Great shakes: famous people with Parkinson disease.

Abstract: James Parkinson is credited with the first complete clinical description of the syndrome attributed to his name, Parkinson disease. It is recognized as the first syndrome defined after neurology became a specialty. Descriptions of Parkinson features are rare in antiquity, and famous people with this disorder have not been found before the 1800s. During the 20th century, more and more famous people appear to be afflicted with Parkinson, and this article reviews some of those who have withstood the "test of Time magazine," and examines some of the reasons why the syndrome is a relatively recent disorder.

Key Words: famous people, history, Parkinson disease

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Although some features of the "shaking palsy" were known as early as 5,000 BC, (1) James Parkinson in 1817 was the first physician to thoroughly describe the syndrome. (2) His essay is still admired today, not only as an example of an excellent description, but also as the first syndrome elucidated after neurology became a specialty. The first famous person with this disorder may have been Wilhelm von Humboldt, who had classic symptoms, as indicated in his own writings some 15 years after Parkinson's description. (3) Despite extensive investigations, not one pharaoh, philosopher, caesar, king, or other famous leader in antiquity was ever described as having the features of this disorder. (4)

Since the 1900s, however, it seems that more and more famous people have had Parkinson disease. This article identifies some of the more notable instances. It is a discussion that involves war, violence, civil rights, politics, and religion--all the elements of an interesting story.

For the purposes of this paper, only those people with Parkinson who have appeared on the cover of Time magazine multiple times will be included. Time was first published in 1923 and virtually invented the weekly news magazine, so it really has captured almost all of the famous people with Parkinson disease. (One notable exception is Margaret Bourke-White, the first female photojournalist. Time can be forgiven, since she did her landmark work for another popular magazine, Life.) One other criterion will be that the subjects of this paper must also be dead, so as to "say no ill of the living."

Adolf Hitler (1889 to 1945)

The first famous person with Parkinson disease featured multiple times on the cover of Time was Adolf Hitler (Fig. 1). He appeared six times (seven if one includes the May 16, 1983, issue featuring the great forgery of Hitler's diaries) and was even "Man of the Year" for 1938.

Lieberman (5) produced convincing evidence that Hitler had Parkinson disease. One interesting speculation by Lieberman was that Hitler's so-called conversion upon hearing of the capitulation of Germany in November of 1918 was really an episode of von Economo encephalitis. That might explain why he had development of Parkinson disease at a relatively young age.

Hitler apparently first had a tremor of his left hand in 1934 at the age of 45. By 1943, his symptoms were fairly apparent, and some speculation has been raised as to whether his symptoms might have contributed to Germany's defeat. (4) Did Hitler subconsciously believe he was physically deteriorating and called for not only the Holocaust but also a premature attack on Russia before defeating the British? Did Parkinson disease cause the sleep inversion and mental inflexibility that prevented Germany's generals from getting permission to bring up Panzer divisions at a critical time during the Normandy invasion? Did Hitler's very close friend and head of the SS, Heinrich Himmler, betray him because he knew Hitler had a progressive neurodegenerative disease? Or did Hitler's physician, Dr. Morrell, misdiagnose his fuehrer's disease and overmedicate him?

[FIGURE 1 OMITTED]

These issues were thoroughly addressed by Horowski et al, (4) and they conclude, "We are convinced that neurologic examination of Hitler and his Parkinson [disease] does not contribute to the difficult task of 'explaining Hitler' but should remain 'a foot-note to history'."

Generalissimo Francisco Franco (1892 to 1975)

The next famous person with Parkinson disease who appeared multiple times on the cover of Time was Generalissimo Francisco Franco (Fig. 2). Like Hitler, he was featured on six occasions, but never as "Man of the Year." He was also a fascist who, at the age of 33, became the youngest general in Europe since Napoleon. In 1936, he led the military uprising against the Spanish Republic and remained in power until his death in 1975. (6)

Franco and Hitler actually met one time in 1940, when they discussed a Spanish takeover of Gibraltar. (7) The "calm monotonous singing voice" of Franco irritated Hitler, and he refused to have anything more to do with him. One speculation was whether the monotonous voice of Franco was a premorbid symptom of Parkinson disease, but it seems unlikely, since the disorder developed some 20 years later.

[FIGURE 2 OMITTED]

Deng Xiaoping (1905 to 1997)

Probably the most famous person under discussion is Deng Xiaoping. Not only was he on the cover of Time six times, he was named "Man of the Year" twice--1978 and 1985 (Fig. 3).

Xiaoping joined the Chinese Communist Party early. He participated in the famous Long March (6,000 miles) from 1934 to 1935 that marked the emergence of Mao Zedong as the dominant leader of the Chinese Communist Party. (7)

He was not always Mao's favorite and was purged twice--once just before the Cultural Revolution in 1966, and in 1975 just before Mao's death. By 1978, however, he became China's supreme leader and led the country in what was called the Great Leap Outward or the New Long March, which tried to repair the damage done by the Cultural Revolution and help modernize the country.

[FIGURE 3 OMITTED]

Xiaoping may have first developed symptoms of Parkinson disease in 1982, but he continued his remarkable leadership of the giant country. His biggest embarrassment came in June of 1989, when he authorized the bloody massacre of the student-led pro-democracy demonstrations in Tianamen Square. He resigned from his last official post in November of that year but still retained power until his death from complications of Parkinson disease in 1997.

George Wallace (1919 to 1998)

The only other past famous person with Parkinson disease who made the cover of Time multiple times was George Wallace. He was the fiery populist governor of Alabama, one of the longest serving state governors in US history, and was featured three times (Fig. 4).

Wallace made three unsuccessful attempts at running for the Democratic nomination for president. The one in 1972 ended when he was paralyzed by a gunshot wound from a would-be assassin. He continued to run the state house from a wheelchair until he finished his term in 1978. He was elected to another term as governor in 1982, winning support among black voters after renouncing his previous segregationist views. Ill health forced him to retire in 1986 saying, "I bid you a fond and affectionate farewell." He died in 1998 of complications of his paralysis and Parkinson disease. (8)

[FIGURE 4 OMITTED]

Wallace won his first term as governor in 1962, running on the platform, "Segregation now, segregation tomorrow, and segregation forever." By the following spring, he took his "stand in the school house door" on the steps of the administration building of the University of Alabama, barring two black students, Vivian Malone and James Hood, from entering the school. After several hours, he finally stepped aside at the request of National Guard Brigadier General Henry Graham, who said it was his "sad duty" to ask Wallace to step aside.

James Hood actually dropped out of the University of Alabama a couple of months later, but came back, earning a PhD in 1997. Wallace had long since renounced his segregationist views, had personally apologized to Hood, and planned to present the PhD. Unfortunately, ill health prevented him.

Ironically, Henry Graham developed Parkinson disease and died a little more than 6 months after Wallace. James Hood wrote a eulogy to General Graham in Time magazine. (9)

Honorable Mention

There were other famous people featured on the cover of Time, but they were listed only once, are still alive, or both. These should at least make an honorable mention status.

Those listed multiple times who are still alive today include Reverend Billy Graham, Pope John Paul II, Yassar Arafat, and Muhammad Ali. Janet Reno is alive, but has been featured only once. Those who have died and were featured on the cover of Time only once include Salvador Dali, the famous surrealist painter; Henry Wade, the "Wade" in the 1972 Roe v. Wade Supreme Court decision; Dr. William Masters, coauthor of the famous book, Human Sexual Response; Pierre Trudeau, the Canadian Prime Minister; and John V. Lindsay, US Congressman and later Mayor of New York City in the turbulent 1960s.

Conclusion

A couple of questions arise after seeing the number of famous people with Parkinson disease. The first centers on the issue of why the syndrome took so long to be recognized. The most likely explanation is that it was a rare disorder in antiquity, since Parkinson disease is a disease of the elderly, and people did not live long. (10) Even if a person lived long enough for the syndrome to develop, it was probably ascribed to "just getting old." (3) Those rare people with youth-onset Parkinson disease probably had an even shorter life expectancy, since the disorder would have limited their ability to take care of themselves.

The other factor in the greater recognition of famous people with Parkinson disease is related to the vast improvement in information technology. It allows much better sharing of information. Certainly Time magazine could not be available without the vastly improved information/technology age.

As to whether there is a premorbid personality trait associated with Parkinson disease that makes people more likely to become famous, there does not appear to be a definitive answer. (11) One big problem is that personality traits are almost impossible to quantify, so that any conclusions regarding traits will probably remain speculative. Then, too, other speculations as to whether Parkinson symptoms influence people to become famous are also insupportable. After all, every one of the people featured in this report had development of Parkinson disease after they become famous.

The most likely explanation as to why more famous people appear to have Parkinson disease is that we live longer now, and those famous people with Parkinson disease have higher visibility.

Work continues to elucidate the underlying cause of Parkinson disease as treatment modalities are improved. Even if this disorder is eradicated, however, perhaps we should be guided by the words of the first famous person with Parkinson disease, Wilhelm von Humboldt, who said, "How a person masters his fate is more important than what his fate is." (12)

Accepted June 22, 2004.

References

1. Parkinson's Disease Backgrounder (Reviewed July 1, 2001). [Online]. Available: http://www.ninds.nih.gov/health_and_medical/pubs/parkinson's _disease_backgrounder.htm [2004, April 2].

2. Parkinson J. An Essay on the Shaking Palsy. London, Sherwood, Neely & Jones, 1817.

3. Horowski R, Horowski L, Vogel S, et al. An essay on Wilhelm von Humboldt and the shaking palsy, Neurology 1995;45:565-568.

4. Horowski R, Horowski L, Calne S, Calne D. From Wilhelm von Humboldt to Hitler: are prominent people more prone to have Parkinson's disease? Parkinson Relat Disord 2000;6:205-214.

5. Lieberman A. Hitler, Parkinson's disease and history, BNI Quarterly 1995;11:4-21.

6. Bourgoin S, Byers P. Francisco Franco Bahamonde. Encyclopedia of World Biography. 2nd ed. Detroit, Gale Research, 1998, pp 52-54.

7. Bourgoin S, Byers P. Den Xiaoping. Encyclopedia of World Biography. 2nd ed. Detroit, Gale Research, 1998, pp 498-500.

8. Bourgoin S, Byers P. George Corley Wallace. Encyclopedia of World Biography. 2nd ed. Detroit, Gale Research, 1998, pp 71-72.

9. Hood J. Eulogy: Henry Graham. Time 1999;153:13:25.

10. Calne DB, Dubini A, Stern G. Did Leonardo describe Parkinson's disease? N Engl J Med 1989;320:594.

11. Todes CH, Lees AJ. The pre-morbid personality of patients with Parkinson's disease. J Neurol Neurosurg Psychiatry 1985;48:97-100.

12. Wilhelm von Humboldt (No date). [Online]. Available: http://www.brainyquote.com/quote.com/quotes/w/wilhelm_von_humboldt.html [2004, April 29].

RELATED ARTICLE: Key Points

* Parkinson disease was only recently described, and was the first clinical syndrome elucidated after neurology became a specialty.

* Parkinson disease is probably more common today because it is a disease of the aging, and people tend to live longer now.

* Disproportionately more famous people appear to be afflicted with Parkinson disease because of their higher visibility (and better news coverage), as opposed to Parkinson disease bestowing some sort of attribute that helps make people famous.

Jeffrey M. Jones, MD, FAAN 

From Neurology of Battle Creek, Battle Creek, MI.

Reprint requests to Dr. Jeffrey M. Jones, Neurology of Battle Creek, 70 West Michigan Avenue, Suite 250, Battle Creek, MI 49017. Email: [e-mail]