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Dr. Sherman Hershfield woke up one morning and was surprised to find himself behind the wheel of his car. Somewhere between his Beverly Hills apartment and his practice in the San Fernando Valley, the silver-haired physician had blacked out. Somehow he’d avoided a crash, but this wasn’t the first time. “I didn’t know what was going on,” he admitted.

Apart from his frequent blackouts, Hershfield was in fine health for a man in his 50s. He was tall and lean, ran six miles a day, and was a strict vegetarian. “I believe a physician should provide exemplary motivation to patients,” he once wrote. “I don’t smoke and have cut out all alcohol.” Hershfield specialized in physical medicine and rehabilitation, and for decades had helped patients with brain injuries learn to walk again and rebuild their lives. Even with his experience, Hershfield didn’t know what was wrong inside his own head.

Perhaps the mystery blackouts were caused by stress, he wondered. Hershfield was the medical director of the rehab center at the San Bernardino Community Hospital, but he also ran a private practice 76 miles away in Winnetka, offering nonsurgical spinal treatments. “Sometimes I worked from 6 a.m. to 3 a.m.,” he recalled, adding that the pressures had cost him his first marriage. At the hospital, Hershfield often slept in the doctor’s lounge, where colleagues nicknamed him “Dr. Columbo,” after the disheveled television detective.

Not long after the blackouts started, Hershfield suffered a grand mal seizure—the type most people imagine when they think of seizures. He was driven to the emergency room, thrashing and writhing like a 6-foot-4-inch fish pulled out of the water. Concerned doctors at the UCLA Medical Center rushed him into an MRI machine and, this being the late 1980s, wondered whether he might have pricked himself with a needle and contracted AIDS. Instead, the scan revealed that his blackouts were actually a swarm of small strokes, and his illness was diagnosed as antiphospholipid syndrome. Hershfield’s immune system was mistakenly creating antibodies that made his blood more likely to clot. Those clots, if they entered his bloodstream and brain, could kill him at any moment.

Doctors prescribed blood-thinning medication and forced Hershfield to quit driving, but he was still fit to practice medicine. Like many other survivors of stroke, he sometimes stuttered, and his speech became slurred. His personality also seemed to change. He suddenly became obsessed with reading and writing poetry. Soon Hershfield’s friends noticed another unusual side effect: He couldn’t stop speaking in rhyme. He finished everyday sentences with rhyming couplets, such as “Now I have to ride the bus. It’s enough to make me cuss.” And curiously, whenever he rhymed, his speech impediments disappeared.

STROKE, or “brain attack,” can happen to any of us at any time. One occurs every 40 seconds in the United States. Strokes can lead to permanent disability and extraordinary side effects: Some patients become hypersexual or compulsive gamblers. Others have even woken up speaking in a fake Chinese accent. “There was a famous guy in Italy who had what they called ‘Pinocchio syndrome,’” said Alice Flaherty, a joint associate professor of neurology and psychiatry at Harvard Medical School. “When he told a lie, he would have a seizure. He was crippled as a businessman.”

One of Flaherty’s most famous cases is that of Tommy McHugh, a 51-year-old British man who suffered a subarachnoid hemorrhage—a stroke caused by bleeding around the brain. McHugh’s stroke changed his entire personality. A grizzled ex-con, he became deeply philosophical and spent 19 hours a day reading poetry, speaking in rhyme, painting, and drawing. He’d never been inside an art gallery before, he joked, “except to maybe steal something.”

For Hershfield, a love of poetry was also completely out of keeping with anything in his past. He was born in Winnipeg, Canada, in 1936, and while his mother was a concert pianist, he followed his father into medical school, graduating in 1960. In Flin Flon, a Canadian mining city, he mended the heads of injured hockey players, then became a resident at the University of Minnesota before serving in the U.S. Army Medical Corps. In 1973, he arrived in Southern California and set up his practice, where he had little time for reading anything but medical journals.

His problems started during the medical-malpractice crisis of the 1970s. Lawsuits against doctors became popular, and the annual cost of Hershfield’s liability insurance rose from $864 to $3,420. In protest, he quit working all but emergency cases, and took a job frying fish at Thousand Oaks Fish and Chips for $2 an hour. Newspapers across America wrote about the doctor who fried fish while wearing hospital scrubs; one noted that Hershfield “looked like he was about to have four cod fillets wheeled into surgery.” He explained: “I’ve always been a person of high moral values. I’ve thought, what the hell do I want out of life? And it comes out, I want to be happy.”

Hershfield did return to medicine, but things went from bad to worse when his business partner and best friend started to abuse drugs. “He was an excellent surgeon, a handsome man who had everything going for him … but he was unable to control his fears and constant bouts of withdrawal and depression, and he tried five times to take his life,” Hershfield recalled. He was there when his friend’s heart finally stopped, after six days on a respirator.

Read the whole, terribly interesting and informative story here:
https://www.theatlantic.com/health/archive/2019/01/doctor-rapp/579634/

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