Tango

Medical school teaching on identifying illness prioritises the categorisation of diagnosis. We have been taught to use a funnel approach, moving from a broad list of possibilities to narrow down till a single diagnosis.

With time, I have lost count of patients who behave and suffer in different manners despite sharing a single diagnosis. This week I have been reading the story of an emergency medicine consultant Jonny Acheson who was diagnosed with Parkinson's disease at the age of 41. The life-changing illness led to his realisation how complex a movement disorder can be. As a matter of fact, Parkinson's isn't simply a movement disorder; there are many non-motor symptoms. 

Everyone with Parkinson's disease has a unique and bespoke drug regime. Even if two patients are prescribed the same drug and dose, they may take them at different times. The surest path to understanding the disease is watching Acheson's YouTube video entitled "All the Same But Different." The film showed us stories of ten different people with ten different symptoms.  

The title of his book, When Your Neurons Dance, also reminds us how dance works for different people with Parkinson's disease. More than 20 years ago, researchers from the Einstein Aging Study had published a landmark study in the New England Journal of Medicine to show that dancing can improve brain health and reduce risk of dementia. Few months ago, I read about how neurologists offered tango therapy for patients living with Parkinson's disease in Burenos Aires. Even those who struggle with the stop-and-start motions of walking can benefit from practicing the "slow, short steps" and pauses of tango. The classic move of sanguchito, or "sandwich", in which one dancer's foot slides between the partner's feet and pauses, offer patients clear cues to guide their bodies.  

If you believe that the national dance of Argentina works for patients living with Parkinson's disease, you won't be surprised to find that tai chi exercise, an ancient Chinese martial art, works too to improve postural stability by weight shifting and ankle sway. 

All these observations show how and why national art varies across cultures and yet works similarly.