The Foreign Service Journal, May 2019

THE FOREIGN SERVICE JOURNAL | MAY 2019 37 pronounced, I finally raised it with my doctors and, throughout 2000, went through a battery of evaluations and tests. In early 2001, I finally learned the results. That gray, bleak February day, typical of winter in Ottawa, seemed a fitting setting for the doctor’s equally bleak verdict. My twitching left thumb and muscle cramps were likely multiple sclerosis (MS), he said, and I would need more tests. He had done a CAT scan, X-rays and a variety of other tests to rule out amyotrophic lateral sclerosis (ALS) and brain tumors, but this diagnosis still left me shell-shocked. I couldn’t quite believe it. Finally, he ruled out MS and declared definitively that I suf- fered from early-onset Parkinson’s disease (PD). I knew about Parkinson’s: it was an old people’s disease, one that affected my Great-Aunt Esther, whose handwriting got shakier with each pass- ing birthday card. But I was only 44 years old, with a young family (my wife, two sons ages 4 and 5), a promising career that I truly enjoyed and lots to look forward to in life. I asked him to double- check that he had the right lab report. Aside from the initial trauma on receiving this news, my wife and I realized we didn’t really knowmuch about this disease. And whether and when to tell others about my diagnosis was an imme- diate concern. As a Foreign Service officer for the U.S. Department of State, I had served in Zaire (now the Democratic Republic of the Congo), Japan, Madagascar and Haiti. With 14 years of service completed, and intending to serve again in hardship posts over- seas—required to move up the ladder in the State Department—I knew that having my medical clearance withdrawn would be a kiss of death to Foreign Service advancement. An officer commits to worldwide availability (i.e., implicit good health). Being the perpetual optimist, I told myself that this couldn’t be the first time that a disability struck the FSO corps, and there must be some way to continue doing the fascinating job that I loved. But I soon found that I was pretty much on my own. The State Depart- ment medical department had few resources to offer. Parkinson’s was a medical disqualification that was rarely—if ever—found in the officers State recruited. If it did strike my colleagues, they likely kept it under wraps for career-promotion reasons if they weren’t already retired. On My Own: Opting for Optimism I started furtively researching Parkinson’s. Thankfully, the internet made information more accessible, Ottawa had excel- lent libraries, and I lived close enough to the United States to avail myself of American resources such as the Parkinson’s Foundation and its voluminous website. The more I read about Parkinson's, and given my lack of family history of the disease, the more it appeared that my diagnosis may have been triggered by my Foreign Service work and residence. As an economic and environ- ment reporting officer, I had been frequently trudging through farmers’ fields, investigating rumored toxic waste areas, or visiting developing world factories with few Occupational Safety and Health Administration worker health standards. I had served in severely underdeveloped places like Congo, Madagascar and Haiti. I recall that during this time, some of my colleagues became ill from exposure to chemical fumigations in their government housing. While in Madagascar, for example, our house was infested with bedbugs and had fleas in the parquet floors. The State Department response was to fumigate the aging mattresses three times in a few short months: probably not advisable for our health, given the products available. Exposure to noxious fertilizers, chemicals and poor environmental conditions are now thought to be elements that may trigger Parkinson’s, particularly if one has a genetic make-up that predisposes one to the disease. Hanging on to a quote by a 19th-century British essayist that “History is not what happens to a man, but what he does with what happens to him,” I decided to treat my disease as a man- ageable chronic illness, not unlike diabetes, which affects many persons, regardless of profession or age. Indeed, I would use Parkinson’s to prove the point that the United States should be represented overseas not just by people of many different ethnici- ties and races, but by persons with great capabilities beyond their disabilities, limps and even shakes! America’s diverse society should be its trademark abroad, representing its strength through its diversity. Newmedications and treatments were coming on stream that made living with PD possible, a better option than just succumbing to physical decline. At times my optimismwas met with a stark realism in the competitive world of diplomacy, however. Some disabilities were clearly more acceptable than others, and I soon discovered that some of my old-school colleagues were less than supportive; Some of my old-school colleagues’ comments about others with medical issues promptedme to avoid disclosing my diagnosis for several years.