I understand your thinking re: relative contributions for clinician vs. public health, but also believe numbers are not everything. The profound influence you can have had on a single patient is literally priceless. I suspect that you were where you were meant/needed to be, if you will excuse my spiritual take. Ironically I have had very similar thoughts as I approach my impending retirement. and having left my research career behind more than a decade ago because of my ever-growing disability. I was trained as an electron microscopist, but discovered 'high throughput' biology -specifically flow cytometry right at the end. How I wish...but I don't regret the joy my many days in the dark looking at individual thin sections of cells gave me. I hope you will come to feel the deep satisfaction your dedication and care for your many patients entitles you to.
Yes, thank you for this post. And having a "profound influence on a single patient" actually has untold ripples, as that patient interacts in the world, and has family and friends. We cannot know our cumulative impact.
I agree with this- I’m sure you have altered the trajectories of many patients’ lives in a positive way that means everything to them. When you’re the one being affected by MS, thoughtful care backed by deep knowledge matters and not all of us have been lucky enough to be your patient. We do all benefit from this blog though so we thank you for that. Best wishes as you take a different tack- we need competent folks at all levels of the system so please do make some breakthroughs that can help us all!
Thank you for everything! I’m sure your patients will find your departure rough since they were so blessed to have you as their neurologist!
The rest of us have been so lucky to have your insights and knowledge available to us through your postings. I would have been lost in my MS journey without them. I still save posts to take with me my annual visits to the Neuro.
Your military career highlights were very successful, and they were lucky to have you for a year. I’m glad that you’re getting to have your do over now at 60!!
Most is us find out later what we should have done , but may never get the chance.
Dear prof G, I wish you all the best in your future career! Thank you for everything you’ve done so far for your patients (both in hospitals and online).
I don’t know when I had IM, but I have EBV antibodies. My mother thinks it was when I was 9 years old, war was raging in Bosnia and access to healthcare was very limited. Mom thinks it was IM because I had fever, could’t walk, but it all went in a couple of days, and she didn’t take me to doctor (and I don’t blame her, we were shelled/bombed every day, going outside was a challenge).
Congratulations on your retirement 🥳 from regular clinical practice. I believe you have had tremendous impact worldwide as a neurologist, especially through your writings. The amount of information in your articles is priceless!
I was very sick with EBV in my undergraduate years, but recovered (after a month in bed.) It left me with an anxiety disorder and panic attacks but relatively ok. Unfortunately as an adult I had another active EBV episode in 2011 which passed relatively quickly but 2 years later I had an aggressive attack deemed to be CIS. In 2015 another blood test confirmed EBV activity and in 2017 my MS kicked off big time with rapidly evolving RRMS. Horrible disease, EBV. Half my social circle had it but I was the sickest and … look at me now :/
Congrats on moving into a new phase of your career, but please remember (and I’m sure you do) as another poster already mentioned, healing the world is a wonderful goal, but each one of us has only one life and you’ve helped every individual you’ve treated make the most of all they have been given. It means everything to the patient, the human, standing in front of you, and we applaud you so sincerely for that. The nhs is a big system but you see us as people, which is immeasurable.
I think because of exactly what you have explained there is why so many of the MS
Community can relate to the way interact with pwms- I think so many are refreshed by your drive to push science forward and make a difference in areas that matter to people with MS.
The people who just collate data, although I know you will say is important, and I recognise that, that’s not what pwms really care about, it’s people like yourself that want to really drive stopping this disease or preventing it for others- the stuff that really matters.
* answer to the question at the bottom, no I had no signs of having EBV or glandular fever, but I was around it from a sick friend in sixth form (a levels) in the uk who still came to school. Even at the school I have just left teachers and students have attended with glandular fever (despite my panic saying what that could cause for others in years to come), no one believe that ebv could cause MS, so getting that message out there one day may help schools to take it seriously.
My bloods showed ebv about 2 years before I was diagnosed due to feeling tired I asked for bloods and that was found. No more discussion on it other than at some point you’ve had glandular fever. That was likely my first disease activity I think, feeling so fatigued that I couldnt compete in my sport. Next after that was altered sensation in my thumb and index finger. Then only taken seriously by GP’s once I had visual issues in a school assembly and they thought it was a stroke- sent home with a migraine by Ed but I begged the gp for a private mri as I don’t get migraines and guess what…. MS.
how weird they found i had EBV through bloods and 2 years later i developed the symptoms of MS. I shall miss Professor Giovannoni. such an interesting man, and so knowledgeable and easy to understand what he was saying. Another good medical man left. we haven't got enough neurologists in this country. First symptom 2000 (after EBV), WENT BLIND temporarily then took until 2016 for a diagnosis, after several attacks of O.N.
Sarah, at least my version does allow edits: there are three dots/periods at the lower right below every post. Click on those dots and you can edit. But I understood your post without difficulty.
Oh, and I did have terrible EBV when in university- slept through my exams! Diagnosed with MS some 30 years later after an adult life of undiagnosed struggles. It’s not easy being taken seriously as a woman in a doc’s office…
I am so grateful for all you do and have done for PWMS. I’m sure your patients are grieving your loss. As for me, I’m all about the upstream, having been a public health nurse and an epidemiologist. If we don’t start looking at causes the illness we survive will just multiply and overwhelm. Best of luck with your work. I would truly love it if the chanting of “end to MS in our lifetime” comes true. But for that we need causes and prevention!
Dr. G, Congratulations on this shift in your work. I only hope you continue to engage us with posts in MS-Selfie! I worked in public health myself, my most cherished accomplishment was uncovering the nexus of factors around credit card debt for college students (depression, alcohol overuse, GPA).
I did have IM as a young adult, unremarkable. It is exciting that IM might point you toward an effective antiviral. Maybe these have been examined already, but I wonder if ACEs and head injuries combine with IM to make one susceptible to MS. I have some ACEs and 2 childhood head injuries.
Your impact at an individual patient level has been enormous, that is for sure. And the ripple effect to friends and family is certainly true as well. I will miss you as my neuro, you have really helped me to take greater ownership of self-management and helped me understand the lifestyle triggers I can teach my kids to avoid to minimise their risk of MS. 60 is young in this age of the “hundred year life” (have you read the Lynda Gratton book?) and a change in career direction at 60 sounds like an amazing idea, you can accomplish both- what an incredible impact from one life!
Oh the Glandular fever point, I haven’t ever had it. My cousin had it when I was young so I suppose I was around the virus but I didn’t have it myself. I did have an unsolved urticaria attack in my teenage years and I have had mumps in my twenties around 2004 when there was an outbreak at British universities and I saw someone else had mentioned mumps too. Would it be helpful to collect this background information at scale? I’m sure patients who read your blog would be happy to contribute to a poll / research survey if that would help your research.
I don't think I've ever had mono but used to suffer with bad sore throats as a child. My twin sister had glandular fever as a teen. I was diagnosed with ms in my fifties and she's fine! Thank you for all your hard work and good luck!
Your title - FAREWELL - NO FANFARE left me tinged with sadness and resonated…) my exit from teaching after 23/24 years of service was this too) until I read further…. I always knew you were someone special ‘rooting,’ for your patients and now the next part of your journey will impact a wider audience/ aka could have ended up as MS people. What a gift that will be for all who can avoid MS through your upcoming research and implementations. Now that is a really exciting chapter to be read and digested. Thank you for all you have done for us MS ers and congratulations for what you are and will be doing to make that difference, that difference which is much needed. Onwards and upwards 👆…🙏🏾
I for one am very pleased you’re continuing to look for the ‘C’ word. Everything that happened in your career pathway led you to this point, so it’s all good. Even the awful motorcycle incident, while you would have probably missed it if had you the choice, appears to have pushed you away from fire fighting on the neurology front line to this. Metaphorically, developing fire extinguishers, safety matches and health and safety policy is way better for those who have been and will be burned than changing a dressing. Thankyou. For entirely non-altruistic reasons, I hope you get your breakthrough soon and I’m not saying goodbye because I will continue to read every word you put into print.
Thank you for your posts which have been at times optimistic but also sometimes quite depressing, however always interesting
Thank you for all your research and explanations etc. As I still try to figure out what works for me, your letters have been very helpful. I have now concluded that for me., exercise good diet but also laughing seeing friends and being in nature are my weapons. It's taken 2 years and daily pilates after a relapse for me to be able to stand upright and walk further
Self-motivation and patience are key to progress in my case. I ve always had plenty of the former but I'm still learning the latter. Enjoy your new career and good luck. All the best
Congratulations on reaching this watershed moment in your career. I'm sure your patients will miss you.
As for IM I had Glandular Fever as an 18 yr old and it wiped me out for about 2 months. I first presented at 51. Although approx 6 months earlier I suddenly developed an unusual itchy rash all over my body except my head. The rash was ugly angry under the skin blotches. My G.P. was quite disinterested. I often wonder if this was related to MS
I understand your thinking re: relative contributions for clinician vs. public health, but also believe numbers are not everything. The profound influence you can have had on a single patient is literally priceless. I suspect that you were where you were meant/needed to be, if you will excuse my spiritual take. Ironically I have had very similar thoughts as I approach my impending retirement. and having left my research career behind more than a decade ago because of my ever-growing disability. I was trained as an electron microscopist, but discovered 'high throughput' biology -specifically flow cytometry right at the end. How I wish...but I don't regret the joy my many days in the dark looking at individual thin sections of cells gave me. I hope you will come to feel the deep satisfaction your dedication and care for your many patients entitles you to.
Yes, thank you for this post. And having a "profound influence on a single patient" actually has untold ripples, as that patient interacts in the world, and has family and friends. We cannot know our cumulative impact.
I agree with this- I’m sure you have altered the trajectories of many patients’ lives in a positive way that means everything to them. When you’re the one being affected by MS, thoughtful care backed by deep knowledge matters and not all of us have been lucky enough to be your patient. We do all benefit from this blog though so we thank you for that. Best wishes as you take a different tack- we need competent folks at all levels of the system so please do make some breakthroughs that can help us all!
Thank you for everything! I’m sure your patients will find your departure rough since they were so blessed to have you as their neurologist!
The rest of us have been so lucky to have your insights and knowledge available to us through your postings. I would have been lost in my MS journey without them. I still save posts to take with me my annual visits to the Neuro.
Your military career highlights were very successful, and they were lucky to have you for a year. I’m glad that you’re getting to have your do over now at 60!!
Most is us find out later what we should have done , but may never get the chance.
Please find out how to stop MS forever!
🙏🙏🙏
Dear prof G, I wish you all the best in your future career! Thank you for everything you’ve done so far for your patients (both in hospitals and online).
I don’t know when I had IM, but I have EBV antibodies. My mother thinks it was when I was 9 years old, war was raging in Bosnia and access to healthcare was very limited. Mom thinks it was IM because I had fever, could’t walk, but it all went in a couple of days, and she didn’t take me to doctor (and I don’t blame her, we were shelled/bombed every day, going outside was a challenge).
Congratulations on your retirement 🥳 from regular clinical practice. I believe you have had tremendous impact worldwide as a neurologist, especially through your writings. The amount of information in your articles is priceless!
I was very sick with EBV in my undergraduate years, but recovered (after a month in bed.) It left me with an anxiety disorder and panic attacks but relatively ok. Unfortunately as an adult I had another active EBV episode in 2011 which passed relatively quickly but 2 years later I had an aggressive attack deemed to be CIS. In 2015 another blood test confirmed EBV activity and in 2017 my MS kicked off big time with rapidly evolving RRMS. Horrible disease, EBV. Half my social circle had it but I was the sickest and … look at me now :/
Congrats on moving into a new phase of your career, but please remember (and I’m sure you do) as another poster already mentioned, healing the world is a wonderful goal, but each one of us has only one life and you’ve helped every individual you’ve treated make the most of all they have been given. It means everything to the patient, the human, standing in front of you, and we applaud you so sincerely for that. The nhs is a big system but you see us as people, which is immeasurable.
I think because of exactly what you have explained there is why so many of the MS
Community can relate to the way interact with pwms- I think so many are refreshed by your drive to push science forward and make a difference in areas that matter to people with MS.
The people who just collate data, although I know you will say is important, and I recognise that, that’s not what pwms really care about, it’s people like yourself that want to really drive stopping this disease or preventing it for others- the stuff that really matters.
* answer to the question at the bottom, no I had no signs of having EBV or glandular fever, but I was around it from a sick friend in sixth form (a levels) in the uk who still came to school. Even at the school I have just left teachers and students have attended with glandular fever (despite my panic saying what that could cause for others in years to come), no one believe that ebv could cause MS, so getting that message out there one day may help schools to take it seriously.
My bloods showed ebv about 2 years before I was diagnosed due to feeling tired I asked for bloods and that was found. No more discussion on it other than at some point you’ve had glandular fever. That was likely my first disease activity I think, feeling so fatigued that I couldnt compete in my sport. Next after that was altered sensation in my thumb and index finger. Then only taken seriously by GP’s once I had visual issues in a school assembly and they thought it was a stroke- sent home with a migraine by Ed but I begged the gp for a private mri as I don’t get migraines and guess what…. MS.
how weird they found i had EBV through bloods and 2 years later i developed the symptoms of MS. I shall miss Professor Giovannoni. such an interesting man, and so knowledgeable and easy to understand what he was saying. Another good medical man left. we haven't got enough neurologists in this country. First symptom 2000 (after EBV), WENT BLIND temporarily then took until 2016 for a diagnosis, after several attacks of O.N.
This platform doesn’t let edits to happen after posted- so I can see I have missed words, but can’t edit 🫣
Sarah, at least my version does allow edits: there are three dots/periods at the lower right below every post. Click on those dots and you can edit. But I understood your post without difficulty.
Hi Judy
All I get get is
Share comment
Delete comment
Hide comment
(Maybe because it’s on the phone? iPhone?)
Sarah, Oh well, you and I certainly gave it the old college try.
I just tried it from my iPhone and all I get is:
Give a gift subscription
Report [this is red letters!]
... the vicissitudes of technology!
Oh, and I did have terrible EBV when in university- slept through my exams! Diagnosed with MS some 30 years later after an adult life of undiagnosed struggles. It’s not easy being taken seriously as a woman in a doc’s office…
I am so grateful for all you do and have done for PWMS. I’m sure your patients are grieving your loss. As for me, I’m all about the upstream, having been a public health nurse and an epidemiologist. If we don’t start looking at causes the illness we survive will just multiply and overwhelm. Best of luck with your work. I would truly love it if the chanting of “end to MS in our lifetime” comes true. But for that we need causes and prevention!
Three cheers to you and thanks again.
Dr. G, Congratulations on this shift in your work. I only hope you continue to engage us with posts in MS-Selfie! I worked in public health myself, my most cherished accomplishment was uncovering the nexus of factors around credit card debt for college students (depression, alcohol overuse, GPA).
I did have IM as a young adult, unremarkable. It is exciting that IM might point you toward an effective antiviral. Maybe these have been examined already, but I wonder if ACEs and head injuries combine with IM to make one susceptible to MS. I have some ACEs and 2 childhood head injuries.
Your impact at an individual patient level has been enormous, that is for sure. And the ripple effect to friends and family is certainly true as well. I will miss you as my neuro, you have really helped me to take greater ownership of self-management and helped me understand the lifestyle triggers I can teach my kids to avoid to minimise their risk of MS. 60 is young in this age of the “hundred year life” (have you read the Lynda Gratton book?) and a change in career direction at 60 sounds like an amazing idea, you can accomplish both- what an incredible impact from one life!
Oh the Glandular fever point, I haven’t ever had it. My cousin had it when I was young so I suppose I was around the virus but I didn’t have it myself. I did have an unsolved urticaria attack in my teenage years and I have had mumps in my twenties around 2004 when there was an outbreak at British universities and I saw someone else had mentioned mumps too. Would it be helpful to collect this background information at scale? I’m sure patients who read your blog would be happy to contribute to a poll / research survey if that would help your research.
I don't think I've ever had mono but used to suffer with bad sore throats as a child. My twin sister had glandular fever as a teen. I was diagnosed with ms in my fifties and she's fine! Thank you for all your hard work and good luck!
I don't think I had mono either but did get a bunch of other infections as a kid.
Thank you, doctor Giovannoni.
Your title - FAREWELL - NO FANFARE left me tinged with sadness and resonated…) my exit from teaching after 23/24 years of service was this too) until I read further…. I always knew you were someone special ‘rooting,’ for your patients and now the next part of your journey will impact a wider audience/ aka could have ended up as MS people. What a gift that will be for all who can avoid MS through your upcoming research and implementations. Now that is a really exciting chapter to be read and digested. Thank you for all you have done for us MS ers and congratulations for what you are and will be doing to make that difference, that difference which is much needed. Onwards and upwards 👆…🙏🏾
I for one am very pleased you’re continuing to look for the ‘C’ word. Everything that happened in your career pathway led you to this point, so it’s all good. Even the awful motorcycle incident, while you would have probably missed it if had you the choice, appears to have pushed you away from fire fighting on the neurology front line to this. Metaphorically, developing fire extinguishers, safety matches and health and safety policy is way better for those who have been and will be burned than changing a dressing. Thankyou. For entirely non-altruistic reasons, I hope you get your breakthrough soon and I’m not saying goodbye because I will continue to read every word you put into print.
Thank you for your posts which have been at times optimistic but also sometimes quite depressing, however always interesting
Thank you for all your research and explanations etc. As I still try to figure out what works for me, your letters have been very helpful. I have now concluded that for me., exercise good diet but also laughing seeing friends and being in nature are my weapons. It's taken 2 years and daily pilates after a relapse for me to be able to stand upright and walk further
Self-motivation and patience are key to progress in my case. I ve always had plenty of the former but I'm still learning the latter. Enjoy your new career and good luck. All the best
Congratulations on reaching this watershed moment in your career. I'm sure your patients will miss you.
As for IM I had Glandular Fever as an 18 yr old and it wiped me out for about 2 months. I first presented at 51. Although approx 6 months earlier I suddenly developed an unusual itchy rash all over my body except my head. The rash was ugly angry under the skin blotches. My G.P. was quite disinterested. I often wonder if this was related to MS