Interview Dr. Shill
Dr. Shill
RC:
Why did you decide to come here to the Muhammad Ali Parkinson’s Research Center?
DS:
A couple of reasons, one is I’m from here, so there’s some family loyalty there. And the other, major reason, is that I was interested in managing Parkinson’s and I thought they did a really quality job here.
RC:
What got you interested in Parkinson’s?
DS:
I think it was the aspects of movement disorders in general, that you could really lay your hands on it. You can see a tremor, you can feel rigidity in a limb, you can really get a sense of how the movement disorder affects the person just by looking at them, just by talking and interacting with them. That was really appealing to me to really get my hands around it and understand it.
RC:
So it’s a more tangible disease than some others?
DS:
Right. I think the physical manifestations of Parkinson’s are often very easy for people to see and I think that was appealing to me in helping me understand it better.
RC:
What are some of the common symptoms of Parkinson’s?
DS:
One of the first things people associate is shaky hands or a tremor. 75% of people with Parkinson’s Disease will have some degree of tremor. And that’s one of the first manifestations in quite a few folks. Some of the other symptoms associated with Parkinson’s are problems related to slowness of movement, small, cramped handwriting, a softening of the voice, maybe dragging a leg when you walk or shuffling your feet -- those types of symptoms.
RC:
Are there any symptoms that maybe people are less aware of that are also in the Parkinson’s camp, so to speak?
DS:
I think one thing that’s part of Parkinson’s that some people don’t understand is some of the cognitive issues; there’s a slowness of thinking, so sometimes it’s hard to get words out. People will have the impression that someone has a lessened IQ because of that and obviously that isn’t true. There’s an impression that maybe the person isn’t “all there” but really it’s just a slowness of thinking that is causing the physical symptoms or really what you see. Pain is a symptom of Parkinson’s in about 30% of people and I don’t think people appreciate that. Some of the stiffness in the arms and legs can lead to some discomfort.
RC:
I’ve heard some Parkinsonians talk about the problem that they are perceived as being drunk because of some of the loss of motor skill and such.
DS:
Right. I’ve certainly had some of my patients who were driving and were pulled over, maybe they’re swerving just a little bit. We actually give people cards that say “I am not intoxicated, I have Parkinson’s Disease.” And they carry that in their wallets.
RC:
That’s great -- can’t let too many people know about that, might be a scapegoat. How does the nervous system function normally -- in a person who’s not afflicted by any sort of brain disorder?
DS:
I’m not exactly sure what you’re getting at, but I’ll try to answer it. When you start to move, there’s a signal that goes from the brain to the muscles. Normally that happens very rapidly -- within 10 or 20 milliseconds. With Parkinson’s Disease, that impulse is slowed. You think about doing something but by the time it’s reached the muscles it’s slowed down. There’s a slowness in initiation of the movement and a slowness in completing it. That’s particularly true for very coordinated movements. Things like handwriting, speech, walking, things that require a coordinated muscle activity, those are the things that are preferentially affected by Parkinson’s Disease.
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