
When most people think of Parkinson’s disease, they picture the characteristic tremor—that involuntary shaking that has become almost synonymous with the condition. But the reality is far more complex than just one visible symptom. Let’s dig into what’s actually happening in the brain, how doctors figure out what’s going on, and what living with this condition really looks like.
What Causes Parkinson’s Disease?
Here’s where things get frustrating for researchers: despite decades of study, scientists still don’t know exactly what causes the nerve cells in the brain to die. I’m going to apologize in advance because I’m going to be using a lot of “doctor talk”—no way around it.
What we do know is that nerve cells (neurons) in the substantia nigra portion of the basal ganglia—an area of the brain controlling movement—become impaired or die, and these neurons normally produce dopamine, an important brain chemical. When these cells stop working properly, dopamine levels drop, and that’s when movement problems begin showing up.
But dopamine isn’t the whole story. People with Parkinson’s also lose nerve endings that produce norepinephrine, the main chemical messenger of the sympathetic nervous system, which helps explain why the disease affects so much more than just movement—things like blood pressure, digestion, and energy levels all take a hit.
Most Parkinson’s cases are idiopathic, meaning the cause is unknown, though contributing factors have been identified. Current thinking suggests a complicated mix of genetic and environmental factors. About 5% to 10% of cases begin before age 50, and these early-onset forms are often, though not always, inherited.
Some risk factors have emerged from research: age is the most significant, with about 1% of those over 65 and around 4.3% of those over 85 affected. Traumatic brain injury significantly increases risk, especially if recent, and repeated head injuries from contact sports can cause what’s called post-traumatic parkinsonism. Muhammad Ali is a classic example of this.
Exposure to pesticides and industrial chemicals has also been identified as a risk factor. Interestingly, large epidemiologic studies consistently show that people who smoke have a lower risk of being diagnosed with Parkinson’s disease than never‑smokers, although smoking is still strongly discouraged because of its many harmful health risks. Large cohort studies in the U.S. and Europe generally find no direct association between alcohol consumption and Parkinson’s disease. A few observational studies show that moderate drinkers have slightly lower Parkinson’s rates. However, researchers believe this may be due to reverse causation (people in early or undiagnosed stages often reduce drinking because of GI or mood changes) and lifestyle confounders (moderate drinkers may differ in socioeconomic status, diet, or activity level). So, the “protective” effect is considered speculative, not causal.
The Symptoms: More Than Just Shaking
The hallmark movement symptoms—what doctors call “motor symptoms”—are what usually bring people to the doctor. Slowed movements, called bradykinesia, is required for a Parkinson’s diagnosis. People describe it as muscle weakness, though it’s really about control, not strength. The classic tremor, stiffness, and balance problems round out the main movement issues. Patients frequently show reduced arm swing, shuffling gait, difficulty initiating movement or turning, masked facial expression, decreased blinking, and soft or monotone speech.
But here’s what often surprises people: many individuals later diagnosed with Parkinson’s notice that prior to experiencing stiffness and tremor, they had sleep problems, constipation, loss of smell, and restless legs. These “prodromal symptoms” can show up years before the movement problems become obvious. Other early signs include mood disorders like anxiety and depression.
The cognitive side deserves attention too. Some people experience changes in cognitive function, including problems with memory, attention, and the ability to plan and accomplish tasks, though hard to pin down due to concurrence with age related memory problems, 20% at the time of diagnosis is a commonly cited number. More contested is how many develop Parkinson’s dementia, with estimates ranging from 20% all the way to 85%.
How Doctors Make the Diagnosis
Here’s something that might surprise you: there are currently no blood or laboratory tests to diagnose non-genetic cases of Parkinson’s. The standard diagnosis is clinical, meaning there’s no test that can give a conclusive result—certain physical symptoms need to be present.
Doctors typically diagnose Parkinson’s by taking a detailed medical history and performing a neurological examination. If symptoms improve after starting medication, that’s another indicator that the person has Parkinson’s.
There are some imaging tools available. The FDA approved an imaging scan called the DaTscan in 2011, which allows doctors to see detailed pictures of the brain’s dopamine system using a radioactive drug and SPECT scanner. But this scan can’t definitively diagnose Parkinson’s though it helps rule out conditions that mimic it. A hallmark of Parkinson’s is the buildup of misfolded alpha-synuclein proteins (Lewy bodies) inside neurons. Whether this is a cause, an effect, or both is still under study—this part of the science remains somewhat speculative.
Recently, researchers developed something more promising: the alpha-synuclein seeding amplification assay can detect abnormal alpha-synuclein in spinal fluid and may detect Parkinson’s in people who haven’t been diagnosed yet. The catch? It requires a spinal tap and isn’t widely available, though scientists are working on blood and saliva tests.
The early diagnostic challenge is real. Many disorders can cause similar symptoms, and people with Parkinson’s-like symptoms from other causes are sometimes said to have parkinsonism, which includes conditions like multiple system atrophy and Lewy body dementia that require different treatments.
What to Expect: The Prognosis
Let’s address the big question: how does Parkinson’s affect life expectancy? The news here is better than you might think. The average life expectancy of a person with Parkinson’s is generally the same as for someone without the disease.
More specifically, average life expectancy has increased by about 55% since 1967, rising to more than 14.5 years from diagnosis. Modern treatments have made a huge difference. Research indicates that those with Parkinson’s and normal cognitive function appear to have a largely normal life expectancy.
That said, timing matters. Research from 2020 suggests that people who receive a diagnosis before age 70 usually experience a greater reduction in life expectancy, and males with Parkinson’s may have a greater reduction in life expectancy than females.
The disease is progressive, meaning it gets worse over time, but symptoms and progression vary from person to person, and neither you nor your doctor can predict which symptoms you’ll get, when, or how severe they’ll be. The tremor-dominant type usually has a more favorable prognosis than the hypokinetic type.
What actually causes death in advanced Parkinson’s? Advanced symptoms can cause falls, pressure ulcers, swallowing difficulties and general frailty, all of which are linked to death. Aspiration pneumonia—when you inhale food or liquid into the lungs—is the leading cause of death for people with Parkinson’s.
Managing the Disease
Currently, there’s no cure for Parkinson’s, but medications or surgery can improve many of the movement symptoms.
The gold standard medication is levodopa (often combined with carbidopa as Sinemet). Healthcare providers use levodopa cautiously and they commonly combine it with other medications to keep your body from processing it before it enters your brain. This helps avoid side effects like nausea, vomiting, and low blood pressure when standing up. The tricky part? Over time, the way your body uses levodopa changes, and it can lose effectiveness.
Beyond levodopa, doctors use MAO-B inhibitors and dopamine agonists. As the disease progresses, these medications become less effective and may cause involuntary muscle movements. When drugs stop working well, there are surgical options to treat severe motor symptoms.
The main surgical treatment today is called deep brain stimulation (DBS). It is the most important therapeutic advancement since the development of levodopa, and it’s been FDA-approved since the late 1990s A surgeon places thin metal wires called electrodes into one or both sides of the brain, in specific areas that control movement. A second procedure implants an impulse generator battery under the collarbone or in the abdomen. It is similar to a heart pacemaker and about the size of a stopwatch, this device delivers electrical stimulation to those targeted brain areas.
A new treatment that is being used is focused ultrasound. Guided by MRI, high-intensity, inaudible sound waves are emitted into the brain, and where these waves cross, they create high energy that destroys a very specific area connected to tremor. It’s considered non-invasive and the FDA has approved it for Parkinson’s tremor that doesn’t respond to medications.
Don’t underestimate lifestyle interventions either. Physical therapy can improve balance and address muscle stiffness, and regular exercise improves strength, flexibility, and balance. Eating a balanced diet helps—drinking plenty of water and eating enough fiber reduces constipation, while omega-3 fats and magnesium may boost cognition and help with anxiety.
Parkinson’s disease sits at the intersection of aging, genetics, environment, and biology. Diagnosis is clinical, progression is gradual and variable, and treatment has become increasingly sophisticated. While it remains incurable, early diagnosis, personalized medication plans, targeted therapies like DBS, and consistent exercise allow many people to maintain meaningful independence for years.
The key message from specialists? Treatment makes a major difference in keeping symptoms from having worse effects, and adjustments to medications and dosages can hugely impact how Parkinson’s affects your life.




















The Freemasons and the Founding Fathers: Secret Society or Just a Really Good Book Club?
By John Turley
On December 14, 2025
In Commentary, History, Politics
You’ve probably heard the whispers—the Freemasons secretly controlled the American Revolution, George Washington wore a special apron, and there’s a hidden pyramid on the dollar bill. It’s the kind of thing that sounds like it came straight from a Nicolas Cage movie. But like most historical legends, the real story is more interesting (and less conspiratorial) than the mythology.
So, what’s the actual deal with Freemasons and America’s founding? Let’s dig in.
What Even Is Freemasonry?
First things first: Freemasonry started out as actual stonemasons’ guilds back in medieval Europe—think guys who built cathedrals sharing trade secrets. But by the early 1700s, it had transformed into something completely different: a philosophical club where educated men gathered to discuss big ideas about morality, reason, and how to be better humans.
The secrecy? That was part of the appeal. Lodges had rituals and passwords, sure, but the core values weren’t exactly hidden. Freemasons were all about Enlightenment thinking—liberty, equality, the pursuit of knowledge. Basically, the kind of stuff that gets you excited if you’re the type who actually enjoys reading philosophy books.
In colonial America, joining a Masonic lodge was a bit like joining an elite networking group today, except instead of swapping business cards, you discussed natural rights and wore fancy aprons. Lawyers, merchants, printers—the educated professional class—flocked to lodges for both the intellectual stimulation and the social connections.
The Founding Fathers: Who Was Actually In?
Let’s separate fact from fiction when it comes to which founders were card-carrying Masons.
Definitely Masons:
George Washington became a Master Mason at 21 in 1753. He wasn’t the most active member—he didn’t attend meetings constantly—but he took it seriously enough to wear his Masonic apron when he laid the cornerstone of the U.S. Capitol in 1793. That’s a pretty public endorsement.
Benjamin Franklin was perhaps the most dedicated Mason among the founders. Initiated in 1731, he eventually became Grand Master of Pennsylvania’s Grand Lodge and helped establish lodges in France during his diplomatic stint. Franklin was basically the poster child for Enlightenment Masonry.
Paul Revere—yes, that Paul Revere—was Grand Master of Massachusetts. His midnight ride gets all the attention, but his Masonic connections were just as important to his Revolutionary activities.
John Hancock also served as Grand Master of Massachusetts. His oversized signature on the Declaration was matched by his outsized commitment to Masonic ideals.
John Marshall, the Chief Justice who shaped American constitutional law, was a dedicated Mason. So was James Monroe, the fifth president.
Here’s a fun stat: of the 56 signers of the Declaration of Independence, at least nine (about 16%) were Masons. Among the 39 who signed the Constitution, roughly thirteen (33%) belonged to the fraternity.
The Maybes:
Thomas Jefferson? Probably not a Mason, despite endless conspiracy theories. There’s no solid evidence of membership, though his Enlightenment philosophy certainly sounded Masonic. His buddy the Marquis de Lafayette was definitely in, which hasn’t helped dispel the rumors.
Alexander Hamilton? The evidence is murky. Some historians think his writings hint at Masonic sympathies, but there’s no membership record.
Definitely Not:
John Adams wasn’t a Mason and was actually skeptical of secret societies. He still believed in many of the same principles, though—virtue, republican government, that sort of thing.
Did the Masons Really Influence the Revolution?
Here’s where it gets interesting. No, the Freemasons didn’t sit around a lodge plotting revolution like some shadowy cabal. But did their ideas and networks matter? Absolutely.
Think about what Masonic lodges provided: a space where educated colonists could meet, discuss radical ideas about natural rights and self-governance, and build trust across colonial boundaries—all without British officials breathing down their necks. These lodges brought together men from different colonies, different religious backgrounds (Anglicans, Quakers, Deists), and different social classes.
The radical part? Inside a lodge, everyone met “on the level.” It didn’t matter if you were born rich or poor—merit and virtue determined your standing. That’s pretty revolutionary thinking in the 1700s when most of the world still believed some people were just born better than others. Sound familiar? “All men are created equal” has a similar ring to it.
Freemasonry also championed religious tolerance. You had to believe in some kind of Supreme Being, but that was it—no specific creed required. This ecumenical approach directly influenced the founders’ commitment to religious freedom and separation of church and state.
The Masonic motto about moving “from darkness to light” through knowledge wasn’t just ritualistic mumbo-jumbo. It reflected genuine Enlightenment belief in reason and progress—the same intellectual current that powered revolutionary thinking.
What About All That Symbolism?
Okay, let’s address the pyramid and the all-seeing eye on the dollar bill. Are they Masonic? Maybe, maybe not. The Great Seal of the United States definitely uses imagery that Masons also used—but so did lots of 18th-century groups drawing on Enlightenment and classical symbolism. The connection is debated among historians.
What’s undeniable is that Masonic culture emphasized architecture and building as metaphors for constructing a just society. When Washington laid that Capitol cornerstone in his Masonic apron, he was making a statement about building something enduring and meaningful.
The “Conspiracy” Question
Let’s be clear: there was no Masonic conspiracy to create America. The fraternity wasn’t even unified—lodges operated independently, and members included both patriots and loyalists. Officially, Masonic organizations tried to stay neutral during the Revolution, though obviously that didn’t work out perfectly when the war split families and communities.
What is true is that many of the Revolution’s most articulate, influential leaders happened to be Masons. And the fraternity’s values—liberty, equality, reason, fraternity—aligned perfectly with revolutionary ideology. Correlation, not conspiracy.
After the Revolution, Freemasonry exploded in popularity. It became associated with the Enlightenment values that had supposedly won the day. Future presidents including Andrew Jackson, James Polk, and Theodore Roosevelt were all Masons. At its 19th-century peak, an estimated one in five American men belonged to a lodge.
What’s the Bottom Line?
The Freemason influence on America’s founding is real, but it’s cultural rather than conspiratorial. The lodges provided a space where Enlightenment ideas could circulate, where colonial leaders could build networks of trust, and where egalitarian principles could be practiced in miniature.
Washington, Franklin, Hancock, and the others weren’t sitting in smoke-filled rooms with secret handshakes planning to overthrow the British crown. They were part of a broader philosophical movement that valued personal improvement, moral virtue, and human rights. The Masonic lodge was one venue—among many—where those ideas took root.
Freemasonry was one tributary feeding into the river of revolutionary thought, along with classical republicanism, British common law, various religious traditions, and plain old grievances about taxes and representation.
The real story is somehow simpler and more fascinating than the conspiracy theories: a bunch of educated colonists joined a fraternity that encouraged them to think big thoughts about human nature and just governance. Those thoughts, debated in lodges and taverns and town halls, eventually sparked a revolution.
Not because of secret symbols or mysterious rituals, but because ideas about liberty and equality—once you start taking them seriously—are genuinely revolutionary.
True confession—The Grumpy Doc is not now, nor has he ever been, a Mason.