Clipboard with plans drawn on paper depicting a planned flare

The War of the Joints

RA the Invader

I read a lot of WWII books and magazines.  I inherited the fascination from my father who showed me hour after hour of a program on Saturday afternoons, Victory at Sea.  If you are over the age of 60, you likely remember the program, and if not, it was about great naval battles of WWII.

This spilled over to my school life as well.  In seventh grade, the principal called my parents to report I was reading an inappropriate book at school.  The book in question was “The Rise and Fall of the Third Reich” by William Shire.  The matter was resolved, I could not read it at school, and my father said the principal was not well balanced (or something like that).  Incidentally, the school Media Center Director kept a copy for me and let me read it after lunch during the time most kids went to the gym to gossip and play basketball.  I loved the rebellion she displayed.

RA as War

When I think about RA,  I often put it in military terms.  For instance, I imagine the fight my body puts up when the foreign invaders (the autoimmune system) show up demanding that the joints are foreign objects that need to be destroyed.

My hands must have been shocked.  What the heck autoimmune system?  What foreign invaders?  We have been around from the start.  I can just see my hands yelling, look RA; if we (his hands) had not learned to put food in this guy’s mouth he would not have been fed, he would have passed in due time and guess what you would have gone as well.

So what, the autoimmune system replies, we have strict orders from the body to attack and destroy you, finger joints.  Ask the wrist my fingers say loud enough for the wrist to hear.

The Argument Within

I sense the argument about being a foreign invader would go on for several months when one day the autoimmune system just moves in and starts to destroy the small finger joints.  As the fingers hurt and lose ground, they might appeal to the wrists.  Please help wrists, tell the autoimmune system we finger joints have been here forever.  We cannot, the wrists say; we do not want the autoimmune system to attack us, we need to keep quiet, so the autoimmune system does not attack us.

Of course, in due course, the autoimmune system shows up anyway and attacks the wrists.  I mean the darn thing is everywhere causing trouble all at once.  Then when the wrists refuse to be conquered the autoimmune system sends in tanks and bombers, and it just has its way with the wrists, elbow, shoulder, and lungs.

Then sensing all the destruction, I head off to the doctor, and I toss in a biologic and hope it can reason with the autoimmune system and at first it works.  But gradually the war returns, and the joints suffer, and soon the entire body is fully involved, and the process repeats.


I know none of this is true.  But it does give a person raised on a steady diet of WWII military programs a framework to understand the disease progression.  First, the autoimmune system makes unreasonable demands for the joints to comply with, the joints say no and soon the battle rages.

As time goes on, we have aircraft carriers, and invasions and missiles and goodness know what else.  Enough, I plead, with the autoimmune system lets have some detente.  But no, it is always right there, always ready to make trouble and always willing to destroy something.

Alright maybe WWII is odd imagery for RA.  Or maybe, just maybe, my father left me with a framework to describe what is happening in my body.  My dad gave me my sense of humor and he may have given me a way to describe RA.  Even if he thought he was just passing the afternoon watching big ships firing big guns.

How do you make sense of RA when you think about it?  Do you use imagery, or do you have a different way of compartmentalizing RA?

Let me know.

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