereavement, a slow suicide by someone who felt less worthy to survive........

I recently visited the Wellcome Collection for their Madness and Modernity exhibition: about mental illness and the visual arts in Vienna 1900.

It was an interesting experience looking back at “treatment modalities” of mental disturbance in one of the most cultured city in Europe at the start of the 20th Century. There was an ancient Chinese saying: 50 steps laughing at 100 steps – a reference to a deserter who ran 50 steps from a battle field laughing at someone who ran 100 steps. Are any of our present day methods any better than what the Viennese dreamed up over a century ago? At least the mental patients (yes, still patients) then had somewhere specially designed and safe to practise their art and be contained. Will the next generation of psychiatrists laugh at what we are currently practising?

It was no coincidence that right next to the Madness and Modernity exhibition is the show of Bobby Baker’s Diary Drawings: Mental illness and me, 1997-2008.

Bobby Baker Wellcome Trust

Bobby Baker is a successful performance artist who had suffered acute psychiatric problems including self harming, which she captured over a period of 10 years in hundreds of 'diary drawings'. These paintings (158 drawings, selected from a total of 711) and commentaries demonstrated her anger with the mental health service and any viewer thinking of entering psychiatry might be put off forever.

Bobby was told by the first psychiatrist she saw that she suffered from borderline personality disorder. (Time article link)

As her story unfolded in her drawings, one gets an uncomfortable feeling about the state of our psychiatric service and wonders if we are even at the 50th step. She has triumphed over some of life’s most frightening experiences despite all.

Bobby Baker Wellcome Collection

“As my ability to function improved, hell became more firmly encased in my skull. I’ve formed the opinion…..that psychosis is a metaphor for extreme suffering. My delusions led to paranoia that a network of professionals was constantly searching for evidence that I was wicked. …….Medication didn’t help – it just made me fatter and fatter.” Bobby Baker Wellcome Collection Exhibition pamphlet.
As a psychiatrist, I could not help being curious about the lack of an early history, having just come from a room showing a replica of Freud’s couch. According to Freud most mental disturbances have roots in one’s early childhood.
The puzzle was solved when I read in the Observer of an interview with her:

“I don't know how but I must ask about her father next - the classic therapist's question is, in her case, inescapable. Again, a picture speaks first. In Telling Keith, she is weeping, her tears bizarrely swirling upwards. Her mouth is open and a sea floods out - in the middle is a tiny, drowning figure. ‘That's my father,’ Baker says. ‘I know,’ I say. I know because, in her autobiographical show Box Story she told audiences about a summer holiday in Brancaster, Norfolk when she was 15 and had just received her surprisingly good O-level results. Telling her father her news was 'the best moment in my life' and he gave her the happiest of hugs. She asked whether he was coming to lunch? Not straight away, he replied. He would have a dip first. A bit later, they heard a woman's voice shouting, ‘Help! Help! Help! A man's been washed out to sea.’ Her mother leapt to her feet shouting, ‘My husband! My husband!’” Kate Kellaway Observer, Sunday 28 June, 2009.

Like my own patient, Bobby Baker suffered from bereavement.

You won’t be able to see the Madness and Modernity as it has finished, but the Bobby Baker drawings are on show at the Wellcome until the 2nd of August. Those running our psychiatric services should perhaps have a good look as they may well be featuring in a future Wellcome Exhibition.

AMAZON-UK The Cockroach Catcher II: Attempted Living

Cockroach Catcher-Seven Minute Cure

Monday, May 26, 2025

GBM: Glioblastoma Multiforme------Pork and Unusual Treatment.

© Am Ang Zhang 2015

A short while back I blogged about GBM and how an innovative treatment may have helped. Being a doctor Dr Anderson noted this:

My wife, Carmen Alicia, called a local friend, also a cardiologist, who sent us to a nearby hospital; there, an MRI exam revealed a small spot on my brain. The neurologist felt it needed to be biopsied to obtain a tissue diagnosis. I immediately returned to Virginia and went to several specialists, who suggested further testing before I decided to have an invasive brain biopsy. I also had a blood test for cysticercosis, an infection that results from eating undercooked pork contaminated with Tenia solium. This common parasite produces cysts all over the body, including the brain. It is the most common reason for seizures in many countries, particularly in India, where children with seizures are first treated for this disease even before other studies are done. My blood test was strongly positive. I started a course of oral medicine to treat it. The test reassured me.

My later research showed that there may indeed be some association of Tenia and GBM.

Is neurocysticercosis a risk factor for glioblastoma multiforme or a

mere coincidence: A case report with review of literature

Neurocysticercosis (NC) is the most frequent and widespread human parasitic infection of the central nervous system (CNS). Glioblastoma multiforme (GBM) is a neoplasm of CNS in elderly population and may have a similar clinical and radiologic presentation as of NC. The coexistence of NC and neoplastic intracranial lesion in an individual is a very rare entity. The incidence of NC among intracranial space occupying lesions is reported to be 1.2-2.5%.[1–4] Though cerebral cysticercosis may be associated with glioma,[5] but this rare coexistence of NC and brain tumors puts into question a causal relationship between the 2 diseases. Here we report a case in which glioma and cysticercosis appeared concomitantly, with continuing progression of low grade Glioma to high grade Glioma (GBM, WHO grade IV).

So some religious dogma might actually be good for ones health.

But watch out, even if you do not eat pork:

Neurocysticercosis in an Orthodox Jewish Community in New York City

All the patients and their families adhered to Orthodox Jewish dietary laws, which forbid the eating of pork. Moreover, T. solium taeniasis due to the ingestion of contaminated pork is extremely unlikely in the United States. Cysticerci were detected in only 3 of more than 83 million hogs examined after slaughter under federal inspection in 1990.

The most likely sources of infection in the patients described in this report were women living and working in the patients' homes who had recently emigrated from Latin American countries where T. solium infection is endemic.

In 2003 the world was in the grip of a new plague that challenged our knowledge of medicine to its limit.

For the first time, doctors and nurses who were normally in the forefront of the fight against diseases were fighting for survival from SARS (Severe Acute Respiratory Syndrome), a new and dangerously contagious disease. The alarm was first raised by its first victim, Carlo Urbani. He was an Italian physician employed by the World Health Organisation (WHO) and based in Hanoi, Vietnam and he gave the disease its current name. It was as if this newly mutated virus knew what it was on about. Get the doctors as they would be the first who could deal with you. Urbani died. So did some of the medical staff that attended the first few patients.

Doctors often thought that they would be immune, a God given right I suppose. Not so this time! The virus obviously knew what it was doing.

SARS, Freedom & Knowledge

A doctor friend had just been diagnosed with GBM (glioblastoma multiforme) grade IV. My hospital librarian had the same tumour and told me that the hospital neurosurgeon got it too. Another close friend who is an ENT surgeon has just been diagnosed with NPC (Nasopharyngeal Carcinoma).

Looks like doctors are no longer as immune as we like to believe and that goes for those that worked closely with doctors like our beloved librarian. .

More about the DOCTOR I mentioned earlier:

He is a cardiologist for thirty five years, (so not a neurosurgeon then) but with the diagnosis his research unravelled one of the possible reasons for "catching" GBM.

Why?

Why did this tumor happen to me? I never smoked and had had no brain injuries, and there is no history of such tumors in my family. As a cardiologist, I had implanted close to 400 pacemakers in my life and during the procedure was exposed to ionizing radiation (X-rays). In the early days we used portable X-ray machines and gave ourselves some protection by using thin lead gowns. Nowadays, heavy lead gowns are worn, and doctors and technicians protect their thyroid and eyes with shields and glasses. We also use heavy sheets of radiation-protective glass that hang from the ceiling.

At some point in my research, I was surprised by an article by a Johns Hopkins-trained cardiologist who now practices in Israel. He had collected data on 23 invasive radiologists and cardiologists who had developed tumors, of which 17 were GBMs on the left side of the brain. I wrote to the author, who told me that he had learned of several more such cases since his article was published, and he added mine to his file."

GBM

" I had a glioblastoma multiforme (commonly called a GBM) grade IV. This is the most malignant brain tumor; no grade II or III exist. A glioblastoma is what killed Sen. Edward M. Kennedy (D-Mass.) in 2009. While rare, it is the most common of the brain tumors. The prognosis is dismal; on average, patients survive only 14 months after diagnosis even with chemotherapy and radiation. After five years, only 5 percent of patients are still alive."

So depressing.

But wait: The Zapping!

" The Preston Robert Tisch Brain Cancer Center at Duke University has the largest experience on the East Coast with my sort of tumor, so I went there for further consultation and treatment.

As doctors there examined me, it was obvious that my tumor had already grown again; in fact, it had quadrupled in size since my initial chemo and radiation. I was offered several treatments and experimental protocols, one of which involved implanting a modified polio virus into my brain. (This had been very successful in treating GBMs in mice.) Duke researchers had been working on this for 10 years and had just received permission from the FDA to treat 10 patients, but for only one a month."

The procedure:

"I was given the Salk polio vaccine to prevent a systemic polio infection.

At Duke, my skull was opened under local anesthesia and I had the viral infusion dripped through a small catheter directly into the tumor in my brain for six hours."

The result:

"I returned to Duke a month after the infusion, and though an MRI showed some expected swelling, the more significant fact was that the tumor had stopped growing. I have gone back to Duke every two months since then, and the tumor, initially the size of a grape, is now a scar, the size of a small pea. It’s been two years since the initial biopsy and radiation, and one year since the experimental polio viral treatment, and I have no evidence of recurrence nor tumor regrowth.

According to a presentation about the research that the Duke doctors gave last May, the results so far are promising: “The first patient enrolled in our study (treated in May 2012) had her symptoms improve rapidly upon virus infusion (she is now symptom-free), had a response in MRI scans, is in excellent health, and continues in school 9 months after the return of her brain tumor was diagnosed. Four patients enrolled in our trial remain alive, and we have observed similarly encouraging responses in other patients. One patient died six months following . . . infusion, due to tumor regrowth.” They added: “Remarkably, there have been no toxic side effects . . . whatsoever, even at the highest possible dose.”

That has been true for me. I feel as fit as I was three years ago, before the first symptoms of the glioblastoma made their appearance. I remain only on an anti-seizure medication."

The full article here>>>> Duke University.

Laoshan China

© Am Ang Zhang 2011

Thirty years ago, I saw mountains as mountains, and waters as waters.

When I arrived at a more intimate knowledge, I came to the point

where I saw that mountains are not mountains,

and waters are not waters.

Thirty years on,

I see mountains once again as mountains, and waters once again as waters.

Adapted from Ching-yuan (1067-1120)

Senator Kennedy, Gliomas and Vesicular Stomatitis Virus (VSV)

The Cockroach Catcher II: Attempted Living

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Cockroach Catcher-Seven Minute Cure

Saturday, August 27, 2022

Finland & Suicide: Settled Medical Science!

Medicine progresses and new discoveries are made though not necessary all that often. Compare with transistor and electronic technology medicine is the tortoise.

Yet, there are things we thought were a given at Medical School. Certainly, functions of well known Vitamins such as A, D & C. Vaccination against Smallpox. Endocrine conditions such as Thyrotoxicosis and Type 1 Diabetes. Stress and Peptic Ulcer is more or less a given. This is the phenomenon of “settled medical science”, next topic please.

We have at our school a wonderful teacher in endocrinology. Coming to think of it, a great one in haematology, GI disorders and I am not even venturing out to other specialties. Of course all our teachers were British trained and many became really the parents of medicine in Hong Kong.

We were so proud of our teachers that we have acquired a degree of arrogance about certain areas of medicine. We certainly know all there is to know about Thyroid, Diabetes and Thalassaemia. Peptic Ulcer is an interesting one as our Professor, Old Mac is not happy and decided that we should only call it Ulcer Syndrome, and as with other syndrome diagnosis, it implies that we still do not know. It has taken nearly another three decades before someone else proved that he was right.

So in 1996, I was in Finland for a World Congress in Infant Psychiatry more or less during the longest daylight week of the whole year. Walking back with some Finnish Child Psychiatrists back to our University Accommodation at well past 11 at night when it was still bright, my Finnish colleagues jokingly said that in Finland, people started contemplating suicide after the Summer Solstice.

That Finland has the highest suicide rate of any first world country is well known and ever since the popularity of the diagnosis of SAD, it was naturally assumed that darkness in the Finnish Winter must have contributed to their famous suicide rate. I was back to

Finland

in 2012, this time for an extended Autumn holiday. Researching before travel uncovered some medical information that surprised me.

Extensive research in

Finland

[1] revealed that the highest rates of suicide started in May peaking at Summer solstice and tailing off symmetrically in July.

Our key finding of statistical significance demonstrates the increased suicide mortality on nationwide level in Finland during the period from May 14th to July 25th. This 76-day period covers symmetrically both sides of summer solstice. During this period there is only 1 to 4 hours of darkness during the night in Helsinki but no darkness at all in Oulu.

This is a high quality research that came out in 2011 in a country where suicide rate is high although in recent years, they have done much in terms of improving mental health care that has quite dramatically moved Finland out of the top few countries.

As I have stated earlier, there are subjects we studied in medical school and had the confident impression that our knowledge on some conditions were complete! Now let us concentrate on other newer conditions. Settled Medical Science indeed.