Category Archives: Parkinson’s disease

Best New Debut Author for 2017

Recently received the very good news that my book, Carrying The Black Bag: A Neurologist’s Bedside Tales, won a national book award for 2017 from The Feathered Quill. This is a really big deal!

Will you please share this good news? The marketing/publicity from a regional publisher is limited and your help in networking my book would be much appreciated. Below is the news release for this award.

 

FOR IMMEDIATE RELEASE

Contact:                Maryglenn McCombs (615) 297-9875 maryglenn@maryglenn.com

 

TEXAS DOCTOR WINS NATIONAL AWARD FOR MEMOIR:

Carrying the Black Bag by Tom Hutton, M.D. among honorees in literary awards competition

 

LUBBOCK, Texas – Texas doctor Tom Hutton, M.D.’s memoir, Carrying the Black Bag: A Neurologist’s Bedside Tales has been named among the winners in the Feathered Quill Literary Awards.

 

Sponsored by Feathered Quill, a leading web-based book review, the Feathered Quill Literary Awards is a national awards program that celebrates excellence in publishing. Recognizing books from both large and independent presses, the Feathered Quill Literary Awards honors the best books in numerous categories.

 

Carrying the Black Bag: A Neurologist’s Bedside Tales, a memoir of Hutton’s career in medicine, was awarded the Bronze medal in the “Best Debut Author” category. Published by Texas Tech University Press, Carrying the Black Bag is available in hardcover edition (6 x 9, 257 pages; photographs; ISBN: 978-0-89672-954-4)

 

According to Ellen Feld, Editor at Feathered Quill “We were overwhelmed by both the number and extraordinary quality of entries for this year’s awards program. In particular, The Best Debut Author category was filled with worthy entries: consequently, it was difficult for our judges to pick among the many excellent contenders. Tom Hutton, M.D.’s memoir, Carrying the Black Bag was a real standout: compelling, well-written, and an incredibly beautiful and hopeful testament to the human spirit. It is our great honor to recognize Dr. Hutton among this year’s Best Debut Authors. We can only hope he has more books in the works.”

 

During his thirty-plus years of practicing in West Texas and Minnesota, physician and neurologist Tom Hutton discovered that a doctor’s best teachers are often his patients. From these (extra)ordinary individuals, Hutton gained a whole-hearted respect for the resourcefulness, courage, and resilience of the human spirit. Hutton’s patients—and the valuable lessons they taught—served as the inspiration for Carrying the Black Bag. Part memoir and part tribute to the patients who faced major illness with grace, grit, and dignity, Carrying the Black Bag invites readers to experience what it is like to be a doctor’s hands, eyes, and heart. Imagine the joy of witnessing a critically ill five-year-old who, against all odds, claws her way back from a coma and near certain death. Meet a lonely Texas widower with Parkinson’s disease who hosts elaborate pinochle parties for a pack of imaginary canines. Step into the surgical booties of the author when he attempts to deliver his own child amid heart-stopping obstetrical complications—during a paralyzing Minnesota blizzard. Through real-life patient narratives, Hutton shines light on ordinary people facing extraordinary challenges. Moreover, this captivating tale captures the drama of medicine—its mystery, pathos, heroism, sacrifice, and humor.

 

Tom Hutton, M. D., is an internationally-recognized clinical and research neurologist and educator. The past president of the Texas Neurological Society, Dr. Hutton served as professor and vice chairman of the Department of Medical and Surgical Neurology at the Texas Tech School of Medicine. He now lives on his cattle ranch near Fredericksburg, Texas. Visit Tom Hutton online at: https://jthomashutton.wordpress.com/

 

Members of the news media wishing to request additional information about Tom Hutton, M.D. or Carrying the Black Bag are kindly asked to contact Maryglenn McCombs by phone: (615) 297-9875 or email: maryglenn@maryglenn.com

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Appearance on Alternative Talk Radio

What fun I had as a guest on KKNW 1150 AM, alternative talk radio for the hour long program “Sunny In Seattle“. Sunny Joy McMillan hosts this wonderful program and asked insightful and probing questions about my book, Carrying The Black Bag: A Neurologist’s Bedside Tales.  We also had well-informed callers who  provided thoughtful observations and questions.

Any opportunity to discuss my book and writing method is always welcome, but particularly when it is carried out with the joy and intelligence shown by Sunny. Below is a MP3 link to the interview on “Sunny in Seattle” should you wish to listen to the full program

I wish everyone a marvelous Thanksgiving. It is good to stop and ponder that which we are grateful among which I am grateful for you, the readers of my blog.

Does Hillary Clinton Really Have Parkinson’s Disease?

I usually avoid writing about political matters. In recent days though, I’ve been asked by multiple friends, both lay people and physicians alike, to share my views on a video put out by Dr. Ted Noel, suggesting Hillary Clinton suffers from Parkinson’s disease (PD).  https://www.youtube.com/watch?v=Zr1IDQ2V1eM

The implications of a potential President of the United States having a progressive neurological disease tends to focus our attention and require careful consideration. For that reason, I’ve decided to share my thoughts on Dr. Noel’s assertions that Hillary Clinton has PD.

My  professional background is that of a practicing clinical and research neurologist. I  treated patients with PD for decades and also directed a Parkinson’s Disease Center of Excellence for the National Parkinson’s Disease Foundation. My background qualifies me to comment on the assertions made by Dr. Noel. He trained as an anesthesiologist and admits to strong political views on his video blog. As for me, I am neither a registered Democrat nor Republican and possess the strong belief that medical and scientific facts must not be viewed through a convenient political lens. Politically driven science leads to bad science.

I have a great interest in the impact of medical disorders on the decision-making of public figures. Toward this end I’ve appeared on History and National Geographic channels discussing the likelihood that Adolf Hitler suffered from PD. I’ve also written on the topic; most extensively in my recently published book entitled, Carrying The Black Bag: A Neurologist’s Bedside Tales. I refer those interested to Chapter 13 and my argument that Adolf Hitler, in addition to his other medical disorders, also suffered from PD and this disorder affected, not only his movements, but also his memory and cognitive function. Hitler’s PD may have impacted his conduct during the latter phases of World War II and influenced the outcome of the war.  The evidence that Adolf Hitler had PD is in my view  substantially stronger than that purported by Dr. Noel for Hillary Clinton.

I support Dr. Noel’s contention that, in the absence of a hands on examination, observing videos of someone with Parkinson’s disease can lead to a strong conclusion that the person had PD. This is possible because the disorder demonstrates easily recognizable tremor, slowness of movement, stooped posture, lack of arm swing, gait abnormalities, and blank facial expression. The neurological examination allows the examiner to feel the particular type of muscular rigidity in PD (so-called cogwheel rigidity) which cannot be observed from a video.

Sketch of a man with PD with the typical features

Sketch of a man with PD with the typical features

What is missing from Dr. Noel’s “facts” is a discussion of how PD develops over time and its typical order of presentation. The medical field refers to this as the natural history of the disease. It is here that Dr. Noel makes several errors, no doubt because his training and experience are in Anesthesiology, not Neurology, nor does he likely have extensive experience in the diagnosis and treatment of people with Parkinson’s disease.

For example, he claims the onset of Hillary Clinton’s alleged PD dates to a fall she suffered eleven years ago, the fall resulting from her PD-related loss of balance. While loss of balance (referred to as loss of postural righting reflexes) is a well known feature of PD, this is NOT an early feature, nor it is a first sign of the disease. Rather balance problems are a late finding in the natural history of the disorder and follow the onset of the more major features, such as tremor, rigidity, slow movements, blank facial expression, and lack of arm swing while walking.

Hand tremor (not head tremor) is the most common presenting sign of PD. This is a slow rhythmic tremor of the fingers, a so-called “pill rolling tremor” named after the apothecaries of old. parkinsonsTo my knowledge, Clinton has never shown this type of tremor. As Dr. Noel points out, the hand tremor can be suppressed by holding the hand against the body or by manipulating an object. Nevertheless, the hand tremor returns periodically, especially when under emotional pressure, and is the most obvious feature of the disorder. Given the many public appearances of Hillary Clinton, this type of tremor, if it existed, should already have been observed many, many times.

Dr. Noel instead refers to the head-bobbing Clinton demonstrates in several videos as her purported tremor. While some people with PD have head tremor, this is unusual and not seen in my experience without tremor elsewhere in the arms or legs. In addition, the tremor of PD is rhythmic and of a certain, predictable rate. Her head bobbing is non-rhythmic and does not appear at all typical in rate or form for the head tremor of PD.

Slow movements, so-called bradykinesia, are another major sign of PD. I have not viewed any video that shows Hillary Clinton demonstrating slow movements beyond what would be expected of a 68-year old person. While treatment can mask the signs of PD, they can still be detected by experienced examiners, at least after the so-called “levodopa holiday” passes which typically lasts no more than a year or two.

Stooped posture, lack of arm swing and leading with the back of the hands while walking (simian posture) with forearms flexed, along with shuffling feet with short steps are convincing features for PD. Again, I am unaware of Clinton demonstrating any of these diagnostic features.

What Dr. Noel points to is a “bug-eyed” facial expression occurred only when Clinton was startled or overwhelmed by reporters shouting questions at her. A person with PD typically has wide-eyes, blank facial expression, and reduced frequency of blinking which Clinton does not demonstrate. A person with PD demonstrates these facial features all of the time, not episodically.

The blank staring facial expression of PD in Muhammad Ali

The blank staring facial expression of PD-  Muhammad Ali

 

Likewise his contention that her recently diagnosed pneumonia resulted from a swallowing abnormality associated with PD fails to be adequately supported. While swallowing problems exist in many persons with advanced PD and may lead to aspiration and pneumonia, they are present in association with the cardinal features of PD, such as tremor, slow movements, and muscular rigidity. The swallowing abnormalities do not occur in the absence of the cardinal features of PD.

We have no evidence these cardinal features of PD exist in the video, nor do we see the minor signs of PD, such as a blank facial expression, lack of arm swing, stooped posture, shuffling gait, soft and muffled voice, simian posturing of the hands, oily skin, dandruff and acne. Clinton’s speech patterns are readily available to anyone who follows the campaign. She does not demonstrate soft and muffled speech as is seen with more advanced PD.

In summary, the evidence presented by Dr. Noel is far from convincing that Hillary Clinton has PD. Dr. Noel has cherry picked various signs without fitting them into a logical context or natural history of PD. I do not believe Hillary Clinton suffers from PD based on current evidence.

Whether she has another neurological disorder cannot be discerned from the limited medical information available. Medical records and examinations are needed.

Dr. Lisa R. Bardack, Hillary Clinton’s Internal Medicine physician, has released limited information on Hillary Clinton. Clinton has treated hypothyroidism, seasonal allergies, and we know of her recently diagnosed bout of pneumonia for which she was placed on antibiotics.

More concerning was the episode of closed head injury that took her a full five months from which to recover. She apparently developed a blood clot within her head in 2012 believed to have been a transverse sinus thrombosis- a very serious  brain disorder. Almost certainly Clinton would have  been attended by a neurologist or a neurosurgeon or both; however no neurological records have been released of this major medical event. We do not know whether she suffered any permanent brain damage or other complications from this episode.

She also has suffered episodes in 1998 and 2009 of deep vein thrombosis (DVTs) in her legs and takes an anticoagulant, Coumadin for prevention of future blood clots.

As an aside, Hillary Clinton’s falls or risk for falls while on Coumadin, demands caution, especially when climbing stairs or at risk for falls or cuts.

Very little medical information has been released for either Hillary Clinton or Donald Trump despite the rhetoric streaming from their campaigns claiming the opposite. As compared to the medical records released by John McCain and George W. Bush when running for President, the currently released medical information is meager by comparison. This is, in my opinion, very unfortunate.

Whether a candidate is healthy enough to become president and perform the duties of the office should be a condition for running. The people who vote would benefit from health information just as they  benefit from policy statements and fiscal plans. Since both major candidates, Clinton and Trump,  respectively are 68 and 70-years of age, the need for this information takes on even greater importance.

The candidates in my opinion should release their full health records and not just politically sanitized versions or the results of their most recent physical examinations. A list of their medications should also be released and would likely be revealing. Lacking a willingness by the candidates for full medical disclosures, a non-partisan panel of medical experts should review all available medical records and attest to the candidate’s health status and their ability health-wise to meet the demands of the office of President of the United States. Such a course of action would be in the best interest of the American people.