'Lost' Photographs

I always had in my mind that, if someone decided to steal my cameras, they should have the courtesy of leaving me my CF cards. Or, if something bad happened to them that the CF cards should survive. I think the reasons would be clear to many of you. Last year, I accidentally formatted one of my CF cards with my camera. Many years ago Masato Yamaki, a wise colleague of mine, told me: ‘if you ever format your cards by accident, don’t take any more pictures. Leave as it is and you may be able to recover the photos’. After realising that my brain had descended into deep stupidity for a brief moment, I remembered my friend and took the card out of the camera and never used it in hopes of recovering the photographs later. The traumatic time after my father’s death made me put off the rescue mission for a long while. Some weeks ago, I bought an SD card and it came with a free subscription for a recovery software. Two of these recovered photographs are below.

You may ask, like I asked myself, why can you recover photographs from a formatted card? Well, they were never really deleted. As a matter of fact, most deletion processes do not actually erase the data. After a bit of research, I can tell you that the vast majority of computers and devices out there, when deleting data, all they do is just mark the space where the data is stored as ‘available’. Thus, the next device or program that reads the card/drive knows that it can write more data into it again. But until that point, all original data is there. When I formatted the CF card, I knew that I had not filled it up. When I recovered the photographs from it, I recovered all the photographs I had taken on that trip that where in that card PLUS other photographs from a previous formatting. Half of the card, then, had been ‘formatted’ twice and photographs where there that shouldn’t have been should formatting be a real data eraser. Now you know, your camera may not delete anything when formatting, it just tells your camera or computer that the space is available again. Good news if you too thought you had lost everything when your brain had a deep descent into stupidity, briefly.

After I recovered the ‘lost’ photographs, I looked at them carefully and I found these two which caught my attention the most.

This was part of my father’s routine before going to sleep. He would sit down in bed, and wait (often half asleep already) until he got the motivation to get up, pull his pyjama trousers up and then lie down to sleep.

Recently I have seen a notable raise in stories that deal with the elderly. At least in the UK, because of the collapse of the UK’s largest care home landlord, the stories of many elderly citizens that live in care homes, or those that live by in social exclusion, we have had an almost comprehensive look at what the elderly years look like today. Most of the articles deal with the treatment elderly people receive, the issues with pensions, fuel poverty (electricity and gas) and psychological issues relating to conditions that come up in old age. I have read most of them with great interest but one of them, on the FT Weekend Magazine, I think was by far the best. It dealt not only with the physical challenges faced by the elderly (the author actually wears a suit that simulates a range of conditions that one could acquire in older age) but it addresses a very, very important question. We all worry about living longer, but how do we live well once we age?

This Day and Age (James Crabtree, Financial Times Weekend Magazine, July, 2011) goes extensively around the US describing different projects running that are meant to help continue an active lifestyle that puts importance on independence and social inclusion. I can only say that even through my parent’s short lived divorce, my father received family visits, often counting my aunt’s grandchildren among them. Besides the fact that my father kept on busy, working, until his late 90s; being surrounded by your own family helped him retain much of his strength and sanity. Could he have lived as long as he did without these elements in his life? Something tells me, no. Indeed, by 99, he was already tired but he never lost faith in the people around him, and neither did we on him. He knew this because we all respected his opinions, even if they were controversial. I feel bad for the generation now retiring during these austerity times. It is hard enough for them to get by with the usual socio economic struggles we all face. Add to that their physical challenges, the common lack of respect by commuters and, if you have no family, a probable life in relative isolation and living longer doesn’t look like a pleasant experience.

I leave you now with a photograph of my father munching on something with his eyes closed, because he would soon take a nap.

Zolpidem and Brain Injury: A short retrospective into the beginning of Stay With Me

Some years ago I had the pleasure of meeting Dr Ralf Clauss at the Royal Surrey County Hospital before leaving to South Africa and work on what was going to become Stay With Me. Dr Clauss works in the Nuclear Medicine Department at the Hospital and specialises in SPECT scans, three dimensional imaging of any part of the body. Dr Clauss has worked for more than 10 years to pin point and find the exact way zolpidem, a sleep inducing drug, works in the brain. His research started when Louis Viljoen, a young man in South Africa, woke up from his Persistent Vegetative State (PVS) after he was given zolpidem. Since then, Dr Clauss has not stopped looking for scientific evidence that Zolpidem can help a patient with a brain injury but also tried to explain how it works.

Zolpidem is marketed worldwide under different names; Stilnox, Silnoct, Ambien, etc. Some families have decided to try zolpidem after reading or hearing about Louis’ story and Dr Clauss’ research. Indeed, there are positive results reported worldwide. The number of these, however, is difficult to determine. Also, not all results are dramatic and many may be quite subtle. However, some weeks ago I found this:

http://www.youtube.com/watch?v=7sE_r-B1Hcs

In an effort to keep families informed, I have asked Dr Clauss to summarise his findings and facts of zolpidem from his research, which is now written below.

Zolpidem is a pharmaceutical used routinely for treating insomnia, inducing sleep by attaching to GABA(A)receptors in the brain. It was first described as a medication for brain damage by Drs Nel and Clauss in the South African Medical Journal of 2000, months after patient Louis Viljoen was unexpectedly aroused from his Vegetative State (SAMJ 90(1): 68- 72). In the decade following the discovery, further case reports and international studies have independently verified these initial findings. The largest multi patient study on zolpidem to date was published by Dr Nyakale et al in April 2010 (Arzneimittelforschung 60(4): 177- 81). The study evaluated 41 patients after brain damage enrolled in the order that they presented to the clinic. 23 scored less than 100/100 on the Barthel Index which indicated that they had a degree of dependency on their carers. Causes of brain damage in these 23 patients were stroke, traumatic brain injury, anaphylaxis, drug overdose and cerebral palsy. All had zolpidem treatment for at least 4 months.  After zolpidem there was a highly significant, 11.3%  mean improvement in activities of daily living as scored on the standard Tinetti Falls Efficacy Scale (p=0.0001) while 6/23 patients improved by 20% or more. Remarkably brain imaging studies in these patients showed that parts of damaged brain, inactive before dosing, started to function again after zolpidem.  The inactive areas had no typical location or distribution pattern and varied from patient to patient. Such areas had previously been considered ‘dead’, but evidently they are dormant rather than dead so the new term ‘neurodormancy’ or ‘brain dormancy’ has been coined to refer to the areas that zolpidem affects. Further information and updates can be found at

http://sites.google.com/site/zolpidemtherapy/home and http://twitter.com/#!/Zolpidemupdates

It is important to stress that Dr Clauss has made efforts to prove the potential positive effects of zolpidem on brain injury patients. As Dr Clauss’ research and work focuses on the scientific side of things, next post I will try to bring the more clinical side. Dr Nel has been in the spot worldwide when it comes to advising the trial of zolpidem to brain injury patients after Louis’ awakening. I wonder, two years after I visited him, how he is getting along.