First Do No Harm

I was concerned to receive Johanna´s recent school report and discover her grades had fallen considerably.  So had her self-confidence. 

Johanna suffered a brain injury at birth which means she has always been partially sighted.  She has an 80% sight loss, but you would never think it to watch her running and climbing like any other girl her age.  You would only notice it when you watch her reading and notice her putting the book right up close to her face and squinting shut her eyes in order to make out the words. 

Johanna is very motivated to learn.  She wants to be able to finish Secondary School and work with young children.  She was crest-fallen to have done so badly in this term´s exams.  “I will be able to finish school, won´t I?” she asked her Mum.

I asked her Mum how Johanna had been health wise recently and the whole story came out.  The school had told Johanna´s Mum she was negligent for not taking her to see a neurologist every year, and had insisted she make her an appointment.  This duly done the neurologist in question had done a CT scan (which was reported as normal) and prescribed her medication for headaches. 

I looked at the medication and was horrified to see it was medicine for epilepsy.  Johanna does not have epilepsy in any shape or form.  Taking such powerful medications explains her lack of concentration and ability to perform at school this term.  And it had done nothing for her headaches, her only complaint. 

Education is so important.  Johanna has a non-progressive brain injury.  It will neither get better nor worse.  There is no medicine available to treat it.  She has learnt to adapt to her disability remarkably.  The primary law of medicine is First Do No Harm.  The doctors treating her need to understand this, rather than prescribing harmful, unnecessary drugs.  The teachers need to understand this rather than demanding unnecessary, detrimental interventions.  Her mother needs to understand this and be able to defend her daughter.  Johanna needs to be able to learn so that she can make something of herself in this life.

I hope I have persuaded Johanna´s mother to stop the medication and only give her paracetamol for headaches as and when they occur.  I think the next step may be to accompany her to the school to try and explain Johanna´s problems.  I don´t suppose I will ever understand why the neurologist prescribed the drug in the first place.