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I am confident that this description of the personality of the author and his struggle with his chronic illness deserves to be read by patients who suffer from similar illnesses and by those who care for them.
Cecil Todes who is both a psychiatrist and psycho-analyst states that Parkinson's disease is ‘a chronic degenerative disorder affecting at least one in a thousand of the population before the age of forty’. As it is considered to be a relatively common disease I have little doubt that a second edition of this book will be forthcoming. In such circumstances perhaps the following suggestions could be considered.
The effect and function of drugs are of primary clinical importance and I read with interest the role of what Todes describes as the four ‘f s - fight, flight, food and sexual behaviour. In this area it would have been helpful to have known more about the fourth ‘f and ways of coming to terms with the sexual limitations in the lives of those suffering from chronic neurological disease.
Likewise, although he has come to terms with not wishing to be the ‘guinea pig’ for every possible new cure, he does not seem to have considered signing a ‘Living Will’ (the Voluntary Euthanasia Society's Advance Declaration as a protection against unwanted ‘medicated survival’). I am left wondering why not? Certainly the moment of cardiac arrest was one where the need to ‘officiously strive to keep alive’ was debatable. In similar circumstances I would not have wished to have been kept alive. Donald Winnicott always prayed that he ‘was alive when he died’ and my prayer has always been: ‘Please God let me only have to die once’. I wonder what is Cecil Todes' prayer?
Perhaps the neurologists are right and that Pergolide may cause arrhythmia. Having taken it with benefit for so long, surely it was worth continuing with the risk rather than deprive himself of the pleasure of the ‘on’ as opposed to so much ‘off’.
The account ends on a positive note with a ‘Fresh Start’. The descrip