Beginning

Through personal narrative, this chapter details the author’s experience of first becoming aware that something was not right with his body. This experience leads to visiting his primary care doctor who tells him that she is concerned about the possibility of his having Parkinson’s disease and then refers the author to a neurologist who is a movement disorder specialist. He is examined by this neurologist, who says, “What worries me is that I think you are in the early stages of Parkinson’s disease,” but who wants the author to have a brain scan that will confirm the clinical diagnosis given his young age and subtle symptoms. The author leaves his office, drives home, and informs his wife that this doctor thinks he have Parkinson’s disease. Here begins his new life as a person with Parkinson’s (PwP).

Hiding

This chapter details a painful period of hiding the author’s illness from others, meaning before he shared his diagnosis publicly. The author recounts the experience of a strange phone call that a physician’s office in Houston made to his parents in North Carolina looking for him, which led to him lying to his mother about his health status. The author also reflects on his discomfort in a work meeting as he sat beside a colleague who is a neurologist, assuming that he could tell that the author had Parkinson’s. He also shares the experience of affiliating with a movement disorder clinic at Houston Methodist Hospital, where he could know about and participate in clinical trials.

Counseling Persons with Parkinson’s

This chapter continues the case study begun in Chapter 8, demonstrating how Phases Two and Three of the loss-based counseling approach look in practice. Together, the counselor and client should proceed with their work in light of the client having a deeper awareness and understanding of his needs and desires. Through further dialogue and by virtue of an ongoing convergence of their horizons of experience, they now collaborate further with the goal of formulating a plan for ameliorating the client’s various concerns. The chapter attends particularly to formulating a plan of action based on primary identified problems and their effects, with the focus here returning to the five purposeful actions, receiving, enduring, adjusting, relocating, and sojourning, and how these inform the work of mourning. The chapter concludes with practical tips for continuing to utilize what the client has learned after counseling ends.

Illness, Transformation, and Resilience

This chapter considers the question of whether and how one may find wellness and happiness within an experience of illness and argues for why this is indeed the case. The chapter also considers how human beings rely on narratives, which we ourselves construct and live by, to understand and make meaning of illness. Furthermore, the chapter considers how changing one’s habits of thinking, acting, and feeling may help assuage the emotional pain linked to living with a chronic illness and help ameliorate practical problems-in-living. The chapter also introduces the concept of ultimate concerns, as well as the author’s categories of vital, relational, vocational, and mortal concerns. The concept of resilience frames the chapter, including what may help strengthen one’s capacity for living with resilience.

Parkinson’s Disease

This chapter provides an introduction to Parkinson’s disease (PD) for the nonmedical specialist reader. It covers the history and prevalence of PD, the disease process and its symptoms (motor and non-motor), disease diagnosis, the stages of Parkinson’s, rates of progression, and treatment approaches. Although no form of treatment stops the disease process, there are treatments that can ease its symptoms. These approaches include pharmacological options, such as carbidopa/levodopa; technological devices, surgical interventions, such as deep brain stimulation; and lifestyle practices, such as regular vigorous exercise. The latter has also been shown to slow disease progression. The chapter concludes with a description of current and future research into treating and possibly stopping the progression of Parkinson’s disease.

Seeing

This chapter recounts an experience of the author’s family taking a summer trip to Italy, approximately eight months after his diagnosis, and the many questions and struggles he experienced related to having Parkinson’s disease. He recalls an experience of existential angst and spiritual questioning while in Vatican City and visiting St. Peter’s Square, and a subsequent experience of watching an older Italian man craft a beautiful decorative metal handrail working from the back of his small car, which encouraged the author. Through that man, the author saw that significant, even beautiful works can be created with rather modest resources. The chapter ends with the memory of his family happening upon an outdoor fashion show in Florence and his watching the lead designer drive up to the staging area and being helped out of his car and into a wheelchair by a woman (presumably his wife), which also encouraged him and showed that those with disabilities make significant contributions.

Living with an Illness Called Parkinson’s

This chapter considers three matters. First, it explains how a counselor best becomes familiar with the experiences and needs of persons with Parkinson’s (PwP) by using a phenomenological approach to counseling. Second, the chapter details the nature of living with Parkinson’s, including the condition’s wide-ranging effects on quality of life. Third, the chapter shows how counselors may work with PwP using a time-limited approach after understanding the fundamental nature of Parkinson’s and what it requires in the way of supportive care. The loss-based counseling (LBC) approach is introduced. Finally, perhaps most crucial for the book as a whole, the chapter presents an argument for why thinking in terms of a person having an illness, as opposed to a disease, is most helpful. Specifically, a focus on disease prioritizes the objective physiological state, whereas a focus on illness prioritizes a person’s subjective experience of living with the disease.

Worrying

Through personal narrative, this chapter details the approximately ten days between the author’s diagnosis by Dr. T and getting results of the brain scan, called a DaTscan, which would confirm the clinical diagnosis of Parkinson’s disease (PD). During this time, his family and he traveled to New York City, where his wife was running the New York City Marathon. The author recounts his struggles with anxiety about the future, especially as concerns the burdens PD could place on his family and on his ability to continue working. The chapter concludes with a phone call from Dr. T, who confirms that the author does have Parkinson’s.

Epilogue

The book concludes as it began, with personal narrative. This Epilogue details three experiences. These include the author disclosing his illness to his boss and then publicly through an op-ed in his local newspaper; having lunch with a former colleague who expresses his sadness over the author’s having Alzheimer’s disease, which shows the author how much work is needed to educate others and raise awareness about Parkinson’s; and his experience in running the Texas Independence Relay on a twelve-person team, five of whose members live with Parkinson’s. The book ends on a hopeful note, based on the author’s realization that his life is far from over and that, in an exciting, interesting, and meaningful way, is only just beginning as a person living with Parkinson’s.

Counseling Persons with Parkinson’s

This chapter demonstrates how a counselor may utilize phase 1 of the loss-based counseling (LBC) approach in practice by presenting a case study of a man, Manny, who has recently been diagnosed with Parkinson’s disease. The five components of the LBC approach, education, identification, formulation, implementation, and evaluation receive attention as concerns Manny’s experience and needs. Showing how a Parkinson’s diagnosis results in feelings of significant loss, the chapter also suggests how attention to purposeful actions (tasks) geared toward ameliorating particular problems-in-living may help ease the burdens of Parkinson’s and, likewise, promote an experience of mourning. The result can be a life with greater measures of acceptance, peace, purpose, joy, and contentment.