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We conclude that what is probably a single gene without an additional environmental insult can cause the pathological changes typical of PD. Our findings therefore enhance the likelihood of a significant genetic component in the cause of sporadic PD.

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By identifying a toxic gene product, future molecular genetic studies in our kindred s may provide insight into the pathogenesis of sporadic PD. Why do I think you care about my plumbing woes? However, the drippy shower has become my constant analogy for living life with a rare disease. However, small town medicine is about as effective with managing a rare disease as Joe and I are at handling our plumbing situation. I have great doctors, really.

A large kindred with autosomal dominant Parkinson's disease.

I am sure they are great with managing many common illnesses. I feel like if I were a typical patient and went to any of my medical team with strep throat or high cholesterol or any number of other common problems they could handle it beautifully. Let me be clear — my frustration is not directed toward local practitioners. The people that are equipped to help me you know, the ones who have actually heard of my illness are hours away.

Medicine in a Small, Small Town

This should probably be addressed 24 months from now. It really is. For my friends with complex medical issues, medical care is pretty much a gamble. The two have talked by phone but never met in person. He does have one piece of equipment that makes Scobey a little less isolated than it used to be.

A new telemedicine monitor—a inch screen mounted with a camera—lets patients talk face-to-face with specialists in Billings without making the mile drive. Patients who need a checkup from a cardiologist can drive to Plentywood, a slightly larger town where the telemedicine machine is equipped with a stethoscope.

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The doors of the clinic were locked shut, but Sawdey was across the street at the Catholic church attending a health fair. Within minutes, Sawdey was giving Lantz the clot-busting drug that saved his life.

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Lantz was flown to Billings to have stents implanted. Many health problems in rural areas can be chalked up to simple demographics. People living on farms or in small towns tend to be older than urbanites, according to the National Rural Health Association, so they face all the illnesses associated with aging. They also tend to have less money to pay for such things as health insurance. Such attitudes can be costly. Sawdey certainly has had trouble bringing patients into his clinic.

He estimates that his caseload could increase by 70 percent if everyone in the area who needed medical care made an appointment. For people who do go to the clinic, rural medicine can be a small blessing.

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Greta Stentoft, 82, says her sister used to drive to Billings every three months to see a specialist for her diabetes. Dallas Gaines and his wife, Maxine, 82, catch flak from their kids for living so far away from a city. If the kids had their way, the two of them would pack up and move to Portland, Ore.

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