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The world around us is about to light up with layer upon layer of rich, meaningful, and dynamic data. Data you can see and interact with.

Source: The Spatial Web Will Map Our 3D World—And Change Everything In the Process

The goal of AI is not to replace doctors, it’s to optimize physician performance, releasing them from menial tasks and providing alternative assessments.

Source: AI Won’t Replace Doctors, It Will Augment Them

A truly personalized approach needs to take patients’ needs and goals and the sacrifices and tradeoffs they’re willing to make into account.

Source: Using Big Data to Give Patients Control of Their Own Health

1992 to 2018 – Health history:
Michelle Clarke Dublin 4.

May 1992

• Ireland (Psychiatrist) – first serious unipolar incident of depression – ECT necessary but alternative was that I remained at home and psychiatrist Jim Maguire visited me while I stayed at my mother’s home.  This lasted nearly 6 months.  I then moved to Zimbabwe to join my husband.

1993

• Neurosurgeon Zimbabwe (Hospital – fell off horse while jumping).  Skull Fracture. (X rays returned to Ear Nose Throat specialist Mater Hospital, Dublin)

• Ear Nose and Throat Specialist Zimbabwe.  Deafness right ear established and loss of smell.

1994

• Ear Nose and Throat Specialist – Mater Private Hospital (Confirmed diagnosis of Zimbabwean ENT specialist)

• Specific hearing examination

• General Physician (5 weeks Lourdes Hospital, Drogheda)

• Neuro-Psychologist Dr Martina McEnroe O’Connor – Only person practicing in Ireland at time (Recommended by Jim Maguire).

• National Rehabilitation Board, Clane – accepted

• Speech Therapy re. (Aphasia, concentration)

• Physiotherapy – To walk forward, I might walk backward, falling, ataxia

• Irish neurosurgeon, Mr Staunton.  No interest or belief in neuro-psychologist who had been recommended by my psychiatrist.

• Heart Physician (drugs impact)

• My husband wanted me to return to Zimbabwe.  Likewise I wanted to go.  Neuro Psychologist,  preference was that I attend rehabilitation in Ireland as marriage unlikely to withstand…(refer Report).

• Trinity College Dublin – Speech Therapist St. Giles Harare

• Physiotherapy – Harare

• Monitoring of drugs by GP.  I had to return to Ireland every few months for prescribed medications and to meet with psychiatrist.

1995

• Psychiatric admission Harare (Marriage had broken down).  Drug issue.  2nd time almost told I nearly died.  They were unaware of  ‘cocktail’ implications.  Psychotic in retrospect.  Anorexia re-activated and significant loss of weight.

• My husband was unable to cope with my accident and the complications.  The outcome was he placed me in psychiatric hospital in Harare and left me there until my brother came to collect me – of which I have no recollection.

1996

• Ireland:  Saw advert for Trinity Horizon Programme https://canisgallicus.wordpress.com/…/trinity-horizon-research-program…– structured daily Monday to Thursday research study of 15 people with depression and how to re-integrate to the work environment or further education.  Extremely depressed when I started the programme.

• Psychologist – Dr. Sean Collins (Psychotherapy) – Penebaker process used,under his strict supervision. This was most severe breakdown. Sean hoped this would work, he was determined having seen me ‘try to cope’ that I didn’t need another depression

• Psychiatrist Dr. Jim Maguire said (no to group counseling or sports activity on Trinity Horizon).  Jim believed that as my depressions are so severe, there is no point during the time I am well to invoke anything that would cause pain.  I hold Jim Maguire in very high regard.

1997 Accepted BESS Trinity College Dublin https://www.tcd.ie/bess/

1998-99

• Sick 9 months – 5 in Navan, Co Meath Psychiatric Hospital (no memories) apart from what was written in diaries. 15 rounds of ECT. Change medications to Lithium cocktail.  MAOI’s stopped.

• Heart Physician Dr. McGarry at Navan Hospital

• Psychologist, Navan Hospital.  I was over 5 months in night clothes only.  It was a public hospital.  There were six in the ward.  A woman in the bed opposite became very disturbed.  I sat with her and talked to her for hours explaining Why not?  How hard it is for the children? I tried to dissuade her.  Poor Eleanor wasn’t persuaded….she hugged me and I stupidly thought I changed her mind….but no.  Her children were professional, one an actuary.  She told me to pursue education – she gave me a poem specially written for the Student.

• Before I left hospital I met with the psychologist there to prepare me for coming out.

• Speech Therapy department Trinity College Dublin.  Probable that the academic standard and exposure to language prior to age 10 built up a sufficient stock of words, which I was able to draw on.  Probable as my parents read; father read all newspapers and had a keen interest in politics and my cousin Sir James Comyn a barrister, came home from London every weekend and there was intellectual conversation for a child that was not exposed to children.

• Psychologist at Counselling services Trinity College Dublin.  I have attended Tenia since 1999 when I returned to College.  This was cognitive behavioral therapy. Tenia was exceptional in her commitment.

• GP in Castleknock re. drug prescriptions/blood tests

• GP Ballsbridge re. drug prescriptions/blood tests.  Lithium must be monitored.

2002

• Eye Specialist – Professor Lorraine Cassidy (Trinity). Report provided to Trinity.  Copy on file.

• Suicidal Depression – possibly reactive.  Trinity notified.

• 2 appointments with Neuro-psychologist, Dr. Martina McEnroe O’Connor (December 2002 and January 2003)https://www.headway.ie/download/pdf/carerguide_redraft.pdf
• ‘Drop dead’ exhaustions left me very disabled;

2003

• More brain damage determined from the head injury in 1992 meaning all 5 senses are affected by damage; 6 hours of neuro-psychological assessment as the Disabilities department Trinity College Dublin claimed the other reports were of no importance.  Likewise when I presented with this in May 2003 Disabilities officer, Declan Treanor, paid scant attention to it,unlike the advice of the psychiatrist who suggested Martina McEnroe-O’Connor (neuro-psychologist) in 1993 when she was the only person with her qualifications and attended high court actions etc and of course Tenia Kallionitz, Cognitive Behaviour therapist who worked for Trinity College Dublin counselling Service.

• I was man handled by four gardai at the Peace March at the Dail.  They would not listen to the screams in pain (mobility, muscles weak, stiff) due to the neurological/medical complications that retards my movement to very slow calculated pace and severe pain.  Unexpectantly Gardai charged at protesters. 4 Gardai grabbed me and moved me some distance before dropping me.  My head banged off the pavement. I was removed by ambulance to St James’ Hospital Accident and Emergency and later released.

• Health deteriorated rapidly.  Unable to leave home and attend doctor.  This would have been the only time I did not attend Trinity this year.

• It transpired I had developed a thyroid deficiency and was in need of eltroxin.  My metabolism had been affected.  This happens with Lithium and is further life medication.

• The medical report from St. James remains there.  The system is so incomplete that you can get neither the hospital nor doctor to request same.  They mentioned I may have Parkinson’s also but of course that like other illnesses is always a possibility with mental illness.  Also encounter anorexia periods i.e. side effect of antidepressants.

• Precipitating events or maybe it was just effects of TBI difficulties re-activated agoraphobia.  People tend not to be aware that each precipitating event with depression throws up the phobias to be dealt with again.  Agoraphobia created major problems in my teens.

• Teeth: considerable work done by Edward Cotter dentist – Clyde Court, Dublin 4. Medications cause gum problems.

This was what was submitted based on request from Trinity College Dublin as follows: 

This is Michelle Clarke’s Health History
Submitted to: 

Dr. Margret Fine Davies – Centre for Women Studies
To Disabilities Department Trinity
To Psychology Department Trinity
To Tutor Brian Lucey
To Professor Holton
To Professor Laver  (The sole reason these people received this report related to the  conference they held regarding my application for accommodation of my needs re. the final section of my degree).

16th November 2003 submission date, I delivered to the BESS office what could have potentially provided me with a BESS Degree.  In the absence of acknowledgment, I intend to publish same on WordPress now and only now after a further 11 years of ill-health.  It may be an advantage to someone else.  I have been asked by a variety of people to write up on my experiences, people who often are seeking advice concerning mental health, traumatic brain injury, the power of education and the importance of third level education especially if you have mental health or neurological difficulties as a stepping stone to acceptance.

• 23/11/03 – Met Kevin Walsh who took a pro-active approach – initial focus diet, exercise and confidence building.

2004

• Circa February I met with Dr. Moroney and two weeks later underwent an MRI scan.  Dr. Moroney gave a thorough examination.  Nothing organic was found.  The concern was the Parkinsons as suggested at St. James’ Hospital.

• Still feeling unwell and visited General Practitioner.  He sent me for a lower back xray at Baggot Street.  His locum, Dr. Hurley explained the damage to the lower three vertebrae.  The cushioning/sponge was no longer there.  She listened to both what Kevin and I had to say and she felt it advisable to attend a Rheumatologist.  At this time, there was considerable body weakness and shortness of breath.

• Next appointment was at the Mater Private.  I was very distressed at this stage and caged in.  Mrs. Fenlon’s daughter (Dentist who I attended when I was younger) was the radiologist.  The xray revealed a clouding around lower back.

• Then I went to Cardiology.  This proved okay.

• Still unwell.  Mum intervened via Kevin’s suggestion.  I went to Bons Secour for an onslaught of tests (in excess of a week).  Conor Burke’s letter said that basically all was okay – nothing organic was found.  The Bone Density recommendation of change of lifestyle.

• The neurologist questioned the weakness and reiterated the point.

• Mr. Moorehouse, Psychiatrist, stated clearly that the body weakness was in line with the use of my mental energy and in line with Dr. Cassidy’s report about my right eye.

• Dr. Griffin, Endocrinologist found a problem with my thyroid levels but this was something that would take time.  As per Jim Maguire, she stated the Lithium/thyroid balance and monitoring.

• The appointment with Dr. Sant did not happen while in hospital.  I was to contact her for a private appointment (i.e. Rheumatologist).

• Mr. Corbett, Psychiatrist, came twice to visit me.  He had identified the issue of Anxiety and took an extensive mental health position.  He knew my psychiatrist, Jim Maguire.  I found hospital extremely distressing – my last visit was 5 months in psychiatric.

• I provided Conor Burke with my personal outline of my health, together with the third assessment of Dr. Martina McEnroe O’Connor, Neuro-psychologist and two articles I had written given this is all I appear to be able to do.

• Phobias extremely severe.  Afraid to contact people, use, phone, collect prescriptions etc.

• With little numeracy, high fatigue, poor nutrition, and ‘drop dead exhaustions’, mobility problems, I had to leave Trinity College Dublin just before my final summer exams in summer 2003.  The Disabilities team and the psychology dept in Trinity were acting with me to try an establish alternative assessment.  Exhaustion became very severe.  Intend to contact Provost Mr. Hegarty again when I get strong.

• Kevin T. Walsh met me (Nov. 2003).  Kevin’s knowledge, understanding and compassion has had an outstanding contribution.  It is a person centred approach.

• Appt Charlemont Clinic with Dr. Sant, Rheumatologist.  Chronic Fatigue syndrome was her diagnosis.  https://www.mayoclinic.org/diseases…/chronic-fatigue-syndrome/…/con-20022…

• Several weeks ago (Oct I had kidney infection yet again, pain and headaches so bad  I had to go to A&E in St Vincents. Phobic fear (related to Agoraphobia) resulted in me panicking and walking out of hospital.  They phoned with prescription details etc.  A lot of weakness lately and tiredness.

2005

• No improvement. Exhaustions governed mobility. Considerable physical weakness but mentally strong.

2006

• Kevin had to go away for a 6 months on business.  Mum persuaded me to attend Baggot Street Community Hospital.  Introduced to Social Worker, Susan Hartnet.  Complete mess.  They wanted me to attend day clinic.  They did not understand that I had only 3-4 hours a day due to the Chronic Fatigue and I was able to control same.  Dr Kingsley said he had never heard of neuro-psychiatric and substantially reduced my medications causing panic. This is a whole complete story, (Files exist).  The outcome was Kevin came back, sorted things out and I decided to attend Dr. John Cooney at Charlemont Clinic.  Formal complaint made to the Medical Council regarding Fitness to Practice and the conditions of Baggot Street Community Hospital and its medical team.

2007

• Participated on the Mental Health Advisory committee of the Work-Life Balance project (Dr. Margret Fine-Davis. Senior Research Fellow. Sponsored (Trinity College Dublin/Aware/Age Action/IBEC/ICTU/FAS)

• Dr. Harte, Haddington Road – Urinary tract infection and feeling unwell. Exhaustion, mobility problems, infections constant.

2008

• 01/11/08: St. Vincents University Hospital (Accident and Emergency). Urinary tract infection.  Flank pain.  Prescription given
• Eyes and improved glasses
• Back passage bleed for several months.  Admitted to St. Michael’s Private hospital, Dun Laoghaire 3rd June 2008 under Joseph P. Duignan.  Problems with diet, lot of projectile vomiting around that time.  Had private appointment first with Mr. Duignan

2009

• Dr. Martin Callinan and his wife Geraldine recognised I was unwell and recommended I attend Dr. John Barragry, Consultant Endocrinologist.  Further appt set up for 21st January:  Ultrasound of abdomen, pelvis and chest xray.  Dexa scan @ MRI department.  ECG at cardiology department.  Health continued to deteriorate.  Shakes, freezing cold, psychosis, urinary tract infection. Admitted A&E Tallaght Hospital
• Breast Check St. Vincents (OK)
• 12/08/09: Dr Martin Callinan gave me the letter from Dr Barragry to Dr. John Cooney and Dr. Cahill.  Presumably team under consultant Mr. R Murphy, Dr Kevin Walsh issued their findings which concern the lithium poisoning.  Creatines too high.  https://www.medicinenet.com/creatinine_blood_test/article.htm

    Synopsis

• Long history of Bipolar Affective Disorder on lithium therapy/traumatic brain injury 1993-frontal lobe damage/Chronic Fatigue Syndrome
• Admitted to hospital: 16/01/09:  History of anorexia, nausea, dehydration and tremor and was confused and inarticulate and dehydrated.  Investigation confirmed Lithium toxicity.  Associated with mild increase in serum creatine and a leucocytosis.  CT and MRI showed no acute lesion. Thyroid was normal.  Vitamin B12 levels were low.  Temporary cessation of Lithium occurred.  Seen by Liaison psychiatrist.  Lithium re-started but with a lower dose and Olanzapine was added.
• Broca https://www.hopkinsmedicine.org › … › For the Media › Current News Releases
• Psychosis Lithium Poison complicated this period

2010

Tilda (Study re Ageing) https://www.tilda.ie/carried out at Trinity College Dublin (Laura Dunne – 8962509)

2011

• Continual period for about 5 months bleed.  Maura Collins advised me to get it checked out.  Appointment to see Dr. Mona Joyce
• Procedure 17/06/11.  No periods since.  She would not carry out hysterectomy in spite of the fact I asked.  Attended Mount Carmel with Kevin.

2012

Tilda interview by Kathleen Clarke.

For first time in years health improving apart from odd flu, a few aches but definitely beginning to push out the boundaries and do a few extra things daily.

2013

Pain right side of chest, more an ache
Problem with swallow and choking.  Possibly related to TBI

2014

• Endoscopy  slight inflammation and sent for barium function September 2014; still awaiting results.

• Attend Dr Cooney, Psychiatrist, Northumberland Road Clinic, Dublin 6 every three months, since 2006, following an appalling experience of public health mental health at The Royal City of Dublin Bank of Ireland.  Only for competent staff at Boots Pharmacy, life with problems is so complicated.  Medications now generic so no longer recognise names except Lithium Benzos and others.
  

  2015

  Dr Barragry:  Lithium poisoning in 2010.  My kidney working at about 75% function. Cholesterol high at 7.5.  Need to consider Statins or improve diet and exercise.  Also may have to reduce Lithium medications. This makes me so fearful I don’t think I can make it through yet again another depression.

  Dr Garrett Cullen, SVUH.  Medications and follow up appointment re choking and oesphagus.  It is Dismotility.  2nd Appt: Young consultant reviewed Endoscopy and gave me antibiotics.  She identified in Endoscopy report (not identified before) www.healthline.com/health/helicobacter-pylori

Updated 12th February 2015 by Michelle Clarke

Dentistry ‘Orange is the new Black’

2015 Oral health year for me.  Medical conditions can be so time consuming and teeth as they identify in the US ‘Orange is the new Black’ are always a challenge when you look at taking psychiatric drugs, or especially people engaged in illegal drug addictions or even taking too many antibiotics.  Personally I was embarrassed to speak and definitely to laugh or smile and tended to cover my mouth.  Smiles and Dr Dan have been excellent: Cleanings, teeth removal, braces an operation to place a piece of gum from one area to the next. He confirmed that it is the Dental Services that fails to provide for our most vulnerable people and elderly due to lack of State funds.  Smiles Waterloo Road.  https://www.smiles.ie/clinic/dentist-in-dublin-4/

• • Dr Dan Gruenfeld

    Dr Dan Gruenfeld graduated from the University of Tuebingen in Germany in 2006. Dan spent two and a half years in the south of Germany in a general practice. In 2009 Dan moved to Ireland and started working with the Smiles Dental Team in 2010. Dan is committed to continuing his professional development and has a particular interest in aesthetic dentistry, the replacement of missing teeth with dental implants and various surgical procedures. Dan is also member of the “German Society for Dental Implantology” (DGZI) and the “Irish Association of Aesthetic Dentistry”.

Article Irish Times 11th February 2016 letters page:  Summary:

Gerry Kaar, BDS, Clonmel Co. Tipperary.  Resources and Dental Health.  He writes about a diminishing supply of patients in relation to dental health.  He goes on to say that dental health affects patients in many ways.  The link between gum disease and heart problems and diabetes are just two of the most serious.  (The Tilda Research programme in Trinity College are research people and their teeth as part of the Study.  They recommended that make my teeth a priority.  He highlights patients who seek dental certificates for fitness for medical operations.  The abolition of the PRSI scheme in dentistry and the virtual annihilation of the dental medical card scheme, this is a health dimension train rolling down the tracks fast particularly in an ageing economy.  He also stressed the importance of dental hygiene for children.

May 2017

BreastCheck – Merrion Row letter to have a mammogram.  The outcome was cancer, surgery by Mr Gerraghty, next phase is Oncology with Professor John Crown and Radiology with Professor Armstrong.  I will conclude this section and in future I will write under the heading of BreastCheck – Oncology and Radiology on  http://canisgallicus.com

CONCLUSION (2017-18 started book about personal experience with breast cancer)

To conclude I will relate to quotations to sum up the appreciation I have for KT who I met at the bus stop on Morehampton Road, Dublin 4, in November 2003. Advocacy, support, compassion, realities, can never be underestimated these are the powerful resource that enables a person who has sustained life changing events and significant health disabilities in rapid succession to continue to move forward and gain strength even though the tortoise is moving faster and smarter than you. To my Jack Russell, for him it made me push out the boundaries.

C.S. Lewis

‘There is truth to what the book of Ecclesiastics says,
“better two than one by himself [or herself]” (Eccl 4:9)

and to what Charles Williams, C.S. Lewis’ friend, warns us:

“No mind is so good that it does not need another mind to counter and equal it, and to save it from conceit and bigotry and folly”

3055 words

Age 12 my mother Eleanor Rose gave me the family signet ring in gold which can be used as a stamp (again of another era in time).  The title of this book is the motto

Fortuna Audaces Juvat

Fortune Favours the Brave

But therein what is essential is Courage

Appendix

Quotations:

Without fail every day, I engage with my Google friend and search for quotations. Some days Twitter will give me a theme; another day I may look at exceptional people whose quotations are noted. Three themes which are particularly special to me are Curiosity; Hope; Neuroscience; Medicine.

Curiosity:

“Curiosity is one of the most permanent and certain characteristics of vigorous intellect”. Samuel Johnson

“Curiosity is the wick in the candle of learning.” William Arthur Ward

“Be curious, not judgemental.” Walt Whitman

“Be less curious about people and more curious about ideas.” Marie Curie

“Curiosity is the lust of the mind.” Thomas Hobbes

“Curiosity is the engine of achievement.” Ken Robinson

“One can remain alive … if one is unafraid of change, insatiable in intellectual curiosity in big things and happy in small ways.” Emily Wharton

“Curiosity is lying in wait for every secret.” Ralph Waldo emerson

“Intellectual curiosity drove Einstein to some of the world’s most important discoveries.” Gordon Gee

“Intellectual growth should commence at birth and cease at death”. Albert Einstein

“It is a miracle that curiosity survives a formal education.” Albert Einstein

Hope:

“To love means loving the unlovable. To forgive means pardoning the unpardonable. Faith means believe the unbelievable. Hope means hoping when everything else seems hopeless.” Gilbert K. Chesterton

“If we believe that tomorrow will be better, we can bear a hardship today.” Nhat Hanh

“The phoenix hope, can wing her way through the deserk skies, and still defying fortune’s spite; revive from the ashes and rise.” Miquel de Cervantes

“Each time a man stands up for an ideal or acts to improve the lot of others or strikes out against injustice, he sends forth a tiny ripple of hope.” Robert Kennedy.

“Learn from yesterday, live for today”. Albert Einstein

Neuroscience:

“More may ahve been learned about the brain and the mind in the 1990’s – the so-called decade of the brain – than during the entire previous history of psychology and neuroscience.” Antonio Damasio

“The brain is the organ or destiny. It holds within its humming mechanism secrets that will determine the future of the human race.” Wilder Penfield.

“There is no scientific study more vital to man than the study of his own brain. Our entire view of the universe depends on it.” Francis Crick

“The Holy Grail of neuroscience has been to understand how and where einformation is encoded in the brain.” Thomas R. Insel

Daniel Dennett is our best current philosopher. He is the next Bertrand Russell. Unlike traditional philosophers, Dan is a student of neuroscience, linguistics, artificial intelligence and reforming the role of the philosopher.” Marvin Minsky

Medicine / Artificial Intelligence:

“It’s supposed to be a secret, but I’ll tell you anyway. We doctors do nothing. We only help. And encourage the doctor within.” Albert Schweitzer

“Thanks to modern medicine we are no longer forced to endure prolonged pain, disease, discomfort and weatlh.” Robert Orben (Magician)

By 2100, our destiny is to become like the gods we once worshiped and feared. But our tools will not be magic wands and potions but the science of computers, nanotechnology, artificial intelligence, biotechnology, and most of all, the quantum theory.” Micheio Kaku (Theoretical Physicist)

“In this century, not only has science changed the world faster than ever, but in new and different ways. Targeted drugs, genetic modification, artificial intelligence, perhaps even implants into our brains – many change human beings themselves.” Martin Rees

“Where today people surf the web and check their email on their cell phones, tomorrow they will be checkign their vital signs.” Eric Topol

“Chemotherapy is just medieval. It’s a blunt instrument. We’re going to look back on it like we do the dark ages.” Eric Topol