Happy birthday, Dr. Parkinson

It is hard to believe you were born 266 years ago in 1755. You were a controversial figure when alive, but you have become famous since you died. A lingering question is if you were really involved in a plot to assassinate King George III (of American Revolution fame).

James (don’t call him Jim, he’s old school British) might prefer to be known as the author of a three-volume series on fossils and paleontology. In the present day, you are most famous for having a chronic and progressive neurodegenerative condition associated with you — Parkinson’s disease. You might want to thank the French neurologist Charcot for naming the disease after you — a somewhat dubious honor.

If this were a Hollywood biopic, there would be a dramatic “Aha” moment when Dr. Parkinson realized there was a previously unknown group of people dealing with similar symptoms. Then there might be a flash forward to the Nobel Prize ceremony where he got a little gold statue and a million euros. He would then marry a well-known ancestor of a famous starlet. James himself would be played by George Clooney.

There are a few issues with this movie supposedly based on facts. First, the good doctor observed hundreds, if not thousands, of people before he wrote up case studies on six individuals for what he labeled the “Shaking Palsy” (paralysis agitans). Second, what is now called PD has been described in writing for thousands of years — around the world including China and India. This was not an unknown condition. Dr. P was the first to systematically describe it and its symptoms. The final insult to reality is the Nobel Prize in medicine was first awarded in 1901 — not in the 1700’s. It comes with a medal, not a statue. — and he got neither. Although, his wife was not famous, but they did have eight children — something must have clicked! Finally, we have no idea if George Clooney would be a good facsimile as we do not know what Dr. P looked like. When you google his name, the likeness that appears is not James Parkinson.

What is most amazing about the good doctor was his ability to use the methods, practices, and principles of science — whether it be in medicine, geology, or paleontology. As a scientist and doctor, he was ahead of his time. Because I write about PD, I will focus on his famous work, “An Essay on the Shaking Palsy.” In his essay, Parkinson gives credit to others (including Galen — a Roman physician from the first century) for early descriptions. Dr. P went further by describing the progression of the disease. His case studies are eerily accurate and could easily be descriptions of me or any one of my PD acquaintances.

One characteristic of advancing Parkinson’s (for some, not all) is “festination.” James Parkinson described it well. “In some cases, when this state of the malady is attained, the patient can no longer exercise himself by walking in his usual manner, but is thrown on the toes and forepart of the feet; being, at the same time irresistibly impelled to take much quicker and shorter steps, and thereby to adopt unwillingly a running pace. In some cases, it is found necessary to entirely substitute running for walking; since otherwise the patient, on proceeding only a very few paces would inevitably fall.”

Despite the somewhat stilted language, this passage is spot on. Falling is no laughing matter. Issues involving falls are one of the leading causes of death for people with PD.

Dr. P described the symptoms of the shaking palsy. He noted, “… the sleep becomes much disturbed.” He described in somewhat graphic terms constipation. He wrote about soft voice, drooling, facial masking, incontinence, and other common symptoms of PD. Remember, not all people with Parkinson’s have all or even most symptoms. Each of us have our own unique galaxy of issues.

Dr. James Parkinson went further in his essay. Chapter III is entitled “Shaking Palsy Distinguished From Other Diseases With Which It May Be Confused.” Just as in modern diagnoses, Dr. P created and utilized inclusion/exclusion criteria to make clinical decisions.

Although Parkinson was an astute observer and physician, he was not perfect. Along with prescribing opium, his writings on the cause of PD were incorrect. That is not so unusual. To this day, scientists and researchers do not know the cause Parkinson’s disease — the shaking palsy.

Born on April 11, we celebrate his birthday as World Parkinson’s Day and the entire month of April as Parkinson’s Awareness month.

Happy Birthday, Jim! Despite what I said in the first paragraph, I get to call him Jim because we have a special relationship — I live with his disease every day.

This is not James Parkinson. The Essay is his.