William Langston, sensed that he might be normally alert. A true medical
mystery, Dr. Langston had to determine how this patient had, overnight,
become “paralyzed” without losing cognitive ability.^1
A quick physical exam ruled out stroke and catatonic schizophrenia.
Although the patient was incapable of moving his limbs, his body was not
flaccid, but was instead rigid. In fact, the patient was described as having
“waxy flexibility,” wherein his arm could be raised overhead, and once the
examiner’s supporting hand was removed, the limb would stay in place.
No, this was not an infection, nor was it a brain hemorrhage, nor was it
insanity. Talking with those who knew him revealed that these symptoms
had come on literally overnight. It was as if the patient had become the
first person in history to come down with a case of profound Parkinson’s
disease (PD) in the span of one day.
The mystery was rapidly solved through careful detective work and a
“trail of ironies,”^2 piecing together ER admission stories from neighboring
cities, police reports, news media alerts, and what is ironically considered
“a bit of luck.” Dr. Langston and other medical investigators identified six
additional Bay Area cases of sudden-onset PD, and all seven patients had
one striking feature in common: they had used a new “synthetic heroin”
that had recently been pushed on the streets of northern California during
the “designer drug phenomenon” of the early 1980s.
The question remained, what was the causative agent behind these
catastrophic afflictions? The scientists, working with law enforcement and
“cooperative” drug dealers, obtained samples of synthetic heroin,
eventually hitting the jackpot and discovering a batch of adulterated drugs
that was comprised almost entirely of MPTP, an unwanted molecular
byproduct of botched kitchen (or Winnebago) chemistry. It turns out that
while manufacturing synthetic heroin, temperature is paramount, and if a
(not so) trustworthy drug dealer is breaking bad and sabotages the cooking
of heroin, a nasty byproduct results that is toxic to a very particular part of
one’s brain.
Langston and colleagues published their findings in Science in 1983,
suggesting that MPTP was toxic to a specific part of the brain that was