Jen Smith

Diagnosis made by hallucinatory voices This is one of those medical cases that sounds unreal, but actually happened. A middle-aged woman, previously completely healthy, suddenly began hearing voices inside her head. She had no history of mental illness, rarely visited doctors, and lived an ordinary life as a wife and mother. One winter evening in 1984, while sitting at home reading, she heard a calm, clear voice say: “Please don’t be afraid. We want to help you.” The voice claimed that it and another voice had once worked at Great Ormond Street Hospital and wanted her to get medical help. The woman had never been there and had no reason to think about hospitals, which made the experience terrifying. To convince her they were “real,” the voices told her three specific facts she didn’t know. When she checked, all three turned out to be true. Instead of feeling reassured, she became convinced she was losing her mind. Panicked, she went to her doctor and was urgently referred to a psychiatrist. At the psychiatric clinic, she was diagnosed with a hallucinatory psychosis, meaning she was hearing voices without an external source. She was started on an antipsychotic medication called thioridazine. Within two weeks, the voices stopped. Relieved, she went on holiday, believing the problem was over. But while abroad, still taking her medication, the voices returned. This time, they were urgent. They told her something was seriously wrong and that she must return to England immediately. They gave her a specific address and told her to go there. When she arrived back in London, her husband drove her to the address, just to prove to her that it was “all in her head.” The address turned out to be the CT scan department of a large London hospital. The voices told her: - She had a brain tumour - Her brainstem was inflamed - She needed a brain scan immediately Because the voices had previously given correct information, she believed them, and was extremely distressed. To reassure her, her psychiatrist requested a CT scan of the brain, clearly stating that there were no physical signs of a brain tumour and that the scan was mainly for reassurance. The request was initially rejected as unnecessary. Eventually, the scan was done. The result was shocking. It revealed a large tumour in the brain, specifically a left frontal parafalcine meningioma, a type of slow-growing brain tumour arising from the brain’s protective coverings. Despite its size, she had: - No headaches - No weakness - No speech problems - No neurological deficits The tumour was quietly sitting there. Neurosurgeons discussed whether to wait or operate immediately. Surgery was chosen. The tumour, measuring about 2.5 × 1.5 inches, was completely removed. When the woman woke up from anesthesia, she later reported hearing the voices one last time: “We are pleased to have helped you. Goodbye.” The voices never returned. Her antipsychotic medication was stopped immediately. She had no hallucinations, no delusions, and no psychiatric symptoms after surgery. Why this case is so fascinating: Doctors have long known that brain tumours can cause psychiatric symptoms, including personality changes, depression, or hallucinations. But this case was extraordinary because: - The voices were calm and reassuring - They gave specific medical instructions - They directed her to the right hospital - They disappeared permanently after tumour removal Some people believed it was something paranormal. Others suspected fabrication. Most clinicians agreed on a simpler explanation: ➡️ The tumour likely caused subtle brain changes that expressed themselves as hallucinations, and once the tumour was removed, the symptoms vanished. The takeaway 👇 This case reminds us that: - Mental symptoms can sometimes have physical causes - Brain tumours don’t always cause pain or weakness - The brain can send distress signals in unexpected ways