Lupus on Heels of Mom's Death, Multiple Sclerosis on
Those of Divorce
Majid Ali, M.D.
Tammy, a woman in her late
forties, consulted me for multiple sclerosis. She
had experienced abnormal sensations in her limbs
with "pins and needles" and weakness of muscles for
a few months. She became very frightened when she
started losing her balance and had difficulty
walking. MRI scans ordered by one neurologist showed
demyelinating lesions in her brain and spinal cord.
A second MRI scan ordered by a second neurologist
confirmed the diagnosis of multiple sclerosis.
"I know it's not that," Tammy spoke after I
finished reading her file and looked up.
"It's not what?" I asked, without really needing
any clarification of her words.
"It's not multiple sclerosis," she said firmly.
"How do you know?"
"I just know."
"How?" I persisted.
"Because that's what happened the last time," she
"What happened last time?"
"They said it was lupus and they gave me
cortisone. I threw the cortisone out after a few
"Then I took a lot of vitamins and my lupus went
"How was lupus diagnosed," I asked, feigning
"They did all the tests. ANA, LE prep and a test
for proteins in the urine. You know, everything the
I had gotten used to such stories by then. The
first few times had been different. It had been hard
to believe patients who told me such stories. It
literally meant throwing out all my medical texts.
Patients with serious autoimmune disorders such as
lupus and multiple sclerosis are not supposed to get
better by simply taking vitamin pills, at least not
according to our medical texts. The hard-nosed
pathologist in me had great difficulty in believing
what medical texts said couldn't be believed. Then
things changed for me. My patients forced me to
think differently. With the passing years, I saw too
many patients who'd positive lupus and rheumatoid
factor tests go on to recover and lived healthy
lives for years. I realized the tests simply
indicate signals of stresses on our immune defenses.
Nothing more. How many times does one have to be hit
on his head?
"Tell me something about the stress in your
life." I returned from my own thoughts.
"You know how it is. Everyone suffers stress in
life," she replied.
"That's true. Still, tell me. Is he very
supportive?" I asked her, gesturing to her husband
who had sat silently listening to us.
"Yeah, he is supportive," she replied after a
slight initial hesitation.
We physicians do learn with time. Minor delays in
answers often tell us more than many carefully
crafted answers from our patients. I smiled at her
husband and returned to my questions.
"What was the year they told you had lupus?" I
"1984." Tammy leaned back in the chair.
"What happened in '84?"
"What happened in '83?"
"Nothing in '84 and nothing in '83?" I looked
into her eyes, persisting in my inquiry.
"What happened in 83?" Tammy sat up.
"Yes, what happened in 83?"
"My mother died." Tammy's neck stiffened.
"Were you close?"
"She was my best friend."
"What happened early this year?"
"What do you mean?"
"What happened in the months before you developed
pins and needles in legs and arms?"
A hurt expression crossed Tammy's face and she
sat up. I looked at her in silence. She seemed to
read my mind and quickly recovered her composure.
Then she turned her face to her husband who glanced
at me uncomfortably. I looked back at Tammy.
"We had family troubles."
"Would you rather not talk about them?" I asked.
"No! There is nothing to hide. We separated for
"Then we got together to see if we could make
"And then we realized it had to end. There had to
be a divorce."
Tammy broke down. I didn't have to look at her
husband to learn anything more. Was there a chance
for some wound healing there? I wondered. Serious
illnesses sometimes break good marriages. Sometimes
they also mend broken ones. If the latter was going
to prevail, it would not be the first time I had
seen a major disease lead to healing of deep wounds
of lost love. Those things just seem to happen.
"Tell me, how do you react to perfumes and
formaldehyde and tobacco smoke?" I changed the
subject. Tammy slumped back into the chair.
Read more at:
The Second Lupus Story
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