November 3, 2026

@michaelokun

As a movement disorders neurologist, I have always been fascinated by the possibility that some of the most influential figures in American history lived with the same neurological conditions we treat in our clinics today. Two particularly compelling examples are John Adams, our second president, and his second cousin Samuel Adams, a leader of the American Revolution whose name now appears on one of America's most recognizable beer labels. In two remarkable historical investigations published in Neurology in 2001 and Movement Disorders in 2005, neurologist Elan Louis and his colleague Patricia Kavanagh examined original letters, diaries, and handwriting samples, uncovering persuasive evidence that both men lived with essential tremor. Samuel's shaking began by his early forties, affected his hands, head, and voice, and progressively interfered with his ability to write. In his signature on the Declaration of Independence, the letter S shows subtle tremulousness, particularly when compared with John's steadier signature immediately below it. By age seventy-one, Samuel could no longer write his own correspondence and relied on others to take dictation. His daughter and grandchildren also reportedly developed tremor, strengthening the case for a familial disorder. John Adams had a somewhat different course. His tremor was detectable in handwriting samples as early as age twenty-five, and over the ensuing decades his letters became increasingly difficult to read. In his later years, he described his hands shaking so severely that writing became extraordinarily difficult, and observers reported that he sometimes needed assistance eating. Although the researchers considered whether John might also have developed parkinsonism late in life, they concluded that essential tremor was the most likely diagnosis. What resonates with me is how much these historical documents reveal about the human experience of a disease that is too often dismissed as a minor inconvenience. These were men who helped shape a nation, yet something as ordinary as holding a pen or bringing food to the mouth became a daily struggle. And what about the Samuel Adams beer label? No evidence there.