(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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