Friday, May 14, 2021

Three books or treasures by neurologist Gonzalez Maldonado.

 

THREE BOOKS BY A PRESTIGIOUS NEUROLOGIST: THREE TREASURES ON THIS PATH TO THE HEART OF THE LABYRINTH.

FIRST.

"The books of Dr. González Maldonado (1): "The strange case of Dr. Parkinson".

 



To explain here what the first two books (published in 1997 and 2004) of the neurologist from Granada, Dr. Rafael González Maldonado, meant to us is both an easy and difficult task.
Easy because it is so much that it is only necessary to narrate it and the quality of his books speaks for itself.
Difficult because his influence reached practically every aspect of our lives.
I price myself for having initiated a friendship with him through social networks and the Internet and it does not affect my judgment in the least (as this comes from the late 90's). Far from flattery or awkward praise, my opinions on the importance of his books are old and previously published. On the other hand, my opinion about his way of being a doctor and, therefore, of treating the sick, is confirmed every time I meet a sick person who has been treated by him or I recommend him to someone and when they come back they tell me how it went.
"The Extraordinary Case of Dr. Parkinson" (1997, republished in 2013), was for my father a real bedside book. It came into his hands around 1999 or 2000, perhaps recommended by an acquaintance.
I have already written about it on Facebook and on my blog, both entitled "Parkinson's here and now". Eventually we bought a second copy for me and we would read passages to each other, trying to really understand what we were reading (i.e., the nearly impossible task of integrating that into a framework of scientific knowledge we didn't have).

Not only is it one of the best books ever written about Parkinson's, in any language and in any era, but it has certain interesting qualities: it is well written; it is valid for patients, families and caregivers, as well as for doctors; and the most remarkable, in my opinion, is that it is a classic in the sense that it is alive, it has pores, it accompanies the reader throughout his life experience with the disease, providing him with knowledge as he is able to understand more things because of the accumulated information and experience. The book changes as the reader evolves over the years.

It also has a great sentimental value for me because my father's copy is full of underlines, notes with different types of letters (reflecting the phase of the illness in which he made them, the emotional state) and they have served me to "date" in time, in an approximate way, his interests and concerns. Even the one that is illegible due to the parkinsonian micrography (very small letters) (it seems that the lines get tired and fall down).


I think it is important to repeat it: one of the most surprising things, seen from today, is how little we understood of this book in the early years, despite how clearly it explains the essentials. It took us a long time to leave behind our ignorance that was anchored in our prejudices that were proof of reasons to the contrary.

As a sample of the union of the scientific and the practical, an excerpt from his book:

"LEMON JUICE.
It is not a quack prescription. Levodopa absorption changes according to gastrointestinal pH. Taking lemon juice (30 ml) with each dose of levodopa increased its plasma levels and improved motor function in a group of Parkinsonians (38), especially those in whom the initial gastric acidity was lower than normal. 254.

Yazawa I, Terao Y, Sai I, Hashimoto K, Sakuta M. [Gastric acid secretion and absorption of levodopa in patients with Parkinson's disease--the effect of supplement therapy to gastric acid]. Rinsho Shinkeigaku 1994; 34:264-266."


Note of 12/03/2021: English translation available.

---


SECOND.

"Dr. Gonzalez Maldonado's books (2): Heterodox treatments in Parkinson's disease.

 


The second book that we knew of the neurologist Dr. Rafael González Maldonado was "Heterodox treatments in Parkinson's disease" (2004), which came to us when we had already started our search for the paths of complementary and alternative treatments. But before this book there were only hesitations motivated by press and TV news (vitamin B2 and elimination of red meat, fermented papaya, etc.).

If the first one was "my father's" book, this one was "mine".

It is an essential work. A brief "encyclopedia" that offers a deep, rigorous and as simple as it can be, vision of a very important part of the universe of unofficial treatments related to Parkinson's (and valid for all other neurodegenerative diseases), with the author's favorable or unfavorable opinion on each one. The footnotes, together with more than 1400 references to scientific studies listed in an appendix at the end, make it 190 pages long.
Nearly 20 years of experience with my father's disease (1994-2012) make it a unique book, not only in Spanish but in any language.
It modeled, stimulated, corrected and influenced our concerns, our searches.
Thanks to "Tratamientos heterodoxos" we were able to start trying many things and we dared to publish in forums.
The sections on vitamins, minerals and trace elements, omega 3 fats, green tea, medicinal plants such as passionflower and valerian, tobacco, chocolate or coffee, were some of the ones we read the most in our two copies of the book.

For example:

"13. PASSIONFLOWER
Passionflower, passion flower or passion fruit is a climbing plant with large red flowers (Passiflora incarnata). Its active ingredient, passionflower, is structurally similar to morphine, but is not addictive. It is a popular remedy for insomnia and nervousness and relieves coughs.
Currently, passionflower is considered a reliable anxiolytic and sedative, as effective as oxazepam and with less functional impairment, so it is useful in Parkinsonians whose gait worsens with benzodiazepines.
In Parkinson's it has other advantages: it potentiates levodopa, reduces resting tremor, relieves night cramps and improves sleep".


This beautiful anecdote told by the famous psychologist Carl Gustav Jung serves me to express what these books meant to us:

"I always remember that one morning I received a really poor piece of writing on a sheet of paper, from a woman who wanted to see me at least once in her life. The letter impressed me greatly, but I wasn't sure what the reason for it was. I invited her to visit me and she came. She was very humble, also intellectually.
I don't think she had completed her elementary studies.
She took care of her brother's house and also ran a small newspaper kiosk.
I cordially asked her and she answered me this way:
"Your books, they are not books, Herr Professor, they are bread..."


Your books, they are not books, doctor, they were and are bread..."


Note dated 12/03/2021:
And they still are. Perhaps even more so than then.

We are still without an English translation in 2021. As strange as it is that elevated homocysteine is still not routinely treated with appropriate doses and forms of vitamins B6, B9 and B12 (especially since levodopa raises the neurotoxic homocysteine).

---

THIRD.

"Dr. Gonzalez Maldonado's books (3): Parkinson's disease and stress.



 

I have already mentioned "El extraño caso del Dr. Parkinson" (1997) and "Tratamientos heterodoxos en la enfermedad de Parkinson" (2004). These two were important in my father's lifetime and, later, in writing this book.
The third one I have read, "Parkinson y estrés", is a treasure to me.

Firstly, because it sets out many interesting and enriching ideas about Parkinson's, which show that its author is at the forefront of what is beginning to be known and intuited about the enormous mysteries of this elusive disease.

Moreover, on a personal level, its author was kind enough to mention and cite my blog "Parkinson's here and now" in his book, specifically by a reference to Dr. Hurni's thesis. This gesture of kindness does not influence in the least my judgment on his books, since my admiration for his works is earlier (as can be seen in the blog).

He seems to me a worthy continuation of the first two books, "The Strange Case..." and "Heterodox Treatments...", focusing on the psychic aspects of Parkinson's, in particular, on the importance of stress in the origin and development of the disease. This idea was put forward by the pioneers of Neurology in the 19th century, but almost abandoned during most of the 20th century by other scientific currents and fashions.
In my opinion, it has brilliant moments of great interest for the non-specialist reader: the exposition of the hypothesis of dopaminergic forging, the possible evolutionary weakness of the substantia nigra, the existence of "Parkinson's diseases", the story about Mark Peter Hurni, the influence of stress on the brain, etc.

Worth an example:

"In the 19th century, but also much earlier, the classics intuited (intuition is a shortcut to knowledge) that stress, intense emotions and suffering in general accelerated the aging process, including the precocious appearance of gray hair. This is part of the popular cultural heritage. It is a constant in our classics from ancient Greek philosophers to recent novelists."

What he says places the three books mentioned above among the most interesting works of popularization of these two centuries of modern Parkinson's History.
These three books by Dr. Gonzalez Maldonado were for years "bread" for my father and me, not just books.".

---

Note 12/03/2021: And they still are. Frequent place to return to review, learn and seek inspiration. And of many memories...

No comments:

Post a Comment