HD in “Revenge”

Episode: Fear^

During an unveiling of his portrait at a party, Governor Grayson feels unwell when he delivers his speech. In a matter of hours, his physician claims that after running a full scan on Governor Grayson, he discovered a CAG repeat of 48.

Dialogue

Doctor: I’m afraid you have Huntington’s disease, Governor.

Charlotte: What is that?

Doctor: It’s a neurological disease where your body slowly starts to lose motor skills and mental acuity. It’s progressing.”

Governor: …and it’s fatal.

Charlotte: No!

Governor: You need to get tested, son. It’s genetic.

Emily: How rapid is the onset?

Doctor: Depends on the patient. You have a high stress job, Governor.

Governor: Nonsense. My grandfather worked until retirement with this disease.

Doctor: You need to consider your options.

Victoria: Say nothing, Conrad, until we know what to do, not even to your staff. Daniel, brief the press.

Daniel tells the press that the Governor suffered from severe dehydration. Victoria walks into the hospital on her phone.

Margaux: I do hope your father will be okay.

Daniel: My father’s nothing if not a survivor.

Margaux: I can see you’re worried. A colleague in Paris has Huntington’s and he’s doing well (Daniel looks up surprised and the press behind him suddenly goes into a frenzy) so I know Conrad can fight this.

Daniel: How, how do you know that my dad has…?

Margaux: Uh, well I received a newsletter as I walked up quoting a source close to the family, which I assumed was you.

Daniel: Excuse me. (walks away hurriedly as press tries to clamor towards him)

Emily: Victoria.

Victoria: Patrick’s left me, Conrad’s dying, Daniel may have it. It was almost good for a while and now it’s being torn away and I just have to sit here and take it.

Emily: Sometimes forces beyond our control can change everything. We’ll get through this…together.

(Daniel walks up)

Daniel: Dad’s diagnosis is out there.

Victoria: What?

Daniel: Apparently someone close to the family went to the press.

Emily: I hate to say it, but with Conrad’s condition being public knowledge…

Victoria: He has to step down.

Daniel: I’m going to go talk to him. (Walks away)

Emily: Who knew besides us?

Victoria: Only Dr. Valdez, but I can’t believe he would destroy his career over this.

Emily: Unless he seems a little too candid with someone he’s interested in. Since Ashley wants money, I’m sure she netted a handsome heyday by selling her story to the press.

Review

In this episode, the characters reveal that the family has a history of Huntington’s disease. However, under the guise of a revenge plot, the doctor was persuaded by an unknown source to tell the family that in a few short hours, he has determined the CAG count of Governor Grayson. Even if the doctor had facilities on site to test samples of Governor Grayson’s DNA, the doctor did not follow the ethical guidelines of genetic testing, which should include a psychology exam, neurology exam and a genetic counseling session. Additionally, it does not appear that the doctor even received signed consent from Governor Grayson, a prerequisite to testing for the disease.

Furthermore, it is clear that Governor Grayson has never discussed his father’s diagnosis of Huntington’s disease with the family. In many HD families, the disease is stigmatized and family members may hide diagnoses of others from their children or spouses. It appears that Governor Grayson has never had any interest in testing for Huntington’s disease, nor has he discussed the possibility of inheritance with his son, Daniel.

For more information on genetic testing, visit our website here.

Episode 2: Sin^

In this second episode featuring Huntington’s disease, Daniel, Governor Grayson’s son, has decided to undergo testing for Huntington’s disease and is waiting for his results.

Daniel: I shouldn’t have judged this magazine by its cover. It turns out they have significant political and cultural pieces too.

Emily: Why the sudden interest?

Daniel: Instead of going crazy waiting around for my Huntington’s test results, I’m grabbing the torro by the horns and having dinner with Margaux at The Muse tonight. I want to help her run Voulez.

Emily: You really think you can do this?

Daniel: Well, I’ve always dreamt of having a job where I could be more creative. Just have to bone up. I’m piping on Scoop next, less of course, my fashion-conscious fiancée wasn’t by my side.

Review

During the waiting period for his test results, Daniel is finding healthy methods of coping. Many genetic counselors will recommend those testing to create a plan for the waiting period in between the blood draw and the results appointment. Many will decide to take on a personal project or go on a vacation during this 3-6 week waiting period.

There is a discrepancy in that Daniel must wait several weeks for his genetic testing results whereas his father received his in one day. This waiting period’s difference highlights the lack of consistent medically accurate information on this television drama.

Dialogue

Charlotte: That’s it! Three days of moping in the dark is the limit.

Governor: I am not moping. I am avoiding the telephoto lenses trying to document how they think the mighty have fallen when I most certainly have not.

Charlotte: Booze in the morning looks a lot like denial, Dad.

Governor: So does moving out at your father’s expense.

Charlotte: I might have to move in just to keep the drink out of your hand. I’m getting you through this whether you like it or not.

Governor: You know, I may have used up all my good luck on you and it was worth it.

Review

Substance abuse is a serious issue for Huntington’s disease families. Occasionally, individuals who are recently diagnosed with the disease may experiment with alcohol, drugs or sexual activities. While this is not the norm, it is important to talk to your healthcare provider if you believe an individual affected by Huntington’s disease is engaging in behavior that is risky to one’s health.

For further information on addressing issues of substance abuse with a Huntington’s disease patient, please reach out to the Huntington’s Disease Society of America here.

Episode: Confession

In this episode, it is revealed to the viewer that Governor Grayson had his driving license revoked. However, it appears that there was no legitimate reason for this action as the doctors have never conducted a neurological exam and the Governor shows no signs of choreo or dance-like movements.

Episode: Mercy^

In this episode, we learn that Father Paul and Governor Grayson has been in a car crash. Governor Grayson was behind the wheel despite his revoked driving license.

Dialogue

Victoria: You better hope he survives because the doctors ordered you not to drive with Huntington’s.

Emily: Father Paul’s dead.

Governor: I knew it was a bad choice. He’s very persuasive. Look, I bought that Ferrari in ’86; it was a gift to myself after getting the Forbes 100. Anyway, Paul and I did a test drive together and he really showed me what that car could do.

Victoria: Are you rehearsing the sob story you’re going to tell at your manslaughter trial?

Governor: No, my dear, I merely want you to understand how Father Paul came to be behind the wheel at the time of the accident.

Emily: What?

Governor: He wanted to relive the memory. Breaks my heart that I let him.

Victoria: I will not be complicit in your crazily obvious lie. And good luck getting the authorities to swallow this tripe.

Daniel: Hey Em, Em. You were first on the scene. What did you see?

Emily: The car was on fire. Father Paul’s body was thrown about 15 feet in front of it.

Governor: And where was I?

Emily: You came up from behind me.

Governor: I was nowhere near the driver’s side of the vehicle, correct?

Emily: Yes, nowhere near.

Governor: You are my guardian angel, Emily. The lord knows where I’d be without you.

Later on, Emily reveals that she has lied about the driving status of her father.

Emily: Conrad [the Governor] caused the accident. I don’t think he ever intended to confess [to causing the accident] and he made damn sure that Father Paul didn’t either.

Nolan: Yeah, I don’t know Em. Murder by auto accident is kind of psychotic. Why would he risk his own life?

Aidan: Well, he’s not afraid to die, that’s a side effect of convincing someone they have a terminal disease.

Nolan: Can we just talk about the elephant in the mansion? Maybe the crash was due to a fake Huntington’s episode?

Emily: I lowered his dosage yesterday so he’d be healthy enough to turn himself in.

At this point in the series, Emily reveals that she is behind the fake Huntington’s disease diagnosis. She is attempting to subvert the Governor’s power by not only leading to the fake diagnosis, but by also causing him to have a car accident that would lead to imprisonment. She lowers his medication dosage so that his side effects weren’t so severe and he’d be forced to turn himself in to the police.

Emily’s plan is evidenced by earlier dialogue between her and an accomplice:

“Give [Governor Grayson] these (hands a bottle of prescription pills to Aidan). Maybe he’ll confess if he thinks he’s at death’s door.”

Dialogue

Governor: I got a call from the hospital today asking me to come in for an MRI, which confirmed a shocking discovery. I’ve been misdiagnosed. I do not have nor ever suffered from Huntington’s disease.

Daniel: What?

Emily: How did they explain the symptoms?

Governor: Seems they were brought on from the stress and the Huntington’s disease medications themself. I realize now what Father Paul meant when he said he was brought back into my life by divine intervention. He was God’s vessel to show me that I’m meant to live a long and meaningful existence here on Earth. Father Paul is no doubt in Heaven and he has earned his wings.

Victoria: Or maybe he’s laughing at you because you had to step down as governor for naught. I know I certainly am.

Governor: Well being governor only distracted me from my true destiny: leading this family. And so the first step is reclaiming my rightful position as master of this house.

Emily speaking to Daniel: You must be happy. Your father’s misdiagnosis puts you in the clear now too.

In the end, Governor Grayson reveals that he has been misdiagnosed with Huntington’s disease as the MRI showed no degeneration in the brain. It is accurate to say that Daniel will never develop HD, as it is not possible for HD to skip a generation. Since Daniel’s father, Conrad the Governor does not have the disease, Daniel cannot inherit it. Unfortunately, however, Revenge does little else to accurately represent disease inheritance and symptoms throughout the series, using Huntington’s disease as a dramatic method of exacting revenge on a family member.

For more information on inheritance, visit our website here.