Monday 9 December 2019

The worried well - finding Ireland's greatest hypochondriac

On the trail of Ireland's greatest hypochondriac and Mrs Clinton's medical notes, Maurice Gueret makes a diagnosis

Uncrowned King of Ulster: Edward Carson - but was he Ireland's greatest hypochondriac?
Uncrowned King of Ulster: Edward Carson - but was he Ireland's greatest hypochondriac?
Dr Maurice Gueret

Ireland's greatest person, patriot, politician, poet, pet and warbler have all been done to death. It's time we were treated to a new educational TV series called Ireland's Greatest Hypochondriacs. The series could traverse borders for RTE with follow-up rights for Europe's Greatest Hypochondriacs, and then the world. There is no shortage of material where health worries are concerned. Medicine has feasted for generations at the tables of tasty neurosis. Florence Nightingale spent the majority of her 90 years in bed. Her favourite posture was flat on her back, making nurse policy notes and thinking she was about to die.

Charles Darwin was a martyr to vague abdominal complaints and imagined diseases of the heart. His own medical studies in Edinburgh lapsed, as he preferred to stuff birds, rather than sit through operations conducted without anaesthetic. An aversion to the sight of fresh blood didn't help, either. Darwin was wise enough to keep his own medical library and not to consult a physician about his many symptoms, in case they curtailed his exotic travels.

If you have ever read the case notes of Hitler's doctor, you will know what a raving incurable his singular Austrian patient was. There are many more world-class imaginers of ailments, both living and dead, and I might consider a few in weeks to come. But I'd like to set readers the task of informing me of any famous Irish hypochondriacs and stories they may have of them.

So as not to upset lawyers and medical ethicists, we should restrict ourselves to deceased hypochondriacs who no longer develop symptoms over Sunday newspapers. Archbishop John Charles McQuaid was once mentioned to me as a hypochondriac, but clinical evidence is thin on the ground. His personal secretary said that six nights a week, after supper, McQuaid would drop into hospitals. Even allowing for the fact that he was not a family man, this does seem to be an inordinate amount of visiting for one cleric. Perhaps he enjoyed comparing his own symptoms with those of the sick. McQuaid's father Eugene had been a GP in Cootehill, Co Cavan. The fastidiousness of his son's hospital-visiting might suggest he may have preferred a life with a stethoscope rather than a gaudy ring. Charles Stewart Parnell was another kettle of fish. Parnell was certainly a very superstitious man. The colour green and the number 13 were among his pet hates. He was a life-long sleepwalker and there is evidence that he suffered from night terrors and panic attacks, which would wake him. The fact that he only lived to the age of 45 might suggest that a modicum of hypochondria was well warranted.

A strong candidate for Ireland's greatest hypochondriac must be Unionist politician Edward Carson, often titled the uncrowned King of Ulster. The famous Dublin barrister played competitive hurley - a game similar to hockey - in his early years at Trinity College, but had to give up all field sports by the time he graduated. According to his biographer, Geoffrey Lewis, Carson had a vulnerable physique, and an obsessive hypochondria preyed on him for most of his life. He once described himself as a "dyspeptic pessimist" and was keen on holiday cures on the garden island of Madeira or spa resorts on the Rhineland. Rather unfairly, I surmise, Carson's second wife, the much younger Ruby Frewen, has been implicated for "making an invalid of her husband".

The only major items in Carson's medical history are a case of diphtheria contracted from a legal friend who died of the disease; and an operation on gallstones, which was very risky in its day. We could have a debate about whether Carson was a true hypochondriac or merely had intense preoccupations during bouts of minor ill health, but he must be up there in the Irish pantheon of 'worried well'. Write to me if you know of other famous folk who might contend. Email or post to Ireland's Greatest Hypocondriac, PO Box 5049, Dublin 6w.

Last week, we were looking at the health of White House candidates, and I promised to return to Hillary and her anti-clotting drug, warfarin. Mrs C has long been associated with health policy, but it's her own personal health that is under the spotlight as the Oval Office looms closer. We know she had a clot behind the knee in 1998 when Bill was President. But in late 2012, she caught a tummy bug on a trip to Europe, which included visits to Dublin and Belfast. A story emerged about how she became so dehydrated that she fainted and banged her head. Concussion symptoms followed this fall, and she was admitted to the New York Presbyterian Hospital where another blood clot was discovered - this time in one of the large brain pools or sinuses that drain blood from behind the brain. This is a serious condition that causes a worsening headache often mixed with stroke symptoms such as limb or facial weakness. Seizures are not uncommon.

The assumption is that Mrs Clinton is predisposed to clots, and may have a form of thrombophilia. Her warfarin dosage needs constant monitoring, as millions of patients worldwide who use it to thin the blood know well. But Hillary's biggest problem may be close monitoring from the media and medical men gathering around Mr Trump. They measure the length of her bathroom breaks, assess her stamina as she walks to waiting cars, and put stories out about the long-term effects of concussion on an 'elderly person in her 60s'. Cousin Hillary is one hell of a brave lady to put herself through the mangle of American democracy.

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

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