The Myth of Normal 62

millions worldwide, is among the best known of the recent additions to this roster. Virtually all autoimmune diseases are characterized by inflammation of the afflicted tissues, organs, and body parts—which explains why frontline medical measures often begin with anti-inflammatory drugs. When nonsteroidal anti-inflammatories like ibuprofen or heavier artillery such as steroids themselves prove inadequate, physicians may prescribe medications to suppress the body’s immune activity. Because the disease had first affected Mee Ok’s joints, the doctors believed it was rheumatoid arthritis. Their prescription was steroids: labmade analogues of the natural stress hormone cortisol, a secretion of the adrenal gland in response to a threat. Ultimately it was the failure of both steroids and immunosuppressants that drove Mee Ok to suicidal despair. Her doctors had nothing left to prescribe. (I should add that Mee Ok’s illness was so extreme that her recovery is entirely unexpected, indeed unexplainable, according to standard medical thinking. I contacted her family physician in Boston, who verified the details.) Although often disruptive and highly distressing, autoimmune symptoms can be nebulous and hard to pinpoint at first—not so much to the patient suffering them and seeking validation and support as to the physician in search of precise findings. Hence, it is not unusual for such diseases, which not infrequently overlap with each other, to fly under the diagnostic radar. Such was the experience of the tennis star Venus Williams, whose illness expressed itself in swollen hands, persistent fatigue, and misshapen joints: symptoms that would be alarming for anyone, even more so for an elite athlete. “I’d go to doctors, but never get any answers, so there was nothing I could do but keep going,” she told a newspaper reporter. “You almost get used to having all these symptoms,” she said. “You tell yourself to shake it off. Just keep going. Over time, you do start to wonder what’s happening and if you’re going crazy.”[1] She was eventually found to have Sjögren’s syndrome, a condition that primarily affects moisture-producing glands so that people suffer dry mouth and dry eyes, but which can also cause dysfunction in many organs such as the lungs, kidneys, pancreas, and blood