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Welcome to a preview of the cabinet of curiosities museum that will accompany THE TRUTH: A TRAGEDY. Enjoy these salient exhibits about John Hopkins (Cynthia’s father), which were personally selected for your viewing delectation by the great performer herself. Many more artefacts will be on display when the museum debuts at 46 Walker Street and so please peruse the gallery at your convenience.

1. Onions!

Please Note: The original musical comedy Onions! – Book by John Hopkins (for which he received the Best Writer Award displayed here), Music by Larry Robertson, Directed by Pam Palmer – was given its premiere and only performance by 10, 11, and 12 year-old students, at the Pike School in 1980.

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2. Space People

An original work by John Goodwin Hopkins, composed of ink on paper (mended frame by Tom Fruin).

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3. This Cabinet Contains Medications Prescribed to John Hopkins, to Alleviate Symptoms of Parkinson’s Disease (* Please Look Behind the Mirror for More Information on Parkinson’s Disease and the Medications and Surgeries Used to Treat its Symptoms *)

3a. Parkinson’s Disease

Parkinson’s Disease is a neurodegenerative disorder which causes a gradual loss of motor function. Named after the British physician James Parkinson, who wrote the first scholarly paper on “the shaking palsy” in 1812, Parkinson’s Disease is a movement disorder whose effects resemble those of related “involuntary movement disorders” such as multiple sclerosis, muscular dystrophy, and cerebral palsy. Its symptoms include: general paralysis of movement, a shuffling gate, drooping posture, lack of arm swing, drooling, slurred speech, diminished facial expression or “frozen” features, loss of manual dexterity, loss of small and large motor control, loss of balance, lethargy, fatigue, depression, and sleep disruption. Parkinson’s symptoms arise from the death of cells located deep within the brain, in an area known as the substantia nigra. The cause of this cellular destruction – in other words, the cause of Parkinson’s Disease – is unknown, and there is no cure for the disease. However, there are many drugs and some surgical techniques available to alleviate its symptoms.

3b. Drugs (Used to Treat Parkinson’s Symptoms)

The cells of the substantia nigra (whose destruction results in Parkinson’s Disease) normally produce dopamine, a neurotransmitter which helps control movement. Lack of dopamine is thus one of the causes of motor degeneration in Parkinson’s Disease, and so dopamine replacement is the aim of many drugs prescribed to Parkinson’s sufferers. Dopamine replacement is trickier than you might imagine, due to the body’s complex structures of self-protection. For example, the blood-brain barrier is a protective layer of specialized cells preventing potentially damaging substances – including dopamine – from entering the brain via the bloodstream. Therefore a dose of pure dopamine or “the straight dope” would not help a Parkinson’s patient, as it would be prevented from penetrating the brain, where it is needed. Instead, a drug called Levidopa is prescribed, which enters the brain and is then converted by surviving nerve cells into dopamine. In order to prevent Levidopa from being converted into dopamine before it has a chance to penetrate the blood-brain barrier, an additional drug called Carbidopa is prescribed, which inhibits enzymes in the bloodstream from converting Levidopa into dopamine too soon. Sinemet is a controlled-release combination of Levidopa and Carbidopa. Additional drugs such as Mirapex are prescribed to enhance dopamine production.

3b1. Drug Side Effects

Medications which alleviate Parkinson’s symptoms do so by affecting brain chemistry. As a result, they can also produce side effects in the form of undesirable behavioral changes and psychiatric disturbances such as stomach upset, nausea, dizziness, fatigue, lethargy, orthostatic hypotension, motor fluctuations, odd dance-like writhing, random, wiggly movements known as choreiform dyskinesia, delusional states, false beliefs, paranoia, compulsive gambling, insomnia, confusion, agitation, disorientation, psychosis, vivid dreams, sleep disruption, low blood pressure, swollen ankles, dementia, diarrhea, unexplained malaise, depression, muscle cramps, anxiety, constipation, vivid nightmares, and non-threatening visual hallucinations.

3c. Surgical Options (Used to Treat Parkinson’s Symptoms)

Parkinson’s symptoms arise not only from the destruction of cells in the substantia nigra, but from resulting mis-firings within the larger structure of which it is a part, known as the basal ganglia: an area deep within the brain made up of the substantia nigra, the subthalamic nucleus, the striatum, and the globus pallidus. For example, when the substantia nigra breaks down, the globus pallidus over-compensates with hyper-activity, resulting in an excessive dampening of motor function. Therefore one of the surgeries used to treat Parkinson’s involves damage to the globus pallidus, called a “pallidotomy.” Another surgical option seeks to decrease the hyper-activity of the globus pallidus in another way: by stimulating adjacent areas, tricking the globus pallidus into decreasing its compensatory activity. This surgical option is known as “Deep Brain Stimulation” and involves the insertion of an electrode – a pacemaker-like device – deep within the brain, which is then connected by thin wires implanted just under the scalp, running to a remote-control receiver implanted in the chest, with which neurologists can activate and adjust the level of deep brain stimulation.

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