The first thing you notice at Lucy Bowen McCauley's dance class for people with Parkinson's disease is the range of symptoms among the 15 people seated in a wide circle around the room. There is a guy with the severe hand tremors that I associate with the degenerative neurological disorder. But there's also a woman who moves with a stiff, awkward gait, a woman confined to a wheelchair and another man who shuffles and suffers from a pronounced, repetitive twitch of his mouth.
A few people appear to have nothing wrong at all. Most of them are friends and relatives there to support Parkinson's sufferers, I would find out later, but one is a fellow who has calmed his symptoms with a deep-brain stimulator implanted in his head.
That is Parkinson's -- a range of terrible, idiosyncratic, life-altering symptoms caused by the loss of various neurotransmitting chemicals in critical parts of the brain.
And then the music starts, and it is clear these people are united by more than just the bad break they share. Their brains -- all our brains, actually -- love music, rhythm and dance in some primal way that creates joy and nourishes the body. Especially a body wracked by tremors or slowed by herky-jerky arms and legs.
"We just trump the disease while we're here," McCauley says after the class at Maryland Youth Ballet in Silver Spring. "It's the perfect antidote."
"Lucy has us moving in ways we have to move," says Bob Frey, 67, the man with hand tremors. We are "moving our feet in certain ways. I have difficulty with that, but I wouldn't be able to do it at all" without the class, he said.
I've written many times that movement is medicine, powerful preventive stuff that keeps your arteries clear and your muscles strong. Here, exercise is therapy, perhaps no match for Parkinson's disease over the two decades that it generally inflicts misery on its 1 million victims, but certainly a dose of nonprescription relief in the short term.
In a 2009 review of the relatively scant medical literature on dance as therapy for Parkinson's, researchers found it as effective as other forms of exercise and noted additional advantages: Music may serve as an external cue that facilitates movement; dance involves stopping and restarting movement, something that is difficult for some people with Parkinson's; dance requires multi-tasking; and dance is social -- an activity that fosters relationships and keeps people with Parkinson's from withdrawing from communities.
"It's like Miracle-Gro for your brain," says Joyce Oberdorf, president and chief executive of the National Parkinson Foundation. "Exercise literally produces chemical changes in your brain that are beneficial, especially when you're a quart low on dopamine, as people with Parkinson's are."
Music and rhythm also appear to benefit people with dementia in some similar ways.
Calling for more study, the Parkinson's researchers nevertheless concluded that "the benefits of dance for those with PD appear to be of large enough magnitude to be clinically meaningful."
Parkinson's sufferers and their advocates long ago decided that is true. The movement started in Brooklyn in 2001, when the organizer of a Parkinson's support group persuaded the Mark Morris Dance Group, an internationally known professional troupe, to offer dance instruction to people with the disease.
Since then, it has spread to more than 100 communities in the United States and eight other countries, according to the Dance for PD website. The Parkinson Foundation also offers dance classes at its 23 chapters across the country, and other groups offer them as well.
After a series of warm-ups and stretches, McCauley and another teacher, Alvaro Palau, take their students through dance steps while they hold onto barres and, finally, through some moves around the floor. The music, "Mack the Knife," "Memories" and the like, is decidedly from the past, but even that has a purpose. According to Oberdorf, it cues up a time when these people moved more freely, helping them visualize a body that once was able to do more.
To end the class, they hold hands in a circle and, one by one, each bows theatrically to the person next to him. It is a wordless gesture of thanks, of empathy, of support that is impossible to miss. Then they all bow once more, together, toward the center of the circle and head outside into the rain.