This Medical Life

In 1347, the European world encountered one of history’s greatest tragedies: the great plague. Today, it is known by many names: the black death, the black plague, or the great mortality. Whatever name we give it though, one thing is clear: those who lived through this time genuinely believed this disease would eradicate of humanity

The true toll of this plague is unknown. Tens of millions of people were killed and those that weren’t, were scarred in every way imaginable. This disease would ravage European cities and countries for 7 years before it finally relented. Amazingly, it would only be 9 years before another plague epidemic appeared. They called this one the ‘Children’s plague’.

Join us with this episode to study the disease that is responsible for millions of deaths in history and still exists with us today.

This is the story of the black plague and Yersinia pestis.

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Familial Hypercholesterolaemia (FH) is an under-recognised genetic condition that causes elevated cholesterol in patients and affects approximately 1/250 people in Australia. Approximately 100,000 Australians have FH but only ~5% are diagnosed. This needs to change.

FH causes early cardiovascular disease and can be a significant cause of morbidity and mortality in those affect. How do I know? Because a few years ago my brother with no significant co-morbidities and a healthy lifestyle had a life-threatening acute myocardial infarct (heart-attack) at the age of 43.

Our special guests for this episode include:

• Dr Gavin Brown (brother of the co-host)
• A/Professor Damon Bell (Chemical pathologist for Clinipath, PhD in FH, A/Prof at the School of Medicine at the University of Western Australia)
• Professor Graeme Suthers (Director of Sonic Genetics Australia)

This is our story of Familial Hypercholesterolaemia.

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Scattered throughout history are epidemics of catarrhal or campaign jaundice (the latter was experienced during military campaigns). The pivotal moment was during World War II where troops became sick with jaundice due to a contaminated Yellow Fever vaccine and sporadic jaundice outbreaks in different countries. While the symptoms appeared similar (ie jaundice), one did not confer immunity to the other and further investigation was needed.

This discovery of Hepatitis A and B lead to the discovery of Non-hepatitis A and Non-hepatitis B: other illnesses that caused jaundice and liver damage. This lead to the identification of Hepatitis C, D, and E. Although they have similar names, these are 5 separate virus and require different tests for identification.

This is the story of hepatitis.

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King Henry VIII was both a literal and a historical giant but his reputation of brutality and malevolence has few equals. He took power at the start of the English renaissance and was responsible for the English reformation. He had inroads into public health and regulated medical practitioners but also oversaw the enactment of vicious traitorous laws where could be jailed or executed for actions (including speaking out) against the crown.

Henry was touted as being a tall and striking young man who was gifted in athletic sports. However, his health deteriorated during his mid-30s apparently as a result of a significant accident in a jousting event. At the age of 55, he died. Legend had it that after his death, he was so large that his coffin exploded. Is this true?

This is the story of King Henry VIII historical autopsy

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How we teach those who come after us is as important as the knowledge we learn for ourselves. Medicine throughout the ages has been an apprenticeship style model, but over the last few hundred years this has changed to tertiary education. However, is this the right model?

Our special guest is Dr Tristan Rutland who is an Anatomical Pathologist at Liverpool hospital and teaches at Western Sydney University. He was the recipient of the Konrad Muller RCPA award for Outstanding Teaching in 2020. He is also very active on Twitter (@TristanRutland7) posting #Tweetorials and Pathology Education.

This is a story of Medical Education.

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At the end of the 14th century, a young woman is skating on a frozen canal and suddenly falls injuring herself. Her name is Lidwina. Over the next 30 years her body deteriorated due to a disease we know today as Multiple Sclerosis. Lidwina faced this illness admirably and was canonized in the late 19th century for her fortitude and faith.

The breakthrough for MS is attributed to Jean-Martin Charcot. Known as the Father of Neurology, he called this condition ‘sclerose en plaque disseminee’ and even watched as his servant ‘Luc’ developed symptoms. He confirmed as her disease when he performed her autopsy and found sclerotic plaques on her spinal cord and brain.  

Our special guest is Dr James Leyden from Leyden Neurology who has been practicing in Adelaide for 12 years. Links to the MS Society of Australia have been provided in the show notes.

This is the story of Multiple Sclerosis.

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Ancient Egyptians hold a special place in history. Their civilization, religions, gods, conquests, traditions and rituals are some of the most well documented and fascinating. Throughout the centuries, we have been able to piece together the health and medicine of our ancient ancestors and the mummification process plays a significant part in this.

Which brings us to story the of Ramesses III and the Judicial papyrus of Turin. This tells a story of the Harem conspiracy to assassinate Ramesses III and ‘overturn the royal bark’. Through modern imaging techniques, the body of Ramesses III has given up its secrets about this conspiracy and the punishment of those responsible.

This is the story of Egyptian mummification and the trial of a millennia.

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If there is one constant throughout all of medical history, it is the value of urine. Our ancient ancestors believed they predict a patient’s recovery (or not) upon examination of their urine to the middle ages where they used a scale of colour, thickness, and sediment.

Urine was also used in a range of non-medical and even commercial uses that boggles the modern mind. This episode examines the history of urine, its uses, and its modern-day medical uses. The range of testing we have available for urine is staggering and it raises the question: is urine liquid gold?

This is the story of urine.

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SLE is a chronic relapsing autoimmune disease. ‘Lupus’ is latin for wolf and glimpses of it can be seen throughout history. However, it is often obscured by the complexity of the disease and the conglomeration of other conditions.

Over time, our understanding of SLE has dramatically improved but it still remains a complex condition to diagnose and a significant challenge to interpret pathology results. Anti-nuclear antibodies (ANA) are commonly ordered but are commonly misunderstood.

Our special guest is Dr Daman Langguth who is a clinical immunologist and Head of the Immunology Department at Sullivan Nicolaides Pathology. We discuss diagnosing, testing, and management of patients with Systemic Lupus Erythematosus.

This is the story of SLE.

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The emergence of syphilis in 15th century Europe caused widespread panic and finger-pointing as to the cause and origin of this disease. Unfortunately, the treatment at the time was as dangerous as it was ineffectual.

Many historical figures have been associated with syphilis; some will have certainly had it but others will be to cast aspersions against one’s character. This is because it is a disease of rare distinction that sits at the historical nexus of a sex, disease, moral depravity, and mental illness.

It would take centuries before the cause of syphilis (Treponema pallidum) would be known. However, despite all of our knowledge and available treatment of syphilis, we see the prevalence of this on the rise.

This is the story of syphilis.

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