Posted by: Helen | 8 December 2014

A tribute to my father

This post was written by Dr Richard Dobrashian MBChB, FRCR

Mustafizur Rahman;           1943-2014

Dad

It is with great sadness that I write to announce the recent death of Mustafiz Rahman who passed away unexpectedly at home on Friday 5th December leaving behind his wife Valerie, 3 children and 5 grandchildren.

Many of you will remember Mustafiz or (Fiz as he was affectionately known) as one of the loyal, outstanding radiologists of the trust. Not only was he an excellent radiologist but also a pioneer. Many of the radiology examinations we take for granted today Fiz introduced into Blackburn during his long and distinguished career. He brought teaching hospital techniques into the district general hospital so patients no longer had to travel to Manchester to get state-of-the-art imaging and procedures. Over the years Fiz introduced many new techniques including angiography, angioplasty, vascular stenting and percutaneous drainage to mention but a few. In 1988 he helped introduce the first CT scanner to Blackburn which was one of the first to be installed outside of a teaching hospital not only in the region but in the country.  Fiz’s biggest passion however was for nuclear medicine and he helped build up over the years an outstanding nuclear medicine department here in Blackburn.

Teaching was also one of his favourite pastimes. Hundreds of doctors from all specialties have benefited from his excellent radiology teaching sessions throughout his career.  His incredible collection of teaching films, accumulated over several decades, was worthy of any textbook.  More latterly Fiz was a highly respected examiner for the Royal College of Radiologists earning him the very prestigious Silver Merit Award for services to the region and nation.

His enthusiasm was infectious, his personality endearing, a true gent through and through. Wherever he went he made friends. He will be remembered with great affection by all those who had the pleasure and honour to work with him.  An outstanding radiologist, a wise and learned teacher and above all a great colleague and friend.

Richard Dobrashian.

Posted by: Helen | 15 September 2013

All roads lead to….home

With the news that my father is, once again, unwell, I find myself, as I have before, wondering what the funeral service for a Muslim atheist might be like.  Yes, we have asked him, though not for a while. But at the last time of asking what sort of send-off he envisaged, he replied “A Christian burial.”

By this, he may simply have meant  a Great British Do, delicate hankies and an enormous buffet; for, of all the men I’ve known, I know none more British than this man from Gopalganj.  Perhaps he wanted to make it clear that he wanted his remains to stay in the country in which he has chosen to make a home, and raise a family.

The only places of worship he attends with any regularity are Roman Catholic churches.  I don’t know for sure, but I don’t suppose it’s possible to have a Requiem Mass for a non-Catholic; however, I would have thought it was possible to have a funeral service in a Catholic church, even for someone who hasn’t been baptised.  A funeral service at which the beginning of Chapter 14 of St John’s Gospel is read.

That part of the Good News is taken by some as promising a Kingdom which is exclusively “Christian” – a members-only club.  I have always read it as the opposite.  You do not have to believe that the Romans conquered Britain to find yourself walking on a Roman road.  More than that, you would find it impossible to travel from, say, London to Newcastle, without following a route they plotted, whether or not you know its name.

In the same way, it is impossible to journey home to the Father without travelling on a road laid through the death, resurrection and redemptive love and mercy of Jesus.  Even if you don’t know who built it, or what it is called.

My Father’s house has many rooms.

My father will probably be here this time next year. Insh’Allah.

Posted by: Helen | 19 April 2013

Professor Dawkins and Saint Thomas

On Saturday 13 April, I was lucky enough to be at QEDcon in Manchester to hear Professor Richard Dawkins in conversation with Robin Ince.  It wasn’t a session I had been expecting to particularly enjoy.  Based on what I’ve read of the Professor’s writing (as much of The God Delusion as I could manage, some blogs and articles), I try to turn any irritation I feel towards him into amusement or pity.  On the Saturday morning, every time I had caught sight of him, my earworms started singing “Poor Professor Dawkins” to the tune “Poor Professor Higgins.”  But if I were to be honest with myself, I think I’m afraid to allow myself to be angry with him, as if, somehow, that would be his victory and my loss.

However, in person, I found him to be gentle, calm and courteous, ready to correct any misunderstandings of his views, always engaging.  And I agreed with much of what he had to say.  Towards the end of the interview, Ince asked him whether he thought he and other atheists should seek some rapprochement with people of liberal faith.  While I can’t quote him verbatim, as I recall, the Professor replied that no, he disagreed with all religion, whether liberal or not.  He went on to explain that he had two reasons for this.  One was that liberal faith, in his view, facilitates fundamentalism.  The second reason, the one I want to write about here, is that faith lauds those who believe things based on no evidence whatsoever.  He supported this with reference to the Gospel accounts of St Thomas who refused to believe in the resurrection until he had seen the risen Jesus for himself, saying that for as long as Thomas is regarded as the lesser of the apostles, because he wanted evidence, faith must be seen as antithetical to reason and the scientific method.

I’ve always liked the stories about St Thomas, perhaps because I have many doubts.  I’m also attracted by the grittiness of him wanting to touch and explore Jesus’s wounds.  The logical explanation is that this is included in the Gospel to make it clear that Thomas wanted proof that the risen Jesus had genuinely suffered injuries that must have been fatal – that this was, in truth, a resurrection not a lucky escape.  But it also makes Thomas very human, laddish even, recognisable to me.

Is Professor Dawkins right to say that Thomas is regarded as somehow “less” than the other apostles?  I have never regarded St Thomas as not quite as good as the others, for two reasons.  One is that I don’t read the words “Blessed are those who have not seen and yet have believed” as synonymous with “Better are those who have not seen and yet have believed.”  It seems axiomatic to me that someone who hasn’t seen the awful wounds of torture on the body of a friend is happier, luckier than someone who has seen something so difficult to bear.  Added to this, if blind faith is a blessing, it does not follow that it is a reward for being, somehow, better (better at what, anyway?)

The other reason why, for me, Thomas’s story is one of the most beautiful is his reaction to Jesus’s wounds “My Lord and my God!”  He first truly sees God in the wounds of another person.  That’s a message full of hope for me because I live in  a world full of wounded people.  And if I could only do what Thomas did – stretch out my hands to touch their wounded hands, look deep into their wounds – I would find real faith; I would see what Thomas saw: my Lord and my God.

Posted by: Helen | 29 April 2012

A prayer utters itself

Today, on the Sunday generally known as Good Shepherd Sunday, my thoughts as usual turn to… Pulp Fiction, still my favourite Quentin Tarantino film.  The reason why is probably obvious: the film’s closing dialogue involves gangster Jules Winnfield (played by Samuel L. Jackson) saying this:

“There’s this passage I got memorized. Ezekiel 25:17. “The path of the righteous man is beset on all sides by the iniquities of the selfish and the tyranny of evil men. Blessed is he who, in the name of charity and good will, shepherds the weak through the valley of darkness, for he is truly his brother’s keeper and the finder of lost children. And I will strike down upon thee with great vengeance and furious anger those who attempt to poison and destroy my brothers. And you will know my name is The Lord when I lay my vengeance upon you.” I been saying that shit for years. And if you heard it, that meant your ass. I never gave much thought to what it meant. I just thought it was some cold-blooded shit to say to a motherfucker before I popped a cap in his ass. But I saw some shit this morning made me think twice. See, now I’m thinking, maybe it means you’re the evil man, and I’m the righteous man, and Mr. 9 millimeter here, he’s the shepherd protecting my righteous ass in the valley of darkness. Or it could mean you’re the righteous man and I’m the shepherd and it’s the world that’s evil and selfish. I’d like that. But that shit ain’t the truth. The truth is, you’re the weak, and I’m the tyranny of evil men. But I’m trying, Ringo. I’m trying real hard to be the shepherd.”

I love that speech, because I identify very strongly with that experience of looking for yourself in scripture and trying so hard to find yourself in the hero’s role only for the truth to dawn at last.  I’m not the solution – I’m the problem.  There are times when I want to pray and I can’t think of any words, and those words of Jules Winnfield come back to me: they’re the weak; I’m the tyranny of evil men; but I’m trying, I’m trying real hard to be the shepherd.

That experience of reaching helplessly for a prayer was part of Howard Storm’s conversion experience as told to the Catholic Herald:

““I was lying there, when I heard a voice say: ‘Pray to God.’ I said: ‘I don’t pray. I don’t believe in God.’ Then, it came a second time; and a third: ‘Pray to God.’

“So, tried to think of a prayer. I started to mumble some things. A mention of God came into a few of these phrases. With each mention the people around me became very, very angry, and started screaming at me: ‘There is no God’ and ‘Nobody can hear you.’ It angered them so much that they were retreating from me. The mention of God was unbearable to them.” Encouraged, he mumbled other jumbled half-remembered phrases: “Glory, glory hallelujah, God Bless America, Our Father who art in heaven…””

As a relatively sceptical Catholic, I was unmoved by much of Howard Storm’s story, knowing that there are physical explanations for out-of-body experiences.  But I was moved by that moment of a man searching, reaching, for prayer.   Such moments of wordless longing, in whatever context, come closest to my understanding of what it is to pray.

The poet laureate, Carol Ann Duffy, an atheist, expresses this more concisely and beautifully than I ever could in the sonnet Prayer.

I am not alone then, in regarding the experience of longing as an essential part of being human.  For me, to be aware of this longing, is the foundation of prayer – whether that prayer is directed at the personification of an interventionist God, or whether it is is an inward act, directed at oneself.

Posted by: Helen | 23 October 2011

A couple of thoughts on a couple of commandments

Jesus said, “You must love the Lord your God with all your heart, with all your soul and with all your mind. This is the greatest and the first commandment. The second resembles it: you must love your neighbour as yourself” (Matthew 22: 34-40).

I had a couple of thoughts on this morning’s Gospel:

The second commandment resembles the first

I’ve never really given this much thought. If I’ve thought about it at all, I’ve thought that it’s obvious: you must love God, you must love your neighbour – yep, I see the resemblance. But does the experience of loving my neighbour resemble the experience of loving God, and if not, why not? Well, loving God – the ultimate reciprocated love – doesn’t, often, feel like reciprocated love for a person. For one there are no hugs. No loving glances, no compliments and no cups of tea first thing in the morning. On the other hand, loving people is much messier than loving God, much more demanding of my time, resource, patience, tolerance. God doesn’t pester when I’m trying to blog. He doesn’t wake me at 5.30am. He doesn’t ask me asinine questions about APB Ethical Standards.

So there isn’t an obvious winner here. I might want loving God to be a more “felt” experience. And I might want the people in my life to be more lovably “godly” (on my terms, i.e. invisible, undemanding and endlessly patience.) I think the truth may be that the second commandmant doesn’t just resemble the first – the two are the same. If I don’t experience the presence of God in other people, I can’t ever love them in the way I was designed to – mercifully, generously, selflessly. I also can’t love God the way I was designed to love him: physically, tangibly, experiencing a genuine desire for him, satisfaction in his presence and consolation in his embrace.

Loving myself happens before (or at very least at the same time) as loving my neighbour

Jesus assumes I love myself. Why? Because he loves me. He is convinced of my worth; like an author with an unpublished manuscript, that, no matter how many rejections he gets, he continues to send to publishers. I am his greatest work. So why don’t I have some conviction of my own worth? And until I do have that conviction, my love for others will – must – be flawed.

Once again, the second commandment is inseparable from the first, because if I could experience God’s love for me in others’ love for me, I might believe in that love, instead of believing, as I do, that when people say they love me, it’s because they don’t know how unlovable I am.

With the Sacrament of the Eucharist comes grace, a grace most easily understood as willingness to love. Perhaps that grace must first be felt as a willingness to love myself. Perhaps loving myself is inseparable from loving God, which is inseparable from loving my neighbour.

Posted by: Helen | 28 February 2011

The happiness project: who’s in charge here?

Following a week with more down days than up days, it’s time for me to take action. I could, in fact, stop here and pat myself on the back (and why not!) because the very process of:
1) identifying an issue;
2) deciding to make a change; and
3) planning actions that will effect this change
is, in fact, a therapeutic process.

Ah. I just did Cheery Bollocks Therapy to myself.

I have been talking about running; this morning I decided to stop talking and start running. I walked The Boy to school, then plugged my iPod into my ears, hit shuffle, and set off on a jog.

If you wish to recreate the leisurely pace of this jog for yourself, this is the shuffle I ended up with:

Hungry like the wolf – Duran Duran
The Workers’ Song – The Dropkick Murphys
Trash – Suede
Baby, I love your way – Big Mountain
Tarzan Boy – Baltimora
Love grows where my Rosemary goes – Edison Lighthouse
You got it – Roy Orbison

I’d be surprised if I covered more than a couple of kilometres, though it felt like about five at the time. And now I’m sweaty, hot and high.

As actions go, running has pretty much instant results. However, to have taken and carried through any action would have served to remind me that I’m still in charge. And while I can say that, things are not so bad.

Posted by: Helen | 27 February 2011

Have a banana!

I’m imagining a round of Family Fortunes in which the question is: We asked 100 people in our survey to name a tropical fruit. You said: “banana;” our survey said…

My suspicion is that the answer would be the “Wah-wah!” that indicates that the competitor’s answer doesn’t feature in the top 5 (7, 9, however many) answers in the survey.

We are so accustomed to the availabillity of the banana that we take it for granted. I recall one day in the office a junior colleague arrived back from the canteen commenting that there were no bananas. I, as you would, immediately burst into a chorus of “Yes! We have no bananas.” Junior colleague could not believe that there genuinely is a song with those lyrics; I ended up, therefore, explaining my own relatively shakey understanding of the WW2 u-boat bloackade, leading to shortages of all imported goods, including bananas.

However, if even the remembrance of the wartime shortages suffered by our parents and grandparents doesn’t make you reach fondly for the curvy yellow fruit, you could try feeding one to a baby. Watching a little person experience the taste of a ripe, mashed banana for the first time is a lovely moment.

Failing that, I have two recipes that might bring a bit of mellow yellow back into your life. If these recipes seem to be heavy on the raising agent, bear in mind that ripe banana is quite dense and damp and, if you’re not careful, can weigh a cake down. Using particularly large bananas may necessitate some additional cooking time; these recipes are happy to be removed from the oven, skewered, then cooked for a further 10 minutes.

Banana, cranberry and chocolate chip loaf

Credit to Delia Smith (Complete Cookery Course) for the fundamental fat/flour/liquid proportions and cooking time.

Sift 4oz of wholemeal flour and 4oz self-raising flour into a large bowl. Add 6oz soft brown sugar, a pinch of salt, 11/2 teaspoons of baking powder, 4 oz butter (at room temperature), and two eggs. Whisk the mixture together thoroughly with an electric hand whisk. Add 4 tablespoons of milk, 1 banana (peeled and chopped), 1oz chopped almonds, 3oz dried cranberries and 3oz chocolate chips. Transfer the mixture into a well-buttered loaf tin (7 or 8 inches long) and bake for an hour at 180 C (170 C fan assisted). The size and ripeness of the banana can affect the cooking time, so this is one cake that I would tend to test with a skewer (if cooked, the skewer should come out of the middle cleanly).

Banana strawberry upside down cake

Credit to Nicole Routhier for a version of this upside down cake, which I have adapted.

The vexatious question with upside down cake, for me, is what to bake it in. Ideally, you would have a skillet that will go from the stove top into the oven, enabling you to cook the syrup in the skillet, add the fruit, add the batter and transfer the pan to the oven. I don’t have such a versatile pan. I, therefore, cooked the syrup in a saucepan and transferred it into a deep-ish 9 inch silicone flan mould. This did have the advantage of not requiring any greasing. If you substitute a cake tin for a silicone mould, I would think you’ll need to grease. However, the fact that the first thing you put into the tin is syrup does tend to rule out loose-bottomed or spring-form tins.

Melt 2oz butter in a saucepan with 2oz dark brown sugar and 2oz granulated sugar. Stir in 1/2 teaspoon of ground cinnamon and 1/2 teaspoon of ground ginger. When the butter is melted and thoroughly combined with the sugar, pour the syrup into the bottom of a tin or silicone. Peel and slice 2 bananas; slice at an angle to get oval shaped pieces. Arrange these evenly in the syrup. Hull and halve approximately 10 strawberries (depending on size). Place these, cut side down, in between the banana slices, until the base of the tin/mould is packed with a single layer of fruit.

Sift 7oz of self-raising flour into a large bowl. Add 2 teaspoons baking powder, 1/2 teaspoon of salt, a few drops of vanilla extract, 4oz butter (at room temperature), 4oz caster sugar, and two large eggs. Whisk with an electric hand beater until smooth. Pour the mixture over the fruits in the tin/mould and bake for 50 minutes at 180C (fan assisted 170C). Let the cake stand in the tin for 15 minutes before holding a platter over the tin and turning the cake out. This is nice served warm with cream, custard or ice cream.

Posted by: Helen | 21 January 2011

Bed, breakfast and discrimination

This blog post is an attempt to set out briefly and with clarity the basis for my opinion that one can define oneself as Christian yet still believe that for a B&B to refuse a double room to a same-sex couple is discrimination and therefore, rightly, illegal in the UK.

For the purposes of this blog post, I am defining discrimination as “unfair treatment of a person or group on the basis of prejudice.”

As I understand it, the Christian B&B owners would argue that:
1) It is an orthodox Christian view that sexual relations outside marriage are illicit.
2) A same-sex couple may not be “married” in the UK.
3) A same-sex couple who share a double room may be tempted to and may commit an illicit sex act.
4) It is their duty as Christians to avoid encouraging, promoting, condoning or permitting a grave sin, as such an illicit sex act would be.

In particular, they would argue that since they require unmarried heterosexual couples to occupy separate rooms, there is no discrimination: their treatment of all unmarried couples is the same.

For me, however, this argument doesn’t wash.

While I could draft an interesting post considering point (1) above, I don’t intend to do so here.

However, point (2) merits some analysis. While it may be an orthodox Christian view that a same sex couple cannot marry, it would also be an orthodox Christian view that a divorce(e) may not remarry. And Catholic Christians would regard a “civil” marriage as an irregular marriage arrangement, until it has been convalidated by the Church. The B&B owners may consider that they cannot take reasonable steps to determine whether married couples should be regarded as in a Christian marriage. However, if they take no steps at all then, simply on the balance of probabilities, in the UK, it is likely that they allow double rooms to be occupied by heterosexual couples that orthodox Christians might regard as “unmarried” (or in the case of the divorce(e), adulterous).

The question of civil marriage is one I find particularly interesting. Unless one takes the view that it is in the power of the state to confer some ontological change on a couple by registering their “marriage”, there should be no distinction between a civil “marriage” and a civil “partnership”. For this reason, I would prefer to see one term only used for all civil registration of relationships, whether heterosexual or same-sex.

To regard a civilly partnered same-sex couple as different from a civilly partnered heterosexual couple would seem to assume that it is in the power of the state to effect a different bond between a couple based on their sex. This seems at very least, illogical.

Point (3), however, is the one that creates the most problems. For while an orthodox Christian may regard sexual relations as licit only within marriage, it does not follow that all sexual acts between a man and his wife are licit. It does not seem to trouble the B&B owners whether heterosexual couples occupying a double room may be tempted to try anal or oral sex or to use contraception. Moreover, they seem untroubled that a single person may book into their B&B with the intention of masturbating with, or without pornography.

The B&B owners may again argue that there is a limit to what they can reasonably do to prevent such acts being committed. However their reasoning that by allowing a same-sex couple to occupy a double room, they do more to permit or encourage an illicit sex act than by permitting a heterosexual “married” coupld to occupy a double room seems flawed to me. It is based on the assumption that the same sex couple are more likely to commit an illicit sex act. I think it is unlikely that there is any evidence to support this assumption. The assumption is, therefore, plainly discriminatory.

In conclusion, therefore, I would say that anyone who considers it to be their Christian duty to prevent persons likely to commit an illicit sex act from occupying a room either together, or alone (if they might be tempted to masturbate) will find it impossible to run a B&B at all. To try to prevent particular individuals or groups from “sinning”, based on your own flawed assessment of their propensity to sin is, in my view, discrimination and is, thankfully, against the law in the UK.

The “orthodox Christian” views described above are not those of the writer of On The Axis.

Posted by: Helen | 15 January 2011

The Caption Competition

The Old Man claims to have been delighted with The Girl’s baptism. He just isn’t very good at conveying delight in a picture. I have wedding photos with a similar expression on his face.

All caption suggestions considered, though my current favourite is “Vasectomy Failure!”

Posted by: Helen | 10 January 2011

How it turned out to be all in my head

Ten years ago, in the Spring of 2001, I made the excuse of needing a repeat prescription to book an appointment with my GP and I mentioned to her that I had been suffering from a persistent headache. This was a headache that was sometimes so bad, I felt it affected my vision. In fact, overall, from my perspective, my vision was getting worse. To put this in context, I am a carrier of Retinitus Pigmentosa (x-related) – a heterozygote – and therefore have a number of the symptoms of RP, though to a milder degree than if I were male.

My GP made the sympathetic doctor face, referred to my notes and said that, as I had RP, visual loss was to be expected. She could see from my notes that I had been diagnosed and then counselled on the genetic implications and prognosis (the condition is untreatable) and she reminded me of this saying that sadly nothing else could be done.

I returned a month later complaining again of a persistent headache, so bad that it was nauseating, accompanied at times by the sensation that I literally couldn’t see out of my right eye. She made the sympathetic doctor face and asked how things were at home. I replied that they were not good – after all, I complained of a headache most of the day, every day. At this point, I may well have wept. She referred to my notes again, observed that I had found fluoxetine helpful with low mood in the past and suggested she prescribe a month’s worth. I agreed.

I continued to suffer from persistent headache, sometimes accompanied by nausea, always accompanied by visual disturbance. I developed some coping strategies for the pain including timing my use of OTC painkillers so that they would be effective if I had to attend an important meeting and developing some visualisations that – while they didn’t reduce the pain – enabled me to focus on work, despite it.

A couple of months into the fluoxetine, I returned to the surgery and saw a locum. He asked about whether I experienced any side effects with fluoxetine and encouraged me to be open about its effects on my sex life. When I admitted that fluoxetine did have an effect on my enjoyment of sex, he suggested I try an alternative: this was nefazodone (Dutonin). He noted that one of the side effects of nefazodone was that it was associated with weight gain. However, he considered this might be less important to my mood than maintaining a healthy sexual relationship.

Nefazodone and I certainly did get on well: all the anti-depressant effect of fluoxetine, and an awful lot easier to achieve orgasm! However it did give me the munchies and I may well have gained as much as 15lbs.

Because of my RP, I was required to take an annual sight test, including binocular visual field test, in order to retain my driving licence. I returned home from holiday to a letter telling me that the DVLA had cancelled my licence as I no longer met the vision requirements. This failure resulted from a combination of narrowed visual field (tunnel vision, if you will) and some not insignificant blind spots within the central visual field. I was 27, used to feeling entirely in control of the events in my life; I was distraught. I found and printed off the Driver and Vehicle Licensing Act and set myself to read it and find the loophole that would get me my licence back. I wrote to Cardiff to ask whether I could get a second opinion, or whether they would like to examine me themselves, but to no avail.

I returned to my GP, fired with anger, to tell her that although I am an RP carrier/sufferer, there is no way that I would have been expected to have lost so much vision as to be unfit to drive at the age of 27. She reluctantly agreed to refer me back to Moorfields. The first available appointment was in October of that year when, unfortunately, I was already booked to be in Australia for a friend’s wedding. They rebooked me for December. In the meantime, I remember that on 11 September 2001, I felt so unwell (headache, nausea, dizziness) that I left the office at lunchtime and was climbing out of a taxi when the first plane hit. I went into my flat to collapse on the sofa where I saw the second plane hit and the towers collapse.

What should have been the holiday of a lifetime was an ordeal from start to finish. I remember having a headache on the plane, in Singapore, at the Sydney Opera House, at the Great Barrier Reef, where I logged in my dive logbook that I was amazed that the current could have been strong enough for me to have been exhausted after only 20 minutes. I returned home feeling tired and thoroughly unwell.

In December, I went to Moorfields to see Professor M, whom I hadn’t seen since he met my husband three years previously, shortly before our marriage to discuss the genetic implications of my condition with us. He has the most marvellous memory and always recalls not only me, but also that when he first met me, when I was his patient at Addenbrookes, he also met my sister, then a clinical medical student at Addenbrookes. He always asks about her fondly, and did on this occasion. The preliminaries were scarcely over before he was looking through my dilated pupils into the back of my eye. And then I had that experience that others who have been seriously unwell may identify with: a doctor who minutes earlier has been chatting cheerfully suddenly goes quiet. And then beckons a colleague to have a look. And then says: “Well, it’s possible that it isn’t serious…”

Professor M then explained to me that I had bilateral papilloedema, which is to say, the optic nerves at the back of both of my eyes were swollen. I was immediately taken down to have an ultrasound scan of my eyes, which found nothing. He then said that a neurologist would need to be involved and as soon as possible, and that he would be referring me to the National Hospital for Neurology and Neurosurgery.

Still unaware of the implications, I called my parents. My father immediately suggested I come home, he would arrange an MRI for me, and I would have the films to take to the National with me. At the weekend, I went home to Chorley and on the Monday morning, I had an MRI at Blackburn Royal Infirmary. My father did not read it himself, but his colleague was comfortable that he was looking at a normal scan.

The following week, accompanied by my sister and clutching my MRI, I went for my first appointment at the National. The SHO, Dr S, took a full history and performed a very thorough neurological examination. She stuck my films on the light box and brought her consultant in. This was the first time I met Dr G. He looked into my eyes, and he looked at the MRI. He observed that to anyone other than a neurologist, the scan would appear normal. However – he pointed out the pituitary fossa – the downward displacement of the pituitary fossa was a sign that it was full of cerebro-spinal fluid. This, he said, could be the only visible sign of a condition that is normally diagnosed by absence: where there is evidence of increased CSF pressure (papilloedema, headache, transient visual obscuration) but an MRI does not find a tumour or anything else apparently creating this pressure, the most likely diagnosis is idiopathic intracranial hypertension. “Have you”, he enquired, “gained any weight recently?”

I was admitted to the National the following day for further examination, a lumbar puncture and for fundus photography. The LP detected opening CSF pressure in the spinal column of 33mmhg (compared to a normal range of 15-20). I was discharged the following day and the day after that, my 28th birthday, Dr S telephoned to confirm that tests on the CSF drawn had found no infection or indications of cancer; they were, therefore, comfortable to begin treatment for IIH. I returned to the hospital to collect my medicine – a drug called acetazolamide.

My father commented later that day that it was fortunate it wasn’t a glioblastoma multiforme, because I would likely have been dead in three months, “…and that would have spoilt everyone’s Christmas.” Mine most of all, Dad. Mine most of all.

IIH is a chronic condition. Ten years later, I am still under Dr G at the National.

Future editions of On The Axis will explain more about IIH, the experience of living with a chronic neurological illness, treatment options including lifestyle management and, possibly, a set of lumbar puncture tips for junior doctors!

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