Chapter 2
Dr. James represents the second patient.
"Patient Michael Brad, Alex Brad's father."
Dr. James calls Marie.
"Marie, why did your husband not come?"
"He's been diagnosed with Parkinsonism."
"I heard Parkinson disease only occurs in old men."
"No. His neurologist told him that it was probably caused by antiemetics. He developed Parkinsonism after taking them. He has bradykinesia, which makes him walk with small steps."
Dr. James remembers his consultation with Michael.
"Sir, you have hypokinetic Parkinsonism. It is one of the main extrapyramidal syndromes. It is associated with dysfunction of the basal ganglia and dopaminergic pathways involving the substantia nigra. You have decreased facial expression, or 'face figée,' rigidity, and bradykinesia."
"My baby's emergency required a lot of running."
"I get you. It must have been hard."
The memory fades.
Back on the phone, Marie continues.
"My husband stopped the antiemetic, is taking L-Dopa, and is getting better."
I am Dr. James, a humble neurologist at BS Hospital. This morning handover has concluded.
A 20-year-old woman comes to me holding her head, looking like she is in severe pain.
"It hurts so much. I puke a lot, too."
I take her temperature using a non-contact infrared thermometer.
It shows 39°C.
"You have a fever. I suspect meningitis. Please lie down."
I go to her right side.
As I gently flex her neck,