As the physician prepared to leave the exam room, the patient's wife spoke up: "Doctor, my husband won't tell you this, but he is suffering," the woman said, her voice cracking. Dr. Timothy Quan, a rheumatologist in central Connecticut, looked at the 69-year-old man he'd been caring for over the past several months. The man gave a brisk nod. It was true. The past few weeks had been a nightmare of pain.
Six months earlier, the patient woke up with a sore, swollen right hand. He figured he must have injured it a few days before when he cleared out a pile of wood in his backyard. He mentioned it to his primary-care physician a couple of weeks later when he went in for a routine exam. The doctor prescribed some ibuprofen and suggested that maybe he was too old for that kind of heavy labor.
The ibuprofen helped but didn't stop the pain from spreading to both shoulders and down his hips and legs. By the time he went back to his doctor a few days later, every muscle, every ligament, every bone in his body seemed to ache. It was worse in the morning, when he was so stiff he could hardly get out of bed.
The patient lived in rural Connecticut, so his physician figured it was probably Lyme disease. He sent him to be tested but felt confident enough in the diagnosis to start him on doxycycline, the antibiotic used to treat most of the infections carried by ticks.
The antibiotic didn't help — he was still in a lot of pain. So his doctor called in a week of prednisone. The aches almost disappeared with the very first pill. They came back with a vengeance, though, when the prescription ended. He tried to tough it out, but the pain worsened every day.