Epilepsy Star: Lance Fogan, M.D.
For this issue we have the fortune of interviewing doctor and author, Dr. Lance Fogan. As a neurologist, he worked for years treating patients diagnosed with epilepsy and now retired, he continues to advocate and educate the public on epilepsy through his wonderful book "Dings" as well as giving lectures, participating in epilepsy events, and through an active on-line presence. Because of his tireless efforts in epilepsy he has been chosen to be our December epilepsy star!
Please tell us about yourself
Born in Buffalo, NY in 1939, I attended public schools. I majored in Anthropology and Linguistics at my local university, the State University of NY at Buffalo, living at home with my widowed mother. Although I knew that a medical career was my calling, I'm so glad I chose this undergraduate major. It opened a more complete "life" for me. I had pet dogs growing up and veterinary medicine seemed like a good fit for me. I got a job on a dairy farm sixty miles south of Buffalo near Jamestown, NY the summer between my sophomore and junior high school years in order to fulfill future veterinary college requirements. I lived on the farm during that summer of 1956. I soon realized that I was not enamored by the large animals. My career goal switched to human medicine. Upon returning from the farm I got an after-school job operating a cigarette-smoking machine in a research lab at Roswell Park Cancer Institute in Buffalo. That fanned my ambitions to enter medicine even more. The scientists collected the cigarette tars, painted them on the skin of mice, and tumors resulted. In 1964, between my third and fourth years of medical school, I sought an experience out "bush" in a remote part of the world. I worked on an Anglican Mission Hospital in Papua New Guinea with an Australian general practitioner for two and a half months. After that, I returned to my Buffalo home by flying around the world for the next six weeks. My future fiancée met me at the airport in New York City when I returned to the United States; we married two weeks after medical school graduation nine months later. Our 50th wedding anniversary was June 13, 2015.
How did you decide to go into neurology and how much of your work involved working with epilepsy?
The neuroanatomy course in the first of the four years of medical school was fascinating for me. Two students shared a human brain that was donated by the person or his family. We dissected it over several months, memorizing all of its parts--the blood vessels, nerves and the eyes. As med school continued, my goal became training in neurology or neurosurgery. Further exposure to the practice of medicine showed me that neurosurgery would demand too much of my life in the operating room away from a future family―I chose to practice neurology. After internship of one year, and then satisfying my military obligation during the height of the Vietnam War by serving two years as a tuberculosis control officer with the U. S. Public Health Service assigned to the Oklahoma State Health Department in Oklahoma City, I began three years of neurology training at Case Western Reserve University Hospitals in Cleveland, Ohio in 1968. I joined the Kaiser Permanente Health Plan in Southern California in 1971. My career as a clinical neurologist was most satisfying and I became chief of the department. As a clinical neurologist I took care of many epilepsy patients of all ages, along with the typical neurologic diseases: stroke, brain tumors, headaches, multiple sclerosis, Lou Gehrig's disease, muscle and nerve diseases, and etc.
Tell us about your book Dings: what inspired you, what was your purpose in writing it, what is it about?
I retired from full-time neurology practice in 1997. A literature/writing class each Saturday in my teacher's private home since 2000 has enriched my life. I and my fellow students--half of whom are in their 80's and 90's―create and write something each week and we read a page or two of our writing in class. In 2009, I read an article in the Los Angeles Times. It told David and Susan Axelrod's (he is former advisor to President Obama) story of their adult daughter who developed severe epilepsy. An idea popped sprang up. "Here is a subject I could write about for my class. I will tell a story about a young child failing school because of unrecognized complex partial seizure blank outs." (This scenario is not uncommon in neurology practices). Because his fictional father is on a combat tour in Iraq, everyone believes the third grader is suffering from anxiety and stress which is why he can't concentrate on his school work. The novel is told from the mother's point-of-view telling of her family's experiences and her attempts to support her son. His teachers say he's not keeping up and they recommend he move back a grade. Since no adult has witnessed―or at least recognized--his covert, non-convulsive seizures, his learning difficulties remain a mystery. Finally he is evaluated by a neurologist. It is only when the specialist asks specific questions about possible blank outs and hallucinating bad smells (classical occurrences in partial complex seizures) that the boy describes his heretofore never mentioned strange symptoms: his confusion episodes, his occasional urinary incontinence (which he hides), and his imagined smells of burning rubber. He calls these symptoms his 'dings.' I immediately appreciated how my novel can educate the reader on epilepsy. The book details what epilepsy is, how it is diagnosed, what tests can be helpful, its treatment and how full and successful lives are very compatible with an epilepsy diagnosis. A practical epilepsy glossary concludes the book.
Have you been able to use Dings to raise epilepsy awareness? How?
I have been posting educational blogs about epilepsy every month since 2011. You can read the blogs on my website: LanceFogan.com. Recent blogs feature excerpts from the novel about the neurological examination.
Teaching is my forte and joy. The title of a PowerPoint presentation I have made to the California Association of School Psychologists at two of their state meetings is "Recognizing Covert, Non-Convulsive Epileptic Seizures in the Classroom." In addition, I have given lectures about epilepsy to nurses in my local school district and to student teachers. I raise epilepsy awareness on Twitter (lance_fogan), LinkedIn and Facebook. I have appeared at local book signings discussing DINGS and epilepsy. I am always available to give epilepsy presentations in my area, the Greater Los Angeles, California region.
The Mayo Clinic's Neurology Dept. is using DINGS as a teaching aide for their students and neurology trainees. The Epilepsy Foundation of America ("Epilepsy.com" Wednesday, June 12, 2013 Summer Reading: Two Books on Epilepsy) and other epilepsy organizations in the United States and in Great Britain (http://livingwellwithepilepsy.com 30 July, 2015 "Emily's Perspective: A review of 'Dings,' by Dr. Lance Fogan) have favorably reviewed DINGS. One comment on Amazon.com epitomizes my purpose for writing the novel. A woman told of her 18 year-old grandson's recent diagnosis of epilepsy. Before that he was thought to have a learning disorder. She wrote that if she had read DINGS sooner, a correct diagnosis of epilepsy could have been made earlier and treatment could have been prescribed much sooner.
Tell us about your continued work to raise epilepsy awareness through other venues.
I am currently raising epilepsy awareness in my teaching as clinical professor of neurology at UCLA of medical students and non-neurology physician trainees and practitioners. I think most lay people would be surprised at the lack of knowledge non-neurologist physicians have in recognizing non-convulsive epilepsy. Individuals suffering complex partial seizure blank outs are frequently found confused; some wander in traffic. When police find them they bring them to hospital emergency rooms where they are misdiagnosed as "alcoholics" or "mental patients." The ER doctors too frequently fail to recognize their true condition and refer them to psychiatrists.
What plans do you have for the future?
I plan to sponsor a table at the Epilepsy Foundation of Greater Los Angeles Annual Walk to End Epilepsy in November, 2015. I will discuss epilepsy from a doctor's point of view and highlight the epilepsy-educational value of DINGS.
Any closing words?
Non-neurologists, especially pediatricians, do not warn their patients who have epilepsy of the great risk of their drowning at home. Whenever I discuss epilepsy I highlight the seventeen people I know of, to date, who have drowned in their bathrooms. Five of these patients fell face-down in the shower, blocking the drain and dying in two inches of water. Consequently, I recommend that people who have epilepsy never take a bath or shower unless someone is at home and the door left open, if possible. Individuals with poorly controlled seizures, especially, should be instructed to sing in their bath/shower. If the singing stops, an attentive relative/housemate should rush to see if they are all right. Non-neurologists, especially pediatricians, do not warn their patients of potential home drownings in epilepsy.
I also recently met the family of a woman with poorly controlled epilepsy. Her father showed me several old severe burns on her forearms and hands. He told me, "Tell your patients to cook only on the BACK burners on their stove tops." I hadn't thought of this. Terrific idea. Let's disseminate that suggestion to further safeguard our friends and patients.
After reading DINGS, only $2.99 as an eBook, patients will be teaching their physicians about epilepsy. The novel is available as audiobook, too.
