But the hallmark of Lewy body disease is the real clincher in this diagnosis: vivid and detailed hallucinations featuring friends and relatives are common. And like Scrooge?s visions, these phantasms are distressing, often terrifying. Finally, in Lewy body dementia, hallucinations occur early in the disease, frequently before the cognitive deficits are apparent. I went back and reread the book with [my nephew, and fellow doctor] Chance?s diagnosis in mind. It fit. It?s clear that once again Dickens has identified a disease, in this case a full century and a half before medicine did.
NOTE: Christopher D. McManus of Maryland,(who ought not be confused with Ig Nobel Prize winner Christopher McManus of London) collected and reported heaps of such diagnoses, first in historical characters, and then in fictional characters from Dickens and elsewhere. McManus published both of his studies:
1. “Dante?s Hair, Buddha?s Teeth, and Tutankhamun?s Breasts: Intimate Gleanings From the Medical Literature” (Annals of Improbable Research, vol. 8, no. 5, September/October 2002).
2.) Dracula?s Pellagra and Lois Lane?s Lungs: Further Gleanings From the Medical Literature” (Annals of Improbable Research, vol. 11, no. 2, March/April 2005).
FURTHER NOTE: And let us not forget Larry Niven’s Larry Niven’s essay “Man of Steel, Woman of Kleenex,” which has been the basis of an assignment in at least one developmental psychology class.