Tracking a Shadow: My Lived Experiment with MS
By Edith Forbes
()
About this ebook
A memoir of the author’s twenty-five-year, self-designed experiment with a nonpharmaceutical approach to multiple sclerosis and of the indomitable mother who taught her to meet trouble with active resistance.
When novelist Edith Forbes experienced her first episode of multiple sclerosis in 1993, few treatments existed. The famously crippling disease was a medical mystery, its cause unknown and its course unpredictable. The only medical advice Forbes received then was to “simply live your life.” She had other ideas.
Forbes grew up on a ranch in Wyoming, raised by a widowed mother who met challenges head on. Besides shouldering responsibility for seven children and a cattle ranch, Forbes’s dynamo mother had ambitions to change the world. As a forward-thinking woman in a largely male business, she became a model of tenacity and independence for her daughter.
After her MS diagnosis, Forbes turned her fear into action, immersing herself in the medical literature to search for ideas. Finding an unexpected connection between the medical information and her own knowledge of agriculture, she embarked on a self-designed experiment that continues to this day.
Tracking a Shadow weaves together the story of Forbes’s personal twenty-five-year medical experiment with a memoir of the mother whose constant determination to look for better answers shaped the author’s unique approach to her disease.
Edith Forbes
Edith Forbes grew up on a family ranch in Wyoming. She graduated from Stanford University with a degree in English. After a short career in computer programming, she abandoned computers for more earthbound pursuits, including farming and writing. Forbes is the author of the novels Alma Rose, Nowle’s Passing, Exit to Reality, and Navigating the Darwin Straits. Her work is characterized by skillful writing, poignant observations, and quiet yet evocative explorations of the human heart. Recently retired from her farm, she works as a writer and plays as a cross-country skier, gardener, musician, reader, and moviegoer. She lives in Vermont. Tracking a Shadow is her first memoir.
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Tracking a Shadow - Edith Forbes
Preface
Folk Dance Weekend
Becket, Massachusetts
Like many people at the camp, the man ahead of me in the lunch line was at once familiar and a stranger. We had met in the whirl of the dance floor, briefly clasping hands to make circles and allemandes or wrapping arms around each other to swing, but we had not conversed. I knew only that he was a light-footed dancer with a bright smile.
Around us, the dining hall crowd was fizzing with happy energy, and when the stranger turned to speak to me, I anticipated a cheerful remark about the music or where we lived.
I keep looking at you,
he said, because you look so much like a friend of mine who just died.
How does one respond to such an opening? The conventional I’m sorry
might sound like I’m sorry I look like your friend.
Asking the obvious questions—Who was the friend? How did she die?—seemed intrusive.
Seeing that I was in a muddle, he quickly added, It’s good that you look like my friend. She was a lovely person, and I’m glad to be reminded of her. She was my doctor as well as a close friend.
Was it . . . was she the same age we are?
She was fifty-four.
A few years younger than me.
So it was untimely. Did she have cancer?
I asked. The automatic guess, for a female younger than sixty. Breast. Ovarian. Cervical.
No, she had multiple sclerosis.
I flinched.
That’s a little spooky,
I said. Because I have multiple sclerosis.
Now he was the one at a loss, and I could almost see the thought balloon over his head: I’ve just ruined her weekend.
I smiled and assured him that I wasn’t troubled by what he’d said. I was just startled by the coincidence.
He said, I also had a great-aunt who had MS. She died of it when she was ninety-three.
We laughed. To anyone familiar with the wild variability of multiple sclerosis, this was an old joke.
At one extreme, the disease has cases like that reported in my local newspaper a few years ago, a college student diagnosed at age twenty and dead at age twenty-two. At the other extreme, it has the ninety-three-year-old great-aunt. In the middle, it has the fifty-four-year-old friend, a physician who presumably had up-to-date information and plenty of access to medical care before she died. The disease follows many pathways, and one can’t know ahead of time which path it will take.
When my new acquaintance made the joke about his great-aunt, he was trying to banish the frightening specter he thought he had raised. In fact, he had not caused me any new anxiety. I had known for two decades that my disease could change from benign to devastating at any time.
What he had done was to reawaken an idea.
Some time before that dance weekend, I had been in a gap between projects, and my brother said, Why don’t you write about your experience with multiple sclerosis? I’ll bet people would be interested.
I said, I haven’t had any experience. I’m perfectly healthy.
He said, That’s just the point.
But where was the story? Yes, the diagnosis had prompted me to make changes in my habits, but I did not know if my actions had made a difference. My good luck might be just that—luck. Many people with MS have minimal symptoms, regardless of what they do. My doctor could not say which it was, because my experimental strategy was my own and had never been the subject of a controlled study. I had no statistical data to put into a scholarly article, and I couldn’t write a story about courageous struggle, because I hadn’t yet needed any courage. So what was there to write about?
At some point, I realized that in my case the specifics of my strategy may have been less important than the simple fact that I had a strategy.
A diagnosis of multiple sclerosis is scary. One’s mind immediately leaps to the worst-case images of incontinence, blindness, spasticity, and a future using a wheelchair. At the time of my first episode, the medical system had no answers. The disease would do whatever it was going to do, and its cause was unknown. The only advice was to live your life and hope that researchers would someday find a treatment.
But what exactly did it mean to live your life
when life now included a permanent shadow companion that often sleeps but could cripple or kill when it wakes up?
1
A Buzz in the Nerves
In the fall of 1993, when I was thirty-eight years old, I noticed some peculiar neurological symptoms. On my left side, from my foot up my leg and torso to my thumb, my nerves prickled. Things my rational brain knew were cold, such as wet sneakers in a chilly rain, felt cold on my right foot but hot on my left.
My family doctor said the sensations might be nothing at all, a passing oddity, but if they were a symptom of a more serious condition, the three leading possibilities were a brain tumor, tertiary syphilis, or multiple sclerosis.
Listening to him, I wondered if he was always so forthright in presenting such sobering possibilities to his patients. He had known me a long time; perhaps he knew I liked a maximum of information and a minimum of medication. On my rare visits to the doctor, I always hoped he’d tell me that the remedy was time or a change in habits, not a drug or surgery. In most cases, he could oblige.
Dr. Hale had a booming bass voice and a joviality that sometimes felt overdone, as if he were covering some social uneasiness. Early in our acquaintance, his manner put me off a bit, and I did not fully appreciate his skill. When I knew him better, he served as a marvelously effective placebo, if placebo is defined as any remedy that works by harnessing the power of the mind.
I once strained a tendon or ligament in my thumb, and after two weeks the thumb was still painful, so I went to see Dr. Hale. He said I didn’t need to do anything to fix the injury; it would get better on its own. I went home, and the next day the pain was gone.
This was typical of our doctor-patient relationship. He understood that what would fix me, as often as not, was information. Drugs were reserved for problems such as bacterial infections, when information was not enough.
In the case of my neurological symptoms, he laid out his analysis. The symptoms themselves were annoying but not debilitating, a pins-and-needles disturbance in my sensory nerves. Since I was in a monogamous relationship and had no other symptoms of venereal disease, tertiary syphilis was highly unlikely. If the neurological symptoms went away (which they soon did), that would rule out a brain tumor. To cover all bases, I had a test for Lyme disease, which came back negative. That left two possibilities: multiple sclerosis or the unexplained passing oddity.
In 1993 the medical treatment for both of these conditions was identical—nothing. Go live your life and see if the symptoms come back. Dr. Hale said I could have an MRI and possibly learn if it was MS, but we agreed that it made more sense to wait for a recurrence.
At that time, I had only a casual knowledge of the disease. When I got home from the appointment, I pulled my big fat complete medical guide
off the shelf and paged through to the letter M. It was a measure of either my good luck or a good constitution that in the midst of many well-thumbed books on nutrition, biology, natural history, and agriculture, the book about medical problems was crisp and shiny, almost untouched.
What I found is that the hallmark of MS is unpredictability. Some diseases, like the common cold, are a minor nuisance. Some diseases, like the lung cancer that killed my father, are a probable death sentence. Some diseases, like arthritis, are chronic and painful but can be managed and do not necessarily shorten life. Multiple sclerosis can be any of these things. Its symptoms can range from prickling in the nerves all the way to blindness, spasticity, incontinence, crippling fatigue, and premature death.
There are famous cases, like the cellist Jacqueline du Pré, whose career and then life were swiftly ended by the disease. There are the more ordinary cases, like a family friend who had occasional troubling flare-ups but generally lived a long and healthy life. Some people do well, others do badly, and medical science does not yet know why.
At the time of that first episode, I was impervious to worry because I was in a state of euphoria. A year earlier, the manuscript of my first novel had been plucked out of a publisher’s slush pile, and a copy of the published book had just arrived in my mailbox. Far from fretting over dire possibilities in a medical text, I was busy ordering flowers to be delivered to my editor and others who worked at the press.
I lived on a beautiful small farm in Vermont. My days were divided between physical work outdoors and hours at my desk working on another novel. In summer I played on a softball team and planted a garden. In winter I cross-country skied. Life was good, and I was not in a mood to be concerned about a hypothetical problem. The symptoms were gone, and there was nothing to be done anyway.
Eighteen months later, in the spring of 1995, the symptoms came back. The prickling now extended to my other foot and my whole hand, and I also experienced Lhermitte’s sign, an electric zing that traveled down my spine when I bent my head forward. This time Dr. Hale recommended that I see a neurologist. He referred me to a staff physician at a nearby medical center.
The neurologist, Dr. Sage, was a lean, scholarly looking man with an air of dignified reserve and a quiet, pleasant voice. He reminded me of the family doctor from my childhood, who was likewise tall, gaunt, and dignified, with a deep, soothing voice that made me want him to keep talking. Even as I was squirming in dread at being stabbed with a needle, I had seen him as wise and kind.
In the Wyoming ranching community where I grew up, doctors in general were notable people, but this doctor made a particular impression because he was so unlike most of our neighbors. As a child I just thought, His accent is different, his manner is different, and everyone seems to think he’s really smart. Not until I was older did I realize that he was Jewish.
In the early drafts of my first novel, which was set in that part of the country, I had used this doctor as a character in the story. Of all the characters in the manuscript, he was the only one who was based directly on a real person. Then an urban friend of mine, who is Jewish, read the manuscript and squawked, "I can’t believe you used such a stereotype character, the small-town doctor who is really smart and