Parkinson's patients: yes we can dance

Chapter 1

2007-12-17T17:00:00.000-05:00

1.
About this site:
Parkinson’s patients can dance. How come?

by Bob Dawson

I have Parkinson’s.
A friend bombarded me with the Blues. I started to dance, and groove, and visualize. Music on – disease much better. Music off – symptoms come back. How come?
I found out on the internet – chat rooms, YouTube, interest groups, e-mail exchanges, that there are Parkinson’s patients who cannot walk, but they can dance.
What’s up with that?

This site does not contain a cure for Parkinson’s.
I do not know if music and dance can help everybody.
If you have Parkinson’s, it is my personal, non-scientific opinion that you should find music that you get off on, play it LOUD, and start to move to the music. Every day.

Dance as therapy.
Dance for flexibility, strength, endurance.
Dance for joy.
Dance in defiance of the disease.
I agree with all of that.

But here is what this site is really about:
Dance for a cure.
Dance to bother the scientists.
Dance to raise a question.

And the question is, if you cannot walk without falling down, if you cannot hold a spoon to feed yourself, if you choke when you swallow, if your mind is losing its ability to give instructions to your muscles, then how come you can get up and dance? Eh? How come? What’s up with that?

Because the answer to our question may lead to a cure for Parkinson’s.
In the past few years, much has been learned about what the brain on music does and what the brain on dancing does and what the brain on Parkinson’s does, and some scientists say it is beginning to make sense. What they are learning about music and dance may soon help to defeat an ancient disease.
Surprising? Not really. The human race had art before agriculture, before building shelters, before language. We are hard-wired for art. And hard-wiring is what the PD’er needs, having burnt out one major set of circuits. Music and dance and science, combined, can eliminate this disease from the face of the earth, forever. It will be the next major disease to be vanquished. The more concentrated the effort, the faster it will get done.

So let’s do it.
Let’s get it on.
Let’s dance as a question mark for all to see.
Someone will find an answer to the question, because the evidence is right before their eyes.

2

A momentary lapse of reason

“… Many mental illnesses are now known to undermine the ability to dance or perform rhythmically – schizophrenia and Parkinson’s, to name just two – and so the sort of rhythmic dancing and music making that have characterized most music across the ages serves as a warranty of physical and mental fitness, perhaps even a warranty of reliability and conscientiousness…”
- page 253 of “This is Your Brain on Music” by Dr. Daniel J. Levitin, neurologist at McGill University, published by Penguin, September 2007
- Scientific American Book Club Selection; L.A. Times Book Award Nominee; New York Times Best-seller for 5 weeks.

My E-mail to author:
Thousands of people are using dance to fight Parkinson’s, usually alone in their homes – YouTube has videos of it, University of Calgary is researching it.

Author replied:
YouTube and a single study at the University of Calgary should not be pit against the judgment of experts.

3.

YouTube, 2006 - Reverett123 posts video and says:
Dancing is fun, but I would rather have the option to walk.

(Play at max volume) Most patients and a good many doctors think of PD as simply a case of dying brain cells creating a shortage of the chemical dopamine. The treatment is to replace the dopamine. If this view was true, then this video would not be possible. I am in a state described as "off" and experiencing "freezing". The medicines are not working and my feet stick to the floor. It is a miserable way to be, trust me. Nothing happens to increase dopamine, yet you see the magic of music.
The importance here is that precious research dollars go by the truckload to the simplistic view of this condition when they should be going to new avenues. Dancing is fun, but I would rather have the option to walk.
YouTube video

4.

A single study at the University of Calgary
Striking a chord
By Anthony A. Davis

It’s a short length of masking tape stuck on a floor, but for some reason Sheila McHutchison can’t step over it. She freezes in her tracks, as if the tape were as impassable as a penitentiary wall.

Parkinson’s disease can do strange things to people. The most common symptoms of this incurable brain disease are tremors, usually beginning in one arm or hand, muscular rigidity and slowness of movement. But in some cases – Sheila is one – the disease also causes patients to freeze up at certain sights, making a simple task like walking impossible. For some, the visual stimulus might be the line between a carpet and hardwood flooring or a crack in a sidewalk. In Sheila’s case, it’s the tape.

But then someone puts on Sheila’s favourite song, ABBA’s “Dancing Queen,” and she has a pas-de-deux with her husband, John. A moment later, facing that little stretch of tape, she easily walks across it. Music seems to melt Parkinson’s freezing effect.

Sadly, three or four minutes after the music subsides, Sheila’s hands again begin to tremble and her upper body wobbles. She is led again to the masking tape and, once again, freezes like a statue when she tries to step over it.

That tape was stuck there by Dr. Bin Hu, head of a national Parkinson’s research project centred in Calgary. Dr. Hu and his collaborators are trying to find out why music, at least temporarily, melts the paralyzing effects of Parkinson’s in some patients….

…Sheila emphasizes that Parkinson’s has not taken over her life. “I have Parkinson’s, but Parkinson’s doesn’t have me,” she says. And when the music plays, she feels like her old self. . .

… Dr. Hu explains that scientists have made great strides in studying how the brain reacts to music. For example, Dr. Robert Zatoore’s group at McGill University has found pleasant music activates almost the same brain regions as those that mediate feelings of reward and pleasure. “What is amazing is that these reward pathways also exist in rats,” Dr. Hu says. Recently, Dr. Hu’s laboratory and researchers in Japan have discovered so-called “cue” neurons, the brain cells that apparently only respond to rewarding auditory tunes but not neutral sounds. When researchers gave rats a sweet drink or other pleasurable reward after playing a certain kind of beep – the rodent’s version of a favourite tune – they discovered that cue cells “fired like crazy” whenever the beep was sounded again. In the meantime, the rats moved 30 to 50 per cent faster than without the “music.”

Dr. Hu believes that cue cells are spared from Parkinson’s disease. When these cells respond to music (and it can’t be any music, explains Dr. Hu, “it must be connected to a person’s feelings, connected to recollections of something enjoyable”), they release chemicals that help Parkinson’s patients temporarily get back their control of movements.

Last December, Dr. Hu and his colleagues began studying Parkinson’s patients who exhibited positive musical responses. His team hopes to eventually study about 30 people, and… Dr. Hu hopes to conduct some of their studies in the homes of patients. … Dr. Hu’s team will capture each step of a patient’s movement using a wireless motion detector and high-speed video recording, a computer system specially developed by Ed Block, chief engineer in the group.

“One of our goals is to make the music effect last longer,” explains Dr. Hu. Another is to figure out how we can help train more Parkinson’s patients to use music as an alternative way of treatment. Both of these goals will greatly benefit from our basic research on the brain pathways and chemicals related to the music effect. Extrapolating from those discoveries, the team will try to develop new and more effective treatments for the illness.

When Dr. Hu’s research project was officially announced in Calgary, country-music star Paul Brandt was on hand to explain how Parkinson’s not only robs individuals of control over their bodies, but also takes an immense toll on sufferers’ families. Brandt’s father-in-law, Bernie Peterson, is in the late stages of Parkinson’s.

Brandt, a former registered nurse at the Alberta Children’s Hospital before breaking out into country music, said he felt a “bit cheated” because of Parkinson’s. Shortly after he met his future wife, Elizabeth, her father, Bernie, had a heart attack in 1994. As his arm hung down from a hospital gurney, Bernie noticed an odd trembling in his fingers. “He didn’t know it then,” recounts Brandt, “but Parkinson’s disease had taken a hold of him and his plans and his wife and his family. And I guess, in a way, it kind of took over me, too. You see, I never really got to meet Bernie, the father-in-law that could have taught me how to finally fix my truck on my own, or remodel an old classic or build a deck on my house. He couldn’t do these things anymore by the time I met him.”

Bernie, a once vigorous man who had flown the first fighter-jets used in the United States Air Force…, today can’t sit alone in a chair. Tremors rock him so badly that, unless his wife, Freda, is there to repeatedly prop him up, he eventually slides helplessly out of most chairs. “You learn to suffer in a kind and forgiving nature,” says Bernie of how he copes with Parkinson’s. “There’s no other way to do it.”

Bernie’s singing son-in-law shook his head when he first heard about Dr. Hu’s project. “I’ve always been skeptical of music therapy honestly,” admits Brandt. “But when I saw this video (of Sheila) suddenly being able to move because of music, and heard the doctors talking about it, honestly my first response was that maybe they would try and use my music and it would actually make patients worse.”

But he realizes now the research is no joke. “It’s almost dreamlike that music could be used to be a treatment for a disease like Parkinson’s.” Sure, it’s always been good for healing an aching heart, says Brandt, “but who knew it could be used for an aching mind.”
Anthony A. Davis is a Calgary writer. First published in Apple Magazine

Chapter 2

2007-12-17T07:08:00.000-05:00

Olie Westheimer said “They need to dance”

Four words. No more, no less
She knew what she was talking about.
Intuitively. And with a lifetime of experience, dancing since she was a child. Knowing dance in every way dance can be known, the mystery of beauty.

Olie Westheimer encountered patients being cared for by her husband, Ivan Bodis-Wollner, M.D., a neurologist and director of the Parkinson's Disease Center of Excellence in Brooklyn, N.Y.

Many PD’ers hide in isolation, sometimes hiding their condition from the world for seven or eight years. But they opened up to her, and she saw their frustrations that their bodies didn't move like they used to. “I don't have a medical background at all,” she said. “But I knew that dancers use all the tricks in the book to get their bodies to do difficult things. I took a gamble. I said, ‘They need to dance.’”

And those who dance, begin to dance...

He was a lawyer with a major international law firm until he was side-swiped by Parkinson’s. Carroll Neesemann, on a Brooklyn corner, going into a studio where the music is loud, and he is with a former social worker and a former teacher, their lives attacked by an enemy they cannot see, and Neesemann’s L-Dopa pills no longer work much any more, and so his fate is sealed, except that…. There he is, with the teacher and the social worker, all of them afflicted with Parkinson’s, and for the love of God, they are burning up the dance floor, as the speakers boom “What Lola wants, Lola gets.”

Later, someone asks the former litigator just exactly what he thinks he is doing, and they get a witness-stand answer: “Dancing takes the symptoms away. It is wonderful to be in control.”

Dance me through the panic 'til I'm gathered safely in

Parkinson’s conspires to take away your control. Your control over your muscles, your control over your body, your control over your life. Neesemann fought back with dance. “It is wonderful to be in control.” And you only really know what he is talking about if you have experienced it: you order your feet to walk and they do not respond at all, because they are disconnected from you. They are no longer under your control.

Well listen up, Parkinson’s. Lola gets what Lola wants. Yes, we can dance.

…Judy Rosenblatt noticed only the music. A retired social worker who was diagnosed in 2004, she says it brings back childhood memories of folk dancing. At age 64, she glides across the dance floor, moving easily, even lightly.

Dance me very tenderly and dance me very long.

Then she pulls off a show-stopper. This sweet retirement age woman, floating like a feather, goes sidestepping across the dance floor to a thumping boom-box chorus of “We Will (We Will) Rock You” by Queen, in the middle of which she somehow transforms it into an ancient Jewish folk dance. Good God in Heaven, how much do the tickets cost, so that I can see that again?

And people thank Judy Rosenblatt, and she speaks softly from a very high place. “It’s a pleasure. It’s easier to move when you hear the music, when you feel the music… when I feel the music, I feel free.”

Lift me like an olive branch and be my homeward dove.
When I feel the music, I feel free.

At the Mark Morris dance studio – with its world-class professional dancers, dozens of half-crippled people struggle in … hanging canes on the ballet barres and parking walkers in the lobby.

They are in for it. This is not a group therapy session. This is world-class international dance. Parkinson’s or not, you dance the full dance. You don’t get any credits for having a disease that prevents you from controlling your body. You have to do it all, just like any other student of classical and modern dance. No excuses, as if having a major part of your brain burn up and die was the same thing as telling the teacher the dog ate your homework. Teacher, I can’t dance classical ballet because part of my brain died. Well, they don’t care if you have a note from the doctor saying that you cannot dance or follow the beat. They are totally senseless to that type of scientific reductionism. Do you still have legs? Check. Got hips? Check. You can dance.

It begins with Pachelbel's Canon in D Major – yeah, that one. A sun salutation, arms stretched to the ceiling, palms together, up and over and down to the floor. There is beauty in every movement. Dancers who can’t walk are saluting the sun. This is not the path of least resistance.
Heginbotham demonstrates a series of poses known as the “embracing phrase” in the Mark Morris repertoire. Social workers, lawyers, teachers, all with Parkinson’s, and they are supposed to dance as if they were going to take the European capitals by storm. Well, yeah.

Ms. Westheimer, Mr. Heginbotham and Mr. Leventhal presented their work at the 16th International Congress on Parkinson’s Disease in Berlin in 2005. Their center has attracted interest from neurologists in England and Norway.

Dance me on and on.

And Heginbotham has precise demands about the next dance. Strong and sharp versus light and airy, sustained versus staccato…. Lots of sharp tap steps, clean and clear and distinct, and lift those toes up, lift those toes. And the dancers are activating mirror neurons in the brain, and the muscle memory. Because muscles have memory, and neurons in the brain can act as mirrors, reflecting the light you shine on them. The light of love and dance and music and reward - all take place in same circuits of the brain. The circuits that can replace the ones that are burnt out. The re-wiring that goes around Parkinson’s. Clean and clear and distinct. And lift those toes. The brain re-inforces old pathways, or creates new ones. Rehearse the sun salutation one more time.

Let me feel you moving like they do in Babylon.

And those who dance, begin to dance. And those who weep, begin.

And some weep for joy, to witness such a thing.
Olie Westheimer, finds nothing all that surprising about it. “You train your muscles and your body, but you really dance with your mind,” she says.

Bernie Pollack is there. A former health science worker, he cannot get around without a walker. "Balance was my big problem," said Bernie Pollack. A person who cares about him is ecstatic that his suffering has been defeated. “Before, Bernie used to fall a couple of times a week, because he couldn’t feel when he was off balance. Now, I can’t remember the last time he fell.”

Pachelbel's Canon in D Major does not allow for falling down. Break-dancing, maybe. Not Pachelbel.

And a researcher said, "The fact that there is a strong relationship between emotion and movement in Parkinson's disease has long been scientifically proven.”

A relationship between emotion and movement. You think? Some artists had notions about that; it is good to see the scientists can also prove it. The dreamer and the man of action. The romantic poem and the hard fact. Parkinson’s patients need both kinds of expertise, to find a cure for the wounded heart and the burnt-out brain.
We dance, but it is neither to remember nor to forget. We dance, right here, right now.

Dance me to your beauty with a burning violin

Maria Parker sat in a wheelchair. She could not walk. Her hands trembled uncontrollably. The frail, 67-year-old woman has Parkinson's disease and did not appear ready to dance.

But she was.

She was ready to dance. If she wanted to, she could say, “I am ready for you, I sure hope you are ready for me.” But she did not need to say anything. Her silence said more.

She got up and slowly raised her hands, and then slowly lowered them. She closed her eyes. And this frail woman, no longer shaking, no longer crippled, appeared to be floating. She appeared to weigh nothing. She appeared to no longer touch the floor. She was graceful, flexible, pointing her toes, arching her back, and floating across the room.

Dance me very tenderly and dance me very long

And for 75 minutes, - how many of you out there dance for 75 minutes? - Leventhal, Heginbotham and Owens got all the Parkinson’s patients out of their chairs and put them through their paces. And this is hard, very hard: there were demi-pliés at ballet barres, modern dance and tap steps, and marches across the studio floor to the strains of "Seventy-Six Trombones."

For Robert Simpson, 58, of Manhattan, the class is transforming. "Before I knew it, I felt I was being lifted. It was a feeling of being transcended. It was so wonderful," Simpson said.

Show me slowly what I only know the limits of

Olie was right. They need to dance. Like they need oxygen to breath. It is not a luxury. It is something you need.

“What happens is that people aren’t living with the disease, they are defined by it, and their lives are a round of doctors’ appointments and therapy. Even a support group is part of that world, and I felt like they should be doing something else.”
Ms. Westheimer points out that some Parkinson’s patients intuitively use techniques similar to dancers’ to master or memorize movement. “They put a hand on the wall or another person as a cue to turn, or play familiar music in their heads to get up, or to start walking again if they freeze.”

Dr. Tagliati: “There is a constellation of symptoms that don’t respond to dopamine treatment, and we are still not very good at taking care of them. We don’t know what dance does, exactly, for these, but it’s a complex and fascinating area of research. And the idea of having something that is considered an expression of beauty and youth and coordination to help those with an inability to move — well, it’s romantic.”

Dance me to the end of love, dance me on and on.
_____________________________
Thanks and gratitude to these four journalists. The quotes from interviews in Chapter 2 are almost entirely from them (the adjectives and comments are mostly mine):

Anne Gehris
Parkinson's sufferers get their groove back through dance
Columbia News Service Nov. 1, 2005

Dawn Fallik
Finding new life through movement
Neurology Now; Jan/Feb 2007

Rosyln Sulcas
Getting Their Groove Back, With Help From the Magic of Dance
New York Times August 25, 2007

Joyce Shelby
Mark Morris dance class aids Parkinson's sufferers
New York Daily News, Oct. 23, 2007

And also, of course, the Prophet Isaiah. Or was that Leonard Cohen? I often mix them up.

Chapter 3

2007-12-15T20:00:00.002-05:00

Being Hank Williams

By Bob Dawson

When tears come down like falling rain
You’ll walk the floor and call my name

--Hank Williams, predicting the future

Cecil the Spastic, formerly known as Cecil the Curr (not his real name; not even his real username) has voiced his objections to Chapter 2.

He says: So I get in my pick-up truck and go to New York City to join a world-class dance studio and learn ballet?

That’s right Cecil. I want to see you in a tutu.

But Cecil says: Why should he have to learn to replicate the movements of other dancers, in a huge studio full of people he does not know, dancing to music he did not choose? As Cecil so eloquently puts it, joining the Bolshoi Ballet is not high on his list of things to do before he dies, although he might be interested in Swan Lake if it involves hunting and fishing. And cold beer.

Cecil, your version of Swan Lake will make you the darling of the critics. Terry Teachout will declare you to have saved Western Civilization. Shoot the swans, roast them on an open fire, drink beer, go fishing, go skinny-dipping in the lake. A whole new post-modern take on traditional ballet. It would do monster box office. Have your agent call my agent. How about we do lunch?

Cecil is one of those internet creatures that the moderators warn you about. He single-handedly caused the meltdown of an internet Parkinson’s group by calling us “spastics”.

The righteous defenders of everybody’s hurt feelings replied with outrage, and soon cranked up to a level of hysteria. Cecil knows how to provoke. He is joking, but he is also serious, at least in the way that Triumph the Insult Dog is serious. “Parkinsonian” sounds like a museum, he said. “Parkie” is much too cute and condescending, "PWP" sounds like an airline and could mean People Without Parkinson's, “PD’ers” is meaningless to anyone who does not know that “PD” stands for Parkinson’s Disease. So Cecil says we should proudly embrace the word “spastic”, just as homosexuals appropriated the word “gay” and Negroes appropriated the word “black”, and the former terms of insult became terms of pride.

Cecil talks about Parkinson’s as an alien, a beast, a spider, a separate entity. It appears to move around. One week, your pillow is completely drenched every night, from saliva, then the drooling stops, and you think you are winning, and then your skin starts falling off. It is probing your defences, it is trying to frighten you.

Cecil tells the story of his friend David, a writer who lived down the road. One of those free-lance editor / writer types, moved out of the city, bought a country house.

The disease caught David like a spider catching a fly in its web, tangling him up, and then injecting him with apathy, paralyzing his will to take action, and then sucking the life out of him. Slowly.

The doctors call it “Parkinson’s Apathy” - the complete lack of desire to do anything at all. Sit in a chair, take the drugs, stare at the wall.

And then it started disconnecting the signals from David’s brain to the muscles he needs to write. He could no longer control his hands, he could no longer hold a pencil, he could no longer type. The writer could no longer write.

So David bought voice recognition software – version 9 of Nuance Dragon Speaking Naturally, the Professional Edition. So that he could dictate to his computer, which would transcribe his spoken words into written words, so the writer could still write.

Parkinson’s watched for some time, and then it made another move: it disconnected the muscles in David’s mouth, the muscles that allow him to move his tongue and shape his lips and blow air through his vocal chords and speak. David’s speech became too slurred and inconsistent for the computer to understand. The beast had outwitted a computer program. And now it had David in a corner, alone and out of touch. The writer who could no longer write. The man of words who could no longer speak.

And then the disease toyed with him for several years, slowly disconnecting more circuits, taking away his ability to walk, to feed himself; even sitting in a chair became impossible.

And then it killed him.

Not directly of course - PD is too cowardly to take you on man-to-man. The beast interfered with the ability to swallow, and he got water in his lungs, so he died of pneumonia.

You know that Creationism idea: when you see a painting, you know that somewhere there must be a painter. We stand in awe of Creation and the Majesty of the Universe and we conclude that there must be a Creator.

Well, Cecil thinks Parkinson’s is the negative version of that. He sees the destruction, he thinks there must be a destructor. He sees he is being robbed, he thinks there must a robber.

He thinks that the disease has its modus operandi. It tests your defences and then develops a plan to kill you. Like everything in nature, it develops patterns, it reacts, it mutates, it survives. It is not a virus or a bacteria, but it is like a computer virus, it re-programs your brain to disconnect from your body. Like a denial-of-service attack on your computer. Is it a hardware breakdown or has the software crashed? What are the incantations to drive out these demons?

Human beings used to be cat food for sabre-tooth tigers. We had to outwit the tigers. Smallpox was a living species that used to kill millions. We fought back and destroyed it. Polio faced our full fury and we beat polio. Parkinson’s must be fought as an enemy, not some “condition” to be placated and tranquilized. Forget the therapy groups. Let’s hunt this beast down and blow it away. That is Cecil’s position.

Cecil has the same disease David had, but he does not have the tremors, the shaking. His hands are perfectly steady, for most activities. Cecil has no problem writing, or typing, or holding a pen.

What the disease did to Cecil is it took away his sense of balance. He cannot tell if he is unbalanced or not, his perception of depth is completely off kilter, and at times he is not sure what is up and what is down. So he falls down easily. So of course, he cannot climb a ladder.

Cecil was a roofer. He spent his entire adult life building and repairing roofs. That’s what he was good at, that’s what he was known for, that’s how he fed his family. And that’s the first thing the beast stole from him.

I told Cecil that PD has many symptoms; but two very common ones - shakey hands and loss of balance, are the norm. In this case they showed up separately in two friends, in the most damaging pattern of distribution, but that is just a coincidence. The fact that the writer could no longer write and the roofer could not longer roof is just a statistically inevitable co-incidence. If they had been airplane pilots, they would have lost their jobs just the same.

I explained to Cecil that it is not an entity, it is an absence. It is not a cancerous growth or a living bacteria, it is an absence, a lack of dopamine and the cells that produce it and the ability to absorb it. Like an absence of water, the water is not planning to kill you, it is simply not there, so you die of thirst.

But that is not how Cecil experiences it. He senses it plotting ways to discourage him, to inject him with Apathy, so it can suck the life out of him. Cecil sees it as a vicious beast, an intelligent predator, and he thinks our response to it should be fierce.

Cecil is a front-line soldier who took a bullet, and whose buddy was captured and killed by the enemy, and so Cecil has seen the beast up close, he knows how powerful it is, and he has formulated two strategies that seem to make the alien hesitate on the battleground:

(1) Do not permit Parkinson’s to inject you with Parkinson’s Apathy.

Make a decision. Force yourself. Get up, stand up, don’t give up the fight. Otherwise the creature will paralyze you and eat you. Its single most powerful weapon is its ability to make you give up on everything. Kick its butt. They say you can’t beat PD. But we say we sure as hell can rough it up real bad. If it came here looking for a fight, it came to the right place. They say the beast always wins in the end? Fine. But the beast is going to be missing some fur, let me tell you. The beast is going to wish it had never challenged us to a fight. The day will come when the beast will go the way of the sabre-toothed tiger. Extinct, gone, and forgotten. That day will come.

(2) Be Hank Williams.

Cecil supports our obsession with music, but he deplores our music. He does not like opera, classical music, rock, electric blues, or big band. He likes Hank Williams (Senior). It was his father’s music. He is defensive about Hank, because it is “hill-billy music”. But Leonard Cohen says that Hank Williams is a hundred floors above us in the Tower of Song. The simple perfection of Hank’s songs – so much said in so few words; like Johnny Cash said, he found it very, very easy to be true. Which for most of us is hard. To perceive, understand, and communicate the essence, truthfully, and to live it. Not very, very easy.

Hank Williams, as a teenager, could write clear and simple and evocative songs straight off the top of his head.

It took Leonard Cohen 13 years to change “like a fish on a hook” to “like a worm on a hook” Thirteen years to make that change, because that it is how long it took to see the truth of what it was that had happened. Thirteen years, to realize that he was the worm, not the fish. It makes a big difference, you know. It can create a fair amount of confusion if you can’t straighten that out, especially in a relationship with a passionate woman. But if what you say is true and if it is heartfelt, it will be beautiful and it will strike a chord.

Cecil is a spastic, but he ain’t no ‘tard.

His living room is decorated with posters and photos of Hank Williams. Cecil has the complete works – all the recordings, all the lyrics, hundreds of cover versions. A big stereo system. Powerful speakers.

Cecil does not sit and listen to old recordings of Hank Williams. Cecil becomes Hank Williams.

Air guitar, karaoke, air drums, air fiddle. Cecil gets up and pretends to play the guitar and he wows the non-existent audience, and he thanks them and then goes into the next song, and he swings and sways with his imaginary band, and he sings the songs. In his living room, telling the crowd that it is great to be back in Wichita – during those times Cecil does not have Parkinson’s disease.

Hank Williams drank too much, and smoked too much, and died coughing at the age of 29. But Hank Williams did not have Parkinson’s Disease. And Cecil becomes Hank Williams. And, for the duration of the show, he is cured.

Good to see you again, Hank. Sold out tonight. Standing room only. They love your music Hank. And he tunes his imaginary guitar, (until we got him a real guitar, which he learned to play in a few months), and the curtains open, and the crowd applauds, and the band starts playing and Hank strolls up front and center, strumming, and then he says Howdy, and then Cecil begins to sing, with a voice that is stating facts with emotional force and truthful clarity, as pure as a mountain stream, and you know that he knows exactly what he is talking about:

I’ll be locked here in this cell
Til my body’s just a shell
And my hair turns whiter than snow

The past is a flower, that withers and dies
I’ll wake up tomorrow, with tears in my eyes

I’ve never seen a night so long
When time goes crawling by
The moon just went behind a cloud
To hide its face and cry

Did you ever see a robin weep
When leaves begin to die?
Like me he’s lost the will to live
I’m so lonesome I could cry

Hank Williams

Chapter 4

2007-12-14T20:10:00.001-05:00

Gabriel Dumont

First Responders Scramble

Blues Alert! Blues Alert! This is not a drill!

The Blues Police scramble to their blue choppers, the true men in blue, the thin blue line. They take off in a swirl of dust, barely over the tree-tops, picking up speed, swooping up and down the hillsides, below the radar, with Howlin’ Wolf on their earphones, until they arrive at the scene of the crisis - and yes, hard to believe but true. There is a party going on around the pool – a diplomat’s residence - and they are playing the Downchild Blues Band at LOW volume. And they are chattering and eating delicate hors d’eouvre and using the Blues as BACKGROUND MUZAC.

You realize, of course, this means war.

But the tension subsides when the host agrees to turn it up LOUD and the Blues Police let him off with a warning: “The volume control on your speakers goes from 1 to 10. Crank it up to 11.”

If you can’t feel the floor vibrating, it is not LOUD enough. If you can’t feel the base line thumping on your chest, it is not LOUD enough. The Blues is not the background soundtrack for the chatter of words in your head. The Blues is designed to stop the chatter of words in your head. To bring you back to the priorities of the heart. To make you dance almost against your will. And so it has to be played LOUD.

Darcey Jerrom? Never met the man. Shaman. Medicine Man.

I said at the beginning of Chapter 1 that I got Parkinson’s and a friend bombarded me with the Blues and that is how this all started.

The friend is Darcey Jerrom.

I have never met him. He lives thousands of miles away. I never asked him for anything.

He bombards me with the Blues. On the internet, or delivered by messenger to my door, with cryptic statements. Relentlessly, for two years. He has sent me about 150 hours of Blues, carefully selected from the 16,000 songs in his collection. If I listen for an hour a day, it would take me five months to listen to the 150 hours he has sent me. But some tracks, I listen to over and over, so it takes more than an hour a day. And I make my own compilations of what I got from Darcey and send them out to other people with Parkinson’s. It’s like one of those chain letters, except that there is no explanation of what happens to you if you break the chain by not playing the Blues. This website will provide that explanation. If blue helicopters land in your backyard, don’t blame me. You had it coming.

I stumbled across Darcey and his website, DustMyBroom, by what some call accident, some call serendipity. I was looking for one thing and found something completely different. Something that is much better than what I was looking for, but that I never would have thought to look for. When that happens to you, pay attention. Someone has opened a new door for you. Accept the universe, right then and there.

Irish tradition

When the doctor told me it is an incurable downward spiral, my Irish heritage, pride, and culture required that I get really drunk and then feel sorry for myself.

Is this my last poutine? What if I die this winter and the Canadiens win the Stanley Cup in the spring and I won’t be there for the looting of St. Catherine Street? What if they discover the cure for Parkinson’s the day after I die, and I become a footnote in medical texts, as the last person in history to die of the disease, and at my funeral the businessmen joke about how “he always said timing is everything -- hahahaha”.

And then I got nostalgic for places and people I had not see in many years, and thought about the northern Indian Rez where Ursula and I lived 30 years ago, and then the Killiniq Inuit we got involved with, and I predicted a quarter of a century ago that there would arise a new generation of native leaders who would be independent, conservative and entrepreneurial. So to see if I was right, I googled around with search terms such as “redneck Injuns” and “conservative socio-political trends among Canadian First Nation aboriginals”

And Google sent me to www.DustMyBroom.com – one of the top five conservative blogs in Canada. Full of redneck Injuns.

Lone Ranger: We are surrounded by Indians.

Tonto: What you mean “we”?

I was too drunk to make much sense of it at the time. In one of the comments sections, some professor in Vancouver was attacking someone named Darcey for not knowing anything about the native people, that if he knew the First Nations he would not talk like a neo-con white supremacist.

Because this Darcey person did not support the apartheid socialist reservation system, and proposed conservative solutions, therefore he must be against the Indians, because liberals are the only humanitarians, or something.

But Darcey, accused of being an ignorant white man who knows nothing about the native people, was not around to defend himself. He had gone to a Blackfoot reservation for one of their traditional celebrations. When he did reply, it was something like this: kipaha kituunn pooneu uta, which apparently means something like “Shut up” in Michif.

Oh, you have never heard of Michif? Well they don’t teach it in universities. It used to be widely spoken on the western plains of what became Canada and the United States. Today there are only about 950 people in the world who speak Michif. Now that the buffalo are gone.

It identifies the speaker as Metis, and so you can expect to see him with the Plains Cree, the Nakota, the Objibwe, the Blackfoot, and the Black Chicago Blues and the Black Delta Blues. Wait a minute, the last two are not Indian tribes!

But you turn on a local Rez radio station, and the song they are playing is Eddie Clearwater singing “Reservation Blues” ("reservation or plantation, you paid your dues.") Where else in the world would you see a poster of Gabriel Dumont beside a poster of Robert Johnson?

Robert Johnson

Chapter 5

2007-12-13T20:20:00.001-05:00

John Lee Hooker

John Lee Hooker was right.

Every Friday night, Darcey would podcast a blues show – Friday Night Blues and Beer at the Broom, as one small part of his political and personal website.

At first I did not know about the blues show. I posted political opinions about other people’s opinions about prevailing opinions and counter-opinions, but I did not care about my own opinions, because I was busy being fatalistic, and then one day I used my Parkinson’s “condition” as an example of something - health care in Canada or something opinionated, and at about three o’clock in the morning there was a message on my computer and it said “John Lee Hooker was right.”

An answer to a question? What was the question? It became part of the game to talk to each other entirely in quotations from Blues songs, and to seek Blues Advice when the Johnny Walker Wisdom ran out.

And my incurable disease was discussed in dance: a blues song about walking in a dead man’s clothes followed by Screamin’ J. singing about doing an oil portrait of a man and then realizing, when painting his eyes, that this man was near death, followed by B.B. King saying he wanted to give up living and go shopping instead, followed by songs of great joy and a lust for life. It’s a good day to die, a good day to live. Darcey got me addicted to the Blues.

John Lee Hooker was right. As an old man, with a lifetime of experience, he boiled it down to its essence, a few words, stating something very important that he himself had experienced and that he had witnessed in other people:

Blues is a healer

All over the world

The blues healed me

It can heal you too

If you let it

John Lee Hooker was not being poetic. He was not being romantic. He was not making a metaphor, an allegory, a simile, or a parable. He was not boasting about the power of the artform that he devoted his life to.

He was stating a fact.

He was stating a plain, simple fact. And he knew what he was talking about. Blues is a healer. He was alerting us to a fact.

And today, scientists are investigating how that works. How is it that some people who cannot walk, can get up from their wheelchairs and dance? There is no longer any question about what John Lee Hooker said. He was right. The question now is to find out why he was right.

Okay, so you’ve got John Lee Hooker on your side.

I suppose Robert Johnson, Buddy Guy, and Muddy Waters all contributed to your anti-Parkinson’s story as well, right?

Ummm, yes.

John Lee Hooker said where to look for a cure and Darcey went searching for the spirit of Robert Johnson and met Buddy Guy who inspired him to record the Blues with Muddy Waters harp player who got Parkinson’s and then when I got Parkinson’s Darcey sent all the Blues in my direction and I wrote about it on Darcey’s site and then a scientist from Beijing with research projects in Calgary and Shanghai came to my house in rural Quebec and we put on Darcey’s blues and danced for him and he showed us some of his research that shows that the cure for PD lies in that direction which is a good thing because in his country there are 30 million people with the disease and we are going to eliminate this disease from the face of the earth.

This kind of thing happens all the time.

In a beehive, all the bees follow exactly the same pattern. The ones who gather the pollen fly to the same places every day. But there are a few bees who fly off in completely new directions. And thereby discover new sources of pollen. They appear to be rebels, disobeying the rules, but in fact the bees that go off in new directions are essential to the survival of the species, because they are the pathfinders for the future.

If you were growing up in northern Manitoba, what path do you think you would have taken? What would you have become?

Darcey first read the complete works of Rudyard Kipling (something like 28 volumes), and then learned to play guitar day and night from the age of 13; playing in bands with Shere Khan and other friends, in an area with a half-dozen Indian reservations. Looking out at the crowd you could sometimes see three or four fist fights going on at the same time. Beer covered the floor. Young nubile Indians girls were handed around like joints. One of the people involved got in seven knife fights, receiving nine knife wounds, yet winning most of the fights as the others were even more wounded.

Now, one knife fight happens to everybody. Who among us has not been in a knife fight? And two knife fights is not a big deal. Three knife fights - maybe you should be more careful. But seven knife fights? Seven? Maybe there’s a pattern there. To an outsider, it looked like these guys would end up in prison, just another aboriginal statistic. Not to blame the victim or anything – of course it was always self-defence – but seven knife fights before you are old enough to get a driver’s licence is a worrisome pattern. Then the Blues took control.

Sometimes just being able to see the pattern helps you to avoid getting trapped in it, becoming Apathetic in prison, and having all the life sucked out of you by the beast. Some prisons have walls; some do not. And Parkinson’s is not the only thing that can take away what you need most, what makes you the person you are. Parkinson’s is not the only condition that can ruin your life. So when you see someone break free from the death-grip of a beast, pay attention. The bee that finds a new pathway is essential to our survival.

Darcey and Shere’s group were playing heavy metal, moving towards head-banging music. And there were some favorite anthems such the one where the guitars sound like cats being killed with chain saws and the drums sound like gunfire and the band screams at the audience: “Thieves and liars! Thieves and liars!” That’s a bit of First Nation heritage that the CBC chose not to show. You should wonder why. (We take you back now to Ottawa where Constitutional talks continue… blah blah blah)

And so what happens next to these head-bangers? Want to hazard a guess? What would you have done? Well, Darcey, from one day to the next, decides to leave the native communities of northern Manitoba and go to the United States on a spiritual quest searching for the soul of the Blues, specifically the spirit of Robert Johnson, the blues genius.

Robert Johnson

A spirit quest – a young Metis from northern Manitoba following the spirit of a black American musician who died 70 years ago. You could not make that up. A committee would never agree to it. A government agency would never comprehend it. Yet it is that kind of thing – freedom, personal decisions, serendipity, new pathways opening new doors – it is that kind of thing that brings about outbursts of creativity, and solutions to ancient problems.

Buddy Guy

As so he ends up in California and meets Buddy Guy, whose influence is so powerful that Darcey goes out and buys a Les Paul, a Strat and a Tele, plays guitar 12 hours a night, leaving blood stains from his lacerated fingers, writing his own blues songs, buying state-of-the-art equipment for his own recording studio, and launching CD’s.

And jamming with a harp player who used to play harp in Muddy Water’s band in Chicago.

And then the harp player got Parkinson’s. And guess what Parkinson’s did to him? It took away his ability to play music.

Muddy Waters

Darcey moved back to Canada. And he brought it all back home. An entire cultural heritage, more blues than we ever knew existed. Something like 3,000 recorded hours of blues, 16,000 songs. And I get bombarded with whatever part of it Darcey thinks I should get next, so in effect the red man is delivering the black man’s music to the white man, to fix the obvious hole in his head.

I always had that feeling, that the Indians were observing us and then just waiting for a few centuries, and one day they will be back in charge. But I never anticipated that when young black Americans veered into gangsta rap, promoting cop killing and bitch slapping, that the entire catalogue of American blues, ignored by a black generation in revolt, would be kept alive by Canadian aboriginals. And there it is: Darcey’s weekly radio show is the best blues show anywhere; there is a weekly television show called Rez Bluez, an hour per week of Canadian Indian blues musicians, there are at least 30 Indian blues bands ready for prime time, there are small villages with their own blues bands, there are more blues musicians per capita among Canadian Indians and Metis than anywhere else, and Darcey has preserved 16,000 songs from the black American descendants of 300 years of brutal slavery – music that points at beauty and healthy sexuality and heartfelt visions of the world.

Some say it is the drums - the drums of Africa and of the Blues and of Indian dances and of the human heartbeat. Some say the outsiders recognize the music of other outsiders. Some say it’s simply that the Blues speaks most clearly to the human condition, to love and life and birth and death and man and woman. It’s simply that native people recognize great art when it touches them.

Many native people are capable of belief. When we say that music and dance can cure Parkinson’s, they find that very, very easy to believe. They are not surprised. They are capable of faith. And rather than talk about it, they just do it.

The Blues rest in the open palm of your hand. Free to go, free to return. Reminding you of what you always knew, but had stopped paying attention to. Reminding you to see with the heart, and to dance with a lust for life.

So if you want to talk about the 28 volumes of Rudyard Kipling, or 16,000 blues tracks, you know where to look. I don’t even want to guess what else they are hiding on the Reservations. They have probably revived the Latin language and re-calculated the Aztec measurement of time, and spend most of their time rehearsing Chinese opera. That would not be much more extreme that what I just went through.

John Lee Hooker was right. We were just a bit slow in paying attention to what he said. As Darcey says, when someone is pointing at the moon, do not stare at his finger.

Darcey Jerrom

Chapter 6

2007-12-12T21:44:00.005-05:00

Dancing in Africa, 50,000 year ago
Before language, before mud huts, before agriculture, we danced.

How Jimi Hendrix defeated the sabre-tooth tigers

Seen any sabre-tooth tigers recently? No? I didn’t think so. Jimi Hendrix scared them away.

We used to be cat food. The caves of the tigers are littered with human bones, chewed on by the big cats. For thousands of years, we were easy pickings. A sabre-tooth tiger would wake up, stretch, look around, and then grab one of your children to drag away and eat. And as soon as the tiger was hungry again, it would be back.

This was before we had language, before we had names for each other, before we knew how to build shelter, before we planted seeds to grow crops. Predators found us to be an excellent food supply, tender and juicy, and we did not have weapons or fangs or claws or exceptional speed or exceptional strength to defend ourselves.

We were cat food

And then somehow, some of us began to observe the patterns of behaviour of our predators. We were good at perceiving and comparing and finding the patterns. And some of us developed a strategy, and soon whole groups of people learned to bang sticks together, then bang on drums, then chant and yell and scream, and as a group, hop forward and stamp our feet to the beat of the drums, and then hop around in circles chanting, banging drums, stomping our feet, moving forward in a line, yelling, hopping backwards in a line…

And the sabre-tooth tigers said, “To hell with this.” And our species survived and the sabre-tooth tiger became extinct.

Because we danced. And chanted and banged the drums. Our species survived and prospered because of art.

And our brains remember that. Our DNA remembers that. The circuits in our brains, and from our brains to our muscles, that handle music and rhythm and dance are solid and re-enforced, ancient and well-protected. Those are the circuits that allow Parkinson’s patients to dance. We need some re-wiring so they can also be used to walk.

Art, music, dance. They are not luxuries, or unimportant frills. They are an essential part of what it is to be human, part of our genetic code.

We had art and music and dance before we had language and villages and agriculture. Playing drums to survive came 20,000 years before agriculture. So our DNA rates music as Number One With A Bullet. Music preceded civilization and allowed us to survive to be able to start a civilization. Our brains remember that. Our brains remember how we stopped the sabre-tooth tigers from eating our children. Our brains found that to be very impressive. So our brains give top level service and protection for music and dance. MRI scans confirm that music and dance light up the brain like nothing else.

The drawings on the caves in France are 35,000 years old. In Africa and Australia there are artworks that are 50,000 years old. There are reports of some artwork that may be 75,000 or 100,000 years old. Whereas, the idea that plants come from seeds, the idea of agriculture, is only 12,000 years old. Dance and music may in fact be as old as walking and running, which date back 2 to 5 million years. (Ward, 2002; Bramble and Lieberman, 2004).

We recognize the drums right away, we want to stomp our feet to the beat, we want to dance together, we want to chant and sing from our hearts, we want to drive away the beast and dance with joy and a lust for life.

It would have all been done faster if we could have sent Jimi Hendrix back in time to play a guitar solo. That would have scared the tigers away a lot faster.

The same brain circuits can be called into action to kill another beast: Parkinson’s. We should do it. We owe it to John Lee Hooker. He knew what he was talking about.

Woman dancing
50,000 years ago. Bradshaw African Collection

Above: Cave painting, France, 20,000 years before agriculture
Below: art from 25,000 to 50,000 years ago.

Chapter 7

2007-12-11T20:40:00.000-05:00

Anecdotal evidence

Sure, Grandma smoked five packs of cigarettes a day, drank a bottle of whisky before breakfast, ate nothing but deep-fried lard, never got any exercise, was vastly overweight, and lived to be 112 years old. But “scientific data” is not the plural of “interesting anecdote” There are always anecdotes available to support any idea. But science needs proof before injecting a million people with a new drug. Or withdrawing the use of an existing treatment. And the story about Grandma is of interest to them, but by itself is not going to change their minds.

You are reading this because it is about Parkinson’s. I don’t think you are reading this site because you have back pain or a broken leg. It is because you have been grabbed by the sabre-tooth tiger which is now dragging you away to its cave to eat you. Fortunately you have your laptop with you and you are googling “Being eaten by tiger – what should I do?” And lucky for you, me and Darcey are here to tell you to put on Jimi Hendrix, LOUD. No tiger in the world can handle that.

I hope you can extract some key words from these anecdotes – some key concepts that will be useful for you in your own fight against the beast. Your anecdotes will be different from mine, but we can learn from each other, and substitute. Such as, where I say “Muddy Waters” you might say “Frank Sinatra” or “Ozzy Osbourne”. Where I say “shake your booty, baby” you might say, “May I have this waltz?” But neither of us can say, “Nothing.” Nothing does not cut it. “Nothing” is when the Parkinson’s Apathy leaves you lying in a heap, and the longer it holds you down, the harder it is going to be to get you up again.

So let us see if we can extract some key concepts from the rambling story of how it came about that I am writing to you. One key concept is something I simply have to order you to do. I can’t argue the point, I just have to state it as a command: play it LOUD. After that, you are on your own to find the Blues Advice and the Johnny Walker Wisdom in these anecdotes. As if your life depended on it. I know mine does.

Too soon old, too late smart

Key Words:

(1) Care about PD Apathy. It is the enemy’s neutron bomb. Make deliberate decisions to be very active. Apathy can’t handle your lust for life. That is why it hates you. This is your responsibility - not the responsibility of your doctor, your friends, your family. Of course they can help or hinder. But it is your gig. You are the only one who can feel the beast breathing down your neck as it prepares to finish you off. Kick its butt.

(2) Look around, and be open to serendipity, which is when you look for one thing and find something better, such as looking for a needle in a haystack and finding the farmer’s daughter instead. If someone opens a new door for you, take a chance, go see what is on the other side. The textbooks say that getting an incurable disease is a “life-changing event”. It isn’t really – you still have to take out the garbage and get some firewood. But it is a good excuse to check out some new directions, make a few new rules, stop being influenced by fools, and I even got one of those windshield stickers that allows me to park in the handicapped spots – all the best parking spots. At least I’ve got that going for me. Serendipity, luck and co-incidence appear to be accidental, or manna from heaven, but they actually rely of an infrastructure that required a huge amount of work by somebody. Like Darcey’s 16,000 blues tracks - a work of love, but also a work of work. Lots and lots of work.

You are either busy dying or you are busy living. Choose the one that is fun.

(3) Choose YOUR music. The Blues has become my choice, after starting out as Darcey’s choice for me based on a prescription for healing from John Lee Hooker, and I highly recommend it. And I am not just saying that to placate the Blues Police. The Blues has the range and the variety and the depth and the impact to fight Parkinson’s.

But you must choose the music that hits you. The music that touches your feelings. The music that is hard to get out of your head. The music that makes you want to dance, or march to war, or make love, or snap your fingers, tap your toes, and flap your flippers. The song they played at your wedding reception, or the CD the jerk took from you as part of the divorce. The song you played over and over when you were in high school, sweating over an impossible puppy love. Or the folk tune Grandma used to hum when she was baking bread.

And go find more music that catches your attention. Whatever turns you on, baby, whatever floats your boat, do your own thing in your own time. Whole albums from the same artist are sometimes repetitive: better to make your own compilations, your own playlists, of songs that mean something to you, songs that you wish you had written and performed. And playlists for different situations. Be greedy. Claim the right to play your music in your own home, every day. The kids may make gagging sounds, the neighbors may think you have finally snapped, but it is not their choice, because they are not the ones being eaten by a sabre-tooth tiger.

(4) Play it LOUD. A good stereo system, shaking up the joint. You need your brain to fall completely into the music. You need to be surrounded by sound. The music must drown out the nonsense in your head – the worries, the doubts, the resentments, the laundry list, the problems with other people, the tax forms, and all the chattering that goes on in your head. You have to clear that all away at least once a day, by blasting your favorite music. And when others complain (and they will) and they say “The music is so loud we can’t even think”, that is exactly what is intended. Your brain needs to stop thinking and have nothing else to do for an hour each day – nothing but re-trace the ancient pathways of music and dance, with no other calculations going on.

(5) Shake it up, baby. Move to the music. At first, even just a little bit. But every day, move some part of your body to the beat of the music. And then more and more. In the privacy of your own home, move freely, re-invent dancing, make it your own. Make whatever movements the music inspires you to make. Dance. Maybe you have not danced in 30 years. All the more reason to dance. Enjoy it. And tell people: the doctor recommends it. This website recommends it. Darcey says dance until your moccasins wear out. There is genuine evidence that dancing does a lot of good for a lot of PD’ers. And there is a genuine belief that the cure for the disease is in there somewhere. So dance. Dance and music may help find a cure.

(6) Visualize. Don’t be a stuck-up narrow-minded middle class boor about this. Yes, it is what teenagers do: play air guitar, pretend to be a rock star. Yes, some people will tell you that you look ridiculous. So throw them out of the audience. Don’t let them buy a ticket to see your show. As with Karaoke, you get to sing. But also, you can dance around pretending to play the guitar, the drums, the sax, the piano. Visualize as intensely as you can that you are the one making this music; this is your band and you know how to play all the instruments, so you can do the guitar solo AND the piano solo AND the drum solo. Make yourself a star in your own living room. Know your songs. Imagine the audience – a huge crowd sometimes, or a small group, or just one person, to whom you offer flowers and love songs. The more you can get into the music, the more powerful it will be in unblocking and re-wiring the rusted out circuits in your brain.

Cecil is Hank Williams. I am so many different blues musicians, I can’t remember all my names. My guitar solos are legendary. And I have heard rumours on the internet - just rumours mind you – that we have a Shania Twain. Can we plan a duet with Hank Williams? That would be hot.

And you, who are you on stage? Frank Sinatra? Keith Richards? Tommy Dorsey? Amadeus Mozart? The choices are endless. So choose. Even singing silently in your head as you walk down the street, make it into an event your brain will remember. The day Edith Piaf sang on Main Street.

Non, je ne regrette rien, rien de rien….

Sabre-tooth tigers hate that kind of stuff.

(7) Find the Zone. The Zone is where you fall into the music, and it lifts you up and carries you away, and you feel free, and the pain is gone, and the universe is beautiful. No, this is not hippie talk or tree-hugging. The Zone is where the music comes up through the floor and into your toes and up your legs, and it sways your hips and raises your arms and flows out the tips of your fingers and you could dance all night. The Zone is where you see that it has been really worthwhile to be alive, and a lot of your complaints seem to dissolve. When you experience the Zone, bookmark it, remember what it feels like, and how you got there, and go there again, on a regular basis, to refresh yourself, and wash off the dust of the day in pure mountain water. You cannot live in the Zone, but you can go there often to find renewal. Some days you are just too tired, or distracted, and you cannot find the Zone. That’s okay. But don’t forget to go there. You need to get recharged. The Zone is that state of bliss, or contentment, or joy, or peacefulness, or enthusiasm, or creativity, that you have been to before, but the hectic pace and the emotional harshness of modern life cause you to forget to return to that special place, the place where your perfect suffering seems less important, where you feel renewed and free. For musicians, the Zone is when you are playing your instrument, and the music takes over – your fingers do the walking, and it is as if the instrument is playing you.

(8) Ask the question. How come some people who cannot walk can dance? Eh? Whassup with that? Ask people, ask doctors, ask scientists. Expect glib answers or put-downs, because you are challenging their view of how things work. But ask anyway, because the question will spread around from person to person, and at some point someone will figure out how to cure Parkinson’s. Asking the question makes them realize that the evidence is right before their eyes. And the more often the medical industry hears this question being asked, from all sides, the sooner they will realize that it is not just a few anecdotes from a few people. Parkinson's attacks different people in different ways, making it confusing to deal with, making it hard to see the patterns of the wounds. But it is the same beast. That' s the pattern. So kill the beast.

(9) Forgot to mention. Play it LOUD.

(10) Place your own Key Words here. It’s your disease. Make your plan.

Coming soon: another chapter, with the latest research.

Meanwhile, play the Blues. LOUD.

See ya’ later.

One more anecdote:

There is a story from several thousand years ago, some guy walking around in the dusty streets of some town in the Middle East, and he comes across a beggar sitting on a mattress, a cripple begging for charity. And he says, “Take up thy bed and walk.” And to everyone’s amazement, the cripple takes up his bed and walks.

I always figured that was one of those metaphorical stories that is supposed to mean something poetic, or it was a story from ancient people who did not distinguish between scientific fact and magic. Or it was just made up to pretend that the guru had supernatural powers.

But now I found out that it happens all the time.

A woman, in a wheelchair, unable to walk without falling down, unable to hold a spoon to eat, unable to care for herself…. And the music comes on, and she gets up from her wheelchair, and she dances. She dances like a teenager. As long as the music plays.

Let’s make the music play for the rest of her life. Take up thy bed and dance.

Blackberry bush. Sören Dawson.

Chapter 8

2007-12-10T20:30:00.017-05:00

Research:

Parkinson’s and pickled herring

Bob,

Research? The research into Parkinson’s has already been completed. The connection between Parkinson’s and pickled herring has been researched, documented and published. And Parkinson’s and cheese. And Parkinson’s and chocolate. When the scientists have reached that level of detail, there is nothing left to research. It has all been done. This is one of the instruction sheets for patients:

Warning: Selegiline might cause a rapid rise in blood pressure and severe throbbing headaches.

Avoid eating foods that contain tyramine, such as cheese (especially aged); sour cream; yogurt; meat, fish, and poultry; especially bologna, pepperoni, salami, summer sausage, pickled herring, liver; avoid certain fruits and vegetables, including avocados, figs, raisins, bananas, and eggplant; fava beans; some soups; and chocolate, bean pods; Marmite concentrated yeast extract; sauerkraut; soy sauce and soy bean condiments, beer, red wine…

Selegiline may cause dizziness or lightheadedness or fainting, confusion, blurred vision, problems with speech or balance, nausea, vomiting, chest pain, seizure (convulsions), hallucinations, twitching muscle movements; pain;

Do not drive, operate machinery, or do anything else that could be dangerous. Using Selegiline may lessen your ability to drive or perform other potentially dangerous tasks.

Sit up or stand slowly, especially in the morning. Also, sit or lie down at the first sign of dizziness, lightheadedness, or weakness.

So what can I eat? What should I do other than lie down and hope to die soon?

If the research has already shown that pickled herring is a major cause of hallucinations among PWP, then all the research has been done, right? Or is the dizziness and fainting caused by starvation? Do we dare to dance when we are warned not to stand up? What do you say to that, Spasticman? You love the billionaire drug companies so much. –JimmyBear (internet discussion group)

JimmyBear,

Why do you hate America? Our intention was to find a cure for Parkinson’s before you come out of hibernation and start growling at us again. Go back to your den; it is not spring yet.

I do not love the drug companies. I love the drugs. They do not prolong my life, but they help coping with having a hole in the head. Which is more than you can say for a lot of products. What did Tang ever do for me?

Sweet Sister Seligilene, put your cool, cool hand on my head. Mysterious Magical Mirapex, take me gambling in Vegas instead. Loving Levadopa, replace the dope-mine in my head.

I get all the best parking spots and all the coolest drugs. I am grateful to the pharmaceutical industry, and I do not resent their profit margins. They are not as profitable as the video game industry, and compared to playing video games, it is much more fun driving a real car at high speed on a twisting and turning back-country road at three o’clock in the morning, with Darcey’s blues blasting, while under the influence of Mirapex and artificial dopamine. Parkinson’s tries to disconnect your brain from your muscles; the drugs try to re-establish the connection. On an S-curve on a gravel road, it’s interesting.

JimmyBear, you do not have the constitutional right to eat chicken. Thomas Jefferson never promised you the pursuit of chocolate, red wine and pickled herring. There are many things you can eat. Insects. You can eat insects. The bark of trees. You can drink water. Hay. If it’s good enough for cows, it should be good enough for you.

Do not do anything dangerous, such as living. Life is Unsafe at Any Speed, as Ralph Nader found out. So be safe by doing nothing. Sit in a chair, swallow the pills, stare at the wall. Give in to Parkinson’s Apathy.

It is a recipe for suicide. And sadly, the instructions are often given to the spouse, the care-giver, the loved one, who will lovingly try to enforce what the authorities say is required. Instead of being united, the couple end up at war over the medical instructions.

Do not eat, drink or be merry, you sinner! Whatever has caused you pleasure in life must be the cause of your illness. Repent! Drive out the demons through suffering and self-deprivation. Exorcism will be the next wave of recommended therapy. No pickled herring for you, you wretched sinner.

But, JimmyBear, there’s another side to this story. What you have in your hands is a letter from the lawyers of the pharmaceutical company. They do not want to be sued by Parkinson’s patients who had no idea that illness might make them feel ill. No one warned them. So now you are being warned.

Predator lawyers have launched massive lawsuits, encouraging people to claim that Parkinson’s drugs forced them into a life of wickedness and depravity. If you take Mirapex, the next thing you know, you stop going to church, stop taking your children to the cottage, declare that there is no God, embezzle money from your employer, sell the house, abandon the family, fly to Las Vegas, rent a car, move into a penthouse, buy cases of champagne, and blow all of your family’s life savings in the gambling casinos, with a hooker under each arm.

And none of that is your decision or your responsibility. It is all non-voluntary muscle spams caused by Mirapex. You had no idea what you were doing when you bought the airline ticket, reserved the hotel room, called for room service. Your brain was not in control of your muscles when you dialed the escort service. You dialed the numbers by co-incidence, like a million monkeys with a million telephones – eventually they dial an escort service without knowing what they are doing. If you can convince the judge and jury, you will be wealthy for life.

The lawyers are promising truckloads of cash to Parkinson’s patients willing to fill out forms claiming that Mirapex forced them to buy big cigars and play poker. (You can fill out the forms on the internet – no postage required!) The lawyers offer the usual deal: they are going to sue for hundreds of millions of dollars, and if you help them win the case by perjury or by saying that the drugs took away your free will, the lawyers will pay you off if they win their case. The lawyers will keep 50% to 75% of the money for themselves; the remainder goes to Parkinson’s patients willing to say that if it weren’t for Mirapex, they would still be teaching Sunday School at the local church, instead of snorting cocaine in the washroom of a casino. If you help the lawyers win the case, you can become an instant millionaire with your share of the shake-down money. If you lose, they do not even charge legal fees. So you cannot lose. Money, that is. Your soul, well...

Sue the pharmaceutical companies, sue the hospital, sue your doctor, sue your neurologist, sue anybody and everybody who devoted their lives to helping you.

And so doctors spend a fortune on liability insurance, and drug companies don’t even bother creating new drugs that are innovative or risky because every drug has side effects, especially drugs aimed at the brain. Mirapex, which is so beneficial to me and to thousands of other people, may be withdrawn from the market; the drug company can be bankrupted by the lawsuits. The doctors who prescribed the drug can be driven to give up their practice.

You, the Parkinson’s patient: part of your brain died. Do you think that a drug aiming at that problem will have no side effects? If the drugs take away your free will to such an extent that you cannot control yourself, then maybe it is time to return to the era of Charles Dickens, when people like you were locked up in institutions. If you buy airline tickets to Vegas against your own free will, then you are a danger to society and yourself and should be declared to be a ward of the state. Brain-dead zombies on drugs cannot be allowed to wander the streets if they are unable to control their own actions. And that is what these Parkies are being offered cash to say. That they cannot control their own actions. That they cannot be trusted. That they cannot be allowed to be free.

Doctors and researchers and pharmacists who try to help are taking a huge personal risk, because reptilian predator lawyers will drag them through years of court, ruin their reputation, push them towards bankruptcy, by trotting out a few Parkinson’s patients who suffered THOSE side-effects, not the other side effects, not the 50% failure rate of some types of Parkinson's brain surgery. Should 50% of them sue the surgeons? And would there then be any more surgeons willing to implant an electronic device in your brain? Did anyone really think that it is not a dangerous thing to try to do?

Researchers are not going to devote their lives to seeking a cure for Parkinson’s when the most cohesive, international and united action the People With Parkinson’s are capable of organizing is to launch a massive lawsuit against the medical industry. Search Google for Parkinson’s Mirapex gambling lawsuit, and you will see. It’s more extensive than any campaign to get rid of the disease. It is more action-oriented than any Parkinson’s Association. It will collect more money than the Michael J. Fox Foundation.

It is a shake-down that relies on Parkinson’s patients claiming that their condition is not just about losing control of their muscles. They also have lost control of their morals, their free well, and the responsibility for their own actions. They cannot control themselves.

So prejudice against them, firing them from their jobs, or as they used to do, locking them up in institutions, (or, in the Dark Ages, burning them at the stake) is all entirely justified. Even today, many people with Parkinson’s, including Michael J. Fox, hide their condition for as long as possible, to avoid the prejudice, the fear, the intolerance, the superstition. Such as the Op-Ed Editor of the L.A. Times, who was publicly accused of failing to publish certain commentators because Parkinson’s had ruined his sense of judgment. Medieval superstition against people who twitch and fall down, as if possessed by demons. And now PWP’s are saying “You were right about the demons. We are possessed and obsessed and out of control."

The lawsuits set the public acceptance of Parkinson’s patients back by several centuries. The public will not remember the word “Mirapex”. They will remember that Parkinson’s patients put their hand on the Bible and testified in court that they are unable to control their own actions.

Parkinson's could be cured if the same amount of energy was put in to helping the researchers instead of bankrupting them.

It reminds me of one of Bergman’s best movies, which was titled very simply: “Shame”.

I wish that at least one Parkinson’s “victim” would say, “Yes, I emptied my bank account, sold the house, flew to Vegas, banged every hooker in sight and spent all my money and now I sleep under a bridge. You got a problem with that? I had a helluva good time. It was my choice. Could you spare a dollar?" No, they sue because they are hungry for sex. Or gambling. Or saying bad words or eating too much chocolate. The lawsuits detail all of those, and more.

JimmyBear, you and I do not share that fate. We make our own choices. So let’s decide to have a glass of red wine and get up and dance. Do the things that make you come alive. The negative instructions about avoiding pickled herring and everything that tastes good are just a legal precaution meaning “Don’t say we didn’t warn you.” They warned us.

But you and I will not heed their warnings. The music was too loud, so we did not hear a damn thing they said. We could sue the Blues musicians. Warning: this music may cause you to dance your ass off, wake up the neighbors, laugh until your ribs hurt, take a taxi to Chicago or the Mississippi delta, play air guitar like a lunatic….. (fill in your own symptoms here).

I am personally going to sue the estate of John Lee Hooker for telling me that Blues is a healer. There was no warning label on the CD. “This music may cause prolonged body movement and states of euphoria. You may even start to think you are black.”

That should be worth a few hundred million dollars in damages.

I fell into this life of wickedness and depravity (song and dance) by taking two cures: one was Mirapex, and the other was the Blues. Like a fool I mixed them, and it strangled up my mind, and now dancers are more beautiful, and I have no sense of time. (Jeremiah)

Hey JimmyBear, wanna join the class action suit against John Lee Hooker? Nobody cross-examines a Grizzly. Not even the Blues Police.

Post-Script. It has come to my attention that some highly respected law firms do not agree with my description of them as "reptilian predators", and some People With Parkinson's who want to sue the drug companies are not pleased either, especially at my lack of comprehension about the suffering of those who take drugs and plunge into compulsive or obsessive behaviour, and the difficulty of avoiding addictions, especially when taking powerful brain-altering drugs. I'm just a country boy, and I would not know about such things.
This website is an advocacy website. It is not a free discussion site. It is a marketing newsletter. But this sub-topic about the creators of Mirapex being sued by the consumers of Mirapex is such an appalling example of the dysfunctionality of the war against Parkinson's, that there will be a chapter called "You've got mail. Fear and Loathing in Las Vegas" and over time various complaints about this chapter will be commented on, unless the whole topic is so loathesome that I won't want to have it around. America spends $200 million a year on Parkinson's research, there has not been a new treatment since L-dopa started half a century ago, the number of people in the U.S.A. with Parkinson's will be eight million soon enough, and the only hot and heavy action going on is that Parkinson's patients are suing the makers of one of the two or three types of drugs that go into your brain to the section where 80% of your brain cells are dead, and try to stimulate it to keep you going. Yeah, let's destroy those guys.
JimmyBear, when there are lawyers around, always say "Notwithstanding any previous statements" every time you talk. And "without prejudice to my other rights and recourses." It will make you sound like a very sophisticated bear.

Chapter 9

2007-12-09T14:00:00.004-05:00

Jules Olitski and the View of Delft

John and Liv, husband and wife. John slowly developed Parkinson’s over a period of about 25 years. Slowly, slowly. With PD, there is no predicting how fast or how far it goes. Every case is different.

PD’ers are fascinated by dance to a remarkable degree. John had never seen a live dance performance, so Liv took him to see Margie Gillis.

John was swept away by the performance. And he swooned. Not as extreme as fainting, but he slid to the floor. Liv tapped him on the cheeks to revive him. He was overwhelmed by beauty. He swooned in a state of euphoria. With a little bit of help from the Selegiline and Mirapex pills.

A man in the row behind was expounding loudly that this kind of dancing should not be supported – look what it did to that poor man -- it is too personal and too emotional, and art should cause intellectual progress and not emotions - lest we slide into bourgeois individualism instead of collective something or other – and he was using art critic’s political terms, with a scornful critique of the dancer and the dance.

Liv was furious and stood up and told him to shut up and keep his arrogance to himself and he should just get to hell out of the building if he is too screwed up in his head to appreciate the height of creativity, and he replied crudely and disdainfully, and she reached over the seats and tried to slap him in the face but he ducked and John wrestled Liv back into her seat and told her not to start a riot and the man she had tried to slap threatened to call the police.

Fortunately, Margie Gillis was not distracted from her performance by the outbreak of swooning and arguing and slapping and wrestling and invocations of the Riot Act and calls for bringing in the police.

It was a grand evening.

Five or six years later, John and Liv were in a restaurant, discussing the cave paintings that portray people dancing, from 50,000 years ago, and Liv said that it is indeed amazing that people were dancing 50,000 years ago. But the reason we know this is that when the people were dancing, there was a painter standing there. Probably with an easel, wearing a French beret, and smoking Gauloises, with home-made paint, and rocks for his canvas. There was a painter interpreting the dancers, 50,000 years ago.

John said music and dance have the most powerful impact, and remember that time when he swooned at a Margie Gillis performance. Dancing and music are immediate, and swoonable, but a painting is for the ages, and its power grows with time, and is a one-of-a-kind item, but you would not swoon because of it.

And the waiter, bringing yet another bottle of red wine, said ,”Oh are you talking about Margie Gillis? That’s her over there.’ And they turned and looked, and there was Margie Gillis, about 5 tables away, eating supper like anybody else.

And John swooned.

He fell off his chair and had to be revived. Liv got down on the floor and held him in her arms, and asked, are you okay, and he said, yes, I am with you.

But friends thought the pills must be getting to him, and that these fainting episodes might be really dangerous.

Then Jules Olitski, who lived in the hill country just south of them, came to the rescue. He reclaimed the verb “to swoon”, as in, “to be overwhelmed by ecstatic joy.” And he was not a musician or a dancer. Except that, actually he was, but it happened to him in colors. He found the Zone in paint. Like the ones who painted the dancers 50,000 years ago. And it was swoonable.

Jules Olitski said: “... I remember coming all of a sudden upon Vermeer’s View of Delft. I was walking towards it, I must have been about twenty feet or more away, and I didn’t even know it was a Vermeer. One doesn’t swoon anymore since the nineteenth century, but like a maiden I swooned… it was the most beautiful painting I had ever seen.”

Jules Olitski

(1922 - 2007)

(Died of Parkinson's Disease)

Chapter 10

2007-12-08T19:16:00.000-05:00

Dancers talk about neurology more than neurologists talk about dancing. The neurologists are imbalanced.

Margie Gillis

"My approach is based on listening to the connection between thought, emotion, spirit and body. This is the natural kinetic process whereby our inner landscape translates into electrical impulses that transmit to the muscles the message as to how and with what quality to move. I explore the physical manifestation of this pure experience of being; the neuromuscular interrelationship." - Margie Gillis

The dancer knows neurology, the dancer knows how the body moves.

Margie Gillis on stage, solo. No actors, no dialogue, no special effects, just recorded music. And her artform is movement and her instrument is herself. Truthful movement. Expression of the human condition in the universe and the beauty of it all, tragically, magnificently, lovingly. 50,000 years in the making, with a cast of millions.

The dancer knows how to go deep inside, to inner feelings and interpretations of the world, formulating a response to the world, and then the brain, having decided a plan of action, sends out electric and chemical signals through an immensely complex nerve system, to the muscles, telling the muscles how and where and when to move, in what sequence, and with what quality.

Dancing is one of the most complex activities that the brain can instruct the muscles to do. Dancers know about movement. Parkinsonians are attracted to dance and to dancers in great numbers. The dancers are extremists of body movement, and they push the human body to its limits. They know things about movement that you cannot learn from a book. They are perfectionists in mind-body co-ordination, the lack of which causes such grief for those with movement disorders.

Geologists study Mt. Everest by looking at satellite photos and examining rock samples. Dancers climb the mountain. They go to the outer limits of human experience, and they do it because it is there to be done; the mountain is there to be climbed.

Oh Lord, don't move the mountain. Teach me how to climb
Oh Lord do not remove my stumbling blocks, but teach me to go around

Jill Bunce talks about “K” who came to the dance class at the age of 56. She swayed and tottered, she could not run or jump, she had tremors down her right side, she literally sat on her hands to stop them from shaking, and then she would aggressively deny having any symptoms of Parkinson’s (which she had had for six years), she had no sense of time and was always late, she spoke of loss and sadness and disability. She was remote and would not talk to anyone and she would slide into black depressions.

And she had been a musician. A music teacher. And guess what was the first thing the Beast stole from her? She could no longer control her fingers to play a musical instrument. Which became less important when she started losing the ability to ride a bike, then to run, then to walk.

It took two years. It took two years for Jill Bunce and the group to get K up and back into life. K wanted folk dancing. And folk dancing she got. Not just a little bit. Not half-hearted. Parkinson’s cannot be defeated with a little bit, with half-hearted.

Ya gotta dance wit’ a feelin’ or you ain’t dancin at all.

-Famous Blues Advice (FBA)

K began to ride her bicycle again, took on a new sense of purpose, started giving talks to groups in town, started driving her car again, started to run and jog and jump for the first time in six years, took an active role in helping others, and became the”wise woman” of the group. And she sat down at the piano and she played.

And she sat down at the piano

and she played.

Jill Bunce, dancer, explains what happened in those 2 years: “The non-verbal act is primary, before the awareness of it occurs. This is due to the brain’s need for a sensory fine-tuning to rapid and complex changes in the environment and involves feedback of information to and from the brain. In PD the feedback system is impaired and so there is a lack of response to behaviour. I have observed this with PD patients who have attachment problems and who have suffered abuse. There seems to be a disruption in feed-back from the behaviour to their conscious awareness of it. The ability to feel what the body experiences is crucial… dance is particularly suited for making what is pre-verbal into consciousness…”

That’s a dancer talking.

Margie Gillis says:

"Dance is the direct communication through nature of our human experience."

"Dance, like nature, is a necessity and at this time it is sadly under valued by society."

"Dance and it's contribution to what is humanly possible and what is health holds a place of honour in me."

"I feel, it seems incumbent upon us, to find ways to keep alive the necessity of dance's contribution to society and to find a way to allow the public to know what is there in truth; that they themselves, and their world of what is real and possible, is illuminated by being with us and supporting our work and research."

Margie Gillis
Our work and research

Dance is a universal human behavior, one associated with

group rituals (Sachs, 1937; Farnell, 1999). Although it is

depicted in cave art from more than 20 000 years ago

(Appenzeller, 1998), dance may be much more ancient than

that. Dance may in fact be as old as the human capacities for

bipedal walking and running, which date back 2--5 million years

(Ward, 2002; Bramble and Lieberman, 2004).
That's a neurologist talking

Chapter 11

2007-05-18T15:39:00.031-04:00

Figure 1. (a) The dance steps consisted of six-step movements in which the left and right legs always alternated. The pattern in the left panel was used for the Metric and Non-Metric dance tasks; the other pattern was used for the self-paced dance task (Motor). The dotted lines in the left panel show the path of each limb as it passes near a position stepped to by the other limb. (b) A subject illustrating the dance task.

Thesis, Antithesis, Synthesis
Dancers and Neurologists get together

We send thanks and gratitude to the dancers who volunteered to do this. For no benefit for themselves, volunteers danced inside the $4 million machine, as it detected the movements of information inside their brains. Showing that the brain, when dancing, is using circuits that are not the same as the ones that are damaged in Parkinson's patients. But this study was not about Parkinson's; it was not funded by the $200 million spent every year on Parkinson's research. This is dancers and neurologists trying to speak the same language, because they know that something is going on in the brain when people dance to the music. Enjoy the following, it is a different form of poetry, but it is definitely poetry, the poetry of science. The dreamer and the man of action: we need you all and we need you now:

Cerebral Cortex

The Neural Basis of Human Dance

Human dance was investigated with positron emission tomography to identify its systems-level organization. Three core aspects of dance were examined: entrainment, meter and patterned movement. Dancers performed small-scale, cyclically repeated tango steps on an inclined surface to the beat of tango music, without visual guidance. Entrainment of dance steps to music, compared to self-pacing of movement, was supported by anterior cerebellar vermis. Movement to a regular, metric rhythm, compared to movement to an irregular rhythm, implicated the right putamen in the voluntary control of metric motion. Spatial navigation of leg movement during dance, when controlling for muscle contraction, activated the medial superior parietal lobule, reflecting proprioceptive and somatosensory contributions to spatial cognition in dance.

Finally, additional cortical, subcortical and cerebellar regions were

active at the systems level. Consistent with recent work on simpler,

rhythmic, motor-sensory behaviors,

these data reveal the interacting network

of brain areas active during spatially patterned,

bipedal, rhythmic movements that are integrated in dance.

Many natural, complex sensorimotor activities involve the integration of rhythm, spatial pattern, synchronization to

external stimuli and coordination of the whole body. Such

activities include old evolutionary adaptations such as hunting,

fighting and play, as well as more recent ones such as group

physical labor, marching, musical performance and sport.

Neuroimaging studies have examined some components of these complex actions, such as the entrainment of movement to external timekeepers or spatial patterning of limb movement. However, this research has typically studied elementary processes such as ankle rotation or finger tapping (e.g. Penhune et al., 1998; Lutz et al., 2000; Debaere et al., 2001; Ehrsson et al., 2003; Sahyoun et al., 2004). A central issue is whether the

neural systems implicated in these elementary processes

‘scale up’ and ‘scale out’ to complex ecological activities. Are the

mechanisms controlling complex sensorimotor processes the same ones as those that underlie elementary processes like ankle rotation and finger tapping or are new mechanisms recruited? For example, dance is a complex sensorimotor action: do known elementary processes underlying simple movements ‘scale up’ to rhythmically timed, spatially patterned whole-body movements seen in human dance? The aim of the present study was to explore these and related issues in the context of examining for the first time the neural basis of dance.

Dance is a universal human behavior, one associated with

group rituals (Sachs, 1937; Farnell, 1999). Although it is

depicted in cave art from more than 20 000 years ago

(Appenzeller, 1998), dance may be much more ancient than

that. Dance may in fact be as old as the human capacities for

bipedal walking and running, which date back 2--5 million years

(Ward, 2002; Bramble and Lieberman, 2004). One of the principal properties of dance is that body movements are organized

into spatial patterns. This patterning of movement encompasses

a trajectory map of the body in exocentric space (Longstaff,

2000) as well as a kinesthetic and visual map of the body schema

in egocentric space (Haggard and Wolpert, 2005). The displacement patterns of dance can involve any body part; every dance

can be characterized by the identity and number of its

participating movement-units. In addition, dances tend to be

modular in organization, being composed of discrete sections

that are concatenated or interleaved with one another cyclically. Because of this combinatoric organization, dances are

amenable to grammatical analysis and description (Hutchinson-

Guest, 1997).

A second property of dance is the synchronization of movements with timekeepers such as musical beats, a capacity that is

apparently specific to humans. Indeed, it is striking how our

bodies can spontaneously move in response to a musical beat.

Virtually all dancing is done to musical rhythms, thereby

permitting a temporal synchronization among dancers. Dance

gestures generally mirror the hierarchical arrangement of

strong and weak beats found in musical rhythm patterns. In

waltz music, for example, the first beat is stressed while the

second and third beats are weaker; likewise in waltz movements, the first step is the broadest and most forceful, while the

second and third steps are shorter and weaker. Thus, the

entrainment of dance to music not only involves synchronization in time but a spatial element related to equating hierarchies

in the motor pattern with those in the musical rhythm.

We conducted a positron emission tomography (PET) study

with amateur dancers performing small-scale, bipedal dance

steps on an inclined surface, as compared to auditory, motor and

rhythmic control tasks. In addition to working towards

a systems-level view of the neural basis of the complex sensorimotor processes underlying dance, we attempted to isolate

the foregoing individual processes, using planned comparisons

in a subtractive design. First, we sought to localize brain areas

involved in the synchronization of leg movement to the rhythm

of an auditory stimulus. For this, we made a planned comparison

of patterned leg movement performed to a musical beat (Metric

condition) with a matched motor pattern performed in a self-

paced though metric manner without an external timekeeper

(Motor condition). A second goal was to identify the brain areas

involved in the voluntary control of metric movements, that is,

dance steps occurring in an equal-time-interval rhythm. For this,

we made a planned comparison of patterned leg movement

paced to music possessing a regular, metric rhythm (Metric

condition) with that paced to music possessing a highly irregular, unpredictable rhythm (Non-Metric condition). Finally, we

sought to isolate the neural basis of spatial patterning of lower-

limb movement by making a planned comparison of the

conditions in which the legs moved in space (Metric condition)

with a condition in which the leg muscles contracted isometrically but without leg movement, also to a metric rhythm

(Contractions condition). By controlling for parameters related

to muscle contraction, we expected this contrast to reveal

brain areas supporting spatial cognition in dance, especially as

related to the lower extremities. Two control conditions

involved passive listening to music (Listening condition) and

eyes-closed rest.

Comments:

The neurologists talk funny, don't you think ? But finally they are getting together. Dancers and Parkinson's patients have the anecdotes, but we need the science.

Thank you to the researchers. We thanked the dancers first, because it is surely no fun to be dancing attached to that machine. But we also send our thanks and gratitude to those who wrote this scientific report, which is like poetry to us, beautiful and elegant and true.

Thank you: Lawrence M. Parsons, Ph.D. Professor of Cognitive Neuroscience, Department of Psychology, The University of Sheffield, Sheffield, United Kingdom.

And Steven Brown and Michael J. Martinez of the Research Imaging Centre at San Antonio, Texas (Steven Brown is now at the Department of Psychology, Simon Fraser University, Burnaby B.C.)

We thank Julie Grezes, Petr Janata, Katz Sakai and two anonymous reviewers for very helpful comments on this manuscript.

Let's get it on:

Materials and Methods

Subjects

Five male and five female amateur dancers, with a mean age of 33.8 years

(range 19--46 years), participated in the study after giving their informed

consent (in accord with the Declaration of Helsinki and the Institutional

Review Board of the University of Texas Health Science Center). Each

individual was without neurological or psychiatric illness. All participants were right-handed, as confirmed by the Edinburgh Handedness

Inventory. Nine of the 10 subjects indicated that they would use their

right leg to kick a ball (Elias and Bryden, 1998). The subjects were

currently active amateur tango dancers, with a mean of 8.5 years of

recent recreational dance experience, of which 2.5 years were of

Argentine tango (range 1--4 years) and the remainder was of a wide

variety of other dance forms (e.g. Latin, ballroom, ballet). In spite of

these individual differences in age and years of overall dance experiences, the dancers were of comparable proficiency in Argentine tango

and in the relatively simple tango tasks used in the study. The subjects

had minimal musical experience.

Stimuli

Commercial recordings of instrumental Argentine tango songs, with

a typical tempo of 60 beats per minute, were presented for the tasks

containing music. All songs were matched for instrumentation, tempo

and tonality, and were presented to subjects using CoolEdit (Syntrillium) from a laptop computer. For the Non-Metric condition, songs

were edited to produce an irregular and unpredictable beat but without

altering the average tempo (i.e. each song had an equal number of

accelerations and decelerations of the tempo at random junctures). The

stimuli for the listening condition were Greek ‘rembetika’ songs that

were matched for the tempo, instrumentation and tonality of the tango

songs. By using music other than tango songs, we sought to minimize

the tendency for stimuli to elicit motor imagery of the dance steps

performed in the movement tasks (see Ehrsson et al., 2003). The

activations observed for this condition, as contrasted to rest, are

described elsewhere (Brown et al., 2004).

Comments:

To make it clear: these dancers and scientists were being dancers and scientists for the sake of climbing the mountain because it is there. They were not fighting Parkinson's, or any other disease. It was for the pure thing itself, the art of dance and the science of dance. We are borrowing this information for our own purposes, to fight Parkinson's. Other people can borrow it for other reasons. That's the beauty of pure art and of pure science. The results of the research are not political or pre-ordained. No one in that group was thinking about Parkinson's disease at all. They went to find the truth, the facts of the case, to know about what is going on when we dance. Not for something or against something. Just the thing itself, in all its beauty and its complexity and its simplicity.

I challenge you to read this science paper. It is good for you. I was absent the day they taught science in school, so I don't understand it all and can hardly fathom how people can think like that - and that is why it is important to read about things that happen when scientists and artists try to figure out the same thing. John Lee Hooker was right.

Let's get it on:

There will be a test, so pay attention

Tasks

The tasks involved the performance of simple bipedal dance movements on a laminated grid (see Procedure). The subjects were trained to be proficient at these dance steps in advance of the scanning session, so very little motor learning likely occurred during the experiment. Six conditions were tested, all of them with the eyes closed: (i) a patterned leg movement synchronized to the beat of metric, regularly timed tango music (Metric); (ii) the same patterned leg movement executed to the beat of non-metric, irregularly timed tango music (Non-Metric); (iii) a matched, patterned leg movement performed with no music (Motor);

4) a condition of isometric leg-muscle contractions synchronized to the

beat of metric tango music but with no leg displacement, in which the

left and right leg-muscles contract in alternation (Contractions); 5)

passive music listening with no movement (Listening); and (vi) silent

motionless ‘Rest’. Subjects experienced little visual stimulation during

trials, as they were lying in a dimly light room with their eyes closed. The dance step for the metric and non-metric conditions consisted of a simple 6-step box pattern (Fig. 1a, left panel) — derived from the basic ‘salida’ step of the Argentine tango — that involved alternation of the left and right feet. The pattern for the Motor condition (Fig. 1a, right panel) was different from that of the Metric and Non-Metric conditions in order to minimize the use of mental imagery of the music from the latter two tasks. For the Metric, Non-Metric and Contractions conditions, subjects were instructed to take one step or make one leg-muscle contraction per strong beat of the music, be that to a metric or non-metric rhythm. For the Motor condition, there was no music for the movement to be entrained to, but subjects were instructed to practice the step, and were given feedback to either quicken or slow the movement if their tempo was too dissimilar from that of the Metric condition. As per instruction, and as verified by observation and feedback, all foot movement occurred in a smooth gliding manner on the surface rather than in a stepping manner; the feet never completely lifted off the surface.

Procedure

While lying supine in the PET scanner, subjects flexed their knees ~90. and placed their feet on a stable, flat, smooth surface, which was inclined ~30. above the horizontal (Fig. 1b). The surface was laminated to reduce friction during foot movement and to minimize compensatory body or head movement. Subjects wore stockings to further reduce friction. Each big toe was visibly marked to facilitate coding of foot position on a grid with centimeter markings, as recorded using a camcorder. The music stimuli were presented via headphones to the subject.

Behavioral Analysis

Behavioral analysis of the rate and extent of videotaped leg movement was performed by one of the authors (M.J.M.) for the three movement tasks from the 40 s PET scan. First, the dance steps were performed quite accurately, often with 1 cm of error. Second, the mean number of steps during the 40 s task interval in the Metric, Non-Metric and Motor conditions was 34.5 ± 4.0, 40.9 ± 8.5 and 36.0 ± 1.3 (mean ± SD). There was no difference in the rates between the Metric and Motor conditions (P > 0.05). However, the average movement rate for Non-Metric dance was higher than that for the other two conditions, indicating that the dancers misinterpreted some secondary beats as primary ones; subjects were most likely susceptible to such errors because tango music is highly syncopated. Third, the perimeter of the triangular movement-path outlined by each foot during the dance tasks was measured. The means across the two feet for the Metric, Non-Metric and Motor conditions were 38.1 ± 8.1, 39.5 ± 6.9 and 30.5 ± 6.4 cm2. The perimeter values for the self-paced dance task were significantly shorter than those for the other two tasks. In absolute terms, this amounted to a difference of ~0.7 cm in each direction, which is small compared to the overall extent of movement (on the order of 6 cm in each direction). The shorter paths likely relate to the use of a different pattern for the Motor condition compared to the other two. This matched pattern was designed so as to preserve the same combination of foot movements (forward, backward, left and right) as the pattern for Metric and Non-Metric. Movement extent for these patterns was not predictable a priori. There was no relationship between years of tango experience and age of subject with respect to performance in the scanner as measured by rate of stepping and by extent and accuracy of steps during the task (data not shown). A correlation analysis of the relationship between movement perimeter and regional cerebral blood flow failed to find significant covariance with any of the observed activations.

Comments: Science is an extreme mental discipline. It is one of the hardest things that a person can do. Every variable must be controlled; every word requires proof, every result must be repeatable by other researchers; every sentence is rigorously challenged by your scientific peers before you can publish it; every concept will be challenged by other schools of thought and other avenues of research. The Scientific Method saves us all from superstition and quackery. My neurologist, Dr. Calvin Melmed, a great spirit, a real DOCTOR, a man of science and a humanitarian, has reminded me three times: "Where is the science? Dancing is good for you, and good for everybody. But to fight a disease? You need the science. You cannot change the medical treatment of millions of people just because you feel good. You must have scientific proof." Dig it. More to come:

Imaging

During the PET session, the subject’s head was immobilized using a closely fitted thermal-plastic facial mask with openings for the eyes, ears, nose and mouth. Auditory stimuli were presented through earpieces taped over the subjects’ ears. During scanning, subjects were instructed to close their eyes and to minimize head and body movement as much as possible. During a session in advance of the scan date and during a practice session on the day of the scan, subjects practiced performing the dance steps in a highly controlled manner while minimizing head movement. Subjects had two PET scans for each of the six tasks. Each scanning session began with the Motor task, and the tasks were thereafter counterbalanced across subjects such that one replication of each task was performed before the next set began. Subjects began each task 30 s prior to injection of the H215O bolus. Bolus uptake required ~20 s to reach the brain, at which time a 40 s scan was triggered by a sufficient rate of coincidence-counts, as measured by the PET camera. At the end of the 40 s scan, the auditory stimulus was terminated and the subject was asked to discontinue the task and lie still during an immediately following 50 s scan.

Comment:

“Subjects began each task 30 s prior to injection of the H215O bolus. Bolus uptake required ~20 s to reach the brain …” Whoa! Are these people serious about it, or what? That’s why we thanked the dancers first. As dancers do, they put their bodies on the line, for truth.

Image Analysis

Positron emission tomography was performed with a CTI HR+ camera, which had a pixel spacing of 2.0 mm, an inter-plane, center-to-center distance of 2.4 mm and 63 transaxial scan planes. Images were reconstructed using a Hanning filter with a cut off frequency of 0.5, resulting in images with a spatial resolution of ~4.3 mm (full-width at half-maximum). The data were smoothed with an isotropic 10 mm Gaussian kernel. Anatomical MRI data was acquired with an Elscint 1.9 T Prestige system with an in-plane resolution of 1 mm2 and 1.5 mm slice thickness. Convex-hull spatial normalization was performed prior to group subtraction (n = 10) using change distribution analysis’ methods (Raichle et al., 1983; Fox et al., 1988; Mintun et al., 1989). Thus, significant changes in cerebral blood flow indicating neural activity were detected with a region-of-interest-free image subtraction strategy. Intra-subject image averaging was performed within conditions (Fox et al., 1988). Images were spatially normalized (Fox et al., 1985) into proportional, bicommissural coordinate space relative to the Talairach atlas (Talairach and Tournoux, 1988) using spatial normalizationperformed by using SN. Inter-scan, intra-subject movement was assessed and corrected using the Woods’ algorithm (Woods et al.,
1993). A search algorithm (Mintun et al., 1989) was used to identify local extrema within a 5 3 5 3 5 voxel search cube. A beta-2 statistic measuring kurtosis and a beta-1 statistic measuring skewness of the extrema histogram (Fox et al., 1988) were used as omnibus tests to assess overall significance (D’Agostino et al., 1990). Critical values for beta statistics were chosen at P <> 4.27, P <>
The analyses of functional images for factors in our experimental design were conducted employing the following planned comparisons. A systems-level view of dancing to music was analyzed by comparing Metric and Rest conditions. The functional neuroanatomy of movement entrainment was analyzed by comparing Metric and Motor conditions, Metric and Music conditions, and Music and Rest conditions. Metric movement was analyzed by comparing Metric and Non-Metric conditions. Spatial pattern of leg movement was analyzed by contrasting Metric and Non-Metric, respectively, with the Contractions conditions. Spatial patterning of movement was also examined in the comparison of Motor and rest conditions. Finally, to eliminate spurious activations resulting from the subtractions of deactivations, we verified every activation in each higher-level contrast by examination of the relevant condition from rest.

Results

A systems-level view of the brain areas contributing to comparativelynatural, although supine, dance performance (Metric
dancing minus Rest, Table 1) revealed activations in bilateral motor, somatosensory and premotor areas, right supplementary motor area, right frontal operculum, left medial superior parietal cortex, superior temporal regions, right cingulate motor area, basal ganglia, and bilateral anterior vermal and posterior-lateral cerebellum. The following planned and post hoc comparisons examine the specific subsystems activated during dance. There were no significant differences detected between male and female dancers in the profiles of activations across conditions(data not shown).

Entrainment of Movement to Music

When dance in a self-paced manner without music (Motor) was subtracted from dance entrained to a musical beat (Metric), the principal signal for this subtraction outside of auditory areas was seen in the vermis of anterior cerebellar lobule III (Fig. 2, Table 2). This activation was also present in the analysis of each task minus rest. These data implicate the anterior vermis in entrainment of movement to music. No such increases for entrainment were observed in other regions activated in common between entrained and self-paced dancing, such as sensorimotor, premotor, superior parietal, cingulate or frontal opercular areas. The increase in vermal activity for entrained dancing was not due to the addition of the accompanying music per se, as the subtraction of music listening from metric dance had no effect on the intensity of the anterior vermal activity (not shown). In addition, this latter subtraction, while eliminating all activity in cortical auditory areas found in both the music-listening condition alone and in entrained dance minus self-paced dance, revealed a significant signal in the right medial geniculate nucleus (Fig. 3a,b). The medial geniculate nucleus was not active during self-paced dance without music. Moreover, metric dance minus self-paced dance and, especially, metric dance minus music listening revealed activity in lateral and vermal aspects of posterior left cerebellar lobules V and VI (Figs 2 and 3b). As suggested later, audiomotor entrainment may be
mediated through the transmission of coarsely processed beat information from subcortical auditory areas to the cerebellum.

Table 1

For all tables, Talairach atlas coordinates are in millimeters along the left--right (x), anterior--posterior (y) and superior--inferior (z) axes. In parentheses after each brain region is the approximate Brodmann area, except in the case of the cerebellum, in which the anatomical labels of Schmahmann et al. (2000) are used. The intensity threshold for this
table is Z [ 4.27, P \ 0.00001 (one-tailed).

Figure 2 The activation (–2,–44,–12) in anterior cerebellar vermis (lobuleIII) in the analysis of Metric dance minus Motor. Also shown is the activation in lobule V. The group mean activations are shown registered onto an averaged brain in all figures. The right side of the figure is the right side of the brain in all figures. At the left end of the figure is a colorscale for the intensityof the activations. The intensity threshold in Figures2—5 is Z>2.58, P<0.005m/s1600-h/table+2.jpg">

Figure 3. (a) Activation in the medial geniculate nucleus in the analyses of Metric dance minus Motor and (b) Metric dance minus music Listening. The peak coordinate for the medial geniculate nucleus in the former subtraction is at (14, –28, –4) whereas that for the latter is at (14, –30, –6). Activity in cerebellar lobule V and VI in the analysis of Metric dance minus music Listening. In coronal and axial views throughout, the left side of the image represents the left side of the brain.

(Figs 2 and 3b). As suggested later, audiomotor entrainment may be mediated through the transmission of coarsely processed beat information from subcortical auditory areas to the cerebellum.

Pay attention.
There will be a test.

Metric Movement

In comparing the dance condition entrained to a metric rhythm with a dance condition entrained to an irregular rhythm (Table 3), we observed a strong signal bilaterally in the putamen for the metric condition, with an emphasis in the right putamen (see Fig. 4, which shows this same pattern when each condition is contrasted with rest). This activity appeared to occur in the somatotopic representation of the leg (Maillard et al., 2000). No such basal ganglia activation was detected for non-metric dance. By contrast, in non-metric dance minus rest, a strong activation was seen in right ventral thalamus, specifically, in the ventral posterior nucleus bordering on the pulvinar. This area was not activated above threshold for metric dance. To explore this pattern of findings, we noted that in a post hoc comparison there were intermediate levels of activity in both putamen and thalamus observed in the performance of both self-paced dancing without music (Motor) and isometric leg-muscle contractions to music (Contractions condition) (Fig. 4, legend). This overall pattern points to a reciprocal relationship in activity between the putamen and ventral thalamus, with metric movement exhibiting strong putamen and weak thalamus responses, and non-metric movement showing the reverse profile. This reciprocity may be causal, as mediated, for example, by the indirect pathway of the basal ganglia circuit, where the ventral thalamus is the major output structure of the basal ganglia (e.g. Rao et al., 1997). Alternatively, it may be incidental, mediated through the intervention of other structures. In either case, the results suggest that the putamen is preferentially activated by movement patterns that are regular and predictable, and that irregular and unpredictable patterns activate other pathways, including those containing the ventral thalamus.

Spatial Patterning of Leg Movement

The analysis of metric dance minus the contractions condition (where the leg muscles were contracted isometrically in an alternating fashion to the beat of metric tango music but without there being leg movement along the surface) revealed activity in the medial portion of the superior parietal lobule [Brodmann’s area (BA) 5/7; precuneus] (Fig. 5, Table 4). Superior parietal activity was equally strong in the subtraction of the contractions condition from either metric dancing or non-metric dancing and for self-paced dancing minus rest, thereby suggesting that this area is specifically involved in spatial guidance of leg movement independent of temporal parameters related to movement timing or entrainment. The dance tasks were performed quite accurately without visual guidance (see Behavioral Analysis), and thus the foregoing activations suggest that the medial superior parietal lobule encodes proprioceptive or somatosensory information about spatial coordinates for leg movement.

Activations seen in each of the movement tasks (minus rest) occurred in the primary motor and sensory cortices (paracentral lobule), premotor cortex,supplementary motor area (SMA), and somatotopic leg areas of the cerebellum (lobules IV and VIII) (Fig. 5; see Table 1 for the coordinates of these activations in metric dance minus rest). In addition, the right frontal operculum (BA 44/6) — near the right-hemisphere homologue of Broca’s area — was activated in all of the tasks involving motor production (minus rest) but not in passive music listening (Fig. 6). Because the intensity of this activation did not vary in each of the movement tasks (minus rest), we attribute its function more to motor sequencing in general (Ehrsson et al., 2000; Janata and Grafton, 2003) than to spatial patterning of limb movement. Finally, activation in the cingulate motor area was also detected for all of the motor conditions (minus rest), although much more so for the movement conditions than for the condition of isometric leg-muscle contractions (see the middle panel of Fig. 5). This activity likely reflects a somatotopic map in this region, as the dorsal bank of the cingulate sulcus in monkeys contains a leg representation, and electrical stimulation of this region leads to hindlimb movement (Luppino et al., 1991).

Discussion

These findings illustrate the coordination of distributed neural systems that underlie bipedal, cyclically repeated dance steps entrained to a musical rhythm. The functional subsystems can be summarized as follows. The superior temporal gyrus and superior temporal pole represent the melodic and harmonic

aspects of the heard music. In parallel, the medial geniculate nucleus appears to send inputs, via brainstem relay nuclei, to the anterior cerebellar vermis and lobules V and VI regarding beat information, to support the entrainment of movement to a musical beat. The basal ganglia, and particularly the putamen,subserve the selection and organization of segments of action,

right cingulate motor area processes aspects of movement intention and the allocation of motor resources. Finally, medial aspects of the superior parietal lobule subserve kinesthetically mediated spatial guidance of leg movement during navigation in dance. This network of brain areas controlling dance will require confirmation and refinement in future studies. There was a trend for right hemisphere dominance for many of our unilateral activations, including the frontal operculum, cingulate motor area, putamen, ventral thalamus and medial

geniculate nucleus, along with a corresponding focus in the left cerebellar vermis. Although no such trend has been observed for natural gait (Fukuyama et al., 1997; Miyai et al., 2001), a study that compared flexion/extension of the ankle, flexion/ extension of the wrist and finger movement, all on the right side of the body (Luft et al., 2002), found that knee movement was accompanied by strong ipsilateral activation in the primary motor cortex and primary sensory cortex. Likewise, a study of imagined or executed flexion/extension of the toes (Ehrsson et al., 2003) reported right frontal operculum activation for right-sided movements.

In addition, recent studies of postural deficits in stroke patients suggest the presence of a distributed system, primarily in the right hemisphere, for representing trunk posture relative to the environment (e.g. Spinazzola et al., 2003). Further research will be needed to clarify the extent to which horizontal placement of the body during the dance tasks might have contributed to our observed right-hemisphere lateralization effects. In future, studies may be able to circumvent the neuroimaging constraints that currently prevent an investigation of important issues such as upright whole-body movements and interpersonal coordination processes involved in pair dancing

(e.g. as in celebrated instances of Rogers doing Astaire’s steps backward and in high heels).

In the following comments, we discuss these observations in more detail, with a view toward assessing how the mechanisms observed in paradigms focusing on controlled elementary processes ‘scale up’ to those for the more complex natural activity of dancing. At a general level, we note that elements of both discrete and rhythmic movements (Schaal et al., 2004) are present in dance, itself a gestural system. As such, the patterns of activations we observed are broadly consistent with the possibility that the subcortical systems activated are involved in the timing and coordination of discontinuous movements, whereas the specific cortical systems activated here may be supporting the control of the continuous movements (Miall and Ivry, 2004).

Figure 4. Reciprocal activation in the putamen and ventral thalamus in Metric and Non-Metric dance. The thalamic activation occurs at the junction of the ventral posterior and pulvinar nuclei. Direct subtraction of Non-Metric from Metric retains the activation in the putamen, and direct subtraction of Metric from Non-Metric retains the activation in the thalamus (not shown). The Z-score values for the putamen and ventral thalamus, respectively, for the four motor conditions were: Metric (5.00, 2.49), Non-Metric (undetectable, 5.78), Motor (3.44, 3.10) and Contractions (3.27, 3.19).

Figure 5. Metric dance minus leg-muscle Contractions eliminates the activations in the premotor and motor-sensory cortices, and leaves signal in the superior parietal lobule, spanning the medial part of BA 5 and 7 (precuneus). Activation in the cingulate motor area is seen to be just above threshold. The activations in the motor-sensory cortex and SMA/ premotor cortex are bilateral even though the figure shows only one hemisphere. The mesial motor strip comprised of SMA/premotor cortex and motor-sensory cortex is active in (a) and (b). (c) The peak coordinate of the anterior focus in the precuneus is (8, –56, 60).

Figure 6. Cerebral blood flow increases in the right frontal operculum (BA 44, see arrows) during the four motor tasks but not music listening. The peak voxel for Motor minus Rest is at (54, 6, 8), for Contractions minus Rest is at (54, 6, 6), and for Metric minus Rest is at (54, 8, 6). The activation in the Non-Metric minus Rest subtraction was slightly more posterior to those for the preceding three conditions and mapped more onto BA 6 than BA 44, with a peak voxel at (58, 0, 6).

Sensorimotor Entrainment

Three key facets of dance were selectively analyzed in our study design: audiomotor entrainment, meter and patterning of movement. For the first facet, a comparison between two matched dance patterns performed at the same rate — one requiring entrainment to a musical beat and the other one self-paced highlighted the importance of the anterior cerebellar vermis (central lobule, III), but not other parts of the motor or sensory system, to entrainment processing. The vermal activation was equally strong in the Metric and Non-Metric dance conditions (data not shown), both of which were based on temporal entrainment. This suggests that the vermis functions in entrainment per se, independent of the nature of the temporal pattern being entrained to. Very similar activations have been observed in recent studies of repetitive lower-limb movement entrained to metric cues in either auditory or visual form. In a functional magnetic resonance imaging (fMRI) study of right-foot flexion/extension timed to a metric auditory cue (Debaere et al., 2001), activity was detected in the anterior cerebellar vermis (3, –45, –18, as compared to 0, –48, –16 here), as it was in a similar fMRI study of right-foot flexion/extension timed to a metric visual cue (Sahyoun et al., 2004; i.e. 2, 48, –20, as compared to 0, –48, –16 here). This region was also activated by rhythmic self-paced walking (Fukuyama et al., 1997: 0, –50, –20, as compared to 0, –48, –16 here) and finger tapping without an ongoing external stimulus (Penhune et al., 1998: 8, –48, –21 and 1, –50, –15, as compared to 0, –48, –16 here). These similarities between the controlled elementary paradigms and dancing imply that common mechanisms are involved in entrainment. This pattern of data highlights the importance of the anterior cerebellar vermis (III) for the entrainment of movement to external timing cues.Interestingly, in our analysis of functional activation data for metric dance minus passive music listening, activity in cortical auditory areas was eliminated, leaving behind a significant signal in the right medial geniculate nucleus as well as posterior cerebellar lobules V and VI. These regions were not found to be activated during self-paced dance steps performed without music (when contrasted to rest). There are substantial reciprocal projections between the thalamic nuclei and cerebellum via brainstem relays (see reviews Schmahmann, 1997). In addition, cerebellar lobules V and VI have been specifically implicated in neuroimaging studies of pitch and melody discrimination, as dissociated from motor coordination or cortical motor activity (e.g. Holcomb et al., 1998; Griffiths et al., 1999; Gaab et al., 2003; Parsons, 2003a; Petacchi et al., 2005). It is thus possible that the sensory input to the anterior cerebellar vermis for entrainment processing involves coarsely processed auditory information from subcortical sites. If so, this would imply that entrainment in dance does not require higher-level musical content (e.g. tonality, harmony, timbre) but may simply depend on low-level beat information, as mediated by subcortical pathways. This hypothesis may in part account for the sharing of entrainment mechanisms between dance and simple sensorimotorbehaviors like finger tapping and ankle rotation.

There is strenuous ongoing debate about the function of the cerebellum, which was classically viewed as a motor-control and coordination structure only but which has recently been implicated in non-motor processes by a wide range of findings (e.g. see reviews in Schmahmann, 1997; Ivry and Fiez, 2000; Rapoport et al., 2000; Vokaer et al., 2002; Bower and Parsons, 2003). The following three hypotheses of cerebellar function are likely to be most pertinent to the findings of this study. One account assumes that the cerebellum embodies internal forward-inverse model pairs (Wolpert et al., 1998); in the present case, such model pairs would need to include the sensory aspects of movement, the movements per se and perception of the auditory beat. Another account (Ivry, 1997) emphasizes the role of cerebellum in supporting timing processes in both the preparation and coordination of motor responses (in vermal and anterior cerebellum) and the sensory perception of duration on the order of hundreds of milliseconds (in lateral cerebellum). In a third view, the role of the cerebellum is to optimize the control of the acquisition of sensory data (Bower, 1997; Bower and Parsons, 2003). In the current case, the cerebellum would be hypothesized to assist cortical, subcortical and peripheral neural structures in collecting optimal auditory and somatosensory information in order to influence the cortical motor system to better synchronize the execution of movement with the auditory rhythm. Further research is needed to clarify the functions of the foregoing cerebellar regions. Metric and Non-metric Movement Another principal feature of our results was seen in the contrast between dance steps entrained to a metric rhythm and the same steps entrained to a non-metric rhythm. We found that metric dance movement induced strong activity bilaterally in the putamen, and especially the right putamen. Non-metric dance movement, in contrast, showed no activity in the putamen but instead displayed a strong signal in the right ventral thalamus. A variety of prior research affirms a role for the basal ganglia in the control of metric movement in rhythmic tapping tasks (e.g. Rao et al., 1997; Penhune et al., 1998) and in piano performance of memorized musical pieces (Parsons et al., 2005). The involvement of the putamen in metric movement is supported by an fMRI study of visually cued, metric right-foot flexion/extension (Sahyoun et al., 2004); the thalamus was much less active. Likewise, in a PET study of the same task (Ehrsson et al., 2000), activity in the putamen, but not the thalamus, was reported. The involvement of the ventral thalamus in non-metric rhythms agrees with similar findings from an fMRI study (Lutz et al., 2000) of tapping the right index finger to a non-metric, randomly timed visual cue (–20, –16, 12, as compared to 18, –24, 8 here).

Overall, the reciprocal activity between putamen and ventral thalamus just described suggests that for both dance and elementary movements, the basal ganglia are preferentially activated in the execution of motor activities having a regular, predictable rhythm and that unpredictable unfamiliar temporal patterns recruit other pathways. This is also congruent with an fMRI study of self-paced finger tapping showing that the basal ganglia were principally active for simple rhythms and that their activity decreased with greater rhythmic complexity, whereas the thalamus (and anterior cerebellar vermis) increased in activation with increasing complexity (Dhamala et al., 2003). In our study, intermediate levels of activity in both the putamen and ventral thalamus were seen for both self-paced dancing without music and for the performance of isometric leg-muscle contractions to metric tango music. Thus, activity in the basal ganglia circuit is modulated by limb displacement and entrainment as well as by the presence or absence of metric regularity. This complex functionality suggests that the basal ganglia might be one part of the brain sensitive to the interactions amongst entrainment, meter and spatial patterning specifically seen in dance.

Somatotopy and Control of Lower Limbs

The third principal aspect of our data highlights the topographic representation of the lower extremity in the motor-sensory cortex as well as in the superior parietal lobule, cingulate motor area, cerebellum, and putamen. Activation of a mesial strip encompassing the leg representation in the primary motor cortex, somatosensory cortex, SMA and premotor cortex was present for all four tasks involving motor activity. Activations in very similar somatotopic regions for the lower extremity have been found in a number of reports using a variety of techniques and paradigms, including the following: a SPECT study of upright walking (Fukuyama et al., 1997); a near-infrared spectroscopy study of bipedal walking on a treadmill (Miyai et al., 2001); an fMRI study of right-foot flexion/extension timed to a metric auditory cue (Debaere et al., 2001); a PET study of this same task (Ehrsson et al., 2000); an fMRI study of metric, visually cued right-foot flexion/extension (Sahyoun et al., 2004); an fMRI study of unipedal flexion/extension of either the left or right knee joint (Luft et al., 2002); an fMRI study of the placement of either foot into visually presented foot postures (Chaminade et al., 2005); and an fMRI study of imagined and executed flexion/extension of the toes timed to a metric auditory cue (Ehrsson et al., 2003). The foregoing motor, premotor, and SMA areas most likely encode parameters related to muscle group, contractile force, initial and final position, and movement direction (Graziano et al., 2002). The SMA, the cingulate motor area and possibly the cerebellum (Ivry, 1997; Wolpert et al., 1998) are likely involved in interhemispheric coupling supporting cyclically repeated coordination of the two homologous limbs, as suggested by studies of bimanual coordination (e.g. Ja¨ ncke et al., 2000). Very similar activations were observed for coordinated unilateral movements of the hand and foot (Ehrsson et al., 2000; Debaere et al., 2001).

The right frontal operculum (BA 44/6) was activated by the four tasks involving motor production but not by music listening, suggesting a general role for this area in motor sequencing rather than a specific role in either spatial patterning or metric entrainment. Responses in the frontal operculum were observed in an fMRI study (Ehrsson et al., 2003) of flexion/ extension of the toe timed to a metric auditory cue (56, 8, 4 and 56, 8, 0, as compared to 54, 8, 6 here), both during mental imagery of movement and actual movement. Comparable activity was also reported in an fMRI study of visually cued metric right-foot flexion/extension (Sahyoun et al., 2004). In a PET study of finger tapping timed to imitate the rhythm of brief sequences of visual stimuli with long or short elements (Penhune et al., 1998), the right frontal operculum was also activated (46, 18, 3, as compared to 54, 8, 6 here). In addition, this region shows activations for motor mental imagery, perception, and imitation tasks involving the hands (Parsons et al., 1995; Grafton et al., 1996; Heiser et al., 2003). Equally pertinent, a region anterior to this one was activated in ballet dancers while observing ballet movements and in capoeira dancers while observing capoeira movements (peaking at Talairach coordinates 54, 35, 1: Calvo-Merino et al., 2005), thereby demonstrating expertise-dependent activity in the frontal operculum. These results support a role for this region in both elementary motor sequencing and in dance, during both perception and production. This activation pattern may also bear on new functional hypotheses that propose supralinguistic sequencing and syntax operations for the region broadly defined as Broca’s region and its right homologue.

The right cingulate motor area (cingulate sulcus) was activated in all four motor tasks, with trends toward larger extents in the three tasks requiring movement of the legs. Similar activity was observed in an fMRI study (Sahyoun et al., 2004) of visually cued metric right-foot flexion/extension (6, 14, 44 and –10, –6, 48, as compared to 8, –6, 44 here). The location of this activation corresponds to cytoachitectonic area 24dd (Vogt and Vogt, 2003), which in monkeys contains a topographic representation of the hindlimb and lower trunk (Luppino et al., 1991; Rizzolatti et al., 1996). This area may encode aspects of movement intention and the allocation of motor resources (Ball et al., 1999), processes required in both elementary motor activities and in dance.

Spatial Cognition

ur findings suggest that the medial superior parietal lobule (BA 5/7, precuneus) plays a role in kinesthetic guidance of leg movement during navigation in dance, interacting with the foregoing motor, somatosensory, timing and sequencing areas. Activation in the medial superior parietal lobule was also observed in an fMRI study of right-foot flexion/extension (Debaere et al., 2001) timed to a metric auditory cue (–3, –42, 69, as compared to –4, –46, 62 here), as well as in a similar PET study (Ehrsson et al., 2000: –10, –45, 68, as compared to –4, –46, 62) that included a condition in which the right foot and right hand were simultaneously flexed or extended (–8, –47, 66, as compared to –4, –46, 62). In addition, the area was activated in a PET study of the tactile discrimination (without visual guidance) of parallel-piped objects pressed against the planta (Young et al., 2004).

Posterior parietal cortex is regarded as subserving a variety of spatial cognitive functions (Colby and Goldberg, 1999; Parsons, 2003b) including those related to body schema (Berlucchi and Aglioti, 1997; Halligan et al., 2003). The inferior and superior parietal lobules receive both somatosensory and visual inputs. The posterior parts of both lobules process visual information, the anterior superior parietal lobule processes somatosensory information, and the anterior inferior parietal lobule integrates somatosensory and visual information (Rizzolatti et al., 1997; Colby and Olsen, 2003). The performance of dance steps with the eyes closed was reported by some of our subjects to be accompanied by mental imagery of their body. Thus, the foregoing parietal activation was likely involved in spatial cognitive functions based on proprioceptive processing of leg position and joint angle and on somatosensory contact of the feet with the surface (Parsons, 1987). Little is known about leg representations in posterior parietal cortex of either humans or monkeys. The monkey homologue of BA 5, area PE, contains leg representations (Rizzolatti et al., 1996). PE is a high-level somatosensory area that does not receive visual inputs and that projects to primary motor cortex. Studies of hand movement find that PE neurons encode limb location in space using a body-centered coordinate system (Lacquaniti et al., 1995). Thus, the medial superior parietal lobule may possess a map of peripersonal (egocentric) space based on proprioceptive cues related to lower limb position. Somesthetic guidance of navigation is key to dance, where vision provides a support role indicating whether space is sufficient to carry out particular movements. The fact that superior parietal lobule is activated in some of the studies of elementary ankle and wrist rotation discussed earlier might suggest that, unlike isometric muscle contraction, these simple movements still have a basic element of spatial patterning to them, simple though it might be. This suggests that activity in this region increases as the spatial and navigational demands of the movement increase.

Conclusion

Dance, like numerous natural, complex sensorimotor activities (e.g. sport, group physical labor, and musical performance), requires the integration of spatial pattern, rhythm, synchronization to external stimuli and whole-body coordination. Our findings suggest that many of the brain areas activated for dance are also recruited in elementary sensorimotor activities. However, the present methods can only show proximity or overlap in the location of neural activity. These results set the stage for more precise techniques that compare the detailed neural computations (e.g. Gold and Shadlen, 2001) performed in regions localized in common for simpler and more complex sensorimotor activities. Moreover, the present findings are based on observations of relatively skilled dancers who are well practiced at performing the dance steps in the study. Thus, our data do not reveal the role of learning in organizing the various elementary and complexity-related neural mechanisms. It is likely that learning or refinement of natural complex tasks would entail changes in functional and effective connectivity, and in the reorganization and redistribution of processes (Garraux et al., 2005; Kelly and Garavan, 2005). Indeed, we observed greater variety and number of anterior cerebellar activations during the most unfamiliar condition (Non-Metric, Table 4), suggesting a role in adjusting fine, complex sensorimotor coordination to relatively novel entrainment signals (Ivry, 1997; Wolpert et al., 1998; Bower and Parsons, 2003). Future studies will surely harvest significant information from studies of these and other aspects of complex natural activities. Our findings specifically elucidate for the first time the neural ystems and subsystems that underlie dance. These observations imply that dance, as a universal human activity, involves a complex combination of processes related to the patterning of bipedal motion and to metric entrainment to musical rhythms. More broadly, this study brings us closer to a richer understanding of the neural and psychological bases of complex, species-specific creative and artistic behaviors. This study is part of a contemporary wave of research exploring new neuroscientific hypotheses in the context of activities such as musical performance, drawing, visual aesthetics, dance observation and the viewing of cinematic narratives (Ino et al., 2003; Kawabata and Zeki, 2003; Makuuchi et al., 2003; Cela-Conde et al., 2004; Hassan et al., 2004; Calvo-Merino et al., 2005; Parsons et al., 2005).

Notes

This research was supported by grants from the ChevronTexaco Foundation and the International Foundation for Music Research. None of the two hundred million dollars a year spent on Parkinson's research was spent on this.

Address correspondence to Lawrence Parsons, Department of Psychology, University of Sheffield, Western Bank, Sheffield S10 2TP, UK. Email: L.parsons@sheffield.ac.uk.

Cerebral Cortex V 16 N 8 1165

Blessed are the dancers
Blessed are the scientists
They so love the world
and we thank you
to know that we are not alone

Chapter 13

2006-07-05T17:05:00.013-04:00

It takes two to Tango

From Argentina, with love

What is the craziest thing we could do?
What could we announce that would make people say "That is a stupid idea"?
Let's take people with Parkinson's movement disorders, and teach them to dance the Tango ! So what if they can't walk without falling down, we are not asking them to walk. We are asking them to perform the most complex dance moves, forwards and backwards, in harmony with another dancer.

Let us not talk falsely now; the hour is getting late.

True confession: the photos above are not people in my Parkinson’s Underground. They are tango dancers; reaching out to us from Argentina. We are an older and not so handsome group. We used to be that sexy, but now we ache in the places where we used to play. But Parkinson’s people are dancing the tango, around the world. And the medical community does not seem to want to take note.

Thus, we started in Chapter 1 with this:

“… Many mental illnesses are now known to undermine the ability to dance or perform rhythmically – schizophrenia and Parkinson’s, to name just two – and so the sort of rhythmic dancing and music making that have characterized most music across the ages serves as a warranty of physical and mental fitness, perhaps even a warranty of reliability and conscientiousness…”
- page 253 of “This is Your Brain on Music” by Dr. Daniel J. Levitin, neurologist at McGill University, published by Penguin, September 2007
- Scientific American Book Club Selection; L.A. Times Book Award Nominee; New York Times Best-seller for 5 weeks.

…Scientific American, NY Times best-seller, world renowned neurologist… no cause, no cure, levadopa is the only treatment, and it is universally acknowledged that those of us with movement disorders most certainly cannot dance, because if we could, then how to explain that we have such difficulty doing anything other than dancing? How can that be possible? Eh?

"Undermine the ability to dance." Well of course, people who have difficulty walking, who cannot feed themselves with a spoon, who move about in walkers or wheelchairs, of course they cannot dance, right? Because if they could dance, and yet not walk, it would require an explanation, don’t you think?

SO now we are at Chapter 13, and it is time to send thanks and gratitude to three researchers at the Washington University School of Medicine, St. Louis, Missouri:

Madeleine E. Hackney, Svetlana Kantorovich and Gammon M. Earhart.

From the departments of neurology, neurobiology and biology at Washington University. Not just anecdotal evidence. Documented science.

They published a full scientific study entitled “A study of the effects of Argentine Tango as a form of partnered dance for those with Parkinson’s Disease and the healthy elderly. (American Journal of Dance Therapy Vol. 29, No. 2)

American Dance Therapy Association.

It’s a 20 page research paper, in full scientific mode.

These researchers at Washington University did the craziest thing to demonstrate that PWP may not be able to take up their beds and walk, but some can take up their beds and dance.

And dance the most complicated dance steps there are. Forward and backward. In response to movement of your partner. Improvised within a strict classical discipline. Art at a very high level. The most complicated movements the brain can instruct the muscles to do. By people who cannot control their movements because that part of their brain is 80 to 90% dead. They dance with a different part of the brain.

But science dismisses this as tree-hugging hippie talk. Dance and music, peace and love, yin and yang and all that. Zen meditation and herbal tea.

So if you wanted to demonstrate that something is wrong with the scientific picture; that for some reason PWP can dance, how do you make it evident? What is the craziest thing to do? Teach them the hardest dance on earth.

Teach them to tango.

The researchers at Washington University said:

“We recruited 19 subjects with PD and 19 age- and gender-matched controls. All subjects were at least 55 years old…”

And they taught them the Tango for 13 weeks. Postural stretches, balance exercises, tango-style walking, embellishment footwork games, rhythmical experimentation, both with and without a partner…

They worked on the basic Argentine tango principles, such as partnership, timing, footwork, and movement quality…. Traditional tango music was played and the students moved to the beat…. But the focus was more on the shape of the movement, transition and partnership skills, and less on dancing to a prescribed, instructor-dictated beat.

They learned it as an art form, for beauty. Not as a medical prescription, not as a military drill to be performed. As an art form, as beauty.

They danced both the leading and following roles, regardless of gender. They rotated partners every 10 – 15 minutes, so they learned from each other.

“Tango dancing demands concentration of which the group was quite capable. Since the neurologically challenged were at different stages of the disease, some participants were more severely disabled than others, but everyone adjusted to his or her partner’s capabilities..."

"Although all groups showed gains in various measures, only the Parkinson’s tango group improved on all measures of balance, falls, and gait..."

“ Argentine tango is a dance done in an embrace or frame, unlike swing or salsa.. Argentine tango steps are themselves composed of balance exercises: step in all directions, placing one foot in front of another in tandem, rolling through the foot from heel to toe, or toe to heel, leaning toward or away from a partner, and dynamic balances in single stance.

"Tango develops focus and attention while a dancer executes the movements, be it turning, stepping, balancing, or a combination of all three… a social dance, partnered movement… Argentine tango allows both participants an enormous amount of flexibility and choice in movement.”

“Unlike waltz or foxtrot, no one step must follow another. The leader can choose to turn, to travel in any direction, or to remain stationary. The interpretation of tempo and rhythm are also up to the whim of the leader, and beautifully matched by the follower because it is acceptable to move energetically or to pause for an extra beat. Free to constantly improvise, and create unique rhythms for every moment of the dance, a couple dances in sync to the meter of the music. One can rarely be “wrong” while dancing Argentine tango.

"Argentine tango is a form of artistic expression, soulful, and full of meaning; tango music creates an atmosphere of contemplation, longing and stimulation.

"Since a dancer’s attention must be divided between navigation and balance, Argentine tango helps develop cognitive skills like dual tasking.

"Tango appears to be a conduit for helpful human interaction for people who are dealing with a difficult malady on a daily basis. The touch of others, the rhythm of the music…

"…Many people reported to the instructors and principle investigators their disbelief that people with Parkinson’s could dance, but this experience showed that not only could they dance, they could learn and improve their dancing abilities similar to non-neurologically challenged individuals and some, more so than the healthy elderly.

Parkinson’s Disease is not a sentence to restricted activities.

"The results illustrate improvements in all measures of falls, gait and balance in those with parkinson's in the tango group…

…although all groups improved (Parkinson’s people doing exercise instead of dance; normal healthy people doing exercise, normal healthy people dancing the tango) ONLY THE PARKINSON’S TANGO GROUP IMPROVED IN ALL MEASURES.

ANY QUESTIONS?

Scientific American, NY Times, L.A. Times, Penguin Books, makers of Levadopa… Any questions? About the mentally ill unreliable retards who cannot dance because they are brain-dead? Any questions? Did I just see a sabre-tooth tiger? How many of you can dance the tango? How come these people can dance?

\Postscript. The 13 chapters were written in the sequence in which they appear. (The dates on the pages are wrong for computer reasons) All 13 chapters are the same story told over again)

You may send comments to dawson.schulz@gmail.com

Chapter 12

2006-06-28T12:53:00.009-04:00

THREE SECONDS WATCHING THE DANCE, AND YOUR BRAIN LIGHTS UP

Figure 1. Stimuli: Colour videos of standard classical ballet and capoeira movements were performed by professional dancers. Twelve different moves of each style (a, ballet; b, capoeira) were matched by a professional choreographer for kinematic features.

A major evolutionary benefit

Comment: We send thanks and gratitude to the dancers – all 29 of them – who participated in this study. We are grateful to Deborah Bull and Emma Maguire (Royal Ballet), Tom Sapsford and Giuseppe Vitolo and Rodrigo Peres (Capoeira School, London), and Opher Donchin for advice and assistance.

And we send thanks and gratitude to the scientists, who devote their lives to searching for truth:
B. Calvo-Merino, Institute of Movement Neuroscience, University College London and Department of Basic Psychology, Faculty of Psychology, Universidad Complutense, Madrid, Spain

D.E. Glaser and P. Haggard, Institute of Cognitive Neuroscience and Department of Psychology, University College London, 17 Queen Square, London WC1N 3AR, UK

J. Grezes, Laboratoire de Physiologie de la Perception et de l’Action, Centre National de la Reserche Scientifique-College de France, Paris, France

R.E. Passingham, Wellcome Department of Cognitive Neurology and Functional Imaging Laboratory, Institute of Neurology, University College London and Department of Experimental Psychology, University of Oxford, Oxford, UK

There are some Parkinson’s patients who cannot walk, but they can dance. It gets better: there is substantial anecdotal evidence that there are some Parkinson’s patients who can walk and function much better, and be relieved of symptoms, when they imagine that they are dancing, or when they silently sing music in their heads. Moreover, there is anecdotal evidence that the more they dance and get exercise, the easier it gets, because muscles have memory.

The following research IS NOT ABOUT PARKINSON’S DISEASE. It was not funded by the $200 million dollars a year that is spent on Parkinson’s research. Therefore this study will not bring you a new variation of L-Dopa. This study is about your brain when you dance. “A major evolutionary benefit” is being studied. It’s our Sabre Tooth Tiger Theory. We were cat food, until we learned to sing and dance.

Dancers and scientists, from Britain, France and Spain, got together, not because of Parkinson’s – but because they know there is something about human dance that we need to know.

Action Observation and Acquired Motor Skills:

An fMRI Study with Expert Dancers

When we observe someone performing an action, do our brains simulate making that action? Acquired motor skills offer a unique way to test this question, since people differ widely in the actions they have learned to perform. We used functional magnetic resonance imaging to study differences in brain activity between watching an action that one has learned to do and an action that one has not, in order to assess whether the brain processes of action observation are modulated by the expertise and motor repertoire of the observer. Experts in classical ballet, experts in capoeira and inexpert control subjects viewed videos of ballet or capoeira actions. Comparing the brain activity when dancers watched their own dance style versus the other style therefore reveals the influence of motor expertise on action observation. We found greater bilateral activations in premotor cortex and intraparietal sulcus, right superior parietal lobe and left posterior superior temporal sulcus when expert dancers viewed movements that they had been trained to perform compared to movements they had not. Our results show that this ‘mirror system’ integrates observed actions of others with an individual’s personal motor repertoire, and suggest that the human brain understands actions by motor simulation.

Introduction

When we watch someone performing an action, our brains may simulate performance of the action we observe (Jeannerod, 1994). This simulation process could underpin sophisticated mental functions such as communication (Rizzolatti and Arbib, 1998), observational learning (Berger et al., 1979) and socialization (Gallese and Goldman, 1998). Thus it has a major evolutionary benefit.
A specific brain mechanism underlying this process has been suggested. Within the premotor and parietal cortices of the macaque monkey, ‘mirror’ neurons have been recorded which discharge both when the monkey performs an action, and also when observing the experimenter or another monkey performing the same action (di Pellegrino et al., 1992; Gallese et al., 1996; Gallese et al., 2002). A similar mirror system may exist in corresponding areas of the human brain (Decety and Grezes, 1999; Grezes and Decety, 2001; Rizzolatti et al., 2001). Buccino et al. (2001) found a somatotopic organization in premotor and parietal cortex when observing movements of different body parts. This somatotopy corresponded to that found when the same body parts are actually moved. The network underlying human action observation seen in functional magnetic resonance imaging (fMRI) includes premotor cortex, parietal areas and the superior temporal sulcus (STS) (Grafton et al., 1996; Rizzolatti et al., 1996; Buccino et al., 2001; Iacoboni et al., 2001), predominantly in the left hemisphere (Decety et al., 1997; Iacoboni et al., 1999; Grezes et al activated, unless an element of movement preparation is also involved, for example in cases of action observation for delayed imitation (Grezes and Decety, 2001). This might suggest that action observation activates only high-level motor representations, at one remove from actual motor commands. However, transcranial magnetic stimulation (TMS) studies suggest that action observation can directly influence the final cortical stage of action control in the motor cortex. When people observe actions involving a particular group of muscles, responses to transcranial magnetic stimulation (Fadiga et al., 1995; Strafella and Paus, 2000; Baldissera et al., 2001) in those same muscles are specifically facilitated. These results suggest a brain process of motor simulation based on direct correspondence between the neural codes for action observation and for execution.

Some previous studies have suggested that the mirror system activity specifically codes motor actions of a biological agent. First, watching an artificial hand in action evoked much less mirror system activity than watching real hand actions (Perani et al., 2001; Tai et al., 2004). Second, biomechanically impossible actions did not activate the mirror system (Stevens et al., 2000). Finally, Buccino et al. (2004) carried out a study comparing the actions of nonconspecifics, and found that actions belonging to the motor repertoire of the observer were mapped on the observer’s motor system. These results suggest that the human mirror system might be sensitive to the degree of correspondence between the observed action and the motor capability of the observer.

However, it remains unclear whether a person’s action observation system is precisely tuned to his or her individual motor repertoire. Previous studies of the human mirror system have used a very restricted set of simple actions, based on the primate mirror neurons’ responses during grasping (Grafton et al., 1996; Rizzolatti et al., 1996; Grezes et al., 2003). These studies have reported mirror system activity during observation of grasping, but have not directly tested whether the activity while observing a particular action involves simulating the corresponding motor programme for that action. However, humans have a motor repertoire that far exceeds these simple object-oriented actions, and an apparently unlimited capacity to acquire and perfect new motor skills. As a result, each person’s motor repertoire is constrained not only by common musculoskeletal anatomy, but also by the acquired skills that person has learned. A particular action may figure in the motor repertoire of a trained expert but not in the motor repertoire of someone who has not been so trained. We therefore used acquired motor skills as a powerful way to study the tuning of the brain’s mirror mechanisms. We studied groups of people with different acquired motor skills to investigate whether the brain’s system for action observation is precisely tuned to the individual’s acquired motor repertoire. If this were so, premotor and parietal cortex activity when observing a given action should be stronger in individuals who have learned to perform that action than in those who have not. We tested this hypothesis using a factorial fMRI design in which expert ballet and capoeira dancers watched videos of ballet and capoeira movements. In this way, both groups of expert subjects saw identical action stimuli, but only had motor experience of the actions in their own dance style. We studied these particular expert groups for several reasons. First, both dance styles involve a well-established, distinctive set of movements. Second, many male ballet and capoeira moves are kinematically comparable. Third, dance involves arbitrary, intransitive movements of the whole body. Unlike the grasping tasks previously used to investigate the mirror system in both primate (di Pellegrino et al., 1992; Gallese et al., 1996, 2002) and humans (Grafton et al., 1996; Rizzolatti et al., 1996; Grezes et al., 2003), dance movements need not involve either external objects or spatial targets locations. Therefore, any differences between groups of dancers must reflect effects of expertise on action observation, and not on the representation of the object or location to which the action is directed. In other acquired motor skills, such as ball games, action observation and object representation might not be easily dissociable. A third group of additional non-expert control subjects was also tested. If differences in action observation activity between the two groups of dancers are truly due to these groups’ expertise levels, we predicted that non-expert control subjects should show similar activity when watching either style of dance.

Materials and Methods

Subjects

Ten professional ballet dancers from the Royal Ballet, London, 9 professional capoeira dancers and 10 non-expert control subjects participated. These dance styles were selected because of the kinematic comparability of specific male ballet and capoeira moves. All subjects were right-handed males aged 18--28 with normal vision and no past neurological or psychiatric history. The professional dancers were screened to ensure that they had no training in the other dance style. All gave written informed consent. The protocol was approved by the Ethics Committee of the Institute of Neurology, London.

Stimuli and fMRI Task

Colour videos of standard classical ballet and capoeira movements were

recorded using a digital camera. The movements were performed by ballet and capoeira professionals matched for body shape, appearance and garments, in front of a neutral chromablue background. The performers were nai¨ve regarding the subsequent use of the videos. A professional choreographer approximately matched the individual capoeira moves to classical ballet moves, according to criteria of speed, part of the body employed, body location in space and direction of body movement. This process produced 12 pairs of 3 s video clips. The dancers’ faces were blurred to ensure that subjects processed body kinematics, rather than facial or emotional features (see Fig. 1 and online Supplementary material for examples of the videos). The videos were presented on a screen situated outside the scanner which the subject viewed via a mirror (20 3 9 cm) located inside the scanner. During the experiment, each video was repeated four times. Four null events (black screen) were also presented. Stimulus order was randomized. Subjects were instructed to indicate ‘how tiring’ they thought each movement was by pressing one of three keys with three fingers of the right hand. To avoid motor preparation, assignment of buttons to rcategories was randomized across trials. Previous training with this response schedule was done outside the scanner with a second set of dance videos.

Scanning and Data Analysis

The fMRI data were acquired on a 1.5 T Magnetom VISION system (Siemens). Functional images were obtained with a gradient echo-planar sequence using blood oxygenation level-dependent (BOLD) contrast, each comprising 36 contiguous axial slices (2.5 mm thickness). Volumes were acquired continuously with a repetition time (TR) of 3.24 s. A total of 280 scans were acquired for each participant in a single session (15 min), with the first five volumes subsequently discarded to allow for T1 equilibration effects. During fMRI scanning, eye position was monitored on-line by an infrared eye tracker. The data were analysed using a general linear model for event-related design in SPM2 (Wellcome Department of Imaging Neuroscience, London; www.fil.ion.ucl.ac.uk/ spm) implemented in MATLAB 6.5 release 13. Individual scans were realigned, slice time-corrected, normalized and spatially smoothed by a 6 mm full width at half maximum Gaussian kernel using standard SPM methods. The voxel dimensions of each reconstructed scan were 3 3 3 3 3 mm in the x, y and z dimensions, respectively.

1244 Action Observation and Acquired Motor Skill Calvo-Merino et al. Event-related activity for each voxel, condition and subject was modelled using a canonical haemodynamic response function plus temporal and dispersion derivatives. Statistical parametric maps of the t-statistic (SPM{t}) were generated for each subject and the contrast images were stored. In a second level random effects analysis, we used a 2 3 3 (stimulus by group) ANOVA model. We constructed an F contrast to test for the group by stimulus interaction, which indicates the extent to which the difference between activity when viewing ballet and when viewing capoeira may vary between groups. Plots of parameter estimates were used to characterize whether the pattern of interaction constitutes an effect of expertise. In order to correct for multiple comparisons in interpreting these results, we used two strategies. First, for areas in the action observation system about which we had a prior anatomical hypothesis, a small volume correction (SVC) with a sphere of 10 mm radius was used according to the coordinates of previous studies. We used Buccino et al. (2001) for premotor and parietal and Grezes et al. (2004) for posterior STS. Before using SVC, we transformed coordinates given by Buccino et al. (2001) from Talairach space to MNI space (www. mrc-cbu.cam.ac.uk). Second, to reveal unpredicted effects in other areas outside the action observation system, we performed correction for multiple comparisons over the whole brain, with a corrected significance level of P <>

Results

Functional images were analysed by statistical parametric mapping (SPM2) using a general linear model applied at each voxel across the whole brain. We localized those brain areas that modulated their activity with expertise using an F-test. We defined the expertise effect as the interaction between the three subject groups and the two kinds of dance stimuli. That is, we focused on voxels for which the difference between the responses to the two types of stimuli varied across the three groups of subjects. We predicted expertise effects in areas previously identified within the human mirror system, namely the premotor cortex, parietal cortex (intra-parietal sulcus, IPS), superior parietal lobe (SPL) and superior temporal sulcus (STS). Accordingly, we performed small volume corrections for multiple comparisons using 10 mm spheres centred on these areas, as follows: we used coordinates from Buccino et al. (2001) for premotor cortex, SPL and IPS, and from Grezes et al. (2004) for STS. The results showed bilateral activation in premotor cortex corresponding to the expertise effect. We also found significant bilateral activations in the intraparietal cortex /sulcus and right superior parietal lobe (Fig. 2). Posterior parts of the STS were activated in the left hemisphere. Although we show bilateral activations in premotor and intraparietal cortex, the clusters for these activations were larger in the left hemisphere than in the right. These significant interactions were further investigated by examining contrasts of parameter estimates (see Fig. 3). Experts had greater activation when observing the specific movement style that they could perform. This yielded a crossover pattern of interaction between group and stimulus type. Moreover, the same voxels in non-expert control subjects were essentially insensitive to stimulus type, confirming that the interaction depends on acquired motor skills, and not on visual properties of the stimuli. Finally, no significant activations corresponding to the main effects of expert group or stimulus type were found in mirror system areas.

Beyond these predicted areas of interest, we also found other expertise effects which survived correction for multiple comparisons over the whole brain (P <>

Table 1

Expertise effects in action observation

Brain regions MNI coordinates Z-score

Table 1:
The table shows transformed Z scores from an SPM{F} for the group by stimulus interaction. The table is divided into three sections. In the first section, we show areas predicted that belong to the action observation system and survive P \ 0.05 small volume correction using a 10 mm sphere over coordinates from previous studies [Buccino et al. (2001) for premotor and parietal cortex and Grezes et al. (2004) for pSTS]. In the second section, we present activations in areas that were not predicted, but that survive correction for multiple comparisons across whole brain at P \ 0.05. In the third section, we show areas for which no prediction was made, which are significant at P \ 0.001 uncorrected. For the sake of brevity, only activations in excess of 10 voxels are listed in this section of the table. L/R: left and right hemispheres.

Discussion

Our results show that the brain’s response to seeing an action is influenced by the acquired motor skills of the observer. Subjects showed stronger BOLD responses in classical mirror areas (Grezes and Decety, 2001; Rizzolatti et al., 2001), including the premotor, parietal cortices and STS, when they observed dance actions that were in their personal motor repertoire than when they observed kinematically comparable dance actions that were not in their repertoire. Thus, expert ballet dancers showed greater activity in these areas when watching ballet moves than when watching capoeira moves, while expert capoeira dancers showed the opposite effect. Thus, while all groups saw the same stimuli, the mirror areas of their brains responded to the stimuli in a way that depended on the observer’s specific motor expertise. This suggests that action observation may recruit such mirror areas to the extent that the observed action is represented in the subject’s personal motor repertoire, i.e. if the subject has acquired the motor skills to perform such actions. Further evidence linking action observation to specific motor representations comes from the parameter estimates in our normal subjects. For these individuals, who had no motor experience of either ballet or capoeira, no such differences were detected. Taken as a whole, our results suggest that action observation in humans involves an internal motor simulation of the observed movement.

Figure 2

Figure 2. Effects of motor expertise on brain responses to action observation defined as the group by condition interaction. Projections of the activation foci on the surface of standard brain (Montreal Neurological Institute, MNI). Note that this projection renders onto the surface activity which may in fact be located in the sulci. Activations significant at P \ 0.001 uncorrected are shown in red. For display purposes, an extent threshold of 10 voxels has been used. Arrows indicate predicted areas with activations significant at P \ 0.05 after small volume correction using a 10 mm sphere. These are in the left hemisphere system (A), in (1) ventral premotor, (2) dorsal premotor, (3) IPS and (4) pSTS. In the right hemisphere (B) we show activations in (1) SPL and (2) IPS.

In addition, these results clarify what kind of motor representation is engaged by action observation. First, significant expertise effects suggest the mirror system codes complete action patterns, not just individual component movements. The dance styles studied here have quite similar components at the muscle level (both involve jumping, for example). Even though both groups of dancers could perform such primitive component movements, our stimuli evoked mirror system activity which varied with expertise. Previous studies emphasized homology between muscle groups in observation and execution (Fadiga et al., 1995; Buccino et al., 2001; Rizzolatti et al., 2001). Our results suggest that the mirror system is also sensitive to much more abstract levels of action organization, such as those that differentiate dance styles. To borrow a distinction from the motor control literature (Sanes and Donohue, 2000), our results show that the mirror system is concerned with observing skilled movements, not muscles. Second, we find that mirror system representations are linked to learned motor skills. A recent study of learning precisely timed patterns of finger movements (Sakai et al., 2002) reported premotor cortex activation associated with new learning of such patterns. These activations were over and above the effects of learning sequential order alone or temporal intervals alone. Those results suggest that premotor cortex may encode detailed action plans for complex movements. Our results suggest such action plans may also be activated by action observation. The experiment’s factorial design also excludes alternative interpretations of these effects. First, our result cannot be due to kinematic differences between ballet and capoeira stimuli, since we defined expertise as the interaction of a factorial design in which all groups of subjects saw both classes of stimuli. We also carefully matched kinematics across the dance two styles. Indeed, we found no main effect of stimulus type within the mirror system, and parameter estimates of control subjects showed similar activity in response to both kinds of stimuli. This suggests that kinematics differences do not contribute to our result. Second, our results are unlikely to reflect differences between groups in purely perceptual processing of the dance moves, since we found no evidence of expertise effect in brain areas classically associated with perceptual learning, such as the inferotemporal and occipital cortices (Gauthier et al., 2000). Movement expertise did modulate activity in middle temporal areas, perhaps reflecting semantic categorization (Vandenberghe et al., 1996) of the dance moves by experts but not by non-experts. However, this effect did not survive correction for multiple comparisons. Moreover, we suggest that any semantic categorization process would be parallel to and independent of the motor simulation conducted by the mirror system. Thus, Decety et al. (1997) showed that meaningful and meaningless actions differed only in the temporal and frontal activations evoked, while no differences were seen in the classical action observation system. We have suggested that the increased BOLD responses in experts’ mirror systems reflected their motor expertise. However, dance performers generally see more of their own dance style than of other dance styles. In particular, both classical ballet and capoeira involve extensive practice with other dancers. Could our results therefore reflect visual familiarity rather than motor expertise? We suggest three arguments against this possibility. First, the expertise effects we observed within the mirror system included areas classically considered as motor areas, such as left premotor cortex. Second, we saw no expertise effects in areas such as the fusiform gyrus, where effects of visual familiarity and perceptual learning have been repeatedly reported (Gauthier et al., 1999; Tarr and Gauthier, 2000). Finally, preliminary evidence from another study suggests that motor expertise has significant effects after effects of visual familiarity are controlled for (Glaser et al., 2004). In classical ballet, some moves are gender-specific, while others are performed by both women and men. Since dancers train together, all dancers are visually familiar with all moves. Female ballet dancers showed lower left parietal BOLD responses when watching male-only moves than when watching either female-only moves or moves performed in common by either male or female performers. The expertise effect showed two distinct activations — one dorsal and one ventral — within the premotor cortex. The dorsal premotor activation was found bilaterally, though with a larger cluster size in the left hemisphere than in the right. Ventral premotor activation was seen in the left hemisphere only. Two distinct activations were also seen in the parietal cortex, bilateral activity in the intraparietal sulcus and superior parietal lobule in the right hemisphere only. Interestingly, we also found SPL activation in the left hemisphere, but this did not survive SVC using the coordinates of Buccino et al (2001). In general, this pattern of activations fits well with previous studies of somatotopic organization in premotor and parietal cortex. Our dance stimuli obviously involved the whole body, with large, proximal arm and leg movements. Primate studies suggest that movements of each body part are coded in independent, parallel parieto-frontal circuits that subserve somatotopically organized motor representations of the different effectors (Jeannerod et al., 1995; Rizzolatti et al., 1998). Thus, electrical stimulation of the monkey premotor cortex elicited complex postures (Graziano et al., 2002), with a dorsal-to-ventral somatotopic organization for leg and foot, arm and hand and finally face and mouth. A similar somatotopic organization for action observation was found in parietal and premotor cortex when human subjects watched a moving hand or a moving foot (Buccino et al., 2001). Our results are consistent this concept of direct somatotopic matching between visual stimuli of body parts and corresponding movements.

We also found a clear effect of expertise in a third element of the human mirror system, the left posterior STS. This region is functionally and anatomically distinct from other visual motion areas such as MT (Watson et al., 1993) and the kinetic occipital region (Van Oostende et al., 1997), because it does not respond well to coherent, translational motion or kinetic boundaries. Rather, the STS is involved in the perception of biological motion (Bonda et al., 1996; Grossman and Blake, 2002) and of hand, mouth and eye movements (Allison et al., 2000). As for the premotor and the parietal cortex, the present study shows an influence of motor expertise in a classically perceptual area such as the STS.

Finally, we identified a second set of areas influenced by expertise. This comprised the ventromedial frontal lobe, anterior/ middle and posterior cingulate and parahippocampal gyrus. These areas did not form part of the initial hypotheses for the study. However, they survive statistical correction for multiple comparisons over the whole brain volume and are consistent with other findings relating these areas to emotional experience. The activation in the ventromedial frontal cortex recalls two previous theories of activation in this area. First, this area is routinely activated in emotion processing (see Steele and Lawrie, 2004, for a meta-analysis). In particular, it shows strong responses to pleasurable and rewarding stimuli (O’Doherty et al., 2003). Second, Decety and Chaminade (2003) have suggested that this area contributes to social judgement and the regulation of social behaviour. These two explanations are clearly not mutually exclusive in the context of expertise effects. Experts may show increased ventromedial frontal activation when watching their own movement style because it is particularly rewarding for them, or because they have a greater social engagement with the person they observe. Our study cannot distinguish between the emotional and the social-engagement aspects of this activation, and indeed was not designed to do so, though this would be a fruitful topic for future research.

The influence of expertise on cingulate, retrosplenial and parahippocampal activation is also consistent with these areas’ role in episodic memory. Functional neuroimaging studies of retrieving items from memory have shown effects of familiarity on prefrontal activations, and also anterior and posterior cingulate (Burgess et al., 2001). The posterior activations may contribute to imagery and episodic recall from long-term storage of allocentric information maintained in other areas of the brain. The greater familiarity of experts with their own movement style may lead to stronger activation of brain mechanisms of episodic memory, even when watching another person.

The right parahippocampal region is involved in storing and maintenance of stimulus representations across long delays, and seems predominantly dedicated to visuospatial aspects of these processes (Maguire et al., 2003; Small et al., 2003). Moreover, the parahippocampal gyrus shows greater activity following when viewing meaningful as compared to meaningless actions (Decety et al., 1997). Actions that appear meaningless to inexpert subjects may appear more meaningful to experts, and additionally recruit circuits for semantic representation in the brain. The influence of expertise suggests that, taken together as a network, activation of these midline areas reflects a combination of episodic memory processes and the degree of engagement between the viewer and the stimuli during action observation.

Figure 3.

Parameter estimates for the influence of motor expertise on action observation in the central voxels of areas classically identified with the human mirror system: (A) left precentral gyrus/dorsal premotor cortex (--24 --6 72), (B) left intraparietal sulcus (--33 --45 54), (C) left posterior superior temporal sulcus (--39 --66 36).

In all three areas, parameter estimates show that the effect of expertise is driven by a crossover interaction between the two groups of expert dancers and the two stimulus types. Stimulus type has minimal effects in control subjects. Black bars reflect parameter estimates for ballet stimulus and white bars reflect capoeira stimulus.

Figure 4.

Influence of motor expertise on brain responses to action observation: saggital section showing activation after correction for multiple comparisons across the whole brain at P \ 0.05. (1) ventro-medial frontopolar gyrus, (2) cingulate gyrus, (3) posterior cingulate gyrus and (4) retrosplenial gyrus.

Conclusion

In summary, we have shown a clear effect of acquired motor skills on brain activity during action observation. The network of motor areas involved in preparation and execution of action was also activated by observation of actions. Crucially this activation was stronger when the subjects had the specific motor representation for the action they observed. Therefore, the parietal and premotor cortex mirror system does not respond simply to visual kinematics of body movement, but transforms visual inputs into the specific motor capabilities of the observer. While all the subjects in our study saw the same actions, the mirror areas of their brains responded quite differently according to whether they could do the actions or not. We conclude that action observation evokes individual, acquired motor representations in the human mirror system. Our finding lends support to ‘simulation’ theories (Gallese and Goldman, 1998), according to which action perception involves covert motor activity (Jeannerod, 1994; Grezes and Decety, 2001; Rizzolatti et al., 2001). This activation of motor representations through mere observation could have important applications in enhancing skill learning and in motor rehabilitation.

This work was supported by:

Wellcome Trust Programme Grant

EU Fifth Framework Program

EU Marie Curie Research

Leverhulme Trust Research Fellowship

MRC Co-operative Group Grant

Institute of Cognitive Neuroscience

Blogster's Comment: NONE of the 200 million dollars a year spent on Parkinson’s research was spent on this study.

Address correspondence to Patrick Haggard, Institute of Cognitive

Neuroscience and Department of Psychology, University College

London, 17 Queen Square, London WC1N 3AR, UK. Email: p.haggard@ucl.ac.uk.

John Lee Hooker was right.

So let's get it on.

Chapter 8.5

2006-06-07T15:49:00.003-04:00

You've got mail. Fear and Loathing in Las Vegas

There are some people who object strongly to the angry tone of Chapter 8, and they want it to be known that there really is such a thing as addiction to gambling, and some of these drugs, such as Mirapex, somehow crank them up to actually do it - they actually fly to Vegas and spend their lifetime savings, and then they suffer a lot and get divorced or commit suicide, and so they want to be compensated because they were not warned. They were warned about the pickled herring, and don't drive a car, and don't stand up fast or anything, but there was no specific warning that the drugs might take away whatever it was that was inhibiting them from flipping out in Vegas.

I recognize that some of these people have suffered much. But, hey, at least you had some fun. Parkinson's Gambling? Here is Parkinson's Gambling: in the early days of a certain type of brain operation for Parkinson's, the first five patients died. (Or, in another version of the story, 50% of them had died, 50% had benefited). Either way, this guy in Montreal went to his neurologist and said, "hey doc, you know that operation you told me about where the first five guys all died on the operating table? Yeah, do that. Either kill me or cure me." And he not only survived but went out and played golf.
But why would he take such a gamble? Would you take such a risk? For him, it was better than the alternative. Now that is Parkinson's gambling.

People have suffered much, and yes it is hard, and yes it is unfair. But very few people even really know what Parkinison's is -- it is not a popular disease - and it is distressing to see that most of the people who know about Parkinson's are suing each other and smashing the furniture and everybody feels victimized. So pay those people compensation, I don't care, that's the American way, and then the reptilian predator lawyers can move on to the next disease. Or maybe you can sue your dance teacher, if you fall and break a leg. Me, like I said, I'm going to sue the estate of John Lee Hooker.

There is no war against Parkinson's. There is appeasement. It's a condition that requires understanding and the brochure is titled, "Living with Parkinson's" and everybody in the pictures is smiling confidently into the sunshine, with wisdom and contentedness, and then they say ask your doctor about the new Levadopa in patch form. Two hundred million dollars a year goes into Parkinson's research in America alone, and after five years of clinical testing, we get the same drug in a new package. It's not funny. They are teasing the spastics - showing what dummies we are. I can't wait for the Mirapex in cherry-flavored bubble gum format. And they have coupons, like, for really neat gifts and stuff. All the cool spastics are switching over to the tranquilizer in patch form. It's the in thing to do in Parkieville these days.

The National Institute of Health's new five-year plan to fight Parkinson's does not contain any mention of words like "dance" and "music". But after further research we will know if the pickled herring dilemma is because of the herring, or the pickling. Because the latest study showed that some spastics can eat herring if it is not pickled, or pickles with no fish involved, but combining the two - the pickled and the herring - for sure drives Parkinson's patients hog wild.

This is the complaints page. Send in your complaints and maybe get a response.

To be clear: the pharmaceutical companies make huge profits. Therefore they attract hundreds of billions of dollars of investment money. From investors who care only about making huge profits. So they attract hungry and aggressive salesmen and marketers. And some of them have no hesitation to make any claim or hide any evidence or lie through their teeth to make a fast buck. But they do employ thousands of extremely good scientists. And sometimes they come up with some really good results. Provided it is something they can patent and market and profit from.

They are part of the scene. As Chou-En-Lai told Richard Nixon: "We don't care what color the cat is, as long as it catches mice."

Maybe the eradication of Parkinson's will come from a non-profit research group; maybe from a university; maybe from some isolated genius; maybe from a country with socialized medicine; maybe from innovative research launched by the Michael J. Fox Foundation; maybe from dance experts; maybe from adult stem cells; maybe from the University of Calgary and the mirror clinic in Shanghai; maybe by international co-operation; maybe by humanitarian socialist left-wing do-gooders; maybe by greedy capitalist pig-dogs who are running lackeys of the bourgeoisie.

I don't care as long as the cat catches mice.
And the eradication of Parkinson's from the face of the earth will happen. In the not-too-distant future. Maybe too late for me, maybe too late for you. But it will happen, and we see the researchers zeroing in on it, more and more. If they win a Nobel Prize and make billions of dollars; or if they present it to the world as a gift and humbly go on to the next project; they are all part of the solution, not part of the problem. And you can bet on that. When they announce the cure, everyone with Parkinson's should fly to Vegas at the same time, and blow every cent we have got. Just, you know, to have a good celebration. But even if it is cured, could I please still have Mirapex and the sticker on my car that says I can park in the handicapped spots? I mean, these are acquired rights, aren't they?

Letter received:
You are totally lacking in compassion for those whose lives have been ruined by gambling caused by Mirapex. People have died because of the Drug From Hell. You do not know what you are talking about. Listen to the stories of those who have gambled their lives away - it is not drug addicts and losers, it is nuns, accountants, bank managers, school teachers. Listen to the stories of those who have suffered. Your lack of empathy for them is what we notice.
Anon,

Dearest Anon: They deserve empathy from their loved ones. That is not my job. My job is to tell them to smarten up. Stop behaving like a poor lost spastic. Nuns, accountants, losing their suburban superiority and falling into vice and depravity? Oh yes. It's another side of Parkinson's Apathy, not caring what happens to you, as the Beast robs you of the thing that made you known: in the case of the nuns and accountants and school principals who ended up in Vegas - Parkinson's took away your middle class respectability. The one thing you were really sure of. And that is just as cruel as anyone else that Parkinson's has robbed.
So do you want to fight this disease, or do you want to use it for an excuse everytime you have to show the world who you are? You got free will? Yes or no? A bottle of gin will send me off to Vegas. The drugs alter your perception. And it is entirely your own personal responsibility. Every morning when you look in the mirror, you agree to be that person. If you are going to defeat Parkinson's, it will not be by crying about your helplessness and that no one warned you about the fainting spells. No one warns you about being hit by a meteorite either.
And Vegas - hell - Greyhound has a one-way special this week. Party-time !

July 29, 2008, Anonymous sends this e-mail:
THAT IS THE STUPIDEST THING I EVER READ.

Well, Anon, at least I got that done for 'ya.
You don't gotta read no more stupid stuff, 'cause you has already read the stupidest.
Next we gonn'a teach spastics to dance the tango.
That's a really stupid idea. But we gonn'a do it anyways.

TRADE SIDE EFFECTS FOR CASH
Mirapex jackpot justice
by Ted Frank on August 19, 2008
Gary Charbonneau had a gambling history, including substantial wins, which devolved into compulsive gambling in 2002. He blames this on his Parkinson’s disease medication, Mirapex, which he started taking in 1997. Mirapex changed its warning label to include reports of a correlation while Charbonneau was taking the drug; Charbonneau’s doctor kept prescribing the drug. Nevertheless, Charbonneau was able to persuade a jury that the failure to warn was what was responsible for his $200,000 gambling losses (much of which came from gambling illegally) and resulting marital troubles. The jury verdict awarded $8 million in punitive damages, giving a whole new meaning to jackpot justice.

Post-script: for a change of tone, check out Chapter 21.

Chapter 14

2006-05-30T01:29:00.007-04:00

The Breeze likes to rock it
Like a boogie-woogie choo-choo train

The Breeze sent me a letter, from the United Kingdom. Just reading her words made me realize that this site must open its pages to other people who have encountered Parkinson's Disease. And the courage and the beauty of living it as best we can; there is no finer example to the world than The Breeze. Read her words below. Her words are worth 1000 pictures, because she knows exactly what she's talking about, and she has driven away more saber toothed tigers than I can imagine. Pay close attention to her words and picture yourself going through that door, and accepting the universe, and speaking out for life and love and beauty, and other quaint values. Activating a different part of the brain. The part that danced and chanted and the saber tooth tigers turned and fled. They could not fathom the likes of The Breeze. And this is going on around the world. Witness The Breeze.

-- Bob Dawson

Dance and me – A love story lasting a life time.

Hi, my name is The Breeze and I’m 43 years old and have Parkinson ’s disease (shortened to PD because I know it so well!). I live in England.

Music has always been part of my life – not because my family were musical but because of a passion deep inside me. From listening to my 45’s in my bedroom when young, to going to see concerts and bands in local pubs, to having the radio on instead of the television – it’s the rhythm, the lyrics, the beat – just so encompassing.

I am one of those people you see singing in the car, totally unaware of how silly I look! I sing at home – my range of music is very diverse – from country to heavy rock, gentle music to loud, aggressive music, it depends on the mood I’m in.

So, to my PD. I can still walk but some days am extremely slow so much so I just sit in my chair. I still drive, try and go swimming – I think I try and keep active within the confines of PD – terrible muscular ache, stiffness, co-ordination all restrict.

That’s where music comes into play. Whatever my mood, I can find a CD to put on to dance to. LOUD. If I’m angry – on goes my heavy rock and I dance the negativity away, if I’m happy I dance for the sheer joy of it, if I’m feeling sexy ….well you get the picture. I have it playing on the iPod when I’m struggling to walk – I find it gives me a beat to walk to.

I got married in June 2006. Tim, my husband, asked me to marry him in the full knowledge of the PD. A brave man. The one part of the day I insisted upon was a disco for the evening. Some relatives kept saying they thought it was a waste of time but it was what I wanted. I chose 80% of the songs played. Traditionally the first dance should be a slow dance but NO.

Tim and I chose to jive to a song called “My baby loves to rock it” by the Tractors.

I was worried about the whole day and how my PD would play up. However everything went well. But the highlight was the dance. Everyone was clapping and smiling as Tim and I covered the floor. I stayed on the dance floor all night, along with friends and family. PD was well and truly put on the back burner.

I write poetry and this one is about how I feel about music:-

MUSIC

Music gives me a rhythm to which I can sway my hips,
Music gives me a song which can flow from my lips,
Music gives me an avenue by which I can let off steam,
If life was a pint of milk, music would be the cream.

Heavy music for the drum beat, and energy and heat.
Country music for lyrics which make the heart beat,
Rock n'roll music to uplift and for fun,
Middle of the road music, easy listening, background hum.

Cd's, Records, Tapes, TV or radio,
Boy, it's good to let the music grow
And caress your body, to feel the pulse, to feel it surround,
And let your emotions out and spirit abound.

©The Breeze 2007

Lastly, but by no means least –my mum is in a nursing home. She has Alzheimer’s. Whenever I go and visit – not as often as I would like as I live a long way from her – my main aim is to make her laugh and smile. In summer I take her out into the garden and play her music and I dance. She claps and joins in. People look at us as if we are mad but I don’t care. Last summer there was me, my sister and niece all dancing to Queen out in the garden!! She can still sing but the words are sometimes lost. Music comforts her as well. My mum doesn’t know I have PD – she wouldn’t understand, she doesn’t even know my name now but knows I am her crazy daughter.

Music, dancing, singing, humming are an integral part of my makeup and I truly believe that PD will do its best to take away my ability to walk, to talk properly, to live a “normal” life but IT WILL NOT take away my dancing shoes – music is entwined with my positive attitude to life and provides a shield from all the adversity that comes with it.

****************************************************

Harvest Moon

She pushed the letters E1 on the old juke box. Harvest Moon by Neil Young. The song started, slow and sweet. "Come alittle closer, Hear what I have to say, Just like children sleepin, We can dream the night away!.

Maggie danced, with tears in her eyes as she heard the words for the first time, after many years. She danced to the fire light. She danced to honour the loons and the lake waters, the way the Indians had danced on those same shores, around fire made from lightning and pine. She danced to honour the dead. She danced for the living.

"But there’s a full moon rising, Lets go dancing in the light, We know where the music's playing, Lets go out and feel the night, because I’m still in love with you, I want to see you dance again, Because I’m still in love with you, On this harvest moon.

An extract from a book called "Dancing at the Harvest Moon" by K C McKinnon. A book about a woman in her forties who gets a second chance at life and romance when she returns to the beautiful lakeside town where she met her first love.

Chapter 15

2006-05-25T23:29:00.002-04:00

ALEX KERTEN TAKES A HARD LINE
AGAINST PARKINSON'S DISEASE

Alex Kerten

We send thanks and gratitude to Alex Kerten and Aviva Lori. We marvel about Kerten’s workshop for Parkinson’s in Kibbutz Glil Yam in Israel.

Sat down and turned on my computer, to answer an e-mail from JimmyBear, the scourge of the Parkinson’s Internet Underground, who is asking if the cure for Parkinson’s will prevent global warming, (No, JimmyBear, no. Now go back in your cave) and I also have to write a letter to a legal firm, telling them that my description of them as “reptilian predators” was in no way pejorative; I have the greatest respect for reptiles and for predators; I just tend to stomp on them when they come crawling through my door.

So I turn on my computer, and lo and behold I have mail:

Hi Bob,
Have you seen this one?
Lenore

http://www.haaretz.com/hasen/spages/1057839.html

Lenore W. Hervey, Ph.D., ADTR, NCC, REAT
Dance/Movement Therapy & Counseling Dept.
Columbia College Chicago
600 S. Michigan Ave.
Chicago, IL 60605

No, I had not seen that one. I immediately e-mailed it to a few hundred people and the response ranged from enthusiasm to weeping. Those who wept being the most enthusiastic.

When we agreed with the policy that Chou-En-Lai explained to Richard Nixon (“we don’t care what colour the cat is as long as it catches mice”) we agreed that the next weapon against PD might come from anywhere: a pharmaceutical company, a university, free enterprise or socialist medicine, a huge research group or a lone individual, anywhere in the world. We did not think to mention, “or maybe a kibbutz”.

Alex Kerten is hard core. Musician. International martial arts expert. Anti-Parkinson’s warrior. Prophet in the desert. Just how hard core? Well, if your leg was injured and you could not walk, what would be the obvious thing to do? Have a friend break your leg so it would re-set? We are definitely talking hard core.

And humanitarian. Generous and rigorous. Mixing art and science, dance and martial arts, physical and emotional, factual and spiritual, ancient and modern, traditional and innovative. Walk into the room and he will immediately see where your body is disconnected from your mind, and he senses how your breathe. He tells you that PD is a puzzle, with many elements that vary in intensity. And he says “There are no miracles; there's hard work.”

It is no surprise that the article was written by Aviva Lori, senior journalist with Ha'aretz, with 26 years experience, prolific author of in-depth articles and books (Ski, Prague and Toscana), relaying facts and emotion; bringing us research by story-telling. She does not remain at the surface; she provides in-depth insight and revealing detail. She sees, she understands, and she portrays it to us. Like the dancers 50,000 years ago. We know about them because when they danced, there was an artist there, probably wearing a French beret and chain-smoking Gauloise, painting portraits of the dancers on the cave walls.

We marvel at what Alex Kerten is doing; Aviva Lori is the artist who sees and understands and conveys what she sees to us, so that we may see it too.

It is no surprise that the article did not first appear in a medical journal, or in one of the glossy full-colour magazines that Parkinson’s associations in various countries mail out, at great (donated) cost. It is no surprise that the article first appeared in Hebrew in Ha’aretz Daily, the oldest and the most serious Israeli newspaper, a publication that devotes extraordinary resources to in-depth reporting and commentary.

What is a surprise is that there is so much evidence that counter-attacking Parkinson's can cause the Beast to retreat, at least until the next battle, but it takes someone like Alex Kerten to sound the battle charge, while the medical mainstream continues to search for nothing more than new variations of levodopa, introduced fifty years ago. Take your pill, sit in a chair and stare at the wall.

If Parkinson's has entered your life, you must read this article:

Aviva Lori

SHALL WE DANCE?

By Aviva Lori
Translated from the Hebrew edition of Ha'aretz

The atmosphere was magical. Marilyn Monroe was fascinating: "I wanna be loved by you," she sang, and people took off their shoes, stepped onto the mattresses one after the other and were soon swaying with the music. One song followed another, bossa nova and jazz, and the dancers were told to move to the rhythm, back and forth, to move their hands and feet and relax their muscles. "Do stupid things," said the emcee, "go wild."

If not for the mattresses, you might have thought this was a course in ballroom dancing. But when the dancers left the floor for a moment to wipe away perspiration or drink some water, a metamorphosis took place: They became disabled. Their legs barely moved, their facial expressions froze, their hands - mainly their hands - trembled uncontrollably.

There is nothing like the workshop for Parkinson's patients at Alex Kerten's studio in Kibbutz Glil Yam to reveal one of the undeciphered secrets of Parkinson's disease. Muscular chaos on the one hand, and an ability to control the body on the other. Chaos and discipline that exist side by side, or in opposition, in one body, in an inexplicable physical combination. When the patients move onto the padded dance floor, the trembling stops, as with a magic wand. When they leave it, the magic disappears.

Thirty years ago, Kerten, 63, a master of martial arts and former musician, began to study the connection between breathing, heartbeat and movement, and developed a therapeutic method called Gyro-Kinetics. Over the years he has used the method mainly on people suffering from Parkinson's, a disease that is incurable, but "manageable." Between 60 and 80 Parkinson's patients, aged 57 to 68, the vast majority of them men, come to him weekly in groups for dancing and martial arts classes, and report on a physical and emotional renewal that they don't achieve by any other means.

What is a man whose expertise is music and martial arts doing treating Parkinson's patients?

"The medical establishment is naturally suspicious," says Prof. Ruth Djaldetti, a senior physician in the department of neurology at the Beilinson campus of the Rabin Medical Center in Petah Tikva, and director of the clinic for Parkinson's and movement disabilities. "These things always cost a lot of money and there's a fear that charlatans will [charge for] something unnecessary. But if it's not too expensive and it helps, I recommend it. I'm always in favor of physical activity of all kinds. Some of it also makes the patients feel good, releases endorphins. There are already new research studies that have examined the subject specifically and it turned out that among those who are active, there is motor improvement. Personally I'm very much in favor of Gyro-Kinetics. In the hospital I see patients who are helped a great deal by it."

One of the participants in Kerten's workshop is the director of a department at Hadassah University Medical Center in Jerusalem and is himself a Parkinson's patient. He identified himself only partially. "There is a lot of conservatism among doctors and quite a bit of arrogance," he says. "Today there is a dominant sect in medicine that favors anything that has been scientifically proven - all the rest is inconsequential. But what Alex is doing with dance has already appeared in the international literature and in other treatment centers in Germany and especially in the United States. The top Parkinson's specialists in Israel recommend it highly. They are aware of the fact that what creates dopamine in the most natural way is walking an hour a day or what Alex is doing."

One of the scientific studies on the subject was carried out four years ago by Kerten himself and Dr. Marietta Anca, director of the clinic for movement disabilities at the Wolfson Medical Center in Holon. "It was a pilot that we did with 16 patients, at different stages of the disease, over three months," says Dr. Anca. "We examined every patient before and after Gyro-Kinetics therapy twice a week for an hour and a half. We wanted to see the immediate and cumulative effect, and which parameters improved. It turned out that the therapy is very effective immediately. Parkinson's patients function on medications every few hours, the way a car operates on fuel. When the effect of the medicine ends, you have to take a pill. In the work we did there were instances when people didn't have to take a pill after the therapy."

How can that be explained scientifically?

"There are studies on the fact that peripheral activation of the limbs causes a positive stimulus to the brain that arouses the cells in that region, and they in turn send pulses back to the limbs. That is how they explain the effectiveness of physiotherapy in paralysis. The same thing happens in Parkinson's. That's why people who engage in activity need less medicine. What is unique about Alex is that his method is very complex and broadly activates all the parts of the body. Long, wide, round and short movements lead to various levels of muscle contraction. If you add the music to that, the process becomes very complex, activates two stimuli simultaneously, each of which is effective in itself. It combines musical activity and movement at the same time, and it helps Parkinson's patients to reorganize their walking strategies."

And over the long term?

"There is definitely a positive cumulative effect. Alex has a patient who for seven years has refused to take medicine, and every day she does the exercises and has managed to this day to avoid medical treatment."

So why does part of the medical establishment reject his methods?

"Doctors are a very conservative group. Especially doctors from the previous generation, who were unwilling to accept innovative methods of therapy. I found out about it from patients who came to me and told me, and when I saw that they had improved I went to Alex to see what it was. Afterward I looked at the literature and found explanations for all these things. We doctors are always looking for scientific proof, and after more than 20 years I can tell you, with great regret, that all the medical statistics are a bunch of nonsense. When I studied medicine, one of the professors told us: 'There are no diseases, there are only patients.' Statistics are good the moment you have to introduce medicines into the health basket and the market, and not when you're treating human beings."

Instead of grating cheese

According to the statistics, between one and two percent of the population will contract Parkinson's after the age of 50 - in other words, they will suffer from a serious chronic shortage of dopamine in the brain. Most of them will be men; for every two men with Parkinson's there is one woman. No one knows exactly what causes the disease and it is impossible to predict who will contract it. The average age of diagnosis is 58, although there are patients aged 30 to 40 who hide their disease as long as they can. They keep their trembling hands in their pockets and try to avoid the harsh social image of the disease that results from its overt motor symptoms: tremors, stiffness and a slow gait. It is generally assumed that the incubation period is about five years, during which there is no early sign heralding its approach.

"In genetic studies, they have found that it is more common among Ashkenazim [Jews of Eastern European origin]," says Daniel Neuman, chair of the Israel Parkinson Association, which has about 1,100 members (out of 20,000-30,000 patients in Israel). "One of the signs of approaching Parkinson's is damage to the sense of smell, which takes place long before the outbreak of the disease," he says.

The medicines existing on the market neutralize the symptoms, calming the tremors, but do not solve the problem. After several years the body may become accustomed to the medication and react in an unpredictable manner. Parkinson's patients call it the on/off situation: There are hours when they feel balanced, but at other times movements become uncontrolled.

"One of the problems of Parkinson's patients is that they shut themselves up at home," says Neuman. "The shortage of dopamine in the brain causes depression and arouses a fear of public exposure, accompanied by a fear of bumping into people and falling. You don't die from the disease, you die from a fall. The previous chairman of the association, for example, got out of the car, fell and died a few months later from the blow to his head. Moreover, as the disease progresses, they begin to speak slowly and quietly, and then they can't be heard. Most of them give up and stop going out."

Here Kerten enters the picture with his Gyro-Kinetics technique, developed on the basis of his knowledge of martial arts and the intense concentration and physical control they demand. Kerten tried to teach Parkinson's patients these abilities. While they are dancing in his workshops, the patients learn to translate the external beat into an inner voice that gives them orders to lift their hands and feet in coordination, a voice that ostensibly bypasses the cells that have deteriorated.

"When you place a metronome in the pocket of a Parkinson's patient, it helps him walk," says Neuman, a retired computer engineer. "Alex plays music with different beats, and that does a similar job." Prof. Djaldetti says that the rhythmic activity stimulates mechanisms in the brain that manage to bypass the cells that have atrophied. "It links up to routes that for healthy people are natural and automatic. For Parkinson's patients the physical activity activates them indirectly."

Robert Rubin, a 57-year-old attorney from San Francisco, married with three daughters, was diagnosed with Parkinson's five years ago. He began taking medication and hoped that would be the end of it, "but I quickly understood I was deceiving myself," he says in a telephone conversation, "that I was not initiating anything but was dependent only on drugs. I have always been very active and athletic and very competitive, I have a high level of self discipline, I'm used to fighting and winning tough cases, and here I was suddenly totally passive. I did acupuncture, massage, but nothing really helped. Then I met Alex."

Three years ago, Rubin visited Israel and met with his girlfriend of 40 years ago, Dorit, now Kerten's wife. The meeting brought him to Kerten's studio and to dance therapy. After that he visited Kerten twice more, each time for an intensive week of therapy. He says that he has tremors in his hands and problems of balance, and that Kerten's therapy helps him mainly psychologically. "He said I have to play the role of a healthy person as much as possible. He imitated my movements and I understood that my face was expressionless. Now I have a large mirror in the office and I make faces in front of it. I try to find ways of conveying to my brain what my brain does not do by itself. Until then, when I walked my legs became entangled and my hands hung frozen on both sides of my body.

"Anyone who doesn't have Parkinson's doesn't think about the steps he takes in the street or about how his hands are raised during walking. Now, thanks to Alex, when I walk I think all the time about how to place my feet on the ground and how to raise my hands in coordination. If I don't think I step on myself. It's a Zen technique, to be here and now. To live the moment. I walk to the office less, but I still work as usual and appear in court. I'm open to the disease in a personal way, less in a professional way; I don't want people to think that my abilities have been affected."

How does it affect your family life?

"When we eat pasta, the girls ask me to grate the cheese for them. And when there are earthquakes sometimes my youngest daughter asks me to stop moving the table."

One, one hundred, one thousand

Kerten's parents met in Israel, in the Haganah (the pre-State paramilitary force). His mother, Bella, immigrated from Poland, and his father, Egon Kerten, a well-known musicologist, immigrated to Israel from Prague in 1940 on the deck of the illegal immigrant ship Patria, and was miraculously saved from drowning. (The ship was accidentally blown up by the Haganah and 267 passengers drowned.) He has taught generations of musicians in Israel, was among the founders of the Israel Radio orchestra, established the Israel Chamber Ensemble with Gary Bertini and afterward was invited by the Turkish government to turn Radio Istanbul into Radio Europe. Alex, who was born in Tel Aviv, was six years old at the time; the family went to Turkey for a year and stayed for eight.

In Istanbul Kerten studied at a British school. In addition to English, Turkish and French he studied two other things in Turkey: boxing and music - music with his father and boxing in the street. "The school made me very tough," he says. "It was an international school with the children of diplomats, but they called me 'dirty Jew, cowardly Jew.' There were a few other Israelis there, and we all got organized and I started my boxing club. There wasn't a day when I didn't get into a fight."

When they returned to Israel his father went back to Israel Radio. Kerten studied for a year in a school in Tel Aviv - and says he achieved his reputation thanks to his boxing ability - and then switched to the British school in Jaffa, where instead of boxing he was able to develop his music. He was a guitarist and eventually participated in plays, various performances, and in the Zadikov Choir, a very successful choir for adults and children whose members were Bulgarian Jews from Jaffa. When his father retired from the Israel Radio orchestra, Alex replaced him. He began his military service in the Combat Engineers Corps and ended up in the Israel Defense Forces orchestra. In the reserves, almost until the age of 50, he was in charge of the reserve ensemble of the orchestra and had the privilege of accompanying the Hagashash Hahiver entertainment troupe, singer Chava Alberstein and Harry Belafonte.

After his discharge he turned to his second love, martial arts. "Apparently I had a subconscious spirit of adventure, after the Holocaust, in order to prove that I was a strong Israeli, not afraid of death." He traveled all over the Far East - Japan, Hong Kong, Thailand - and sustained many tough blows and injuries. "It suited me. I believe in the brain, but at the time I was not yet aware that the dominant element in martial arts is that with it you can control your body, as well as pain and fear. In Japan I had a friend, Doron Navon, who is still there, and I trained there with the greatest masters. On the way, I was very seriously injured in
Thailand; I was hit in the knee while practicing Tahi box."

He underwent two operations at Sheba Medical Center in Tel Hashomer, and the prognosis was that he would not be able to return to athletic activity. "My leg was totally straight, and I couldn't bend it." But he refused to accept the decision and examined other possibilities. "I decided that I would rehabilitate myself," he recalls. "I climbed mountains, went skiing, but nothing happened. I was told that there was perhaps one person who could save my leg, a man named Gad Skornik, the Israeli judo champion. I went to him. He grabbed my leg and said, 'You know that I've always loved you with all my heart,' pulled at me with all his strength and broke my knee. I fainted, but then it healed and the cartilage was built up. I joined Gadi, began to train and we worked together for 20 years. I became one of his leading teachers; it was my religion. We developed kempo jitsu, which is now the IDF method. We trained the members of the department and the Shin Bet security services."

Alongside his work in martial arts - courses, workshops and teaching - Kerten founded a company for the manufacture of children's clothing that became a large family firm called "K," which is now run by his first wife and their three children. "At first we built a sewing factory in the Ramle Prison and the Neve Tirzah Prison; none of the big companies that bought from us knew the clothing was made in prison."

Over time, he stopped playing instruments, but did not abandon music. "When I worked in martial arts I always worked with music. At some stage I began to research the influence of jazz rhythm on the heartbeat and pulse, and at the same time I treated people with movement disabilities. Almost everyone who works in the martial arts treats people. I treated problems of concentration, breathing and posture, and at a certain point people with Parkinson's began to come. One, two, 10, 100, 1,000. It happened on its own and I discovered that I had a very broad knowledge of the disease. Like an artist who knows how to paint things that he feels, or a pianist who feels the music, in the same way I feel the person just by looking at him. I know how to diagnose his breathing rate. At first I had a lot of question for doctors and physiotherapists, who were not so understanding."

Those who spoke in Kerten's favor were the patients themselves. Hanna Cohen Aharonov, 69, from Jerusalem, contracted Parkinson's when she was 57. Since then she has been taking medications, engages in various kinds of physical activity - walking, swimming, Feldenkrais exercises - and now Gyro-Kinetics as well. "My son is involved in music," she says. "He heard about Alex through a friend and tried to convince me to go there. I told him that I do so many things, but he urged me to go just for the diagnosis. I went and I was impressed. It really spoke to me both psychologically and physically."

She feels the effect in simple everyday activities. "At first I couldn't get up from the chair quickly, when there was a phone call for example, and Alex taught me how to do it. I don't want to take so many pills because they have side effects, so at night I don't take medicine and it would take me 15 minutes to get out of bed. Alex taught me how to get out of bed. These are little things, but they make life easier. Since then I've been attending a group in Yad Sarah in Jerusalem taught by a student of his. It's amazing sometimes that I can't walk, it's hard for me to move, yet when I hear music I can dance to the rhythm."

Healthy with Parkinson's

Kerten speaks through his belly. He has a round one, somewhat bigger than usual in teachers of movement and physical activity, but he caresses it with great affection and explains its existence - aside from his love for croissants - as ideological. "All our philosophy is constructed around the round belly, as the center of intelligence and information. In the East they say: 'You're very intelligent, you have a round belly.'"

If the connection between the belly and the brain is responsible for physical and emotional balance in general, this is even more true in Parkinson's, when the body loses its synchronization.

"When there is no connection between the heartbeat and the brain waves, breathing and pulse, the entire body loses its synchronization. I know how to get them synchronized, to a situation where the breathing, the brain waves, the pulse and the movement begin to come together," says Kerten.

He works slowly. Before he brings patients into the dance group, he prepares them for several months with passive methods, massage and touch on the treatment table. "I teach them how to breathe. To stop thinking. Not to hear and not to see, but to listen to the music. We practice rhythm. Afterward, I teach them how to conduct an orchestra. To use facial expressions. And only then do they join the group. At first they improvise with their feet and hands and finally with their entire body, and suddenly the difficult things become easy. It's easy for them to walk. If they can walk to the theater without falling along the way, or sit in a cafe and talk to other people, that's already a tremendous success."

What's the key word or phrase?

"'I can do it.' To live the present and not worry about the future. You learn to take responsibility for your body, because the disease is not that of your wife or your children. You are responsible for it and for your life. It's like religion: There are no miracles; there's hard work. You have to work out at least twice a day, morning and evening. There are people who believe in drugs, who say 'It's convenient for me not to do anything.' I don't suit them. I suit those who believe that you don't have to be a professional Parkinson's sufferer, but rather a healthy person with Parkinson's."

A British couple, Estelle and Laurie Philips, she a psychologist and he a psychotherapist, live in southwest England. The two heard about Kerten from Robert Rubin and came to Israel two months ago for 10 days of dance therapy. Estelle has been suffering from Parkinson's for six years. "It was a complicated process," says Laurie in a phone conversation, "because her movements were restricted and she had a problem with balance. In a sense, the therapy was perfect for us because we danced a lot before she fell ill."

What did you find in Kerten that you hadn't been familiar with previously?

"It's entirely different from what we experienced in the past, and we've been through a lot over the years. I searched the entire Internet, I looked everywhere, and nothing has been as effective as this. I can say that he has a much better understanding of Parkinson's than anyone else. Most research is about chemical treatments and much less about what he does. It's not only effective for my wife but for our relationship as well, because since she fell ill I have become her caregiver, which I had never been before, and now I can separate myself from her and live my life. And she has received more self confidence and become less dependent on me. Even her desire to leave the house and do things has improved. It's true that you have to work out every day, and that's what she does. Now we're trying to organize a group of Parkinson's patients that will bring Alex here."

Four men in spotless judo outfits were rolling on the mattress to the strains of jazz music. Kerten sat in his deejay's cubicle giving instructions. They looked skilled - yellow and red belts - touched each other with the corners of their uniforms, put down their feet, pulled each other's hands from above and tried to get an ippon.

"I must say something to people from the medical world who have no awareness," said Dr. A. of Tel Aviv, a 64-year-old psychiatrist, at the end of the session. "I didn't get a recommendation from the neurologist who treats me to come here. But I'm a doctor, I understand psychophysiology and I know how the physiological systems in the body are constructed. We work here on coordination and that is definitely anti-Parkinson's. I don't know if I've undergone a change for the better, but there's no change for the worse, and that's quite an achievement."

Chapter 16

2006-05-20T23:18:00.004-04:00

Parkinson’s chain letters!

Back by popular demand! The official soundtrack of parkinsonsdance.blogspot.com
The Sabre Tooth Tiger Edition of Bob’s Basement Bootleg Blues for Baby Boomers Battling the Beast

It’s an MP3 Data disc offering you 13 and 1/2 hours of music that Parkinson’s blues fans dance to every day. And it circulates around the world as a chain letter. We guarantee that after you purchase this fine collector’s item, you will never, never be attacked by a Sabre Tooth Tiger. None of our competitors offer that guarantee. It’s almost all Blues, selected from the thousands of hours of Blues in Darcey Jerrom’s library at Friday Night Blues & Beer at dustmybroom.com. But it is not all Blues: we sent a copy to a Parkinson’s dance group in Barcelona and they added on some songs in Spanish and Catalan and sent it back, so we dance to each other’s music, and then I think it was Carlos Hernz (“Bad Kitty Fridays” “I Has The Parkinson’s”) who added the Radio Tarifa drums (radio station that serves southern Spain, Gibraltar and North Africa) and then Madman Marty added in some Dead Can Dance, with a note saying “well I guess then we can dance too”, and somebody in Poland added a few tiny bits of burning Gypsy violin – wish we had more of that.

Anyway, that’s how it works. It’s a chain letter. You download the music onto your computer; dance to it a lot until you find the songs that speak for you; the songs that have an emotional impact on you, the songs you can imagine yourself singing to a huge audience or to one person. Then you delete the songs that you don’t like, add in some more songs that you like, burn a new disc, and pass it on to someone with Parkinson’s or to someone without Parkinson’s who should know about it. It’s a chain letter. Do not break the thread. Pass it on, and you will win the lottery and famous movie stars will ring your doorbell, wanting to go to bed with you. Fail to pass it on, and there is a mathematically quantifiable possibility that you will be struck by a meteorite, a misfortune so rare that they will name it after you.

EXTRA SPECIAL BONUS TRACK

For the first time ever, the Sabre Tooth Tiger edition of Bob’s Basement Bootleg Blues for Baby Boomers Battling the Beast contains a SPECIAL BONUS TRACK !!!! By popular demand, we have added a wedding song chosen by The Breeze: “Baby Likes to Rock it like a Boogie – Woogie Choo Choo Train.”

Our money-back guarantee: If you are not fully satisfied with this dance music, return the portion of the music you have not listened to and we will return the portion of your money we have not spent. None of our competitors offer the same guarantee.

AT A PRICE THAT CONTRIBUTES TO GLOBAL DEFLATION.
How much do you usually pay for a one-hour album, with 7 or 8 songs, of which you only like 2 or 3? Maybe $25?
So 13 and a half hours of music would cost you $337.50.
And how much are we charging for 13 and a half hours of great music?

$10 Canadian!!!

That's right! For only $10 Canadian, or some vaguely equivalent amount in some other currency, shipping and handling included, we will burn 2 discs on a computer, mail one to you, and give the second one to someone with Parkinson's or someone without Parkinson's who should know better.

Don’t delay! Click here to send an e-mail to the Parkinson’s Blues Chain Letter Committee. We will e-mail back, revealing the top secret address of our World Headquarters, and then you can send the $10 check, money order or something interesting and we will send you a copy of the exclusive Sabre Tooth Tiger Edition, burned one at a time, especially for you. When the cure for Parkinson’s finally comes (and it will) you will have in your possession this unique artifact, a musical chain letter of dance music for people who are not supposed to be able to dance. Order your copy now and play it LOUD.

It's just an example. Make your own. Whatever kind of music turns you on, baby. Whatever floats your boat. Do your own thing in your own time in your own way. Maybe you want waltz music. So, delete a bunch of songs you don't like and add music you do like and pass it on. It's music for people who are not supposed to be able to dance. But they do. What's up with that? If enough people ask the question maybe someday somebody will look for the answer. It would be interesting to know. Maybe dancing is just a temporary rush, like a strong cup of coffee. Or maybe the dancing and music part of the brain is heavily re-enforced and highly protected, because we were dancing tens of thousands of years before agriculture; we were making music and dancing before we had language, before we had shelters. Banging on sticks and chanting and dancing scared away the sabre tooth tigers. Just as, last week, a neighbour put up a “For Sale” sign on his lawn. As we say, PLAY IT LOUD. If the neighbours do not call the police, then it is not LOUD enough. The music has to drown out that chatter in your head and you have to find the Zone where you float and you're completely in harmony, lost in the music. And for wonderful moments, you are cured.

And that's what this Sabre Toothed Tiger MP3 is for. We dance to it. We even compete with ourselves and each other, over the internet. (Few of us have actually met.) When it's someone who can barely walk, who cannot feed themselves because they cannot hold a spoon, they cannot button or unbutton a coat; the first time they get up and dance and everybody is stunned; usually they just get through the first song. Is it possible to extend those minutes into hours? Is it possible to extend those hours into days? Is it possible to extend those days into years? I mean, I'd go for that.

And so, one song is not enough. Soon you dance through three songs. And then somebody reports they danced starting from I Got the Blues All over Me:
"The Blues got in my eyes last night, and I couldn’t sleep
the Blues got in my mouth at breakfast time, and I couldn’t eat
you know I got the Blues all over me
the Blues got in my mouth and I couldn’t talk
the Blues got in my feet like arthritis and I couldn’t walk
I wonder why the Blues won’t let me be”
(a perfect description of Parkinson’s)
And they danced all the way to Born to Play the Blues:
“Some folk was born to fly airplanes
some folk was born to stay on the ground
some folk was born to lift your spirits
some folk was born to bring your sprits down
some folk was born to tell you the truth
some folk can’t help but tell you lies
it put my mind to wondering
maybe some folk was born just to play the Blues.”

And some people eventually get through the whole 13 ½ hours. Not dancing all the time – taking breaks and all, and generally horsing around, taking the whole day off; letting the music flow through them for 13 ½ hours. The absence of symptoms is not perfect – you have to fight sometimes to keep yourself in the Zone; you tend to drift in and out, it takes a lot of persistence and joyous effort. TRY IT. I MEAN YOU OUT THERE, WHETHER YOU HAVE PARKINSON’S OR NOT. TRY TO FOLLOW THIS FOR 13 ½ HOURS. Can you keep up with us Parkies on the dance floor?

This disc is also to help you search for Blues Advice, when the Johnny Walker Wisdom runs out.

Here, for example, Penny Lang advises you to find out what fills you with bliss (the Zone) and to follow it: (Penny’s Blues)
I never once did anything at the moment I did not want to do
Some say I’m just plain crazy
But I look back and say what the hell is wrong with you
You got the money-man on the left
You got the landlord on the right
You got not another job for three months
And you’re out of sight
You’re losing it baby
You got to try to keep it all in
So you just stay in your kitchen
And paint another wall or write:
“It’s time to begin”
You know I have friends who like to act
And some paint and some like to dance
They’ve been working at their craft, you know
But they never even get one chance
And they’re doing ok with what they do
But they just can’t seem to get it out to you
But what I want to say is
You’ve all got something you know that you can do
You’ve all got something that gets to you
But if it hits you the wrong way
Honey that’s not the thing you should be paying attention to
Find out what it is
He said “Follow your bliss”
That man knew what it is we ought to do

Penny Lang
Follow your bliss.

Chapter 17

2006-05-15T22:54:00.002-04:00

They gave Kate Kelsall a card to show to people. It reads: “I am not inebriated and it is not contagious”.

Kate Kelsall

See that woman in the garden playing the accordion, with her open face and her warm and joyous smile? Yeah, her. That’s Kate Kelsall, and they put a warning label on her. The government re-assures you, that despite playing accordion in the garden, she’s not drunk and she doesn’t have bugs. So what are they afraid of? Maybe she is too free? Or too happy? Or they are afraid they could never be as strong in the face of adversity as she is? So they gave her a label: “not drunk, not contagious.” Thing is, she is not the one who needs to carry a warning sign. If Parkies have to be labelled, everybody should have to be labelled.

She should have a card saying, “I am not inebriated but you seem to be.”

She should hand out cards saying, “What the hell is wrong with you?”

Kate Kelsall is not drunk and she will not infect you with viruses, but the experts failed to register that her spirit is contagious. And that is far more dangerous.

Could somebody straighten out the medical industry about what is going around out here? The scientists will not reach the moon if they keep aiming at the wrong one.

They should be encouraging more people to be like Kate.

In case you hadn’t noticed, this is an advocacy website about one school of thought. We want to find out if we can migrate to the part of the brain that handles dance and music, because Parkinson’s does not damage that part of the brain.

But we will be just as happy if the cure for Parkinson’s comes from some other school of thought. That’s why Kate Kelsall’s website is one you must visit. She watches over the whole scene, with an open mind and a generous spirit.

Kate Kelsall is a musician, dancer, writer, and den mother to us all on the Parkinson’s internet. She is our reference point when we need a sanity check about Parkinson’s, when we need to regain balance. Her website, with all its links and archives - is complete, informative, humane, many-sided. Shake, Rattle and Roll

She has two signature anthems: "What a Difference a Day Made" and "I Can See Clearly Now". She means it. And she is generally not inebriated and generally does not have the ‘flu. But she is contagious.

She describes better than anyone else what we all went through, that first day:

The Answer

By Kate Kelsall at Shake Rattle and Roll (excerpt)

I squeezed into the tiny exam room. Although I was only 46 years old, I looked like a senior on a cruise, dressed in my green and white striped polyester pantsuit, fresh off the rack from J.C. Penney’s.

The 85-degree temperature probably broke a record. I didn’t know if it is the heat or the humidity, but it was certainly hot.

I was oblivious to the sun-shiny day. The mountains in the west were a blur. The birds chirped outside, and I hated them. I wanted to be anywhere else, except in these confined quarters.

Instead, I was at the Neurology Office of Kaiser Permanente in Westminster, Colorado, on May 8, 1996, waiting for the answer as to what ailed me. For nearly six months, my left hand shook. My left arm hung there like a dead animal. I dropped things. People told me I had a blank facial expression. My voice was soft and raspy. Typing on the computer slowed and became punctuated with errors. A typed word such as “home” appeared as “homeeeeeeee” on the computer screen. My fingers grew minds of their own.

Although, I tried not to worry, I secretly hoped this physician would have the answer and prescribe medication that would take care of my medical woes.

When the physician entered the room, I sat up and tried to act alert. She looked more like an attorney than a doctor in her business suit. She was short, slim and appeared to be in her thirties. We both hovered around five feet. Her first name was Mindy, but I knew I wouldn’t be calling her that. I wanted her to be the one with the answer. Dr. Mindy Wiener became my neurologist. I’d had an internist and an OB-GYN, but never a neurologist.

During the prior two months, she administered neurological tests. She had asked me to open and close my hands and tap my feet. She had attempted to push me over from behind. She had requested that I take off my shoes, outstretch my arms, and walk with one foot in front of the other. My body fell hard against the cool tile of the exam room. I failed that test. She scanned my brain with an MRI, zapped my nerves with electrical currents, and then referred me to specialists.

I sat with Dr. Wiener on that hot afternoon as she reviewed my tests and scrutinized the medical reports and X-rays. Her mouth pinched, and brows furrowed.

I distracted myself by looking away at the walls, which were undecorated except for her certificate of residency in neurology from the New England Medical School Hospitals in Boston. The silence was excruciating. When she finally did speak, her words seemed scrambled. I leaned forward and focused to understand.

“I have good news and bad news,” she said. “The good news is that you don’t have a brain tumor, Lou Gehrig’s disease or Wilson’s disease. The bad news is that it appears that you have Parkinson’s Disease.”

Somehow I missed the part about the good news. I didn’t want to have anything to do with any of those dreadful diseases.

Too afraid to ask out loud, I silently questioned: Will I end up in a wheelchair? Will I be able to work until retirement? What about playing in the accordion competition?

I left the land of health and entered into the land of illness, a different country, where I became a permanent resident.

I was issued an ID card that says in big bold letters that I AM NOT INEBRIATED, that I have a medical condition called PARKINSON’S DISEASE, and that it is NOT CONTAGIOUS.

Dr. Wiener had the answer. It was not the answer that I wanted to hear.

Postscript:
Kate had the courage to have the Deep Brain Stimulation (DBS) surgery performed on May 4, 2005. It terrifies us all, that operation. It caused her to suffer for two years, but since then she has found ways to make it help her. Today, she continues to play accordion, solo and with the Silver Notes Ensemble, and she continues to dance with the Rockyettes, a Colorado take-off on the Music City Hall Rockettes of New York City. She volunteers with DBS patients and their families at the University of Colorado Hospital and co-leads a DBS support group. She participates in yoga classes three times a week. She maintains and continues writing her blog, the go-to site for us Parkies when we need a full and level-headed and well-written description of what is going on with this beastly disease, and when we need to be comforted by her calm and her warmth and her acceptance of reality.

Here at the Parkinson’s Underground Internet Conspiracy, we are printing up cards and giving them to Parkinson’s patients to hand out in the street and during conversations, as many as required, depending on the situation.

The cards say:

“Heavily drugged, wants to dance.”

“I have Parkinson’s. WTF is your excuse?”

“Wanna snort some Mirapex, baby?”

“Not inebriated. Please get me some booze”

“Come with me to Vegas.”

“No known cause, no known cure. A lot like you.”

“Part of my brain is dead, and it was my favorite part.”

“Your tax dollars at work.”

“Parkinson’s: $200 million a year research; nothing new in 60 years. Just give us the money and bugger off.”

“I was okay until I met you.”

“They are doing experiments on me. Are you one of them?”

“Mind-blowing.”

“Who to sue? Who to sue?”

“When you hear sizzling and smoke comes out your ears, you’ve got what I’ve got.”

“I have trouble undressing myself. Want to be a good citizen?”

“What the hell is wrong with you?”

“I call myself a spastic. What do you call yourself?”

“When I fall down, I am just practising for my sky-diving classes.”

“The Parkinson’s Underground Internet Conspiracy – rich, powerful, stoned on levodopa, and coming to your neighborhood sooner than you think.”

“Don’t drink the water. It’s in the water.”

“There, but for the grace of God… no, wait a minute.”

“And to think that I used to vote Liberal.”

“So just exactly what are you afraid of?”

"Seen any sabre tooth tigers recently?"

“At least it teaches me a lot about you.”

“They will stamp you, and they will label you. Like they do with pants and shirts.”

“We will soon be a majority. Things will change.”

“We are pretending to have Parkinson’s, just like Michael J. Fox.”

“We can’t dance, the experts say. But we are awfully good stuntmen and body doubles.”

ANY MORE QUESTIONS, MISTER?

ANY MORE QUESTIONS?

The Rockyettes

Kate Kelsall. The show must go on.

Chapter 18

2006-05-10T21:06:00.001-04:00

Eradicate Parkinson’s Disease from the face of the earth, forever.

I was sitting at the window, looking out at the warm summer rain. That’s my driveway, lined with maple trees planted by the children of the man who built the house in 1840. He built it for beauty, as a statement of love for a woman, and he named all the local roads for her and for their children.

The view above is from the west side of my house. It’s on an obscure back road in rural Quebec. I was sitting there at the window, looking out at the rain.
(to be continued)

Dr. Bin Hu, from Beijing, Shanghai, and Calgary! The space between the photo above and the declaration below is where you came in. To be continued soon. The declaration:

We had a war against polio and we won.
We had a war against smallpox and we won.
Now we want a war against Parkinson’s.
And we will win.
The objective is very clear and very straight forward:

ERADICATE PARKINSONS DISEASE
FROM THE FACE OF THE EARTH
FOREVER

Chapter 19

2006-05-05T23:32:00.011-04:00

Things happen

when a person transcends all the reasons
for not acting on behalf of another --
whether it's fear, anxiety, repulsion, or ignorance.
Something happens in that interchange
that is incredibly creative

See that blonde woman in the middle of the photo? That’s Jeanine Young-Mason. In Iraq. Talking to Iraqi nurses. Teaching at the School for Nurses in Baghdad. In 1987. Think about it.

The wars we have fought and won. Against polio, against smallpox, against infant mortality, against famine. And there are many more such wars we could win. There are brave people who choose their wars carefully and go to the front lines where there are the most casualties; they win wars against the diseases that are enemies of the entire human race.

Their victories endure forever, around the world.

I got up at 4:00 a.m. In early June, that's an hour before sunrise. The hour of the wolf. The hour of the most deaths and the most births. The hour when the enemy attacks. A most excellent time to go walking in the forest.

I took mirapex, selegiline, and levodopa and waited for the impact. At 4:30 a.m. I went outside with a flashlight, but I was walking like one of those new Japanese robots, mobile, but stiffly mechanical. And try as I might, I could not stop dragging my feet--I could not lift my feet—I stared at my feet and cursed them and cajoled them, and tried kicking things, but they just would not listen. My muscles were either unable, or unwilling, to move the way I wanted them to. Dangerous to go walking in the forest where there are so many things to trip over. So I went back to the house, by which time the levodopa was kicking in, making me a highly agitated speedy robot, so I took another hit of selegiline. Sweet Sister Selegiline, put your cool cool hand on my head. And I put another hit of Mirapex in my pocket, just in case. You never know when a hit of Magical Mysterious Mirapex may be just the thing to pull you through.

I walked in the forest for an hour, sometimes in silence, sometimes listening to music on my earphones. Dylan was singing “They don’t like you to be so free.” I checked out trees that I could cut down for firewood. My feet did exactly as they were told. I could have run a race.

I went back to the house around 6 a.m. and turned on the computer. This website was getting a lot of hits. They go in waves, so there is nothing special about that. But it was strange that, whereas most visitors check out one or two chapters that interest them, many of the recent visitors were staying on the site for a very long time, reading every single page. That’s a lot of reading, a lot of time. What for? Who are these people? Errr, whassup, doc?

So I queried Google Analytics. The map over-lay showed that these visitors were in clusters – highly concentrated in a few cities. I dug deeper into Analytics and it showed that the hits were coming from inside major teaching hospitals, and from the neighbourhoods around them. I queried Analytics again, and found out that these visits were coming from a referral in a magazine I had never heard of: Clinical Nurse Specialist.

From there, Google led me to Jeanine Young-Mason, EdD, RN, CS, FAAN, Distinguished Professor Emeriti, School of Nursing, University of Massachusetts.

And her message was:

“It was not surprising to me to learn that there is a movement across United States now to provide music and dance classes for those with Parkinson's disease.”

A movement across United States--that's the kind of talk I like to hear. It is actually happening. To provide music and dance… Holy Cow! Did you read that? People are actually talking about it? That’s great.

There are many millions of people in the world who have Parkinson's Disease. And they have spouses and parents and children and friends and neighbours and loved ones and care-givers and doctors and nurses and scientists and pharmacists... and dancers. Millions of people are involved in this.

A startling thing about having Parkinson’s is the way other people react.

The ones who try to break down your spirit are just doing what they always do. They will make bold moves against you, thinking that you are in a weakened state. In business, there are even a few competitors who have called some of my clients, telling them that they should switch suppliers, instead of taking the risk of relying on someone with Parkinson’s. It’s like being followed by a pack of jackals while crossing the desert, with vultures circling overhead, waiting for the Parkinson’s patient to stumble and fall. The same ones tell you business is like war. It’s not. And if it was, they would throw the first rock and then run and hide. You know the type.

And there seems to be some sort of vested interest in portraying the world as being all violent and wicked and corrupt, and everybody is a victim, and nobody cares. And news is not news if it is not about something grim or gruesome. So you get the impression that the streets are full of murderers, deadly diseases are spreading like wildfire, there is no one you can trust; it’s all begrudgement and survival of the most vicious. Hatred, envy, war, and rumours of war.

Looked through the papers
Makes you want to cry
Nobody cares
If the people live or die

And it is easy to add a bit more to the despair, it is easy to curse the darkness while blowing out every candle that anyone dares to light.

I know you've heard it's over now and war must surely come, the cities they are broke in half and the middle men are gone. But let me ask you one more time, O children of the dusk, All these hunters who are shrieking now, do they speak for us?

Thank you again, Leonard. I don’t know what I would have done without you.

Having Parkinson’s, the most stunning discovery is when the clouds part, rainbows appear, the heavens open and angels dressed in white descend ladders, singing praises to the Majesty of Creation. It is very surprising the first time you see it, but then you start to realize it happens all the time. I’m not saying it becomes routine; I am saying you start to join in the singing.

From this broken hill
All your praises they shall ring

Agape is not for mortals? Well, then, if these be not mortal, then there are a lot of angels and saints. Having Parkinson’s, we have a vantage point to witness the generosity of the human heart, the beauty of the Truth and the truthfulness of Beauty, the good will among people; the surprising dedication of those who consecrate time and soul to doing saintly things and magical things and effective things, working bravely and fiercely and lovingly on the front lines where the casualties are the heaviest. As Toulouse Lautrec said in Moulin Rouge --- it is spectacular, spectacular.

From this broken hill
I will sing to you

Where do all these angels come from? Don’t they read the newspapers? This is supposed to be a cynical society, a “me, me, me” generation. Fear and contempt and greed and war and rumours of war. But let us bring forth witnesses who have glimpsed the moment when people in despair start to weep with joy, when a painter swoons in front of a Vermeer, when a first responder runs into a building that everyone else is fleeing, when a nurse works the night-shift in an understaffed emergency ward, when Parkinson’s Apathy and Parkinson’s Anxiety are switched off in an instant, and people who can hardly walk get up and dance to the Beauty of it all. We are surrounded by a cloud of witnesses There are millions of such witnesses; you can hear the angels sing from above. And you can learn to sing with them. As Jeanine says, compassion is substantially a learned behavior, and hope is contagious.

All of a sudden, that night, she turned to him as he paced the hallways of the nursing home, silent and locked inside himself, alone and wounded, and she said, "Do you want to dance?"

"Oh yes!" Was the reply.

Thereafter when she was on duty and free the two would dance together.

Dance me through the panic
Until I’m gathered safely in

Jeanine Young-Mason is a nurse. And a teacher of nurses. Teaching nurses to combine art and science; compassion and rigorous preparation. She has seen it all. There are hundreds of stories she could tell.

She has been writing in the Clinical Nurse Specialist for 18 years. She has published a prodigious amount of original work; books, articles, interviews.

She says: "compassion is the essential topic in medicine and nursing. A lot of people confuse compassion with empathy, pity, charity, or this warm, fuzzy feeling when gets when one sees someone suffering and wants to be closer. But compassion is tough stuff. Things happen when a person essentially transcends all the reasons for not acting on behalf of another -- -- whether it's fear, anxiety, repulsion, or ignorance. Something happens in that interchange that is incredibly creative, so when people are compassionate on behalf of those who are suffering, they are refreshed. Aspiring nurses and doctors should come to terms with the cost of it, and the rewards, and if they don't feel called to overcome indifference, that it's far better that they pull out. Don't choose a profession which absolutely requires that you be prepared for the task of human relations. Never mind this doctor-patient or nurse-patient relationship -- it's about human relationships and what it costs to be present for other individuals in a vulnerable state." (“The Interview”, John Koch, Boston Globe).

She teaches tough compassionate nursing, and the connection between art and health.

Some of the books she has written: the titles alone say a lot:
The Patient's Voice: Experience of Illness (in English and Japanese)
States of Exile: Correspondence between Art, Literature and Nursing
21 Words For nurses
Clinical Nurse Specialist: Journal for Advanced Nursing Practice
Critical Moments: Doctor and Nurse Narratives and Reflections
And she teaches the expressions of compassion in Kurosawa’s Ikuru, the understanding of suffering and compassion expressed by Sophocles, the body language of Rodin’s sculptures, Tolstoi’s Death of Ivan Ilych; and consoling the inconsolable.
Her website : www.arts4health.org

In case you weren't listening:
"Compassion Is Tough Stuff"

Jeanine Young-Mason has hundreds of stories to tell; the one I chose to relay to you is about Parkinson’s. One of her young students, wanting to become a nurse, but didn't have enough money to pay room and board and tuition in the school of nursing. So she volunteered to take the Certified Nursing Assistant course in a local nursing home. There, she worked the night shift. A volunteer, in an institution for people expecting to die soon.

Jeanine wrote this:

… “Finding that there were particular stretches into late evening and early morning when most residents were sleeping, she conversed extensively with those who could not sleep. Over time she and those residents together wrote life story sheets she shared with nursing staff.

Late at night and in the early mornings They would write life story sheets together

One gentleman, in particular, had great difficulty sleeping and he would pace the halls continuously with some difficulty. He seemed to her so unhappy. The student would walk alongside him up and down the corridors and encourage him to speak. Finally one night he told her: he'd been a professional dancer and had taught ballroom dancing for decades at an Arthur Murray studio in New York City.

That night, she turned to him and said, "do you want to dance?"

"Oh yes!" Was the reply.

Thereafter when she was on duty and free the two would dance together. He improved considerably, talked to people, quit pacing the hallways all night, and, like a gift from an angel, he was able to sleep.

Summary: just in case you missed the play, there were 6 acts. Pay attention; you will be called upon to play both of the lead roles in the play, first as the patient and then as the care-giver, and we are going to rehearse a lot before opening night. Of course you may improvise at will, but do not neglect to portray the original story. It is a sacred story.

[1] She volunteers to work the night shift in a home for the desperately ill. One man, with Parkinson's, speaks to no one, and paces up and down the hallways all night with considerable difficulty, as he can barely walk. He is closed in on himself and he is wounded and alone. So what does she do? She accepts his silence and goes with him. Walking up and down the hallways in the middle of the night, in silence. Night after night.

(2) Slowly, he begins to answer her gentle soft-spoken questions. She gets him to begin talking about his life. And then one night he tells her he had been a dancer and a dance teacher, in New York City, before he got Parkinson's. The disease had taken away his definition of himself.

(3) And here is the moment it happened. She did not fill out a form or make a report or even wait for further conversations. Following her instincts and training, she asked him if he wanted to dance.

(4) Yes he wanted to dance, and so they danced every time she was on duty.

(5) Many of his Parkinson's symptoms disappeared immediately. The dreadful Parkinson's insomnia, the tortured and anguished nights, lying in sweat and saliva with your face turned to the wall, trembling and pained, unable to sleep, exhausted at sunrise…

Suddenly he could sleep like a baby. A major sympton could be switched off like a light switch.

And the Parkinson's Apathy--not caring about anything or anyone, not caring even about your own life--suddenly the apathy was gone. The Parkinson's depression, the Parkinson's isolation, the refusal to communicate. All of those symptoms stopped, from one day to the next. He still had Parkinson's, he still had balance problems, he still had mobility problems, but his definition of himself came back alive. He packed up his bags and went home.

(6) Dear Budget Deficit Authority in Charge,
Total Cost to the medical healthcare system: $0
Total savings to the medical healthcare system: substantial
You do the math.

Let your mercy spill
On all these burning hearts

Have you been listening to the prophets?

One of the prophets describes a woman who rides the drifts like an escaped ski, her course is the caress of the hill, her track is a drawing on the snow in a moment of its particular arrangement with wind and rock. Something in her so loves the world that she gives herself to the laws of gravity and chance. Far from flying with the angels, she traces with the fidelity of a seismograph needle the state of the solid landscape. She is at home in the world. She can love the shape of human beings, the fine and twisted shapes of the heart. It is good to have among us such balancing monsters of love.

North View
Oil on canvas by Sören Dawson

Chapter 20

2006-04-30T23:10:00.039-04:00

…we are surrounded by a great cloud of witnesses, let us throw off everything that hinders, and run with perseverance the race marked out for us…

You are here.

I personally discovered the links between Parkinson’s Disease, music and dance. I was the only person I knew who knew what I knew. Then I went on that new-fangled electrical internet screen, and I found out there are other people who have known about this for some time.

Thousands of people.

For decades.

Maybe much longer than that? Centuries? Take up thy bed and dance?

Don't know. But Dance Therapy was recognized as a profession in the 1940's. Imagine this: the American Dance Therapy Association has 1,100 members. Wanna join? Well, it's not one of those weekly group hug events on Thursday nights at 7 in the basement of the Unitarian Church. For you to be certified to be my dance therapist, I just have to show up; you have to first go out and get a Master's Degree, and then you do the internship: 3,500 hours of intensely supervised clinical internship, battling a full range of illnesses and injuries. www.adta.org These people are serious; like surgeons and doctors.

So, if during their entire career, 1,100 certified dance therapists each teach 100 Parkies to dance, that's one hundred ten thousand Parkies, right? That's a lot of witnesses. The scientists must have interviewed and polled the 1,100 dance therapists and many tens of thousands of people they helped, right? And all the dance therapists are now making millions on television, Dancing with Forgotten Formerly Famous Celebrities? I love those dancing shows. Very beautiful. And even in the small towns, dance studios are popping up everywhere. I wish they would go back to calling them dance halls. It is magnificent that dance is making such a massive world-wide come-back.

But are there things that ADTA members could tell us, maybe about what they observed about Parkinson's people, or what? Did the scientists ever come knocking? Has it all been disproved, because even with 1,100 dance therapy teachers, nothing worth mentioning resulted from it? At a minimum, we know that dance and music improve physical and mental health. For everybody. And is very important for Parkies. But if we take it much farther - work at it intensely year after year - is it possible to re-train the brain to go around the areas that are damaged and make use of the areas that Parkinson's is too chicken to attack: the parts of the brain that handle music and dance. ADTA: This space, flexible in size, is for you:

Lenore Hervey is a leader in the ADTA. She sent me Aviva Lori's article about Alex Kerten (Chapter 15) and lots more information and help over the past 4 years. She is head of a dance / movement department at Columbia College in Chicago. She has been a major source of encouragement to me over the years.

I also heard from several other members of ADTA, and from their colleagues in a few other countries, such as Australia, I have lost track of some and this computer has so many crash-landings, I think it needs some Mirapex. So some may have to e-mail again.

I heard from Donna Newman-Bluestein, who watches over some of the public relations for ADTA. She has a website about the musings of a dance therapist, at dancetherapymusings.typepad.com

This chapter is open for people who want to say something. Can be just a few sentences. Or more. The Editor is severe and selfish. And slow. And compulsive. But if you have witnessed something about all of this, or have something to say about it, there is space for you here. It does not have to be about a person or a life. It can be about most anything related to whatever this is about. A reader's question: isn't music enough? Why pay for a place for people to dance when all they have to do is sit down and listen to their earphones? Or what? I would say it is obvious that physical commitment increases the hit rate. And why not choose to dance and thereby listen to the music also? Another reader's question: are you going to judge art for the extent to which it reduces your medical bill? Utilitarianism run amok? And the care-givers... And the Zone. Parkinson's cannot find the door to the Zone. Parkinson's does not dare attack that part of the brain. People find it in different places. Jules Olitski found it in colours. He would faint in art galleries. In hockey, it's the high-speed break-away, one-on-one. Some people appear to stay in the Zone a long time, such as Margie Gillis dancing. The Zone is when, well, you know how to describe it better than me, if you are a dancer. We are open to the conclusion that it is all just a temporary burst of adrenalin, a last flash of dopamine production, or maybe it's only a placebo effect. So don't be afraid to tell us all the truth. Dancing is good, so is a shot of whiskey. But I still can't get rid of the sight of that woman, getting up out of her wheelchair, and dancing. And my friend who pretends to be Hank Williams. No symptoms during a two hour concert. Unable to climb stairs without falling down. There could be a lot of interesting things happen if the human race finds out that there was some sort of reason why every culture in the world had music and dance tens of thousands of years before they figured out gardening, or shelter, or clothing. The point is not that the ancients win the argument because they were first; the point is that they win the argument because they were right. Art started before Andy Warhol, which is why he never found it. Art started before we built mud huts. There is a reason for that. Maybe it is a very necessary thing, not just something they have to introduce the Oscars. Maybe you need it like oxygen and freedom and pizza. That would be interesting, to find out that it's not a good idea to throw away abilities that helped us to survive and grow for tens of thousands of years.

Probably there will be another chapter after this, to outline the complex organisational structure and rules and regulations of the Parkinson's Internet Underground Conspiracy. First we take Manhattan. Then we take Berlin. Not as easy as it sounds.
After that, other than a possible report from University of Calgary in the fall, I will be on shore leave at times, waiting for a miracle to come, or attacking the ecology with a chain-saw, for firewood. Aggressivity towards the ecology is another thing that can reduce my symptoms, but it wouldn't be the same website. People just aren't ready for that. But from time to time somebody like me has got to practice what he preaches, and right now I have to step back, observe the Beast and its strategy and tactics, and take a run at it again, fiercely. The Beast has been gaining strength. Alex Kerten was right about it being hard work. We tell you to go dancing, to find the Zone, to get exercise, to battle the Beast as if your life depended on it. But we neglect to tell you it's not enough to go to the local discussion-and-dance group every second Thursday night at 7. It takes a lot more than that. A lot of time and a lot of effort, and flexible strategies depending on how the Beast fights back by changing the nature and the intensity of the mixture of symptoms. Is this all nonsense? Are we all barking up the wrong tree here? Well, it can't harm anybody to dance and listen to music and find the Zone and remember what we forgot about Beauty. But if we really fight hard, day after day, does the brain begin to accept a strategy whereby we would win? Parkinson's does not touch the ancient, powerful part of the brain that handles song and dance. Parkinson's is chicken. It won't take you on where it might lose. But are we able to stay where we are winning? Can we decide which circuits in the brain are going to handle our e-mails to our muscles? We want to go around the burnt-out dopamine section of the brain with high-speed connections with immense bandwidth, and a wicked cool soundtrack. That's how we want Parkinson's to be dealt with. The Baby Boomers have arrived at old age. It's going to get loud.
Give war a chance.
This space is for you: adta. Whatever you want to do with it; it's cool with me. I am completely humbled that there are these people who consecrate so much of their time and their human being as human and as being, to helping poor wretches like me. There are these dancers, you know, a thousand certified, thousands more freelance, and you know, they help thousands of injured people to fight back with dance. Every day. They have this freedom to move their bodies and they can just go, but instead they turn around and help the ones who cannot move their bodies properly, because they, the dancers, know what it is like to fall down on stage, and they know what it is like to dance in a state of bliss where all your earthly pains disappear for awhile, and you see fireworks where there are none. There is an entire association of people who do that. It is staggering.

(to be continued)

OH, don't run away if you are not in the association and do not have the Master's Degree and the thousands of hours of extreme internship, but you teach dance or dance by yourself or use dance to heal the wounded - America is like that. You can put a sign on your door and proclaim yourself to be a specialist in something - it's freedom, folks. But amazingly, they are. They are specialists in something. The healing arts, for one thing.

There was a time not long ago when I was the only person I had ever known who had Parkinson's, and I explored the disease extensively in my home and forest and barn. And I formulated certain ideas about it. When a sabre tooth tiger is chewing on your leg, you tend to pay attention and try to, rapidly, ascertain whether or not there is something could stop this from happening. It is NOT a nice little puddy-tat.

So after some time I knew about 4 or 5 other Parkies on the internet, never meeting them, of course; in most cases not even knowing their real names.

And then I look wider and wider and people e-mail me stuff about dance and Parkinson's.. and there are LOTS of sites about it and there are THOUSANDS of people devoting their lives to teaching the wounded to dance; and there are TENS OF THOUSANDS of Parkies who have been up dancing, and there are MILLIONS of care-givers observing the situation every minute of every day - just ask my wife, Ursula - and there will be TENS OF MILLIONS of Parkie patients around the world when the whole Baby Boomer generation starts wrecking the old age system. Well, if fixing this is a major re-hab and it's not in the nation's budget, fine. But TRILLIONS of dollars in savings would be there instantly if we could cure a few of the major diseases. So if PD is too tough, then move on in your triage and cure some other disease; but if there is some reason to suggest that barricading Parkinson's into its burnt out bunker and then going to live in the part of the brain that defeated the sabre tooth tigers.. if that is a completey absurd concept, then chuck the concept overboard. But I would like to point out that there are an awful lot of witnesses. When you have thousands of dancers and dance therapists out there; and tens of thousands who have participated, do the scientists know what these artists know? And what do the aritists know. And what do the scientists know. About this one thing. About this one question. How come my buddy gets better when he is Hank Williams? I know it's probably just that he is a nut case; but there are many other witnesses; there are people who couldn't walk and can dance. So, you know, just lay it on us. The truth. It's the placebo effect, right?
But one of us might be wrong. There are many witnesses who say they saw something entirely new to them. They often cannot relay clearly to us what it was. But there are these moments when those who dance, begin to dance, and those who weep, begin. And it is the witnesses who are weeping, to witness such a thing. I tell visitors it is in the water. You can't fool us.

Dance for beauty, not for disease

July 4, 2009

So I asked for witnesses, and within a day Kate Kelsall sends me some very special, significant quotes; connected to Olie Westheimer and the world-famous Mark Morris Dance Group taking their madness and their method to other parts of the world: whereas I had told them, based on information received from a famous rabbi, that first they would take Manhattan, then they would take Berlin. For strategic reasons connected to serendipity and justice, the dancers altered this: first they took Brooklyn, now they are taking Colorado. Together with Barbara Willis, who created a similar dance movement for Parkinson’s in Colorado, without having met Olie and the Mark Morris dancers.

It’s from an article posted on Kate’s Shake, Rattle and Roll:
http://katekelsall.typepad.com/my_weblog/2009/07/parkinsons-dancers-focus-on-dance-not-disease.html

It is very significant because it shows that this movement is spreading across North America (hello Sarah Robichaud in Toronto) and around the world (hello Alex Kerten in Israel); (hello PD dance group in Barcelona); AND it follows the party line that we love at this website; a very important commandment: FOCUS ON THE DANCE, NOT THE DISEASE. Olie promotes that concept – dance for Beauty; the disease does not deserve such attention; you get to the Zone easier by entering into Beauty than by cursing an evil disease; Beauty owes us nothing, it has no job to do other than to be beautiful. This is part of a long civil war in the arts community (“Should art be beautiful or is the purpose of art to denounce the running-dog lackies of the bourgeoisie by promoting ugliness, despair and revulsion?”). Lots of Parkies, Jimmybear being one, do not show interest in that debate; but notice that the beneficial impact of dancing is greater when they are not dancing for the purpose of achieving a beneficial impact. You are aiming at the moon for its beauty and to see earth from outer space; if the scientists want you to collect some rock samples, you will, but that has nothing to do with why you are going to the moon, it just makes it easier to get financing because they want to say “Oh look at the moon rocks.” “These rocks came from the moon.” But I personally talked to a guy who had been on the moon and then went around giving inspirational speeches, and he was a geologist, not a space pilot, and he was all like, “What rocks?” It’s okay to go to the moon and get some rocks for your rock collection, and maybe the finance committee thought it would be diamonds or reveal the mystery of the universe, but it is not true that the people who went to the moon went just to get some rocks. That’s what they told people to get past the security guard.
“We are geologists looking for some rocks.”

If you are going to go through life making up alibis, at least make up something credible. There is only one reason to go to the moon: to personally, physically, at the risk of your life, travel through the majesty of creation and look back at the beauty of the earth and marvel that such beauty and danger can blast out of the big explosion that we part of – we have been called upon to witness the Big Bang – the earth is one more object hurtling through space as our entire galaxy still speeds away from the site of the original explosion.

They went to the moon to blow their minds. Same reason you dance. Not just because it is cost effective. But because you need to go back to the pre-verbal you, so you are so you, and your body remembers. If you dance for the disease, your body thinks disease. If you dance because you want to see the dark side of the moon today and the full moon tonight, and you want to beat on a drum and dance around the campfire… THEN your brain says, “Yeah, baby, let’s get it on.” Focus on the beauty, not on the disease. Can’t always do that, of course. Some days you just telephone to the world from a great distance and they do not hear what you are saying. But when you can…. you being so very you is contagious, even to yourself.

I am not inebriated (yet) so let’s make way for quotes from witnesses that Kate Kelsall sent me, and here is an additional point about the Brooklyn dancers and the Colorado dancers getting it on: Did Kate find this in Scientific American? Journal of Neurology? L.A. Times? Slate? The New Yorker? Vanity Fair? Le monde? Der Spiegel?

No, Kate found it in the New Bern Sun Journal, circulation 14,673, serving Craven County, North Carolina, since 1914, “just a three hour drive from Myrtle Beach”. Owned by Freedom Communications. Motto: “Keep the torch of freedom burning brightly”.
The article is by Brian Newsome – a concise and clear writer. “News-o-me”? Or “New-so-me”? New was so you and old was so me.

I don’t often get to visit the U.S.A., but what just happened is very American. Kate Kelsall, at Shake Rattle and Roll in Colorado; Willis in Colorado joining Westheimer and the world-class Morris dancers; news of this comes from Newsome at the New Bern Sun Journal in North Carolina; and Kate sends it to me in rural Quebec and I send it onward right here and now. America: infinite mixtures of fate and freedom. God bless America!

Kate conveys the hard line:
“You’re not going to observe any signs of apathy or depression in these Parkinson's dancers in Colorado Springs and Brooklyn. In fact, even talking about Parkinson’s Disease is forbidden in their dance classes. Their focus is on dance, not disease.” Yes, ma’am.

We asked for witnesses, and witnesses were sent. All of these are from the New Bern Sun Journal:

Witnesses: Willis & Westheimer:
Willis, a retired nurse who worked in neurology, and Westheimer, are both well-versed in science, as well as dance, and they say the intersection of performing arts and Parkinson's is not as strange as it might seem at first.

Dance requires an intense focus on movement, balance, vision, techniques…

"You'd never hear a dancer saying, ‘Oh, I use cognitive strategies to dance,'" said Westheimer, but that's exactly what they're doing

"Science is now beginning to understand what dancers know."

Willis said the "mindfulness" of dance and the power of music add something that other exercise does not.

Witness: Barbara Willis
"It's amazing how, if you have a tremor, it will disappear during this song," Willis,73, tells them. "These moves are difficult for us, but the music overcomes it.".. Her eyes are closed, and she seems lost in the music.
… all with the idea that they can use movement to combat a disease infamous for taking it away. "Parkinson's wants to take you and fold you in half and never let you go," Willis says. Every move is a way to slowly unfold again.

Willis' class was born out of her personal experience with the disease. A dancer since her youth, she was diagnosed in 1999. Her neurologist, impressed with her progress, urged her to start a class for others. Unknown to her, a similar program was taking place in Brooklyn, N.Y.

Witness: Olie Westheimer
Olie says:
"The aim of the class is to try to move as beautifully as you can."
"It sounds crazy, but it works," Westheimer said.

Witness: Margaret Schenkman
Margaret Schenkman of the University of Colorado, is leading a study…. whether dancing somehow helps repair the brain or somehow compensates for the disease's deficits… is a mystery. Some animal studies have linked exercise with reversing the progression of the disease, but what happens in animals doesn't always prove true in humans. Her study is at least a year away from completion.

Witness: Dr. Brian Grabert
… neurologist at Colorado Springs Health Partners, treats about 200 Parkinson's patients, including people involved in dance …says: dancing Parkies are more upbeat and less apathetic… having fewer falls, one of the most serious consequences of the disease as it progresses

Witness: Ric Pfarrer 55, financial planner and president of a Parkinson's support group, attends Willis' dance class. He said the chance to come together and have a good time can be as valuable as any physical benefit.

Witness Peggy Robinson, 60, "I like feeling like I'm not all alone."

At Westheimer's classes, in fact, talk about Parkinson's is not allowed because the emotional escape is one of its strengths.
"There's no problem talked about in our class," she said.
"We're just dancing."

Considering that 80 percent of Parkinson's sufferers have experienced bouts of depression and report feeling isolated, that's nothing to take lightly.

Grabert said apathy is one of the most common mood disorders associated with the disease, but that's not something he's seen in Willis and other Parkinson's patients who dance.

Parkinson’s dancers focus on dance, not on disease

http://katekelsall.typepad.com/my_weblog/2009/07/parkinsons-dancers-focus-on-dance-not-disease.html

Dance for Beauty, dance in the Zone where Parkinson’s, a cowardly disease, is too chicken to follow you. Forget your perfect suffering; do not dance for the disease, this rotten stupid evil disease does not deserve any such recognition. Focus on beautiful movement; don’t focus on the disease. And one more reminder: lots, not a little bit. Many hours a week, not just a few hours. With heart and body and soul, not half-heartedly. Fighting Parkinson’s requires of you much more than an hour a week with a support group. They say it takes 10,000 hours of practice to do anything well. Anything. Dance, playing an instrument, painting; carpentry, cooking, understanding history, architecture, hockey, getting physically fit, making wine from your home-grown grapes – the people who have done it for 10,000 hours are the ones you recognize right away as being the experts, the experienced, the leaders. Want to be really, really good at playing the piano? On any stage at any time? Commit to 10,000 hours. Minimum. For example, 4 hours a day, 6 days a week, for 7 or 8 years. Don’t expect it to require less commitment to fight a disease for which there is no known cause and no known cure.
Thousands of studies have been done about Parkinson’s. Especially about the drugs. (not to mention pickled herring). But has there been any study done about fighting PD with the same dedication – and commitment of time – as is routinely expected of a dancer or violinist or motorcycle repair man? The Harley dealer who can tell you everything about your machine just by listening to the engine? (Hello, Gray Theus) The guitarist who can join in and improvise live on stage with songs he hasn’t heard before? (Hello, Oren of Chatham Street) 10,000 hours of experience, training the muscles of your fingers to remember how to play the guitar.

There is instant coffee and powdered orange sugar that is supposed to make orange juice if you mix it with water, and they even have instant potatoes – I cannot imagine why there are instant potatoes; - and so patients expect instant cures, and the medical industry tries to provide them. Just take this pill three times a day. I am all in favor of pills and I am grateful for the drugs that help me cope with this absurd disease -- but when you have major movement disabilities, is there any reason to believe that you can fight that with minimal commitment? Is there any reason why that would take less time than learning to play the violin?

But I don’t think that has been studied. If you took a thousand Parkies and they fought the disease 4 hours a day; or more! Dancing, exercise, training the brain and muscles; and whatever other tricks of the trade can be learned from others: acting, martial arts, humour – I don’t know what all - but if fighting the disease became a full-time commitment, would the brain accept a winning strategy instead of allowing itself to be defeated by what is basically a very primitive and stupid and unnecessary disease?
Have there been any studies about that? No? Nobody has enough time. Here take this pill instead. Instant relief, instant high. Until your body chucks out the pills five years later. The five years, they call it the Parkinson’s Honeymoon, where it all goes great before Parkinson’s gets bitchy and ruins the marriage by ripping out the nerve and muscle communication systems that allow you to do some fairly vital things, such as swallow food.

Parkinson’s Honeymoon with levodopa? 5 year average before the side effects crush you? I don’t want a Parkinson’s Honeymoon for a marriage to a drug that turns against you after 5 years. I don’t want to be married to Parkinson’s. I want to kill the Beast.

It would be interesting to find out if Parkies could regain control of their bodies if they put in as much time and effort as if they were training for the Olympics.

Sparta, trained for strength and discipline and sacrifice; Athens expressing energetic creativity and individuality. Do both?

The rain has stopped and I think I will sit under the tree and have a beer with Ursula. That’s a good plan too.

Sparta for me alone; Athens for us together.
And the Olympic torch gets passed on.

Has there ever been a clinical trial like that? Planting the orchard, harvesting the oranges, squeezing fresh orange juice instead of mixing instant Tang with water? Because it is unlikely we can fool our brains and our muscles with quick and easy substitutes; instant pills and immediate gratification; we expect doctors to give us a miracle pill and we can go home and forget all about it. And believe me, I would be the first to swallow such a pill. I would take three of them. Instant relief. If you want Infomercials promoting Mirapex, I’m the spokesperson you need.

But with your brain becoming disconnected from your body, it is going to take some major efforts for rehabilitation, to get your brain back in communication with your muscles.

How many hours of golf did Tiger play before re-inventing the perfection of the game? How many hours did Manitas de Plata play guitar before the Gypsies gave him that name: “little fingers of silver”? How many times did Wayne Gretsky pass the puck in junior leagues before he shattered all the records in the major leagues?

John Lennon summed it up: “Christ, it don’t come easy.”

Doctors would not make themselves popular if they told you to change your way of living.

If you suffer from a major movement disability, such as PD, it may well be that you should be setting your agenda to train for the Olympics, for Carnegie Hall, for climbing Mount Everest. You will not get to do any of them, and maybe you will end up as a strong cripple rather than a weak cripple, but there is this possibility that your brain might surprise you by going along for the adventure. When you require your brain to spend hours every day rehearsing for your great performance – the day when you walk down Main Street without fear of falling, and go to a restaurant and know that you can hold a fork and swallow your food without choking, and then have a conversation knowing that your words will be understood. That, folks, would be a revolution. Wouldn’t it be funny if it just takes practice, like everything else?

Ah, probably all nonsense. I think I’ll have another beer. But send me some more witnesses ! And as Olie says, “Focus on the dance, not the disease.” Think about that, all the more so if you do not have Parkinson’s. Every symptom that I have, you also have; it’s just that mine are more extreme and mixed with other symptoms that change in intensity to a distressing degree. But there is nothing that I have that you do not have, except the intensity. Ever been extremely tired? Ever have painful joints? Ever been unable to sleep? Ever get dizzy and confused and forget names? Ever fall down very suddenly? And so on. Those are all symptoms that are normal except when they are not normal. So in your own life, learn from the Parkies, even if you are in full health. In business, in politics, in art, in fighting a cause, in getting married for better or for worse, in teaching children, in looking out at the history of the world and trying to fix up a few things for the future, remember: “Focus on the dance, not the disease.”

You are beautiful when you dance. Come over here by the window. Dance in the sunlight. Your shadow is dancing too. The reason why the sun came up this morning was to see you dance. There could be no better reason. And you can hand out little cards to people, warning them that it is contagious. Not the disease - that is not contagious. The dancing - that is VERY contagious. So focus on the dance, not the disease.

There is space here for more witnesses, if the spirit moves you:

(and thanks for all the fish).

Witness: Carl Hernz
Sometimes Bad Kitty doesn’t let me get more sleep after my cereal. Time to cry over the situation? No, sometimes Bad Kitty just wants me to enjoy another sunrise I figure. You know I missed practically all of them until I got young-onset Parkinson’s. They’re pretty wonderful, even when you don’t feel your best.
--Carl Hernz
http://www.apologysmology.com/

Bob says: Carl, that paragraph is a statement for the ages. Understated, powerful, like a long haiku. Your faith shines through; your generous spirit. And because of you, there are many people who now understand Bad Kitty Fridays.

Witness: Stanley Jordan

I've always wanted to do more than just making albums and playing gigs. I wanted a higher calling, higher than commercial or artistic success. If you can touch someone, really help their life, now that would be something special. Once when I was a teenager, I had a date to jam with a girl, Allison, who played piano. I almost canceled, because I had come down with the flu. We must have played at least 4 hours together, and at the end of the session, I felt healed. That memory always stuck with me. Then one day years later I met a music therapist named Donna Poland. Now I make stops during my concert tours to contact local music therapists and observe what they do. I talk with some of their patients too. This has been very rewarding to be able to see first hand how this work is helping people. Medical science is realizing more and more that the mind and body are linked, and that our thoughts can affect our bodies.

Witness: Joyce.......
Yes I want to dance, too.
Isn’t it great, the power of Music? I believe that if as much time and effort and research were spent on the things that help, and why they do instead of the pathology of this weird disease,we would be rid of it by now. So let us make a joyful noise and dance!
Bob says: Joyce, uhhh, is that Joyce Pinckney? What a social faux pas - I did not recognize you... and we were introduced by Dr. Bin Hu. Dear readers, I present Joyce Pinckney, soon to be published author of a Parkinson's story.
Joyce says: I have had my diagnosis for 14 years and I am fighting it all the way. Mostly with music ,arts, dance, writing, composing, and denial...
Former country farm girl from Saskatchewan, registered nurse ‘64’, Head Nurse on paediatrics Saskatoon University Hospital, mother, piano teacher, batik artist, belly dancer, jazz educator, player, writer of short stories and poetry. Composer of Jazz songs and teaching stuff for students . And now worthy opponent of Parkinson disease. Oh and I am also a grandma.
(Joyce's space; to be continued)

Witness: the other Louise
You may not always control how it ends up, but you can control your intentions when you begin. When you go through that door, begin with an open heart “Agape is disinterested love. … Agape does not begin by discriminating between worthy and unworthy people, or any qualities people possess. It begins by loving others for their sakes. … It springs from the need of the other person.” Martin Luther King, Jr. (1958)

Memo to Carl Hernz. The senior executive committee of the Parkinson’s Internet Underground has voted unanimously to send you the following message:

We love you.

And they also voted a special mention for Bad Kitty, for being so wise. Cats have been on earth 50,000,000 years longer than the human beings. They know.

They know.

Did Shakespeare use pesticides?
William Shakespeare (1564-1616)
second part of Henry VI:

Dick: "Why dost thou quiver, man ?
Say: "The palsy, and not fear, provokes me."

Did Leonardo da Vinci market Mirapex? (1452-1519)

"You will see those who move their trembling hands and head, the soul with all its power cannot prevent the trembling."

Witness: Luke 13.11
And there was a woman who for eighteen years had had a sickness caused by a spirit; and she was bent double, and could not straighten up at all. And He said to her, “Woman, you are freed from your sickness.” And He laid His hands on her; and immediately she was made erect again and began glorifying God.

Dear Bob,
I hope you don't mind me responding to your comments on the "So You Think You Can Dance" article in Scientific American online...I wanted to let you know that I am one of the teachers in the Dance for Parkinson's program at the Mark Morris Dance Group in New York City (and we are working to set up other classes around the world). Three dancers here been teaching our class, based on a mix of modern dance, ballet, tap, jazz and improvisation, for about seven years in close collaboration with Olie Westheimer and the Brooklyn Parkinson Group. This summer, we're doing our first research study to investigate what happens in the class more scientifically. But throughout, our focus is on dance: we aren't dance therapists or healers, and we don't focus the class on the disease, "coping" or symptoms. Our class is about dance, and music, and developing a supportive social community, and in that way it is a fun, expressive, artistic, and collaborative venture. Of course we hear from participants that the class benefits them in very specific ways that relate directly to PD, but the emphasis is always firmly on dancing for the sake of dancing.

David B. Leventhal

Mark Morris Dance Group

Witness - Dr. Michael S. Okun
National Parkinson Foundation Medical Director.
Dance therapy seems to be proving to be a very useful modality for patients with Parkinson’s disease. In some magical way, dance seems to be able to override some of the abnormal brain circuitry in a subset of patients. What a miraculous phenomena to see someone who struggles walking, dance.