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WESTSIDE / COVER STORY : A MAN OF STEEL : David Altman Rises Above His Debilitating, Lifelong 'Tin Man's' Disease


David Altman is a young man in motion. And that's the story--a miracle actually.

Altman, 23, was never expected to walk again, much less pace the floor as he did recently, talking about his return from the brink of oblivion.

He was never expected to gesture with his gnarled hands, jabbing them in the air as if he were a conductor gearing up for a crescendo. Or to graduate from UCLA this spring with a 3.85 grade point average. Or to get a perfect score on the law school admissions test, winning a spot at UCLA School of Law.

As a boy of 10, Altman developed a very bad case of a rare disease--dermatomyositis, an inflammation of the skin and muscles that is debilitating, and sometimes fatal.

In Altman's case, the disease was for years a living death. His body produced huge sheets of rock-hard calcium, literally entombing him in a self-made body cast.

"I had my own personal body armor," Altman says.

Sometimes the calcium would melt on its own, causing painful abscesses that required surgery--dozens of surgeries. Sometimes doctors tried to remove pieces of it, including a 4 1/2-inch-thick chunk that was embedded in Altman's backside.

Because of the stiffness he will have to battle all of his days, health care workers have dubbed his ailment Tin Man's disease.

"He, indeed, looks like the Tin Man in the Wizard of Oz," says Dr. Bram Bernstein, who is David Altman's doctor and heads the rheumatology department at Childrens Hospital in Los Angeles.

Beneath Altman's inflexible exterior, however, lies a hero's heart and a champion's will, say those who know him. And his story offers a formidable lesson in the power of mind over matter.

He "is a walking tribute to the human spirit," UCLA Economics Professor Earl A. Thompson wrote in a recommendation for his former student. "He possesses a truly astounding combination of intellectual ability and sheer physical courage."

Born in Odessa, in the former Soviet Union, Altman arrived in the United States with his parents, Raisa and Jack, when he was 4. The family lived in Detroit, but moved to California in 1979 after a vacation there the year before. They eventually settled in Santa Monica, where they still live.

Altman says he remembers vividly the onset of his illness, how the simple chore of sweeping leaves in the back yard gradually became harder--and finally impossible. His muscles seemed to desert him; he was always tired.

A rash on his hands and face plus a high fever led to a misdiagnosis of the disease as lupus, a related but distinctly different ailment.

It took two years, and the persistence of Altman's indomitable mother, to obtain the correct diagnosis at Childrens Hospital's internationally known rheumatology department.

While there are no statistics on the number of juvenile cases of dermatomyositis, Bernstein said he sees one case of it for every 20 cases he sees of juvenile rheumatoid arthritis--itself a rare condition afflicting 100,000 children nationwide.

"The average pediatrician has probably never seen a case," Bernstein said.

The doctor said dermatomyositis is an autoimmune disorder that is possibly caused by a virus. It is treated with anti-inflammatory drugs, such as cortisone, and immunosuppressant drugs, like those used to fight cancer. The disease causes painful inflammation of the skin and muscles, especially at the major joints--hips, shoulders, elbows, knees.


In some children (adults get the disorder, too), internal muscles are affected, deteriorating to the point that patients can't breathe or their intestines perforate, causing death.

David Altman's disease took the other common course for children when he developed calcinosis. As a complication of dermatomyositis, the body's calcium production mechanism can run amok, laying rock-hard deposits under the skin and sometimes in the muscle tissue itself.

Touch Altman's arm where there is a calcium deposit, and it feels like he has a steel plate embedded there. That was how it felt to Altman, too, who for several years in the '80s could not walk, sit or even at times feed himself. "He couldn't open his mouth to put in a teaspoon," said his mother, an accountant who gave up her job to care for her son.

Not surprisingly, Altman was depressed and irritable. During those periods when he was not hospitalized, he lay on a gurney in the darkened living room of his Santa Monica home, wanting no light, no television, no food, no human contact. Every 15 minutes, he had to be repositioned because of the pain.

"It was like being crunched between two pieces of calcium," Altman said.

During months of hospitalization, Altman says he was a "beast patient," lashing out at nurses, who drew straws to see who would have to care for him. "I was a jerk; I really was," Altman says.

If so, he had cause. At times, Altman's body was covered with sores that for Bernstein brought to mind a parable from the Book of Job, in which Satan tested Job's faith by covering his body with boils "from the sole of his foot unto his crown."


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