Lessons From Lisbon

Above is the Discoveries Monument on the north bank of the Tagus River in Lisbon, Portugal. It was built in 1960 to commemorate the 500th anniversary of the death of Prince Henry the Navigator, who is shown at the front cradling a small sailing vessel. It memorializes what for my money is the most enthralling and influential period in the history of western civilization – the age of exploration, when Europeans decided to go out and see what the rest of the world was all about.

Walking the streets of Lisbon, it is hard to believe that this place was once the economic and cultural center of Europe. Though there are pockets of the city that seem to be thriving, with some great museums and restaurants, the rest is mostly dimly lit streets of slippery cobblestone with surprisingly little activity for a European capital.

But we can always dream of what was. There is no time or place I’d rather visit than those first few decades of the 16th century when Portugal connected Europe to the world. Learning about that period is what first sparked my interest in history and still has me romanticizing what life of a conquistador must have been. 

That history can still be seen on the faces of the people here. A local guide told me that it is impossible to tell who is Portuguese and who is a tourist because that age brought women and men from every corner of the earth to Portugal. The Portuguese still seem to pride themselves on their outward perspective as in conversation they often make a point of contrasting themselves with their ‘inward looking’ Iberian rivals, the Spanish.

What drove so many to set sail for blank spots on a map? Sure many went pursuing the same things that have always driven us – money, fame and glory, but there must have been more. I like to believe that for some it was that simple innate curiosity we have of the unknown, of novelty and the joy of new knowledge, a need to explore not just new places, but new challenges, new ideas and new ways of thinking, all mixed with a healthy skepticism for what everyone was telling them about was out there. It must have taken some bold and ambitious leadership to set aside what was for what could be and plot course after course for uncharted waters.

Lisbon has also been an important source of literary inspiration and it played an important role in a book that I’ve probably read half-a-dozen times, Candide. Written by French philosopher Voltaire, Candide is part adventure novel, part philosophical diatribe. In it the hero, Candide, after extensive travel and a series of unfortunate events that included witnessing the earthquake of 1755 that leveled Lisbon, learns the hard way not to read too much into the ideologies of his day. It ends with him deciding to cast aside some of the ideas and beliefs that pervaded Europe at the time and settle on a remote farm to spend his days tending to his garden. (For a good recap of Candide watch the video below from Crash Course)

Now, after more than a decade traveling and living in foreign lands myself, and having spent the last three searching for truth to a question vital to my well being, I find myself drawn to the lessons Lisbon has left me.

Deciding what and who to believe about what is going on in my brain has been the most challenging problem I have ever faced. It has led me around the world and back again seeking out anyone who might have some clues as to the best way forward. It has also given me the chance to speak frequently to rooms filled with scientists and physicians to convey what I have learned and give my own opinions on what needs to be done.

That led me here, to Lisbon, where two weeks ago I was invited to attend the ADPD meeting, the world’s largest annual gathering of experts in Alzheimer’s and Parkinson’s. There, at a session sponsored by Roche, I shared the stage with Prof. Bastiaan Bloem, a literal and figurative giant in the field. Despite meeting him for the first time just twenty minutes before we went on stage, I think we managed to put on a decent show….

My part was an abridged version of a much longer talk I have been giving at several academic centers and biotech companies. For those who may want to see the full thing, here is a four hour seminar I gave at McGill early last month.

Now, in addition to this being a long-winded way of doing a little shameless self promotion, there is a point I’m trying to build towards.

As you can see if you watch either talk, I have grown more than a little cynical of the way things are in medical science. This cynicism was cemented at the ADPD meeting where many of my suspicions about the nature of medical science were confirmed. I point this out not to direct blame at the meeting itself, it just happened to be the place where it all came together for me. A lot of interesting and positive things did come from it, as you can read about here from Dr. Simon Stott at the Science of Parkinson’s, who also mentions some of those same faults I see.

But it’s one thing to diagnose a problem, it is another to figure out what to do about it. I don’t have all the answers, but I have a few ideas and suggestions for what needs to be done which I will be elaborating on in the days, weeks and months to come here. But to start, I think it will require a shift in thinking on the part of a lot of people. A move away from things as they are towards a new way of thinking about these problems.

Fundamentally what I think it will take is much of that same reckless curiosity that drove Henry the Navigator and all those who followed to new lands, mixed with a little of Candide’s shedding of the ideological baggage that held him back. It will be difficult for some but I think necessary if we are going to progress.

Or, as Voltaire put it, “I should like to know which is worse: to be ravished a hundred times by pirates, and have a buttock cut off, and run the gauntlet of the Bulgarians, and be flogged and hanged in an auto-da-fe, and be dissected, and have to row in a galley — in short, to undergo all the miseries we have each of us suffered — or simply to sit here and do nothing?’
That is a hard question,’ said Candide.”

More on that to come…

 

 

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But before I go I do want to highlight one other thing I came across here from Josepha Domingues. Josepha, or Ju, is a physiotherapist and PhD student at Radbound University. She has pioneered an innovative new form of physiotherapy that involves, well, a whole hell of a lot of trampolines…

 

The effects were temporary, but bouncing around in that trampoline jungle gym under her guidance did more good for my condition than anything those thousands of doctors and scientists could do at the moment. I think if we could clone an army of her we’d do more good in the fight against this disease than almost anything any drug in development has to offer.

 

Obrigado!

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