DR. JOHN'S CASE NOTES : THE PARIS SYNDROME This particular condition has intrigued me for some time. It's name owes its origin to the fact that it was first experienced by Japanese tourists, who were visiting Paris for the first time. Many of them suffered from acute mental breakdowns. Despite the vast number of Japanese nationals who visit major cities around the world each year, it is only when they visit Paris that this terrible affliction takes hold. However, I have discovered that some of my bridge clients represent a parallel group, plagued by the same symptoms. However, in their case, it is when they visit any city for the first time, to take part in a high profile bridge congress or tournament. Both groups are victims to a severe form of "culture shock". Polite Japanese tourists arrive in Paris with an idyllic view of the city, as depicted in such films as Amelia. However, the reality of a modern, smog-filled, heartless metropolis would then start to challenge their beliefs . Moreover, when they came into contact with, say, a rude French waiter, the shock and devastation was such that they become totally unable to rationalise the situation. This caused them to encounter a severe state of confusion. Further episodes, therefore, of harsh reality would ultimately shatter their dreams, and the inexplicable contradictions inevitably brought on full-blown mental breakdowns. With my client group of aspiring bridge players, they too mistakenly envisaged a city congress outing as being one of wonder and excitement. The idea of meeting and playing against bridge celebrities and top class internationals was going to create for them a truly wonderful bridge experience. However, this idyllic view was always destined to be shattered, once they entered that arena with its quarrelsome beasts and ruthless predators. A major culture shock was simply waiting to happen. Unable to separate their naive and grossly over-optimistic expectations with the shocking reality, the extent of their confusion was such severe symptoms of the syndrome quickly surfaced. At a recent congress in Leeds, two players from the Cardinal BC, who were making their first quest for greenies, found themselves being rushed to hospital for emergency treatment.........after being reduced to gibbering wrecks. The ambulance paramedics, responsible for these decisions, genuinely believed that the severity of their mental break-down was such, they both posed a suicide-risk. For bridge players, falling victim to the Paris syndrome is of genuine serious concern.