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December 1996

Three Get Ready

Author Affiliations

Rochester, NY

Arch Neurol. 1996;53(12):1222-1223. doi:10.1001/archneur.1996.00550120030012

Abe, Elsa, and Esther are 3 never-married, middle-aged siblings, each of whom has had the familial form of amyotrophic lateral sclerosis (ALS) for about 5 years. Their mother and grandfather died of ALS: she lived 4 years with the disease; he lived 3 years. Abe (the oldest) and his 2 sisters are all under the care of the same elderly physician, old "Doc" Trinaire, who took such kindly care of their mother through her protracted illness and was at her bedside when she died.

Abe, who had been a cantor, developed respiratory failure as the first sign of illness; Elsa, an artist, first lost the function of her hands; and Esther, who had worked as a mail carrier, became unable to walk.

As the 3 started to weaken in parts of their bodies that had initially been spared, they began to discuss their unwillingness to progress to the state of

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