Friday 15 December 2017

Rude health: Silvio's ticker - can a new heart valve resurrect Berlusconi's career?

Let's hope there is no 'bunga bunga' in the cardiac ward, says Maurice Gueret, as he tests Shaw's woolly theories

Silvio Berlusconi was admitted to hospital in Milan suffering from a heart-valve problem
Silvio Berlusconi was admitted to hospital in Milan suffering from a heart-valve problem
Dr Maurice Gueret.

Patient Of The Summer Award goes to former prime minister Silvio Berlusconi of Italy. Bunga bunga has taken its toll on the ticker of the 79-year-old media mogul. He will have sore ribs for a few months after open-heart surgery to replace an incompetent aortic valve. This valve controls the exit of blood from the heart so breathlessness, tiredness and puffy ankles result if it begins to leak. By all accounts, Signor Silvio was in quite a poor state on admission to Milan's San Raffaele Hospital.

His supporters hope the new valve might resurrect the political career of the man they call 'The Knight'. He once promised them that he would live to be 130. The San Raffaele was the first high-tech private hospital to be built in Italy in 1971, and was granted university status along the way by its well-to-do patrons. Mr Berlusconi fell out with many of Italy's doctors and nurses some years ago when he tried to make it mandatory for them to report the presence of illegal aliens in their clinics and hospitals. There aren't too many migrants that get admitted to the San Raffaele. Mr Berlusconi can parade his recovery dressing gown in peace through the corridors.

I was writing about the health benefits of gardening recently and extolling the merits of the Bloom festival at the Phoenix Park. Well, we made our annual flying visit and enjoyed the displays, but it has to be said that the garden end of things is in danger of being upstaged by the abundance of food. When two industries collide, the one with deepest pockets tends to dominate. There were too many chefs this year, and not enough folk with green fingers for my taste. A lady doctor who grew up in a rural mental hospital wrote to tell me of the great importance attached to farming and gardening in the institution where her family lived.

She recalls the hospital farm, where the patients looked after the dairy cows and pigs. They grew all their own spuds and other vegetables, and, in a quadrangle area, the patients could plant an area of their own with flowers. She tells me that the old mental hospital in Arles, where Vincent van Gogh was once a patient, had the exact same set-up. This particular GP has very lucky patients. Her hens are in a field, with a colourful coop visible from the waiting room. She grows herbs and lavender just outside the surgery, amid apple and plum trees. A child once remarked that the surgery avenue was like heaven.

A lot of young lads who get expelled from school turn out to be more genius than guttersnipe. Willy Rontgen was one such boy. Thrown out of technical school in Utrecht for drawing his teacher on the blackboard, we doctors know him best as the man who discovered X-rays. He found them quite by chance as he was passing electricity through gas. He christened them X-rays, and called his wife in to have her hand pictured, ring and all. The mysterious rays penetrated flesh much better than her bones, and a new medical science emerged from the shadows. Some 120 years later, we still talk about X-rays. We may have Cat scans, ultrasounds, bariums, MRIs and PETs, but at the end of the day, patients still want a sign that says "X-ray".

Wonderful things now happen in these hospital departments - they can target cancer with bullseye medicines, block off blood supply to nasty growths and even patch up dangerous and leaky blood vessels. There has been a move away from using X-ray as the catch-all title for these departments. Patients looking for the X-ray sign are often disappointed and bamboozled by departments of diagnostic scanning and imaging, therapeutic radiology facilities and interventional radiological directorates. Willy Rontgen used the letter 'x' because he didn't know what the rays were. Those who plan hospital signage might do likewise.

We draw our series on great Irish hypochondriacs to a close with a peek beneath the blankets of George Bernard Shaw. Barely recognised today in his Dublin homeland, Shaw comes second only to Shakespeare as the greatest dramatist these islands produced. His health obsessions were quite public, and Shaw had a separate section in his diary marked "fads", which sums up much of his philosophy. His anti-vaccination views were well known. Shaw was immunised against smallpox as an infant in Dublin, yet came down with the disease in his mid 20s. It left his face so pockmarked that he grew his trademark beard. Today, we recognise that no vaccine affords 100pc immunity. He regarded them all as failures. Shaw avoided alcohol, the downfall of his father; and refused tea, too. A lifelong vegetarian, he survived on porridge for breakfast and pocketfuls of nuts or raisins for lunch. Cheese, fruit, omelettes, potatoes and chocolate biscuits filled dinner and the gaps.

Shaw disagreed with the germ theory of disease that was in vogue, preferring to moralise and see sickness as a sign of weak will. He slept with his bedroom windows wide open in winter and adopted fasting, exercise and hygiene rituals to ward off pestilences. He was a devout fan of the odd cult of Jaegerism. Gustav Jaeger was a German medic with a great interest in animals. He advocated the wearing of rough animal fabrics close to the skin instead of those made from plant fibres. Dr Jaeger claimed that it cured his own haemorrhoids and indigestion. He theorised that wearing dead vegetable fibres simply drove nasty body vapours and skin secretions back through the skin from whence they came. Shaw liked Dr Jaeger's woolly theories and took to wearing sheep-hair suits and avoiding cotton and linen like the plague. Little wonder he had a reputation for being prickly.

Dr Maurice Gueret is editor of the 'Irish Medical Directory'

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