May 19, 2011 -- Larry David pushes the boundaries of comedy more than usual in a new season episode of "Curb Your Enthusiasm." With the help of Michael J. Fox, who will play himself, the show pokes fun at Parkinson's disease.
Fox, who has lived with Parkinson's disease since 1991, told TV Guide that the episode has Larry David believing that "I'm being symptomatic just to annoy him -- a whole passive-aggressive thing. He's complaining because I'm shuffling and making noise upstairs. It's very funny."
This isn't the first time Fox has reprised a role that plays off his Parkinson's symptoms. In "The Good Wife," he played a lawyer who used his neurological disorder (tardive dyskinia) to sway the judge and jury.
His new role, however, can't but raise question: When is it OK to use Parkinson's as a punch line?
Showing the struggles of a character who lives with Parkinson's can raise public awareness of the disease and reduce some of the stigma surrounding it. But does it help -- or hurt -- those living with Parkinson's when these symptoms, such as the uncontrollable jerky movements of dyskinesia, become the butt of a TV joke? Parkinson's experts say probably yes.
"It has long been recognized that humor can help those suffering from chronic conditions better cope with their diseases, and any chance to increase awareness of Parkinson's disease among the general public is important," says Dr. Cheryl Waters at the Neurological Institute at Columbia University Medical Center.
"Who best to represent Parkinson's in a humorous light than an actual comedian with the disease? I truly hope this won't offend patients with Parkinson's," she says.
Even if it is portrayed in an "irreverent" light on the show, Dr. Joseph Jankovic, director of the Parkinson's Disease Center at Baylor College of Medicine, says the "benefits outweigh the negative.
"If this series can increase awareness about the disease and help identify more individuals with some of the symptoms Mr. Fox displays -- great!" he says.
Sharon Kha, of Tucson, Ariz., says that in some ways only Fox -- or someone else with Parkinson's -- could poke fun productively. Kha is not a doctor, but she has plenty of experience using humor to cope with and teach about Parkinson's: She is a PD patient herself, and for the past three years has used educational (and often humorous) raps to help others cope.
"It's never nice to poke fun at sick people, but when we can poke fun at ourselves, it has the effect of whittling down the disease to a more manageable size," she says.
Making Fun vs. Making Light
There's a stark difference between using humor to lighten stigma and using it to make fun of those with PD, however. For instance, in 2006, radio host Rush Limbaugh raised hackles in the Parkinson's community when he accused Fox of "exaggerating" his symptoms during a political ad on stem cell research on his radio show.
"This is purely an act," Limbaugh says, flailing his arms around in mimic of Fox's dyskinesia."Either he didn't take his medication or he's acting." In fact, jerky movements are a sign of taking medication. When patients don't take their medication, they tend to have difficulty moving, not difficulty staying still.
But experts see Fox's role in "Curb Your Enthusiasm" as an opportunity for advocacy and as a way to respond to this kind of misinformed mocking.
"Who better to convey what the personal experience of this disease is like? It seems particularly appropriate as a follow-up to the Rush Limbaugh incident where Fox's symptoms, which are very much real, were portrayed as a fabrication," says Dr. David Standaert, director of the Center for Neurodegeneration and Experimental Therapeutics at the University of Alabama at Birmingham. "Over 1.5 million in America have PD, and their symptoms are real, too."