With reddish hair cut short and dangly earrings the patient sits as the doctor skims the pages of information she has filled in. Her right hand moves gently in her lap. He gazes up at her and asks what brings her to the movement disorders clinic. She looks down at her hands in her lap and raises her right hand to exhibit the fine tremble occurring between her two first fingers and thumb. As she does so the movement disappears. The physician asks when she first noticed the tremor and the woman replies it has been there awhile. At first she thought it was simply nerves, but when it kept reappearing she grew concerned and spoke with her father on the telephone. He was diagnosed with Parkinson’s disease when he was sixty five. She is forty-eight.
The physician explains to be diagnosed with PD one must have two of the three principle symptoms, and respond positively to the drug levodopa. The three classical symptoms are slowness, rigidity and tremor. Her emotions overtake her and she cries, taking a tissue from her bag, the doctor continues explaining there are far worse illnesses to be given, though there is still no cure for the progressive neurological disease. When she inquires whether her children are at risk, he comments the hereditary component is present in a minority of patients, though some studies have found a genetic component for the disease.
The doctor asks about other symptoms and the patient sighs and responds she has trouble sleeping, but has had the problem ever since she had children. Sometimes, she concedes she feels slow in the head. When she and her husband go to the movies she frequently doesn’t understand the humor. Across the desk the doctor smiles and asks whether she can recall the last show she went to. The patient dabs her eyes as her gaze drifts above the physician’s head, in thought, and she smiles ruefully unable to recall the title.
Switching seats to the examination table he asks her to raise her shoulders in a shrug. Her neck seemingly vanishes, her shoulders are so supple. Her arms and wrists however have some stiffness in the surrounding muscles. As he works to assess her rigidity, the doctor speaks about the importance of exercise. She smiles and remembers the title of the movie, Hangover Two. He commends her choice of cinema, affirming laughter is good. As he speaks her smile fades and he wonders aloud whether she is taking an antidepressant. She shakes her head no, telling him she prefers to take as little medication as possible. The physician concedes most of his PD patients eventually need an antidepressant to function at their highest quality of life. The patient looks at him without comment.