Tuesday, January 20, 2015

Blog #1: Dr. Lance Fogan's Background


(This blog was originally posted on June 5, 2011)

                                                       
 

I practiced full-time clinical neurology for twenty-six years in a large medical group in southern California. My patients included children and adults. Then, I practiced part- time for another ten years, and as Clinical Professor of Neurology at UCLA’s School of Medicine, I taught medical students and trainees in family practice, internal medicine, and psychiatry. Additionally, I lead conferences at a county hospital where brains of deceased patients are dissected and studied in order to elucidate disease processes and advance our medical knowledge.

 Epilepsy is a disorder of brain function. It occurs in one percent of the population, and it can develop at any age. It assumes various forms, from short blank outs, to prolonged shaking with loss of consciousness. Many brain diseases and injuries can cause epilepsy, but often no obvious cause can be identified.

            My retirement from full-time clinical neurology practice in 1997 has  given me the time to  expand my knowledge of literature and sharpen my writing skills. Fortune smiled upon me when I found my literature/writing teacher, Donald Freed, in 2000. Participating in weekly classes in his home has helped my goal of reading the great literary works. At my mentor’s urgings to undertake a writing project, I created DINGS.

The idea for this novel came in February 2009. I had read a newspaper article about a prominent political family’s involvement with their child’s severe epilepsy.  The emotional impact of their plight immediately sparked my imagination. I thought, why don’t I write a story about epilepsy that I can work on in my writing class? I’m certainly qualified to write it, and I could help to educate people in addition to creating a fascinating story. 

I focused on what I considered an interesting approach—a protagonist with unrecognized seizures; the very common “complex partial” seizure-type. The story will deal with a young boy whose mind occasionally blanks out. Because he’s a young third-grade eight-year-old, he would have difficulty understanding—much less explaining to others—these very confusing seizure sensations. They’re also known as temporal lobe or psychomotor seizures.  This is how he could be afflicted with disordered thinking that would be unrecognized by adults, especially if the adults never observed his silent blank-out seizures. The novel will be directed to the adult reader.

I became excited thinking about this interesting scenario: it was a situation that I had occasionally seen in my practice. School nurses and teachers initially hadn’t recognized these seizures and it sometimes took months before anyone became suspicious that something was wrong with a child.

My two grandsons in grammar school promote in me a feeling of kinship with children this age. I thought that they could guide me in developing a fictional character that would reflect genuine childhood based on their activities and experiences.

Putting the boy’s father on deployment in the Iraq war theater would make it plausible for the adults in the boy’s life to assume that his poor school achievement is caused by worry and anxiety about his dad. My motivation to write grew intense upon imagining how the neurologist would take the neurological history.  Uncovering the diagnosis would parallel a detective story.

The child comes to medical attention when a moderate fever triggers a grand mal convulsion. Fevers often precipitate seizures in persons who have epilepsy. But, no one yet appreciates Conner’s blank-out seizures every few weeks for a year. The parents only know about his single grand mal seizure, and they’re anxious to have the neurologist say that their boy is “fine,” and that they can get on with their lives.

However, the neurologist’s expert questioning reveals that Conner has often experienced premonitory symptoms. Conner admits that he’s had hard-to-describe sensations, including imagining smelling foul odors. These classical elements of complex partial seizures indicate that the boy hasn’t just had his first seizure; he’s had many seizures, albeit of a different form. The boy has epilepsy. The parents are devastated. The mother wants her normal boy back. The old prejudices against people with epilepsy unfold in her mind. She thinks of the pictures of “idiots” with epilepsy in mental institutions of a century ago that she had seen in books; their faces full of bromide-induced rashes, the primary epilepsy medication in use at that time.

My novel describes the emotional journey the family travels from exploring his school problems to the impact of the ultimate diagnosis. They want their normal boy back. What will his future hold? Will Conner “outgrow” this condition—a possibility that the neurologist dangled out for them to reach for, to pray for. Will the medications control his seizures? My novel addresses these questions and the hardships that accompany epilepsy. 

            I started this book in February 2009. Working with my writing mentor and an editor/assistant, many re-writes ensued. The novel was completed in mid-spring, 2011 and I am searching for a literary agent/publisher.

Extremely valuable advice for me was my writing teacher’s encouragement to send pertinent chapters to the professionals who interact with my protagonist. These individuals: school psychologists, private practice psychologists, elementary school teachers, school nurses, a child psychiatrist, and child neurologists, have given me relevant suggestions as to how they perform their work in their clinical and school settings.

            This is my first blog. I look forward to exploring epilepsy with everyone who has an interest in this illness. I invite you to return to my website: LanceFogan.com, to read additional blogs as they are posted.

 


Lance Fogan, M.D. is Clinical Professor of Neurology at the David Geffen School of Medicine at UCLA. “DINGS” is his first novel. It is a mother’s dramatic story that teaches epilepsy.


 

 

 

 

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