Martin J Brodie

Martin J Brodie

DISSECTING ROOM LIFELINE Martin J Brodie Martin Brodie trained in general medicine and clinical pharmacology in the UK in Glasgow and London. He was ...

205KB Sizes 4 Downloads 108 Views

DISSECTING ROOM

LIFELINE Martin J Brodie Martin Brodie trained in general medicine and clinical pharmacology in the UK in Glasgow and London. He was appointed consultant in 1981, after which he developed an interest in antiepileptic drugs and the management of epilepsy. He is director of the Epilepsy Unit at Glasgow’s Western Infirmary and an honorary professor at the University of Glasgow. Who was your most influential teacher, and why? In the fourth year of my undergraduate training, my supervisor—an enthusiastic young senior registrar—made me appreciate that clinical medicine was an interesting and fulfilling way of spending one’s life. I have never lost my fascination in attempting to unravel complicated diagnostic problems. How do you relax? With difficulty —I’m not very good at relaxing. I used to play chess, but this is anything but relaxing. What is your greatest regret? I don’t release endorphins during exercise. What apart from your partner is the passion of your life? Cask strength single malt whisky. What are you currently reading? Le Carre’s The perfect gardener— rather over the top as far as the ruthlessness or, for that matter, the influence of the pharmaceutical industry is concerned, but it is beautifully written. Do you believe in capital punishment? Sometimes. What is your favourite country? Scotland—beautiful in the rain, spectacular in the sun. Independent soon, I hope. Do you apply subjective moral judgments in your work? I try to resist the temptation, usually successfully. What part of your work gives you the most pleasure? Making young people who have difficult-to-control epilepsy seizure free and giving them hope for the future. If you had not entered your current profession, what would you have liked to do? I originally planned to become a barrister, and sometimes wonder how such an alternative life would have worked out. Do you believe in monogamy? Yes—one wife at a time.

1632

“HRT is for women who go mad at the menopause” s a student I asked a consultant gynaecologist “What’s HRT?”. He replied, “Its Hormone Replacement Therapy, we use it for women who go mad at the menopause.” During the 1970s in the UK, HRT was viewed with suspicion. Our undergraduate textbook only briefly mentioned hot flushes and (over)emphasised the benefits of the menopause: “for many women the menopause is a blessed relief from the burden of childbearing”. Over the ensuing years I learnt much about HRT, but nothing prepared me for the physiological onslaught that can hit you when your oestrogen finally runs out. Being fat, I had hoped that I would have few menopausal symptoms and, apart from buying a fan and not bulk buying tampons, I decided to wait and see. Unfortunately menopausal symptoms creep up on you—how do you know what a hot flush is when you’ve never had one before. At night you learn to “sleep” with one leg outside the duvet, you become giddy in the mornings at first and then for most of the day, compensate by holding onto the examination couch in clinics and to the lectern when lecturing. My lethargy increased, so I bought a carbon monoxide monitor and installed a new boiler to exclude some hidden toxin. I still managed to work, but speaking at international meetings needed herculean effort. Finally one December night, after suffering many hot flushes by proxy, my Jack Russell/sleeping partner (JR), became uncharacteristically ratty. With a frustrated “woof” that’s normally reserved for cats he sees but cannot reach, JR voted with his paws, jumped off the bed and lay on the floor, head buried desolately in his paws! To compound matters I found I had hypertension and, after a 30lb-weight loss,

A

menses stopped abruptly; intermittent attacks of intense calmness and surreal separation of mind and spirit ensued. I finally decided to seek help when, during one such episode, I was in the middle of a clinic. A kind (male) consultant physician was summoned who, having found no cause for my plethora of symptoms, gently asked if I could be pregnant or depressed. My female colleagues were highly amused and commented that it was a new millennium and there had recently been a new, albeit, manmade “star” in the sky —perhaps I had been impregnated with a new messianic variant JC virus I thought. My male colleagues, God bless them, did not think pregnancy was implausible but whatever was wrong, I felt increasingly wretched and wondered if I really was (just) depressed. I became one of those patients who resort to writing symptoms on scraps of paper and search the internet for explanations—it is surprising what you find under oestradiol and neurotransmitters. It was time to see my GP for HRT—you know the drug you give to women who go mad at the menopause. After 6 days of HRT, JR was back to nocturnal snuggle duties and by 6 weeks I felt upgraded from 8 to 256 megabytes of RAM (more realistically 128 perhaps) with a new processor to boot! Learning points. 1 Stick your patches on before you shower or they fall off. 2 If you are a middle-aged, dog-tired woman whose partner/JR will not snuggle any more, and you find that your name badge has become an essential aide memoire, then think about taking HRT. It will almost certainly be more costeffective than changing your boiler/ partner and will keep the dog happy! Anona Blackwell

THE LANCET • Vol 357 • May 19, 2001

For personal use. Only reproduce with permission from The Lancet Publishing Group.