"Is He a Doctor?"

By Jean Parkin

This book is about the breakthrough in finding a cure for tuberculosis thirty years after the drug isoniazid was introduced. The action and metabolism of isoniazid was unknown in many ways. Dr. Parkin, clinical pharmacologist, and Prof. Peter Donald, pediatrician, employed at the Tygerberg Hospital / Stellenbosch University Medical School, collaborated in research related to the pharmacology and pharmacokinetics of the drug. It shows the exciting progress forward until eventually, their publications roused world interest as they were accepted and published worldwide. They had formed a research team with several other doctors, as the names in the respective publications show.

• Language: English
• Publisher: AuthorHouse
• Release date: Nov 23, 2016
• ISBN: 9781524650889

Jean Parkin

She was born and reared in South Africa.She emigrated to Canada, and has Canadian Citizenship. She was married to the late Dr. Don Parkin and has five children. She is a classically trained Soprano, collects Art and reads the Classics.She believes in Sir Ernest Shackleton's motto " By endurance we conquer"

Book preview

Is HE a Doctor?

JEAN PARKIN

36788.png

AuthorHouse™

1663 Liberty Drive

Bloomington, IN 47403

www.authorhouse.com

Phone: [phone]

© 2016 Jean Parkin. All rights reserved.

No part of this book may be reproduced, stored in a retrieval system, or transmitted by any means without the written permission of the author.

Published by AuthorHouse 11/21/2016

ISBN: 978-1-5246-5089-6 (sc)

ISBN: 978-1-5246-5088-9 (e)

Any people depicted in stock imagery provided by Thinkstock are models,

and such images are being used for illustrative purposes only.

Certain stock imagery © Thinkstock.

Because of the dynamic nature of the Internet, any web addresses or links contained in this book may have changed since publication and may no longer be valid. The views expressed in this work are solely those of the author and do not necessarily reflect the views of the publisher, and the publisher hereby disclaims any responsibility for them.

Contents

Dedication

Introduction

Don Parkin An Appreciation

Chapter 1

Chapter 2

Chapter 3

Chapter 4

Chapter 5

Chapter 6

Chapter 7

Chapter 8

Chapter 9

Chapter 10

Chapter 11

The Children

About Prof. Peter R. Donald.

Acknowledgements

Sources of Reference

Dedication

I dedicate this work to the original Team;

Prof. Peter R. Donald, Dr. L. Gent (dec), Dr. H. Seifart.

and to; Norman, Ingrid& Renier, Andrew & Jayne, Sonya,& Donald.

and to all 10 our Grandchildren,

also to Dr. Miguel Pereira and his wife, Michelle,

whom as virtual strangers, stood by us throughout Don’s illness and demise, in professional assistance and friendship.

Introduction

Tuberculosis, in previous centuries known as consumption, has struck down millions of people of all ages. Death was the ultimate reaper for a disease that is highly infectious and remorseless without treatment. Dr. Don Parkin and Prof. Peter Donald gathered round them a team of Medical Professionals, and in their extensive research this team found a drug for satisfactory treatment, a breakthrough, a gift to the TB sufferers in the world. This is their story and more specifically, that of Dr Donald P. Parkin.

In the words of Prof. Donald, this is how it started.

Prof%20Peter%20Donald%20(2).JPG

Prof. Peter Donald

DON PARKIN An Appreciation

My first recollection of Don dates from about 1976. I was the Pediatric Registrar on call, and Don was the House Doctor. Don had done a lumbar puncture on a child with suspected meningitis that had produced a turbid Cerebrospinal Fluid indicating probable meningitis. I had forgotten the precise details of the incident, but Don reminded me later that I had been very annoyed that the child had not been started on anti-biotic treatment. Sharing an after hours call in a busy Hospital, where life and death is ones daily fare, is a certain way to get to know one’s companions, and I soon became aware of Don’s sterling qualities.

Don was totally reliable and always aware of what was going on around him, and more important in the context of Medicine. He was also very aware of the character of the people he was dealing with, whether it was the junior Nurse in the ward, a porter or the grandmother who had brought a child to the Hospital, he had them all summed up and knew instinctively the best way to approach them. Our working relationship became a close and understanding friendship. In 1978, when I married Dr. Lana van Zyl, Don, Jean and the children were present as old friends.

Lana and I left for Australia after the wedding, and when I returned to Tygerberg Hospital a year later, I found Don established in the Dept. of Pharmacology, working as a Clinical Pharmacologist. At that time I had little idea where my career was going, but had an interest in Infectious Diseases, and had worked for a year at the City Hospital for Infectious Diseases in Cape Town. It was one of the main Cape Town Hospitals for managing Tuberculosis. This was known to some of my colleagues, and as I still knew many of the City Hospital staff, it led to several projects related to TB that required access to patients with various complications. On reading the literature related to the treatment of TB, it was apparent that relatively little was known about the pharmacokinetics of many of the standard anti-tuberculosis drugs; somehow the Academic world had forgotten all about the disease.

I discussed all this with Don, and he was able to persuade his Head of Dept. of the potential importance of what we had in mind. Within a year we had gathered a small team in the Dept. of Pharmacology, and were engaged in our first studies. The essential members of this team were Don, Dr. Heiner Seifart, Dr. Lawrence Gent and myself. Don’s part in this could best be described as the yeast in the gingerbread. However, not only did Don make the gingerbread rise, he also had the insight and patience to handle the inevitable problems encountered in any research program, and to maintain the interest of the other members of the team in times of difficulty.

From the start much of our work was focused on the pharmacokinetics of Isoniazid. We were fortunate that the start of our research coincided with the increased availability of more sophisticated pharmacological methodologies, such as high pressure liquid chromatography and molecular genetics. This enabled us to give a new slant on the existing older data. With the aid of these newer methodologies, we were soon able to start making original contributions to TB literature with regard to drugs that were already more than thirty years old. These were happy days for our whole team; we had work to do, it was original work, and far from being the traditional esoteric occupation of academics in an ivory tower. It related to one of the most important infectious diseases in the world, and we were getting it published in leading Journals.

One of my lasting memories of these days, is coming to the Dept. of Pharmacology, turning left to go to the Seminar Room, and finding Don standing in front of the blackboard, puzzling over some or other mathematical formula that might, for example, elucidate the differences between the NAT2 genotypes in their handling of Isoniazid and its metabolites. The next step would be a cup of tea, and then we would sit down in front of the blackboard and discuss the matter from all different angles, and invite anyone who came in to join in the discussion. Much the same would happen at lunchtime, when we would chew the academic cud, while munching our sandwiches. In this way all our doubts and ideas related to the work in hand, would be thoroughly discussed and approaches and solutions developed.

Perhaps the most important contribution Don was able to make in the literature, was related to the influence of the N-acetyltransferase type2 genotype on the pharmacokinetics of Isoniazid. The existence of three phenotypes of excretion of Isoniazid, had been known since the discovery of Isoniazid, but it had proved impossible to differentiate them clearly. With the aid of molecular genetics, Don’s mathematical insights, and the analytical ability of Drs. Gent and Seifart, we were able to finally tie the whole thing together, and to provide a precise phenotypic differentiation of the different speeds with which Isoniazid was excreted, and backed this up with genotypic confirmation. Don’s work was published in several Journals, but most importantly in the American Review of Respiratory Diseases, probably the most prestigious Journal publishing Tuberculosis related research.

At that time there was very