Providentia

Understanding Infantile Amnesia

Given the profound influence that early life experiences can have upon psychosocial functioning later in life, it is intriguing that most adults fail to recall autobiographical events from their early childhood years. Infantile amnesia is the term used to describe this phenomenon of accelerated forgetting during infancy, and it is not unique to humans. Over the years, information garnered from animal studies has provided clues as to the neurobiological basis of infantile amnesia. A new review published in the journal Behavioral Brain Research  provides a neurobiological update on what is now known about infantile amnesia since the publication of Campbell and Spear’s seminal review on the topic more than 40 years ago. The authors present evidence that infantile amnesia is unlikely to be explained by a unitary theory, with the protracted development of multiple brain regions and neurotransmitter systems important for learning and memory likely to be involved. The recent discovery that exposure to early life stress can alleviate infantile amnesia offers a potential explanation as to how early adversity can so profoundly affect mental health in adulthood, and understanding the neurobiological basis for this early transition may lead to the development of effective therapeutic interventions.

For the abstract

With a Gentle Touch

“See how she leans her cheek upon her hand. O, that I were a glove upon that hand
That I might touch that cheek!”  William Shakespeare

The physical sensation of being touched can have a powerful effect depending on the way you are being touched and who is doing the touching. 

Whether you are being gently stroked by a significant other or receiving  an affectionate touch from a  friend or family member, the pleasure that touch brings is an important part of most social relationships. Even in professional settings, a pleasant handshake helps reinforce the close association we often have with employers and co-workers. Touch can also be important in health care settings with worried patients often feeling reassured by the friendly touch of a doctor or nurse. 

The sensation of being touched can produce a wide range of physiological and biochemical changes in the body including decreased heart rate and blood pressure as well as reduced cortisol (link is external) and increased oxytocin (link is external). MRI studies have also shown that gentle touching can activate key areas of the brain including the orbitofrontal and caudate cortex. Gentle touching  also leads to changes in the brain's serotonin levels which may help explain why massaging can relieve pain.

To read more, check out my new Psychology Today blog post.

Spanish Exorcist Warns of Rise in Vampire Ritual Killings

A Spanish exorcist who had ordered a mass exorcism of the entire country of Mexico in 2015 is warning that recent murders in the country could be part of a new wave of Satanic killings aimed at turning victims into vampires.   Father Jose Antonio Fortea in the official exorcist of the diocese of Alcala de Henares in Madrid.  Well-known for his outspoken views on demonic possession and Satanic influences, Father Fortea points to cases such as the recent murder of 24-year-old Edwin Juarez Palma in warning of the rise of such cases in secular societies.   Palma was reportedly strangled, beaten, and mutilated with a broken bottle at a cyber cafe known as "Freak Shop" in Chihuahua, Mexico.   The body was later found abandoned in a street wrapped in plastic bags, apparently to disguise it as a drug-related murder. 

The three men and one women who have been arrested for the killing are reportedly self-professed Satanists belonging to a sect known as the "Sons of Baphomet."  They chose Edwin Palma due to his fascination with vampires and persuaded him to take part in a ritual intended to transform him into a vampire.  Palma was apparently unaware that he would be killed by the cultists. 

Father Fortea warns that the "vampire fad is very close to Satanism" and that "the more a society  abandons the ways of God, the more cases of Satanism. The more a nation is Christian, there are fewer cases of devil worship."    He blames the current rash of Satanic crimes on the cult of Santa Muerte or "Sacred Death" which is on the rise in Mexico and the southwestern United States.   Despite the active opposition of the Catholic church which regards the cult as "blasphemous", worship of the folk saint, believed to be inspired by pre-Columbian beliefs has grown to millions of followers.   Even though Santa Muerte is a personification of death, believers associate the saint with healing and protection in the afterlife.    Santa Muerte is also seen as a protector of Mexico's sexual minorities who often feel outcast in society.   

The cult of Santa Muerte is also popular with many of Mexico's criminal gangs with images being found in numerous drug houses in Mexico and the United States.  Most worshippers are law-abiding however and allegations of links between Santa Muerte and Satanic cults seem exaggerated.   There is also no indication that Edwin Juarez Palma's murder was linked to Santa Muerte or that his death is part of a greater trend.   The murder has generated outrage from friends and family of the dead man and the cultists responsible face up to forty years in prison if convicted.

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Laying an Egg

Happy Easter to all.  Since I'm otherwise occupied with family matters, I thought I'd rerun this in the spirit of the holiday.

 

England was in full religious ferment during the first few years of the 19th century.  Joanna Southcott was leading a messianic crusade with countless followers revering her as "the Lamb" who would bring them to salvation.  Other prophets like Richard Brothers had their own crusades  promising the imminent coming of God's kingdom on Earth (the English were considered to be God's chosen people).  Tales of signs and wonders proclaiming the impending Second Coming spread widely.

Which brings us to Mary Bateman (a.k.a. "The Yorkshire Witch").  Born Mary Harker on a small farm in North Yorkshire in 1768, Mary had few choices but to go into service (much as Joanna Southcott did).  Unfortunately, Mary was not a particularly good servant and quickly acquired a reputation for petty thieving which got her fired.  As a compulsive liar, thief, confidence artist, and all-around crook, Mary never managed to hold any job for long.  She was a very good actress however and managed to impress people with her claims of supernatural powers.  By 1788, she had set herself up in Leeds as a dressmaker and part-time fortune teller.  Her marriage to John Bateman nearly ended when her husband discovered his wife's criminal past.  On one occasion, she tricked him into going to his home town to see his father who was supposedly ill.  While he was away, Mary sold her husband's clothes to pay off a debt and avoid prison. He eventually joined the militia to get away from his treacherous wife but  later returned.   The two of them then settled down into a larcenous life together (they had four children and Mary was the main supporter of the entire family).

With no other source of income, Mary became a full-time fortune teller and con artist.  Posing as "Mrs. Moore", a seventh child of a seventh child, Mary carried out elaborate schemes to trick victims into handing over their savings to her.  She developed quite a reputation as a local miracle worker who could accomplish amazing things with her powers.  She was also a keen observer of new trends and always trying to find ways to exploit them for her own profit.  When Joanna Southcott's began "sealing" her followers in 1802 (giving them a special token to mark them as being among the 144,000 to be saved according to the Book of Revelation), Mary managed to get one of the markers herself.  It was then that she began one of her most notorious (and profitable) schemes.

Although her reputation as a fortune-teller had begun to suffer (too many of her victims complained), Mary played on her status as one of Southcott's "sealed" to make an amazing announcement. Like many other country women of her time, she kept several hens to supply her with fresh eggs and she claimed that one of them had laid an egg with the inscription "Crist is coming."  Mary announced that she had been granted a vision which told her that her hen would lay fourteen special eggs and that the last one would mark the beginning of the Apocalypse.  As word of this marvel began to spread, more eggs bearing religious inscriptions were laid and crowds quickly gathered (she charged them a penny each to seen her marvelous hens). Not only did the eggs proclaim Christ's coming, but they announced that it would happen very soon which added to the growing hysteria.  Along with making money from displaying the chickens, Mary also began providing pilgrims with special "seals" (a piece of paper bearing the initials "JC") which would guarantee its bearer admission into Heaven following the Apocalypse.  Thousands of visitors came to be saved. 

It's hard to say how long this would have gone on but a skeptical doctor managed to examine one of the eggs and found that the inscription had been written in ink.  When authorities were notified, they staged a raid on the tavern where Mary lived with her chickens.  They caught her red-handed (so to speak) inserting one of her special eggs up the chicken's egg duct so it could be "laid" later.  Mary was arrested and the resulting scandal forced Joanna Southcott to stop sealing her own followers because of the stigma.  

A little thing like public exposure didn't stop Mary Bateman for long.  She simply switched to becoming a practitioner of folk remedies (as well as being an abortionist).  Her services were in high enough demand that the inevitable rumours about the people buying her "medicines" didn't deter other customers.    Two Quaker sisters named Kitchen sought out her services until one of them sickened and died after taking "medicine" that Mary had provided.  When the mother of the two women arrived to deal with her daughter's death, she ended up sickening and dying as well along with her surviving daughter.  All three of them were buried in the same grave.  Although Mary insisted that all three of the Kitchen women had died of the plague, authorities quickly became suspicious.   After their creditors investigated what property was remaining, they found scarcely any furniture or belongings left in the Kitchen sisters' house. 

Amazingly, Mary was able to continue with her frauds despite the suspicion that she had crossed the line from theft to murder.  The previous death of another woman, Rebecca Perigo, was also being investigated after her husband complained to authorities in 1808.  It was the husband, still being fleeced by Mary two years after his wife's death, who arranged for a meeting at which she was arrested by two officers.  A search of Mary Bateman's house turned up items that had belonged to Rebecca Perigo and the Kitchen sisters.  The various ingredients that went into her "remedies" were also found, including poison.  After going on trial at York in 1809, Mary was quickly found guilty of murder despite her repeated claims of innocence.  Desperate to escape hanging, Mary even tried "pleading her belly" (claiming to be pregnant) although a medical examination proved otherwise.

With all her legal options exhausted, Mary Bateman went to the gallows on March 20, 1809.  More than five thousand people turned out for the hanging including many who still believed in her supernatural powers and were convinced that the "Yorkshire witch" would somehow save herself from death.  As the Annals of Yorkshire later described the hanging, Mary "was launched into eternity with a lie upon her lips having denied her guilt to the last".   As was the common practice of the time for executed murderers, her body was turned over the the local medical school for dissection.  There was enough public interest in Mary's corpse for the local hospital to charge money to see the body (more than 2500 people paid threepence each).  Her skin was also tanned and cut into pieces so they could be sold as souvenirs.  Believers in the powers of the ``Yorkshire Witch`` used the skin pieces as talismans (it would have galled Mary to know that she wasn`t making any money from her corpse).

Mary Bateman`s skeleton is still on display at the Thackray Medical Museum in Leeds, England.  Visitors seeing her there can appreciate her presence as a strange sort of testimonial to the power of human gullibility and how easily it can be exploited. 

Killing President Garfield

It was on July 2, 1881, as he was walking through a Washington, D.C. railroad station that President James Garfield was shot in the arm and lower back by a disturbed loner named Charles Guiteau. As the President slumped to the ground, Guiteau cried out "I am the Stalwart of Stalwarts" before being taken into custody. President Garfield was taken to the White House where doctors worked to save his life. Unfortunately, the sixteen doctors who were called in to tend the president had no notion that their own unsterilized hands and instruments were a danger to their patient (this was years before sterilization became common practice in medicine). The actual shooting had left no more than a minor wound but the doctors and their relentless poking and probing did the rest. After Garfield finally died on September 19, an autopsy determined that he likely would have lived had the doctors simply left him alone.  Although the lead surgeon later made a public apology, it probably didn't help that the doctors submitted a bill for their services afterwards (the bill was only partially paid).

As the first presidential assassin ever to be put on trial (or at least the first successful one), Charles Guiteau's case riveted public attention although defending him proved to be a nightmare for his legal team (led by his brother-in-law). Throughout the trial, Guiteau was housed at the St. Elizabeth's Psychiatric Hospital although he opposed any attempt to have him declared insane. His bizarre behaviour during the trial remains the stuff of legal legend. He systematically abused his defenders, wrote his testimony in the form of epic poems which he recited in court, composed his autobiography (including an advertisement for a future bride), and repeatedly tried defending himself. While his argument that he didn't kill Garfield and that the doctors were really responsible for his death was true enough, it failed to sway the jury.

Both prosecution and defence attempted to bring in medical experts to testify concerning Guiteau's mental state but the jury was put off by the spectacle of "duelling credentials"   It was also one of the first American trials in which the newly adopted M'Naghten Rule was applied and Guiteau's appearance of sanity probably helped seal his fate. Guiteau's insistence that he was "legally insane but not medically insane" worked against him and swayed the jury into thinking that he was only faking insanity. He seemed incapable of realizing the hatred that the American public had for him despite being nearly killed on two occasions during the trial.   Since he honestly appeared to see himself as the Hand of God in bringing down the president, Guiteau seemed genuinely astonished when the jury brought in a verdict of guilty (nobody else was).  

His appeal was later denied and Guiteau was executed on June 30, 1882. To the end, he tried to make the execution into a media spectacle and used the occasion to recite a poem that he composed (and if those in attendance weren't in a hanging mood at first, they likely were by the time he finished his long, rambling poem). His request to have an orchestra at the hanging was denied.   After his execution, the body was never returned to the family to be buried according to custom.  In fact, the current whereabouts of Guiteau's skeleton is somewhat of a mystery.

The usual problem with attempting a psychiatric diagnosis on the basis of historical accounts certainly applies here although Guiteau's bizarre behaviour suggests some possibilities. One of the most intriguing theories relates to the fact that Guiteau had contracted syphilis from a prostitute years before (which had been used against him in the trial to prove his "moral depravity"). An autopsy determined that his brain showed signs of damage relating to neurosyphilis but the results were felt to be inconclusive. The flamboyance and grandiosity that Guiteau showed during the trial seem to fit with the diagnosis of syphilis-related dementia but it could fit other diagnoses as well. The question of whether Guiteau was wrongfully executed was debated in the psychiatric literature long after his death.

Was Guiteau insane? Would he have been executed had he killed anyone other than a U.S. president? You be the judge.

A Canadian Perspective on Using Psychologists for Enhanced Interrogation

For decades, forensic psychologists have dedicated much effort to applying their research and theory to improve the criminal justice system. However, recently, the roles of psychologists have expanded to more direct involvement as consultants in criminal investigations. The recent scandal involving the collusion of the American Psychological Association leadership with torture-endorsing interrogation programs suggests that it is an optimal time to reflect upon these expanding consultation activities. A new article in the journal Canadian Psychology explores emerging practical and ethical issues confronting forensic psychologists acting as consultants in criminal investigations, and provide recommendations for best practices in this context. Specifically, the article focuses on the increasing application of psychology in 3 investigative contexts: advising police on interrogation or other investigative strategies, evaluating the credibility of suspect statements, and consulting with emergency response teams in hostage-taking or barricade situations. The application of psychological science in law enforcement settings is rapidly evolving, which means it requires more empirical attention, ethical analysis, and specific training to ensure that psychologists are acting in the best interest of everyone involved. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

For the abstract

Can Listening to Music Help Control Pain?

One good thing about music, when it hits you, you feel no pain.  Bob Marley

There is no disputing that the need for effective pain relief has never been greater.   While we all experience pain once in a while, chronic pain (usually defined as pain lasting longer than three to six months) can be devastating for many pain sufferers.   With an estimated ten to 55 percent of people worldwide developing chronic pain worldwide, it's hardly surprising that pain relievers, particularly medications containing form of opium, are in constant demand in countries around the world.   Along with obtaining these drugs legally through a doctor's prescription, there are also street drugs that can also be used for relieving pain, including heroin and opium.   Though there are alternative methods for pain management that avoid the potential addiction issues surrounding opiates, research studies  looking into  their actual effectiveness often yield contradictory results..

 As an alternative to medication,  non-chemical pain management techniques such as relaxation training or guided imagery can also help control pain using the principle of distraction.   By using different mental activities to occupy the minds of pain patients, their awareness of pain is reduced which provides basic relief.   While using relaxation training or interactive media such as video games or virtual reality can help provide the distraction pain patients need, they often aren't cost-effective compared to less expensive options such as medication.  Whether due to the expense of providing trained staff to teach relaxation techniques or the cost of specialized equipment, many physicians find it easier and cheaper to prescribe pain medication.   Even when pain management programs are available, the demand for treatment can mean long waiting lists and needless suffering.

But what about simpler alternatives such as listening to music?   Research looking at the link between music listening and pain tolerance suggests that it is not only effective in relieving acute and chronic pain but can also help patients manage anxiety and depression.    According to one study from 2012, two daily sessions of music listening helped a sample of chronic pain patients relieve symptoms related to conditions such fibromyalgia, inflammatory disease, or neurogenic pain as well as the anxiety and depression linked to chronic pain. 

To read more, check out my new Psychology Today blog post.

 

Are Antipsychotic Drugs Being Overprescribed to Elderly Patients?

Antipsychotic medications are primarily used to help people with severe mental illness control symptoms of psychosis such as hallucinations, delusions, or disordered thinking.   So, why are these medications being increasingly prescribed to elderly patients?  According to Tev Patel, a clinical pharmacist with the Centre for Family Medicine in Kitchener, and an assistant professor at the University of Waterloo, many antipsychotics are being prescribed to elderly patients when they are clearly not needed, even when serious side effects could potentially put the lives of these patients at risk.   

"The use appears to be quite prevalent in terms of anti-psychotics in patients who have dementia and are above 65 years of age," she said in an interview with CBC News.   "in some patients, they're quite effective, and in others, they're not effective at all," she added.  Even in cases where patients are openly violent or psychotic, she argues that anti-psychotic medication should only be used as a short-term solutions rather than as a long-term method for keeping patients calm. 

But a new University of Waterloo study suggests that anti-psychotics are being overused with dementia patients, often with little real justification.  Lead researcher Chris Perlman, an assistant professor at the University of Waterloo's School of Public Health and Health Systems, has been looking at data from across Canada with patients in acute care hospitals, nursing homes and complex continuing care facilities, and even home care.   Among the study's findings are that:

• Fourteen percent of patients in home care have been prescribed anti-psychotic medications
• Twenty-seven percent of acute care hospital patients on waiting list for nursing home beds have been prescribed anti-psychotic medication
• 35 percent of patients in long-term care facilities have also been prescribed anti-psychotic medication.

In many cases, the medication is prescribed to elderly patients even if they aren't showing "behavioural or psychological symptoms."  While anti-psychotic medication is typically used for patients suffering from schizophrenia or other severe mental health disorders,  their sedative effects make them useful in tranquilizing patients and make it easier to care for them.  Such "off-label" use for psychiatric medication is hardly uncommon and dementia patients in other provinces are also frequently over-medicated as well.  Among the adverse side effects linked to many anti-psychotic medications are: 

• Headaches
• Weight gain
• Extrapyramidal symptoms including tremors, restless legs, and movement problems often seen in patients with Parkinson's disease
• Anticholinergic side effects such as blurred vision, constipation, constipation, and dry mouth.
• Less common symptoms can include tardive dyskinesia, a frequently irreversible neurological syndrome with repetitive movements of the face, legs, or torso.

Since elderly patients often have other medical conditions for which they are being treated, the possibility of adverse drug interactions also remains high and doctors need to be vigilant in monitoring their medication.   Given the potential dangers involved with using anti-psychotic medication on these patients, Christ Perlman says that is is "alarming" to see what is happening across Ontario.   

While advocacy groups such as the Ontario Long Term Care Association note that fewer long term care homes are using anti-psychotic medication to treat elderly residents,  these facilities still need to provide more behavioural support programs to avoid the need for overmedicating patients.   As the number of dementia patients continues to rise worldwide,  relying on medication to make them more manageable may become a much bigger problem in the years to come.

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Making Old Men Young (Part 2 of 2)

Continued from Part One

With all the publicity surrounding Charles-Edouard Brown-Sequard's new discovery, it wasn't just the elderly who saw a chance to relive their glory days.

Long considered a baseball legend, James "Pud" Galvin had a spectacular career as a Major League pitcher for the Buffalo Bisons and, later, the St. Louis Alleghenys.   Having earned the nickname "Pud" for his reputation of making batters "look like pudding", Galvin held all-time records for shutouts, wins, and innings pitched and became the first Major League Baseball pitcher to win 300 games by 1888.   He also held the record for games started since baseball rules allowed his team to use him as starting pitcher in half of their games.  His endurance and stamina earned his other nickname, "the little Steam Engine."  Despite his astonishing record though, the general consensus for fans and players alike was that Galvin's career was fading since the "magic" of his early days was no longer there. 

By 1889 when the Brown-Sequard craze was in full swing, Pud Galvin was 32 and the prospect of retirement was hardly appealing.  This was long before the era of baseball millionaires and Galvin's retirement would have meant a sharp loss of income.  Whether he came up with the idea of trying Brown-Sequard's remedy on his own or whether someone else suggested it to him, Pud Galvin needed little encouragement.    On August 12, 1889, he received received an experimental injection of the Brown-Sequard compound at the Western Pennsylvania Medical College.  The very next day, Galvin pitched a 9-0 shutout against Boston and journalists had little trouble giving Brown-Sequard's magic elixir most of the credit for the win.

According to one rather glowing Washington Post news story,  Pud Galvin's victory represent the best proof yet that Brown-Sequard's discovery was the real thing.   "If there still be doubting Thomases who concede no virtue in the elixir," said the journalist who broke the story, "they are respectfully referred to Galvin’s record in yesterday’s Boston-Pittsburgh game. It is the best proof yet furnished of the value of the discovery.”   Not only was the use of artificial stimulants in professional sports a non-issue in the 19th century, but the story went on to suggest that teams across the country could use the elixir to enhance the performance of their flagging athletes as well.  

Almost as quickly as the fad first began however, the enthusiasm over Charles-Edouard Brown-Sequard's wondrous elixir soon faded.  Not only were other researchers getting mixed results from their own experiments but some physicians were warning that the compound could actually be dangerous in its own right.   Even though Brown-Sequard stressed the importance of proper filtering to remove harmful bacteria, at least one doctor found dangerous levels of Myobacterium tuberculosis when he examined samples of the compound under a microscope.    Along with the medical critics, Brown-Sequard and his supporters also faced the wrath of the anti-vivisectionists (a precursor of the modern animal rights movement) who objected to the killing of animals to use for medical purposes.  

Meanwhile, Brown-Sequard continued with his experiments, including trying his compound on elderly women to see if it worked the same as with elderly men.  Since the main reason behind Brown-Sequard's success with male patients was his accidental discovery of the stimulating effects of testosterone (which wouldn't be formally discovered until the 20th century), it's hardly surprising that female patients weren't getting the same benefits that men were.   Also, testosterone's effects are usually temporary, which was likely why the "boost" the elixir provided faded rapidly.

Despite the limited success of doctors using the elixir, new stories of deaths linked to the treatment, mostly due to blood poisoning, made doctors more cautious about giving it to their patients.   More importantly, it became apparent that actual benefits from Brown-Sequard's compound didn't come close to meeting the grandiose claims that had been made.   As one wag pointed out,  "When Brown-Sequard revealed the secret of his great discovery and how to compound it and it got fully under way, death, the reaper, might take a protracted vacation if he didn't go out of business altogether.  But the elixir played out about as fast as it played in, the grim reaper is attending to business as usual, and the graveyards are receiving their usual quota of mortality."

By 1890, the world had moved on to other big news stories and the Brown-Sequard elixir was largely ignored by the press except for the occasional mocking article.  Though Charles-Edouard Brown-Sequard still insisted that his discovery worked as promised, fewer supporters put their faith in him.   Sadly, despite his claims of being rejuvenated by regular injections of his compound, he still died in 1894 at the ripe old age of 77.   Today, he is mainly remembered for his discovery of the neurological syndrome that still bears his name.   If his elixir is remembered at all, it's for Brown-Sequard's accidental discovery of the stimulating effects of testosterone.

Not that this meant the end of his rejuvenation dream, mind you.   Years after Brown-Sequard's death, medical hucksters continued to offer his injections to willing patients.   According to one newspaper advertisement from 1899, the "Famous Brown-Sequard Cure for Diseases of Men and Nervous Affections" could be used to treat "Nervous Debility, Vital Weakness, Impotence, Loss of Vitality and other diseases of Men, including Infections of the Bladder and Kidneys."   The same clinic offering the injections also boasted that they had the exclusive right to use the Brown-Sequard cure in the United States and that it was available nowhere else (which was likely true given that it  had been largely discredited by that time). 

This hucksterism only appealed to the gullible rich still willing to pay for a treatment that had already been dismissed by mainstream medicine as quackery.  Still, later researcher such as Serge Voronoff would be inspired by Brown-Sequard's research to explore new ways of rejuvenating men using testosterone.   This, in turn, would inspire a new round of quackery with treatments even more bizarre than what Brown-Sequard had advocated, but that's another story.

Remember Pud Galvin?   He couldn't maintain his amazing winning streak and Cy Young would surpass him in all-time wins in 1889.  While there is nothing to indicate that he ever received more injections, Galvin eventually retired from professional baseball in 1892 and died penniless twenty years later. Along with his then-unbroken record for wins, games started and shutouts, he also has the dubious distinction of being the first professional baseball player to use a performance-enhancing substance.  In a sense, Galvin's experience with the Brown-Sequard elixir would herald the much later scandals surrounding the use of steroids in professional sports. 

Which is probably not the legacy he would have wanted.

Shooting Dr. Tourette

1893 was not Gilles de la Tourette's year. Not only was he devastated by the death of his son Jean to meningitis but also by the loss of his mentor, the prominent neurologist Jean-Martin Charcot, to a lung disease shortly afterward. Sadly, there was even more to come for the internationally recognized neurologist.

On December 6, a young woman, dressed in black, rang the doorbell at the Rue de l'Universite apartment building where Dr. Tourette lived. His valet told her that the doctor was out but she insisted on waiting for him. After about fifteen minutes, Tourette returned from seeing a patient at a local hospital and she immediately confronted him in his consulting room. The woman, Rose Kamper, had been one of his patients at the Pitie-Salpetriere Hospital and demanded money from him for "ruining her life". He recognized that she was emotionally disturbed and offered to have her readmitted to hospital under his care. After she failed to reply, Tourette got up to leave the room when the woman took out a revolver and shot him in the back of the neck.

Rose Kamper made no attempt at escape after the shooting and simply sat in the hall until the police came. She reportedly muttered, "I know, that what I just have done was wrong, but it was necessary and now I am satisfied. At least one of them has now paid for the others (the other doctors who had treated her)."  While her victim's injury wasn't life-threatening, an attempt made on the life of one of the most prominent physicians in Paris certainly made news.

Police later found that Rose had nothing in her possession but a series of newspaper clippings about hysteria (which was still a new medical term a the time). As more details became known, her story was gradually pieced together. Rose Kamper's mental problems had begun several years before and led to her being placed under Dr. Tourette's care. As she told the psychiatrists who later examined her, "Within me there are actually two different people, one physical and one intellectual, my thoughts no longer belong only to me, but also to those, who possess me. During the day my intellect allows me to resist the powers which enter me without my knowledge, but at night I am overpowered". She apparently believed that Tourette and the other doctors at the Salpetrerie had caused her mental illness through hypnosis.

Tourette's mentor, Jean-Martin Charcot, had pioneered the medical use of hypnosis in treating the emotional condition that he first termed "hysteria". In his Salpetrerie clinic, Charcot's research on the many female patients who had been sent to him for treatment had made him famous across Europe. Charcot went on to train a generation of neurologists and psychiatrists in his techniques (including Tourette and Sigmund Freud, among others) but there was still considerable controversy over what hypnosis represented.  As a result of this controvery, Rose Kamper's trial quickly became a test of dueling theorists who argued about the very nature of hypnosis itself.   Rose maintained that Tourette and the other Salpetriere doctors had hypnotized her against her will and her defense attorney even argued that the hypnosis had somehow caused the shooting. Following a sensational trial, the judge eventually ruled that hypnosis had nothing to do with Rose Kamper's actions and she was declared insane

Although Dr. Tourette recovered physically from the shooting, the emotional impact would linger. Rose Kamper's testimony and the heavy newspaper coverage of the trial damaged his professional reputation. Despite his fame as a physician and numerous honours, Gilles de la Tourette's condition began deteriorating with fluctuating episodes of depression, mania and mental confusion. By 1901, he was forced to give up his medical practice as his behaviour became increasingly bizarre. Alarmed over Tourette's worsening condition and threats of suicide, his family and colleagues made arrangements for him to travel to Lucerne, Switzerland for a rest. On May 28, 1901, he was called to a psychiatric hospital near Lausanne, supposedly to see a patient. Once there, Tourette was forcibly admitted and kept for treatment. His family had arranged for him to be held in a Swiss hospital because they were afraid of the publicity that would have followed his receiving psychiatric treatment in France.

Records still exist showing Tourette's outrage over being held in the psychiatric hospital and the forced restraints that were used to keep him there. Despite numerous letters to various medical and government officials protesting his treatment, Gilles de la Tourette would never leave. Over time, he became increasingly psychotic with rambling speech and convulsions. He eventually died on May 22, 1904 with his wife and surviving children being at his side. While the actual cause of death is still unclear, neurosyphilis has been advanced as one possibility (it was common enough at the time). Whatever the medical reason, Gilles de la Tourette's death at the age of 46 ended a remarkable medical career. Despite his research contributions, he is primarily remembered today for the developmental tic disorder that bears his name.

Ironically, Rose Kamper probably fared better than the man she shot.  After her sentencing, she was housed in different hospitals before being sent to an "Institute for the Insane" in Villejuif, France. She was later moved to another asylum after she stabbed a nurse with a fork.  Following Rose's escape from the asylum in 1910, police launched an intense manhunt due to fears over her violent history. Rose was eventually found by police living under her maiden name of Lecoq and working as a seamstress. Since she appeared relatively stable, her doctors allowed her to live in the community despite later readmissions to psychiatric hospitals. She eventually died in 1955 at the age of 92.