This blog explains my choice to become a neurologist
and how I became a champion raising epilepsy awareness. A large, multi-clinic epilepsy
group, the Northeast Regional Epilepsy Group,
which has clinics in the New York City area, New Jersey and in Connecticut (http://www.epilepsygroup.com/newsletter-detail24/), recently chose me as
their “epilepsy star” to be featured in their December, 2015 newsletter They served up
several questions that explored my background, how I came to write my epilepsy
novel, DINGS, and my activities in
raising epilepsy awareness. The article follows:
Northeast
Regional Epilepsy Group Epilepsy Star: Lance Fogan, MD
For
this issue we have the fortune of interviewing doctor and author, Dr. Lance
Fogan. As a neurologist, he worked for
years treating patients diagnosed with epilepsy and now retired, he continues
to advocate and educate the public on epilepsy through his wonderful book
"Dings" as well as giving lectures, participating in epilepsy events,
and through an active on-line presence.
Because of his tireless efforts in epilepsy he has been chosen to be our
December epilepsy star!
Please tell us about yourself.
Born
in Buffalo, NY in 1939, I attended public schools. I majored in Anthropology
and Linguistics at my local university, the State University of NY at Buffalo,
living at home with my widowed mother. Although I knew that a medical career
was my calling, I'm so glad I chose this undergraduate major. It opened a more
complete "life" for me. I had pet dogs growing up and veterinary
medicine seemed like a good fit for me. I got a job on a dairy farm sixty miles
south of Buffalo near Jamestown, NY the summer between my sophomore and junior
high school years in order to fulfill future veterinary college requirements. I
lived on the farm during that summer of 1956. I soon realized that I was not
enamored by the large animals. My career goal switched to human medicine. Upon
returning from the farm I got an after-school job operating a cigarette-smoking
machine in a research lab at Roswell Park Cancer Institute in Buffalo. That
fanned my ambitions to enter medicine even more. The scientists collected the
cigarette tars, painted them on the skin of mice, and tumors resulted. In 1964,
between my third and fourth years of medical school, I sought an experience out
"bush" in a remote part of the world. I worked on an Anglican Mission
Hospital in Papua New Guinea with an Australian general practitioner for two
and a half months. After that, I returned to my Buffalo home by flying around
the world for the next six weeks. My future fiancée met me at the airport in
New York City when I returned to the United States; we married two weeks after
medical school graduation nine months later. Our 50th wedding anniversary was
June 13, 2015.
How did you decide to go into neurology and
how much of your work involved working with epilepsy?
The
neuroanatomy course in the first of the four years of medical school was
fascinating for me. Two students shared a human brain that was donated by the
person or his family. We dissected it over several months, memorizing all of
its parts--the blood vessels, nerves and the eyes. As med school continued, my
goal became training in neurology or neurosurgery. Further exposure to the
practice of medicine showed me that neurosurgery would demand too much of my
life in the operating room away from a future family―I chose to practice
neurology. After internship of one year, and then satisfying my military
obligation during the height of the Vietnam War by serving two years as a
tuberculosis control officer with the U. S. Public Health Service assigned to
the Oklahoma State Health Department in Oklahoma City, I began three years of
neurology training at Case Western Reserve University Hospitals in Cleveland,
Ohio in 1968. I joined the Kaiser Permanente Health Plan in Southern California
in 1971. My career as a clinical neurologist was most satisfying and I became
chief of the department. As a clinical neurologist I took care of many epilepsy
patients of all ages, along with the typical neurologic diseases: stroke, brain
tumors, headaches, multiple sclerosis, Lou Gehrig's disease, muscle and nerve
diseases, and etc.
Tell us about your book Dings: what
inspired you, what was your purpose in writing it, what is it about?
I
retired from full-time neurology practice in 1997. A literature/writing class
each Saturday in my teacher's private home since 2000 has enriched my life. I
and my fellow students--half of whom are in their 80's and 90's―create and
write something each week and we read a page or two of our writing in class. In
2009, I read an article in the Los Angeles Times. It told David and Susan
Axelrod's (he is former advisor to President Obama) story of their adult
daughter who developed severe epilepsy. An idea popped sprang up. "Here is
a subject I could write about for my class. I will tell a story about a young
child failing school because of unrecognized complex partial seizure blank
outs." (This scenario is not uncommon in neurology practices). Because his
fictional father is on a combat tour in Iraq, everyone believes the third
grader is suffering from anxiety and stress which is why he can't concentrate
on his school work. The novel is told from the mother's point-of-view telling
of her family's experiences and her attempts to support her son. His teachers
say he's not keeping up and they recommend he move back a grade. Since no adult
has witnessed―or at least recognized--his covert, non-convulsive seizures, his
learning difficulties remain a mystery. Finally he is evaluated by a
neurologist. It is only when the specialist asks specific questions about
possible blank outs and hallucinating bad smells (classical occurrences in
partial complex seizures) that the boy describes his heretofore never mentioned
strange symptoms: his confusion episodes, his occasional urinary incontinence
(which he hides), and his imagined smells of burning rubber. He calls these
symptoms his 'dings.' I immediately appreciated how my novel can educate the
reader on epilepsy. The book details what epilepsy is, how it is diagnosed,
what tests can be helpful, its treatment and how full and successful lives are
very compatible with an epilepsy diagnosis. A practical epilepsy glossary
concludes the book.
Have you been able to use Dings to raise
epilepsy awareness? How?
I
have been posting educational blogs about epilepsy every month since 2011. You
can read the blogs on my website: LanceFogan.com. Recent blogs feature excerpts
from the novel about the neurological examination.
Teaching
is my forte and joy. The title of a PowerPoint presentation I have made to the
California Association of School Psychologists at two of their annual state
meetings is "Recognizing Covert, Non-Convulsive Epileptic Seizures in the
Classroom." In addition, I have given lectures about epilepsy to nurses in
my local school district and to student teachers. I raise epilepsy awareness on
Twitter (@lance_fogan), LinkedIn and on Facebook. I have appeared at local book
signings discussing DINGS and epilepsy. I am always available to give epilepsy
presentations in my area, the Greater Los Angeles, California region.
The
Mayo Clinic's Neurology Dept. is using DINGS as a teaching aide for their
students and neurology trainees. The Epilepsy Foundation of America
("Epilepsy.com" Wednesday, June 12, 2013 Summer Reading: Two Books on
Epilepsy) and other epilepsy organizations in the United States and in Great
Britain (http://livingwellwithepilepsy.com
30 July, 2015 "Emily's Perspective: A review of 'Dings,' by Dr.
Lance Fogan) have favorably reviewed DINGS. One comment on Amazon.com
epitomizes my purpose for writing the novel. A woman told of her 18 year-old
grandson's recent diagnosis of epilepsy. Before that he was thought to have a “learning disorder.” She wrote that if she
had read DINGS sooner, a correct diagnosis of epilepsy could have been made
earlier and treatment could have been prescribed much sooner.
Tell us about your continued work to raise
epilepsy awareness through other venues.
I
am currently raising epilepsy awareness in my teaching as clinical professor of
neurology at UCLA of medical students and non-neurology physician trainees and
practitioners. I think most lay people would be surprised at the lack of
knowledge non-neurologist physicians have in recognizing non-convulsive
epilepsy. Individuals suffering complex partial seizure blank outs are
frequently found confused; some wander in traffic. When police find them they
bring them to hospital emergency rooms where they are misdiagnosed as
"alcoholics" or "mental patients." The ER doctors too
frequently fail to recognize their true condition and refer them to
psychiatrists.
What plans do you have for the future?
I
plan to sponsor a table at the Epilepsy Foundation of Greater Los Angeles
Annual Walk to End Epilepsy in November, 2015. I will discuss epilepsy from a
doctor's point of view and highlight the epilepsy-educational value of DINGS.
Any closing words?
Non-neurologists,
especially pediatricians, do not warn their patients who have epilepsy of the
great risk of their drowning at home. Whenever I discuss epilepsy I highlight
the seventeen people I know of, to date, who have drowned in their bathrooms.
Five of these patients fell face-down in the shower blocking the drain and
dying in two inches of water. Consequently, I recommend that people who have
epilepsy never take a bath or shower unless someone is at home and the door
left open, if possible. Individuals with poorly controlled seizures,
especially, should be instructed to sing in their bath/shower. If the singing
stops, an attentive relative/housemate should rush to see if they are all
right. Non-neurologists, especially pediatricians, do not warn their patients
of potential home drownings in epilepsy.
I
also recently met the family of a woman with poorly controlled epilepsy. Her
father showed me several old severe burns on her forearms and hands. He told
me, "Tell your patients to cook only on the BACK burners on their stove
tops." I hadn't thought of this. Terrific idea! Let's disseminate that
suggestion to further safeguard our friends and patients.
After
reading DINGS, only $2.99 as an eBook, patients will be teaching their
physicians about epilepsy. The novel is available as audiobook, too.
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, now available in eBook, audiobook
and soft cover editions.
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