Disability Studies Quarterly
Fall 2005, Volume 25, No. 4
Copyright 2005 by the Society
for Disability Studies

Misfit as Metaphor: The Question and the Contradiction of Lupus in Flannery O'Connor's "A Good Man Is Hard to Find"

Carl S. Horner, PhD
Professor of American Literature and Director of Creative Writing
Flagler College Dept. of English
P.O. Box 1027
St. Augustine, FL 32085-1027
E-mail: hornercs@flagler.edu

Elena V. Barnes, MD, FACR
Private Practice in Immunology

Scholars of Flannery O'Connor's life and literature have questioned why a devout Catholic, nurtured since childhood in the oldest Southern American demand for doing pretty, would create such a violent and self-contradictory figure as the Misfit in "A Good Man Is Hard to Find." However, grappling with fragmented or with incorrect information about systemic lupus erythematosus (SLE),1 an immune disorder that tortured the artist the entire time during which she wrote "A Good Man Is Hard to Find," commentators have not made a connection between the self-attacking, self-dismantling, killing violence of SLE and the Misfit who emerges on one level of O'Connor's ambiguous literary universe as a metaphor of the baffling disease.

With grim and certain diagnosis in July of 1952, Atlanta specialist Arthur J. Merrill informed Flannery O'Connor that lupus, and not rheumatoid arthritis, as concluded earlier by a physician in O'Connor's hometown, engendered her hip pain and other symptoms of internal distress (Habit, 1980, pp. 38-39). By the time that she began to write "A Good Man Is Hard to Find," O'Connor knew that her affliction would kill her–indeed, that her body was attacking and killing itself. As boldly as she suffered multiple blood transfusions and the violence of her lupus flares, O'Connor could not have forced this ravaging pain and confusion out of her mind before she forwarded "A Good Man Is Hard to Find" to Partisan Review in 1953 (Habit p. 59).

Although "a sense of urgency" invades O'Connor's final personal letters, Sally Fitzgerald (1980) observes that even close friends failed to recognize the intensity of her illness as this brave, positive, and often comical woman struggled with her crippling, killing disease. The "light tone" of her letters gallantly suppresses subtle and thus overlooked confessions of "sorrow" and "misery" (Habit p. 560). If O'Connor complained neither of pain nor of fear during typical conversations with friends, given the violence that devastated her body and that shocked her confidence during lupus flares, as well as the fatigue and assisted mobility that she had to endure even during remission, "how could she have failed to suffer" moments of "loneliness . . . resentment or self-pity . . . and much more" as she internalized "the reality of a permanently curtailed life" (p. xiv).

Unable to take for granted or to expect the normal life time of an able-bodied person, this brave and noble artist chose not to use SLE as an excuse for thwarted literary opportunity. Within the agony of lupus, persisted a literary genius more ecstatic, more defiant, more insistent, more enabling than any healthy time earlier in her life. In Why Flannery O'Connor Stayed Home, Marion Montgomery (1981) cites an interview in which O'Connor ironically made light of the effect that lupus had at least on the actual writing of her fiction: "The disease is of no consequence to my writing since for that I use my head and not my feet" (p. 17). However, in two letters written in the summer of 1957, she articulated the paradox that disability enlarged her literary ability: "I stayed away" from home, the artist intimated to Cecil Dawkins, a friend and regular correspondent, "from the time I was 20 until I was 25 with the notion that the life of my writing depended on my staying away. I would certainly have persisted in that delusion had I not got very ill and had to come home. The best of my writing has been done here [in Andalusia]" (Habit, 1980, p. 230). In "Good Country People" (1955), Joy, who named herself Hulga in order to contradict her mother's clichéd hope for any happiness in her life, a kindred misfit "who never danced a step or had any normal good times" (p. 162), makes "plain" to Mrs. Hopewell "that if it had not been for this [weakened heart] condition, she would be far from these red [Georgia] hills" (p. 164). In the second letter, sent also to Dawkins, O'Connor added in response to her extended "bone trouble" and to the frustrating "crutches" that she needed for mobility: "but when you can't be too active physically, there is nothing left to do but write so I may have a blessing in disguise" (Habit p. 234). O'Connor kept a pen and paper under the pillow on her bed even at times caretakers ordered her to rest. Caring for disabled patients, contemporary neuro-psychiatrists prescribe neither exclusion nor prohibition but stimulating relationships with friends and involvement in hobbies and in the arts. Passionate involvement, demanded by her inner resources, drove O'Connor to literary immortality.

Even during periods in which O'Connor's health was "stabilized" as much as possible, Sally Fitzgerald (1980) observed the frustration that invaded her friend's life–specifically, the "diminished strength" that kept her from working on her fiction "more than two or three hours a day" (Habit p. xiv). Writing to Sally and Robert Fitzgerald in the summer of 1952, O'Connor indicated that even after "two blood transfusions," she found her "tongue hanging on the [typewriter] keys [in the minor task of writing a letter] most of the time" (Habit p. 41). With blood transfusions and with steroid drugs, the most aggressive treatment known to physicians in the early fifties, Arthur J. Merrill predicted to Flannery O'Connor and to her mother that the artist could live only another ten to fifteen years, aware that victims typically survived no more than four to ten years. In "Good Country People" (1955), a story published in the first collection (1971) with "A Good Man Is Hard to Find" (1953), O'Connor pushes the clock on the horror of Joy-Hulga's terminal disease: "The doctors had told Mrs. Hopewell that with the best of care, Joy might see forty-five" (p. 164).

In The Habit of Being, Sally Fitzgerald (1980) explains that Flannery O'Connor struggled gallantly "under the hard constraint of disseminated lupus erythematosus, a dangerous disease of metabolical origin–incurable but controllable by steroid drugs–which exhausts the energies of its victims and necessitates an extremely careful and restricted life" (pp. xiii-xiv). Dorothy Tuck McFarland (1976) adds in Flannery O'Connor: "Lupus causes the body to produce antibodies that attack its own tissues, and affects the blood, joints, and internal organs" (p. 7). Indeed, this information defines true characteristics of lupus; however, working only with these incomplete explanations–working, that is, without an adequate context in which to understand how the immune system misfits its own potency–literary specialists would fail adequately to interpret the contradiction of SLE or its influence both on O'Connor's intuition and on her fiction.

"The acute phase of lupus," Fitzgerald (1980) further notes, "is characterized by a rash, over the bridge of the nose and cheeks, in the shape of a butterfly" (p. 67). Physician Sheldon Paul Blau (1974) refutes a universal relevance of what Fitzgerald identifies as "the acute phase" on the basis that the rash may or may not develop in the affliction (p. 5) and that the more devastating effects of lupus occur internally, as they did in O'Connor's illness from 1950 until her death in 1964. SLE attacked not only her hip joints, a well publicized fact about the artist's affliction, but finally her kidneys. In a letter written in 1961 to Elizabeth Fenwick Way, O'Connor explained the external rash as the controllable symptom of "the skin-type of [discoid] lupus and not systemic lupus" (Habit, 1980, p. 440).

The American Lupus Society (1983) advises its patients that in 1948 Mayo Clinic Physician Malcolm Hargraves identified an actual "LE cell" in the blood of systemic lupus erythematosus victims, the internal lupus that attacked O'Connor. In a revelation to Way, O'Connor acknowledged the difficulty that physicians faced in tracking the cell: "The LE cells don't have to show up in the tests for you to have... Lupus with a capital L" (Habit, 1980, p. 389). "LE involves changes in the blood vessels and the connective tissue, which supports the cells of the body in much the same way that mortar connects and supports bricks of a house" (Society p.1).

Given the "most common clinical manifestations" of fever and swollen, stiff, and painful body joints, documented by the American Lupus Society (1983, p. 5), and again identified by M. C. Hochberg's SLE criteria, updated (1997) for the American College of Rheumatology (p. 1725), readers can see why even medical practitioners have mistaken lupus for arthritis. "I am languishing on my bed of semi affliction, this time with AWTHRITUS," O'Connor wrote to Betty Boyd Love, led by her doctors in 1950 at Baldwin Memorial "Horspital" to believe that "the acute rheumatoid arthritis" was the cause of her agony, an affliction that "leaves you always willing to sit down, lie down, lie flatter" (Habit, 1980, p. 22). Reinforcing false perception about O'Connor's infirmity, the biographic sketch preceding Three by Flannery O'Connor (1983) misinforms readers that the artist suffered "from a hereditary rheumatic [as opposed to immune] ailment."

Even contemporary medical doctors have confused arthritis with the far more agonizing immune disorder known as lupus.2 "The connective-tissue disorders are . . . known collectively as autoimmune disorders," Blau (1974) explains, "disorders manifesting self-attack, self-repulsion on the cellular level. Rheumatoid arthritis and other connective-tissue disorders can also, to an extent, be so described. But lupus is the prototype, the classic and confounding example of what is perhaps the most perplexing puzzle in medicine" (8).3 Shaun Ruddy and colleagues (2001) add that such self-immunity disorders can spread to all internal organs (pp. 1109-16).

While medical doctors have in past decades undertaken intense research in cardiology, hematology, gastroenterology, urology, gynecology, neurology–essentially, in every imaginable field of internal medicine–as well as in immunology, dermatology, dentistry, pharmacology, psychology, and even ecology, why the body attacks itself as it does in lupus remains a threatening, irreconcilable puzzle (Blau, 1974, pp. 6-7). "There are at least six genes responsible for causing lupus," explains well-known specialist Arthur Krieg, "but they have not yet been identified" (cited in Hales, 1992, p. 62). Ruddy and colleagues (2001) argue 21 genes currently known for human SLE; however, those are susceptibility genes. "The number of genes a person must inherit to develop clinical disease is unknown; it is likely to be several, with full gene effect depending partly on other modifying or protective genes in the same individual, gender, and the strength or environmental stimuli that can trigger disease" (pp. 1091-92).

In "The Disease That Fools the Doctors," Diane Hales (1992) writes that researchers "suspect it takes a one-two punch of genetic predisposition plus various environmental triggers to set off the baffling symptoms that earmark lupus" (p. 62). Contemporary lupus specialists also "suspect that a special type of allergic reaction causes the disease," as the American Lupus Society (1983) reports. "It is believed that patients develop antibodies against their own tissues, as if vaccinated against themselves. These antibodies are known as auto-antibodies (auto means self) and the type of allergy is called auto immunity, or an allergy against oneself" (p. 2).

Humans must not underestimate the potency of the immune system. Without the activities of this defense, Blau (1974) predicts in utter respect, "we would succumb shortly after birth to the host of inimical agents and substances in our environment" (p. 64). When the body responds "to provoking agents, as a class termed antigens–including allergens as well as infection-causing organisms such as bacteria and viruses," the vicious and "raging antigen-antibody battle and its accompanying inflammation" testify to a potentially deadly conflict, ultimately resolved in favor of healthy individuals. In the lupus victim, however, the battle "continues–or comes and goes at unpredictable intervals–as a chronic condition, succumbing to no known antibiotics or other anti-infection agents. Further, there is no explanation for the unrelenting attack, no identifiable infectious organism or other foreign invader. While antibodies are demonstrably active in lupus, their activity appears undirected, or more accurately, misdirected" (pp. 7-8).

"Lupus typically plays a cruel game of hide-and-seek," Hales (1992) reports, adding that the disease is no more predictable than the "Cheshire cat" for which it is appropriately nick-named. "Patients often go into remission for weeks, months, even years. But the reappearance of the same or completely different symptoms–called flares–can occur without warning and, just like a remission, last an unpredictable length of time. Many patients feel fine and then something–a day in the sun, an injury, too much stress, or too little rest–triggers a flare that may knock them off their feet" (p. 62).

By far, one of the most "mysterious" or eruptive and therefore frustrating and terrifying contradictions of human reality "is that phenomenon called autoimmunity–mobilization of the body's defense system against the body itself," Blau (1974) explains. "Not only do lupus patients evidence higher-than-normal antibody levels against particular viruses, they also evidence antibodies that can be clearly shown to be specifically primed for battle against the body's own tissue–against the patient's own red cells, blood vessels, muscles, and other organs" (p. 61).

Unaware of the far-reaching violence of lupus, Preston M. Browning (1974) concludes in Flannery O'Connor that the disease "mainly affects the blood vessels" (p. 2). However, in this complex affliction, "more dramatically than in any other connective-tissue disorder," Blau (1974) explains that the immune system marshals "its not inconsiderable defenses against its own tissues, furiously attacking and sometimes successfully destroying" any of the multiple "fibers of its own body" (p. 8). In an interview with James R. Copeland (1986), the Florida surgeon stressed that "in this auto [self] immune disorder, the immune system perceives various tissues and cells of its own body as foreign, alien material." The immune system, in releasing its deadly defenses, "does not sense that it is attacking its own tissue, attacking to kill–to kill itself."

Flannery O'Connor suffered the whirlpool of this biological paranoia. In 1956, she warned fellow lupus victim Elizabeth Fenwick Way about outside responses to the pain of lupus: "Everybody now talks about it's all-in-the-mind. When I was in the hospital [Emory Hospital in Atlanta, a leading center then and now for the treatment of lupus] even the nurse's aides that didn't have sense enough to do anything but empty the ice-water were full of that chatter" (Habit, 1980, p. 154). "Honey, take up knitting, and you won't notice the pain," a general practitioner advised lupus victim Deborah Raynes (1987) when she expressed the same agony in her hip joints that tortured O'Connor. "No," this pain is "not just a little ache–they just don't know," Raynes continued, focusing how utterly disabled, to the horror even of temporary loss of consciousness, a victim can find herself in the lupus flare.4

"Some days I wake up and I'm just as tired as I was when I went to bed," confesses Gail Edwards, a contemporary lupus victim agonizing over the same symptoms of hip pain and fatigue that tormented Flannery O'Connor. "I try to move" during a lupus flare, "and my legs feel as if they're buried up to the knees in sand. The pain is like a whine inside my body, niggling away at my hips or back" (cited in Hales, 1992, p. 60). Rosemarie Garland Thomson (1997) documents "exclusionary" medical and political "discourse" that dictates "cultural rules" for "crippledness," for "what bodies should be or do," including "troubling concerns" over "limits. . . . vulnerability, control, and identity" (pp. 5-6, 11). McFarland (1976) argues that this feeling of being vulnerable, disposable, or limited, precipitated by a life-threatening disease, explains the terrifying quality of spiritual transcendence discovered in O'Connor's fiction (pp. 7-8).

With new insight about SLE, readers discover another key with which to probe the shocking questions and contradictions of O'Connor's literary Misfit. Indeed, when the Misfit collides with the reductive complacency, absolute self-righteousness, and blind certainties of the Grandmother, confident that she has figured out the human world, O'Connor can fill his mouth only with the pain of confusion–only with the words of one, like herself, who is wrestling to understand the contradiction of his existence:

My daddy said I was a different breed of dog from my brothers and sisters. "You know," Daddy said, "it's some that can live their whole life out without asking about it and it's others has to know why it is, and this boy is one of the latters. He's going to be into everything!" (pp. 128-29)

Beyond the possibility that the Misfit is nothing more than a psychotic killer who has murdered his own father,5 readers discover O'Connor's more alarming insight that her literary figure suffers the impossibility of simple answers and simple solutions to complex human experience, the absurdity of certainty, or the crisis of uncertainty, emerging on this level of the story as the metaphor of lupus, the enemy within.

As a lupus victim, O'Connor could think of herself as a misfit, artistically confessing her own regret that life had not been fair. In varying degrees of intricacy, O'Connor's Misfit evokes her own despair, why me?6 "Does it seem right to you, lady," the Misfit asks the Grandmother, in the wake of her fundamentalist Christian solutions to self-dismantling reality, "that one is punished a heap and another ain't punished at all?" On the first level of his assertion that he "aint been treated right," the Misfit questions the corrupt or contradictory nature of American criminal justice, that a crime can persist undetected or that politicians can reduce a sentence for an individual with strong networking.

In a second and more terrifying implication, readers extend the Misfit's question to O'Connor's heightened sensitivity of human mortality. Some people do live long and physically painless lives, while the unlucky victims of insensitive biological reality suffer and die from diseases over which they and their doctors have neither permanent nor truly effective control. In the voice of her truth-seeking Misfit, O'Connor questions not only the injustice of fear and pain in the human universe but also the contradiction of lupus, a human body allergic to itself: "I call myself The Misfit . . . because I can't make what all I done wrong fit what all I gone through in punishment" (p. 131). Having to face the day-to-day violence of lupus, certainly by the time that she began to write "A Good Man Is Hard to Find," O'Connor rejected the inherited, romanticized, clichéd, or uninformed belief that our body beautiful consists of a system of cooperating, coordinated, harmoniously conceived parts. In her struggle with SLE, she suffered the shattering revelation that the human body is not necessarily a unified whole.7

When Flannery O'Connor creates the questions and contradictions that pull themselves apart in "A Good Man Is Hard to Find," she represents the self-attacking, self-dismantling violence of SLE in the oxymoron of her gentleman killer. A "defenseless-looking" (p. 133), quiet, soft-spoken, gentle, kind, sensitive, pensive, thoughtful, and yet simultaneously thoughtless, unpredictable, impulsive, mean, cruel, dangerous, violent, and murderous Misfit evokes a complexity larger and more potent than he is.

As refined as the Misfit appears in the "silver-rimmed spectacles that gave him a scholarly look" (p. 126), his crude and illiterate speech contradicts the image irreconcilably. As polite as he is to apologize for wearing no shirt in the company of the Grandmother and Mother, and as kind and sensitive as he is to soothe the Grandmother after Bailey shocks her (and the unruly children) with the presupposed lethal behavior of escaped convicts, the Misfit finally tells Hiram and Bobby Lee to "throw" the dead body of the Grandmother "where you thrown the others" (p. 133), contradicting any respect or compassion either that he had felt or that he had expressed earlier for the lives of his victims. Resolving that "no pleasure but meanness" can exist if Jesus failed His mission of faith, love, and salvation, the Misfit adds viciously that all an individual can do is to "enjoy" last moments in life in waste and destruction "by killing somebody or burning down his house or doing some other meanness to him" (p. 132). Yet again, he only pulls the inhumanity apart when he scolds Bobby Lee for thinking that cruelty is fun: "It's no real pleasure in life" (p. 133), he utters, after violently destroying his last victim.

Although the Grandmother speaks in fear and desperation for her life, hysterically appealing to the mercy ironically of a rational-irrational killer, the Misfit probably does spring from "good blood" (p. 131).8 Not once does he contradict his claim that his parents were the "finest people in the world." Not once does he indicate any abuse or ill treatment: "God never made a finer woman than my mother and my daddy's heart was pure gold" (p. 127). Beyond the "head-doctor" (p. 130) at the Federal penitentiary who diagnosed (misdiagnosed within the analogy of O'Connor's first medical doctor perceiving not lupus but arthritis) the Misfit as a psychotic killer, O'Connor intuitively sensed the irony of her own blood crisis, rife with lupus cells and necessitating transfusions. The terminally ill develop not only hindsight but unconscious foresight. O'Connor inherited lupus from her father, who simultaneously gave her life and the disease that killed it. In this scraping, scathing, surprising, self-displacing universe, bodies do go off balance–even bodies conceived and nurtured by good parents.

As sensitively as the Misfit responds to his own recognition that "Jesus thown everything off balance" if he "ever raised the dead," he shoots the Grandmother "three times through the chest" merely for recognizing him as one of her "babies," as one of her "own children" (pp. 131-32)–an act metaphoric not of the Biblical number three but of reverse betrayal–an act metaphoric as well of an immune system infected with lupus, and thus blind to any possibility of relationship. The Misfit tells the Grandmother that she and her family would have experienced a more fortunate end to their car "ACCIDENT," as the children put it, had she not "reckernized" (pp. 126-27) him as a notorious killer. However, nothing happens accidentally in "A Good Man Is Hard to Find." Nothing ever does in O'Connor's fiction.

Sara Gordon (2000) writes that O'Connor "creates and explores" fierce literary worlds (p. 245), driven not with the "thinly allegorical" figures of non-literary fiction but with shocking and consistently ugly perception of human life on earth (p. 94). If readers feel uneasy considering the horror of the Misfit's contradictory and violent deeds, is it not that without the intuition of the terminally ill they cling to the hope that their lives are secure–that their moments on earth are as certain–as guaranteed–as life without disease? In the dearth of information available to scholars, is it not that confessions of "natural sorrow" and "misery" (Habit p. 560) have gone unheard not only in her letters, as Fitzgerald (1980) notes, but also in "A Good Man Is Hard to Find"? Flannery O'Connor, whose affliction baptized her in the agony of lupus, projected into "A Good Man Is Hard to Find" the thumbprint metaphor of biological reality that drops sickness, accident, and death as uncontrollably as Georgia rain. Within the slow violence of SLE, O'Connor stirred boldly with human mortality.


American Lupus Society. (1983). Lupus erythematosus. E. L. Dubois & M. B. Cox (Eds.). Torrance: American Lupus Society.

Anonymous Lupus Victim. (1987). Interview, 20 April.

Blau, S. P. (1974). Lupus: The body against itself. New York: Doubleday.

Browning, P. M. (1974). Flannery O'Connor. Carbondale: Southern Illinois University Press.

Copeland, J. R. (1986). Interviews, 24 September to 6 October.

Gordon, S. (2000). Flannery O'Connor: The obedient imagination. Athens: University of Georgia Press.

Hales, D. (1992). The disease that fools the doctors. Good Housekeeping, April, 60-64.

Hochberg, M. C. (1997). "Updating the American College of Rheumatology: Revised criteria for the classification of systemic lupus erythematosus." Arthritis Rheum, 40, 1725.

McFarland, D. T. (1976). Flannery O'Connor. New York: Ungar.

Montgomery, M. (1981). Why Flannery O'Connor stayed home. Vol. 1 of The prophetic poet and the spirit of the age. LaSalle: Sugden.

O'Connor, F. (1971). "A good man is hard to find." Flannery O'Connor: The complete stories. New York: Farrar. 11-29.

O'Connor, F. (1971). "Good country people." Flannery O'Connor: The complete stories. New York: Farrar, 159-183.

O'Connor, F. (1980). The habit of being: Letters of Flannery O'Connor. S. Fitzgerald (Ed.). New York: Vintage-Random House.

O'Connor, F. (1983). Three by Flannery O'Connor. New York: Signet-New American Library.

Raynes, D. (1987-1992). Discussions and Correspondence, 15 January to 23 December.

Ruddy, S., et al. (2001). Kelley's textbook of rheumatology. 6th ed. London: Saunders-Elsevier.

Thomson, R. G. (1997). Extraordinary bodies. New York: Columbia University Press.


1 Sheldon Paul Blau (1974) writes that Hippocrates identified "an erosive, disfiguring malady" capable of "eating away at the skin and flesh of the face." Even present-day researchers and physicians do not know the exact disease that Hippocrates described, and it is doubtful that lupus qualifies; however, figuring that the symptoms resembled wolf bites, a number of unnamed mid-nineteenth century scholars subsequently termed the affliction "lupus," a Latin word for "wolf" (p. 5). Less evasive information about the name of the disease dates from 1840 when Ferdinand von Hebra published his recognition of the red skin rash of lupus, which appears, he wrote, "mainly on the face, on the cheeks and nose in a distribution not dissimilar to a butterfly" (cited in Blau p. 5). When and if the face rash occurs, Blau explains that "butterfly rash" is now a common description among physicians and victims (p. 5). In 1851, Pierre Cazenave introduced the terms "lupus erythemateux," meaning "lupus characterized by redness," thus codifying the external rash as well as the internal inflammation that can develop. Not until the turn of the century, however, did Sir William Osler of Johns Hopkins University publish a series of studies "concluding in no uncertain terms," Blau cites, "that lupus erythematosus was a systemic disorder, affecting various parts of the body–not only the skin, but the joints and internal organs as well" (pp. 5-6).

2 Another popular misconception is that lupus is a form of AIDS, or acquired immune deficiency syndrome. In a series of discussions about SLE, surgeon James R. Copeland (1986) explained that a "lack of immune response," or "a suppressed immune system," qualifies AIDS as the exact opposite of SLE. Unquestionably, "lupus is the obverse of the AIDS coin," Blau (1974) advises. "In AIDS, the system seems . . . to lurch to a halt, abandoning the body's defenses and leaving it vulnerable to assault by alien invaders causing seldom-seen diseases. In lupus, on the other hand . . . the body's defenders do not sink into nodding lethargy but rather are stirred to inappropriate activity, striking out wildly not against foreign incursions but against the very organism of which they are a part" (p. 4).

A less popular and yet still troubling misconception is that lupus is a form of cancer. Blau (1974) emphasizes the difference between "aberrant cell proliferation" in cancer and cell attack in lupus (p. 8).

3 SLE is a connective-tissue disorder classified as a "collagen disease," collagen being "a specific protein substance that forms an important part of connective-tissue fibrils throughout the body" (Blau, 1974, p. 7). Shaun Ruddy and colleagues (2001) argue updated perception: "What we know now is that SLE is not just collagen vascular disease, nor is it confined to the connective tissues. It is a disease of fluctuating immune dysfunction, associated with antibodies, and it has enormous potential for variation both within a single patient over time and across population of patients" (p. 1107).

4 A number of weeks after this discussion, Horner found Raynes (1987) collapsed on his office desk. Tiny pools of tears sparkled on the wood under her eyes. Horner had to carry her to his car and then into her apartment in which again she collapsed unable to speak or to move on her couch for the remainder of the afternoon.

5 "I am not interested in abnormal psychology" (Habit, 1980, p. 437), O'Connor advised an English professor in 1961.

6 After more than twenty-five years of eating the purest foods (often from health-food stores), exercising regularly and wisely, and up-holding the highest human values of compassion, honesty, kindness, generosity, and loyalty, an anonymous SLE victim (1987) lamented that she could utter only "why me?" when her doctor finally diagnosed her fever and hip pain as lupus.

7 "The human body is supposed to be a unified whole, along with a thousand other 'shoulds' in life," Raynes (1987) noted, observing the temporary nature of the lupus victim's day-to-day activities. "For example, at 32 years old, I should be able to walk without pain, lift a dinner plate, and so on," but simplicity, certainty, and predictability do not exist for the victims of SLE. "Some days I can walk–some days I can't. Some days it seems I can count on nothing," Raynes explained, citing Ecclesiastes in order to pull her identification with O'Connor's crisis into a shared perspective: "I returned, and saw under the sun, that the race is not to the swift, nor the battle to the strong, neither yet bread to the wise, nor yet riches to men of understanding, nor yet favor to men of skill; but time and chance happeneth to them all" (9:11).

8 SLE attacked not only O'Connor's hip joints but finally her kidneys. In May of 1964, the year in which she died of lupus, O'Connor wrote to her playwright friend, Maryat Lee: "Dr. Burrell says I have declared a moratorium on making blood–something that apparently happens in lupus," adding that she suffered approximately 10 blood transfusions in 1951 (Habit, 1980, p. 578). In June of 1964, she explained her kidney condition to Lee (p. 584) and more specifically to Cecil Dawkins: "The trouble is mostly kidneys–they don't refine poisons out of the proteins & therefore you don't make blood like you should or you lose it like you shouldn't or something" (p. 587). Copeland (1986) confirmed that blood may not cleanse itself properly as a result of lupus.