A good neighbour is better than a far friend.

I’m a clinical physicist that worked in the Radboud university hospital in Nijmegen, The Netherlands from 1975 until December 2010. First 5 years in leukaemia research, then at the Anesthesiology Department.

In the last 5 years of my career I developed a mouse model for the investigation of Ventilator Induced Lung Injury (VILI). Several PhD students finished their thesis with it although I always opposed Slutsky’s proposition that VILI came from overstretching the alveoli. I concluded that PPV introduced atelectasis as a direct result of the switch from the iron lung (polio epidemic of 1950-60).  Since then, the battle against atelectasis began and everybody was fighting the symptoms by recruitment. I never succeeded in convincing our research group and I retired in 2010.  Never-the-less I kept a strong idea in my mind: damaged lungs should be ventilated by Negative Pressure Ventilation (NPV).

Then my life of retirement started and I enjoyed music much more. I played the piano in a trio (clarinet viola, and piano), a quintet with four wind instruments, 4 sopranos’, a flutist with whom I gave performances in several retirement centres and nursing homes; I also accompanied several choirs and attended many concerts (sometimes 5 in a week). Happy life!

Then came Corona, which in fact ended all musical activities (except playing at home).

Upon hearing what was going on in the hospitals, it brought up that old idea again: damaged lungs should be ventilated by NPV, in earnest I started to send my message all over the world. Without success.

Then one of my colleagues, an anaesthetist who had some experience with NPV and agrees all the way with my ideas said: “Jan, you are trying to fight a war you never can win, for they just don’t want to”.

One of my next actions was to write about NPV to my old PhD students. One of them is an anaesthetist in Groningen (University hospital) who also had to assist at the ICU for Corona; he could not bring any change in thoughts either.  However, he sent me the EXOVENT article in Anaesthesia, and that really changed my life.

Look at this history: January 20, 2021, he sends me the Anaesthesia article with the words: “this will be interesting for you”.  One day later I write Malcolm Coulthard to say that I have been fighting for NPV since 2005.  The next day Malcolm invited me to join in.  On February 2nd I held my lecture for the EXOVENT group and I finally got recognition from you guys. Thanks Heaven!

One emotional problem remains for me, on December 7th my neighbour died of Coronavirus after her second pneumothorax on a ventilator. That convinced me that also pneumothorax must be the result of (high) positive pressure, and I have found much convincing material in recent literature.  Sometimes I have difficult feelings that the death of my nicest neighbour brought this recognition to me, and that the grief of her three daughters whom she has left behind motivated me a lot extra.  There is a Dutch proverb that says “a good neighbour is better than a far friend”; she was the living realisation of this proverb.


Jan van Egmond

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