The patient's doctor in Ohio sent records from the past two years. thyroid disease celiac disease (which affects the digestive system and is triggered by foods containing gluten). The list includes hepatitis B and C Lyme disease Sjogren's syndrome (which affects the glands that produce tears and saliva) lupus and other diseases of the connective tissues H.I.V. Podell has a list of unusual diseases that he considers in patients who have this kind of diffuse pain. 'I went for the zebras,' he said, meaning rare diseases, 'because frankly, after all the doctors she's seen, I was pretty sure all the horses had already been looked at.' He was determined not to miss this diagnosis. 'And I didn't want to drop it.' So in addition to having her doctor send him all the studies she had so far, he wanted her to get other tests - lots of tests. 'She'd put all her eggs in my basket,' he told me.

But he was worried about seeing this patient. He sees a lot of people who have pain all over their bodies. Podell is a rheumatologist - a specialist in diseases of the tissues that hold the body together - bones, muscles, tendons. She had seen so many doctors, and no one knew what was wrong. She went to the emergency room, where a doctor was worried that she'd had a stroke. The first time it happened, it was just her left arm.

Recently she had episodes during which she would lose her strength on one side of her body. She had fibromyalgia, anemia, endometriosis. Now, seven years after her daughter was born, her entire body ached almost all the time. It became unbearable when she was pregnant and developed crippling back pain. She told him that her whole life had been one of near-constant pain. Her voice was soft and high-pitched and sounded younger than her 33 years. He would need copies of her medical records and recent test results, and he would need to talk with her before he saw her. If she were going to travel, Podell told the sister, he wanted to make sure that he could do something for her. The patient, however, lived in Ohio, and Podell was in Middlebury, Conn. Podell wasn't sure he could help but wanted to try. I have heard you are the best, and if there is help out there, you are the one who will find it. 'I am very desperate for help,' she wrote, 'and I am struggling every day all day without relief. The sister handed Podell a letter from the patient. Over the past 10 years, the patient - now 33 - became completely disabled by strange pains and odd episodes of weakness that no one could explain. People told her that Podell was a doctor who specialized in diagnosing odd diseases, and she hoped he might finally solve the puzzle of her older sister's mysterious illness. David Podell, who was a friend of a friend and had a reputation as a kinder version of TV's Dr. 'Will you please see my sister?' the young woman asked Dr.

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