When did you meet Mickey?
1971
Where did you meet him?
USAF Hospital, RAF Lakenheath, Suffolk, England
Memory of Mickey
I was watching “Eyes on the Prize” last night and could hardly stop thinking about friend Mickey. I remember probing him after dinners at Lidgate Hall to explain for me what I needed to know about the Civil Rights movement in America. You see, I was 12 when LBJ signed the Voting Rights Act in 1964. My worldview was perfectly solipsistic while friend Mickey had been paying attention throughout the period. By the time he and Sharon “adopted” me, I was 19 and beginning to pay attention and certainly had impressions and concerns of the then current social and political milieu (Richard Nixon was our Commander in Chief for goodness sake!). As all who have contributed to these pages will attest, Mickey’s assessment of very nearly anything at all was thorough, measured, well supported with data , engaging and, though he might be ill-at-ease with this characterization, NEVER wrong!
I enjoyed a lot of quality time with Mickey, Sharon, and Abby back then and it has been an ongoing and much cherished gift across the lifespan. In keeping with a theme noted by other contributors, I include photos of Mickey and my ‘chilren (as Al would say). On 10/28/98, Dr. Mickey arrived in the delivery room a few minutes after my son, Eric emerged from the womb…he’d brought a sack of fried chicken from the Church’s up the street from the hospital in Decatur! I love the picture of Mickey and Kate doing crafts that Mickey brought along; he genuinely liked the company of children and they sure did reciprocate that sentiment.
Y’all should have been there the day he diagnosed a case of Rocky Mountain Spotted Fever in rural Suffolk, England! His brilliance shall not soon diminish given how much he gave to so many. What a man, our friend Mickey.
Carl,
Those photos are treasures! Also, thanks for reminding me about the case of Rocky Mountain Spotted Fever. As I recall some doctors from Cambridge drove over to RAF Lakenheath to see the patient with the disease they’d never seen. Not too much of that going around in England!
Dearest Sharon,
Thinking of you ever_day. Thanks for leaving me a message (!)…it hepped.
xo_carl
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From Physiopedia:
http://www.physio-pedia.com/Rocky_Mountain_Spotted_Fever
These quotations:
Prevalence
United States
Between 1993 and 1996, there were 1253 reported cases of Rocky Mountain Spotted Fever (RMSF). This amount of confirmed incidence is roughly 2.2 cases per million. [1] Since that time period there has been some increase in confirmed cases. In 2008, the number of cases jumped to approximately 8 per million. However, the number of fatalities has decreased and currently is about 0.5%.
“Worldwide
Other cases of RMSF have been confirmed in Canada, Mexico, Central America, Columbia, as well as Brazil. Currently, there haven’t been any confirmed cases of RMSF beyond the boarders (sic) of the American continents.[3]”
So, it seems the authors missed the confirmed diagnosis of RMSF by Dr. Mickey in England around 1972. Hope the National Health people don’t get complacent. Maybe we should warn the unsuspecting Brits given that Mickey isn’t especially likely to let them know, at least not in modalities we are used to.
Here’s an even better paper for anyone wishing to bone up on Rocky Mountain Spotted Fever !>)
http://emedicine.medscape.com/article/228042-overview#a4
“There have been no documented cases of RMSF infection outside of the Americas.”
Tell you what, this brief (albeit welcome) distraction has certainly brought home for me the magnitude and reach of Mickey’s diagnostic prowess. Rocky Mountain Spotted Fever really did not then and does not now occur “outside of the Americas”. Moreover, though my memory is a bit fuzzy on this point, I don’t recall that Mickey ever actually saw a case of it in med school though it’s possible, to wit:
“Even though the disease is known as Rocky Mountain spotted fever, it is more commonly found in the eastern United States. Georgia, Maryland, North Carolina, Oklahoma, South Carolina, Tennessee, and Virginia are among the states that have confirmed the largest number of cases.”
Nevertheless, differential diagnosis needs candling against:
Meningoceccemia[2][3]
Enteroviral infection[2]
Typhus[2]
Ehrlichiosis[2]
Immune complex vasculitis[2][3]
Typhoid fever[2][3]
Leptospirosis[2]
Dengue[2]
Infectious mononucleosis[2][3]
Bacterial sepsis[2][3]
Gastroenteritis[2][3]
Bronchitis[2][3]
Pneumonia[2][3]
Hepatitis[3]
Idiopathic Thrombocytopenic Purpura[3]
Meningitis[3]
Henoch-Schonlein Purpura[3]
Kawasaki Disease[3]
Measles[3]
Rubella[3]
Syphilis[3]
Ehrlichiosis[3]
Lyme’s Disease[3]
Q Fever[3]
Relapsing Fever[3]
Tularemia[3]
Toxic Shock Syndrome[3]
Influenza[3]
Entervirus infection[3]
Disseminated gonococcal infection[3]
Drug hypersensivity[3]
Staphylococcal sepsis[3]
Murine typhus[3]
Rickettsialpox[3]
Recrudescent typhus[3]
Sylvatic flying squirrel-associated Rickettsia prowazekii infection[3]
And that’s for where it is likely to occur! It simply doesn’t happen in rural Suffolk, England.
I remember the patient, a career non-commissioned officer, white male, 40yrs, presenting at the Internal Medicine Clinic. Didn’t take Mickey long at all to determine that he’d been on leave in CONUS (the continental United States) and had been out fishing in the puckerbrush somewhere (where ticks happen). Amazing really when you think about it.