Читать книгу Who's Killing the Doctors? II - Alex Swift - Страница 13

It was the neuropathology conference that was held early on Fridays in the Basic Sciences building of the Medical School. Each week the conference was started by the chief neuropathologist. He gave in a nut shell a brief outline of the case for the audience. The group consisted of neurology and neurosurgery attendings and residents and generally too of several medical students rotating through those two services. The shown case was generally of a recently deceased person.

The detailed clinical history was read, generally no more than two pages, by one of the residents. Then an attending discussed the different possibilities of what may have been, in his judgment, the most likely, correct diagnosis. The chief neuro-pathologist would then follow, presenting in a large screen the slides of the tissues studied in the autopsy, telling the audience what the final, correct diagnosis was.

The case in question was that of a 29 year old woman who had had an 18 month history of generalized progressive incoordination and loss of balance till her death, having been bed ridden for her last 6 months. A friend of Dr. Martin and his senior, Dr. Jack Bear, had taken care of her for some time till she’d died in the neurology ward, and another in his department, Dr. Carlo Porky, had also known her. This last guy, a child neurologist himself, had been consulted in the case -though he usually limited his practice to those under age 20- because of his expertise in neurodegenerative disorders, generally the turf of child neurologists. Both came to the podium, both presuming that she had had some sort of hereditary progressive encephalopathy, or perhaps some form of rapidly advancing M.S. (=Multiple Sclerosis) or P.M.L. (=Progressive Multifocal Leuko-encephalopathy).

No other clinical possibilities were offered by others in the audience as the Neuropathologist, Dr. Collier, asked others to venture their opinion before he gave the final dictum. But in the long pause, the young Dr. Frank Martin got up to say:

“Why can’t this be a case of C.J.D., Creutzfeldt Jacob Disease?”

Dr. Jack Bear quickly got up reacting to that comment by a guy so junior to him:

“Frank, if this turns out to be C.J.D., I’ll give you my Med School Diploma!”

Well, well, well. It DID turn out to be C.J.D.! It is a fatal, progressive encephalo-pathy, supposedly caused by a ‘slow virus.’ We hear that to this date Dr. Martin still keeps Dr. Bear’s Diploma! [just a copy]. On the other hand, Dr. Carlo Porky appeared annoyed with Dr. Martin having been the first to arrive at the correct diagnosis without the benefit of the pathology slides. From then on he was never in good terms with him.

We hear that the tissue of such patient was sent to the pathologists of the NIH (the National Institute of Health) in Bethesda, MD, who concurred with the diagnosis of C.J.D. They further inoculated such tissue into a monkey, who came down, the poor fellow, with C.J.D. several months later!

And upon learning of the diagnosis of C.J.D., Dr. Bear did more detective work into the background of the unfortunate patient and he found out that approximately 6 months prior to the onset of her incoordination she had had a corneal transplant AND that the donor of such cornea had been the cadaver of a person who had died of C.J.D.!

Needless to say, the case, as the first ever of a human-to-human transmission of C.J.D. (via the transplanted cornea) was published in the world-wide, prestigious New Britain Journal of Medicine (name changed). The listed authors were Dr. Bear, the Pathologist Dr. Collier and two neuropathologists of the NIH. There was no mention of the only physician -Dr. Frank Martin- who had been the one to arrive at the correct clinical diagnosis before the pathologist! Ah well…‘I was not meant for fame.’

Two other cases of C.J.D. were diagnosed in the subsequent years, both presented in similar conferences to the University Neurology and Neurosurgery staff. Onehad been missed completely by the main attending clinician AND by the neurologist who had discussed the case in the neuro conference, Dr. Carlo Porky. This guy had given a brilliant, exhaustive list of clinical possibilities but missed C.J.D. completely; only to be given again correctly by a raised hand in the audience, that of Dr. Frank Martin, before Dr. Collier gave the final word with his pathology slides.

You can imagine how really pissed off Dr. Porky was with Dr. Martin, who was not even part of the full time Faculty staff as HE was…

[We hear -the actual truth, not fictionalized for this novel- that at the point where the State officials (at the Office of Professional Conduct, OPC) were entertaining disbarring Dr. Martin, that Dr. Porky contributed decisively to his demise by voting him out of his Department Faculty Staff and Hospital privileges. Apparently -this writer hears- because Dr. Martin did not want to share night call with Dr. Porky! Thus his fateful sack was being sealed!]