A Hidden Diagnosis

 I recently listened to This American Life's podcast investigating the case of Dr. Vince Gilmer, who unexpectedly murdered his father in an uncharacteristic bout of rage. Prior to the incident, Dr. Gilmer was known as a selfless, kind-hearted doctor, husband, and son in North Carolina who went out of his way to serve his patients and focused on building strong relationships. Over a short period of time, his wife, friends, and co-workers started noticing a change in Dr. Gilmer's behavior. He had a car accident that others believed was caused by Dr. Gilmer purposefully to get out of a state board exam or get a new truck. He also refused to attend therapy with his wife, so she suggested a divorce, and he got an apartment the very next day and filed the divorce. Eventually, Dr. Gilmer developed a drinking problem in addition to his erratic behaviors, which led to him murdering his father.

Dr. Gilmer was found guilty of premeditated murder because he showed little remorse for and the detectives on the case were convinced that he was putting on an act every time he was around them, having acute mood swings, broad and graded movements, fidgeting, stooping posture, and the tendency to pace. He was sentenced to life in prison with no parole, but Dr. Gilmer continued to plea for help, explaining that he believed his actions were caused by decreased serotonin because he had stopped taking his medication before the incident. Finally, a doctor that had taken his position at the clinic he previously worked in had developed an interest in the case because of the patients that had nothing but glowing reviews for their previous doctor. After digging into the timeline of events and testimonials from Dr. Gilmer's friends, co-workers, and patients, both he, the podcast investigator, and a psychiatrist make a visit to see him in prison. At their meeting, they noticed Dr. Gilmer's behaviors, repetitive speech and body movements, jerky movements, and an inability to focus. The psychiatrist strongly believed that serotonin deficiency or traumatic brain injury could not be the cause but suggested that his behaviors hit the marks for Huntingdon's disease. Soon, Dr. Vilmer was given a genetic test to test for Huntingdon's, and it came back positive. After six years of begging for help and trying to find a reason behind his own behaviors, Dr. Gilmer finally had an answer to why his behaviors had led to such drastic actions. 

I chose this resource for Huntingdon's disease because we do not often think of neurodegenerative conditions having such severe consequences on the lives of the people they affect. This podcast reveals the importance of recognizing changes in the behaviors of our family, friends, and clients and taking action in order to prevent the suffering that Dr. Gilmer had to endure. Even if Dr. Glimer's family and friends had no reason to suspect that he had Huntingdon's, I think that there was still enough evidence for change in behavior to call for an intervention. He went from being a responsible, personable, caring man to a person that was almost unrecognizable to the people around him. Although we cannot fault his wife, friends, or co-workers for staying away, I think that if the general public was more aware of the actions we can take when a loved one exhibits a sudden change in behavior, they would have been able to act in a proactive way to Dr. Glimer's changes. It is important for occupational therapists and other health care providers to be resourceful and educational toward our community by offering access to reliable information, connections within the community, providers, and emergency services in order to provide the tools that people need to guide their loved ones to seek care. 

This case relates to our course because it shows the importance of knowing the cardinal signs of Huntingdon's disease, as well as all other conditions. It shows how this condition can have a major effect on the occupations of our clients by causing drastic changes in mental and physical health, which can cause damage to the social relationships with caregivers, friends, and co-workers. This leads to reliance on others in helping to perform activities of daily living, such as walking, talking, taking medications, and dressing, as well as instrumental activities of daily living, such as finances, driving, safely preparing meals, and maintaining relationships. I recommend this resource to others because it exhibits the importance of education, involvement of the family, recognizing hallmark signs, and intervening as early as possible for people who have sudden changes in behavior. 

References

Dr. Gilmer and Mr. Hyde. (2013, April 12). This American Life. https://www.thisamericanlife.org/492/dr-gilmer-and-mr-hyde

‌NPR’s This American life. (2015, December 14). HOPES Huntington’s Disease Information. https://hopes.stanford.edu/npr-this-american-life/

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