APLOMB AT THE CENTER OF THE STORM Jennifer McVige, MD ’05, got the diagnosis right as the nation watched and debated
During that time, 18 girls exhibited symptoms ranging from twitches, seizures and fainting spells to body spasms and involuntary sounds. The recurring behaviors confounded the girls’ parents, school administrators and health officials. By January 2012, the story unfolding in the Town of LeRoy in upstate New York—birthplace of Jell-O gelatin dessert—held the nation’s attention. Environmental activist Erin Brockovich suggested that toxic waste from a 1970 train derailment could be the cause. A New Jersey physician, Rosario Trifiletti, said the girls suffered from a neuropsychiatric disorder associated with streptococcal infections. But in the end, it was pediatric neurologist Jennifer McVige, MD ’05, and Laszlo Mechtler, MD, medical director of Dent Neurologic Institute, who diagnosed the students with stress-related conversion disorder, which begins with stress, trauma or psychological distress and manifests in physical symptoms. McVige also determined that the girls suffered from mass-psychogenic illness, formerly referred to as mass hysteria. She treated 14 of the 18 teens, and the girls— away from the media spotlight—improved. Today, most of her patients no longer exhibit recurring symptoms. “It was a whirlwind, a complete upheaval of my life,” McVige says. “I had no idea how much I would grow intellectually and emotionally from that experience.”
By Mark SoMMer
Confidence and Perspective McVige grew up on Colvin Avenue in North Buffalo and completed high school at City Honors. She attended the University of Rochester, graduating with a bachelor’s degree in neuropsychology. In her senior year, she went abroad to study for seven months on the island of Lamu, on Kenya’s northern coastline, where she learned Swahili. The experience of being “a pale Irish kid” among Africans in an Islamic culture was life altering, she says. “I used to go to a store and ask at the window for shampoo. I would say, ‘white person shampoo,’ which is what it was called. I remember returning to the States and going into a Rite Aid, and I cried because
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there was an entire aisle of shampoos. I felt guilty about our excess.” Back in Rochester, McVige worked with an innercity counseling program, studying play therapy for sexually abused children. She then enrolled at UB, where she earned a master’s degree in behavioral neuroscience and psychology and a medical degree. She credits UB medical school with giving her the confidence to withstand the sustained media glare and adversity she recently experienced. “The medical school was amazing,” McVige says. “A lot of the strength and trust in my judgment came from instrumental educators who taught me to believe in myself and to be firm in my values and judgment.” Patricia Duffner, MD ’72, a pediatric neurologist, and Mechtler, an adult neurologist, were critical influences, explains McVige. “Their compassion really made me want to emulate their style of medicine.” After completing a pediatric neurology residency at UB and a fellowship in neurological imaging and headache medicine at Dent Neurologic Institute, McVige worked at a satellite site in Batavia, N.Y., where she was the only pediatric neurologist in a city of 15,000 people. A Rare Diagnosis It was there, in October 2011, that a teen came into her practice after waking up with abnormal movements. McVige thought the symptoms appeared stress-related, along the lines of conversion disorder. It wasn’t unusual, as she typically sees one or two cases a week of the stress-related disorder. “They go blind or can’t walk, or have a tic or twitch in an arm or neck or shoulder or legs, and verbal tics like vocalization,” McVige explains. “It is a subconscious evolution of neurological symptoms. The patients are not aware they’re doing it because it’s not of their own accord.” Another patient came through the following week with similar symptoms. The next week brought another, and most of the others soon followed. They ranged from cheerleaders and athletes to Goth girls and bookworms. While conversion disorders are common, mass psychogenic illness is very rare. Predictably, it
Photo by Douglas Levere
The medical phenomenon began in September 2011, shortly after school resumed at LeRoy Junior-Senior High School, and then largely faded from view after the media spectacle was over the following March.
Jennifer McVige, MD ’05
affected older girls first, starting with tics and moving on to vocalization, like a high-pitched “huh” sound or barking. Then the majority, at different points, passed out. About half had seizure-like shaking spells, and most later developed migraine headaches. McVige treated her patients with cognitive behavioral therapy, psychological intervention and medications. She rejected an environmental explanation because it would have stood to reason that those most vulnerable—the old, the very young and those with compromised immune systems—would be stricken. But that wasn’t the case, since only young and healthy girls were affected. Media and Misinformation A couple of the girls McVige didn’t see went on national television in January and suggested causes for their behavior that were never substantiated. “We lost control when it went to the media,” McVige says. “Everyone was almost better until then. Having the kids on The Today Show, CNN and on social media made it ten times worse.” So did misinformation. “There were things I knew, and that no one else knew, that I couldn’t discuss,” McVige explains. “The crux of this is that it can be a stress-related problem, and they said there was no stress in their lives.” McVige worked closely with Mechtler, who confirmed the diagnosis. Both appeared on CNN with Brockovich’s assistant and with Trifiletti, who attributed the girls’ condition to PANDAS, associated with strep infections. On another occasion, McVige went on the air with Sanjay Gupta, MD, the cable network’s chief medical reporter. She also made frequent appearances on local TV and radio.
“I don’t think I could come up with enough accolades for the job Dr. McVige did. . . . The symptoms went away exactly how she said they would, and when she said they would.” —Father of a patient
Some parents resisted the conversion-disorder diagnosis because they wanted a medical diagnosis—they didn’t like the stigma of a psychological determination, McVige says. Over time, McVige started seeing other girls pivotal to the story and began to “put bigger pieces together.” Grateful Parent “I don’t think I could come up with enough accolades for the job Dr. McVige did,” says the father of one of the girls McVige treated and who requested anonymity to protect his daughter’s identity. “She was incredibly professional and compassionate. My daughter felt comfortable with her, and the level of trust was very high. We concurred with her diagnosis of the conversion disorder because it just made sense. The proof is in the pudding. The symptoms went away exactly how she said they would, and when she said they would.” The phenomenon died down in early 2012, about the time an article about it was published in the New York Times Magazine. The last few girls graduated this June, and “the town no longer wants to talk about it,” says McVige. At least once a year, McVige gets a call from a small town experiencing something similar. SUMMER 2016
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