Tuesday, 15 November 2022




Schizophrenic disease, anxious panic,

Or depressive thoughts cycling with manic.

Such disorders endogenous

(No cause that's exogenous) —

Your shrink terms these ills non-organic.

Does your body feel like you're half-dead?
Can drug side-effects mess with your head?
A meticulous shrink:
"It's organic, I think.
Get a medical workup instead."
Dr.G.H. and Giorgio Coniglio, 2022
Authors' Note:  A psychiatric workup for mental disorders starts with the separation of causality into two streams. In the first, brain function, thoughts and behavior may be altered by subtle or unusual manifestations of disease in body systems outside the brain — these are sometimes termed exogenous. In the second stream, manifestations are attributable to disorder of the brain itself (usually of unknown cause) in patterns reflective of neurosis, schizophrenia and depressive illness. In somewhat archaic, but still utilized descriptions, psychiatrists may refer to this distinction as indicating organic versus non-organic mental disorders. 


In the frontal lobes, meningioma

Presses on, slowly grows in its stroma.

Bizarre thoughts are expressed,

Vicious acts unredressed —

Symptoms med students learn pre-diploma.
Dr.G.H. and Giorgio Coniglio, 2022
Authors' Note: stroma: connective tissue that supports normal body structures and, on occasion, abnormal growths
Meningioma is a not-uncommon slowly growing benign tumor within the cranium. Pressure on adjacent portions of normal brain induce neurological symptoms. When the tumor is located in the frontal cortex, neuropsychiatric manifestations may include bizarre thoughts, frequently paranoid, and unrepressed behavior. Fortunately, the tumors, when suspected, are readily diagnosed on neuro-imaging studies, and surgical therapy is often curative.

Brain tumours account for only a small portion of patients suffering such neuropsychiatric symptoms; however, medical practitioners frequently hope that such a correctable cause may be discovered.


You're depressed and withdrawn, so retractive,

Since your thyroid gland's gone rarefactive.

Body functions slow, too.

But, the best test for you —

TSH, it's sky-high — still reactive.

Dr.G.H. and Giorgio Coniglio, 2022

Authors' Note: By far the most common cause of thyroid hormone deficiency or hypothyroidism (historically known by the moniker myxedema for a type of puffy swelling and rash in the legs) is progressive destruction of normal hormone-producing tissue by the process of colloid degeneration. Owing to the metabolic role of thyroid hormone, most body functions slow as a result of this deficiency, resulting, for example, in a slow pulse and weight gain. For the brain in general, somnolence and depression may be accompanied in extreme cases by a derangement of mentation known as 'myxedema madness'.

Under normal circumstances, the anterior pituitary gland, stimulated by the hypophysis, an adjacent brain control center, plays a key role as the 'master gland' in regulating hormone production. When the thyroid gland is flagging, the master gland increases its production of TSH (thyroid stimulating hormone), a messenger that is excreted into the bloodstream, targeted to increase the peripheral gland's production to normal levels. Fortunately, the robust sensing mechanism in the hypophysis and pituitary, not impaired by the metabolic slowdown elsewhere, produces high levels of blood TSH so reliably that a simple blood test can be used as the best test for the hypothyroid state. 


Recent grandiose thoughts you have had —

You're the Hulk, Gandhi or George Bush (dad);

'Then a seizure grand mal;

Cause: diffuse lesions small — *

That's cerebral metastases — Bad!
*(High-dose steroids and rads,
Bring some respite, still sad).
Dr G.H. and Giorgio Coniglio, 2022


General paresis (insane),

Syphilitic late syndrome, now plain,

Younger men it was killin'

(Era pre-penicillin).

I hope we won't see it again!
Dr.G.H. and Giorgio Coniglio, 2022
Authors' Note:
paresis: weakness or fatigue
General paresis of the insane, known by the initialism GPI, was recognized as a distinct disease in 1822, and considered by the Victorians to be a form of madness in persons, primarily men, of dissolute character. It took another century until it was confirmed that it was caused by spirochetes, causative organism for syphilis, damaging the brain in the late (tertiary) stage, and that its progression could be halted by antibiotics such as anti-malarial arsenicals and, after 1940, penicillin. Once a relatively common problem on a global scale, GPI now seems to be confined to developing countries.


There's a latent disease jocks should dread:

CTE — caused by blows to the head.

It's like Alzheimer's (early),

You're confused and act surly.

Diagnosis? That's made when you're dead.

Contact sports are the field that you tread?

Tackle broadcasting fieldplay instead.
Dr.G.H. and Giorgio Coniglio, 2022   OEDILF#119223
Authors' Note:  Although military recruits and physically abused spouses also number among the victims of this disease of insidious onset, (characteristically diagnosed with certainty only at post-mortem examination), it is the scourge of those who earlier in life indulged in contact sports, particularly those with a risk of repetitive minor brain trauma.

Everything that you wanted to know about chronic traumatic encephalopathy can be found in the author's note appended to MikeAq's verse on the subject.


High-dose steroids may cause symptoms manic,

Whereas other minds shrivel or panic.

Increased suicide rates —

(Tapered dose, that abates)

Side-effect, 'til you're done, looms titanic.

Dr G.H. and Giorgio Coniglio, 2022
Authors' Note: A course of high-dose synthetic corticosteroids, e.g. dexamethasone, may be used to help bring under control a severe exacerbation of a chronic illness, e.g. asthma, inflammatory diseases, or an initial presentation, e.g. anaphylaxis, septic shock or brain swelling. Owing to the common side-effect of drug-induced euphoria/mania and other psychiatric issues, doctors attempt to taper the high doses as soon as possible.


"Back a spell, had a spill." Recall's hazy;

Two months passed, Hazel's ill and acts crazy.

Then a CAT-scan referral

Found her chronic subdural.

That flaw fixed, she feels fresh as a daisy.
 Dr G.H. and Giorgio Coniglio, 2022
Authors' Note: A chronic subdural hematoma is a space-occupying intracranial lesion resulting from the body's failure to resorb blood that collected between the dural membrane and the brain parenchyma, usually caused by traumatic head injury. Whereas an initial expanding clot presents as a neurosurgical emergency, smaller clots, with a tendency to absorb fluid and expand gradually, may be later suggested only by chronic neuropsychiatric symptoms. In jargon used in actual medical settings and in televised fictional series, the term for the lesion responsible may be shortened to subdural.

In elderly patients, such as Hazel, and in those on blood-thinning drugs, the trauma required to incite events such as those in this tale may be minor or even subliminal.


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