Russell Farris and Per Marin MD PhD book review by David Wheldon MB FRCPath
This book explains how common, non-resolving intracellular infections can, over long periods of time, subvert the body's defences by causing chronic elevation of cortisol while provoking chronic activation of pro-inflammatory cytokines; this has serious repercussions, including type II diabetes, atheroma and heart disease. Much of what we put down to ageing is caused by chronic infection.
When I started as a clinical medical student in Bristol, England, I joined my colleagues and went to the appointed ward. We were still known as 'clerks' then. The ward was in a huge and antiquated eighteenth century building. We democratically elected a 'Head Clerk' who allocated patients to us. We then 'clerked' our patients, in our naïve way, stumbling though primers of examination technique. So much had to be learned in so short a time. One of the consultants was known to be pleasant and a good teacher; the other was feared for his mordant sarcasm. My first patient was a small man of 42; he smiled at me with amazingly friendly eyes. 'They've given me you, have they?' He lay propped on pillows; he couldn't find the breath to sit up. The slightest exertion exhausted him. Finding the energy for bodily functions, even with the help of several nurses, was an agony of breathlessness. Over the years he had become a cardiac cripple; a series of myocardial infarctions had removed most of the muscle of his heart; the lost muscle had been replaced by a fibrous sac which blew in and out with each beat, effectively reducing his cardiac function even further. He had the stigmata of hyperlipidaemia, including yellowish streaks on both upper eyelids. He had uncontrollable diabetes. He was unfailingly friendly even when I made a botch of drawing blood from his veins. His intravenous lines never lasted very long before they clotted. We got on together very well. I never heard him complain once about his predicament........................................................................