Box Turtle Bulletin

The Daily Agenda for Monday, December 12

TODAY IN HISTORY:
Danish Surgeon Dies Of Mysterious Disease: 1977. Dr. Grethe Rask was a formidable and indomitable woman who was as intense as she was relentless in the care that she gave to her patients in the remote Zairian villages near the Congo River basin. She first went to a primitive rural hospital in northern Zaire in 1972 delivering much-needed surgery to her patients amid appalling poverty and severe shortages. Everything was in short supply: syringes, antiseptics, even surgical gloves. Supplies were used and re-used until they wore out, and it wasn’t unusual for her to perform emergency surgeries with her bare hands. After putting together a simple jungle hospital in the remote village of Abumombaz and bringing it into operation, she took on a job as head surgeon at the Danish Red Cross Hospital in Kinshasa in 1975. A fellow doctor and friend, Dr. Ib Bygbjerg, became worried over Gerthe’s weight loss. She was suffering from persistent diarrhea and fatigue, but given the host of often unknown tropical diseases which were common in northern Zaire, her condition was easily overlooked at first. But when standard treatments only temporarily alleviated the symptoms without actually restoring her health, Bygbjerg looked further and found that her lymph nodes, the glands that play an essential role on the body’s immune system, were completely out of whack. They had been swollen for nearly two years for no apparent reason.

In July 1977, Grethe took a vacation to South Africa to try to rest up from her constant fatigue, but her condition got worse. She became short of breath and was flown immediately back home to Denmark. Some of Denmark’s best doctors worked frantically to try to figure out what was wrong with her, but the more they looked, the mysteries surrounding her health only deepened. The inside of her mouth was covered with yeast infections, staph infections spread throughout her body, and blood tests showed that her T-cells, which are the main component of a body’s immune system, were completely gone. When that happens, the natural assumption was lymph cancer, but biopsies ruled out that as a cause for her immune system’s collapse. On December 12, her body finally gave out and she died.

An autopsy revealed that her lungs were filled with Pneumocystis carinii, a yeast-like fungus which causes a severe pneumonia. Because it is one of the easiest organisms for an immune system to fight off, it is extremely rare in healthy people. And even in the rare cases where people did catch it, it was usually treatable. It’s one of those diseases that nobody dies from, but Gerthe did. It was just one more conundrum added to a host of mysteries.

Five years later,  gay men, Haitians, hemophiliacs, and intravenous drug uses also began to die in very large numbers of the same type of pneumonia that people almost never caught, let alone died from before.  This time, Pneumocystis carinii pneumonia became so common its acronym, PCP, entered into the lingo of the gay community along with KS (Kaposi’s sarcoma, a previously rare form of cancer), and AIDS. American epidemiologists were mostly looking at AIDS as an American disease however, and with most of the people coming down with AIDS coming from stigmatized populations, the disease itself was similarly stigmatized. It was, in the popular mind anyway, a “gay plague.” But in 1983, Dr. Bygbjerg recalled his colleague and friend, and had in mined a more likely source for the disease. He published Gerthe’s medical case history in the April 23, 1983 issue of The Lancet and concluded:

“During my stay in Zaire in 1976 I was impressed by the epidemiological and virological flying teams from the USA and Europe who quickly identified Ebola virus. Perhaps such teams should search for another African virus, albeit slow killing, and explore the possible connection between endemic and epidemic AIDS/KS in Africa and America.”

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As always, please consider this your open thread for the day.