DR KNUT KVERNEBO

From: Dr. Knut Kvernebo

To: Mr. Gabriel Berberian

Dear Mr. Gabriel Berberian
>
> Niels Christian Hvidt has recommended me to write you a letter regarding the stigmatization of Myrna. The background history for this letter is the following:
>
> I am a professor of Cardiothoracic Surgery at University of Oslo, Norway, with working address Ullevaal University Hospital. My background is MD and PhD (University of Oslo), and my research activities has been concentrated to aspects of blood circulation.

> A special research topic has been a rare condition called erythromelalgia (EM). In this condition, affected patients have red, warm and painful hands or feet, and may develop skin ulcers. In this condition the key mechanism in the pathogenesis is micro vascular arteriovenous shunting of skin blood flow, creating a condition where there is high levels of blood flow, but the affected skin is still hypoxic.
>
> For several years I have been interested in knowing whether microvascular arteriovenous shunting could be present in subjects with stigmata.
> I have discussed this topic with the Catholic Bishop in Oslo dr. Schwentzer and he gave me the advice to contact the leader of the Swedish Catholic seminar in Roma, Julio Cesare. He again directed me to Niels Christian, whom I met during my 4 months sabbatical in Rome in the autumn of 2003.
> During a meeting with Niels Christian and Theologian and Medical doctor Manievski, I have become aware of your knowledge of and your observations of Myrna.
>
> I have tried to look for scientific papers related to religious stigmatization, searching the Pub Med database, but have not found any reports in peer reviewed journals. In prof. Manievski's book (in Italian) I see references to reports on clinical observations of stigmata, but again not on more scientific reports observing the phenomenon with advanced technologies.
>
> I have proposed to Niels Christian to create a team of scientists with high reputation and expertise, to observe Myrna during stigmatization, and perform physiological examinations of skin blood flow. The aim is then to write a paper in a high rated peer reviewed journal (like Journal of Investigative Dermatology or Lancet).

> If we can manage to do these examinations, the following paper will of course only be an observational study, but with objective observations, I am sure such a paper will have great interest in the medical world.

> From my communication with Niels Christian, I understand that from a theological point of view, it is a subject of debate whether God uses His laws of nature to induce miracles, or whether He bypasses these laws and creates the miracles directly. If He uses His own laws of nature, it will be interesting to study the physiological mechanisms that takes place before, during and after stigmatization.
>
> The two methods we would like to use are both non-invasive, and can easily be applied bed side, without pain for the subject under investigation. Examinations will take 15 - 20 minutes each time, and it would be of great interest to investigate Myrna two times a day before, after and during stigmatization.
>
> The techniques we have available are: Laser Doppler Perfusion Imaging (LDPI) and Computer Assisted Video Microscopy (CAVM) of skin capillaries. We have published a number of papers using these techniques.
>
> Our team of scientists consist of:

> Niels Christian Hvidt, Doctor of Theology, The Theological Faculty, Pontifical Gregorian University, Rome, Italy
> Goran Salerud, PhD, Professor of Biomedical Technology, Institute of Biomedical Engineering, University of Linkøping, Sweden
> Oivind Ekeberg, MD, PhD, Professor of Behavioral Sciences in medicine, Medical faculty, University of Oslo, Norway
> Cato Mork, MD, defending his PhD thesis in June 2004, Consultant Dermatologist, Rikshospitalet, Oslo, Norway
> Knut Kvernebo, MD, PhD, Professor of Cardiothoracic Surgery, Medical Faculty, University of Oslo, Norway
>
> You will find that all members are experiences scientist, and find their publication lists in the Pub med database. I know Niels Christian only from contact in Rome, but the other three scientists I know from many years of collaboration and friendship. I can strongly recommend them as honest, and friendly individuals, that will all behave in a respectful manner towards the task and towards persons they meet during such a project.
>
> We would be grateful if you could give us advice on how to proceed with the idea. From your experience, do you think Myrna are willing to let us examine the skin circulation during possible stigmatization in the Easter of 2004?
>
>
> Yours sincerely
>
> Knut Kvernebo
>
>
> Professor Knut Kvernebo MD, PhD
> Dept. of Cardio thoracic surgery
> Ullevaal University Hospital
> N- 0450 Oslo
> NORWAY
> Phone: (+47) 22 119500

Dear Gabriel;

In two days time we are on our way to Damascus. We have prepared well for the trip and here is the outline of the plans: We arrive 11 people on Mon 5 April at 14.50 with OS 0841 from Vienna Representatives from the Norwegian Embassy will probably be there to help us through the immigration with our 34 kg of equipment. We will stay at the Semiramis hotel - phone (963-11) 2233555 - 2120225 Members of the scientific team are: Ekeberg Øivind, MD, Professor of medical behavior science, University of Oslo, Norway Häggblad Erik, PhD. student in medical technology, Linkøping University, Sweden Hvidt, Niels Christian, Dr. Theology, The Pontifical Gregorian University, Rome Kvernebo Anne Kari, Medical student, University of Lund, Sweden Mørk, Cato, MD, PhD, Consultant Dermatologist, The National Hospital, Oslo, Norway Salerud, Gøran, Professor of Medical Technology, Linkøping University, Sweden Knut Kvernebo, Professor of cardiac surgery, University of Oslo, Norway We are happy if we have some time with you on the Monday to go through the project and discuss practical details. On Tuesday 6 April we hope to see Myrna (and her advisers) for a first meeting. We hope she will tell us a little of her experiences, and we want to inform her of the nature of our planned examinations. On Tuesday later in the day- if possible -, we hope to obtain baseline data for the measurements. Our daily program will be to have breakfast, then have a group meeting with information and discussions of plans of the day. We will also rehearse on the laboratory protocol for obtaining data in an efficient way. The aim is to perform all measurements in 20 minutes at each occasion. I hope the team will have some time together for short informal presentations for the rest of the team: Niels Christian: Miracles Gøran: Techniques for measuring blood circulation Cato: Healing of skin wounds Knut: Physiology of skin circulation We have not planned such a programme in detail, but if every body are willing to give such a presentation, and you are most welcome to participate. Time and place will be discussed in Damascus. Our wish is to examine Myrna before, during and after the stigmata. The examinations we want to collect are the following: Laser Doppler Perfusion Imaging (LDPI): This technique performs non-touch measurements of blood circulation - the data are presented as circulation pictures of the tissue under investigation; Computer assisted video microscopy (CAVM): This technique consist of a hand held video camera combined with a magnification lens held in touch with the skin. Immersion oil is used. The pictures captured on a pc show skin capillaries - the number and density Light spectroscopy: This device illuminates the skin with ordinary light, and from the reflexes the equipment can examine the content of oxygen In the skin blood cells. We will also measure skin electrical impedance - a measure of the content of salt in the skin and skin temperature None of these measurements are invasive or painful or have harmful side effects. If Myrna will allow, we will also bring simple equipment for taking a blood sample, a small sample from the bleeding from the wounds, and a small sample of oil from the skin. We also hope to take pictures of the wounds. As guaranteed before, Niels Christian and I will see to that we stick to a professional ethical codex. For the medical team, this means that we will work - as usual in our research - according to the rules of the Helsinki declaration. This means that Myrna must authorize the publication of any data collected in Damascus. I hope this information is useful for you, and invite you to raise any question whenever you want to. We look forward to the meeting in Damascus with great excitement! All the best Knut--
Professor Knut Kvernebo, MD, PhD
Dept. of Cardiothoracic Surgery
Ullevaal University Hospital
N 0450 Oslo
NORWAY

Phone: +47 22 119500
Fax: +47 22 117470

( Results are expected within 3 months - July 2004 )

Dear Gabriel

We will arrive in Damascus Monday 5 April 2004 and return home Tuesday 13 April by Austrian airlines.

We will arrive 14:50 and will probably need some time to get through the customs and reach the hotel. The Norwegian Embassy will help us booking hotel, and we have been recommended to stay at the Semiramis Hotel, located near to the old town.
On the Monday we will probably only have time to find the hotel and have dinner.

On the Tuesday we would like to see Myrna and her family, and explain the nature of investigations. Then we would like to make some measurements on a daily basis (20 - 30 minutes). The Norwegian Embassy recommended us to take a trip to Palmyra, and we will see whether we have time when we are in Damascus.

We think it is extremely important to have time to explain the nature of our investigations to Myrna and the people nearest to her. Therefore it is nice if we can have some extra time during the first meeting.

We have planned the following investigations:

We would like to take some ordinary photos, as have been taken many times before.
If possible we would like to take one drop of blood from her finger, and one drop from the bleeding from the wounds - as have been taken at earlier occasions.
We would like to take one drop of the olive oil for analysis - as has been taken before.
We plan to bring an instrument that , without touching the skin, can make a picture consisting of pixels representing the blood circulation in each pixel. In this way one can for example make a picture of the hand, where blue areas represent low blood flow areas and red areas represent high flow areas. This examination does not give any pain and have no adverse effects. The acquisition of the data for the picture takes about one minute per area.
We also plan to use another instrument that gives an estimate of the oxygen content of the red blood cells in the skin. The examination is also without pain, and can best be compared with illuminating the skin with ordinary electric light. The technique has no adverse effects.
The last examination is a small hand held video camera, that is attached to a small microscope. With this instrument, one can see capillaries in the skin, and assess their density in different skin locations. Also this technique is free of pain, but the microscope has to touch the skin. Technically this is the most difficult data to obtain. The technique has no adverse effects

All in all this set of measurements will take around 20 minutes each time, and it would be preferable to examine her before, during and after the stigmata.

Niels Christian and I have discussed the responsibilities towards Myrna and her supervisors, towards our own consciences, and the responsibilities we have professionally as theologian and medical doctors, and scientists.

All participating doctors are used to collect data from patients and control subjects, and our professional code and behavior is guided by the Helsinki declaration. This means that since Myrna is an easily identifiable person, she must consent before any data from her is published.

We will also bring a written introduction and recommendation of the Bishop of Oslo, dr. Schwenzer.

We all are exited about seeing Myrna and her family. Please send our regards to her, and do not hesitate to contact me if you have any more questions.

Look forward to seeing you in Damascus.

Thank you

Knut

--
Professor Knut Kvernebo MD, PhD
Loennhaugen alle 3a
N - 0374 Oslo
NORWAY
Phone: +47 22 490975

( Results are expected within 3 months - July 2004 )