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CASE 8: PARKINSON’S DISEASE

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> CASE 8 Parkinson’s Disease

Harry’s office is on the eighth floor, with a commanding view of campus, befitting a college provost. He was sitting on a couch in his office, a copy of Moby Dick open at his side, as he reflected on his 14-year journey with Parkinson’s disease. Although medical care continues to improve, there remains no cure for PD. Receiving this diagnosis must be very difficult, and being a part of a patient’s journey through this process is both an honor and a responsibility. Harry agreed to discuss his experience since his diagnosis, providing valuable insight for future healthcare providers.

Growing up in New York, Harry became interested in a vocation that allowed him to command his time, rather than following in the family business of politics and law. He studied modern thought and literature, and later became interested in Frederick Olmstead, the urban reformer. When Harry attended graduate school on the West Coast, he studied the enlightenment, writing his dissertation on Jefferson’s educational model and his studies of architecture. After finishing his dissertation in the summer of 1980, Harry traveled back east for his first teaching job at Middlebury College in Vermont. He moved up the ranks in academia over the next few decades, relocating across the country for opportunities before finally settling in southern California. Studying literature grounded Harry in a pragmatism that, he says, helps him live with PD.

“Rigidity is my constant companion,” Harry muses, as he now realizes some early symptoms of rigidity were signs of PD. He used to run an eight-mile course regularly with a running partner, who asked one day, “Why do you run with your right arm pinned to your chest?”

Harry was never flexible, and this observed stiffness was not especially odd or out of place, so he ignored the comment and explained it away as just normal for him. He also noticed that every now and then, before he’d deliver a speech, he’d tremble, and he felt new aches in his back, during long walks, that did not respond to a course of physical therapy or stretching. Because there was no recognizable history of neurologic disease in the family, the cause was assumed to be coming from the central nervous system. He underwent medical testing consisting of CT and MRI, which were both negative for tumor or other CNS diseases.

He finally went to see a neurologist, who suspected Parkinsonism, and carefully examined him to determine the definitive diagnosis. Harry was diagnosed with early onset PD and a central nervous system disorder after several years of increasing rigidity, which he describes as feeling like the “Tin Man after a rainstorm.” He never had the resting tremor, or a family history of the disease, which may have delayed diagnosis somewhat.

Harry approached this diagnosis in his typical style—researching the disease enough to understand that determining the ideal treatment of his PD would take time—so he decided not ...

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