Not long ago, Sarah, a friend and patient of mine, called me from the Los Angeles Airport because she forgot a doctor’s note explaining why her dog, Big Ed, should be allowed to accompany her on a flight to Paris. I quickly wrote an email explaining that Sarah was a renal transplant patient, who depended on Big Ed to allay chronic anxiety. Fortunately, the officials of the airline accepted it. Sarah boarded the plane with Big Ed buckled in with her, and they crossed the Atlantic together.

For the others in the plane, it may have just been one more transoceanic flight, but to Sarah, it seemed the trip of a lifetime. In some ways, looking back, it did turn out to be one of the most important trips of her life, but not in the way she had expected.

Sarah had suffered from poor health since she was a child. It started even before she started school, with a variety of minor infections and frequent colds, then escalated, in junior high school, to a series of uncomfortable and persistent fevers. Her doctor assured her it was a just viral infection that would likely get better with time. It turned out to be a misdiagnosis.  Sarah continued to feel worse and then began suffering from joint pain and that was followed by an odd, frightening facial rash. She underwent a series of blood tests, which revealed she was suffering from something more serious than a viral infection. One of the tests, called an anti-nuclear antibody, or ANA, was strongly positive. It meant her immune system was malfunctioning and attacking her own tissue. Other sophisticated tests confirmed a diagnosis of Systemic Lupus Erythematosus (SLE, or Lupus). Sarah and her mother were devastated. They were told her future would be filled with long and chromic health battles, with wide-ranging symptoms. They were shocked and upset, but even that sober diagnosis did not fully paint the picture of what was to come.

Sarah’s mother, Susan, had a will of iron, though, and an indomitable maternal spirit. Her reaction to Sarah’s diagnosis changed quickly from disbelief to a stubborn will to fight for her daughter. She accepted the challenge like a tigress defending her young. Again, having family support is such an important element in these stories – although the patient’s own character and resolve is ultimately the most essential part of healing.