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The Woman Who Lost Her Skin And Other
Dermatological Tales 1st Edition Rob Norman Digital
Instant Download
Author(s): Rob Norman
ISBN(s): 9780415343565, 0415343569
Edition: 1
File Details: PDF, 3.06 MB
Year: 2004
Language: english
THE WOMAN WHO LOST HER SKIN
 THE WOMAN WHO LOST HER SKIN
(AND OTHER DERMATOLOGICAL TALES)

Dr Robert A. Norman
First published 2004
by Routledge
11 New Fetter lane, London EC4P 4EE

Simultaneously published in the USA and Canada

by Routledge
29 West 35th Street, New York, NY 10001

Routledge is an imprint of the Taylor & Francis Group

This edition published in the Taylor & Francis e-Library, 2004.

© 2004 Robert A. Norman

All rights reserved. No part of this book may be reprinted or reproduced

or utilized in any form or by any electronic, mechanical, or other means,
now known or hereafter invented, including photocopying or recording, or
in any information storage or retrieval system, without permission in
writing from the publishers.

British Library Cataloguing in Publication Data

A catalogue record for this book is available from the British Library

Library of Congress Cataloging in Publication Data

A catalog record for this book has been requested

ISBN 0-203-34197-X Master e-book ISBN

ISBN 0-415-34356-9
 CONTENTS
Author’s biographical details vi
Acknowledgements vii
Foreword ix
One Liquid Air 1
Two The Woman Who Lost Her Skin 5
Three Numbness of the Arm 15
Four A Mystery 19
Five Melanoma 21
Six The Eye of the Storm 31
Seven The Color of Burn 37
Eight A Hairy Tale 43
Nine Little Bubbles 53
Ten A Life on the Skin 59
Eleven The Birthmark Revisited 69
Twelve Not a Wolf 75
Thirteen Apollo’s Legacy 81
Fourteen From Dracula to Cancer Slayer 89
Fifteen Wart’s New 95
Sixteen A Day in the Life 103
Dr Rob Norman’s first job was as a
caddy at Cascade Country Club in
his hometown of Grand Rapids,
Michigan. His next career move
(at age 15) was to assist in the toy
department at Herpolsheimer’s, a
huge downtown department store.
Rob was quickly promoted to run
the Christmas train attached to the
ceiling of the bargain basement,
where mothers handed him rolls of dimes to keep their
children on the train while they went shopping. It was at
that time that he developed his first comedy act, keeping the
kids entertained with jokes (“Did you hear the one about the
mother who left her little kid on the train?”) It was also at
that point that he spent time soul-searching (almost ten
minutes) and realized that retail was not his passion. He put
his youthful efforts into medicine and writing.
He became an emergency room doc and family practitioner,
and spent time in the Big Apple and Beantown, having his
plays produced, and wrote a piece for the Letterman show.
The opportunity came to be a dermatologic physician and
surgeon and he grabbed it by the epidermis. Rob is a clinical
instructor for several medical schools and has volunteered on
medical committees to improve patient care. He participated in
medical programs in Scotland, Haiti, and, in the fall of 2001,
in Cuba. Rob has written 15 books, over 200 medical and
general articles, including articles for Discover magazine.
He wrote the lyrics, co-produced and played harmonica on
two Blues CDs and continues to write comedy.
He and his wife Carol have five children. He knows
none of them by first name but keeps pictures of them in his
wallet so he can keep track when they ask for money.

vi
 ACKNOWLEDGEMENTS
Thanks to Karen Bowler and Claire Gauler of Routledge,
London, for their incredible work. Much love to my wife
Carol, my children and other family, my fellow doctors,
students, office staff, and my patients. (Patients’ stories have
been adapted for this book and names and personal details
have been changed.)
Chapters Two, Three and Five have previously been
published in earlier forms in Discover Magazine; Chapter
Four in an earlier form in Cutis magazine. Chapters One and
Sixteen have been published in a book by Rob Norman –
Take Two Aspirin and See Yourself in the Morning
(Mancorp Publishing, 1997), and Chapter Five was
published in Mother Nature, Father Time (North Shore
Press, 1998).

vii
 FOREWORD
In this fascinating, delightful, insightful and informative
account of frontline medicine Dr Robert Norman joins a
notable list of physician storytellers who report their daily,
intimate experiences for the enlightenment and
entertainment of the public. He is a worthy descendant of the
likes of Chekhov who brought the physician's eye to the
comedies and tragedies of the sick and scared.
While this book is eminently readable and therefore
susceptible to the criticism of being superficial – even funny
– no one should be deceived by Norman's lively, narrative
style. Chronic skin diseases cause a lot of misery with
devastating effects on the quality of people’s lives. Norman
shows his empathetic skills in his humanistic, non-affected
manner of cheerfully helping these patients.
Dr Norman is a scholar who possesses the rare ability to
use the conversational form to communicate how the caring,
compassionate doctor deals with frightened patients. He is
the holistic doctor who takes into account patients' beliefs
and feelings to the enhancement of a favorable therapeutic
outcome.
Norman is a talking–listening doctor who knows how to
avoid doctor-speak to learn more about his patients' fears
and hopes. This book allows you become a close observer of
what is actually going on in the patient–doctor encounter.
Medical students, drowning in a Niagara of new evidence-
based medicine, would do well to read this account. They
will learn much more about the art of medicine than the
professoriate has the time or interest to teach them.
In a time when doctors are widely thought to be merely
technocrats who dispense medicines rather than
psychological support and counseling, Norman's chatty
account is an inspiration for those who long for that

ix
 The Woman Who Lost Her Skin

endangered species – the old-fashioned family doctor with a

wonderful bedside manner, who instinctively knew more
about healing than the molecular biologists of today.
Moreover, by reading this book, harried doctors of today,
threatened with a chaotic legal system and the bureaucratic
hassles of managed care, can arm themselves against early
bum-out and despair by seeing first-hand the satisfaction and
joy that Norman gamers from his unique down-home style in
fulfilling the Hippocratic goal of relieving suffering.
One further message of this richly textured, multi-
layered saga is noteworthy, namely, you don't have to
commit social suicide by becoming a doctor holed up in
professional isolation from the beautiful outside world.
Norman is a role model of balance in seeking the good life.
You can raise five kids, be a sports enthusiast, engage in a
wide range of community efforts and have a helluva lot of
fun at the same time.
Albert Kligman, MD

x
 One

LIQUID AIR
Since I’m a dermatologist, I need to give you the low-down
on the skin. It’s the body’s largest organ, and truly an
amazing structure. At twenty square feet and nine pounds,
it’s an excellent device to protect the inner environment.
The skin has three major components: the epidermis,
dermis, and subcutaneous layers. The epidermis, the
outermost layer of skin, has a top layer called the stratum
corneum, composed of closely-packed cells which helps
protect the skin from external abuse. Underneath are
pigment cells, which provide our variation in color, and
immune cells, which filter out foreign materials and
dangerous substances. The middle layer is the dermis, where
collagen, blood vessels, nerves, and other substrates live.
Below the dermis is the fatty subcutaneous layer, which
protects and insulates.
When you’re a baby, your skin is elastic and resilient,
and it changes every day from then on. We lose about 1% of
collagen every year after age thirty, as well as elastic fibers
and blood vessels that attach to the epidermis. The result is
crinkles and wrinkles – a rather unfair exchange. The skin
becomes sallow and pale. We increase fat deposition in the
areas we don’t like, and we lose fat and therefore insulation
in other body areas such as the face, arms, and legs, which
decreases our tolerance for cold. The underlying tissue
depletion makes us more prone to injury, and the loss of
nerves provides for poor heat tolerance.
Now, on top of all these natural occurrences of aging,
consider increased exposure to UV light, alcohol, smoking,
diet, and heredity. The protective ozone layer is thinning,
and skin cancer rates are increasing. In the United States one
person dies every hour from skin cancer; one third of all

1
 The Woman Who Lost Her Skin

cancers are skin cancer, and 40-50% of all Americans who

reach age 65 will develop skin cancer in their lifetime. And
in the UK it is the fastest-growing and most common form
of cancer, and skin cancer rates have doubled over the last
10 years, with over 40,000 new cases diagnosed each year.
Three basic types of skin cancer exist. The most
common is basal cell, but this is also the least likely to
spread. One third of all basal cells occur around the nose.
Other common areas are on and around the ears, upper back,
neck, and cheeks. Squamous cell cancers are more likely to
spread, and, like basal cells, are generally the result of
chronic sun exposure. Melanomas are the deadliest cancer.
When a melanoma has grown to the size of a dime, it already
has a 50% chance of having spread. The rate of melanoma in
the US has doubled in the past 30 years and, each year,
53,600 people learn they have melanoma.
So how can we prevent these cancers from growing and
killing?
Children must be protected from harmful exposure to
UV rays. Studies have shown that the risk of developing skin
cancer increases if they have three blistering sunburns before
the age of 18. The younger a child is when the burns occur,
the greater the risk.
I recommend every year on your birthday to get your
birthday suit checked. Stay out of the sun, use sun blocks
with a sun protection factor of 15 or greater every day, and
use mild antibacterial soaps and cleansers. You should wear
sunglasses with ultraviolet protective coating, and hats with
brims wide enough to protect the head, ears, and neck.
Special clothing can be purchased which protects the skin
from UV damage. And remember, the UV light from tanning
beds is equally dangerous. There is no such thing as a safe
and glowing tan, unless one uses self-tanning creams. And
remember that many medicines taken internally, such as

2
 Liquid Air

tetracycline and estrogens can increase sensitivity to

ultraviolet light and the chance of you burning your skin.
Many techniques are available for treatment of
cancerous and pre-cancerous lesions. Cryosurgery, the use of
liquid nitrogen for treatment of abnormal skin lesions, has
been used since the early 1900s. Whitehouse had an article
published in the Journal of the American Medical
Association in 1907 entitled “Liquid air in dermatology: its
indications and limitations.” A doctor named Torre came
along in the 1960s and developed a practical apparatus to
use liquid air in a spray form. It rapidly developed into the
preferred method of cryosurgery for treating benign and
malignant lesions. When I ask my nurse if my guns are
loaded, she knows that I’m referring to the canisters I use to
administer my liquid nitrogen therapy. And, like many
dermatologists, I shoot them all day long.
When you think of it, liquid nitrogen is truly remarkable
– using liquid at sub-zero temperatures to destroy tissue in a
relatively easy manner. Destruction of malignant cells
requires a temperature at least as cold as -50 degrees
centigrade. Not only does it seem magical to me that the
liquid stays liquid at these temperatures, but the results can
be amazing.
How does it work? Cryosurgery targets the dermal–
epidermal junction providing separation and removal of
epidermal lesions. In simple terms, the nasty, unwanted
growths usually blister and fall off. And here are some of the
benefits compared to other surgery: very little, if any,
bleeding; no additional anesthesia is required; low rate of
wound infection; no sutures; a biopsy can be done while the
lesion is frozen; rapid healing; fast, easy procedure. Not bad.
The skin is an amazing, versatile organ. There are good
treatments available for your skin ills. My advice, however,
is to protect your skin and prevent skin cancers and other
problems. But you can always just mail me your stories.

3
 Two

THE WOMAN WHO LOST HER SKIN

I was called to the hospital for a consult on a woman who my
friend and fellow physician, Bill Cook, said he had admitted
because she was “losing her skin.” Bill was the primary care
doctor for the 28-year-old woman, named Mary. He told me
she had come to his office with the sudden onset of skin
peeling, weakness, and painful and irritated eyes and mouth.
From his description, I had an idea of Mary’s disease, and
made my way to see her prior to my morning office hours.
Hospitals are progressing to become more and more places
of super-specialization, in which doctors trained strictly in
hospital medicine (“hospitalists”) will rule the domain. Most
patients will be taken care of in sub-acute and outpatient
settings, and only those in more critical conditions will roost in
hospitals.
Before going in to see Mary, I reviewed her chart. She had
been hospitalized the day before, and the routine admission
orders such as chest x-ray and blood tests were in place. In
addition, she had been placed on intravenous fluid replacement
therapy and pain medications.
I found Mary in her bed, staring blankly up at the passing
images on the TV. After approaching her side, I introduced
myself. She smiled and said, “Hey.”
“I’d like to take a look at your skin,” I said. “If that’s OK.”
“What’s left of it,” she offered.
“I’ll be back shortly,” I said. I went out and found a nurse
to help. A perky middle-aged woman named Peggy came to
my aid. We both gloved, and she gently pulled back Mary’s
sheets. I tried to keep my most deadpan, yet alert, expression as
I witnessed the devastation brought on by her disease. ‘She
may be looking right at me,’ I thought, and I didn’t want to add
panic. An underlying blanket of red covered her entire skin

5
 The Woman Who Lost Her Skin

surface, and the top layer was sloughing off in large sheets like
wet wallpaper. Mary’s face, neck, trunk, legs, feet –
everywhere – had been captured by this crimson devil which
appeared ready to take her down forever. I looked at the few
islands of normal skin like a capsized sailor seeking refuge
from a sea of fire. I had seen two other patients with this
disorder before, but neither of this severity. What devastation!
I examined her everywhere – skin, genitals, mouth, and
eyes – and then I pulled off my gloves. I looked up at Mary,
who in fact was peering at me like a hunting dog who had
found her prey. Peggy stood patiently by.
“Whaddayathink, Doc?” she asked. Her words slid together
like a multiflavored ice cream cone that had melted.
Apparently, she was groggy from her pain medications.
“It appears that you have a fairly severe reaction to a
medicine you took,” I said. “It doesn’t happen very often, but
when it does, it can be a real challenge. Here’s the good news.
I’m going to make sure you get the best treatment we have, and
I’ll let you know everything I recommend, OK?”
She nodded. “What happened?”
“Good question,” I said. “Have you had medicines in the
last few weeks?”
“I take something for my knees. It’s like a pain pill, but it
never gave me a problem before.”
“Anything else?”
She pondered for a moment, her eyes focusing somewhere
in the middle ground. “I did have an ear ache, and I took
something I found in my cabinet. I’d have to check it. I
remember one of the kids or somebody used it when they had
an infection and it helped them, so I took it a few days.”
“How long ago did you take it?” I queried.
“I think it was about two weeks ago,” she said.
“And this just started a day or two ago?” I asked.
“Day before yesterday, yeah, I started losing my skin. Felt
hot all over, and sick to my stomach. First I just had the rash on

6
 The Woman Who Lost Her Skin

my face, arms and legs, and then it was all over, even my lips
and my eyes. I got these blisters like I was in one of those
horror movies after a nuclear explosion.”
“Can you have the medicine brought here?” I asked.
“Sure,” she said.
“Are you in much pain?” I asked.
“Not really. I feel kind of stoned,” she said. “But I’m trying
to take in everything you’re telling me.”
“The pain medications can make you feel quite tired,” I
said. “I appreciate the fact that you are trying to talk with me; it
will definitely help in your care.”
Stop for a moment. Can you imagine this? Do you remember
the last time, if you have had a minor burn, you watched as a
small part of your skin peeled off? Picture what it must be like
if your entire skin peeled off. How would you feel about
yourself? Imagine Mary the day before her skin rebellion,
brushing her hair, putting on her make-up, touching herself
with a dab of perfume, rubbing moisturizer on her supple, fully
intact skin. Put yourself in her busy life, taking care of her
husband and kids, moving around in her job as a receptionist,
and greeting customers with a smile. A day before, she was
fulfilling all the obligations of an active life. Now here she
was, immobile, her skin peeling off, the disinfectant smells of
the hospital replacing her usual scents, the awareness of the
monitors and buzzers replacing her everyday senses. And the
disarming assault arose from inside, not from something
external like a burn. This mutiny of her vital covering could
make her feel as alien to herself as the skin that was being
rejected.
“We need to watch you very carefully over the next several
days to make sure you don’t get an infection or lose too much
of your vital fluids,” I said. “The skin acts as a barrier to
bacteria; therefore we have to take every precaution to protect
you until your skin returns in full. As you know, we are made

7
 The Woman Who Lost Her Skin

of a high percentage of water. The skin is like a regulator to

help make sure the right amount of fluid stays in, and the
correct amount goes out. Without skin, you lose the principal
way your body maintains a fluid balance.” I paused, giving her
time to absorb my little speech. “It looks like you’ve lost most
of your skin surface, and it will take some time to get a new
one. You need the IV fluids so you don’t get dehydrated. And
we have to be very careful about infection. Please be patient
and hang in.”
“I’ll be here, Doc,” she said.
“I’ll need to take a small sample of your skin to send to the
pathologist. It will help in confirming your diagnosis.”
“Whatever. It’s OK,” Mary said. “I probably won’t feel it
too much.”
Mary was right; she showed very little discomfort as I
anesthetized the irritated skin and used a tiny punch tool to
extract a sample. I put it into the biopsy bottle, where the
pathologist would take it out later for preparation and
examination.
I discussed Mary’s situation with Peggy, and thanked her
for her time. Next I called Bill Cook and put together a game
plan. In Mary’s case, we were initially able to stabilize her and
improve her condition in the internal medicine unit of our
hospital, given the excellent medical care provided in that
setting. However, with such a dramatic skin insurrection, after
three days of hospitalization I ordered Mary to be transferred to
the burn unit, where I felt more comfortable with the highly
qualified staff’s expertise in dealing with the problems of an
acute process like Mary’s. An efficient program of fluid
administration and its modification according to the needs of
the patient being treated can only be carried out with careful,
accurate, and current data, most importantly the intake and
output of fluid (water from all sources in, urine output). A
number of physiologic criteria indicating the efficiency of the
fluid therapy must be carefully monitored, including the

8
 The Woman Who Lost Her Skin

patient’s vital signs (blood pressure, pulse, respiration,

temperature) and general condition, the hematocrit, complete
blood count, serum electrolytes, and the central venous
pressure. The trend of the venous pressure readings from half-
hour to half-hour, for example, is usually the first indication of
over- or under-replacement of fluid. In addition, topical
antibacterial agents are applied to control wound infection. The
treatment usually consists of loose gauze dressings saturated
with antibacterial ointment applied directly over the denuded
skin. And nutritional assessment is crucial to determine
metabolic conditions. All of these factors play an integral part
in burn injuries, so the burn unit is an excellent place for
someone like Mary to be supervised.
I went back, talked with Mary, and explained why we
needed to move her. “I agree,” she said.
“And I need to get some other folks in to take a peek at
you, like an ophthalmologist.”
“My eyes have been pretty dry,” she offered. “And my
mouth.”
Mary suffered from toxic epidermal necrolysis, or TEN, which
is often a reaction to medication. Most cases sprout 1–3 weeks
after starting the drug. If the patient had a similar eruption in
the past, the time interval drops to less than 48 hours due to
increased sensitization to the offending agent.
Not only is TEN one of the most severe drug reactions, but
the condition may progress very rapidly, as it did with Mary.
Statistically, one in seven patients lose their entire epidermis in
24 hours. Without this major barrier, the body acts like a party
invitation for bad critters. The mouth often dries up, making
the oral intake of fluids and food unbearable, which further
intensifies the imbalances brought on by loss of skin.
Although TEN is considered exceedingly rare, its
frequency may be underestimated because of misdiagnosis of
mild and marginal cases. The disease is much more common in
adults, but has been described in the medical literature in

9
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-«• •*r o" S cm' m a. Jl cog >- £ O ^ S £■ coo CO •^ ^ oo s s ■
 TABLE 68 BRITISH MORTGACI Schedule Showing Details of
Each Type of Investment 1959 Oct. SI Bonds— Corporate per
Balance Sheet » 695,769 Add Investment Reserve 10,000 $ 705,769
Less Accrued Interest Totals per Subsidiary Ledger < 705,769 —
Atlantic and Allied Interests —Other Companies * 705,769 Total
Corporate Bonds S 705.769 Stocks— per Balance Sheet 12,950,022
Add Investment Reserve 750,000 $3,700,022 Less Accrued D
ividends Total Stocks »3,700,022 —Atlantic and Allied Interests *
156,348 —Other Companies 3,543,674 ToUl Stocks S3,700,022 Short
Term Notes—per Balance Sheet Less Accrued Interest Total Short
Term Notes • • • • —Atlantic and Allied Interests — Other
Companies Total Short Term Notes Loans Secured by Investments—
per Balance Sheet Less Loans against Guaranteed Investment
Certificates Less Accrued Interest Total Loans — Atlantic and Allied
Interests Total (corporate) Bonds, Stocks, Notes and Loans
$4,405,791 —Atlantic and Allied Interests * 156.348 —Other
Corporate 4,249.443 $4,405,791 Note: These total Atlantic figures
agree with the figures shown on the breakdown each year. of these
investments as at October 31 94
 rRUST COMPANY [antic Acceptance and Allied Interests,
and Other Corporations 1962 Oct. SI $1,440,043 140,000 196S Oct.
SI $ 954,093 140.000 196i Oct. SI $ 1.399,849 140,000 1965 June
SO % 1,304,680 140,000 $1,580,043 $ 1,094,093 $ 1,094,093 $
1,539,849 22,635 $ 1.444.680 $1,580,043 $ 1,517,214 $ 1,444.680
$ 158,300 1,421,743 $ 208,300 885,793 $ 208,300 1,308,914 $
208,300 1,236,380 $1,580,043 $ 1,094,093 $ 1.517,214 $ 1,444,680
$3,905,164 797.310 $ 5,165,352 850,000 $ 6,350,522 850,000 $
5,327,274 850,000 $4,702,474 $ 6,015,352 $ 7,200,522 $ 6,177,274
$4,702,474 $ 6,015,352 1 7.200,522 $ 6,177,274 $ 734,661
3,967,813 % 1,004,346 5,011,006 $ 1.232.540 5.967,982 $
1,594,257 4,583,017 $4,702,474 $ 6,015,352 $ 7.200,522 $
6.177,274 $2,605,385 $ 4,681.686 $ 4,326,889 26,889 $10,737,864
$2,605,385 $ 4,681,686 $ 4,300,000 $10,737,864 $2,605,385 $
2,000,000 2,681,686 $ 3,450,000 850,000 $ 5,740,000 4,997,864
$2,605,385 S 4,681,686 $ 4,300,000 $10,737,864 $ 511,570 31,570
$ 1.635,887 125,637 $ 2,768.465 286,830 20,712 $ 3,997,767
89,802 $ 480.000 $ 1,510,250 $ 2,460,923 $ 3,907,965 $ 480,000 1
1,510,250 $ 2,460,923 $ 3,907,965 $9,367,902 $13,301,381
$15,478,659 $22,267,783 $3,978,346 5,389,556 i 4.722,896
8,578,485 $ 7,351,757 8,126,902 $11,450,512 10,817,271
$9,367,902 $13,301,381 $15,478,659 $22,267,783 95
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TABLE 69 (Continued) M I •> I •• t^us — o c^ ■* "^^'^ I

I I 1 QO I O C5 057 135 ,811 ,000 1 625. 49. 549, ,500, ■rj^ U5 CD
•» «* «» •» I TT Ol »0 »0 00 I lOO l2S s o CO 1 i n s « s M M I ^ 1 I
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S 535. 49, 480, ,699, g CO ■^ «» ^ So — o_tq cc 05 O OS — -.^
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coo O z 97
 TABLE 70 FUNDS INVESTFO (S MILLIONS I 23 BRITISH
MORTCl ANALYSIS OF CORPORA 20 19 18 THE ATLANTIC
ACCEPTANCE COMPLEX INCLUDES LOANS AND INVESTMENTS IN
THE FOLLOWING COMPANIES ATLANTIC ACCEPTANCE
CORPORATION LIMITED ANALOGUE CONTROLS INC. ASSOCIATED
CANADIAN HOLDINGS LIMITED AURORA LEASING CORPORATION
LIMITED COMMODORE SALES ACCEPTANCE LIMITED COMMODORE
BUSINESS MACHINES (CANADA) LIMITED LONDON LIGHTHOUSE
INVESTMENTS LIMITED MAVETY FILM DELIVERY LIMITED N.G.K.
INVESTMENTS LIMITED TRANS -COMMERCIAL ACCEPTANCE
LIMITED WESTERN HERITAGE PROPERTIES LIMITED PERSONAL
COLLATERAL LOANS TO RELATED INDIVIDUALS N^ INVESTMEN ;f:
THE PEAK lOIAl INVESTMENT Of $2), 769.000 OCCURBED AT APRIL
30.1945 98
The text on this page is estimated to be only 25.95%
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IT COMPANY ND COLLATERAL LOANS FUNDS INVESTED I i

MILLIONS I 23 22 20 19 _ 2 1 t>TH END 99
 TABLE 71 BRITISH MORTGAG Limitatioi Under the Loan and
Tni Dee. SI 1956 Capital Stock and Reserve Funds Capital Stock
General Reserve Profit and Loss Account Mortgage Reserve Company
Stock Reserve Bonds Reserve Real Estate held for Investment
Reserve Real Estate held for Sale Reserve Total Capital and Reserves
A -15%. B-20%. Deposits and Guaranteed Investments Trust
Deposits Short-Term Deposits Short-Term Notes General Guaranteed
Funds Interest Due and Accrued Total Deposits and Guaranteed
Investments C-5%.. Section 142(1) (a) (iii)-B-l-C S 1,015,000 $
1,028 1,300.000 1,400 100.693 92 537,778 387 183,731 383
140,000 150 $ 3,277,202 $ 3,442. $ 491,580 S 516. S 655,440 S 688
$ 7,893,778 $ 7,623 10,943,827 14,355 113,563 161 $18,951,168
$22,139 $ 947,560 S 1.106 $ 1,603,000 $ 1.795 100
 TRUST COMPANY Investments )rporations Act — Sec. 142
U.S1 Oct. SI Oct. SI Oct. 31 Oct. SI Oct. SI Dec. 31 1958 1959 1960
1961 1962 1963 1964 ,042,600 $ 1,047.500 $ 1,058,400 $ 1.177,900
$ 1,379,300 $ 1.445,715 $ 1,484.735 500,000 1,600,000 1,700,000
1,900,000 2,400,000 2,700,000 3,500,000 81.370 205,608 176.156
215,462 201,030 174,728 294.505 351,108 270,471 350,837
445.254 559,200 702,300 900.900 450,000 820.000 820,000
797,310 797,310 850,000 850.000 260,000 150,000 150.000
150,000 150,000 150.000 150.000 _ — — — 180.000 — — —
200.000 ,685,078 $ 4,093,579 $ 4.255.393 $ 4,685.926 $ 5,486,840
$ 6.022,743 $ 7.560.140 552,762 $ 614,037 $ 638,309 $ 702,889 $
823,026 $ 903,411 $ 1.134,021 737,016 $ 818.716 $ 851.079 $
937,185 $ 1.097,368 $ 1.204.548 $ 1,512,028 1.778.644 $ 8,757,662
$ 9.306,813 $10,740,181 $10,623,000 $14,852,865 $24,743,216 _
745.964 1,159,657 1,855,580 4,036,428 3.338,341 _ — —
2,605,000 — 1,049.080 ',231,280 21.869,790 28,767,731 32,917,449
43,841,513 56.208,500 68.674,750 239,175 392.317 609,154
748,938 929,708 1,425,103 1.794,753 1.249,099 $31,019,769
$39,429,662 $45,566,225 $59,854,837 $76,522,896 $99,600,140
1,312,455 $ 1.550.990 $ 1.971.485 $ 2,278,310 $ 2,992.740 $
3,826,145 $ 4,980,005 !,049,471 % 2,369,706 $ 2.822.564 $
3,215.495 $ 4.090,108 $ 5,030,693 $ 6,492,033 101
 TABLE 72 BRITISH MORTGAC Estimated Losses on Corpors
Involved in t Book Value of Holdings June 17/65 Bonds — Corporate
Aurora Leasing Corporation Limited — 7% unsecured — Convertible
Notes $ 120,300 Commodore Business Machines (Canada) Limited—
Series A Debentures 50,000 N.G.K. Investments Limited— Notes
38,000 Stocks Atlantic Acceptance Corporation Limited— 42,670
Common Shares 625,057 Atlantic Acceptance Corporation Limited—
2,795 5H% Preferred 49,135 Atlantic Acceptance Corporation
Limited— 2nd Preferred— Series A— 22,705 Shares. . 549,811
Aurora Leasing Corporation Limited — 22,500 Common Shares
70,285 Commodore Business Machines (Canada) Limited— 47,250
Common Shares 202,469 Commodore Business Machines (Canada)
Limited— 58,750 Warrants 17,500 N.G.K. Investments Limited—
2,000 Common Shares — Mavety Film Delivery Limited— 500
Common Shares 80,000 Short Term Notes Atlantic Acceptance
Corporation Limited— Senior Secured 2,400,000 Atlantic Acceptance
Corporation Limited— Subordinate 1,000,000 Atlantic Acceptance
Corporation Limited— Treasure Island Gardens Limited 750,000
Aurora Leasing Corporation Limited — Notes 1,860,000 London
Lighthouse Investments Limited 480,000 Collateral Loans Notes of
Officers of Annett & Co. and others 227,373 Note of C. P. Morgan —
secured by Commodore Business Machines "B" Debentures.. 200,000
Note of C. P. Morgan — secured by various Common Shares 200,000
Note of C. P. Morgan— secured by 18,000 Atlantic Acceptance
Common Shares 250,000 Note of H. Wagman — secured by
Commodore Business Machines "B" Debentures . . . 100,000 Note of
M. Kapp — secured by Commodore Business Machines "B"
Debentures 100,000 Note of J. Tramiel — secured by Commodore
Business Machines "B" Debentures. . . . 100,000 Loans to various
persons — secured by Western Heritage Properties' Securities
348,087 Note of Associated Canadian Holdings Limited — secured by
Commodore Business Machines (Canada) Limited "C" Debentures
and Shares 192,500 Note of N.G.K. Investments Limited— secured
by Commodore Business Machines (Canada) Limited "C" Debentures
and Shares 240,000 Note of Trans-Commercial Acceptance Limited
— secured by Notes and Preferred Shares of Commodore Business
Machines (Canada) Limited 1,450,000 Note of Western Heritage
Properties Limited 500,000 112,200,517 102
 TRUST COMPANY vestments and Collateral Loans lantic
Complex Estimated or Actual Loss % 96,300 12.500 34,000
Comments Unsecured claim filed with Trustee in Bankruptcy,
estimated proceeds will be 20% of claim . Redeemed at 75% of face
value. Unsecured claim filed with Trustee in Bankruptcy for $40,000-
expected proceeds wiU be 10%. 607,545 43,638 504,632 70,285
131,593 43,000 Actual loss based on sale of all holdings. Partial sale
of holdings— remainder considered valueless. Partial sale of holdings
— remainder considered valueless. Company in Bankruptcy— Shares
considered valueless. Actual loss on sale of Shares to Jaypen
Holdings at $1.50. Internal information indicated a possibility of sale
at .35 ea. Company in Bankruptcy— Shares considered valueless.
Actual loss on sale of total holdings. 600,000 Receiver's estimated
recovery is 75% for Secured Notes. 1,000,000 No recovery is
expected for Subordinate Note holders. 750,000 No recovery
expected. 1,488,000 Unsecured claim filed— estimated value is 20%
of claim. 425,000 Settlement received on assignment of interest to a
third party. — Repaid in full. 27,084 This excludes the possible value
of claims against the estate of C. P. Morgan. 142,698 Loss expected
based on valuing remaining Five Wheels Shares, at $1 and
anticipating no recovery from the estate of C. P. Morgan. 225,825
This excludes the possible value of claims against the estate of C. P.
Morgan. 13,542 This excludes the value of claims against H.
Wagman. — Collateral sold and remaining balance repaid. —
Collateral sold and remaining balance repaid. — Poindexter Loan still
outstanding— full recovery expected. 5,000 Redemption of collateral
at 75% of face value. 26,000 Redemption of Debentures at 75% and
sale of Shares $1.50. 625,000 Redemption of Securities at approx.
35% of face value plus 50.000 Common Shares valued at $1.50 ea.
— New Note issued and fully guaranteed. $6,771,642 103
The text on this page is estimated to be only 5.90%
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TABLE 73 I I o -^ 'T O I I I o u H 5 s^ t^ t~ o o § o K5 (M
1 I 1 s 1^ i < g o H s CO o t:>- O^ ^ J, ITS ift o" »o :s O -I-, I 5 5
Us? -;; o •= Q ■2 3 I I = "■02 i 2 I I E S I „ , o 2 o s o E O S E 2 c J
> £ J5 o '5 J c3 00 c S o ^ « o o 2 -T3 U 5" "5 .^ ^° 1 1 3 t5 o ■^ 2
Z < 105
 TABLE 74 BRITISH MORTGAG Summary of Advances of
Principal Against Securi October 31, 1960 to 19( Specific Mortgages
Tip Top Tailors Ltd Calvert- Dale Estates Elmore Belfield Companies
Towers Stores Sentry Stores I.G.A. Stores Treasure Island, et al,
London London Lighthouse Indiancrest Old York Lane Properties
Hengran Development Ltd Shopping Centres Sub-Divisions Bowling
Alleys Leaseholds Mortgages Other Mortgages Over $50.000 Total
Mortgages Over $50.000 Mortgages Under $50,000 Total Mortgages
(inclusive of foreclosures) Adjustment to Reconcile with Balance
Sheet Amounts Add Accrued interest Interest capitalized on
properties held for resale Less Investment Reserve As per Balance
Sheets Mortgages Property held for resale October SI, 1960 October
SI. 196 % ' $ 445,000 $ 1.104,250 — 600,000 344,413 250.000
351.100 3.26 4.05 1.37 .48 220,300 187,000 351,000 $ 1.046,100
1,302,000 440,000 155,000 $ 2,806.963 2,115,100 i 991,000
961,700 : $ 2,943,100 7,443,782 $10,386,882 21,747,619
$32,134,501 108,444 $32,026,057 $32,026,057 $32,026,057 9.16
23.16 32.32 67.68 $32,134,501 100.00 $37,650,030 $37,650,030
52,690 $37,597,340 $37,597,340 $37,597,340 106
 rRUST COMPANY Mortgages, Leaseholds and Real Property,
as at 1 July 19, 1965 ober 31, 1962 Oclober 31, 1963 October 31,
1964 July 19, 1 965 % % % % $ 900.000 $ 964,000 00 000 $
500,000 500.000 870.118 63,794 2,149,211 2,193.015 1.803.323
18,000 2,931,416 4.781.971 4.922.176 97,000 2,489,000 2,459,000
1,500,000 2.425,000 3,312,679 37 123 328,550 319,276 311,841
55,000 237,000 1.418,760 2.166,262 480,000 95,600 48.000
248,000 246.000 243,000 27,185 15.77 322,100 15.64 322,100
18.96 322,100 $17,820,499 41,702 $ 9,205,277 $14,640,122 20.35
99 800 5.67 2,988,328 5.07 4,380,561 5.67 5.336.932 80,100 2.79
1,541.527 2.61 1.464,296 1.90 1.950,199 51 800 2.07 941,104 1.60
917,500 1.19 906,162 300,000 .51 964,000 1.25 1,229,119 1.40 —
26.30 25.43 170,000 $22,536,479 .22 29.19 166,000 .19 173,402
$14,976,236 $27,408,911 31.28 132,600 26.27 52.57 15,836,897
S30,813,133 26.83 52.26 19,307,460 $41,843,939 25.01 54.20
19,720,955 22.51 06,002 $47,129,866 53.79 '45,916 47.43 100.00
28,152,665 $58,965,798 47.74 100.00 35.361,981 $77,205,920
45.80 100.00 40,494,920 46.21 !51,918 $87,624,786 100.00 $
1,725,700 $ 1,772,000 $ 256.659 424,605 $79,356,225 493,118
$89,889,904 i51,918 $59,222,457 i59,200 799,610 200.000
1,430,000 !92,718 $58,422,847 $79,156,225 $88,459,904 '83,663
$56,326,063 $76,439,377 $85,736,202 109,055 2.096.784 2.716,848
2,723,702 !92,718 158.422.847 $79,156,225 $88,459,904 107
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