William Pat Marshall, M.D.

TN Patient and former member of the TNA Board of Directors

It started in 1989.  You know the drill:  Visits to the family physician, the ear nose and throat specialist- twice -the dentist, an oral surgeon, then to the neurologist, and a neurosurgeon.  Being a physician didn’t help much, although I began to suspect Tic Doloreaux before receiving an official diagnosis from my neurologist.  

My story is familiar.  By 1993, I was taking 1200 mg of Tegretol daily and feeling sedated.  I wasn’t finding relief and couldn’t do my job.  I wasn’t in control. 

It was during this period that I cried for the second time, but not the last, in my adult life.  The first was when my father died.  But finding TNA and talking to Claire Patterson made me feel that I wasn’t really alone.  We talked a long time on a Sunday morning that she had probably not reserved for me.  She gave me hope. 

Although my first treatment, the percutaneous balloon compression, caused side effects, it resolved most symptoms in about six months.  Relief set in.  A bit of arrogance followed.  I told myself my problem had gone, just like when I took my first Tegretol.  I made a couple of contributions to TNA and felt good.  Two years and 10 months later it hit again.  This time I was a real mess.  My problem was worse.

Taking up to 1400mg of Tegretol and 900 mg of Neurontin daily gave me no relief.  So I tried the percutaneous stereotactic rhizotomy.  I awoke after the procedure and cried with relief, not pain.  I felt as if I had my life back.  I sincerely thanked the doctor.  But within hours, the pain returned.  I was once a proud, almost indestructible man.  The type of person my family depended on; sure, a pillar of strength.  Now I was almost mad.  I’d been jerked around by this problem that promised to leave, only to return.

I had another percutaneous stereotactic rhizotomy.  By now I knew that life without out pain was fleeting.  This thing doesn’t have a cure.  Treatments, yes–cure, no.  Another attack occurred in March 2002. I was sitting at my computer, minding my own business, and out of the blue, without provocation, it returned, as if to say, “Hello, didn’t want you to forget about me.”  Microvascular Decompression was seriously discussed.  When I first developed TN, the MVD surgery wasn’t as well accepted as in 2002.  This time I took the plunge and came up with relief that has lasted more than a year now.

But I’m realistic today and thankful for the good days.  What have I faced that other TN patients experience?  My friends and colleagues might have been more sympathetic if they could have seen something, like a cut or disfigurement.  But I looked fine.  The stability of my emotions was questioned.  Several asked if I was sure it wasn’t just my “nerves”.  Fortunately, my wife understood my discomfort.  Does this sound familiar?

One thing I’ve learned – don’t wait.  You just make decisions based on the best available information.  Maybe the information will improve and the choice will be clear the next time.  And that’s why I’m such a big supporter of TNA and the newest member of the Association’s Board of Directors.  As the first ever physician board member, I want to provide support and information to all patients and families so they can be empowered to make the best treatment decisions for themselves.  

I often describe myself and others who move through their lives with TN as “those of us who have been baptized by the demon.”  As a doctor, I have a new appreciation for my patients with pain.  I will be more understanding and supportive.  Never again will I be arrogant, thinking I’ve beaten TN.  I know some good will come from this ordeal, but please Lord, I don’t have to experience every disease to have compassion.