Toronto, May 17, 2026
A diagnosis
About this time last year, I was diagnosed with Parkinson’s Disease. Parkinson’s (known familiarly as “PD”) is a progressive movement disorder of the central nervous system. The American writer and humourist Calvin Trillin has described “central nervous system” as the most frightening phrase in the English language.
The full list of debilitating Parkinson’s symptoms is overwhelming. There’s no cure and little treatment. The good news is that my neurologist (I have one now) says my case is mild and progressing slowly. For the moment at least, the diagnosis seems worse than the reality.
What do you do when you are told you have a serious illness? Your concept of self needs to accommodate a new and important fact. But how, and by how much?
My first reaction to the PD diagnosis was not to take it too seriously. The symptoms were mild, I felt well, and—hey—I’m in my eighties, what do you expect? If you’re driving a 1944 Ford, don’t be surprised if a wheel comes off. If your left leg trembles occasionally, it’s not PD, it’s because you’re old. The day after I was diagnosed I cheerfully went off to Copenhagen on holiday.
1944 Ford European Eight DeLuxe Saloon
But my insouciance was unsustainable. The Parkinson’s diagnosis slowly took hold, as I tried to figure out its portent. Now, it is with me always. “Who is the third who walks always beside you? /When I count, there are only you and I together/ But when I look ahead up the white road/ There is always another one walking beside you…” (T.S. Eliot, “The Waste Land”) Now, Parkinson’s is always walking with me.
The distinguished British neurologist Suzanne O’Sullivan, in her 2025 book The Age of Diagnosis: How Our Obsession with Medical Labels Is Making Us Sicker, writes: “I have seen the harm that medical labels do, how they can create a sick role, how they can limit people’s dreams... People enact the features of a disease just through anxiety about that disease, through searching their bodies for symptoms and through expectations...” O’Sullivan describes what is known as the classification effect: “When a person is given a label or diagnosis it inadvertently instructs them on which new signs and symptoms to look out for, and, in searching their body for other typical signs of the disorder, the attention paid to the body and the expectation of symptoms leads them to register bodily changes that they [sic] might previously have been dismissed.”
I find it hard to fight the classification effect. It’s difficult not to interpret every ache, twinge and malfunction of your body as an expression of your disease. But to create a “sick role” is a bad thing. Your illness, even if the symptoms start to overwhelm, is only one part of a complex and rich identity you have constructed over a long time. A sick role must not be allowed to undermine that identity.
What about how others see you? Should you make it generally known when you are diagnosed with a serious disease? There are reasons to stay quiet. Medical circumstances are private. There is no obligation to tell anyone anything. And you don’t want to compromise your public identity by allowing others to see you principally through the lens of a medical label. You don’t want to be “the guy with Parkinson’s.” Or cancer. Or whatever.
But hiding important facts from family and friends suggests a lack of trust. (The most common reaction from old friends when I tell them my diagnosis is to express gratitude for being told.) More generally, it’s hard work to keep a secret from the world, particularly if the symptoms of disease start becoming evident. Information is notoriously impossible to control.
I learnt a lot from my friend Murray, who died almost exactly two years ago after suffering from blood cancer for a long time. He was open and matter-of-fact about his illness. He even joked about it sometimes. Murray’s candour and good humour were a gift from him to those he loved and who loved him back.
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Some reader comments on Endgame #131 (“My sporting life”)
My nephew Vic writes from Grantham, U.K.: “When I was a child the evening news always ended with a funny or happy story, that ended a long time ago. My local news channel in the UK has brought it back, well done !!, however it hasn’t encouraged me to watch the news. I spend my time helping family and others, that gives me the feeling I need to stay sane.”
Wise words from Jim Turk: “I find I’m coping with the terrible state of the world at my advancing age in a way almost opposite to you and your friend Bill. I am even more of a news junky than ever... I have reflected on why I do that on top of working so many hours each day at my job directing the Centre for Free Expression at TMU. I think it is how I cope with the realization that, contrary to my youthful embrace of Martin Luther King Jr.’s assertion that ‘the arc of the moral universe is long, but it bends toward justice,’ I now realize that it bends in whichever direction humanity makes it bend, and right now the bad guys are winning. That is so depressing but the only way I can avoid having my old age consumed by hopelessness is to try, in whatever little time I have left, to do more than ever to try to help bend the arc in a good direction. It is hard to be optimistic but the alternative is despair and I can’t live with that at my age.”
A pithy comment from Bob Rae: “It is actually possible to walk and chew gum at the same time, to follow sports, gossip, law and politics.”
From David Wolinsky: “At 85, I’d love to replace politics with sports but I’m not sure I’ll still be around when the next Canadian team or golfer wins a major championship. From an entertainment point of view, I’m not sure that any sport or quasi-sport other than World Wide Wrestling matches the entertainment value of the President, Vice President, Kash Patel, Pete Hegseth, and Robert F. Kennedy Jr., and unlike these characters WWW isn’t likely to kill me before my age does so I’ll hang with politics.”
Michael Mendelson says: “I stopped watching sports when Henderson won the winning goal in the 1972 Soviet-Canada series. How could it ever get better?”
Randy Hahn makes some astute comments: “As for the most recent Endgame—while I understand your inclination to avoid the noise of the news which generates fear and anger, I’m not at all certain that professional sports with its supposed parameters and recognized rules will end up proving to be more salutary. Your growing interest in the NBA will lead to the realization that the league’s referees are known to make calls that favour the stars of the league or the team that is thought to be deserving, often because of a recent missed call. In hockey the referees are known to often put away their whistles in close playoff games. In baseball strike zones can expand and contract depending on the whims of whoever is the umpire of the day. Which brings to mind the perspective of John Roberts, the Chief Justice of the US Supreme Court, that judges simply call balls and strikes. The legal system in many places is thought by many to provide a structure of arrangements where rules and their application can lead to predictability and coherence. I expect that your long-time experience as a lawyer might prompt you to recognize that notwithstanding such a high-minded goal there is still lots of anger, recrimination, and gnashing of teeth along the way.”
Janet Price puts in a plug for All Remaining Passengers: “I’m not much interested in sports—for me, walking outside in nature, reading a good book (like All Remaining Passengers!!), meditating.”
Harry Katz gives the book a favourable review in his interesting blog “Unsolicited Feedback.”
And John Gregory gives a tip on how to get it: “My bet is that any independent bookstore in the country could order in All Remaining Passengers in a matter of days. My local TYPE store in Toronto has never failed to find any book—Canadian or American—I have asked about and have it to me in a few days. No need to enrich Jeff Bezos further for the purpose if we’re not in the catchment areas of the good stores mentioned.”
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Illness and identity is a huge issue, not only for patients but also for docs. Medical trainees were admonished by their staff physicians for referring on rounds to “the lung cancer in room 12” or “the congestive heart failure in ER”, as opposed to the person with those problems. And medical sociologists in the last century wrote about “the sick role” where, for some patients, illness becomes identity. Finding the sweet spot between the extremes of denial and defeat is the challenge, but generally it’s harder to keep a secret than to share the truth. And other people, noticing symptoms, may be left to their own fantasies about what is actually going on. I watched one of my Cape Breton uncles cope with Parkinsonism over 25 years. He claimed it improved his golf game by slowing down his backswing - true to his character. We bring our unique trajectories and temperaments to the templates of disease, leading to the variety of illness experience. But you will always be, alliteratively, Philip first and foremost!
At our age we all have stuff. The trick is to apply all the treatments (potions, pills, etc
) we can and get on with living.