Dr Cecil Todes: Author of 'Shadow Over My Brain'

Cecil Todes was a consultant child psychiatrist, psychoanalyst and author of an original and now classic book about his own Parkinson's disease, Shadow Over My Brain.

On its first publication, in 1990, the book was highly praised in its preface by the neurologist and writer Oliver Sacks. As well as being of great interest to the general reader and Parkinson's disease sufferer, it should be essential reading for all medical students interested in neurology and for all trainee specialist neurologists. It is the first book about Parkinson's disease ever to be written and researched by a Parkinsonian patient.

When Todes came to the UK from a Jewish South African background in the mid 1950s, to escape the oppressive apartheid regime prevailing at the time, he had already qualified in dentistry at the University of the Witwatersrand. He gained more qualifications in London by specialising in orthodontics and gained a fellowship in dentistry. For any more ordinary mortal these professional attainments might have been enough, but not for Cecil Todes, who was driven also to become a qualified physician and then psychiatrist and psychoanalyst.

In 1957, he enrolled as a medical student at the West London Hospital, which later merged with Charing Cross Hospital Medical School, where we became colleagues and friends. After two pre-GMC registration jobs, Todes had the brainwave of going to the United States to take up a Harvard psychiatric training residency in Boston. It was while in America that he married Lili Loebl, a journalist for Newsweek.

On his return in 1965 we successfully prepared together for the Diploma of Psychological Medicine examination. He was appointed almost immediately as senior registrar in Adolescent Psychiatry at the Tavistock Clinic and granted training there with the distinguished psychoanalyst and pioneer in attachment theory, Dr John Bowlby. Attachment theory and loss were to influence profoundly Todes's subsequent ideas and development.

He also trained with the eclectic paediatrician and psychoanalyst Dr Donald Winnicott; meanwhile, he underwent a Freudian training psychoanalysis with Dr Lothair Rubinstein, a refugee from Nazi Vienna. He was appointed consultant child psychiatrist in 1970 at Barnet Hospital, transferring shortly afterwards to Great Ormond Street Hospital and then to the Paddington Centre for Psychotherapy, where he remained until he took early retirement from the NHS, because of Parkinson's disease, in 1987; remarkably, however, he continued practising psychoanalysis and psychotherapy privately until 1992.

His Parkinson's was so mild at its onset in 1971 that the then professor of neurology at the London Hospital told him to ignore it. The first symptom had been the stopping of his automatic watch when he had ceased swinging his left arm while walking.

Todes publicly broke his association with Anna Freud and her clinic for disturbed young children in 1977, after he had formed the judgement that her insistence on assessments and treatment methods only by herself and her students, rather than trained child therapists, were antiquated and out of touch with modern standards. He was never overawed by the big names of psychoanalysis and what some regarded as the cult of the Freud family, and it was also his conclusion that Sigmund Freud's biographer, Ernest Jones, was chiefly responsible for the damaging rift between Freud and Carl Jung, an observation which may be regarded as an important contribution to the study of psychoanalysis.

Perhaps the most important thrust of Shadow Over My Brain is the possible psychosomatic causation of Parkinson's disease, due to early loss of a loved one in genetically predisposed individuals, and the importance of somatopsychic mechanisms, such as music, pottery and swimming in the rehabilitation of Phase Two Parkinson's. Todes's mother had died just before his seventh birthday and he experienced this as a great loss. His own training psychoanalysis probably revived this early traumatic memory and its strong emotions, and this was reinforced when his own training psychoanalyst suddenly died in his presence in Vienna.

Shadow Over My Brain reveals a resourcefulness, determination and rare originality, and with the Parkinsonian condition made an opportunity to explore the relationship between mind and body for both sick and healthy. It also portrays an enormous courage in trying a range of new medications and treatments for the disease; Todes even underwent a radical and unsuccessful foetal cell transplant into his brain. Although he was befriended and treated by leading neurologists, he also felt they lost interest in his case when it became very chronic. He describes how he experienced episodes of breaks with reality as a side effect of medication, leading to hospitalisation.

With the average prognosis of life for Parkinson's sufferers extending up to 20 years, he survived for almost 40.

Nathaniel Minton

Cecil Jacob Todes, child psychiatrist and psychoanalyst: born Johannesburg, South Africa 29 May 1931; twice married (two sons, one daughter); died London 5 June 2008.

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