Every human being is biochemically unique. Yet the medicine that treats us is highly standardized. Side effects run rampant even in over the counter drugs, and much more catastrophic events have occurred in standard procedures. You can’t blame medical professionals for being so stringent to their habits; after all, a lot is at stake. But still, every now and then cases that demonstrate that perhaps subjective data is discarded much prematurely, do occur.

One such case occurred in 2001 to Dr. Allan Hobson, a Psychiatrist. He suffered a stroke and recorded its developments from a patient’s view. When he first registered at a hospital, the neurological consultant who diagnosed him declared “C’est classique!” - that Hobson had a typical case of Wallenberg syndrome. This was accompanied by atrial fibrillation, an abnormal heart rhythm that is associated with strokes. Within the year, he also developed a severe case of pneumonia. With a host of other psychological and pharmacological problems, Hobson was at one point sitting at death’s doorstep.

With undoubtedly great medical care though, he recovered, and from what I know, wrote several books since and continued his research on dreams. But the experience he went through - the sleepless nights, the vivid hallucinations, the loss of various cognitive functions - made him realize that the typical understanding of such syndromes and the common prognosis that comes with it, could very much be misunderstood.

For example, the set of events as described by his doctors were as such: An arrhythmia causes interruptions of blood supply to his brain damaging his brain stem. Most of the symptoms that occur during the stroke are typical. These are:

* Movement difficulties (ataxia);
* Balance (vestibular) deficits and postural instability;
* Double vision (diplopia);
* Pupillary inequality;
* Loss of sensation, and sensations of burning and tickling, on the right side of his face;
* Lip drooping on the right;
* Paralysis of the muscles of the pharynx on the right;
* Paralysis of the right vocal cord;
* Mildly decreased sensitivity to pain and markedly decreased sensitivity to temperature change of the left side of his body below the neck

But Hobson also suffers from total insomnia, which is apparently not described in Wallenberg’s syndrome. This is followed by further abnormal heart rhythm; the doctors cannot explain why. Then he develops pneumonia about seven months later. Again, thought to be unrelated by the medical staff.

Hobson’s own idea of what occurred is somewhat different. I cannot verify his side of the story since I am not a medical professional, but from layman’s terms, it does seem to make more sense. Hobson believes the initial fibrillation was caused by the stroke, rather than being an after effect. The stroke itself was caused by a clot in his vertebral artery (of the cerebellum). Destruction to the “pons” structure in the brain most likely affected the heart rate. This would also have caused an impairment in his pulmonary distribution system further reducing the effectiveness of his lungs in clearing out fluids and particles that come with food. Pneumonia would then easily pounce on this opportunity.

Hobson arrived at his conclusion based on many factors that I have not mentioned in this article, but clearly his diagnosis seems more complete. So how did Allan Hobson the patient do better than Allan Hobson the doctor? Probably because his accounts are much more in touch with the symptoms as they occur. Often doctors take the words of their patients lightly, predicting only what text books tell them, and just as often, medical “irregularities” occur.

Many common medical procedures have their roots in older traditions of healing, and clearly those developed subjectively. So while it would be total insanity to give up the scientific method in practice, it would probably be helpful to be a little more tolerant to sound subjective data. Personally I lean towards hard objectivity.  In fact, a book by the title “Biology as Ideology” has been prescribed to me a number of times. But I can’t say I can argue with Hobson, not only because he knew much more about the subject than I do, but also because standardization was probably wrong in this case.

Luckily, no harm was done in this misdiagnosis, but who’s to say something like this doesn’t happen more often? We recently had an article titled “The fraud of homeopathy”, so at the risk of being misunderstood, I wish to make clear that I am not advocating such sciences, but simply asking for a less retaliatory, more rational system. I believe this is the job of many social scientists, to separate philosophy, culture, and science. I find that seldom I am not able to draw the line.

Hobsons’ wonderful article that became a hit when it was published can be found at http://www.dana.org/news/cerebrum/detail.aspx?id=2860

Last 5 posts by Abhishek Bhatnagar

• Thank you Mr. Bush. No, really! - January 6th, 2009
• Where is the case for optimism? - December 29th, 2008
• Mutiny on a Chromosome - December 20th, 2008
• Conservation-ing - December 1st, 2008
• The life of a language - November 30th, 2008

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