In 1887 Pierre Aristide André Brouillet depicted one of the greatest scenes in medical history. In his masterpiece A Clinical Lesson at the Salpêtrière, Marie “Blanche” Wittman is in a fit of “Hysteria”. Examining her is Jean-Martin Charcot, the founder of modern neurology and the Napoleon of the neuroses. Blanche is contorted, opisthotonic, and in a recognizable state for any neurologist more than one month into residency. Charcot is calm, cool, and collected. His most proximal assistant, Joseph Babinski, is reflexively supporting Blanche, and is as equally undisturbed (maybe even amused). The rest of the crowd- including the likes of Henri Parinaud, Georges Gilles de la Tourette, Alix Joffroy, Pierre Marie, and Paul Richer -looks on in mixed intrigue, disbelieve, and even concern. They want to learn from Charcot, but more importantly, they want to learn from Blanche.
Neurology was built on cases like Blanche Wittman. Alois Alzheimer opened the brain of Auguste D. James Parkinson described a Shaking Palsy after examining only six patients, three on the streets of London (one from afar). Who knows what new syndrome, disease, radiographic finding, or genetic variant will be discovered after the identification and description of only one patient.
We have all had that interesting patient that we wanted to “write up”. We spend hours editing the description to a tight word count, cropping and labeling the perfect figures, and finding one of the few remaining journals open to taking case reports. We submit to be rejected and re-submit again as we see the hours melt away and the impact factors fall. I think there is a better way.
In June 2019 I had the opportunity to see A Clinical Lesson at the Salpêtrière in person at the Paris Descartes University (after a very kind medical student let me in and showed me the way). For me, it was as inspiring as Mona Lisa less than a mile away. I want to be Charcot. But I also want YOU to be Charcot. I want to stop our Neurological community from losing one of its most valuable learning tools and launching pads: the case report. So submit your case to Real Head Cases and let’s continue the tradition that got us where we are today.