Thursday, June 16, 2011

Days 13-15: Terror Tour and Bavaria

Day 13

Breakfast with a Fellow

We met Dr. Lourda Geoghegan for breakfast. Dr. Geoghegan was a fellow only last year, and took Nicole and me on what I read on Wikipedia is affectionately referred to as a “Terror Tour” – a double decker red sightseeing bus that happens to roll through some of the more dangerous neighbourhoods of Belfast to display the “Peace Walls”, which are up to 20 foot barbed wire walls cutting between neighbourhoods which were assembled over the years to try to keep the violence down at night. The locals, still socioeconomically disadvantaged, don’t appreciate being living history or part of a tourist attraction, and we were greeted with many middle fingers.

Less depressing attractions included the dock where they built the Titantic, which is still a major source of pride. I asked a local about that – because it sank and all - and he pointed to a t-shirt at a tourist shop:


Built by Irishmen

Sunk by an Englishman

The tour guide also mentioned that the iceberg was Canadian.

Day 14

I flew from Dublin to Frankfurt and caught a train to Wuerzburg, Germany. Smooth ride except Aer Lingus only sent one of my bags. This could be bad.

Day 15

Today I am in Wuerzburg, Germany, to present twice at an experts meeting put together by neuropsychologist Gerhard Mueller, who runs one of the few sports concussion practices in Germany. Dr. Mueller’s hope is that I can help convince local neurologists, insurers, and sports administrators that concussions are something that needs to be taken seriously.

Dr. Mueller offered to take me sightseeing prior to the meeting, so he picked me up and we headed into the city. Wuerzburg is tucked away in the rolling hills of northern Bavaria and is a university town of about 200,000 with tremendous medical expertise, history, and vineyards.

We started at the Wuerzburg castle, home of the Bishops of Wuerzburg since around 1200. It is surrounded by 3 steep slopes, giving only one approach for attack, which is part of the reason it’s only been captured one time. In the war against the Swedes, which I missed in my world history class, the castle was under siege. The Bishop’s forces sallied forth for a brief and successful attack, but when they retreated back to the castle, too many dead bodies were on the drawbridge to close it, and the Swedes were able to enter. I thought you’d find that interesting.

I also saw my first medieval pool in the courtyard of the castle – but it was for horses.

Sometimes I think this trip is fate, and today that was because I entered the chapel of the castle to find the tombs of the bishops of the castle, with their images carved in stone above their tombs. Gerhard explained that when the bishops die, each is buried in three separate places. Their body goes to a monastery in the countryside, their hearts to the Wuerzburg Cathedral in town, and their brains lay right under my feet. So if I ever want to explore brain trauma practices of the last eight centuries, I know where to look!

On the way to the Bishop’s palace, an UNESCO heritage site in the city, I mentioned to Gerhard that I’ve been told not to expect German athletes to want to participate in research involving brain donation due to practices of the Nazis. Gerhard told me that only around 10% of Germans are organ donors or willing to donate their bodies to research – Germany has an opt in system like the US, unlike Belgium, where you are presumed a donor unless you actively opt out. Gerhard explained that he understands their hesitation, as during the Third Reich his own great aunt, who had schizophrenia, died while part of a forced ‘hunger experiment’, which I can only assume meant the studies where they see how long people last without food. Horrifying.

The palace was a sight to behold, built in the early 1700’s and reminiscent of Versailles. Much of it was destroyed near the end of World War II – in fact, almost 90% of Wuerzburg was bombed by British and American forces in March, 1945. The palace holds the world’s largest fresco painting north of Italy, and it survived the attack but was not exposed to the elements. It shows scenes from the five known continents (Australia and Antarctica weren’t known to Europeans yet). There is a statue to an American General who committed scarce resources to saving the fresco once we took the city.

After the tour Gerhard and I went to the experts meeting. It was a great opportunity to share our work and learn about the current practices in German. The good news was that Gerhard and his team were up on the latest and greatest in concussion. The bad news is that for many in the audience, this was the first time exploring this issue, and even the top pro sports teams don’t have concussion experts involved in the care of patients. One neurologist complained multiple times that without an algorithm based on MRI or something, it is impossible to know what to tell patients. I said, yes, we need more guidance, but we are years away from that and we still need doctors to see patients with concussions, so suck it up and pay attention.

There were two members of the media there, one print and one television, so we got the word out and had a great discussion.

One of the more enlightening points was that German sports do not have the same school-based infrastructure that the US has. Athletes play for their local club team, and they pay to participate. One key takeaway is that there is no obvious and easy legislative or governmental method through which to mandate, for instance, concussion education. The other piece of bad news is that as academic competition grows, private clubs are losing enrollment, so some presumed that they will not be eager to sound the alarm that sports are dangerous for the brain…

The good news is that my bag finally arrived at 8 pm.

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