A little past five o’clock on the afternoon of October 11, 1978,a young black woman shuffled on the arm of a friend into the emergencyroom of Alvarado Community Hospital, in San Diego, California, and askedto be admitted for psychiatric help. Her name, she said, was SheilaAllen, her age was 24 and her complaint (as later interpreted andstandardized and noted on her chart) was “bizarre behavior, withlooseness of thought associations and severe depression associated withsuicidal thoughts.” She was admitted after a brief examination tothe psychiatric wing, and was made comfortable there in a double room.
The following day, and for several days thereafter, she was examined,tested and variously observed. The results of these evaluations wereinconclusive, and on October 16 a member of the psychiatric staff namedRobert Brewer was appointed attending physician. “I went in to see her after rounds the next morning,” Dr.Brewer says. “She was sitting on the edge of the bed–sittingthere with the help of a nurse.
She was tall, with a beautiful figure,a beautiful face and beautiful, wide-apart eyes. She was also pathetic.She didn’t seem to have any strength at all. She couldn’twalk. She could hardly sit up. She could hardly lift her arms. Iintroduced myself and made some getting-acquainted talk.
I took herhistory and did a routine physical and checked her mental states. Shewas just as weak as she looked. She was well oriented and alert. Therewas some evidence of conversion hysteria.
I finished up with a lot ofhistory and a lot of problems, but no strong impressions in anydirection. I was inclined to go functional, but not entirely. I did aresidency in neurology, and I always try to keep the organic possibilityin mind.
I started thinking ‘multiple sclerosis.’ Her age,for one thing, was right. Multiple sclerosis is a young person’sdisease.
But I’m a listener. I think that if you listen longenough your patient will usually tell you what the trouble is. So Iasked her what she thought was her trouble. She said, ‘I’m akook.
‘ I said, ‘Maybe so, but before we go that road I’dlike you to see a neurologist I know.’ She almost blew up. Ithink she might have hit me if she’d had the strength. She said,’I don’t want to see a neurologist. I’ve seen a dozenneurologists. I’m a kook. I’m in the kook hospital.
I wantyou to fix up my kookiness’ But I wasn’t convinced. And thatafternoon I called Fred Baughman, the neurologist I had in mind.” I met Sheila Allen in the spring of 1983, some five years afterthat pitiful outburst. We met, by prearrangement, in San Diego, in theoffice of Dr. Brewer’s neurological colleague Dr.
Fred Baughman,Jr. She looked good–the picture of health, and beautiful, and entirelyfree (if she had ever been otherwise) of kookiness. “Oh, I was,” she told me. “I was a kook. I had tobe, after what I’d been through. If a person can be driven crazy,that was me. But, of course, I wasn’t really crazy.
I was simplyin despair. I had been sick for so long–for almost four years. I wasgetting sicker and sicker. I was almost helpless. I went to AlvaradoHospital because I couldn’t think of anything else to do. I hadfinally given up.
“I don’t know when my trouble actually started. I mean,it came on so innocently. I guess it began in Dallas sometime in 1974.
No, I’m not from Dallas. I was born in the Chicago area–inMaywood, Illinois. But when I was 14 my parents moved to Los Angeles,and I went to high school there. I ran track, and I was a cheerleader.I’ve always liked sports. I’ve always loved to run and danceand bike and that sort of thing. I went to Cal State, at Northridge,for a year, and I studied physical education.
I went to Dallas becauseI wanted a change. Tehre were no problems at home, or anything likethat. I just wanted a change. I got a job at a Sears store,demonstrating cosmetics.
Then a friend told me that Braniff was hiringflight attendants. I had an interview, and they hired me and sent me totheir school–six weeks of emergency procedures, first aid, posture,grammar, how to prepare the meals. I was based in Dallas, and I flewevery stop between there and Chicago and sometimes New York–all over.I think March of 1974 was when the trouble first began. I was outdancing one night, and my legs gave out on me. I mean, I fell down.But I was able to get right up, and I said it was my high heels.
That’s what I thought. So I went to lower heels, and then onenight it happened again. It was just like that first time.
I was ableto get right up and go on. Nobody seemed to think anything of it. So Iwasn’t really worried.
But when I had my regular Braniff physicalin August I mentioned it to the doctor. He gave me an extra-carefulcheckup and passed me. He said I was in great shape.
He said I wasprobably just tired–too much standing. Well, flying is all standing.You hardly ever sit down on a flight. So that made sense.
But then mylegs began to hurt. I wasn’t just tired, I also hurt–at the endof a flight, or walking through the airports. Like O’Hare. Or,especially, Dallas.
You know how big it is. We were always having towalk from Gate 1 to Gate 22. My legs would cramp. It was a real tightpain.
I would have to sit down and rest for a couple of minutes. ThenI’d be all right. But all the girls were always complaining aboutbeing tired, so I still didn’t think too much about it. Until itbegan to affect my arms. Just lifting two trays, and my arms wouldbegin to tremble. It seemed like they didn’t want to hold.
Even acoffeepot was almost too much for my strength. I tried to get moresleep. But I just got tireder and tireder. And I began to almost missflights because I ahd to sit down so often along the concourses andrest. So what I did was just get up earlier. If there’s one thingI’ve got, it’s will power. I drove myself as hard as I could.But I was getting worried now–real worried.
I went to a doctor one ofmy friends knew. He said to take it easy. Stop driving myself so hard.He gave me a prescription for Valium. “That would have been around the end of 1974. I thought maybeI wasn’t eating right. It’s hard to eat right whenyou’re flying.
All too often, after we had served the passengerstheir lunches or dinners there wouldn’t be any food left. Most ofthe girls carried candy bars for those emergencies. I carried what Icalled my survival package–tuna fish and peanut butter and crackers andraw carrots and lots of vitamins. A lot of the girls recommended a shotof bourbon at bedtime.
I tried that, and it was all right, but Icouldn’t see that it helped me any. I had to realize that mytiredness was different from the other girls’. So finally–I thinkit was in October, or maybe November, of 1975–I tried again. I went toan orthopedic specialist. I told him about my legs, how weak theywere–and my arms.
He looked me over; he was very thorough. But hecouldn’t find anything wrong. He said it was probably my job–thestanding and the stress, and all that. His advice was to quit, to takea leave or something. But I loved flying.
I loved my job. And I lovedthe money. I had a little Opel GT sports car.
I had a nice apartment.I had a wonderful life. So I kept on working–getting to the airportearly enough so I could make it to the gate, and getting back homelate–and resting every change I got. I stopped talking about myproblems to the other girls. I didn’t want them to say anything.I wanted to keep my job. But I was only fooling myself.
It was justtoo much for me. In February of 1976, I asked for a vacation, and theygave me three weeks’ leave. I went to my favorite place–toHawaii. I relaxed and rested and tried to enjoy myself. The threeweeks went by, and I was the same as always.
I just didn’t haveany strength. I went back to Dallas and gave my two weeks’ notice.I said I had personal problems. Which was true enough. My sister Enidflew in from L.A. and drove me home in my little Opel–back home to myparents. “It’s hard to explain just how I felt.
I was worriedabout feeling so tired and weak. But I still really thought it would goaway. I still really thought I’d get better.
Anyway, Icouldn’t just sit around the house. That isn’t my way. Iwent out and got a job–two jobs, as a matter of fact. I got a daytimejob demonstrating cosmetics again. I worked in various stores doingmake-up. And at night I worked as a cocktail waitress in a club.
Isuppose that was kind of foolish. Because I had the same oldtrouble–the same problem with trays, the same problem with all thestanding and walking. I had to wear heels at the cocktail job, and, ofcourse, that made things that much worse. Every now and then, I droppeda tray. I could tell when it was coming on–I’d think, There goesthe tray. The other waitresses dropped things, too.
But they onlydropped a glass or something. I dropped the whole tray. But the bosswas crazy about me. That made everything O.K. This was in the summerof 1976.
But finally the boss got to be too much for me. I had toquit. I had already quit the cosmetics job. Two jobs were too big aload for me, and the cocktail job paid better. When I quit that, I got adaytime job as a hostess in a restaurant at the beach. I guess I knewby then that there was something really wrong, but I wanted to work. Imissed that airline income. It’s hard to change when you get usedto a certain level of living.
“When I first came home to L.A., I had gone to the familydoctor.
He couldn’t find anything wrong with me. Then I met achiropractor at a party and told him my problem. He checked me out andcouldn’t find anything wrong, either. He referred me to a womanpsychologist.
She game me an IQ test. That only told her that I wasbright. So she gave me another test.
And then another. She neverseemed to try to think anything out–she just kept giving me tests. Idecided she was a waste of time, and quit. I also quit my hostess job.I had to–I was getting weaker every day. Everything I did hurt. Ithurt to comb my hair. My arms were so heavy and weak.
It was hard forme to drive my car. Once or twice, it was really frightening. I’dtry to brake or something, and my foot wouldn’t move. One Sundayafternoon, I took my little three-year-old niece to the park. When wewere driving home, a traffic light up ahead turned red and I started tobrake and I couldn’t lift my foot. Oh, my God! I thought.I’m going to kill us both. I told my niece to get down on thefloor.
I hung on to the wheel and we sailed across the intersection.Thank God, there was nobody coming. I don’t know how I ever madeit home. That was the last time I drove. I was at home now all thetime.
But I had problems even there. I don’t know how many timesmy legs gave out and I fell down the stairs. They were carpeted, thankGod, so I wasn’t hurt much. That was going down. Climbing thestairs, I practically had to crawl.
My mom was a problem, too. Shekept saying I was just trying to upset her. She didn’t really meanthat. The real reason was that she couldn’t bear to think therewas something wrong with me. And my sisters. We would be getting readyto go out somewhere, and it took me so long to get ready they’d gooff without me.
I got so I was crying a lot. I’d try to pick up aglass, and my arm would go limp. And I’d say, ‘Oh,no!’–and fall into a chair and just cry.
“But I still hadn’t given up. When I quit going to thatwoman psychologist, my chiropractor friend suggested I see apsychiatrist. I was going out with the chiropractor some, and he wasreally trying to help. He was convinced that my trouble waspsychosomatic. I didn’t know what to think. Some days I wasbetter, and some days I was worse. Some days I could get dressed and goout and everything was almost like normal.
Then the next morning Icouldn’t even fix breakfast. I had a drawer full ofprescriptions–Valium, Elavil, Equanil, all those drugs. Every doctor Iwent to see prescribed something.
I tried them all and I couldn’tsee any difference. I couldn’t see that any of them helped. So Iwent to a psychiatrist. He was a white guy. Some of the doctorsI’d seen were white. Some were black. Anyway, I went to thispsychiatrist once a week. We talked.
We went over everything I’dbeen told by all the others. He said I must face it–I had apsychosomatic problem. I liked him; he was a nice man.
He made me feelbetter about myself, which helped. But I didn’t really believewhat he said. Then I had my family–my mother and my brother and mythree sisters–on me. They made it perfectly plain. They said I wascrazy. I said to myself that they were crazy. “About that time, in December of 1976, I met a nice guy fromSan Diego.
He was a big guy–6’6″ and 270 pounds. His namewas Ira Watley, and he had been playing offensive tackle for Miami.He’d just got cut. He was going back home to San Diego, and hesuggested I come with him–get away from my family. He knew they weredriving me nuts.
I thought about it. Then one morning I woke up and Ialmost couldn’t get out of bed. But I made it, and started down tobreakfast, and fell. I fell all the way down the stairs. I didn’tknow whether I was hurt or not–I hurt all over anyway. I must havelooked awful, because my mother helped me up and took me to theemergency room of a hospital a few blocks away.
There was a youngdoctor on duty. He examined me, and everything–my arms and legs andall. He said to wait, and went away. He came back with a textbook andhe stood there studying it. Then he said, ‘I would think you mighthave myasthenia gravis, but the symptoms aren’t right. Myastheniagravis starts with the eyes and face, with drooping eyelids and troubleswallowing. You don’t have that.’ He said he thought I oughtto see a psychiatrist.
He gave me a prescripton for Elavil. “That made up my mind. I went to San Diego with Ira. He wasreally understanding. He wanted to get married. I didn’t thinkso–not right then. But I was feeling a little better and getting alittle restless. I wanted to do something.
Ira suggested I go toschool–to a business college he knew about. So I enrolled. That wasin February 1977. But it was the same old story. I wasn’t reallyany better. The school was on the second floor–a walkup–and thosestairs were too much.
I would go late, so people wouldn’t see mestruggling. It was one step and rest, another step and rest. Somedays, I could go three steps without resting. I was taking typing. Andfinally I couldn’t do it. I couldn’t hold out my arms. Itwas a three-month course, but I never finished it.
After that, I juststayed home. Except to go to the doctor. I had already seen a coupleof doctors in San Diego. One was a regular internist.
The other was aneurologist. They were like all the rest: psychosomatic, Valium. ButIra kept pushing me to keep trying to get some help. I even went to adoctor in La Jolla who tried to hypnotize me. I wouldn’thypnotize, and that frustrated him. He told me I didn’t want toget well. Then I tried an orthopedic surgeon.
He asked me to lift myarms. I couldn’t do it. He stumped out of the room.
He said hecouldn’t help me because I wouldn’t cooperate. Then I triedanother psychiatrist. I had four or five visits.
The psychiatrists andthe psychologists were all alike: What did your last doctor say? I see.Well, I agree. Psychosomatic. I’m going to give you a prescriptionfor an antidepressant. Some of them started with my childhood. Somestarted now and worked back. I told them I had a normal childhood–anormal middle-class childhood.
I told them I didn’t hate myparents, and they didn’t hate me. They were loving parents. Thepsychiatrist I went to four or five times, he saw Ira when Ira broughtme to his office. I told you Ira is a very big man. So this doctor hada new idea. He asked me if Ira beat me.
“I started getting completely worse in June–June of 1978, Irawas away. The Winnipeg Blue Bombers had signed him on, and he wastraining up there in Canada. He had arranged everything before he left.He had his father come over and look after me. He sent me his checkevery week, and one of his friends–either Frank or Drake–would take meto the bank and to the supermarket, or wherever. Frank was verysympathetic. He had been in Vietnam and had some therapy. He persuadedme to try the state mental-Health center.
I joined their group-therapyclass. I went for a while, But the classes were kindergarten stuff, andI wouldn’t take the drugs they offered. Elavil was one of them,and it actually seemed to trigger more weakness. It seemed to actuallyloosen my muscles. I had some bad experiences even without drugs.I’d sit down in a chair, and when I wanted to get up Icouldn’t.
I’d have to wait for Ira’s dad or somebody tohelp me. It got so I was afraid to cook, I remember one afternoon I hadsome vegetables on the stove. I left the kitchen and fell, and Icouldn’t get up.
I just lay there smelling them burn. The housewas full of smoke when Ira’s dad came in and turned off the stove.It was an awful feeling. I wasn’t good for anything. I used tosit and meditate and pray. I’d fix my mind on, say, fishing orshopping, and try not to think of anything else.
I did a lot ofpraying. I’d say the Lord’s Prayer over and over and over.It helped me, I think, I prayed in bed in the morning, too. I kept aBible by the bed. In the morning, when I woke up, I’d read orpray, and finally I’d have the strength to get up. One morning, Icouldn’t comb my hair.
I didn’t have the strength. I finallyhad to lay my head on the sink, and that way I could use my arms alittle. There was another time. Drake and his brother Lee took mefishing with them out on the park dock. After a while, I went to thebathroom. I sat down on the toilet, and I couldn’t get back up.
Nobody came in. I yelled and yelled, and finally Lee came in and got meout. “I think that was about the last time I went out anywhere. Iknew I was reaching the end of the line. My muscles were getting weakerand weaker. I had to rest more and more. I knew that pretty soonI’d be helpless.
I had to do something before it was too late. Idecided my only hope was to get hospitalized. And I knew that the bestway I could get hospitalized was to talk depression and suicide. Thatwas one thing I’d learned from all those psychologists andpsychiatrists. The hospital I picked was Alvarado Community Hospital.It was the nearest one to Ira’s apartment. It got Frank to driveme there, and he had to practically carry me into the emergency room. Itold my story, and they took me in.
I remember that date. I rememberit very well. It was Wednesday, October 11, 1978, late in theafternoon. But the date I really remember is the following Wednesday,October 18, around noon.
That was the day I met Dr. Baughman. He cameinto my room and looked me over and told me what my trouble was. I hadmyasthenia gravis.” “Well, yes,” Dr. Baughman said to me. “It wasalmost as quick and easy as that.
I was pretty sure the minute I sawher that her trouble was myasthenia gravis. The only other possibilitywas amyotrophic lateral sclerosis, and she was much too young forthat.” Dr. Baughman is a slight, wiry man of 50, with a bang ofsandy gray hair and a wide, warm, country-boy smile.
He was smilingnow. “But it wasn’t magic. Myasthenia gravis is a specialinterest of mine. I trained at Mt. Sinai, in New York, and Mt.
Sinaihas a rather famous myasthenia-gravis research laboratory. Someimportant work has been done there. So I learned about myastheniagravis early, and it is always on my mind. There is a saying aboutdiagnosis–about why doctors often fail to recognize one of the lesscommon diseases. It goes, ‘When you hear hoofbeats, you don’tnecessarily think of a zebra.’ I recognized the hoofbeats of azebra. That was my only magic.
I won’t say myasthenia gravis is acommon disease. But it isn’t a rarity, either. The nationaloccurrence rate is one in 20,000. I see my share, because I’maware.
I average three to five new cases a year. Women seem to be moresusceptible than men–particularly young women. Myasthenia gravis is agood descriptive name. The ‘my’ refers to muscle, and’asthenia’ come from the Greek for weakness. It isn’t asgravis–as serious–a disease as it once was. It was first described inthe 17th century, and it was named around the end of the 19th century,and in those days and up until the middle 1950s it was very often fatal.There is a treatment now. But, of course, it can’t be treated ifit isn’t diagnosed.
That’s the problem. In that respect,Sheila was a classic case. “I remember my first look at Sheila. Bob Brewer had called meand said he had some doubts about a psychiatric patient at Alvarado, andwould I take a look. So the next day I went up to Four South when Ifinished my regular rounds. The first order of business is the visualimpression.
And oh, Lord! She was pathetic–truly pathetic. She waslying in bed and not exactly crying–sort of whimpering. There was afeeling of just hopelessness. Her beauty made it all the worse. I knewthe moment I saw her that there was a profound, generalized muscleweakness. I called a nurse, and we got her sitting up.
She tried tohelp, but it was a genuine, real weakness. Nothing functional about it.Her face was normal, and so was her speech. There was a slight nasalcharacter, but not much. I had the nurse get her to her feet and walk.It was a definitely abnormal gait–it was a waddle. that indicated ahip-girdle weakness.
We have a scale of evaluation. It begins at zero,then trace, then poor, then fair, then good. Sheila’s hip andshoulder girdles were poor to fair. Her body and feet were in the goodrange. The weakness was symmetrical, and there was just no questionabout it.
I knew her history, and I didn’t believe a word of allthose psychiatric evaluations. This was a serious muscle disease. “It’s sad to think how close she came to an earlydiagnosis. I’m talking about that young doctor up in Los Angeles.He suspected myasthenia gravis, but he made the common mistake of goingentirely by the book. The books all emphasize that the presentingsymptoms are drooping eyelids, facial weakness and palatal weakness–difficulty in speaking. The classic teaching requires thepresence of one or more of those symptoms for a diagnosis of myasthenia.I had one patient who was referred to me by an ophthalmologist.
A manhad come to him complaining that he was losing his eyesight. Theophthalmologist recognized that the cause of his failing sight was thedrooping eyelids of myasthenia gravis. I wish the textbooks were alittle less rigid.
But the fact is that a mere suspicion of myastheniais enough, because there’s a quick and easy diagnostic test that isalmost entirely reliable. “Myasthenia gravis is a fundamentally mysterious disease. Imean the basic cause is unknown. It is generally thought to be one ofthe several auto-immune disease–the consequence of some disturbance inthe body’s immune system. Antibodies appear in the blood thatinterfere with the supply of a substance called acetylcholine, whichmediates neuromuscular function.
I’m putting a highly complicatedprocess in very simple terms. The result of this inhibition is aweakness much like the weakness induced by the poison curare, and thetreatment of myasthenia gravis has derived from an understanding ofcurare intoxication. The site of the physiological defect in bothcurare poisoning and myasthenia gravis is the neuromuscular junction.In the absence of acetylcholine, the muscular response very rapidlydecreases. A period of rest will, at least for a time, restoresufficient acetylcholine to allow for normal function, but only for alimited time. Then the weakness returns.
Drugs have been developedthat are antagonistic, in varying degrees, to the substance thatinhibits acetylcholine. One of these anticholinesterase agents isinvolved in the diagnostic test for myasthenia gravis. Tensilon–or,generically, edrophonium choride–has the power to restore almost normalmuscular function almost instantly, in a matter of moments. Its effectlasts only moments, but a positive response to Tensilon is diagnostic ofmyasthenia gravis. “Tensilon was developed at Mt. Sinai in 1952, and I’veused it many times. The effect is always starting. I gave Sheila theusual dose–ten milligrams, injected intravenously.
I waited a moment,and then checked her arm strength. There was resistance topressure–maybe 80 to 85 per cent of normal. So I asked her to get upand walk. She said, ‘You know I can’t walk.
‘ I told herto try. She gave me a doubtful look–and sat up. Then she stood up.Then she walked across the room. It was a miracle. It’s always amiracle, but this was one of the most miraculous. I’ll neverforget the look on her face.
She was dazed. She was stunned. Thetears were running down her cheeks.
I felt the way I always do when Isee that miracle happen. I felt–I don’t know–almost godlike.Then she began to give out. I helped her back to bed.
She collapsed.It was all over.” Sheila Allen was discharged from Alvarado Community Hospital on themorning of Thursday, October 26, 1978. That was 15 days after the dayof her admittance and 8 days after her dramatic noonday meeting with Dr.Baughman.
In the cours eof those 8 days, she was introduced to another,and more durable, anticholinesterase agent, called, Mestinon, and aneffective dosage (one 60-milligram tablet every four hours) wasdetermined. Tensilon is of only diagnostic value. The dischargesummary noted, “Discharged to outpatient treatment, to be followedby Dr.
Patricia Marrow for supportive psychotherapy (in adjusting tothe presence of a chronic debilitating illness) and by Dr. FredBaughman for control of myasthenia gravis.” Her condition, thesummary added, was “markedly improved.” It was indeed. Thefriend who had helped her into the hospital was there to meet her on herdeparture. She was pleased by his thoughtfulness, she was glad to havehis company, but she didn’t need his help. She walked out of thehospital with the easy gait of any normal 24-year-old woman. She was,for all practical purposes, a normal young woman, and two weeks later,in early November, she was leading a normal life.
She had a jobdemonstrating cosmetics at a San Diego department store, and she wasattending evening classes at a school for real-estate brokers. Dr. Baughman saw Miss Allen at his office soon after her hospitaldischarge, and once a month thereafter.
At their December meeting, onDecember 5, he noted that her response to Mestinon was entirelysatisfactory. It was better than that of many other patients in hisexperience, and inferior to none. Nevertheless, he watched her closelyand questioned her closely at their monthly meetings. There is always achance that Mestinon, or any other anticholinesterase agent, may in timeweaken in its mastery. There is a surgical procedure that can provide avigorous supplement to Mestinon therapy. This involves the removal ofthe thymus gland. The thymus is one of the endocrine glands and issituated in the windpipe, just below the thyroid gland. Its functionhas to do with the development and maintenance of the immunologicalsystem.
The thymus develops rapidly in infancy, grows more slowly untilaround puberty and then, in most people, begins to wither away. It hasbeen established that in victims of myasthenia gravis the thymus isabnormally intact, and its functions seem to have been perverted intothe phenomenon of autoimmunity. In the course of the summer of 1979,Dr. Baughman decided that Miss Allen would benefit from the removal ofher thymus, and he arranged with a thoracic surgeon named David M. Longto perform the operation. Miss Allen was admitted to El Cajon ValleyHospital on September 25 and underwent a transcervical thymectomy thefollowing morning.
The operation was a complete success, and its goodresults were immediately apparent. Dr. baughman noted that within lessthan two hours Miss Allen’s muscular powers were stronger than atany time since he had diagnosed her illness. On September 29, she wasdischarged. “Oh, sure,” Miss Allen told me toward the end of our talkin Dr. Baughman’s office. “I knew that a thymectomy was aserious operation. Dr. Baughman told me all about it. But of course Iagreed. Whatever he suggested was gospel to me. He was the messiah.He is the messiah. I moved back to Los Angeles in January of 1980, butwe keep in touch–I’m still on Mestinon; I always will be–and Isee him here once a year. It seems to me that I feel better every day.When I moved back to L.A., I had finished my real-estate course, and Iwent in with my mother and father in their real-estate business. I alsodid volunteer work for a while in a hospital in the neighborhood. I didphysical counseling. Then, in 1982, I heard about a new airline openingup with flights between L.A. and Hawaii, and I applied, and they took meon. I’m a senior flight attendant, and I do seven turnaboutflights a month. Between trips, I still work in real estate. The onlytrouble I have now is trying to hold myself back. I don’t want towalk–I want to run. I’m so full of strength and energy. I guessI’m making up for lost time. I told my new boyfriend about mymyasthenia. He said, ‘So what?’ We dance all night.”