Updated: May 22,
2001 12:47 a.m. EDT
Copyright © 2001 Nando Media
Scripps Howard News Service
(May 22, 2001 12:47 a.m. EDT) - President Josiah "Jed" Bartlet isn't the only person whose job is on the line because of multiple sclerosis.
Bartlet, a Nobel Prize economist, is the fictional president of the United States in the TV drama, "The West Wing." Martin Sheen plays the role.
For more than a year, viewers have shared a secret known, in the fictional Washington, only by a handful of people: The president has multiple sclerosis. He had it when he ran for the Oval Office and has concealed the fact.
Now, in the season finale, he has told the whole world. Suddenly he's not a good bet for a second term - or even for finishing the first one.
Powerful people of both parties are asking whether he can handle the job, with MS's crippling symptoms looming.
Meanwhile, a special prosecutor will be examining his, er, lack of frankness. You know about special prosecutors.
Fortunately for Bartlet, this is fiction. But the scenario is all too real for people living with MS. They are real people, and many of them are in danger of losing real jobs if their employers learn they have MS.
While Bartlet decided to tell all, real people with MS have a mixed response to the ethical question, "Is it my duty to tell my employer I have MS?"
The Harris Poll recently asked people with MS whether they had ever tried to hide their disease from an employer.
Forty percent said they had.
MS is a disease of the central nervous system. It can cause such widely varying symptoms as blindness, numbness, paralysis or difficulty in walking, just to name a few.
But it can also be in remission for years - as with NBC-TV's President Bartlet.
The effects of the disease in any one person, according to the National MS Society, are "unpredictability."
It can take as much as five years to find out how MS will affect a specific individual. One may spend life in a wheelchair, while another may be blind but able to walk three miles a day.
Life expectancy after diagnosis is near normal, thanks to improved treatment. In 1890 it was only five years, and in 1970 it was around 32 years.
You're more at risk for MS if you're female and if you're young. Inexplicably, your danger is greater the farther from the Equator you grew up.
In an article for the National MS Society, Loren A. Rolak, M.D., says science tends to blame a gene that is harmless until it is triggered by a virus. Only if you inherit that gene and catch that virus, they suggest, do you develop MS.
The symptoms are caused by the inability of the spinal cord and brain to carry signals. They're like wires that have lost their insulation.
A material called myelin insulates each nerve fiber from others in the bundle. In MS, something destroys the myelin.
Although their symptoms vary, people with MS share three worries, according to the national society.
What course the disease
will take. The National MS Society says, "MS is difficult to diagnose,
and its progress, severity, and specific symptoms in any one person cannot
yet be predicted."
The society praises the "West Wing" writers for continually learning about MS. It points out that they "could have greatly distorted MS facts to further their story line."
Whether to keep working
or not. A Society publication, "Should I Work?," says it takes many years
to consider these choices and make realistic plans.
It urges employees to check out an employer's policies on sick leave, short-term disability and insurance.
Whether to disclose
the illness to your employer. We're back at TV's Oval Office.
Health Law Professor Wendy Mariner of Boston University warns that there are few effective laws protecting MS patients, for example, from being fired. If you take the company to court, she says, the boss wins more than 90 percent of the cases.
So should you tell?
A failure to tell the truth is usually considered ethically questionable. But not always.
What would you say to David Lander, who was "Squiggy" in "Laverne and Shirley"?
CNN medical writer Elizabeth Cohen quotes Lander:
"I hid it for 15 years," he's quoted as saying, "primarily because I didn't think show business would embrace the fact that I have a chronic disease. ..."
Lander, now a scout for the Anaheim Angels, is thankful for the airing of President Bartlet's dilemma. He thinks it will help convince employers that many people with MS can still do a full day's work.