Today we had two guest patients, one each for lectures on Parkinson disease and cerebellar ataxia, a disease of severely uncoordinated movement. Both patients had been first diagnosed in his/her early forties and had to adjust from a normal adult life to one of increasing disability. The second patient, a man with cerebellar ataxia, continues to golf several times a week even though he walks with a cane and suffers from slurred speech. He told us that he heard that Michael J. Fox still golfs, "and he's worse than me!" I was struck by the importance of role models.
Both patients were cheerful and good-humored, but what I really admired about them was their willingness to make themselves vulnerable for the purpose of teaching. Our lecturer, a neurologist, began by conducting a neuro exam on his patient with Parkinson's in front of the class: she did very well. He then used a small handheld machine to turn off her deep brain stimulator (magic!) and repeated the exam a few minutes later: this time, the patient was shaky and uncoordinated, clearly uncomfortable and dangerously unstable on her feet. Finally, the doctor turned the deep brain stimulator back on and the patient returned to what appeared to be a very normal, non-Parkinsonian state.
The immediate effect of the deep brain stimulation was awing; more than that, my visceral fear that the machine would not turn back on, leaving our guest in her more severe form of disability, gave me a glimpse of how anxious a patient must feel when a drug starts to wear off or stop working. How precarious to be dependent on modern medicine: a semblance of health can so quickly fade away.
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