Tales from the crypt

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Dear Editor,

I do recall from my days at medical school that many pathologists would be in a drunken state when undertaking post mortem. But after 20 years,  I thought they would have cut back on the high wine as they undertake the important job of establishing cause of death. Clearly, rather than cutting back they have doubled up. For the evidence can be found in a Post-Mortem undertaken on Dannie Persaud by Dr. Nehaul Singh, where the cause of death was established as gastritis. The reality is, that young man was more likely to die from a lightning strike than gastritis. That gastritis story is absolute hogwash.

Firstly, gastritis is inflammation of the stomach which in the context of Dannie Persaud was likely down to alcohol. More often than not gastritis may cause some stomach upset leading to vomiting with the occasional streaks of blood. Very rarely, gastritis will cause significant bleed which would be evident in the person’s vomitus and faeces. It is very unusual for a fit labourer to have been vomiting blood and fainted, yet the blood was not evident to observers. Further, a young and fit man like Dannie Persaud, would cardiovascularly compensated very well from bleeding and is unlikely to faint from a little bleeding.

Therefore, the gastritis story is absolute Nansy Story that surely has Dr. Mootoo turning in his grave.


Then the police report quoted Dr. Nehaul Singh as saying this;

“It must be noted that the condition gastritis stomach is a result of bleeding in the stomach which causes bleeding in the brain and led to the victim becoming dizzy, fell and hit his head,”

For Christ sake, what is the pathophysiological link between stomach bleed and a brain bleed? Absolutely none in this case. Absolutely none unless Mr. Persaud had low platelets from alcohol. And in that case he would have been bleeding everywhere.

Certainly, this young man must be allowed to rest in peace with a logical cause of death and here I will present it. Mr. Dannie Persaud, you died from a catastrophic brain bleed likely as a result of falling while intoxicated. In the absence of significant blood in your stomach, around the immediate environs where you were found or melaena, the gastritis played little role in your death. Further Mr. Persaud,  in view of you being discovered unconscious in a private residence, your death should be investigated by the police and the coroner to rule out foul play. Finally, may you haunt those who got your cause of death wrong.

Dr Mark Devonish MBBS MSc. Med. Ed. FRCP(Edin)  FRCP
Consultant Acute Medicine 
Nottingham University Hospital

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