Tintin – a diagnosis by Dr Fairytale

0

tintinI have taken this referral from Claude Cyr, a professor of medicine at Quebec’s Sherbrooke University asking for some differential diagnoses. Professor Cyr has already hypothesised that: “Tintin never aged during his 50-year career because the repeated blows he took to the head triggered a growth hormone deficiency.

This intrepid Belgian reporter has suffered 50 significant losses of consciousness during his many adventures. I hypothesise that Tintin has growth hormone deficiency and hypogonadotropic hypogonadism (a disorder of the pituitary gland) from repeated trauma. This could explain his delayed statural growth, delayed onset of puberty and lack of libido.” Although this opinion appears on the surface to be valid, it fails to take into account some of his other symptoms.

Psychogenic amnesia

People have described Tintin as ‘a well-rounded, yet open-ended character, noting his rather neutral personality – sometimes labelled as bland’. In fact, even the name ‘Tintin’ remains a mystery and whether it is a first name or a surname is unknown. It may not actually be his real name, but rather a pseudonym that the character uses to protect his identity. At this point it is worth considering his early upbringing.

Tintin was raised by his mother who died of illness when he was a child. He never knew or met his father, whom Tintin believes to be dead. Early trauma is thought to be a major risk factor for Psychogenic amnesia, a disorder characterized by abnormal memory functioning in the absence of structural brain damage or a known neurobiological cause. Here, a patient can lose their autobiographical memory and personal identity even though they are able to learn new information and perform everyday functions normally. Professor Cyr points out there is a history of head injury, however these symptoms were present prior to these.

Hookworms & Iron-Deficient Anaemia

Tintin shows growth deficiency, pale skin and thinning hair. At times he has remarked about the bright lights (Tintin in Tibet) and has often felt faint (Tintin – The Blue Lotus). This could clearly be a result of this simple but untreated condition. Because it tends to develop slowly, adaptation occurs, and the disease often goes unrecognised for some time.

Iron deficiency anaemia can be caused by parasitic infections, such as hookworms, with the intestinal bleeding leading to faecal blood loss and iron deficiency. In his travels it is likely that Tintin would have been exposed to such parasite given that they are rife in Sub-Saharan Africa (Tintin in the Congo) and India.

Craniopharyngioma

A rare, usually suprasellar, neoplasm that develops from the nests of epithelium derived from Rathke’s pouch (an embryonic precursor of the anterior pituitary) and grows very slowly along the pituitary stalk. They usually are classified as benign and comprise 9 percent of all paediatric brain tumours – occurring in children between 5 and 10 years of age.

On light microscopy, the cysts are seen to be lined by stratified squamous epithelium with keratin pearls. The cysts are usually filled with a yellow, viscous fluid that is rich is cholesterol crystals. This would account for a reduced growth hormone release. It is much like the original diagnosis made by Professor Cyr but sounds much more medical and uses some great long words.

An Addendum

As a side-note, Tintin is remarkable in that he is apparently devoid of sexual or romantic feeling. In the last adventure a female, Martine Vandezande, flirted with Tintin and appeared to ask him out on a date towards the end but nothing ever happened. He, however, describes Snowy, a Wire Fox Terrier who travels everywhere with him, as “having a bond that is deeper than life”. This would not impact on his growth but it may necessitate a detailed psychosexual history – including fantasy exploration – and a psychiatric referral.