Nhoroondo yeMatambudziko Ekufamba: Jean-Martin Charcot

Uye nhasi ndinofara kutaura naDr. Christopher Goetz. Who is a professor in the Department of Neurological Sciences and Pharmacology, uye aimbove director weMovement Disorders Program paRush University Medical Center muChicago. Nhasi tichataura nezvenhoroondo yezvirwere zvekufamba uye kunyanya kutaura nezvemipiro yaJean Martin Charcot uyo akaberekwa makore anopfuura 2200 apfuura muna 1825. Tinokutendai zvikuru nekubatana nesu nhasi, Dr. Goetz.

Dr. Christopher Goetz: Ndiwo mufaro wangu.

Dr. Sara Schaefer: Saka tichatanga nekutaura nezvaCharcot. Ndiani murume uyu? Anotsanangurwa [00:01:00] semuvambi wepfungwa dzemazuva ano asi akazviita. Akashanda mukurapa kwakasiyana-siyana uye zvechokwadi mumwe wevanhu vanonyanya kuzivikanwa mukurapa vane mazita akawanda akafanana nezita rake.

Tiudzei nezvake uye simba rake pakurapa kwakazara uye kunyanya pauropi.

Dr. Christopher Goetz: Muzana remakore rechi19, Chikoro cheMishonga cheFrance chaive nzvimbo yepamusoro yekudzidza muchipatara, uye Charcot akadzidziswa sachiremba wepfungwa uye neurology zvakasiyana zvachose muFrance, munhoroondo yezana remakore rechi19. Saka kukura kwake kweneurology yekiriniki yetsinga kwakabva mukurapa.

Hazvina kubva mukurapa kwepfungwa. Hazvina kubva muzvirwere zvepfungwa. Zvakabuda mukurapa kwekiriniki. Uye kare, chinhu chinoshamisa pamusoro pehurongwa hwekurapa hweFrance ndechekuti muzana remakore rechi19. Pfungwa iyi [00:02:00] yekugadzira mabasa ehunyanzvi yakava chiratidzo chehurongwa hwekurapa hweParis uye mapurofesa akasiyana-siyana epamusoro-soro angave aive nyanzvi yemapapu, aizotora varwere kubva muhurongwa hwehutano hweveruzhinji uye kugadzira sevhisi yemapapu. Uye purofesa wehepatology aizotora kubva muzvipatara zvese zveveruzhinji varwere vechiropa vakanakisa uye vanonakidza. Saka izvi zvakaitika muhurongwa hwekurapa hwese hweParis kuti vagadzire pfungwa iyi yehunyanzvi hwekurapa.

Mugumisiro weizvi waive wekuti Salpêtrière kwaishanda Charcot yakanga yapera simba rezvaionekwa nevamwe vanachiremba sezvinonakidza uye zvakasara zvaive varwere vasingaperi, vasingarapike, vazhinji vacho vachiwira muzvirwere zvearthritis uye zvakazopedzisira zvava [00:03:00] zvirwere zvetsinga uye Charcot ndiye aibatsirwa asi zvakare akabatwa neizvi nekuti akasara aine varwere ava.

Asi raive zano rake kuvaisa mumapoka, kuvatarisa zvakadzama uye kubva pane izvi. Akagadzira munda wekiriniki yetsinga dzeropa nekuti vazhinji vevarwere ava vaive nearthritis uye kazhinji vese kana kuti neurologic, uye ndipo paakava nyanzvi yepamusoro yekiriniki muzvirwere zvetsinga. Aivewo munhu ainyatsoziva nezvekuzivisa vanhu, nekuda kwerudzi rwake rwehunhu hwesimba uye nzira yake yekudzidzisa. Aikwezva vanhu kuti vauye kumakirasi ake uye aive aita hurukuro dzekuratidzwa kwevarwere muamphitheater uye vachiratidzwa pamberi pevadzidzi zvekuti waisagona kurega izvozvo zvichifadzwa nezvaairatidza. Uye nekuti aive nevarwere vakawanda zvekuti Salpêtrière yaigara varwere zviuru zvishanu panguva yebasa rake.

Saka aive nevarwere vakawanda vekusarudza kubva kwavari, uye aigadzira imwe ine kudengenyeka kwekuzorora, imwe ine kudengenyeka kwekuita, zviratidzo zvakasiyana-siyana zvetsinga. Aive nevarwere vakakwana zvekuti aigona kuvadzidza kwenguva refu nekuti hapana akabuda muSalpêtrière. Yaive nzvimbo yekurapa varwere vanorwara zvakanyanya. uye vanhu vakanyoresa ipapo vanogara ikoko nekusingaperi.

Dr. Sara Schaefer: Saka wakamutaura semudzidzisi, izvo zviri chimwe chezvinhu zvinondikwezva kwaari. Uye pamusoro pevanhu vazhinji vandinobvunzurudza nezvekugara mu neurology vanoyeuka nguva iyo murwere akaunzwa kuchikoro chavo chekurapa, purogiramu yepre clerkship, murwere ane kudengenyeka ainzwa kukurudzirwa kwepfungwa uye vakaona chiremba achivhura kana kudzima DBS iyoyo uye zvakavaita kuti vafarire [00:05:00] neurology. Zviri pachena kuti iyi inzira yekare uye ine simba yekudzidzisa nekukurudzira vadzidzi vekurapa. Uye wakataurawo kuti, wakataura kuti anodhirowa vanhu, asi anodhirowawo, handiti? Anodhirowa uye anotora mifananidzo uye sevanhu vane matambudziko ekufamba, vanachiremba vepfungwa tinofarira zvikuru vhidhiyo nevhidhiyo yemurwere.

Uye ndinofanira kufungidzira kuti Charcot aizova mumwe wevanhu vanotora mavhidhiyo dai aive netekinoroji iyoyo makore mazana maviri apfuura. Asi mungataura zvishoma nezvazvo here? Nezvekuti akapesvedzera sei, kushandiswa kwemifananidzo iyoyo mukudzidzisa nekudzidza nezvezvirwere zvetsinga?

Dr. Christopher Goetz: Charcot aive chiremba wekuona zvakanyanya uye aivimba neziso rake kuti aongorore chirwere chake uye kuti atevere varwere. Uye kutaura chokwadi pane mashoko akanaka kwazvo, uye kana ndikatora echipiri kuti ndiwane pano, aibata nevarwere zvakananga uye [00:06:00] kukosha kwakakosha kuti ukwanise kuona uye ari kushanda pazviri.

Dr. Sara Schaefer: Ndinofunga ndine mashoko acho chaiwo. Ndeekuti here, "Kana chiremba, semucherechedzi achida kuona zvinhu sezvazviri chaizvo, anofanira kunyora pasi pfungwa dzake, obva aenderera mberi asina pfungwa dzaagara achifunga"?

Dr. Christopher Goetz: Mashoko akanaka iwayo, asi ane chekuita nekusasarura uye kusave nerusaruro rwemukati, rwuri chikamu chedzidziso yake. Asi regai ndikuverengerei mamwe mashoko, uye ari kutaura nevadzidzi vake, "Ngatitii mumwe munhu ane simba mu physiology kana anatomy, kuti chiremba akangwara zvikuru. Aya haasi mashoko ekurumbidza chaiwo, asi kana ukati pane mumwe ane ziso rakapinza, anoziva kuona, pamwe ndiyo kurumbidza kukuru kwaunogona kupa". Uye chakakosha pano maererano nehurukuro yedu ndechekuti hurukuro dzaCharcot [00:07:00] dzakanyorwa. Saka kwemakore a1887 na88 uye zvakare 88 na89, gore redzidzo, kwaive nevadzidzi vaigara pamberi peauditorium uye vakanyora chaizvo kubvunzurudzwa kwevarwere vechiremba.

Saka tine Charcot, kusiyana nevakawanda vanachiremba vepfungwa nevadzidzisi vane mukurumbira, tine shoko rake chairo. Ehe, zvakagadziriswa uye pamwe hazvisi izvo chaizvo zvaakataura. Uye, sezvinongoita podcast inogona kugadziriswa. Kunyange zvakadaro, tine Charcot achitaura zvinhu zvinondibata mwoyo. Uye ndinoashandisa sezvishandiso zvekudzidzisa, asi ndinoashandisawo semhepo yekufema pazuva randinenge ndaora mwoyo.

Saka, anoramba ari mudzidzisi. Ane simba, nekuda kwehunhu uye zviri mukati, asiwo nekuda kwehunhu hwemashoko ake.

Dr. Sara Schaefer: Uye wataura, kuona chaizvo [00:08:00] uye kuva mucherechedzi ane hanya, izvo zvandinofunga kuti zvinopindirana zvikuru nenyanzvi dzezvirwere zvekufamba dzinokoshesa zvikuru chikamu chekutarisa chehupenyu hwedu.

Ndinofunga kuti Charcot angadai ari nyanzvi yezvirwere zvekufamba dai aive mupenyu nhasi.

Dr. Christopher Goetz: Ehe, akapa mipiro yakawanda mukusagadzikana kwekufamba. Uye zvakare, kana tikangoshandisa mamwe mashoko, zvirokwazvo Parkinson, James Parkinson's, ndiye akamutangira. Ndiko 1817. Uye Charcot aive mumakore ekuma1860, makumi manomwe, makumi masere maererano nedzidziso yake. Asi Charcot ndiye akatanga kuziva bradykinesia.

Bradykinesia, hongu, ndiyo chiratidzo cheParkinson's. Haisi kudedera, haisi kusagadzikana kwechimiro chemuviri, haisi kuomarara. Ibradykinesia ndiyo musimboti, uye zvimwe zvakawanikwa zvekuwedzera. Asi akakwanisa kupatsanura izvi uye akati kuvadzidzi vake, zvakare, murwere ari pamberi pake, [00:09:00] "Kune kunonoka kupfuura kushaya simba chaiko kwebasa rekufambisa nhengo dzemuviri. Pasinei nekudedera, murwere achiri kukwanisa kuita zviito zvakawanda zvekufambisa nhengo dzemuviri, asi anozviita nekunonoka kukuru pakati pekufunga nekuita. Pane nguva yakareba. Munhu angafunga kuti basa retsinga rinodiwa rinogona kungoburitswa nekushanda nesimba kukuru kuitira kuti mafambiro madiki akonzere kuneta kwakanyanya."

Itsananguro yakanaka yechiratidzo chechirwere cheParkinson. Charcot inongotsanangurwa chete.

Dr. Sara Schaefer: Uye zita racho rakatochinjwa nepesvedzero yake. Ndizvozvo. Yaiva paralysis agitans, kana kuti shaking palsy, iyo isingasanganisiri, sezvamataura, zvese zvatinoziva nezvekuti chirwere cheParkinson chinogona sei kuunza. Uye akanga asiri chikamu chechikonzero chakaita kuti chitumidzwe zita raJames Parkinson here?

Dr. Christopher Goetz: Akasuma izwi iri ndokukumbira vanhu kuti vatumidze kuti [00:10:00] kubva zvino chirwere cheParkinson, vachikudza chirwere cheParkinson, asiwo kusimbisa kuti haufanirwe kuva nechirwere chekuoma mitezo. Kutaura zvazviri, hauna chirwere chekuoma mitezo. Hapana kushaya simba kwega kwega, kubva mukuwana zvinhu zvinoshamisa, uye hazvifanirwe kunge paine kudedera.

Uye akatsanangura, waimbotaura kare, progressive supranuclear palsy, iyo yaisazivikanwa kusvika gare gare. Asi akaziva kuti kune dzimwe nzira dzeParkinsonism dzaisanyanya kuoneka, kana kuti dzisiri dzeParkinsonism. Uye akaratidza varwere vakanga vasina kutarisa zvakanaka.

Akaratidza varwere vaiva ne frontalis activation uye procerus sign. Izvi zvakazivikanwa asi hazvina kutaurwa mazita chaiwo nekuti anatomi ye progressive supranuclear palsy haina kuzivikanwa. Asi pfungwa yekutora zvakawanikwa pakiriniki uye kuienzanisa ne anatomial [00:11:00] correlate. Ndiyo chipo, chipo chikuru chaCharcot chinofanira kuyeuka mudzidzi wese ndechekuti kuedza kushanda nehukama huripo pakati pechirwere chekiriniki nemaronda emuviri nemazvo. Uye ndiyo archetype ndeye amyotrophic lateral sclerosis, iyo isiri movement disorder, asi zvakadaro imotor disorder uye kuitumidza ne anatomial pamwe ne clinical. Amyotrophic, clinical. Lateral sclerosis, anatomic.

Saka kuva nepfungwa iyoyo yemuviri uye yekiriniki yakaiswa mushoko rimwe chete chipo chaCharcot.

Dr. Sara Schaefer: Uye ndinofunga kuti izvozvo zvinobva pakuti aibva kumishonga kwete kupfungwa dzepfungwa senzira yake yekunzwisisa zvirwere zvetsinga.

Dr. Christopher Goetz: Ndizvo. Ndizvo. Aive munhu aitarisa muviri wemunhu nekuti varwere vaigara kuSalpêtrière, murwere wese [00:12:00] aive wake nekuti pavakafa pfungwa dzavo dzaive dzehurumende.

Akagadzira rabhoritari yekuongorora zvitunha kuti atange kutarisa murwere wega wega maererano nemutsipa, uropi, uropi hahuna kudzidzwa zvakadzama. Izvi zvakazoitika gare gare nevadzidzi vake, asi akatanga chidzidzo ichocho chekuti, ndine varwere vakawanda vane zviratidzo izvi. Regai nditarise maronda aya.

Uye kutaura chokwadi, gomarara iri rinoenderana nechiratidzo chekiriniki, uye kunyange chiratidzo ichi chekiriniki chinofanira kufanotaura kuti murwere uyu achafa riini, kuti pachava negomarara mumusana iwoyo.

Pachava neronda mu cortex yekuruboshwe. Uye kuti tikwanise kufanotaura hukama ihwohwo, ndiyo nzira yekiriniki ye anatomic iyo iri nhaka yaCharcot.

Dr. Sara Schaefer: Uyezve, kwete kungotsanangura izvi nemutauro wakanaka uye wakarurama [00:13:00], asiwo kudhirowa zvinhu zvaakaona, sezviratidzo zveprocerus kuitira kuti tigone kuzvitarisa izvozvi toti, zvinoita semurwere ari mukiriniki yangu ane PSP.

Dr. Christopher Goetz: Ichokwadi nekuti aive mugadziri wemafirimu. Akanga asiri muimbi mukuru, asi nekushandisa nzira yekuderedza pfungwa dzake nemitsara mishoma, aigona kutora zvinhu zvakakosha zvechirwere chetsinga. Saka, mukati mezvinyorwa zvake mune mifananidzo yake yevarwere vake, uye iyi inhoroondo yakapfuma, nhoroondo yemifananidzo.

Wataura nezvekutora mifananidzo. Uye zvechokwadi akabatanidza vanyori vemifananidzo vane hunyanzvi, vavezi vemifananidzo, nevatori vemifananidzo kuti vatore mifananidzo yakasiyana-siyana yakakanganisika. Uye akatoshandisa mifananidzo yekufamba kwenguva kuti abate kufamba kwezvirwere zvekufamba. Zvinonakidza kuti haana kushandisa cinematography.

Kudhirowa mafirimu muFrance kwakanga kwave kupomerwa mhosva [00:14:00], nekuti mushure mekunge hama dzekwaLumiere dzagadzira dhirowa, yakashandiswa zvisina kunaka mumitambo yekuratidzira vanhu vane hurema uye yaionekwa zvisina kunaka mubasa rekurapa. Saka vadzidzi vekuCharcot chete ndivo vakashanyira Paris, vakatora kamera yeLumiere vachidzokera kunyika dzavo, iyo muenzaniso wekare ndiMarinesco akadzokera kuRomania ndokutora varwere vake sezvakaitwa naCharcot pamitsetse mirefu iyi, yechirwere chimwe chete kuti uone hunhu hwechirwere, asi Charcot haana kudaro. Hapana dhirowa mafirimu munhoroondo yeCharcot. Zvakakosha kukoshesa, asi ndinobvumirana kuti angadai akafarira vhidhiyo.

Dr. Sara Schaefer: Zvakanaka, unoramba uchitaura nezvevadzidzi vake uye iye pachake semudzidzisi. Uye ane vadzidzi vakawanda vakakurumbira [00:15:00] uye ane simba guru munguva pfupi iri kutevera. Unoda kutaura nezvevanhu vashoma vaunofunga kuti vakakurumbira, vakadzidziswa naCharcot here?

Dr. Christopher Goetz: Zvakanaka, ndinofunga kuti chakakosha kuziva ndechekuti kirasi yeCharcot yakava chikamu cherwendo rukuru rwaitumirwa vanachiremba veboka revamwe vanhu kuEurope kutenderera uye kuenda kuLondon kunoona Hughlings Jackson, kuenda kuParis uye kugara mukirasi yeCharcot. Zvadaro kuenda kuPrussia uye kushanyira Berlin nenzvimbo dzakasiyana-siyana dzepasi rose.

Yaiva mhando yerwendo rwekuenda kuchipatara uye yaive nechirongwa uye Charcot ndiye aive pamusoro pechirongwa ichocho. Saka vanachiremba vekuAmerica vakaenda kunoshanya. Uye kune zvinyorwa zvakanaka kwazvo zvakanyorwa naS. Weir Mitchell nevamwe vekuAmerica vakasiyana-siyana vakaenda. Asi mukati meFrance, Babinski akadzidziswa naCharcot, [00:16:00] Pierre Marie. Vanhu vese vechizvarwa chinotevera kunze kwaDejerine, naMadam Dejerine havana kudzidzira. Vakanga vasiri chikamu chechikoro cheCharcot. Dejerine akashanda naVulpian uyo aive pedyo naCharcot, asi zvakadaro, Dejerine aisave chikamu chenguva yevadzidzi veCharcot, asi akasarudzwa kuva chigaro cheCharcot mushure mekufa kwaCharcot. Kwete ipapo ipapo, asi pakupedzisira akava chigaro cheCharcot.

Saka kunyange Sigmund Freud akapedza nguva yakati wandei achishandisa Charcot brief, asi akauya kuzodzidza nezvechirwere ichi nekuti Charcot aitodzidza nezveuropi hwevarwere vane zvirwere zvakasiyana-siyana zvetsinga. Akafarira zvepfungwa nekuda kwemaitiro aaiona mutsinga, asi haana kudzidza nezvepfungwa.

Akauya senyanzvi yezvetsinga, kuzodzidza pasi paCharcot senyanzvi yezvetsinga.[00:17:00] 

Dr. Sara Schaefer: Uye Tourette aivewo mudzidzi wake. Uye Tourette

Dr. Christopher Goetz: Aive, Tourette angangodaro asiri chiremba wepfungwa akangwara, kunyanya pakuverenga kwangu. Asi aive mudzidzi uye aive mudzidzi akazvipira kuna Charcot. Charcot aive netsika kubva pakuverenga kwangu yekurega vechidiki vachitora danho rekutanga nekuongorora chirwere uye kuva munyori wekutanga uye akaedza mvura yacho, uye kana zvikabudirira, ipapo ndiye akatora chigaro.

Asi akabvumira vechidiki kuti vave vanyori vekutanga vepfungwa itsva. Uye zvese zvakanyorwa munyaya yekutanga nezve tic disorder naTourette zvinobva kuna Charcot. Zviri pachena kuti idzodzo inhoroondo dzese dzakabva kuvakuru vakuru vangadai vakangotaura nezvaCharcot. Tourette ndiye akagamuchira muchero iwoyo zvechokwadi. Ndizvozvo.

Dr. Sara Schaefer: Saka tingataure zvishoma here nezvemupiro waCharcot kupfungwa dze [00:18:00] dzehysteria uye pamwe kunyange functional neurological disorders uye kuti mafungiro ake nezvazvo angave akachinja sei mafungiro edu emangwana nezvezvirwere izvi?

Dr. Christopher Goetz: Zvakanaka, ndinofunga, ndinofunga zvakawanda zvezvakamboitwa maererano nehysteria. Hysteria yakachinja rudzi rwepfungwa yayo. Uye muzana remakore rechi19, hysteria yaive chirwere chetsinga uye Charcot akaedza kuinzwisisa uye akanzwa kuti yakanga isiri chironda mupfungwa yemaumbirwo, asi chironda chinoshanduka kana chinoshanda mupfungwa yekuchinja kwechinguvana mune imwe chete anatomu.

Saka paive nehwaro hwemuviri hwehysteria uye zvidzidzo zvakawanda zvemazuva ano zvezvirwere zvekufamba kwemuviri zvinotarisa MR inoshanda. Uye ona shanduko munzvimbo dzinoonekwa [00:19:00] nekukuvara kwechimiro kusingachinji. Asi izvi zvaive zvenguva pfupi, zvinoshanda uye zvinogoneka kukurapa kwakasiyana-siyana kwakasiyana nekwetsinga.

Akarasikirwa nekutendeseka kukuru. Ndinofunga kuti kurasikirwa kwekutendeseka ikoko kwakaiswa zvishoma. Uye izvi zvine chekuita nenhoroondo yenzira iyo Salpêtrière yakavakwa nayo. Asi ndinofunga kuti akanga asiri chiremba wepfungwa. Akanga asina kumbobvira ava chiremba wepfungwa. Akanga asina kana chekuita nebazi repfungwa reSalpêtrière.

Basa rake raiva rekurapa tsinga, asi paiva nekutya kukuru pabasa iroro rekurapa tsinga.

Dr. Sara Schaefer: Ehe. Sekuverenga kwangu, aivewo mutsigiri mukuru mukusataura kuti kuongororwa kwechirwere chehysteria kunongoitwa nevakadzi chete, kutaura kuti varume vanogonawo kukanganiswa nezvirwere izvi uye kuzvibatanidza nenhoroondo ye [00:20:00] pamwe chete, sezvamakataura, kuzvibatanidza nepfungwa kana dambudziko repfungwa risingatarisirwi pane dambudziko repfungwa.

Kunyangwe ndichiziva kuti mafungiro ake akachinjawo muhupenyu hwake uye zviri pachena kuti pane gakava guru pamusoro pekuti zvese izvi zvakagadziriswa sei kumashure kuma1800s, handiti?

Dr. Christopher Goetz: Wakarurama chose kuti Charcot pamwe haazivikanwe, asi ndiye munhu akasimbisa kuti hysteria yakanga isiri chirwere chevakadzi. Uye chimwe cheizvi ingori nzvimbo yeSalpêtrière. Salpêtrière, kana ukaishanyira iri kumashure kwechiteshi chikuru chechitima cheGare d'Austerlitz.

Asi panguva iyoyo kwaiva neGare d'Orléans, asi chaive chiteshi chechitima uye vashandi vese vechitima vaiva nechero rudzi rwedambudziko retsinga [00:21:00] vakaendeswa kuCharcot. Saka akaona nhamba huru kwazvo yechitima, uye njanji yaive yakakwirira kwazvo muindasitiri, yakakwirira kupfuura nzira itsva uye inokurumidza, nzira yekufambisa yakanyanya muindasitiri yaive muindasitiri yezvitima.

Saka akaona varume ava vaiva pasi pekushushikana kukuru munharaunda iyi yenjanji. Uye ainyatsosimbisa kuti kukuvara kwavanosangana nako kunogona kukonzera, kunyangwe vachiporesa netsinga, vanosara vaine zviratidzo zvekushamisika. Aiva nepfungwa yekuti kukwanisa kubatwa nepfungwa uye kuva nepfungwa dzekushamisika kwakabatana nehunyanzvi. Saka kugona kubatwa nepfungwa dzekushamisika uye kuratidza kuti varwere ava vanogona sei kuchinja mashandiro avo etsinga [00:22:00] zvichienderana nehukuru hwepfungwa dzavo dzekushamisika kwaive chikamu chepfungwa yake yezwi retsinga dzepfungwa dzezvakawanikwa zvekushamisika. Asi akaona izvi, sezvaakataura, pamwe chete nevarume, pamwe nemadzimai.

Saka kuti tibve papfungwa yechirwere cheovarian kana chirwere chemuchibereko, kuti ichi chaive chirwere chetsinga, chirwere cheuropi, uye chaifanira kuremekedzwa, chaifanira kudzidzwa, uye chaifanira kurapwa. Asi izvozvo zvakangoitikawo nekuti aishanda kuseri kwechiteshi chechitima.

Dr. Sara Schaefer: Mikana inogogodza. 

Dr. Christopher Goetz: Ndinozviziva. Ini chaizvo uye iye aizviziva chaizvo uye akazviziva. Ehe.

Dr. Sara Schaefer: Mukupedzisa, mungandiudza zvamunofunga here? Mataura zvishoma nezvemabasa ake, nhaka yake. Munofunga kuti vateereri vemazuva ano vanofanira kudzidza chii kubva kuna Charcot nehurukuro yedu yanhasi?

Dr. Christopher Goetz: [00:23:00] Zvakanaka, ndinofunga kuti zvechokwadi unoda kugara uchiyeuka pfungwa iyo vanachiremba vepfungwa vanozvirumbidza nayo nezvechironda uye chiratidzo chekiriniki. Ndiyo pfungwa yeCharcot inobva zvakananga kubva kuna Charcot yekutsvaga chironda. Tsvaga chironda chimwe chete, asi kuti uve nechido chekugamuchira chironda chakawanda.

Izvozvo iCharcotism. Uye kana tikazvibata nekuti Charcot ndiye akatidzidzisa. Kuti tisarega chero munhu achikanganwa izvozvo. Ndichakuudzai kuti chinonyanya kundibaya mwoyo mashoko aCharcot achitaura nezvake, kwete kunyanya nezvechirwere chekufamba, asi nezvedambudziko remurwere wetsinga waasingakwanise kurapa.

Uye ndinofunga kuti tose tinonzwa tsitsi nekuti tinoona varwere vatisingakwanise kurapa. Tinogona kuvabatsira, tinogona kuvanyaradza. Asi hatigone kuvarapa. Uye chiremba wemazuva ano anotarisana sei nechokwadi ichocho? Kune ini, ndinonzwa nemashoko aya kuti ndichagovana nemi kuti ndigumise kuti ndine Charcot pafudzi rangu.

Ndiri naye ipapo pandinofunga nezvezvinogona kunge zvichikonzera kuora mwoyo, asi zvinozopedzisira zvava tariro. Saka akaona murwere, uye panyaya yandataura pano, murwere ane bulbar amyotrophic lateral sclerosis, chirwere chinoparadza. Uye murwere anoongororwa, murwere anokurukurwa, pamberi pevateereri. Uye anobva adzinga murwere ndokuvaudza kuti mudzidzi wepachikoro achabuda mumaminitsi mashoma kuti amupe danho rinotevera rekuti achanzwa sei zviri nani, uye ipapo anotendeukira kuvateereri vake ndokuti, "Zviri pachena kuti handina kutaura nezvekufanotaura pamberi pemurwere murombo achangobva kubuda mukamuri. Kufanotaura kwacho kunosemesa. Zvinosuwisa kutaura, asi kuna chiremba [00:25:00] kungave kusuruvara kana kwete haisiriyo nyaya. Chokwadi ndicho dambudziko. Regai murwere ararame mukufungidzira kusvika kumagumo. Zvakanaka, zvine hunhu, asi chiremba, basa rake nderei? Zvechokwadi basa redu nderekusiyana. Ngatirambei tichitsvaga pasinei nezvose, ngatigare tichitsvaga sezvo iriyo nzira yakanakisisa yekuwana. Uye pamwe nekuda kwekuedza kwedu nhasi, mutongo wemangwana hauzove wenhasi".

Uye ndichakuudza, ndakazvifunga kakawanda mazuva ese pandaisangana nematambudziko nevarwere kana kuti pandichaona murwere akaoma uyo tariro inondipa. Ehe, ibasa rangu kunyaradza murwere. Ndinofanira kutaura chokwadi kuti tashanduka kubva mukubata kwedu nevarwere uye kuvimbika kwavari.

Asi pfungwa yacho haisi iyo. Pfungwa yacho ndeyekuti tingaita sei nayo sevanachiremba? Basa redu nderei? [00:26:00] tinozvinyengera here? Kwete, tinoramba tichitsvaga uye ndosaka tiri vanachiremba vedzidzo, kana kuti tiri vanachiremba vari kurapa varwere uye vanogara vakavhura maziso edu kuti vawane mukana unotevera wekubatsira murwere.

Kungoramba tichitarisa uye tisina pfungwa chaiyo, ndipo patingangodzidza chimwe chinhu chichaita kuti fungidziro inotevera ive nani. Izvozvo zvinondibata mwoyo, uye ndanga ndiri mubhizinesi iri kwenguva yakareba. Ndagara ndichishandisa izvozvo mavhiki akawanda. Saka ndinosiya izvozvo kune vese vandinoshanda navo nekuti ndinofunga kuti inhaka yakanaka.

Uye iwayo ndiwo mashoko aCharcot akataurwa pamberi pevateereri vevadzidzi nevanoshanda navo nevashanyi. Zvinondibata pandinoverenga mashoko iwayo. Saka ndinoramba ndichifunga nezvazvo. Ndinokutendai nekufarira kwenyu uye ndinotarisira kuti nhengo yeMovement Disorder Society ichafarira mumwe waanoshanda naye anoramba achidedera uye, hongu, makore mazana maviri apfuura, asi nhaka yake ichiripo [00:27:00].

Dr. Sara Schaefer: Zvechokwadi. Tinokutendai nekugovana ruzivo urwu rwese nezvake nemashoko ake akanaka akakwanisa kunyorwa nekusingaperi, izvo zvinoshamisa kwatiri makore mazana maviri gare gare. Uye zviri pachena kuti aive nezvidzidzo zvakawanda zvekudzidzisa uye achiri kuzviita.

Dr. Christopher Goetz: Ndizvozvo. Ndizvozvo. Ndatenda nekufarira kwenyu.