Survival
Authors: M D Zimmerman, K Appadurai, J G Scott, L B Jellett, F H Garlick
Journal: Annals of Internal Medicine (1997)

On Being a Patient1 September 1997SurvivalMark D. Zimmerman, MD, Kana Appadurai, MBBS, MRCP(UK), James G. Scott, MBBS, Leon B. Jellett, MDBS, FRACP, FRACMA, and Frank H. Garlick, MS, FRCS, FRACSMark D. Zimmerman, MDPatan Hospital; Katmandu, NepalWestlake, AustraliaRoyal Brisbane Hospital; Brisbane, AustraliaIpswich, AustraliaAspley, AustraliaSearch for more papers by this author, Kana Appadurai, MBBS, MRCP(UK)Patan Hospital; Katmandu, NepalWestlake, AustraliaRoyal Brisbane Hospital; Brisbane, AustraliaIpswich, AustraliaAspley, AustraliaSearch for more papers by this author, James G. Scott, MBBSPatan Hospital; Katmandu, NepalWestlake, AustraliaRoyal Brisbane Hospital; Brisbane, AustraliaIpswich, AustraliaAspley, AustraliaSearch for more papers by this author, Leon B. Jellett, MDBS, FRACP, FRACMAPatan Hospital; Katmandu, NepalWestlake, AustraliaRoyal Brisbane Hospital; Brisbane, AustraliaIpswich, AustraliaAspley, AustraliaSearch for more papers by this author, and Frank H. Garlick, MS, FRCS, FRACSPatan Hospital; Katmandu, NepalWestlake, AustraliaRoyal Brisbane Hospital; Brisbane, AustraliaIpswich, AustraliaAspley, AustraliaSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-127-5-199709010-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The following account was written by James G. Scott.Case HistoryWhen my ordeal began, I was 22 years old. I had come to Nepal from Australia 5 weeks before to do my senior year elective for medical school and to hike in the Himalaya. Several months before leaving home, I had become engaged. At home, in addition to studying, I trained as many as 10 hours per week in various sports, especially karate (in which I had competed at an international level).At the suggestion of local physicians, I spent the first 2 weeks hiking and climbed to an ...References1. O'Connor A, Johnson-Sabine E. Hunger strikers. Med Sci Law. 1988; 28:62-4. Google Scholar2. Frommel D, Gautier M, Questiaux E, Schwartzenberg L. Voluntary total fasting: a challenge for the medical community Lancet. 1984; 1:1451-2. Google Scholar3. Falzi G, Ronchi E. Wernicke's lethal encephalopathy in voluntary, total, prolonged fasting. Forensic Sci Int. 1990; 47:17-20. Google Scholar4. Pentland B, Mawdsley C. Wernicke's encephalopathy following “hunger strike.” Postgrad Med J. 1982; 58:427-8. Google Scholar5. Devathasan G, Koh C. Wernicke's encephalopathy in prolonged fasting [Letter] Lancet. 1982; 2:1108-9. Google Scholar6. Waterston JA, Gilligan BS. Wernicke's encephalopathy after prolonged fasting. Med J Aust. 1986; 145:154-5. Google Scholar7. Souba W, Wilmore D. In: Shils ME, Young VR, eds. Modern Nutrition in Health and Disease. 7th ed. Philadelphia: Lea & Febiger; 1988:1314-24. Google Scholar8. Soares MJ, Shetty PS. Basal metabolic rates and metabolic economy in chronic uncernutrition. Eur J Clin Nutr. 1991; 45:363-73. Google Scholar9. Shimizu H, Miyazaki M, Shimomura Y, Kobayashi I. Alterec hormone status in a female deprived of food for 18 days. J Med. 1991; 22:201-10. Google Scholar10. Alleyne GA. Protein-Energy Malnutrition. London: Arnolc. 1977:93-103. Google Scholar11. Solomon SM, Kirby DF. The refeeding syndrome: a review. JPEN J Parenter Enteral Nutr. 1990; 14:90-7. Google Scholar12. O'Connor LR, Wheeler WS, Bethune JE. Effect of hypophosphatemia on myocardial performance in man. N Engl J Med. 1977; 297:901-3. Google Scholar13. Knochel JP. Complications of total parenteral nutrition. Kidney Int. 1985; 27:489-96. Google Scholar14. Heath D, Williams DR. Man at High Altitude: The Pathophysiology of Accimatization and Adaptation. 2d ed. Edinburgh: Churchill Livingstone. 1981:216. Google Scholar15. Cahill GF Jr. Starvation in man. N Engl J Med. 1970; 282:668-75. Google Scholar16. Hoffer L. Starvation In: Shils M, Young V; eds. Modern Nutrition in Health and Disease. 7th ed. Philadelphia: Lea and Febiger. 1988:774. Google Scholar17. Apovian CM, McMahon MM, Bistrian BR. Guidelines for refeeding the marasmic patient. Crit Care Med. 1990; 18:1030-3. Google Scholar18. Holy Bible. New Revised Standard Version. Dt. 9:9, 1 Kings 19:8, Lk 4:2. Google Scholar19. Victor M, Adams RD, Collins GH. The Wernicke-Korsakoff Syndrome. 2d ed. Philadelphia: FA Davis, 1989. Google Scholar20. Skelton WP 3d, Skelton NK. Thiamine deficiency neuropathy. It's still common today. Postgrad Med. 1989; 85:301-6. Google Scholar21. Drenick EJ, Joven CB, Swendseid ME. Occurrence of acute Wernicke's encephalopathy during prolonged starvation for the treatment of obesity. N Engl J Med. 1966; 274:937-9. Google Scholar22. Handler CE, Perkin GD. Anorexia nervosa and Wernicke's encephalopathy: an underdiagnosed association [Letter] Lancet. 1982; 2:771-2. Google Scholar23. Roche SW, Lane RJ, Wade JP. Thalamic hemorrhages in the Wernicke-Korsakoff syndrome demonstrated by computed comography [Letter]. Ann Neurol. 1988; 23:312. Google Scholar24. Lindberg MC, Oyler RA. Wernicke's encephalopathy. Am Fam Physician. 1990; 41:1205-9. Google Scholar25. Roud PC. Psychosocial variables associated with the exceptional survival of patients with advanced malignant disease. Int J Psychiatry Med. 1986-87; 16:113-22. Google Scholar26. Kahana E, Kahana B, Harel Z, Rosner T. In: Wilson J, Harel Z, Kahan B, eds. Human Adaptation to Extreme Stress: From the Holocaust to Vietnam. New York: Plenum Pr; 1988:55-79. Google Scholar27. Stein S, Linn MW, Stein EM. Psychologic correlates of survival in nursing home cancer patients. Gerontologist. 1989; 29:224-8. Google Scholar28. Siegel BS. Love, Medicine, and Miracles: Lessons Learned about Self-Healing from a Surgeon's Experience with Exceptional Patients. New York: Harper and Row; 1986. Google Scholar29. Pearlin L, Schooler C. In: McCubbin HI, Cauble AE, eds. Family Stress, Coping, and Social Support, Springfield, IL: Thomas; 1978:109-35. Google Scholar30. Glassman J. The Cancer Survivers. New York: Dial Pr; 1983. Google Scholar31. Herman JL. Trauma and Recovery. New York: Basic Books; 1992:57-61. Google Scholar Author, Article, and Disclosure InformationAuthors: Mark D. Zimmerman, MD; Kana Appadurai, MBBS, MRCP(UK); James G. Scott, MBBS; Leon B. Jellett, MDBS, FRACP, FRACMA; Frank H. Garlick, MS, FRCS, FRACSAffiliations: Patan Hospital; Katmandu, NepalWestlake, AustraliaRoyal Brisbane Hospital; Brisbane, AustraliaIpswich, AustraliaAspley, AustraliaCorresponding Author: Mark D. Zimmerman, MD, Patan Hospital, Box 252, Katmandu, Nepal.Current Author Addresses: Dr. Zimmerman: Patan Hospital, Box 252, Katmandu, Nepal. Dr. Appadurai: 274 Horizon Drive, Westlake QLD 4074, Australia. Dr. Scott: Royal Brisbane Hospital, Herston Road, Brisbane QLD 4029, Australia. Dr. Jellett: First Floor, Office Tower, Westway Centre, Gordon Street, Ipswich QLD 4305, Australia. Dr. Garlick: 27 Chartwell Street, Aspley QLD 4034, Australia. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byImplications of preoperative hypoalbuminemia in colorectal surgeryTube Feeding in Dementia: How Incentives Undermine Health Care Quality and Patient SafetyFolic acid in alcohol-withdrawal deliriumImmunonutrition: an updateEnteral Nutrition in the Critically III Patient: A Practical Approach 1 September 1997Volume 127, Issue 5Page: 405-409KeywordsAlbuminsEatingFatsFoodNystagmusPhosphatesProteinsResearch laboratoriesStarvationThiamine ePublished: 15 August 2000 Issue Published: 1 September 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...