Your Powers

7 Real stories

Brain structure and function is so sophisticated and it does reach the finest status of creation as I see it (detailed information will be included in the Structure & Function window).

The mind is in practice a brain tissue in action, or otherwise the use of brain cells and fibers.
Some times the mind tends to play out of order, and does escape the rules of brain standard function (somatic or organic) and in these circumstances we tend to call that “none-organic” or “functional”. We don’t seem to understand a lot about those “supernumerary” functions of the brain and we tend to call them “psychological”. When none-organic actions become organic, but we can’t detect the changes via our assessing methods we call it “summarization” which probably best described as: the act of dominating the sub-conscious mind over the conscious mind.
Practical live is full of examples when the sub-conscious mind govern human behavior and actions. I have seen many of them during my years of medical experience. I’ll mention below few real examples for demonstration and obviously to pass an important message for all of us to try and think seriously about why they have happened, and what sort of people who could become victims for this sort of behavior. The events were from my memory, but every thing mentioned here is real and genuine.

Case – 1
Heartlands Hospital – Birmingham

It was Friday, and I was working as RMO (resident medical on-call) = SHO. About 10:00 pm. in the Accident & Emergency department. A young girl (18 yrs. old) was brought in by an ambulance…. drug over-dose. She took many tablets of paracetamol, and the blood drug level was toxic. She has been assessed as required, and a management plan was in place very soon. She had her necessary treatment, and by around 00:30 am she was recovering very well.

I was doing a quick round to see those admitted earlier who were not very well to find out how they were doing. I stopped at this young lady’s bed to find her almost back to normal, and she was a bit tired but fully alert. I had a quick chat with her mostly for reassuring and left her to have some rest. I continued my quick round, and about 03:00am when I had more emergencies arriving in A&E and that had continued until about 05:30 am. I had no supper, and no sleep at all.
I decided to sit down and eat something quick, and then I thought of having some sleep as the morning post-take round usually starts at 08:00 am. After some consideration I gave up the idea of attempting to have some sleep.
It was around 06:30 am and it was summer time. The morning was bright, and the sunshine was everywhere.
I walked by that young lady’s bed and I found her already showered and refreshed herself. She was back to normal and ready for discharge. I greeted her and asked her permission to talk about her problem and why she decided to take an over-dose.
She was polite, relaxed, and quite genuine for an over-dose girl !. I sat on a chair next to her bed and started talking about the nice morning, the summer and related subjects in order for me to gain the trust and confidence of this young girl. She appeared motivated, positive, and intelligent. She was willing to talk about herself.
I asked her about this over-dose, and the previous 3 over-doses she had in the past. She told me a lot about her private life, and her social circumstances with the lack of parental presence in her life. She was not very emotional, but I could easily notice some sorrow expressions on her face. I was understanding and supportive, and she was generous and genuine in her answers to all my questions. She told me that on Wednesday ( 2 days before this admission) she had a long planned session with psychiatrists in connection to her previous over-doses. I felt unhappy about the quality of that psychiatric support as obviously it did not work. I had a long serious discussion with her about life and living. I have shown her ways on how for her to believe that her life is worth living, and that taking drugs would never had solved problems for anyone.

It took me in total about 60 minutes talking to this young lady, and I must say that it was bi-directional talk, and her contributions in the discussion were active and positive, which was probably the drive behind me spending all of that time with her especially that I had no sleep what so ever all night, and I was really tired.
At the end of that session, I realized that the young lady was not depressed, she was very clever and intelligent. Considering her age she was by all standards very successful in her life ( had car, house, and a secured job !). I thanked her about being open and honest with me (which has helped me a lot to help her), and told her that she will be discharged following the round with my consultant.
Following the post-take round i.e about 10:00 am, I had a phone call from a lady introduced herself as a psychiatrist. She asked me about that young lady, and whether she was admitted to the hospital. When I told her that the young lady has taken overdose which was toxic, and she was supported as required… she said: “ah, she has done it again then”. She added immediately; “this lady needs to be sectioned” (means detained in a psychiatric hospital under supervision!). I felt even more disappointed with that reaction. I was not happy at all about that sort of dealing with this type of young, clever, and intelligent people whose only mistake was “taking overdose at a time of stress”. I told her without hesitations: this young lady does not require sectioning in my view. I told her about my conversation with her that early morning, and that she was very positive. I then added, she is not a potential risk for suicide. I told her that: this young lady is not in my view depressed, and following my conversation with her she showed me a lot of courage and positive, mature thinking about her future.
The psychiatrist was good listener I must admit, and she told me: “but, I still need to see her”. Her speaking tune was different, and her reaction was much smoothed down.
At 10:00 on that Saturday, I went straight to the young girl and told her that the psychiatrist is planning to see you in the hospital. I told her about psychiatrist’s planning to section her, and advised the young lady to be positive, calm, and just to be “herself”… exactly the same way you were with me in the early morning. She promised me to do so, and I knew for definite that she would do just that.
At 02:00pm, I went back to see the young lady to find out the outcome, and to discharge her from the hospital. When I asked her about the psychiatrist visit, she smiled and told me: she was happy!.
I looked at her clinical notes to read: ” …… I was very much surprised to find this young lady has completely changed her attitudes towards life. She was positive, motivated, and she did not look suicidal. I don’t need to follow her up”. I smiled with a lot of relieve and I was really contented. I must say that I thanked myself for making all the effort, and considered the time given to that young girl was “worth it”.
I thanked her for her cooperation, and discharged her from the hospital with no plans for follow up. Naturally that young lady was so happy, and thankful for my help and support. I haven’t seen that young lady again, and did not have any further information about her, but I still believe that she had a happy life with no new attempts to intoxicate herself with drugs.
Case – 2
Heartlands Hospital – Birmingham

It was Monday morning when I started a locum in general medicine as an SHO (senior house officer). I came to the ward, and started my round to learn about my patients. It was few minutes when a young girl joined me introducing herself as The House Officer. She did not introduce herself to me as “I am your house officer”!.
She was arrogant, and seeing herself a bit HIGH. I thought at that stage she was probably seeing me as a “locum” doctor, and that she probably thought of herself as better than me. I was in her eyes a foreigner and a locum, then I learnt later that she was told by her consultant to “be in charge” instead of me !.
I wasn’t bothered that much, as I know my abilities and I was confident. I played it “cool”, which appeared to have annoyed her. There was another female medical student, so I started asking few questions about patient’s management for teaching purposes directing my questions to the medical student who was struggling to answer. The “arrogant” HO was answering some of my questions looking at the medical student’s face, but was not looking at me as a matter of “deliberately” ignoring my presence all together. I remained cool and calm, and continued my ward round.
At one stage, “my” over-confident HO took the lead over me, and started chatting with patients. She was telling the medical student about the management informing her about the required investigations and so on. She indicated to the medical student that she was planning to do one specific test for a particular patient, and I know for sure that, the mentioned test was not right. I politely interfered asking the HO about the need for it in that particular case. She was stunned in her place and obviously she found herself at a loss. She couldn’t explain, and she admitted “defeat” without expressing the “word”. I felt that I had scored a significant “needed” silent “win”.
The round was moving on slowly, but steadily and I was scoring many more points over that “proud” HO !. I found myself automatically leading the round, and the over-confident HO was losing her confidence gradually submitting to my clinical skills which were initially un-recognised by her.
It was 11:00am when “The HO’s” rather than “my HO’s” bleep went off. She answered the call, and she started mourning and blaming her “bad luck”. I asked her smiling: what is the matter?. She replied: they wanted me to go to ward **….. to talk to Mr XY. I said: where is the problem?. She replied: oh, you don’t know this man. She added: he was medically discharged 3 months ago, but he doesn’t want to leave the hospital….. everyone has spoken to him from my consultant to the ward sister on many occasions, but he remained adamant not to leave the hospital. She added: he was discharged to go to “old people’s home” and he was not keen on the idea in principle so, he refused to visit the place to allow social services to deal with his discharging arrangements.
I said: let us go together and see him.
He was in his late sixties, looked rather healthy. He was lying in bed facing the door, and a big window was behind him.
I was aware of the challenge, and I have been warned by almost everyone around him that he was not an easy patient.
I walked in, greeting him with a smile, but he was not interested at all. I commented about the weather, and the sunny day, and that when the day is sunny we all feel happy and relaxed.
All what he managed to say was: I can’t see the sun. I said: you can’t see the sun if you put it behind you. I added: if you sit up and look around you, you will see the beautiful day outside. He replied: I am not interested, and I don’t like to see the sun. He added: I think the day is dark and sad.
I became more aware of the task in front of me. Two ward nurses, one of them was a ward sister, came to watch me “fail” as everyone else did over the last 3 months; they jokingly commented.
It took me around 45 minutes changing my tactics, approaches, and handling. Nothing worked, and I just started to feel frustrated inside me. I am not that kind of a person who admits defeat very easily, and challenges are always my piece of cake !.
He was telling me now and then: I don’t want to go to that place because I smell very bad, and people will run away from me. That was his apparent reason for not leaving the hospital to go to the place for just a visit to see if it was suitable for him or not.
I have used all my skills and charm to persuade him, but for no avails. Eventually, I told him: I am now holding your hand, and sitting very close to you. If you really “smell” I would have not done that. He replied: you are a doctor, and doctors don’t mind bad smelling patients.
I then told him kindly and softly: you are like my dad, and if I don’t like my dad to go to that place, I would never have asked you to do so. That was the magic word… dad!.
He became very emotional, and broke into tears. With little batting on his shoulder, and holding his hand warmly, he melted down and said: because you said that you are like my son, I will go and visit the place.
Ah, what a relieve !. I had the loud applauding from everyone who was there ( the “now” my house officer, the medical student, the two ward nurses, and a third male nurse who joined them during the process as a matter of “curiosity”).
That was a big achievement for me in front of all those “sarcastic” spectators, and in particular that “arrogant” HO, who since then became a different person. On that moment of time she recognised me as her official SHO, and that was my “prize” for that 
success !.

Case – 3
North Staffordshire Royal Infirmary

It was Tuesday 06:30pm when I was working as an SHO in Neurology. I was resting as the neurology ward was quiet, and all patients were stable.
I was sitting and watching T.V. when my bleep went off. I answered the call, and it was from A&E. The medical RMO asked me to come down and see a 17 years young lady who had a “stroke” !. I said: a stroke at this age ?!. The RMO confirmed what he was talking about: yes, it is a clear stroke with right sided weakness including face and speech.
I went down to A&E with a big question in my mind: Is it really a stroke?. I found myself answering immediately: I doubted it very much.
It was not busy in A&E when I arrived to the young lady’s cubicle. She was lying on the couch fully conscious, but her speech was really very slurred, and I could notice at that very minute that her face was obviously weak as well. Her sister (19 years old) was with her.

I spoke to the young patient and managed to take a good history of what has happened. There was nothing suspicious at that stage. I proceeded with the clinical examination, and… yes, it was all consistent with acute stroke apart from two things: I have noticed two small scars on this lady’s tummy on the lower right side ( one for appendicectomy, and one for an ovarian cyst she told me answering my query). The second thing which as well took my attention that both her big toes went down ward when the soles of her feet were stroked (the old Babinski test !).
She had none of the factors which increase the chances of having a stroke, and her blood pressure was fine.
It took me no time to think that: It was not a stroke… this is none organic I whispered to myself.
I decided immediately to move on and try my best to help this young girl. I said nothing to her about the diagnosis, but I clearly mentioned to her that: it doesn’t look like a stroke to me, and there is a good chance for you to recover. I added straight away: you can help me to make you better.
I started a plan based on suggestibility and encouragement with some tricks to divert her attention. She was very good listener, and she followed my instructions with good concentration. It took me about 30 minutes to get this lady completely back to normal. Her sister was there, and a male nurse joined me in the middle of my “challenging technique”. Both remained completely silent, and were watching me very closely to see “probably” what this “witch” doctor is doing !..
She moved her four limbs, she started to speak normal, and her facial weakness recovered fully as well.
I asked her to sit up, and with some reluctance ( it was deliberate reluctance I must say as at that time, she probably knew that she had nothing wrong with her).
I asked her then to stand up, and she did with a lot of twisting and swaying. She stood, then walked, then turned around. At that stage, she smiled and was really happy.
I asked her to walk out of the cubicle, and she did. I asked her to return to her couch, and told the male nurse that: this lady had no stroke.
I spoke to the medical RMO and told him that: your young lady patient had no stroke, and she stood and walked normal.
He said: then we will discharge her. I said: no, please keep this young lady over night, and ask a psychiatrist to see her before discharge in the morning. I told the RMO, if this lady is discharged tonight, she will come back later with similar problems, or she may take an over dose.
I left A&E returning back to my base, but I heard nothing since about that young lady.

Case – 4

North Staffordshire Royal Infirmary
It was Friday afternoon. The time was 06:00pm, I was an SHO on-call for neurology. It was quiet, and all patients were fine.
That was my last day in NSRI, a place which I liked it very much. I was dubbed over there as a “doctor with magic hands” !.
I was looking for something to do, and while looking through patient’s notes in the war I found an interesting case.
A 22 years young lady who was admitted to NSRI about 3 weeks earlier. She was seen at first in a local hospital close to her address.
She had a sudden onset of leg weakness with loss of sensations below her waist. She was assessed and investigated fully since admission to NSRI, including blood investigations almost looking for every possible cause. She had MRI for brain and whole spine on more than one occasion. She had a lumbar puncture with cerebrospinal fluid analysis for every possible cause, and she had an electric test (neurophysiology), and X-ray chest. The results of her all investigations were completely unremarkable. She had physiotherapy input on many occasions, but she remained unable to stand, and to feel anything below her waist.
I read every bit of her clinical course, and I realised that there was no idea about her “unexplained illness”. Transverse myelitis was the only diagnosis considered during her 3 weeks stay in NSRI. She had two courses of steroids with no benefits what so ever.
I thought about this case, but with my limited neurological experience in neurology, I couldn’t think of anything different.
I asked the ward nurses to let me know when her mother comes to visit her that evening, and they did.
I met her mother who was on her own, and I took her to an office in the ward with one aim in my mind…. to get more information about what has happened to this young lady.
Listening to the full story, I could not identify any unusual events apart from one event which fired in my head.
During the process of questions and answers I learnt that the young lady is the oldest of two daughters, and a son. She was her “mother’s girl” by all means, and she was recently married to her boyfriend who was unemployed, she they had no choice but to stay in her mother’s house for indefinite time.
I have finished with the young lady’s mother, and allowed her to visit her daughter without saying anything.
At 08:00pm following the end of visiting time, I decided to go and assess the young lady.
She was in a cubicle of 6 beds. All beds were full, and she was the only young patient.
I came to her bed to find her lying in bed very much relaxed, and she did not look unwell. I greeted her introducing myself to her, and told her that I spoke to her mum before hand.
She was a nice lady with very good manners. After asking her about her illness, I asked for her permission to examine her. She was cooperative, and motivated.
I finished my full neurological examination with no abnormal findings. All her neurological assessment was completely normal apart from her unable to move her legs, but I could appreciate any real weakness. She was unable to pass the message from her brain to her legs, and that was in my view her main problem.
I told her that on my examination, I couldn’t find anything wrong in connection to her nerve functions, and that obviously was added to her unremarkable investigations, and the lack of any response to the given treatment.
I told her about the possibility of none neurological disorder, and mentioned how some time the brain and the mind are not working together ( non-synchronized). I obviously have mentioned about my earlier experience with that young “stroke” patient, and how that young girl was on her feet in 45 minutes. I told the young lady about a possible similar out-come if she tries hard to get better. She promised me to follow all my instructions, and do what I ask her to do.
I have again started with suggestions, encouragement, and mild support with few tricks to let her realise that she was doing everything herself. It took me full 60 minutes with escalating improvement in leg functions. She then moved her legs, stood, and walked.
I pulled the curtains apart, and there was a loud applaud from all of the ladies were in her cubicle. They were really cheered, and they congratulate her. She became more confident, and obviously she was so ecstatic.
It was evening tea, and the tea lady just pushed the trolly in. I asked the young girl to serve tea/ coffee to the ladies, and she did with no problems. Every oe was looking at her face with a big smile and nice wishes.
Follwing that, I asked the young lady to walk to the nurses’ station (about 10 yards from her bed) and to ring her mother to tell her that she was fine. She did, with cheers from the two nurses who were there unaware about what has happened over the previous 60 minutes or so.
Every one was so happy for that young lady, and on the next morning my neurology consultant came for Saturday round asking me if there was any problem. I told him about that young lady, and his first expression was: I was very suspecious about this lady’s illness. He added; I always thought that this lady’s problems were functinal in nature. He obviously congratulated me for that “success” approving the registrar’s previous dubbing me “doctor with magic hands” with a big smile.
When I asked him if he wanted to discharge her to her home, he said: we rather discharge her to the referring hospital, and then they will make the discharge.
I have not heard anything about that lady since that time.

Case – 5

Univesity Hospital, Coventry
This story is about a very respectable lady in her 50s who was seen for a full 15 years by a neurologist with a lot of respect in the neurology courts. She was seeing him for “migraine” which was considered difficult to control. He has tried on her most of the available medications which are used for migraine protection (prophylaxis). When I saw her she was on 4 of them, all taken together including Ergotamine which I have never used for migraine prophylaxis.
She told me that when she read the information about me in The Coventry Telegraph following my 
Best Healthcare Professional Award by Migraine Action group, she contacted her GP asking for a referral to see me.
Good dealing with patients has been appreciated and rewarded.
Good dealing with patients has been appreciated and rewarded.

She came with her husband, and naturally after introduction and formalities I listened to her story giving her enough time to tell me all about her suffering.
I have then examined her, and had a long talk with her and her husband. I decided to do few blood investigations, and I requested a CT brain scan knowing in advance that very unlikely the scan would reveal any significant changes having migraine for 15 years. I had my reasoning and justification for doing that scan as part of management in her case.
Obviously my holistic approach of managing migraine has appealed her, and she was a good listener to my advices in connection to life style, building up confidence, search for any anxieties in herself and around herself, etc.
The first meeting was up to her expectations as expressed by both of them at the end of that consultation. A clear plan for medication withdrawal was explained to her, with written clear instructions about what to do next.
I met her with her husband in three other sessions about 45 minutes each. Every session was friendly and very civilized, with a lot of more information about herself, and her inner thinking with a very positive support from her husband who was open minded and well educated.
I have managed to expose a lot about many of her bad habits, and some obsessions as well. A kind of “brain-wash” approach was used in her case with removing the bad and replacing it with what I thought a suitable “good”. All was done in a relaxed atmosphere, and obviously the whole process was “interactive”.
At the end of her third session, she was only on 20mg. of Amitriptyline and a lot of “positive advices”…. her migraine was much milder and infrequent. Her sleeping pattern was clearly improved, and her days were more enjoyable.
At her last (4th. session), she was much better than I expected. She was confident, and contented with that small dose of Amitriptyline, obviously free from the side effects of the other three medications. She was discharged from follow up with broad smiles on each face of us. That was considered a success story, and obviously a good example of good listening on the doctor’s side, and good cooperation on the patient’s side, with positive support from her husband who was an integral part of the whole process.

Case – 6
University Hospital, Coventry
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Case – 7

University Hospital, Coventry

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An attempt to understand around us via pondering inside us