Month: April 2018

Kurt Gödel

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Kurt Gödel was a brilliant mathematician/logician and created Gödel’s incompleteness theorem. He was also completely crazy and was very paranoid.

Here are some interesting tidbits:

In February of 1951, Godel was hospitalized for delayed treatment of a bleeding duodenal ulcer requiring massive blood transfusions. The undue delay was apparently caused by his distrust of doctors. In February 1978, shortly after Godel’s death, his brother wrote that “My brother had a very individual and fixed opinion about everything. Unfortunately he believed all his life that he was always right not only in mathematics but also in medicine, so he was a very difficult patient for his doctors” (1987:26).

Hao Wang. A Logical Journey: From Godel to Philosophy (Representation and Mind) (Kindle Locations 647-650). Kindle Edition.

Dr. Joseph M. Rampona was for many years Godel’s physician in Princeton, probably from 1935 to 1969. In an interview in May 1986 (see Schimanovich et al. 19957), he said that Godel had refused to go to the hospital to be treated for the ulcer and that they had to ask Einstein to persuade him. The relationship between Godel and Einstein was, according to Rampona, “very very close. I felt that Einstein in his presence was like a blanket for him. He felt confident then. He could really speak to the world at that moment. Einstein was for him a kind of protection.” The very morning when Dr. Rampona put Godel in the hospital, J. Robert Oppenheimer, director of the institute, telephoned him and said, “Believe it or not, doctor, but there is the greatest logician since the days of Aristotle!”

Hao Wang. A Logical Journey: From Godel to Philosophy (Representation and Mind) (Kindle Locations 654-655). Kindle Edition.

another tidbit added:

Oskar Morgenstern, who knew Godel well and was also acquainted with Einstein (probably through Godel), wrote to the Austrian government toward the end of 1965 to recommend honoring Godel on his sixtieth birthday:

1.6.2 Einstein has often told me that in the late years of his life he has continually sought Godel’s company, in order to have discussions with him. Once he said to me that his own work no longer meant much, that he came to the Institute merely ‘to have the privilege to walk home with Godel: [The “late years” probably began in 1951, when Einstein stopped working on the unified theory.]

Hao Wang. A Logical Journey: From Godel to Philosophy (Representation and Mind) (Kindle Locations 956-959). Kindle Edition.

Hypertensive crisis

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Definition: a hypertensive crisis (HC) is a systolic blood pressure (SBP) of >220 mm Hg and/or a diastolic blood pressure (DBP) of >120 mm Hg. It can be subdivided in

  1. A hypertensive emergency (HC with organ damage)
  2. A hypertensive urgency (HC without organ damage)

Most common organs to be affect by acute hypertension:

  • Heart (perform heart examination, ECG, CXR, consider cardiac enzymes)
  • Kidneys (evaluate fluid status, examine kidney function in the blood)
  • Brain (assess neurological status, consider CT or MRI)
  • Eyes (assess ophtamoligical status, assess the retina with fundoscopy)

In the case of a hypertensive urgency: start Nifedipin Retard 10 mg; assess blood pressure after 2 hours. Send patient home if BP <200/120 mm Hg

In the case of hypertensive emergency: start Labetolol or in the case of cardiac organ failure: a nitrate derivative. Admit the patient at the MC/IC/CCU.

Try to find causative or luxating factors and eliminate them, such as: low medication adherence, liquorice (tea), kidney disorder, drugs (cocaïne/ecstacy/amphatemines), medication that cause hypertension.

IMPORTANT TO NOTE: HYPERTENSIVE URGENCY OCCUR IN CASE OF AORTIC DISSECTION: tests to evaluate: CXR, D-DIMER, CTA-THORAX

Transfusion reactions

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  1. TRALI (Transfusion-related acute lung injury) ARDS
  2. TACO (Transfusion-associated circulatory overload) decompensation
  3. AHR (Acute hemolytic reaction) hemolyse, fever
  4. Anaphylaxis (Bronchospasm, urticaria, hypotension, angio-edema)