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From Anecdote to Antidote
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Dedication:
This book is dedicated to the memory of Brian Klein and
the sadness of his passing; and to my wife, Caryn – to
our family and the brightness of our lives.

Acknowledgments:
I would like to thank Dee DelBello for the encouragement
to write this book. Thanks also to Marci Smith, Robert Rozycki, and most especially to Derek Rydall, without whose help this task would never have succeeded.

 
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Excerpt From Anecdote to Antidote:

 

SECTION 3: “THINGS”
INTRODUCTION

Foreign cultures, the intricacies of faith, the depth and breadth of the human mind — as inscrutable as any or all of these may be for some, the world of medicine can seem just as byzantine and impenetrable to the uninitiated. Maybe that’s why television shows like Quincy, ER, CSI, and the like are so popular and so long-lived. The everyday world of medicine generates more than enough fodder for both screen writers and mystery buffs with its seemingly endless false leads, hidden clues, and complex yet often invisible network of relationships, causes, and effects, each leading down a series of potential blind alleys.

As an example, I’m put in mind of a building from my alma mater, the University of Rome. Near the ancient campus compound, there is a large and impressive building to the immediate right. It bears the name “The Institute for Syphilis and Dermatology.”

Interesting combination, no? What could the link possibly be between dermatology and history’s most famous venereal disease? The pairing cracks open the door to any number of jokes, but the fact that it is carved above the entrance to a department building at one of the oldest institutions of higher learning in the Western world leaves many scratching their heads.

Before the antibiotic era, when syphilis was rampant, the rashes caused by this disease were plentiful and diverse beyond the initial skin ulcerations in the genital area. Therefore, the presentation of any rash or skin lesion always contained syphilis as part of the differential diagnosis; it was so prevalent that it deserved equal billing with dermatology. Even during my training in the early 1960s, we still saw the many different varieties of skin rashes that were the results of syphilis, as well as malformations in babies born to sufferers, and even elderly people with telltale signs of prior disease. I once examined, as part of a supervised group of medical students, an elderly grandmother suffering from bronchitis when the professor pointed out, very quietly, that one pupil was pin-point while the other was dilated — a sign of late-stage neurological syphilis. There was something in her past that certainly no one would want to talk about to her grandchildren.

Syphilis (in its tertiary stage) also causes changes in personality and dementia. It has long been rumored that Idi Amin, the ruthless former dictator of Uganda, was treated for neurological syphilis in Israel while there for a military training course, long before the fateful raid on Entebbe. Though never proven, he was known to have a taste for brothels and was treated for “social diseases” several times as a young man in the British Colonial Army. Perhaps tertiary syphilis was the reason he was so crazy.

I have taken this detour through the wonderful world of syphilis to illustrate the number of hidden rooms and secret passages in the great labyrinth of medicine, and how so many seemingly unrelated things are somehow connected. Since I’ve already introduced you to some of the “People” with whom I’ve crossed paths, and taken you to some of the more interesting “Places” I’ve been (and shared the lessons I’ve learned from all of them along the way), I’d like to teach you all a few “Things” about practical medicine and health maintenance — some more straight-ahead scientific, some philosophical, some coldly practical, but all guaranteed to maintain your interest. I really do feel, as I said in the first section, that the modern doctor-patient relationship should be more of a partnership and less of a dictatorship. To that end, I am quite glad to see my patients becoming more informed about certain things, thanks to the Internet and sites like WebMD and such.

Nevertheless, there’s a lot more out there than can be found on WebMD and some things you will be worth finding while others should be ignored or taken with the proper number of salt grains. Almost every day the news blares mixed messages from some new medical report or another, resulting in a huge spate of patient visits just so they can come to me and complain, “I thought dairy was good, now the surgeon general tells me it’s bad. Which is it, doc?”

This is where knowledge of some medical basics as well as of yourself can help you. When consulting medical journals or popular web sites, it is important to assess the information in the proper context and work out a solution that feels right for you. In a way, it’s a review and reinforcement of what I said before: our body can usually tell us when something is wrong. I’d like to hope that this third section helps us listen to our bodies as closely as we do (or should) our doctors. Think of it as a limited crash course of study through medical school.

Check out all three categories: “People” – “Places” – “Things

 

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Copyright (©) 2006–8 Richard Klein, M.D.

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or any other means electronic, mechanical, photocopying, recording, or otherwise without the prior written permission of the publisher.

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