What MPTP did to Govea's brain is very similar to what happens in the brain of a person with Parkinson's disease. The chemical had eaten away the normal, dark-colored cells in a small area at the base of the brain called the substantia nigra (Latin for "black stuff") -- which is also damaged by Parkinson's disease.
These cells normally produce dopamine, a neurotransmitter that allows brain cells to communicate with one another. Their dead area in Govea's brain resulted in the abrupt onset of the symptoms of Parkinson's disease: slowness, rigidity and tremor. Technically, however, Govea does not have Parkinson's disease: The cause of his condition is known, unlike that of Parkinson's. His case is extraordinary precisely for this reason.
To researchers, a chemical that essentially induces Parkinson's is like a golden egg: rarely discovered and very valuable. Researchers could suddenly create an animal model of the disease, which provided unprecedented insights into new treatments. Deep brain stimulation eventually evolved out of the physiological and neuroanatomical understanding derived from studies performed with MPTP in animals.
But as the research was still ongoing, Govea's condition worsened. He became emaciated and unable to eat, drink or use the bathroom by himself. His mother had taken to feeding him through a straw. "I'm tired of shaking," he told her, "If I die, let me die."
In August of 1981, he found brief respite. He was treated with a drug called levadopa, and his symptoms virtually vanished. But the medication caused hallucinations and delusions -- side effects worse than the symptoms it was meant to treat. Govea blamed the "voices in his head" in 1982 when he was nabbed for a bank robbery in Greenfield, California. Several customers had recognized him by his tremor. He spent the next decade in Vacaville State Prison.
In 1991, about 90 days after his release, he said he began hearing voices again. They told Govea to rob a liquor store at knifepoint, which he did. He was sent back to prison and in 1995 at Pelican Bay State Prison, he attacked a guard and was charged with attempted murder. He pleaded not guilty by reason of insanity and was sentenced to a minimum of 31 years at Atascadero State Hospital, a term he now serves.
"He did not do well when he first came," said David Curtis, his former social worker. He was extremely violent, assaulting patients and hospital employees. On top of that, by the late '90s another side effect of levadopa called dyskinesias, involuntary jerking and swaying movements, had become so bad that it occasionally cut off his breathing.
Some MPTP victims sent to Sweden for treatment with fetal cells had varying degrees of success (the subject of The Case of the Frozen Addicts), but Govea wasn't considered a good candidate for the experimental therapy because of his criminal status and other details of his case -- a blessing in disguise, as it turned out.
In 2001, in a last-ditch effort to help Govea, the doctor assigned to the hospital's medical unit, Dr. Linda Kocsis, asked him if he would be willing to undergo an experimental procedure, called deep brain stimulation, to treat his tremor. Govea said she told him: "You'd be like a guinea pig."