Since she first entered politics, state Sen. Lisa A. Gladden has kept a secret. More than a decade later, she wants to share it on her own terms: Gladden has multiple sclerosis.
It's not all that dramatic, she says. Except for a weak left eye, the 46-year-old Baltimore Democrat says she is symptom-free.
So why is she going public now about a condition she has kept to herself, her family and a handful of friends since she was first diagnosed in 1995?
Gladden says she's tired of keeping the diagnosis a secret — as if it were something to be embarrassed about.
"I didn't want to get outed until I was ready," she said during a recent interview at her office at the state public defender's service, where she works the nine months the General Assembly is not in session. "I guess I'm ready."
Part of her reason for coming forward now, Gladden said, is that she'd like to help clear up some misconceptions about a disease that affects an estimated 400,000 Americans and that many still think of as catastrophic.
"They think MS is terminal or something. It's not a death sentence," she said. "The more people know, the more people can work together, the more they can make it less daunting for people who have been recently diagnosed."
In fact, MS can manifest itself in many different ways — from a debilitating condition to one that remains dormant and symptom-free for decades.
"It comes in different flavors, just like 31 flavors of Baskin-Robbins," said Gladden, who was elected to her third term in the Senate last month.
MS is a chronic disease that affects the nervous system, stripping away the protective coating of nerve fibers and interfering with signals between the brain and the body. Its precise cause is unknown, though some people might have a genetic predisposition to developing the condition.
In rare cases, the disease can result in near-total paralysis, but milder symptoms are more common. They can include speech problems, chronic fatigue, lack of balance or mobility and impaired vision. Or someone with MS can have none of the above.
Mark Roeder, president of the Maryland chapter of the Multiple Sclerosis Society, said many people mix up MS with more devastating conditions.
"They confuse MS with muscular dystrophy and a variety of other — what we call sound-alike — diseases," he said.
Dr. Walter Royal, director of the Maryland Center for Multiple Sclerosis Treatment and Research at the University of Maryland, agreed that the disease is poorly understood.
"The image that most people have about MS is about a person in a wheelchair, while that is more associated with later-stage disease," he said.
Royal, who has treated Gladden for her MS and who spoke with her permission, said her disease has followed a relatively benign course.
"The fact that she has had a diagnosis this long and that she continues to function at the level that she is, that's a good predictor for her having a continued very stable disease," he said.
Gladden first suspected something was wrong physically in 1995, when at 31 she noticed problems with her left eye while attending a camp for her favorite sport — bowling. When she returned, she went to Mercy Hospital.
"The ophthalmologist said you probably have MS, and I discounted him," she said. A further battery of tests at Johns Hopkins followed — "brain scans, spinal taps, icky stuff" — that confirmed the eye doctor's suspicions.
Gladden still recalls that the physician who broke the news wasn't very reassuring.
"I remember a time when I was first diagnosed, I thought I'm not going to buy any more shoes," Gladden said. But she quickly put those thoughts behind her and moved on.
"You have to live your life, and I had to be smart about a diagnosis that could be difficult, debilitating and devastating," she said.
Gladden picked difficult. "I wasn't going to do devastating," she said.
Arney Rosenblat, spokeswoman for the National MS Society, said that until 1993, MS was classified as a nontreatable disease. Since then, a range of effective medications have come to the market.
"There are now eight different therapies on the market that will help control the disease and minimize symptoms, and a half a dozen more that are moving through the pipeline," she said.
As luck would have it, Gladden's diagnosis came about the same time one of the first effective drugs for controlling the symptoms of MS became available. She recalls that her doctor wrote her a prescription for Avonex on the first day it was certified by the Food and Drug Administration.
At the time, the cost of the medication was at least as surprising as the diagnosis — $800 a month to a young woman whose contractual work for the public defender's office came with no prescription drug benefit. But Gladden's mother agreed to split the cost with her.
The next hurdle was to learn how to give herself the shots every week — the only alternative to showing up at an MS clinic each week. With a gesture like a boasting fisherman, she described the daunting length of the needles required for the self-injections.
"Figuratively and literally, it can be a pain in the butt," she said.
A few years after her diagnosis, in 1998, Gladden made the leap into public life with a run for the House of Delegates representing her Northwest Baltimore district. She candidly admits that one factor that played into her decision to run was the prescription drug coverage that is available to Maryland legislators.
By that time, she said, her few MS symptoms were nothing more than an "absolute afterthought." Gladden won that race and went on to serve a term in the House of Delegates.
In 2002, she won a hard-fought campaign to replace retiring longtime senator Clarence W. Blount.
Gladden said MS has not impaired her ability to represent her constituents and she's hopeful voters will understand her reluctance to go public.
"I've had MS for 15 years. I haven't done a poor job, and I don't think the MS limits my ability to do a good job at all," she said. Neither, Gladden added, would it keep her from a possible future campaign for higher office.
The senator said she's aware her previously controlled symptoms could take a turn for the worse. She is resigned to the likelihood that her vision will probably worsen. And she's come to terms with the possibility she might need to use a cane or scooter as she ages. But Gladden figures that medical science isn't standing still either.
"Technology's going to be around to help," she said.
Royal, her physician, said there's no reason MS should limit her ambitions.
"With her being on treatment, the chances of her doing well are increased and I would not assume that things should necessarily worsen for her if she were to run for higher office," he said.
Gladden says she doesn't plan to become an advocate on behalf of those with the disease. Nor does she intend to make disability rights any more a focus of her legislative work than it has been previously.
"I'm not the poster child for MS," she said. "I don't want people's sympathy. I don't want people saying 'poor Lisa.'"
Gladden said her form of activism will be to make herself available to talk with people who have recently been diagnosed with MS about coping with its challenges.
"I'll talk to them and make it funny," she said. "I'll show them that a spinal tap is funny."
Information on MS
National Multiple Sclerosis Society, Maryland Chapter, 11403 Cronhill Drive, Suite E, Owings Mills, 443-641-1200. Contact: firstname.lastname@example.org. National chapter, nationalmssociety.org, 800-344-4867
Multiple Sclerosis Association of America, 706 Haddonfield Road, Cherry Hill, N.J. 08002, 800-532-7667; msaa.com
Maryland Center for Multiple Sclerosis, University of Maryland, 16 S. Eutaw St., 3rd floor, Baltimore 21201, 410-328-5605; http://www.umm.edu/ms/multiple_sclerosis_resources.htm. Contact: CDorsey@som.umaryland.edu