Affirmation

It truly was nothing short of a medical miracle.

Today a woman came to speak to our class about what it was like to have Parkinson's.

She told us about how she had diagnosed herself 14 years ago while watching the 1996 Olympic Games. As Muhammad Ali lit the cauldron at the opening ceremonies the commentators made reference to his Parkinson's disease, and in that moment her life changed. She recognized the symptoms he showed as the same ones she had been developing, and trying to ignore.

The woman spoke about when her suspicions were finally confirmed. How she went home from the appointment lost and afraid for her future. She talked about the horrible side effects she suffered from the medication treatment and how walking had become an impossible feat.

As she told her story I started thinking, "hang on...she doesn't appear to have that severe of symptoms". I couldn't see much of a tremor, she didn't appear stiff or show the Parkinson's mask, her gait seemed almost completely normal.

She then spoke about deep brain stimulation (DBS) and how she had had the treatment several years earlier. I vaguely recalled some lecture during nursing school where they mentioned this treatment but I couldn't grab on to any info in my brain. I thought, "wow the treatment must have really worked for her!" Still thinking that they just drilled into your skull, inserted the electrodes, zapped and then took them out.

But she went on to talk about the plastic grommets that the wires go through on her skull and how the pacemaker was near her waist, that she could turn the DBS on or off, or adjust it (within parameters) at will. Apparently some people develop slurred speech or other unwanted side effects so they only turn it on (or up) when they want to move.

I was now sitting straight up. This is clearly a much cooler procedure than I had thought.

The National Institute on Health gives a good summary of the procedure here, but in brief:

"DBS uses a surgically implanted, battery-operated medical device called a neurostimulator—similar to a heart pacemaker and approximately the size of a stopwatch—to deliver electrical stimulation to targeted areas in the brain that control movement, blocking the abnormal nerve signals that cause tremor and PD symptoms.

Before the procedure, a neurosurgeon uses magnetic resonance imaging (MRI) or computed tomography (CT) scanning to identify and locate the exact target within the brain where electrical nerve signals generate the PD symptoms. Some surgeons may use microelectrode recording—which involves a small wire that monitors the activity of nerve cells in the target area—to more specifically identify the precise brain target that will be stimulated. Generally, these targets are the thalamus, subthalamic nucleus, and globus pallidus."

She finished her lecture and then said, "ok now I am going to turn the DBS off so you can see what happens".

With that she pulled a remote-control looking device, held it to her abdomen and clicked a button.

Within moments her arms shook with pronounced tremors, her face changed to an unexpressive stare, and she slowly turned her body in an attempt to walk. She lifted up a jerky arm to show us her attempt to count on each finger but only a profound tremor showed. Her speech became slow but her voice cleared of what sounded like a mild sore throat. She explained that the 'resident frog' in her throat was the only mild side effect the DBS had in her case. With a difficult maneuver she switched the DBS on again by clicking the button.

Her tremor vanished. The frog in her voice returned, her speech slowly returned to its normal tempo and she turned back toward the podium.

I was actually on the verge of tears, even now as I am typing this. I really don't think I am able to convey the impact this demonstration had on me. She was two different people with the press of a button. One would have been unable to drink from a cup and the other had just given a one hour presentation. I really believe that I witnessed a miracle. And I don't use that term lightly. I have been in the room when people who were without a pulse or breath in their body were brought back to life using medications and electricity.

But this moved me in a completely different way.

Suddenly all of the stress, and studying, financial burden, and lack of sleep, became worth it.

Medical conventions often get under my skin. I wonder some days why I am going into a profession that pushes drugs, ignores preventative health, and sees peoples lives as a business.

But if modern medicine means I get to be in the field of work that can do that for patients, I am happy.

Thrilled in fact. And strangely humbled.

It has been a good day.