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Thursday, December 23, 2010


Unique Case of Aerial Sleigh-Borne Present-Deliverer's Syndrome
Source: North Pole Journal of Medicine, vol 1 no.1, December 1997 Author: Dr. Iman Elf, M.D.
On January 2, 1997, Mr. C, an obese, white caucasian male, who appeared approximately 65 years old, but who could not accurately state his age, presented to my family practice office with complaints of generalized aches and pains, sore red eyes, depression, and general malaise. The patient's face was erythematic, and he was in mild respiratory distress, although his demeanor was jolly. He attributed these symptoms to being "not as young as I used to be, HO! HO! HO!", but thought he should have them checked out.
The patient's occupation is delivering presents once a year, on December 25th, to many people worldwide. He flies in a sleigh pulled by eight reindeer, and gains access to homes via chimneys. He has performed this work for as long as he can remember. Upon examination and ascertaining Mr. C's medical history, I have discovered what I believe to be a unique and heretofore undescribed medical syndrome related to this man's occupation and lifestyle, named Aerial Sleigh-Borne Present-Deliverer's Syndrome, or ASBPDS for short.
Medical History: Mr. C. admits to drinking only once a year, and only when someone puts rum in the eggnog left for him to consume during his working hours. However, I believe his bulbous nose and erythematic face may indicate long-term ethanol abuse. He has smoked pipe tobacco for many years, although workplace regulations at the North Pole have forced him to cut back to one or two pipes per day for the last 5 years. He has had no major illnesses or surgeries in the past. He has no known allergies. Travel history is extensive, as he visits nearly every location in the world annually. He has had all his immunizations, including all available vaccines for tropical diseases. He does little exercise and eats large meals with high sugar and cholesterol levels, and a high percentage of calories derived from fat (he subsists all year on food he collects on Dec. 25, which consists mainly of eggnog, Cola drinks, and cookies).
Family history was unavailable, as the patient could not name any relatives.
Physical Examination and Review of Systems, With Social/Occupational Correlates: The patient wears corrective lenses, and has 20/80 vision. His conjunctivae were hyperalgesic and erythematous, and Fluorescein staining revealed numerous randomly occurring corneal abrasions. This appears to be caused by dust, debris, and other particles which strike his eyes at high velocity during his flights. He has headaches nearly every day, usually starting half way through the day, and worsened by stress. He had extensive ecchymoses, abrasions, lacerations, and first-degree burns on his head, arms, legs, and back, which I believe to be caused mainly by trauma experienced during repeated chimney descents and falls from his sleigh. Collisions with birds during his flight, gunshot wounds (while flying over the Los Angles area) and bites consistent with reindeer teeth may also have contributed to these wounds.
Patches of leukoderma and anesthesia on his nose, cheeks, penis, and distal digits are consistent with frostbite caused by periods of hypothermia during high-altitude flights. He had a blood pressure of 150/95, a heart rate of 90 beats/minute, and a respiratory rate of 40. He has had shortness of breath for several years, which worsens during exertion.
He has no evidence of acute cardiac or pulmonary failure, but it was my opinion that he is quite unfit due to his mainly sedentary lifestyle and poor eating habits which, along with his stress, smoking, and male gender, place him at high risk for coronary heart disease, myocardial infarction, emphysema and other problems. Blood tests subsequently revealed higher-than-normal CO levels, which I attribute to smoke inhalation during chimney descent into non-extinguished fireplaces. He has experienced chronic back pain for several years. A neurological examination was consistent with a mild herniation of his L4-L5 or L5-S1 disk, which probably resulted from carrying a heavy sack of toys, enduring bumpy sleigh rides, and his jarring feet-first falls to the bottom of chimneys. Mr. C. had a swollen left scrotum, which, upon biopsy, was diagnosed as scrotal cancer, the likely etiology being the soot from chimneys.
Psychiatric Examination and Social/Occupational Correlates: Mr. C's depression has been chronic for several years. I do not believe it to be organic in nature-rather, he has a number of unresolved issues in his personal and professional life which cause him distress. He exhibits long-term amnesia, and cannot recall any events more than 5 years ago. This may be due to a repressed psychological trauma he experienced, head trauma, or, more likely, the mythical nature of his existence. Although the patient has a jolly demeanor, he expresses profound unhappiness.
He reports anger at not receiving royalties for the widespread commercial use of his likeness and name. Although he reports satisfaction with the sex he has with his wife, I sense he may feel erotic impulses when children sit on his lap, and I worry he may have pedophillic tendencies. This could be the subconscious reason he employs only vertically-challenged workers ("elfs"), but I believe his hiring practices are more likely a reaction formation due to body-image problems stemming from his obesity.
The patient feels annoyed and worried when he is told many people do not believe he exists, and I feel this may develop into a serious identity crisis if not dealt with. He reports great stress over having to choose which gifts to give to children, and a feeling of guilt and inadequacy over the decisions he makes as to which children are "naughty" and "nice". Because he experiences total darkness lasting many months during winter at the North Pole, Seasonal Affective Disorder (SAD) may be a contributor to his depression.
Treatment and Counseling: All Mr. C's wounds were cleaned and dressed, and he was prescribed an antibiotic ointment for his eyes. A referral to a physiotherapist was made to ameliorate his disk problem.
On February 9, a bilateral orchidectomy was performed, and no further cancer has been detected as of this writing. He was counselled to wash soot from his body regularly, to avoid lit-fire chimney descents where practicable, and to consider switching to a closed-sleigh, heated, pressurized sleigh. He refused suggestions to add a helmet and protective accessories to his uniform.
He was put on a high-fibre, low cholesterol diet, and advised to reduce his smoking and drinking. He has shown success with these lifestyle changes so far, although it remains to be seen whether he will be able to resist the treats left out for him next Christmas. He visits a psychiatrist weekly, and reports doing "Not too bad, HO! HO! HO!".
Conclusions: Physicians, when presented with aerial sleigh-borne present-deliverers exhibiting more than a few of these symptoms, should seriously consider ASBPDS as their differential diagnosis. I encourage other physicians with access to patients working in allied professions (e.g.Nightly Teeth-Purchasers or Annual Candied Egg Providers) to investigate whether analogous anatomical/ physiological/psychological syndromes exist. The happiness of children everywhere depend on effective management of these syndromes. 
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Sunday, December 19, 2010


“He only employs his passion who can make no use of his reason.”
I would say producing the “new” will was a serious overreaching on Althea’s part. Senator William Sharon’s adopted son by his second marraige, Frederick Newlander, continued to fight his father's and Althea's divorce settlement in the California courts, delaying and obfuscating, But Frederick also launched a new front in Federal court - which he had access to because the estate Althea was now laying claim to was spread out over two states. Frederick's lawyers argued in Federal Court that the new will which Althea had produced was a forgery, as were the “fraudulent” marriage contracts. And in Federal Court, it was Althea’s lawyer, David Terry, who delayed and obfuscated. But Terry lost round one when the federal judge decided he could not make any decision without first taking testimony and evidence under oath. That meant Frederick's lawyers could force testimony under oath. And this led to Althea’s downfall, but not for what was said in court, but for how she reacted to what was said.
The girl was under a lot of pressure. And Althea did not respond well to pressure. She had always been carrying a grudge, and the more the lawyers told her no, the heaveir that grudge became. Eventually she also began to carry a pistol in her hand bag. She began to loudly denounce witnesses who offended her - in open court. And it all went down on the record. She shouted at one man, “I will shoot him yet; that very man sitting there!” When the court appointed examiner asked her to be still, she drew her gun. “They shall not slander me!" she shouted. "I can hit a four-bit piece nine times out of ten.” While pointing her pistol at one of the opposition lawyers, she assured him, “I will not shoot you just now, unless you would like to be shot and think you deserve it.” A federal marshal disarmed the lady. But the incident made it into the 1,723 page report the examiner provided to the two Federal judges  who would decide the case. And they decided that the will and the marriage contracts were both forgeries, enjoined Althea from claiming otherwise, and ordered her to hand over the documents to Frederick Newlander.
“If passion drives you, let reason hold the reins.”
Ben Franklin
But the judges went even further, lecturing Althea in open court, contending that “…property and position are in themselves some certain guaranty of truth in their possessor…”, and that “A woman who voluntarily submits to live with a millionaire for hire ought not…be allowed to punish her paramour for the immorality of which she was a part…” It is hard to find a more able defense of the Victorian ideal of the nobility of wealth and the original sin of women, than that argued by these two Federal judges. I'm not saying that Althea was justified in the way she expressed her anger with the courts, but I am saying that she was nuts. 
But, as we all know, some men are drawn to crazy women. On January 7, 1886, two weeks after this lecture, Althea and her lawyer, David Terry, were married. He became the smitten Cupid to her Psyche. She played psycho to his old fool. On the face of it Althea came out ahead. She now had a defender who saw the court room as an extension of his happy home. His reaction to the unbraiding she had received in court was as blunt as a knife fight; “They shall not brand my wife a strumpet.” The legal strategy he chose matched his temperament. Terry decided to simply ignore the federal court ruling. After all, Senator Sharon was dead, which, David Terry argued, had rendered any court decisions concerning the California divorce case an “ineffective, inoperative, unenforceable pronunciamento.”
And by simply ignoring the existence of the Federal Court order vacating the will, he avoided dealing with the charges that the will had been forged. Plus, if Althea continued to hold onto the marriage contracts, in defiance of the Federal court order, she could still use them as evidence in her California divorce case, which Sharon’s son Fredrick continued to fight in state court. And it was about here, as the fall of 1886 approached, that Frederick Newlander opened yet a third front against Althea and David Terry; the political front.
“But this had been a sin of passion, not of principle, nor even purpose.”
Nathaniel Hawthorne
In the elections of November of 1886, Fredrick Newlander threw huge sums behind the “Blind Boss”, Christopher Buckley. Buckley's bi-partisan political machine had run San Francisco city hall for years, but had been recently thrown out of power by Republican reformers. But with Newlander money, Democrats under Buckley were swept back into office. This allowed Buckley to appoint judges friendly to the Sharon divorce case. Althea's alimony had already been reduced, from $2,500 a month, to $500. Now, the estate of Senator Sharon was granted an entirely new trial - which would have forced a living woman to argue she should be granted a divorce from a husband who had been dead for two years. But before that travesty of logic could occur, the California Supreme Court, now stacked with new judges whose election had been financed by Frederick Newlander, overturned the original decision in the divorce case. The common law marraige of Senator Sharon and Althea was retroactivly null and void. And with that, officially, Althea was now a perjurer and forger, in both the Federal and the State courts.
While these momentous events were unfolding, the time limit for Althea to appeal the Federal Court Order, requiring her to hand over the marriage agreements and the will, ran out. Immediately Frederick’s lawyers requested an order of contempt be issued against her, which the Federal Court, meeting in the Assessor's Building in San Francisco, immediately agreed to do. Terry’s strategy of defiance was thus proven bankrupt. Twice he appealed the contempt court orders all the way to the U.S Supreme Court, and twice the order was affirmed. This is what happens when lawyers stop thinking with their big heads.
“It is with our passions as it is with fire and water; they are good servants, but bad masters.”
Roger L’Estrange
So, on September 3, 1888, Althea and David Terry found themselves back in the Assesors' Building, while the final decision in their contempt case was read out by the ancient, pompous, humorless, Federal Judge Stephen J. Field.
Fields (above) was a sitting justice of the Supreme Court, helping out during the summer while that the Supremes were in recess. This was a man who was passionate about the law, with no doubt about his own correctness, and not forgiving of those who disagreed with him. In other words, he was the perfect counterweight to Althea’s passion.
As he droned on, reading the intricate legal justifications of his decision, the irrepressible Althea leapt to her feet. “Judge,” she demanded, “are you going to take the responsibility of ordering me to deliver up that marriage contract?” Barely pausing in his recitation, Judge Field ordered, “Remove that woman from the courtroom. The court will deal with her hereafter.” As a Marshal  reached for Althea, David Terry’s drew his six foot muscular frame up from his chair, and warned the Marshal, “No man shall touch my wife”, and then punched the marshal right in the mouth, knocking out his tooth.
“Passion is a sort of fever in the mind, which ever leaves us weaker than it found us.”
William Penn
The fight was on. Several Federal Marshals and assorted guards and lawyers who had been waiting for just this sort of outburst from these two, descended upon the feisty pair. A bowie knife was stripped from David Terry’s fist, and a loaded pistol was confiscated from Althea’s purse. The lady scratched faces, the old man threw punches, but once order was restored the court completed reading the decision of contempt on the earlier court order, which, needless to say went against Althea and David. The Court then immediately moved on to the trial of the both David and Althea for their most recent show of contempt for the court. Judge Field ordered David Terry to spend six months in the Alameda county jail. Althea was sentenced to one month. The two new convicts now had a new enemy.
Now, if these two litigants had regained full control of their faculties, and issued a pro forma apology, as any sane person in this situation would have done, that would have been the end of this tale. But neither David nor Althea were able, once they calmed down, to regain their perspective. And that is my favorite definition of insanity - the inability to lose your rage, overnight. 
“Death is the only pure, beautiful conclusion of a great passion.”
David Lawrence
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