A Brain on Fire

The Thing About Parkinson’s

There is a thing about Parkinson’s that nobody warns you about, which is that it is not the disease you think it is.

You think it is shaking. Everyone thinks it is shaking. You think it is Michael J. Fox on Letterman, Muhammad Ali lighting the torch in Atlanta, your grandmother’s left hand fluttering against the kitchen table while she pretended not to notice. The shaking has done a generation of publicity work for this disease. It is the part you can see from across a room, and seeing is what we have decided counts. But the shaking is, in the great architecture of what this illness actually does, a kind of decoy. The thing you are watching is not the thing that is happening.

What is happening is quieter, and older, and considerably more strange.

Somewhere in your brain, in a small pigmented region called the substantia nigra (Latin for “black substance,” because the people who named these things were not in the business of consolation), the neurons that produce dopamine are dying. They …