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ALS, the "Other Tyrant" in Gehrig's Life.

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Eleanor Gehrig said there were two things that were tyrant over her life with Gehrig, the consecutive games streak and ALS.

In June 1939, all anyone knew was that Gehrig was having his worst season ever. There was a strange, sudden diminish in his strength that raged on the more he played. He would collapse on the field, in the locker room, etc., for apparently no reason.

On the advice of a friend, Eleanor placed a call to Mayo Clinic in Rochester, Minnesota. Mayo had/has an extremely high reputation for breakthrough research and medical expertise. Eleanor's call was transferred immediately to Dr. Charles Mayo. Dr. Mayo had been following Gehrig's career, particularly the mysterious depletion in his strength. He told Eleanor, "We'll welcome him with open arms. Get him here."

Eleanor agreed to convince Gehrig to go, on one condition, that she be the first, and only, one to know his full prognosis. Dr. Mayo was hesitant, saying (in gender stereotypical fashion of the day) that it was Mayo's policy to give full disclosure to the head of the household; he assumed Gehrig was the head. Eleanor corrected him by pointing out Gehrig had given her full control over household finances, therefore she was the only viable head of household.

After speaking to Dr. Mayo, Eleanor arranged Gehrigs flight from Chicago, where the Yankees were to play, to Minnesota. The only to-do was convince prideful Gehrig, who refused to stop playing just because he had broken bones, to go to the Mayo Clinic. All Gehrig said to her request was, "Ok, pal. "

On June 13, 1939, Gehrig arrived at Mayo Clinic.  WIthout even touching a stethoscope to Gehrig's chest, Dr. Harold C. Habein, the first doctor to meet with Gehrig, knew what was wrong; he could tell by the walk, the posture. As Gehrig walked toward him, Dr. Habein felt his heart sink. His own mother had died from a full-blown battle with a disease called amyotrophic lateral sclerosis (read More About ALS).

During Gehrig's time, little was known of amyotrophic lateral sclerosis (ALS). Many referred to it as creeping paralysis because title fit subject; ALS is characterized by a deterioration in muscle control. The victims become incapable of movement. What people don't understand, they ridicule. So, sadly, many creeping paralysis victims were considered idiots and a source of shame to their families. It was common to lock the victims in attics or wood sheds, anywhere away from public view.

In a way, it was fortunate that Gehrig developed ALS; his case forced the public to face the issue.

What was known at the time about ALS was mostly kept in medical circles. When her husband was diagnosed, Eleanor delved into all the research she could find. She quickly became a clinical expert. Later in life she passed along all she knew in her autobiography. For instance, she cites the following information in the introduction: "Guam is listed as a clean port by the Navy, with no venereal disease, malaria, or dengue. One strange disease is present - amyotrophic lateral sclerosis."

This is her excellent explanation of ALS:
"In a healthy person, I found, the nerve fibers are covered with a fatty sheath called myelin, whether the fibers are in the brain, spinal cord or anywhere else in the body. This myelin sheath acts like the insulation on an electric wire. When the disease strikes, a mysterious change occurs that destroys the protective myelin in areas of the nervous system.... Whenever the myelin sheath is destroyed, it is replaced by a scar - sclerotic tissue. So wherever the nerve insulation has been damaged, the nerve itself is so affected that impulses no longer pass through. The adjoining parts of the body become paralyzed; the arms and legs often become immobile."

All in all, the most important details that were known of ALS were (1) unknown cause(s) and (2) no cure.

Dr. Habein distinctly remembered the feet-dragging walk and twisted facial expression of his mother. Gehrig was showing the same symptoms. Before he lost his smile, Dr. Habein showed Gehrig to the designated room, then went to Dr. Mayo and told him that he feared Gehrig had ALS. Dr. Mayo told him to check more into it.

That he did. Gehrig stayed at Mayo Clinic for six days. "Take your time and give me the works," Gehrig told them with his signature grin.

Dr. Habein's fear was confirmed. On June 19, Gehrig's 36th birthday, the diagnosis was official. As Eleanor requested, Mayo Clinic called her in secret before they gave Gehrig the diagnosis. The diagnosis: amyotrophic lateral sclerosis, a rare and terminal illness. Full prognosis: immediate retirement from baseball, expect rapid paralysis, incapacitation of speech/swallowing/etc., no loss in mental capabilities, and a life expectancy of two and a half more years. Eleanor was told that the cause for ALS was unknown, but it was painless, non-contagious, and cruel in manner of attack. The nervous system, and thus muscle function, is affected; the mind is left intact. In other words, the victims are copiously conscious of their surroundings and of how "vegetable" they are.

This, as Eleanor requested, was not the prognosis Gehrig was given. He was told that he had ALS, but he was also told that there would be no severely bleak impact on his life. Gehrig must have been relieved to know he was not just getting old and washed up, but that he had a condition that was ruining his statistics.  For the 3 days after his diagnosis, the Mayo doctors took him fishing (one of his passions) in the lakes surrounding Rochester to help him come to terms with his diagnosis before sending him back to his life. Gehrig surely felt the need to figure out how to break the news to Eleanor. Again, he was unaware that Eleanor knew more than him. When the group returned to the clinic on June , Gehrig sat down and wrote a letter to his wife:
"Mornin Sweet:
Really, I don't know how to start and I'm not much at breaking news gently. But am going to write it as there is no use in keeping you in suspense. I'll tell it all, just as it is.
As for breaking this news to the papers, I thought and the Dr.s approved, that they write a medical report and then a laymen's interpretation underneath, and I would tell the papermen here that I felt it was my duty to my employers that they have first-hand information and that I felt sure they would give it to the newspapermen. That seemed the most logical way to all of us here and I felt it was such vital news that it wouldn't be fair to have Joe [McCarthy, manager] and Ed [Barrow, owner] read about it in the papers.
However, don't be too alarmed or sympathetic, for the most important thing for me is no fatigue and no strain or major worries. The bad news is lateral sclerosis, in our language chronic infantile paralysis. There isn't any cure, the best they can hope is to check it at the point it is now and there is a 50-50 chance for that. My instructions and my physicians will be furnished me by Dr. O'Leary.
There are very few of these cases. It is probably caused by some germ. However, my first question was transmission. No danger whatever. Never heard of transmitting it to mates. If there were (and I made them doubly assure me) you certainly would never have been allowed within 100 feet of me.
There is a 50-50 chance of keeping me as I am. I may need a cane in 10 or 15 years. Playing is out of the question and Paul [Mayo doctor] suggests a coaching job or job in the office or writing. I made him honestly assure me that it will not affect me mentally.
They seem to think I'll get along all right if I can reconcile myself to this condition, which I have done but only after they assured me there is no danger of transmission and that I will not become mentally unbalanced and thereby become a burden on your hands for life.
I adore you, sweetheart."

Dr. Habein released this statement to the newspapers after Gehrig had the chance to tell the Yankees:
"This is to certify that Mr. Lou Gehrig has been under examination at the Mayo Clinic from June 13 to June 19, inclusive.
After a careful and complete examination, it was found that he is suffering from amyotrophic lateral sclerosis. This type of illness involves the motor pathways and cells of the central nervous system and, in lay terms, is known as a form of chronic poliomyelitis - infantile paralysis.
The nature of this trouble makes it such that Mr. Gehrig will be unable to continue his active participation as a baseball player, inasmuch as it is advisable that he conserve his muscular energy. He could, however, continue in some executive capacity."

Dr. Habein's statement, unfortunately, did not settle qualms over how Gehrig developed ALS. The public filled in the blanks with such guesses as he had caught something during All-Star tours in Japan or his streak being too much for his body. There was a vicious rumor that ALS was contagious and would spread to the other Yankees, god forbid. But all of this was nonsense and put to rest.

Bill Dickey, Gehrig's longtime friend, teammate, and roommate on the road, stated after Gehrig's diagnosis, "I knew there was something seriously wrong with him...[one day] he was standing looking out the window and I was sitting behind him, talking to him, and I saw one leg give way, just as though somebody had tapped him sharlply at the back on the knee joint.... So I knew it was something serious, but I didn't know it was as bad as this."

The Mayo doctors appointed Dr. Caldwell Esselstyn, a friend and neighbor of Gehrig, to be his primary physician in New York. Dr. Esselstyn's main form of treatment was the then-revolutionary vitamin E shots which the Mayo clinic sent to Gehrig in the mail.

Perhaps Gehrig knew he was dying. When he caught up with the Yankees in Washington after his visit at Mayo clinic, he was greeted happily by a group of Boy Scouts at the train station. The boys waved and wished him luck with the Series. Gehrig waved back at them, but then leaned toward his companion, reporter Rud Rennie, and said, "They're wishing me luck - and I'm dying."

Eleanor insists that Gehrig never knew his full prognosis, so much so she seems to profess her burden of guilt in her autobiography, saying, "I just lied all the way through, and he believed it - so trustingly that he didn't read up on [ALS] himself or crowd his doctors to tell him more."

His ALS progressed so rapidly that it was not long before he virtually was a shut-in. He was too weak to attend his own Hall of Fame induction in December of 1939.  During the months of constraint, he was entertained by an array of Broadway stars, friends, and neighbors. Eleanor brought many of them to the house with that specific purpose. Fred Fisher, songwriter; Pitzy Katz, vaudevillian; John Kieran, New York Times sportswriter; Tallulah Bankhead, Broadway actress, along with the cast of The Little Frog; Ed Barrow; teammates Bill Dickey, Frank Crosetti, and Babe Ruth. Virtually everyone Gehrig knew showed up at his house in New Rochelle, New York, at some point.

"Everybody who came to the house," Eleanor said, "was screened and warned: no backslapping or stuff like that because Lou was too smart for that."

For a time he corresponded with other ALS victims around the country. Piles of cards and letters poured in from well-wishers eager to give Gehrig encouragement.  Though he tried to respond to all of them, he eventually was too overwhelmed by even a simple task like writing.

Gehrig became more and more paralyzed, to the point he couldn't walk. Yet he absolutely refused to have a wheelchair, even in the worst of it.

Then, in 1941, Gehrig was finally bedridden. He desired only the essential people to see him: Eleanor, Mom, Pop, Dr. Esselstyn, Eleanor's mother. "Lou didn't want anyone to see him as he lost the power from that great, sturdy physique and the viatlity from that great chiseled face," Eleanor explained.  He lost power, strength, and so much weight it must have been startling to see him.  By the end of his battle he had gone from a bulky 200+ pounds to 25 pounds underweight.

Despite knowing full well that his body was wasting away, Gehrig never lost faith that his wife and doctors would bring him through it.

Gehrig lived for 23 months in his home battling ALS. The last few hours, he slipped in and out of consciousness.  Then, finally, on June, 2, 1941, he succumed.  He passed peacefully in the presence of his wife, parents, mother-in-law, and doctor.  His death came almost 16 years to the day his playing streak began (June 1, 1925), and 17 days before his 38th birthday.

New York City mayor (and former Gehrig employer) LaGuardia ordered flags to be flown at half staff the next day.

June 4 was Gehrig's funeral. The Yankee game for that day was cancelled. Realistically the game was cancelled due to rain, but sentimentally, what Yankee could play during Gehrig's funeral?

At his funeral, the minister, E. Willis Scott, was simple in point, foregoing on speeches. "We need none," he said, "because you all knew him."

Read Gehrig's Obituary

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Written by S. Kaden, 2002