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Health

Playing with Parkinson's

Like her bow as it dips up and down, the career of aviolinist with Parkinson's disease is a balance of optimism and challenges.

By JEREMY OLSON
Published April 18, 2006

Violinist Kristin Kemper is still. She waits in the orchestra, measure after measure, her violin propped on her knee, for the conductor to cue her strings into the melody.

Eleven beats, 10, 9, 8 . . .

If not for her medicine, Kemper's hands might be shaking and her head bobbing. That's how it was three years ago when she was diagnosed with Parkinson's disease. Waiting to play was the most nerve-racking moment back then, before medication helped her overcome her tremors.

Medication tends to wear off, though, so the tremors could return.

Not today. Kemper snaps her violin to her chin.

4, 3, 2, 1 . . .

Her right hand darts the bow across the strings. The movements are quick - almost imperceptible but for the humming from her violin. The piece is Concierto Andaluz, and the pace is allegretto, which means Kemper is playing almost as fast as it gets.

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An estimated 1.5-million Americans live with Parkinson's, a disease caused by the death or damage of brain cells that regulate muscular coordination. It gets worse with time.

The way each person confronts this illness is unique. Some seek escape by traveling the globe. Others dive into scientific literature. Many must abandon their livelihoods.

Kemper plans to play until she can't.

"Everything is going really well for me now," she said, "but I know that isn't going to last until age 65, when I am supposed to retire."

The 38-year-old from Birchwood, Minn., has been a member of the Minnesota Orchestra since 2000. She uses her talent to raise money for Parkinson's treatment and research. There is no cure. Existing medications only stave off the symptoms.

Kemper's first sign of a problem came four years ago. Vertigo, or constant dizziness, isn't a classic Parkinson's symptom. But Kemper was suspicious. She later recalled awakening to the movement of her ring finger, which involuntarily tapped once on her bed and again a few minutes later.

Her handwriting scrunched up, her head seemed to bobble, and her left arm didn't swing when she walked. She noticed tremors during rests in concerts and rehearsals, and a little difficulty turning the pages of the sheet music.

She waited for more than a year after her diagnosis to inform the orchestra. Medication had controlled the symptoms by then, but she worried about how the orchestra's management and her fellow musicians would react.

Since then, with strong support from director Osmo Vanska and her colleagues, she has continued playing full time, three to eight performances a week plus rehearsals. Other violinists rotate chairs and take concerts off. She doesn't.

"I want to play everything," she said. "You know, sometimes I think, 'Oh gee, it would be really great to have the concerto off tonight,' but then I think, 'Well, I want to do it all while I can do it.' "

She takes several medications at low doses, but part of her treatment plan is to take extra medication just before a performance to ensure that her muscles stay relaxed. Taken an hour before a concert, and on an empty stomach, the extra pill can reliably prepare her to perform at her best.

"That," she said, "is one of the few things I can control."

It's a bit of a departure from traditional thinking about medicating the symptoms of Parkinson's. Drugs tend to lose effectiveness over time, so one school of thought is to use as small a dosage as possible for as long as possible, especially in cases of early-onset Parkinson's.

Kemper's neurologist, Dr. Martha Nance, is more aggressive. A few years ago, there was a single drug for Parkinson's, Sinemet. Now there are a dozen options. Who knows what the next generation of research will bring? Why be so stingy with medication now when the future is so unclear?

"One of the challenges in treating a person with Parkinson's is tailoring a particular treatment to what a patient needs," Nance said. "That requires an understanding of who the patient is and what she wants to get accomplished."

One of her patients is a pilot who wouldn't be allowed to fly if he took a certain Parkinson's drug. So Nance prescribed a different drug. It's a philosophy of treatment called "journeying."

Nance takes this tack with all her patients, but the road with Kemper has taken an interesting turn.

Kemper and Nance were taking part in a television interview last fall when Nance mentioned that she used to play piano. Kemper immediately saw an opportunity: a Parkinson's fundraiser featuring a patient on violin and her neurologist on piano.

Nance gulped at the idea of using her high school piano skills to accompany a world-class violinist. But she agreed. It's what she does. She is already playing basketball in a fundraiser for Huntington's disease.

"I hope I don't jam my finger shooting free throws," Nance said, "because it would get in the way of playing the piano."

Kemper makes the best of things, but Parkinson's has changed her life. Plans to have children were disrupted. Goals for retirement were undermined, because she doesn't know when retirement will occur.

"I try not to think things like, 'I hope this isn't the last time I ever get to play,' " Kemper said. "I had a little bit of that right at the beginning . . . so I sort of made that go away."

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Back at the youth concert, Kemper now plays the last fast-paced, technically demanding piece. The tempo is allegro, which is a turbo boost beyond allegretto.

Kemper's fingers flit across the strings as the notes scale up and down. The bow in her right hand tips up and down as it moves from string to string.

The conductor draws the orchestra to its close, and the children, from the front row to the balconies, cheer. Kemper stands calmly, embracing the applause with no outward emotion. Inside? That's something else.

"You get this incredible rush from playing fantastic music with a fantastic conductor and great colleagues," she said. "I hope that rush never goes away."

[Last modified April 18, 2006, 09:33:40]