Telling the World

I had accepted the position of associate chief of staff for ambulatory care and made plans to move once school for the kids had ended. A month later, I was told that I had multiple sclerosis. When I asked about my long-term prognosis, the answers were vague.

“It's an unpredictable disease,” they said. “Some do well. Others experience a relentless downhill course. However, you have many favorable signs. You'll probably do relatively well.”

I logged on to PubMed to check the literature for myself. What I read was depressing. I confirmed that no cure has been found. Although treatment may decrease the frequency of exacerbations by one third, the most effective therapy left many with flu-like symptoms for 24 hours after the injection and cost $1000 a month. That's a lot of money and substantial side effects for merely a possible benefit. After 10 years, one third of people with multiple sclerosis require assistance walking and one half can no longer work. However, my neurologist had said I had many favorable signs. We moved to Iowa.

Every morning I jogged, took my injections, and then went to work. I saw patients, taught residents, and worked on developing our department. My family prospered. When running became too difficult, I put in a pool and switched to swimming.

But whenever I saw veterans using their electric wheelchairs, I wondered whether that would be me some day. Would I become wheelchair-bound, a burden to my family? Dark thoughts began to intrude, especially at night. I …