Clinicians don't cease diagnosing patients once our clinical work is done. Most of us can recall debating whether to point out an atypical mole or another concerning finding to a stranger in public.
Patients even recognize their own experiences and help lead others to clinical care.
And our diagnostic abilities can sometimes prove entertaining when interpreting plotlines in all sorts of storytelling, with endocrinology often making appearances in literature and film.
For instance, much debate has ensued about what Tiny Tim probably suffered from in Dickens's A Christmas Carol; a combination of tuberculosis and rickets makes the most sense to me, as detailed in a report in JAMA.
Malcolm Gladwell pointed out that Goliath in the biblical story probably got his stature and his inability to miss a shepherd boy's slingshot from a pituitary tumor. And the plot of Steel Magnolias revolves around type 1 diabetes.
Most recently, I began to see endocrinology everywhere in probably the most successful series of stories of recent times: the Harry Potter chronicles.
If, like me, you have a Potter-obsessed household, you might have watched the Return to Hogwarts special on HBO earlier this year. One of the observations that piqued my attention was when Emma Watson and Daniel Radcliffe joked about the hormones running rampant as the characters and actors who played them navigated adolescence, growing from children to teens as they made successive movies.
The Wizarding World of Hormones
Popular culture has picked up on the comedy of these sometimes awkward pubertal transitions, repeatedly skewered by Saturday Night Live. However, this line made me ponder other less-famous hormones that could explain some of the fantastical findings of the wizarding world.
Hormones — invisible chemical messenger — are truly magical. They are most famous for sexual development but also empower growth, bone strength, fluid homeostasis, weight, carbohydrate metabolism, salt balance, blood pressure regulation, and any other function you can imagine; indeed, thyroid hormone is crucial for almost every system of the body.
Perhaps, the notable transformation of the main characters through puberty isn't the only hormonal influence we should credit. (This article may contain spoilers: My husband didn't read the Harry Potter series until we read it to our second grader so sadly learned at the age of 37 about the tragedy that befell Dumbledore.)
Diagnosing the Characters
Just for fun, here are some other hormonal diagnoses that could explain some of the dark arts represented in the series.
Could Hagrid the giant have acromegaly? Clinical signs include enlarged hands and feet as well as excess growth of the ears and nose. A good way to check for these changes is to compare old photographs with the present condition. The actor who plays Hagrid, Robbie Coltrane, looks very different from the character after his transformation. Someone check his IGF-1 — the hormone that manages the effects of growth hormone!
Neville Longbottom, the series' late bloomer, is the poster child for teens with constitutional delay of growth and puberty. This often frustrating but benign condition that plagues the "slow developer" tends to run in families and causes those who have it consternation as they wait to grow while their peers surpass them in stature and other ways; it also leads for them to be underestimated, as we witness with Neville in the Harry Potter series.
Voldemort: Depicted without a nose, if He-Who-Must-Not-Be-Named had congenital central abnormalities, he should be screened for central pituitary hormone deficits because the pituitary gland shares common embryology with other midline structures. (His evil has nothing to do with his possible underlying endocrinopathies.)
The Weasley family: if any of these redheaded wizards presented with adrenal insufficiency and rapidly progressive obesity, a POMC (proopiomelanocortin) mutation should be considered.
Nearly Headless Nick's near-decapitation might have affected his thyroid or parathyroid glands — Hogwarts physician Madame Pomfrey should pay special attention to his thyroid stimulating hormone and calcium levels, at least if she is willing to take advantage of Muggle remedies.
Moaning Myrtle, who was killed by the Basilisk in the girls' lavatory, continues with tantrums and moans as she haunts the same bathroom at Hogwarts. Could it be that Myrtle's groans and psychiatric overtones were a sign of hypercalcemia, and she was using the facilities as she tried to pass a kidney stone? At the very least causes of polyuria should be investigated, including diabetes insipidus and diabetes mellitus. A unifying diagnosis of never being able to leave the bathroom and vision changes requiring serious glasses like hers would be untreated septo-optic dysplasia or other causes of pituitary malformation or disruption.
And though Dolores Umbridge doesn't have an obvious endocrine disorder, she seems like the kind of person who would visit an endocrine office after doing loads of "her own research" and arrive with a list of labs she demands.
Severus Snape provides a good opportunity to point out someone with excessively greasy skin and abnormal sweating (hyperhidrosis) as an adult, symptoms that perhaps would be best managed by our colleagues in dermatology.
The Dementors: These demons clearly work for insurance companies, tormenting the young wizards with denials and prior authorization requests.
Endocrinology Is Everywhere but Often Not Seen With the Naked Eye
Enzyme names sound a lot like spell incantations. Iodothyronine deiodinase? HMG CoA reductase? Future authors looking for new spells need look no further than their closest endocrine textbook.
Please note, I consider all my patients to be miraculous and worthy of admiration — these comparisons are all in good fun and in no way diminish the weight of these conditions.
As Rubeus Hagrid himself said, "I am what I am, an' I'm not ashamed. 'Never be ashamed,' my ol' dad used ter say, 'there's some who'll hold it against you, but they're not worth botherin' with.'"
Like magic, endocrinology can't be seen with the naked eye, but it's everywhere we look, if only we choose to look.
Lead image: Siempreverde22/Dreamstime
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Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Harry Potter's World Offers View Into Magic of Endocrinology - Medscape - Jun 22, 2022.