windsurfing on my homemade board
windsurfing on my homemade board
I graduated from the University of Toronto in Jan 1943 in the first accelerated group during WWII. I then did a rotating internship for 8 months at St. Joseph’s Hospital, following which I was in the RCAMC, and sent to Camp Borden to the A22 Training setup for doctors, and other medical personnel for 6 weeks. I was then seconded to the T&S Wing of the Armoured Corps at Camp Borden in the Regimental Aid Post for about 1 year and then to the #1 Training Corps of the Armoured Corps in Camp Borden in charge of the Regimental Aid Post for another year where I was also responsible for the Dental Corps and the Engineering Personnel.
I applied to take a course in Psychiatry in late 1944, by sending an application letter through the camp medical office. This was accepted and I took a 6-month course in Neurology and Psychiatry in Toronto for 2 months each at the Toronto Psychiatric Hospital, the Toronto General Hospital, and Christie Street Hospital (for veterans of the armed services). The European war ended before the end of this course, and I and 4 others were seconded to Christie St. Hospital in the Neurology and Psychiatry unit to help look after the patients there. This later continued at the new Veterans Hospital – Sunnybrook beginning in late September 1947. I then took a 2-month course at the Montreal Neurological Institute, and the Queen Mary Veterans Hospital in Montreal in Electroencephalography, under Dr. Herbert Jasper and Dr. John Kershman. Here I met and saw many of the other staff on the MNI and observed Dr. Wilder Penfield one morning performing an operation to relieve epilepsy on a patient, while Dr. Jasper did the EEG recording at that time.
I stayed with Sunnybrook until the end of 1968, when it was taken over by the University of Toronto reading the EEGs as a consultant, and had joined the staff of St. Joseph’s Hospital in 1950, becoming on the active staff when I received my certification in Psychiatry in 1952. I stayed there since, having been elevated to the Honorary Staff in 1992. Since that time I have attended patients in my private office until closing my office July 15, 1999,
My interest in Narcolepsy was started in 1948 by seeing a patient with the condition who told me that he had nightmares of his teeth coming loose and rolling around like marbles in his mouth. These occurred as he awoke from this nightmare, and he at the time had waking sleep paralysis. I suggested that must have been a funny feeling and he agreed. I then read some to the extant literature of the time.
I then recalled that my mother used to doze off in church and when I was seven years of age she would ask me to nudge her so her head would not droop in church. I did. I later noticed that when I did not behave and she was annoyed with me that her face would sag, and her head would bob and sway for a short time, at the end of which she would give me her verbal abuse very politely.
Some years later when I was in practice she became quite angry and had to sit down once. After this I placed her on Benzedrine 5mg am & noon, and she had less of the cataplexy, and could have her afternoon naps without dreaming of driving her grandmother’s horses through the sap bush in the spring.
I added up the number of patients I saw with Narcolepsy or suspicions of it from 1950 to 1965 while I practiced at 226 Roncesvalles Ave., Toronto and they amounted to 3113 in number. I then moved my office to Bloor St. W. and I have never yet added all the patients from 1965 to 1982 into a database. Since 1982 I have seen 3771 patients and of them 1340 had symptoms of Narcolepsy.
I became aware in 1977 about the Sleep Researchers who set up the present criteria for diagnosis of Narcolepsy. I eventually got a copy of Dement et al,’s article "The nature of the narcoleptic attack." I did not agree with their conclusions.
This was nothing new with me, as I had read Freud’s works (some of them) for 6 months in 1945, and had come to the conclusion that his conclusions were illogical, and quit believing his theories. I also thought that seeing a patient 5 days a week for 50 minutes at a time for 5 years, would bore me and the patient terribly and that there must be some shorter way to treat. This opinion of mine did not make me popular in this city, as many believed in Freud’s ideas.
Having seen Dr. W. Penfield stimulate the brain to find where the focus of abnormality was, and to see where other important areas were that he did not wish to remove to treat the patient’s epilepsy, and thinking about the psychiatric syndromes, which at this time were mentioned as occurring in families; led me to conclude that all mental illness occurred in the brain and that the chemistries of the connections were involved. This opinion made me less popular than ever as at this time in the mid 1950's we had 40+ psychoanalysts here in Toronto, and they had all the good jobs in psychiatry in charge of the new psychiatry wards in general hospitals, and in charge of the mental hospitals as well.
I continued on giving Electroshock treatment for depression, and using barbiturates for tense patients, and sleeping difficulties.
The planners could not leave well enough along as they decided the barbiturates were too dangerous to give patients, and brought up the benzodiazepenes as the answer to the treatment of neurotic conditions, and insomnia. After awhile these lost favour and then the latter were only supposed to be used for 2 weeks in a lifetime to treat chronic or acute insomnia, and that one is supposed to use sleep hygiene to learn to go to sleep. I have seen no statistics from those who seem to like sleep hygiene so well, about how many are improved by using sleep hygiene. My patients who have tried it told me it did not work.
I had a kidney stone one spring (1976), and went to a hospital, where I was given Demerol 75mg q3h. I told the doctor the next am that was not enough often enough–that qs. on a prescription meant enough often enough. He gave me Demerol 100mg q3h. I have news for you and all others, this only lasted 2 ½ hours, and then the nurse will not repeat it till the 3 hours are up, and then you have to wait another 20 min or so till it starts to relieve the pain. After about 10 days for some reason the acute pain which only occurred at night with me, stopped and I went home to pass the stone some 10 days later without pain, for which I was very grateful. When the pain was worst I thought that there was a white-hot electric wire in my right side that was short circuiting the generating station at Niagara Falls.
I wrote a book "The Mask of Wakefulness," or "So You Think You’re Awake," and sent or gave it to 303 doctors, patients, and friends. 43% of doctors and 53% of the patients and friends answered. 90% of both of these groups thought that it was good, they learned more about this illness, and said I should publish it. The majority of this book was presented at the Eastern EEG Association Meeting at Val David in 1993. I was told by one doctor there that it was well received.
I also wrote "A Simple Theory of Mental Illness," a short monograph, which describes the fact that patients decide their ways of behaving. I have never noted that the classic theories of mental illness ever have allowed the patient to think and make up his/her mind.
I then after talking to the 1300+ Narcoleptic patients at some time along the way I wrote "Scenarios of Behaviour" in Narcolepsy, and gave it to all my patients and sent it to many family doctors who were seeing them. The patients when asked if this was the story of their life, agreed and when asked what percentage, would tell me their estimate, which is listed at the end of this monograph. I presented "A Simple Theory" & "Scenerios of Behaviour" at the 1995 meeting of the Clinical Research Society of Toronto. I had no slides, and one doctor asked why, and I said the monograph did not need slides, and he said "Yes it was the voice of experience."
I later wrote the "Narcoleptic Diagnostic Myths" and presented this at the Eastern EEG Association meeting at Mt. Gabriel in 1995, as a poster presentation at the Canadian Congress of Neurology in London, Ont. In Jun. 1996, and at the Ont. Psychiatric meeting in Toronto in Jun. 1997. It was well received.
Some of the above-mentioned monographs are listed at the side and can be accessed here, and downloaded if you wish. The book is being updated and it will take some time to do all the charts using the increased numbers of patients.
Yours,
Errol B Cahoon, M.D., D.Psych., F.R.C.P.C.
May 9, 2004.
I finally closed my office on Jul 19, 1999. I have been writing letters for my patients ever since to help them maintain their disability pensions, and to their new doctors, when they have to get new doctors, giving the doctors the patients histories.
I also send my business card with the letter, so they can if they wish, read my web site, which is <www.gta.igs.net/~ecahoon>. Be my guest and try it yourself. Let me know if you like it or hate it, and the reasons why.