The Art Institute of Chicago has quite an interesting collection. What caught my eye the other afternoon was a Pre-Raphaelite, well one of three that Rossetti did and the original I believe was in the Tate, London
Beata Beatrix 1871/72
Art Institute Web Site
A founder of the Pre-Raphaelite Brotherhood, Dante Gabriel Rossetti was both a poet and a painter. In this picture, he portrayed the dying Beatrice from Dante Alighieri’s Vita nuova, a medieval tale of idealized love and loss that had personal meaning for Rossetti, who had lost his wife, the artist Elizabeth Siddal, in 1862. He began the first version of the work, now in the Tate Gallery, London
Pre-Raphalites reminded me of our
librarian.
She and her husband retired to Dorset and
one year we decided to visit their new place and have a taste of the old England Sussex
They proudly showed us the guest room
because it was decorated with some of the last scrolls of William Morris wall
paper that they happened by.
How charming.
After dinner the conversation somehow turned
to the Pre-Raphaelites and our librarian promptly produced a book with an
amazing painting on its cover.
In a chance encounter with Andrew Lloyd
Webber, Josceline Dimbleby asked him bluntly if she could go and see the
portrait he had of her great-aunt, Amy Gaskell.
“Ah, that wonderful dark picture,” Andrew
said. “Yes, please come……Well, I think she looks rather like you......”
“Did you know that she died young?”
Josceline asked Andrew.
“Of a broken heart.”
She told Andrew that she would try to find
out more. This led her to start researching into the life of Amy, her mother
May and the famous Pre-Raphaelite painter Edward Burne-Jones and the result was
the book A Profound Secret[1].
I looked at the book cover and thought the
portrait reminded me of the Picasso I used for my Anorexia Blog.
It is said that as a young man Picasso
admired the pre-Raphaelites and Edward Burne-Jones so much that in 1900 he
would have gone to London rather than Paris
“There was a hint in the book that she
might well have died of Anorexia!” My hostess said.
It was a fascinating book, like good
family biographies are, as long as you accept that it is not going to be as
organised as fiction. A good writer helps and Josceline Dimbleby is a well established
food and travel writer.
For a psychiatrist, it is especially
interesting as he is allowed glimpses into the various personalities, their
psychiatric problems and the resulting family dynamics, without the
interference of the usual psychiatric labelling or coding. Unfortunately self
medicating with alcohol, opium and other fancy substances was rife in that era (and
perhaps now too) and the result could often be tragic.
Indeed Josceline thought at one point in
the book that Amy might have suffered from Anorexia although it was not a known
condition at the time. She left it till the end of the book to let us into the
final secret. You will have to find out for yourself.
Without the effect of drugs that would
double the bodyweight, we have in the end one of the most beautiful portraits
of the Pre-Raphaelites. Burne-Jones’ life is of course another psychiatric
book: his mother died when he was six days old and many felt that all his life
he was searching for the perfect mother he so missed. It is indeed ironical
that the art world has been much enriched by what was essentially untreated
bereavement.
Psychiatry may need to look again at what
we have been doing, as we do not seem to have found another Burne-Jones.
Does
having a good hunch make you a good doctor or are we all so tick-box trained
that we have lost that art. Why is it then that House MD is so popular when the
story line is around the “hunch” of Doctor House?
Fortunately
for our librarian, her GP (family physician) has managed to keep that ability.
My
friend was blessed with good health all her life. She seldom sees her GP
so just before last Christmas she turned up because she has been having this
funny headache that the usual OTC pain killers would not shift.
She
would not have gone to the doctor except the extended family was going on a
skiing holiday.
She
managed to get to the surgery before they close. The receptionist told her that
the doctor was about to leave. She was about to get an appointment for after
Christmas when her doctor came out and was surprised to see my friend.
I
have always told my juniors to be on the look out for situations like this.
Life is strange. Such last minute situations always seem to bring in surprises.
One should always be on the look out for what patient reveal to you as a
“perhaps it is not important”.
Also
any patient that you have not seen for a long time deserves a thorough
examination.
She
was seen immediately.
So
no quick prescription of a stronger pain killer and no “have a nice holiday”
then.
She
took a careful history and did a quick examination including a thorough
neurological examination.
Nothing.
Then
something strange happened. Looking back now, I did wonder if she had spent
sometime at a Neurological Unit.
She
asked my friend to count backwards from 100.
My
friend could not manage at 67.
She
was admitted to a regional neurological unit. A scan showed that she had a left
parietal glioma. She still remembered being seen by the neurosurgeon after her
scan at 11 at night:
“We
are taking it out in the morning!”
The
skiing was cancelled.
Glioblastoma Multiformis (GBM)
In 2013, I came across an
article in the Washington Post[1] about none other than a
doctor that was diagnosed with the condition. But his story took a bit of a
twist that my further research was to reveal.
When we met our librarian,
she told me that the hospital neurosurgeon had also been diagnosed with GBM. He
has now retired and is being treated at Queens Square
Then another London Medical School
Since it has been quite a
few decades since I was at Queens
Square
Is it an infectious
condition? Why all the people I know are linked to hospitals. Could we have a
Dr House style brain storming. Is there any modern treatment as I vaguely
remember it as one of the most vicious brain tumours.
OK, Senator Kennedy has no hospital link, except
for treatment there.
But lets see what our doctor/patient
found:
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
Well, I think that is as far as we can go
on the hospital link. What about others.
Sharp eyed readers reading Anderson
I have always maintained that in ancient times,
there are very observant people that noticed links that few people would have
noticed. In order to drive fear into people for their own protection, these
observations were somehow incorporated into religious believes.
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
He obviously did not relate Tenia solium
to GBM, but my further research showed something rather extraordinary.
There has indeed been case reports of
neurocysticercosis[4] associated with GBM. This would now explain what
Dr. Anderson reported as a by-line. There is even a case of both husband and
wife “catching” GBM[5] and to me Tenia solium infection would be the
natural explanation.
Then I discovered something quite
shocking: Tenia infection can occur in Orthodox Jews[6]. No, I do not think they secretly eat pork, but
apparently they can catch it from nannies from endemic countries.
But the main exciting part of Dr.
Anderson’s article was his treatment when the traditional one failed.
DURHAM, N.C. – An attack on glioblastoma brain tumor cells that uses a
modified poliovirus is showing encouraging results in an early study to
establish the proper dose level, researchers at Duke Cancer Institute report.
The treatment, developed at Duke and tested in an ongoing phase 1 study,
capitalizes on the discovery that cancer cells have an abundance of receptors
that work like magnets drawing the poliovirus, which then infects and kills the
cells.
He decided to have the treatment and two
years later he appeared on a CBS 60 minutes about the new treatment[8].
Part of the transcript:
Dr. Fritz Andersen showed us the results in another
patient -- himself. He's a retired cardiologist and at age 70, he became the
second person in the polio trial.
Dr. Fritz Andersen: This is a fairly sizeable
temporal tumor, which means...
Scott Pelley: That we see right here.
On the left is his tumor before treatment, on the
right a hairline scar where it used to be. Like Stephanie, that was nearly
three years ago.
Dr. Fritz Andersen: So when they said that this
thing is just a small scar, and we think it's possibly cured. I nearly fell off
my chair. I said, "that's, that's, that's impossible." They said,
"well, we don't know, but so far it looks fantastic."
Scott Pelley: Do you consider yourself cured? Or do
you call it remission?
Dr. Fritz Andersen: I feel it is a cure, and I live
my life that way.
Well, he has done well, both our Librarian and the
Paediatrician that returned to Hong Kong did
not make it.
[1] https://www.washingtonpost.com/national/health-science/surgery-radiation-and-chemo-didnt-stop-the-tumor-but-an-experimental-treatment-did/2013/09/23/1b8e8f92-0f4f-11e3-85b6-d27422650fd5_story.html?hpid=z9
[2] https://www.washingtonpost.com/national/health-science/surgery-radiation-and-chemo-didnt-stop-the-tumor-but-an-experimental-treatment-did/2013/09/23/1b8e8f92-0f4f-11e3-85b6-d27422650fd5_story.html?hpid=z9
[3]
And the pig, because it has a
cloven hoof that is completely split, but will not regurgitate its cud; it is unclean for you. You shall not eat of their flesh,
and you shall not touch their carcasses; they are unclean for you.
[4] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3579054/
[5] http://www.ncbi.nlm.nih.gov/pubmed/24348390
[6] http://www.nejm.org/doi/full/10.1056/NEJM199209033271004
[7] http://bit.ly/20fFFVy
[8] http://cbsn.ws/1BUFFvc
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