THE CASE OF THE BUSY NEUROLOGIST

By Nicholas Regush

April 4, 2002 - Meet Blizzard Man! A neurologist who works through his patients so quickly that he even stops suddenly in the middle of a sentence and begins dictating a medical letter to his secretary. He moves so fast that he forgets he is speaking to a live human being, his patient.

A friend called the other day to tell me about his meeting with Blizzard Man. This was a highly important day for my friend because he was banking on the intelligence, curiosity and compassion of this doctor in the hope that he could avoid having his driver’s license revoked.

He had suffered a seizure while driving, fortunately not injuring himself or anyone else. The seizure occurred after he had taken Echinacea for a cold. It was actually the second time he had suffered a seizure shortly after taking this herbal remedy. When he was examined at the hospital it was discovered that his blood level for Dilantin, the anti-seizure drug he was taking, was very low. A couple of days later, another test revealed normal blood levels for Dilantin. He had wondered whether Echinacea had contributed in some way to the two seizures.

He asked for my help and I reviewed the available scientific literature. There were some suggestions that Echinacea could interact with prescription drugs and enhance their effects, particularly the anti-inflammatory action of NSAIDS (e.g. Motrin, Naprosyn, Advid and Aspirin). And it is a product that is contraindicated in a wide range of illnesses, particularly chronic conditions, such as MS, rheumatoid arthritis, AIDS and tuberculosis. Recent cases reported in the Annals of Allergy, Asthma and Immunology (January 2002) indicate that this highly popular remedy may cause mild or severe allergic reactions. According to the U.S. National Institutes of Health’s Center For Complementary and Alternative Medicine, anyone with health complications should not take Echinacea. Of course, research on the herb is limited and there was no real evidence available that it can help to trigger seizures.

Nonetheless, my friend hoped that he could discuss the issue with his doctor. He was hoping that Blizzard Man might hold still for a moment or two to actually comprehend fully his concern about the possible link between the herb and his seizures. Well, Blizzard Man had no time to talk about anything. His assistant had already done a preliminary screening of what had occurred and he dismissed any discussion of Echinacea by giving my friend an abstract to read about the herb. And that was it. No detailed case history. No probing questions. Nothing of the sort.

"He’s talking and moving so fast that you can’t pin him down on anything," my friend said.

So I asked the obvious question: "Did you stop him in his tracks and tell him to slow down?"

"I thought of doing it, but…"

"Yeah, I know, you were afraid he wouldn’t help you keep your license."

Silence for a few seconds.

I probed. "Do you realize that he was essentially dismissing you as a human being?"

"Yeah, I know, but…"

In my book, doctors like Blizzard Man are quacks. They have no business practicing medicine. No doctor needs to be in that much of a hurry. They should be shut down before they either kill someone or ruin someone’s life.

As it turned out, Blizzard Man dictated a brief but succinct letter advising government bureaucrats who would review my friend’s case that he should keep his license.

But he also told my friend, something like, " If we don’t make it work this time, we’ll go at them again."

Thanks, my friend thought nervously.