Dr. Paul Ehrlich
After 40 years of practice, give or take, this was a first. A new patient in his 20s arrived in the office with an elevated eosinophil count. Just to remind you these white blood cells are drawn to sites like the lungs in allergic asthma and the gastric tract. Normally they are a potent weapon against parasites. When there are no parasites, they protect against the wrong things, resulting in short-term distress and long-term damage.
This patient’s most grievous complaint was a symptom I don’t normally associate with elevated eos, but after getting batted from one specialist to another, one of these doctors, noting the high numbers, recommended that he see an expert.
“So how did you find me?” I asked him. I don’t think of myself as an expert.
“I Googled and it said that eosinophils were discovered by Paul Ehrlich.”
I took out a book and turned to an entry on my namesake that said he died in 1915. Obviously he had never heard of the “Magic Bullet,” not even the movie.
“Are you related at least?” Negative.
I have had a lot of fun with the fact that I was named after the father of immunology, without whose work I might not have had my wonderful career, but it had never resulted in a “referral” before.
The good news is that the mix-up wasn’t an exercise in futility. I discussed the history with my colleague Dr. Purvi Parikh. She immediately pointed me to one of the new monoclonal antibodies that had been developed for eosinophilic asthma. (She recently wrote about them here.) These drugs suppress the chemical signals that summon eosinophils to places where they don’t belong.
This is a classic arc for new drug development. A drug developed for one purpose shows promise for other symptoms—off-label uses–leading to research that broadens the prescribing criteria. A call to a drug rep brought an immediate and enthusiastic response, allowing us to commence treatment right away. (For all the bad press, Big Pharma has its strengths.)
An older doctor learns from a younger one, and a patient has hope for a happy and healthier future. Medicine at its most satisfying.