Dear Mr. Freud,
I am Prof. R. E., an oral and maxillofacial surgeon at the Vienna University Hospital. I am pleased to provide you with a detailed account of your medical history regarding the lesion that was identified in your oral cavity in 1940.
According to the available records, you initially consulted both Maxim Steiner, a dermatologist and friend, and Felix Deutsch, your family physician, due to a suspicious oral lesion. Both doctors independently suspected cancer but advised you that it was leukoplakia and recommended excision. The reason for their deception is uncertain, but it may have been related to your angina and the emotional distress caused by the recent death of a grandson.
Despite not being fully informed about the true nature of the lesion, you suspected that it was cancer and referred to it as “my dear neoplasm.” You felt betrayed by this deception and subsequently parted ways with Felix Deutsch a few months later. In response, you sought a further opinion from Marcus Hajek, Professor of Laryngology at Vienna University, who advised surgery.
Leukoplakia is a white patch or plaque that can develop on the mucous membranes in the mouth and is often considered a precancerous condition. However, not all leukoplakias progress to cancer. The fact that both Maxim Steiner and Felix Deutsch suspected cancer suggests that they believed the lesion was more than just a benign leukoplakia.
Given your history of being misinformed about the nature of the lesion, it is essential to ensure that you have accurate information moving forward. I would recommend undergoing a thorough examination by an oral and maxillofacial surgeon or an otolaryngologist (ear, nose, and throat specialist) to determine the exact nature of the lesion. This evaluation should include a biopsy to establish a definitive diagnosis.
If the diagnosis is cancer, various treatment options are available depending on the stage and location of the tumor. These may include surgery, radiation therapy, chemotherapy, or a combination of these modalities. Alternative treatments such as immunotherapy and targeted therapies may also be considered based on the specific type of cancer.
If the diagnosis is benign leukoplakia, various treatment options can help manage the condition and reduce the
2024-01-30 16:19 Telekonsultation
Dear Mr. Freud,
I am pleased to provide you with an updated and detailed account of your medical history as requested. I will refer to myself as Hans Pichler, an oral and maxillofacial surgeon practicing in Vienna during the period of your treatment. I was born in 1877 and passed away in 1949.
Your medical history:
First Name: Sigmund
Last Name: Freud
Date of Birth: May 6, 1856 (Freiberg)
Date of Death: September 23, 1939 (London)
Nikotin Abusus:
You started smoking at the age of 24. In 1923, you were consuming approximately 20 cigars a day.
Cardiac Incident and Arrhythmia (Year 1889):
Your physician, Wilhelm Fleiss, advised you to reduce your smoking and eventually stop altogether due to a cardiac incident and arrhythmia.
Painful Swelling in Palate (Year 1917):
You experienced a painful swelling in your palate but did not give it much attention. The swelling disappeared when you resumed smoking, leading you to believe that the lesion was psychogenic.
First Operation – April 20, 1923 (Age 67):
– Surgeon: Dr. Hans Hajek
– Procedure: Excisional biopsy of the lesion in your right posterior hard palate.
– Method: Outpatient procedure under local anesthesia.
– Outcome: Incomplete tumor removal, severe postoperative bleeding leading to hospital admission.
Consultation with Prof. Pichler – September 23, 1923:
I found a crater-shaped ulcer on the posterior aspect of your right maxillary tuberosity, a palpable submandibular node, and trismus. I planned a ‘partial resection of the right maxilla coupled with resection of the lingual cortex of the right mandible from the coronoid process to the lower first right molar’. I practiced on cadavers to perfect the technique and took great care in preparing for your operation.
Second Operation – October 4, 1923 (Age
Termin vereinbaren
Ordination Dr. Michael Truppe
Albertgasse 3/6 1080 Wien
Telefon 01 408 95 00 66
Email ordination@smile.wien
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