are patients for our annual conference, co-sponsored by the VA Health Care System and medical school. Past conferences have examined the deaths of Edgar Allan Poe, Alexander the Great, Mozart and others. Below is an abbreviated case history of this year’s patient. An expanded version will be provided at the conference.

Born in Florence, Italy to British parents, the patient was sickly as a child with recurrent respiratory infections. Independent and deeply religious, at age 16 the child experienced a "mystic’s calling to lift the load of suffering from the helpless and the miserable." This led to a career as a health care professional, administrator, consultant and social activist. The patient remained single throughout life, had no children and did not smoke.

At age 35 the patient traveled to Turkey to work as a health care professional and hospital administrator whose team treated patients suffering from battle wounds, cholera, diarrhea, dysentery, typhoid, typhus, brucellosis, frostbite and gangrene. They worked under extraordinarily squalid and mentally and physically exhausting conditions, and thousands died while under their care. The patient’s illness began suddenly with tremendous fatigue and fever shortly after arriving in the Crimea. A physician rated the illness "as bad an attack of fever as I have seen." The patient’s condition "fluctuated between satisfactory and critical, with relapses in the morning, followed by recovery, and then another relapse in the evening." Bed rest was the principal treatment, and the crisis finally ended after two weeks. Five months later the patient was hospitalized for severe sciatica, accompanied shortly thereafter by bouts of dysentery, earache, laryngitis and insomnia.

During the next 32 years, the patient complained of insomnia, anorexia, nausea, irritability, nervousness, depression and frequently expressed a sense of failure and worthlessness. There appeared to be several relapses of the original febrile illness in addition to "nervous tremors" and pain diagnosed by a noted neurologist as "congestion of the spine." Because of chronic fatigue and other assorted symptoms, the patient chose to be confined to a chair, couch or bed, yet remained dedicated to the cause of health care reform and was held in high esteem by colleagues. From age 43 to 46, the patient had arthralgias, "recurrent spasms of the heart," and dyspnea due to severe chest pain. Partial relief was obtained from subcutaneous injections of opium.

At age 68, symptoms of chronic illness began to abate, depression lifted, and gradually the patient began to venture from the bedroom. At 75, the patient complained of failing memory and eyesight, although visitors found their host to be lively, factual and witty. Blindness occurred at age 81, and one year later the patient became so demented that round-the-clock nursing care was required. At age 90, the patient died while asleep. The death certificate attributed the passing to old age and heart failure.

Historical Clinopathological Conference

Friday, May 2, 2003 - 1:00 - 2:30 p.m. Davidge Hall

Free Attendance (Physicians May Obtain 1.5 Hours Of CME Credit for $20)

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