DIAGNOSIS

Doctor Benaroch’s fundamental point in writing this speculative history is to emphasize the importance of a patient’s explanation of their symptoms in coming to a conclusion about a diagnosis.

Audio-book Review
 By Chet Yarbrough

Blog: awalkingdelight
 Website: chetyarbrough.blog

Medical Mysteries Across History

By: Roy Benaroch MD

Narrated by: Roy Benaroch

Roy Benaroch MD (Author, general pediatrician practitioner at Emory University near Atlanta, Georgia.

From kings to jazz singers, Roy Benaroch reviews the diagnosis of ten historical figures with a medical opinion about their cause of death. Based on written evidence of their physical complaints, Benaroch offers a medical opinion about what today’s knowledge of medicine would have revealed about their lives and causes of death.

Benaroch presents his analysis with an element of mystery by not revealing the more familiar names of the dying person until later in each chapter.

The historical figures he chooses are famous, so their medical complaints are recorded in ancient or more modern publications. With written documentation of their complaints, Benaroch gives his opinion on modern-day diagnosis with cursory notes about their accomplishments. In his review of written reports of their medical complaints, he surmises a medical diagnosis and their probable cause of death.

This interesting and brief journey through history reflects on the medical complaints of Franklin Roosevelt, Helen Keller, Marie Curie, Alexander the Great, Billie Holiday, and King Henry VIII, among four others not noted here. Roosevelt’s polio, Keller’s deafness and blindness, Marie Curie’s aplastic anemia, Billie Holiday’s addiction, and the causes of death for Alexander the Great and King Henry are interesting examples of Beneroch’s diagnosis of their diseases, its symptoms, and how their medical complaints should or could be treated today.

Though polio had been around for thousands of years, it is not identified as a virus until 1909. It usually attacks children under age 5 but can be acquired from contaminated water at any age.

Roosevelt first shows symptom of paralysis when he reaches the age of 39 in 1921. His symptoms were fever, muscle weakness, facial numbness, bowel and bladder dysfunction. Benaroch notes Roosevelt first notes symptoms after diving into water off his family’s yacht. Dr. Robert Lovett, with consultation from William Keen (a former doctor for Presidents and America’s first brain surgeon) came up with the correct diagnosis.

A practical nurse named Anne Sulivan is hired by Keller’s family because of her experience with deaf children.

Helen Keller, aka “bronco kid” because of her unruly behavior as a child, contracted an illness at age of 19 months. She exhibited a high fever and lost consciousness. She survives her symptoms but is unable to hear or see after her return to consciousness. Benaroch explains the high fever likely induced damage to Keller’s optic nerve and auditory processing system without fatally impairing her remaining nervous system. Sullivan becomes Keller’s teacher and companion who helps Keller learn how to read, write, and speak despite her lost sight and hearing. Keller becomes the first deafblind person to earn a Bachelor of Arts degree. She became a global advocate for the blind from 1924 to 1968 when she died.

Marie Curie is diagnosed with aplastic anemia, a disease that destroys bone marrow ability to create red blood cells.

Marie Curie and her husband were chemists working with radioactive material before its harmful effects were known. Her husband dies in a street accident in 1906 so is not known to have been affected by their joint experiments with radium and polonium. Later, Marie Curie works with x-ray machines during WWI. To compound her risk from exposure, she is known to have carried test tubes of radium around in her lab coat. Benaroch notes Curie dies at age 66 in 1934 which is remarkable considering her exposure to radon and other radioactive materials. Benaroch explains her symptoms are fatigue, shortness of breath, rapid heartbeat, bruising, headache, and fever. However, years after her death, Curie’s body is not found to have excessive levels of radiation in her remains. The cause of death remains obscure according to another book that notes Curie as an exemplar of women in science.

Benaroch notes drugs are miracles of pain reduction. When one becomes addicted to drugs to relieve one’s pain, humans need treatment, not incarceration.

Benaroch tells the story of Billie Holiday’s tragic life and death. As a physician, he notes a condition of human abuse that ranges from a low of 1 to a high of 10. His opinion is that Holliday nears 8 if not 10 on that scale. She was raped twice as a teenager, married three times to husbands that abused and took advantage of her fame and income from singing. She was arrested several times for drug possession and with a drug conviction in 1947, her cabaret license is revoked. Though she made a lot of money as a blues singer, Benaroch explains she died from cirrhosis of the liver at the age of 44 with $750 strapped to her leg. Benaroch notes addiction is a disease that continues to be misunderstood by the public and law enforcement. Benaroch explains America lost a national treasure when Billie Holiday died. He implies being black in America is hard but being addicted and black in America is a death sentence.

Benaroch suggests Alexander the Great drank to excess by choice, not because of addiction to alcohol.

Alexander the Great is characterized by Benaroch as a binge drinker, not an alcoholic. On Alexander’s last overindulgence, he falls unconscious, appears to quit breathing, and dies. The odd recording of his condition after death is that the body lays quiescent for several days without putrefaction. The embalmers refuse to treat his body because he appears to be something other than dead. Benaroch is unsure of whether this is a myth or accurate report of Alexander’s dead body. After considering what written record exists, Benaroch suggests Alexander probably died from blood poisoning from a former wound that never healed. Alexander appears alert up until his breathing and heartbeat stops. Benaroch suggests the slow advance of organ shutdown from blood poisoning allows Alexander to react to those who draw his attention. Benaroch infers the lack of putrefaction is likely a myth because blood poisoning could slow Alexander’s breathing and his stillness and inactivity reduce his heartbeat to the point that his body remained nourished enough to delay his actual death.

Benaroch notes jousting events in which the King of England’s head is hit with a lance. In a 1524 Henry is nearly killed in a match.

Benaroch’s diagnosis of King Henry is one of the more interesting diagnoses of his short book. Benaroch suggests Henry, in his early years as ruler of England, is an affable, intelligent, and effective monarch. However, Benaroch suggests Henry’s athletic life resulted in head injuries that changed his personality and the direction of his reign to one of erratic rule, unnecessary divorces, marriages, and behavior unbecoming a King. He is hit in the face by splinters from one jousing encounter that could have killed him. He continues to participate in jousting tournaments.

In 1533, Henry formally marries Anne Boleyn after his marriage to Catherine of Aragon. Henry marries four more times between 1533 and 1543. Benaroch suggests Henry’s behavior changes as he got older. In Beraroch’s opinion, he becomes more of an erratic tyrant than pragmatic ruler because of repeated head injuries. Jousting, like football, is a physical hard-hitting sport that has affected many of history’s athletes.

Doctor Benaroch’s fundamental point in writing this speculative history is to emphasize the importance of a patient’s explanation of their symptoms in coming to a conclusion about a diagnosis. Physical examination is important but listening to a patient’s physical and mental explanations of their condition are the best evidence for determining a correct diagnosis. This is the belief of other physician’s books that have been reviewed in this blog. There are many reasons why doctors may misdiagnose a patient’s condition. Some are too busy to take the time necessary to properly understand a patient’s comments. Doctors have various levels of experience and may not know how to interpret what a patient is saying. That does not change the point of Benaroch’s observations. It is essential for a good diagnosis to be based on the details of the patient’s history.

ANOTHER LAS VEGAS

BEAUTIFUL, QUIET, AND FUN

WALKING, BIKING, CLIMBING STAIRS

Red Rock Canyon is one of many natural wonders in the Las Vegas Valley.  Hiking, biking, and climbing are popular resident and tourist pastimes.

Climber

ROCK CLIMBERS IN RED ROCK CANYON–20 MINUTES FROM THE LAS VEGAS STRIP

Charleston Boulevard is a major east/west arterial road in Las Vegas.  Travel for 20 minutes east on the Boulevard and Red Rock Canyon looms large; the vista explains the name.  Like rusty pieces of sheet metal, hills are colored and striped by iron oxide bleeding red below a blue skyline.  In January, it can be cold (say 30 to 40 degrees) and windy (say 30 to 40 mph) but on a good January day temperatures can be in the 60s with no wind.

Red-Rock-Canyon-Vicinity-Map-273x300[1]

Charleston Boulevard is a major east/west arterial road in Las Vegas.  Travel for 20 minutes east on the Boulevard and Red Rock Canyon looms large; the vista explains the name.

Hiking the Bristlecone Loop on winter days is an oddly quiet experience, even though birds are flying in and out of parched bushes and bleached bark trees, there is little chirping.  Burros track the fields and valleys with an occasional mountain goat peeking down from a ridge.

Hike #2 2011_2011 09 01_2824

HIKING THE BRISTLECONE LOOP ON WINTER DAYS IS AN ODDLY QUIET EXPERIENCE, EVEN THOUGH BIRDS ARE FLYING IN AND OUT OF PARCHED BUSHES AND BLEACHED BARKTREES, THERE IS LITTLE CHIPING.

Well-traveled hiking Trails split the terrain leading to tiny snow melt waterfalls, clear water streams and occasional wild life.  Ancient tribes left their mark on sandstone Red Rock Canyon monoliths jutting from dried grass ground.  Climbers cling to mountain face crevices on their way to nowhere to satisfy some untouched need.

Hiking Muffin and earlier Red Rock_0562

A VIEW OF LAS VEGAS IN THE DISTANCE FROM A HIKE UP “MUFFIN”

The Las Vegas Valley packs a lot of life styles within an hour’s drive; i.e. entertainment and dining that rivals New York; Boulder Dam, Mount Charleston, and Red Rock Canyon that offer every outdoor experience  a resident or tourist can think of.

Another Trail @ Mt. Charleston_2011 09 16_2937_edited-1

VIEW FROM MT. CHARLESTON–WHEN ITS 100 DEGREES IN LAS VEGAS, THIS 30 MINUTE DRIVE DROPS THE TEMPERATURE TO 80 DEGREES.

Backyard Sunset

SETTING SUN IN LAS VEGAS

As “Borat”, the comic actor says—WHAT A COUNTRY.

THE PRICE OF OBSESSION

Audio-book Review
By Chet Yarbrough

(Blog:awalkingdelight)
Website: chetyarbrough.blog

The Kid 

Written by: Ben Bradlee, Jr.

Narration by:  Dave Mallow

BEN BRADLEE, JR. (AUTHOR, WRITER-EDITOR FOR THE BOSTON GLOBE)

BEN BRADLEE, JR. (AUTHOR, WRITER-EDITOR FOR THE BOSTON GLOBE)

Nearly two-thirds of “The Kid” is about Ted Williams as an extraordinary ballplayer, fisherman, and sports spokesman; the remaining third details Williams’ failure as a husband and father.  Ted Williams marries three times, and divorces three times; he philanders as a husband, and ignores the early lives of his three children; i.e. the first from wife number one; the two others from wife number three.

Ben Bradlee, Jr. pulls no punches in recounting parts of Williams’ life that Ted Williams would possibly regret; that is, if the psychological picture painted by Bradlee is correct.  After finishing Bradlee’s book, one believes Williams would lament mistakes made in his family life.  Williams’ drive for perfection and fragile self-confidence left little time for a wife’s needs, or a child’s parenting.

The price of Williams’ obsession for “being the best” is three divorces, an older daughter that rebels against convention, a son that feels entitled, and a daughter who idolizes, fears, and desires her father’s attention.  All of Williams’ wives are beautiful but a handsome husband with a beautiful wife is shown by Bradlee’s story to be a small part of a happy marriage.  Bradlee suggests infidelity, anger, and single-minded focus destined Ted Williams for divorce. 

TED WILLIAMS & LOUIS KAUFMAN (MS. KAUFMAN DIED 1993)

Williams seems only able to maintain a relationship with a woman who tolerates his imperfections; not as a sycophant, but as an ally; i.e. a woman who complements his strengths and accepts his weaknesses.  Only one woman, whom he does not marry, fulfills that description; i.e. his lifelong admirer, Louise Kaufman.

Bradlee exposes raw facts about Williams’ children.  His oldest child, Bobby-Jo, is committed to a psychiatric ward for mental instability, is released, gets married, philanders, becomes an alcoholic, has two children, divorces, and is disowned by Williams.

BOBBY-JO WILLIAMS FERRELL AND HUSBAND MARK (TED WILLIAMS DAUGHTER FROM HIS FIRST MARRIAGE)

BOBBY-JO WILLIAMS FERRELL AND THEN HUSBAND MARK IN 2002. (As his first child, Bobby Jo, flirts with insanity, Williams provides financial support but very little personal attention.  At the end of his life, Williams removes Bobby Jo from his will, except for a $200,000 life insurance annuity. )

JOHN-HENRY WILLIAMS (1968-2004)

Williams only boy, John-Henry, is characterized as a thief that steals his mother’s paintings, borrows money against Ted Williams’ name (without his knowledge), fails to pay it back, and lies about it.  John-Henry trades on his father’s reputation as though he is entitled.

Bradlee tells a story of John-Henry’s selling Ted Williams’ signed memorabilia and then brag about his ability to forge his father’s name.  Claudia, John-Henry’s sister, refuses to believe John-Henry forges their father’s signature.  She chooses to make her own way in life by living abroad, learning French and German, and establishing her own identity without the influence of her father’s reputation.

CLAUDIA WILLIAMS (WROTE A MEMOIR-MY FATHER-ABOUT TED WILLIAMS)

CLAUDIA WILLIAMS (WROTE A MEMOIR-MY FATHER-ABOUT TED WILLIAMS)

Late in Williams’ life, Bradlee shows Williams expresses love for John-Henry and Claudia but, in the progress of their maturity, they assert their independence either in self-interested affection or rebellion.  Fatherly influence in his children’s early life seems limited.  William’s way of living life and his acquired wealth seem his most pronounced paternal influences.

Bradlee infers Williams had little time for his children until retired from baseball.  Even then, professional fishing took the place of fatherhood; at least, until much later in Williams’ life.  As an example of William’s love for his children, Bradlee notes Williams proudly attends a college graduation ceremony for his son and sheds prideful tears for John-Henry’s accomplishment.  Later, it becomes known that John-Henry did not really graduate.  He is 3 credits short; e.g. one of several deceptions by John-Henry that are forgiven or discounted by Williams.

Bradlee savages John-Henry’s reputation by inferring that, though he loves his father, he reeks of dishonesty, feels entitled by paternity, and tarnishes Ted Williams’ fame and name.

Bradlee’s biography of Ted Williams ends sadly with the picture of a ravaged legend that appears to have sacrificed too much to become the greatest hitter in baseball.  Bradlee shows Ted Williams as a towering sports figure but a tiny, unimpressive husband and father.