Ask any child of the ’80s about Michael J. Fox, and they’ll probably bring up Alex P. Keaton (the unapologetically conservative son on the sitcom "Family Ties") and Marty McFly (the time-traveling teen from the "Back to the Future" trilogy). Even though Marty was a high school student, Fox was 28 years old when "Back to the Future Part III" hit theaters in 1990. A year later, he was diagnosed with a form of Parkinson’s disease, according to the Michael J. Fox Foundation for Parkinson’s Research’s website.

For the next 30 years, Fox came to terms with the disease, moving from hiding it and diving full force into his work to managing it openly by starting a foundation to search for a cure, according to the foundation’s site. His optimism was tested over the years and unlike Marty McFly, Fox doesn’t have a flying DeLorean that allows him to rewrite the past to create his ideal future. While the actor might see his future differently than he once did, he surely hasn’t given up on it. Here’s a look at his history with Parkinson’s disease.

Michael J. Fox was diagnosed with early-onset Parkinson’s disease

"I was so scared. I was so unfamiliar with Parkinson’s," Michael J. Fox admitted during an interview with The New York Times. "Someone is saying your life is going to be completely changed." According to the National Institute on Aging, Parkinson’s disease is a type of brain disorder in which the person may feel basically fine at first (like Fox did when he was diagnosed) but will increasingly develop symptoms, ranging from fatigue to difficulty walking.

While Parkinson’s usually occurs around age 60, Fox developed a form called "young-onset Parkinson’s disease", per the Michael J. Fox Foundation. This is also referred to as early onset Parkinson’s disease, and it first manifests itself in someone when they are under 50 years old (via National Institute on Aging). Only about 5 to 10% of people with Parkinson’s have this form.

Knowing he would be experiencing symptoms but not knowing just how soon or how severe, Fox threw himself into his work, taking on movie projects with an emphasis on quantity over quality. "If I’d had any imperative to accomplish anything with movies, it shouldn’t have been to do as many quick successful ones as I could," Fox told The New York Times. It should’ve been to do as many good ones as I could. To do one good one." Unfortunately, projects like "Greedy" and "Life with Mikey" flopped with both critics and audiences alike.

His symptoms began subtly

Did Michael J. Fox have any warning that he had Parkinson’s disease? Technically, yes. He woke up one morning to notice his pinkie shaking, the Rehabilitation Hospital of Southern New Mexico detailed. And while fingers can twitch for a whole host of reasons, even small tremors can hint at larger health issues.

According to the Parkinson’s Foundation, Parkinson’s disease occurs in five stages. While symptoms can vary from person to person, tremors, and issues with walking, posture, and making facial expressions are all common signs of stage one. These symptoms usually worsen by stage two and are accompanied by rigidity. By stage three, an individual with Parkinson’s may experience problems with balance and may have difficulty with everyday tasks like eating. In stage four, that same individual may not be able to walk without assistance and loses their independence. And by stage five, a wheelchair is typically required, as well as round-the-clock care.

In addition to these symptoms, Parkinson’s can impact a person’s memory, as Fox conveyed in an interview with People magazine. "My short-term memory is shot," Fox reflected in 2020, adding "I always had a real proficiency for lines and memorization. And I had some extreme situations where the last couple of jobs I did were actually really word-heavy parts. I struggled during both of them."

Michael J. Fox credits his wife, Tracy Pollan, for helping him through his diagnosis and beyond

When diagnosed with a chronic disease as Michael J. Fox was, it’s only natural to ask, "Why?" Perhaps there’s a comfort in understanding the cause and effect in this situation. Maybe just being able to connect the dots creates some control. However, the "why" is often the most difficult if not impossible factor to determine.

Despite all of the research into Parkinson’s, the exact cause of it remains unknown, according to the Michael J. Fox Foundation. Several components are connected to the disease, but like random jigsaw puzzle pieces, it is still not clear how these elements come together to cause Parkinson’s. What we do know is that early-onset Parkinson’s usually has a genetic factor (via Parkinson’s Foundation). In fact, research is finding connections between certain genes and the likelihood of developing this form of Parkinson’s disease. Yet, it is possible to have these genes and never develop the disease at any point in your life.

Despite all of the unknowns, Fox has maintained an optimistic outlook in part because of the support of his wife (and "Family Ties" costar) Tracy Pollan. "We didn’t know what to expect," Fox tells NBC’s Today. "One of the things I’ll always love Tracy for is that at that moment, she didn’t blink." And according to a teary-eyed Fox, through all the ups and downs that followed, she still hasn’t blinked.

The actor wasn’t initially open about his Parkinson’s diagnosis

Michael J. Fox was diagnosed with Parkinson’s disease in 1991, but he stayed quiet about it for seven years, only telling people who needed to know (via Biography). Finding new career success with the film "The American President," Fox returned to television with the sitcom "Spin City." This, however, meant talking about his diagnosis with the network and production company. "I said it could get very bad or not get bad," he recalled to People in 1998. "They said, ‘Let’s go!’" It would be two seasons into the show’s run before Fox told his costars about his condition.

It’s understandable that someone with Parkinson’s would feel anxiety and not want to talk about the disease. The European Parkinson’s Disease Association’s website explains that it is common for someone with this disease to experience mild to severe general social anxiety in which they are worried about being judged. And, unfortunately, that fear can exacerbate some of their symptoms like shaking. But beyond this, research shows that the way Parkinson’s disease can change a person’s brain chemistry may alone bring on feelings of anxiety. In addition, someone with Parkinson’s might develop akathisia, a different condition which mimics anxiety in that the person is uncontrollably restless.

Ultimately, Fox came to an important realization: To properly accept having Parkinson’s, he needed to be open about it. This turning point for Fox, however, meant he had to make significant changes in his life.

Michael J. Fox stepped away from television and created a foundation

After going public in 1998 with his Parkinson’s disease diagnosis, Michael J. Fox found support from Meredith Baxter, the actress who played his mother on "Family Ties." She said in a statement provided to The Washington Post, "The fact that Michael is passing along his experience and truth is a very courageous and loving thing to do." After telling the world about his condition, Fox continued his role on "Spin City" as the Deputy Mayor of New York City Mike Flaherty for another two years.

"One of the reasons I left ‘Spin City’ was that I felt my face hardening," Fox explained to The New York Times. "My movements were constricted. If you watch episodes from the last couple of seasons, you’ll see I would anchor myself against a desk or the wall. Eventually it was too burdensome."

As it turned out, Fox’s final performance as Mike Flaherty before retiring from "Spin City" was on the 100th episode of the popular sitcom, per the Michael J. Fox Foundation. It wasn’t long after this curtain call that he opened his foundation with the mission to cure what’d long been considered an incurable disease.

Michael J. Fox underwent brain surgery

After deciding to go public, Fox had brain surgery to treat his Parkinson’s disease. According to Brain & Life magazine, he underwent a procedure called thalamotomy in an attempt to control his tremors. This called for making a small hole in Fox’s thalamus (part of the brain, which plays a role in motor activity). Is that risky? No, it’s very risky! Dr. Jason M. Schwalb told Brain & Life, "If the targeting is inaccurate by 3 mm, the patient can have permanent neurologic injury."

However, Parkinson’s patients may opt for a different type of brain surgery called DBS or deep brain stimulation (via Healthline). Similar to pacemaker surgery for a heart condition, DBS involves implanting electrodes in the brain, which are connected to a stimulation device in the person’s chest (via The Georgia Straight). While a thalamotomy is considered an unconventional approach, DBS is "the most commonly performed surgical treatment for Parkinson’s," per the Michael J. Fox Foundation.

Lawyer Jim McNasby found the information about DBS particularly useful (via Healthline). Like Fox, McNasby was diagnosed with early-onset Parkinson’s and remembers when Fox went public about his condition. "Michael J. Fox had just come out with the early onset Parkinson’s idea and so it was just coming into the public domain," he told Healthline. Because of his pro bono work with the Foundation, McNasby learned about DBS and found it greatly reduced his symptoms.

He continues to believe in an eventual cure

When Michael J. Fox created his foundation, he didn’t see it existing past 10 years (via The New York Times). Why? Because in 2000, he believed research efforts by his nonprofit would cure Parkinson’s disease, and so make its existence unnecessary. More than 20 years later, the Michael J. Fox Foundation is at the forefront of research into not only the possible genetic components of Parkinson’s but also environmental and aging factors that might impact the disease (via Michael J. Fox Foundation).

According to the foundation’s website, for some people there is a connection between developing Parkinson’s and being exposed to toxic substances like pesticides or MPTP. Head injuries may for some individuals play a role in developing this disease. By far, however, the most significant factor when it comes to Parkinson’s is simply aging since the older a person’s cells are, the more vulnerable they may be to harm. Plus, the fact that human genes change during a person’s lifespan may also play a part in who develops Parkinson’s.

When asked in 2019, "Almost 20 years later, what’s your thinking about finding a cure for Parkinson’s?" Fox replied, "I still believe in a cure," and he acknowledged the importance of more effective treatments (via The New York Times). And his foundation’s website echoes this idea, stating, "Better understanding of the complex genetic, environmental, aging and other factors that lead to Parkinson’s would be game-changing in our pursuit of preventive and therapeutic treatment options."

Michael J. Fox is hopeful about new treatments

Since the cause of Parkinson’s disease is still not clear, treating it can be challenging. And even when a medicine is effective, that doesn’t mean there aren’t any side effects. As Michael J. Fox told The New York Times, although carbidopa-levodopa medication had been the "gold standard" for Parkinson’s patients, it can cause dyskinesias, in which a part of the body moves involuntarily. Fox himself has this side effect from his medications and so some nights, he will sleep on the floor rather than in his bed to both provide some resistance to his movements and avoid disturbing his wife’s rest, according to Men’s Health.

A number of medications used to treat Parkinson’s focus on the effects of dopamine on the mind and body (via Healthline). This is because this chemical produced by our brains allows us to coordinate our muscle movements. Not surprisingly, a common aspect of Parkinson’s is having lower levels of dopamine. So, when taking carbidopa-levodopa, levodopa helps to replenish dopamine, and carbidopa slows the breakdown of levodopa.

In addition, Amantadine (Symmetrel) can help with levodopa-related involuntary movements. Nevertheless, during his interview with The New York Times, Fox talked about the importance of finding better treatment options, "like a rescue inhaler for when you freeze," he said, referring to how sometimes Parkinson’s patients are unable to move. "Treatments for that can make a huge difference in people’s lives," he continued.

The actor returned to TV

After stepping away from "Spin City," Michael J. Fox found he wasn’t done being an actor. In fact, it was during his Emmy-nominated role on "Boston Legal" that he had a realization. "I remember the smell of the arclight while we shot," Fox told The New York Times. "Something about that smell made me think, Acting is what I do. And I needed to find a way to do it with my new instrument."

For Fox, his body is his "instrument." He often used facial expressions while acting for maximum effect. Now, Parkinson’s was forcing him to change his approach to acting. One attempt, "The Michael J. Fox Show," was a sitcom about an affable newscaster dealing with Parkinson’s. It lasted only a few months. "I didn’t have the energy to keep the show on the track that I’d set it out on," Fox told the magazine. Fox also explained that the intention of the show wasn’t to make Parkinson’s "funny."

In a different approach from "The Michael J. Fox Show," Fox took on the role of Lewis Canning, a reoccurring antagonistic character on the dramas "The Good Wife" and "The Good Fight" (via Michael J. Fox Foundation). A lawyer with a ruthless streak, Canning was not above using his tardive dyskinesia, a real-life side effect of certain drugs, to manipulate a trial. It’s similar symptoms to Parkinson’s brought legitimacy to the role.

Michael J. Fox underwent spinal surgery in 2018

While Parkinson’s disease can affect how someone walks, Michael J. Fox found he was having difficulty with his leg movements for a different reason in 2018 (via CBC). The culprit causing him difficulty was actually a benign tumor on his spine. Despite not being cancerous, the growth would eventually leave him paralyzed unless he underwent a very risky spinal surgery to have it removed (via Johns Hopkins Medicine). How risky? Well, as Fox said in a telephone interview with the medical institution, the surgery was "not one that a lot of doctors were eager to tackle."

Fortunately for Fox, Dr. Nicholas Theodore agreed to perform the surgery and immediately put the actor at ease not only with his credentials but also his sense of humor. Fox recalled that when the subject of other medical experts not wanting to try this surgery came up, he responded with, "Who wants to be the guy who paralyzes Michael J. Fox?" Fox continued, saying, "That was a really great icebreaker." In the end, the surgery took five hours but was a complete success.

Of course, any major surgery requires recovery time, and Fox discovered he had to relearn how to take steps and properly distribute and redistribute his weight, per the CBC. He described the process as "quite painstaking," and after months of therapy, he was experiencing "a suffocating loss of privacy" because of the number of people needed to help him.

Michael J. Fox broke his arm and lost his optimism

It was the summer of 2018 and the year had already been rough for Michael J. Fox. Now, in addition to managing a progressive disease, he was recovering from spinal surgery and starving for a little time to himself, according to the CBC. But no sooner did he get his wish when he slipped on a tile in his kitchen and fell on his arm, shattering it. Alone and unable to get help, Fox remembered at that moment, he was tired of his "when life hands you lemons, make lemonade" attitude about his condition. "That was the point where I went ‘I’m out of the freakin’ lemonade business,’" he told the CBC. "’I can’t put a shiny face on this. This sucks, and who am I to tell people to be optimistic?’"

Fractures are not uncommon among people with Parkinson’s. According to the Parkinson’s Foundation, the disease can cause changes to a person’s skeleton, including lower bone density. In fact, if a person with Parkinson’s does less walking and other exercises in which their skeleton needs to support their weight, they run the risk of weaker bones, increasing their chances of bone fractures if they fall. In Fox’s case, as he detailed to the CBC. his arm was so badly broken that it needed to be rebuilt. And what about his optimism? That too would need some rebuilding.

This is who encouraged Michael J. Fox during his darkest days

For about 27 years, Michael J. Fox approached having Parkinson’s disease with optimism. But in 2018, after an accident that shattered his arm, that optimism was all but gone (via CBC). In the months that followed, the actor watched old television programs and reflected on his earlier performances. Then, he thought of a late friend who’d also had Parkinson’s disease: Muhammed Ali.

It would be a couple years after Fox announced his diagnosis with the disease that the boxing champion reached out to him (via ABC News). Over a phone call, Ali told Fox, "With you in this fight, we can win." The two then worked together to raise awareness about their shared condition. In 2018, two years after Ali’s death, Fox decided to reach out to Ali’s widow, Lonnie, and ask if his late friend had ever watched himself on TV (via CBC). He did indeed. This gave Fox a new perspective. "He accepts and realizes it’s great to have been that. It’s great to have done that," Fox told the CBC.

Someone having a temporary lack of optimism is different than being clinically depressed. However, it’s worth noting that depression is common for someone with Parkinson’s (via American Parkinson Disease Association). In fact, it can be the first sign of the disease for some people. Thankfully, it is treatable, although treatment can vary from person to person. Additionally, depression is not a guaranteed symptom of the disease.

Michael J. Fox embraced realistic optimism

In 2020, Michael J. Fox rebuilt his optimism, but a bit differently this time. The source of it came not from throwing himself into his work or trying to cure Parkinson’s disease in 10 years as he’d originally set out to do. Instead, it came down to acceptance. "I think the first thing you have to do is accept if you’re faced with a difficult situation," Fox told USA Today, adding, "And once I do that, that doesn’t mean I can’t ever change it. I can change it, but I have to accept it for what it is first, before I can change it." Acceptance isn’t always easy, though. As Fox told The Guardian, "I used to walk fast, but every step now is a frigging math problem, so I take it slow." He accepted that a cure in his lifetime was not likely going to happen, but "that’s just the way it goes."

Breaking his arm had taught him an important lesson: You must be realistic, as well as optimistic, and that being grateful for the good in your life "is what makes optimism sustainable," he told USA Today. With the slogan "Strength in optimism. Hope in progress," the American Parkinson Disease Association echoes Fox’s newfound approach to practical positivity. And even with the realization that a cure is not plausible in the near future, Fox’s own foundation states, "Even in the face of tremendous challenges, our promise to push Parkinson’s research forward remains steadfast."

Michael J. Fox has a built-in support team

Although Michael J. Fox was by himself when he broke his arm in 2018, he’s been anything but alone as his early-onset Parkinson’s disease has progressed. As he told NBC’s Today, his wife Tracy Pollan has been by his side since the very beginning. "She’s there in the front lines with me every single day," he said. "She never pretends to know as much as I know. And the other thing Tracy does is, if there’s something funny, let’s get to the funny. We’ll deal with the tragic later."

While medical professionals are crucial for managing Parkinson’s disease, the role of the "care partners" in their lives should not be underestimated. As the Michael J. Fox Foundation explained, "Care partners take on many responsibilities, from accompanying a loved one to doctor appointments to managing more household responsibilities." And these doctor appointments can include counselors, nutritionists, and movement disorder specialists, as well as several different types of therapists (via Michael J. Fox Foundation).

In addition to his wife and their four children, Fox has a four-legged member of his care team: a rescue dog named Gus (via USA Today). According to Men’s Health, on one particular morning when Fox slept on the floor due to his involuntary movements, Gus decided to sleep by Fox. Seeing his faithful, mostly-Great-Dane mutt as he woke up immediately made Fox’s morning a happy one.

Michael J. Fox retired from acting a second time

Despite returning to the small screen on TV shows like "Scrubs," "Boston Legal," and "Curb Your Enthusiasm" after his initial retirement, Michael J. Fox announced in November 2020 that he was entering a second retirement from acting. "There are reasons for my lapses in memorization — be they age, cognitive issues with the disease, distraction from the constant sensations of Parkinson’s, or lack of sensation because of the spine — but I read it as a message, an indicator," he wrote in his 2020 memoir (via Today).

When thinking of Parkinson’s disease, many may picture difficulty walking or shaking. However, as the Parkinson’s Foundation explained, there are also cognitive issues such as "difficulty remembering information or have trouble finding the right words when speaking." In addition, language difficulties connected to Parkinson’s can manifest themselves during times of stress or when under pressure (like an actor might experience while filming a scene). Other non-movement symptoms can include difficulty making decisions and maintaining focus especially in a group situation, as well as a general slowing down in one’s thinking.

Even though Fox may have put acting behind him, he remains hopeful that he might find himself in the spotlight again while simultaneously accepting it may never happen. "That [second retirement] could change, because everything changes. But if this is the end of my acting career, so be it," he wrote.

There’s no time like the future for Michael J. Fox

Titled "No Time Like the Future: An Optimist Considers Mortality," Michael J. Fox’s 2020 memoir describes how Fox came to understand and embrace his new form of reality-based and gratitude-driven optimism (via The Guardian). Although Fox is unable to physically write with a keyboard or a pen, he dictated this fourth memoir through as assistant. "He has increasing difficulty in forming words, and occasionally needs a wheelchair," The Guardian noted. But that didn’t stop him from engaging in an almost two-hour interview, nearly skipping lunch to keep the conversation going.

Although Fox has stepped away from acting, he’s still involved in his foundation. Its Deputy CEO, Sohini Chowdhury, sees possibly big advances in Parkinson’s treatments happening in the next few years. "It’s important to remember that a cure can mean different things to different people," she told the European Parkinson’s Disease Association. "If you’re able to improve the symptom management of the disease to an extent where having the disease has very little impact on your day-to-day life, that could be considered a cure."

Fox himself told The New York Times that better treatments for managing Parkinson’s symptoms can make a big different in people’s lives. "Now, if we can prophylactically keep Parkinson’s symptoms from developing in a person, is that a cure? No. Would I take it? Yes."