What does a cup of coffee mean to you? For some, it’s a much-needed supplement to help one get through the day, while for others, it’s an accompaniment paired well with toast. For me, it marks the beginning of a journey.

Recently a man with a left hand tremor was referred to me for evaluation. He reported having a progressive resting tremor with dystonic posturing of the hand for nearly 2 years. He had associated stiffness and limited dexterity of the left hand. He is right-handed so he was able to compensate for these symptoms. After hearing his story and carefully examining him, it was clear that he had Young Onset Parkinson’s disease. He had come to the clinic suspecting this diagnosis but 5% hopeful that I would tell him something different. Once I revealed my thoughts, I could physically see his anxiety melt into horror. His worry was palpable. What we do or say next would set the tone of how he moves forward.

It then dawned on me, that I was the one in the white coat. I was the king of this castle. In this small, restricted environment of a castle, I was holding all the cards. In reality, what I did next would set the tone of how he moves forward.

Unconventionally I decided to move outside my comfort zone. I asked him if he would like to join me for a cup of coffee. The surprised look on his face gave way to a smile. We left the office together and walked down the hospital corridor as colleagues. We chatted about life, kids, work and insurance. Upon returning, coffee in hand, we discussed his options regarding family and work. We discussed how he might want to change his high deductible health care coverage to one that is more comprehensive. Once back in the examination room, we openly discussed his diagnosis and his need for lifestyle changes, dietary changes, exercise and possibly medications. We both then left, he to his family and me to my office, having finished our coffee.

This was an emotional experience for me, one that kept me on a high for the rest of the day, impacting how I engaged other patients and colleagues. I imagine how he must have felt once he left our encounter. I will rephrase my original question. What can a cup of coffee mean to you?


Suketu M. Khandhar, MD is a neurologist and movement disorder doctor at Kaiser Permanente Medical Center in Northern California. He was a faculty member at the 4th World Parkinson Congress in Portland, Oregon and has attended many past World Parkinson Congresses.

Ideas and opinions expressed in this post reflect that of the author(s) solely. They do not necessarily reflect the opinions of the World Parkinson Coalition®