The prostate cancer patient who suddenly spoke with an Irish brogue

Happy St. Paddy's Day

(St. Paddy’s Day, Chicago-style. Howard Wolinsky.)

By Howard Wolinsky

Chicago can’t wait until March 17 to celebrate St. Paddy’s Day. So today (March 11) The River Chicago runs green today starting at 10 a.m. Central. It’s tradition (with the exception of in the first year of CVID-19 in 2020 when there was no official dye job. Not to say there wasn’t an unofficial one, of course.)

We have a creek in my town, Flossmoor, Illinois, that may be naturally green-ish and our St. Patrick’s Day parade was on March 4 so that the Flossmorons, as I call our citizenry, can attend the festivities in Chicago. Two St. Patrick Days for the price of a train ticket on the Metra.

St. Patrick is the patron saint of Ireland, where he brought Christianity in the 5th Century. He also is supposed to have driven the snakes into the sea. Bishop Patrick himself wrote that he raised people from the dead. Impressive work.

In celebration, in the City of Big Shoulders, corn beef, and cabbage will be consumed by cattle cars full. Green beer will flow in the pubs accompanied by public urination and drunks falling onto the boulevards and alleys.

Every eejit will be spouting a Dublin brogue.

This is a long lead-in to the strange Oliver Sacks-like tale of the man with prostate cancer who suddenly spoke with an Irish accent.

Only a small number of such cases have been identified in the medical literature.

It’s known as foreign accent syndrome (FAS)—only about 100 cases have been recorded in the world. It occurs when a patient develops an accent usually in cases where there have been strokes or trauma to the face or head.

Now, for the first time, Duke University researchers have reported a case in which a patient with prostate cancer developed FAS with an Irish brogue.

The patient in his 50s had metastatic hormone-sensitive prostate cancer and was receiving androgen deprivation therapy and abiraterone acetate/prednisone.

He had been diagnosed with prostate cancer 20 months prior to his speech issues. At that point, he reported notable changes to his usual speech patterns, as he had begun to speak with an "Irish brogue."

(Pissing green on the Chicago River—Howard Wolinsky.)

Researchers reported: "The patient had never been to Ireland and had never previously spoken in an Irish accent, though he had Irish family/friends and had lived in England briefly in his 20s," the team from Duke Cancer Institute wrote of the Californian. "His accent was uncontrollable, present in all settings and gradually became persistent."

The case report was published in BMJ Case Reports.

Medical oncologist Andrew Armstrong, MD, of the Duke Cancer Institute, one of the patient’s doctors, told me this man was frightened at first about his accent change. But he grew accustomed to it after no other worrisome pathology, such as a stroke, was ruled out.

Armstrong said: “When I first met him, he was more amused by it than anything but could not control it or revert back to his old accent. His family was much more concerned about his cancer than his accent issue.”

What could trigger this?

The patient told doctors that he had not suffered any head trauma, nor any other symptoms beyond unintentional weight loss. An MRI of his brain came back as normal, but a CT scan of his pelvis and abdomen revealed that his prostate cancer was progressing. As well as being diagnosed with FAS, he was referred to neurology for further investigation.

Armstrong said: “Certainly, a psychological component is possible, and we do not have a clear biologic explanation for this syndrome. Previous reports as we discuss have been linked to stress, trauma, brain injury, brain tumors, or strokes, and he did eventually develop CNS metastases from his prostate cancer, so it is possible that this had a physical cause in his language center.”

Armstrong said another possibility is a paraneoplastic syndrome, a group of symptoms that may develop when substances released by some cancer cells disrupt the normal function of surrounding cells and tissue. The brogue could have been linked to his small cell prostate cancer transformation.

In other cases of foreign language syndrome, a variety of accents have been reported, including French, English, German, Swedish, Welsh, Spanish, Chinese, Korean, and Irish. There has been a case where a Spanish speaker began speaking Spanish with a British accent. Why not?

I listened to recordings of the prostate patient who spoke with the Irish accent until he died in palliative care.

I detected a slight brogue. I am convinced I can do better. It’s my birthright as a native Chicagoan.

You can listen and decide for yourself and vote: https://www.dropbox.com/t/t1qx4BcXhkVvrRwW

Always best to get some second opinions, right?

So I asked my pal Dubliner Tom Hope, 75, who has been on active surveillance for 14 years, what he thought. Tom wasn’t impressed. He said: “This speaker does not have an Irish accent. To me, he sounds American.”

Then, I asked Antoinette Perry, PhD, a molecular biologist and long-time prostate cancer researcher at University College Dublin, to listen to two tapes. She said: “First one sounds a mix of perhaps Northern Ireland with an American twang. The second one is harder to place,  but I agree with Tom; I don't hear too strong an Irish accent!!”

So accent or not, Slaintѐ to all. Happy St. Paddy’s Day. Be safe out there.

(Green hats, green beer, green river—Howard Wolinsky.)

Still, Happy St. Patrick’s Day. Today, we’re all Irish,

---

When Irish eyes are shining … You can hear the angels sing

By Howard Wolinsky

On this day of all days, I am reminded of my late friend Dick O’Connell. A fellow South Sider. A man among men. An honorable man. A principled man. A bright man with a wry sense of humor.

Like me, was part of the newspaper fraternity. He began his career writing headlines and photo captions. According to family members, he was involved in putting together the newspaper marking one of the most tragic events in Chicago, the Our Lady of Angels School fire in 1958.

The next year he was drafted and served as a Green Beret captain in Vietnam.

He sweated more through more nights while earning his MBA from the concrete jungle at the University of Chicago, than he did during his time in Vietnam.

Dick, an executive with Blue Cross/Blue Shield of Illinois and a confidante of Chicago and national pols, was devoted to helping children. Working with city officials, he developed the West Side Children's Garden, a park near the Henry Horner Homes, and the Chicago and Blue Cross CareVan, a mobile immunization clinic serving the city's most impoverished neighborhoods.

He was a devoted father who did everything he could to help his daughter who ultimately died from a brain tumor. I introduced him to another friend, a nationally recognized neurosurgeon, who operated on her. It wasn’t enough.

Dick’s daughter’s death haunted him, and I believe, led him to a dark place. He died in 1997.

If I drank, I’d have a green beer today in his memory.

I’ll toast Dick with a saying he had framed on his desk alongside a photo of his departed daughter:

“May those who love us, love us;

And for those who don't love us,

May God turn their hearts;

And if He doesn't turn their hearts,

May He turn their ankles,

So we will know them by their limping.”

― Old Irish Curse

Dick, you died too young.

---