Amyotrophic lateral sclerosis (ALS) is better known as Lou Gehrig’s disease after the record-setting New York Yankees hitter who died at the age of 37 from ALS. This year is the 75th anniversary of Gehrig’s famous speech in which he said farewell to more than 60,000 fans at Yankee Stadium and called himself “The luckiest man on the face of the earth.”
In ALS, a progressive neurodegenerative disease with no known cause, motor nerve cells in the brain and spinal cord are attacked and ultimately are no longer able to relay messages to muscles. The result is the loss of voluntary muscle control and movement of the arms, legs, diaphragm, and chest wall muscles. Despite this damage, patients with ALS retain sight, smell, taste, hearing, and the ability to recognize touch.
One of the most common neuromuscular diseases, ALS affects people of all races and ethnicities worldwide. Each year 5,600 Americans are diagnosed with ALS, usually between the ages of 40 and 70 years. More men than women are affected. The average life expectancy is 2 to 5 years from the time of diagnosis. Half of all patients with ALS live for 3 or more years after diagnosis, 20% live for 5 or more years, and 10% live for more than 10 years.
The presentation and course of ALS are diverse and its onset and early progression may be insidious. Muscle weakness is the initial hallmark. In the early stages, tripping or dropping items may occur as well as abnormal fatigue of the arms and legs, muscle cramping, and fasciculations (twitching). These generalized signs develop into more obvious muscle weakness and atrophy. Eventually, patients are unable to stand, walk, or use their extremities. Difficulty swallowing and chewing impairs the ability to eat. Cognitive abilities generally remain intact, and patients are aware of their progressive loss of function. As the muscles of the respiratory system weaken, patients have difficulty breathing and ultimately require permanent ventilator support. Most patients with ALS die of respiratory failure.
The signs and symptoms of ALS in its early stages can mimic other diseases such as polio, West Nile virus, Lyme disease, multiple sclerosis, and spinal muscular atrophy. The fasciculations and muscle cramps seen in ALS can also occur in other conditions. Therefore, patients who have been diagnosed with ALS should seek out a center that specializes in ALS.
There is no cure for ALS. However, recent advances in research and improved medical care are allowing many patients to live longer, more productive lives. Today, in many specialized ALS centers in the United States and worldwide, multidisciplinary medical teams provide clinical and psychological care, education, and support services.
Lou Gehrig’s diagnosis of ALS brought national and international attention to the disease. Today, his courage serves as an inspiration for the 30,000 Americans with ALS. We hope that, as the banner of the ALS Association reads, “Someday we’ll be able to name a cure after Lou Gehrig instead of a disease.”
Established in 1985, the mission of the ALS Association is to lead the fight to treat and cure ALS through global research and nationwide advocacy, while empowering people with Lou Gehrig’s disease and their families to live fuller lives by providing them with compassionate care and support.
‘The Luckiest Man on the Face of the Earth’: Lou Gehrig’s Tragedy and Triumph 75th Anniversary
The “Iron Horse of Baseball” had humble origins. Born in East Harlem on June 19, 1903, the son of German immigrants, Heinrich and Christina Fack Gehrig, Henry Louis “Lou” Gehrig was the only one of their 4 children to survive infancy. His father was in poor health, and his mother worked tirelessly to lift the family out of poverty and to ensure that Gehrig received a good education. He entered Columbia University to study engineering on a football scholarship in February 1921. His prowess at baseball was soon discovered, and Gehrig was signed to the Yankees in 1923.
Gehrig, the Yankees’ first baseman, along with the illustrious “Sultan of Swat,” Babe Ruth, formed the most formidable tandem of hitters that baseball has ever seen. In 1931, Gehrig set an American League record with 184 runs batted in (RBIs), which remains today. On June 3, 1932, playing against Philadelphia, Gehrig became the first in more than 30 years to hit 4 home runs in 1 game (preceded by Bobby Lowe in 1894 [Boston] and Ed Delahanty [Philadelphia] in 1896). Al Simmons robbed Gehrig of a 5th home run that day by making a great catch of a fly ball that was heading over the center field fence. In 1934, Gehrig won the Triple Crown by leading the league in batting average, home runs, and RBIs over a full season. Only 17 players have received that award; Miguel Cabrera held the title in 2012, preceded by Carl Yastrzemski in 1967.
Gehrig led the Yankees to 6 World Series titles. He was an All Star 7 times and twice was named Most Valuable Player. His career batting average was .340; he had 2,721 hits, 493 home runs, and 23 grand slams; and he had batted in 1,995 runs. Gehrig averaged a record 147 RBIs a season, while batting right behind baseball’s greatest base-cleaners ever, the Babe and “The Yankee Clipper,” Joe DiMaggio.
Named the Iron Horse because of his quiet and unassuming manner coupled with mental and physical toughness, the 6-feet, 200-pound Gehrig played despite hand, foot, and back injuries. Years later, x-ray films of his hands showed 17 previously unknown fractures that had healed while he continued to play ball. Over his 13 years in the Yankees’ lineup, Gehrig played in 2,130 consecutive games. It was not until more than 50 years later in 1995 that Cal Ripken, Jr, “The Iron Man,” broke Gehrig’s record.
The 1938 baseball season brought an unaccustomed slump for Gehrig. After a battery of tests at the Mayo Clinic, doctors confirmed the diagnosis of amyotrophic lateral sclerosis (ALS) on June 19, 1939. It was Gehrig’s 36th birthday. He would never play baseball again.
Only a few weeks later, Gehrig was honored at Yankee Stadium. With the same dignity and appreciation that he had shown throughout his career, Gehrig took the microphone and addressed more than 60,000 of his adoring fans: “Fans, for the past 2 weeks you have been reading about the bad break I got. Yet today I consider myself the luckiest man on the face of the earth…. I might have had a bad break, but I’ve got an awful lot to live for.” This July 4th will be the 75th anniversary of that famous speech.
Gehrig was voted into the Baseball Hall of Fame immediately and the Yankees retired his uniform, number 4, both unprecedented honors. Gehrig died of ALS on June 2, only a few weeks before his 38th birthday. His ashes were buried at Kensico Cemetery in Valhalla, New York.
Gehrig’s diagnosis put the spotlight on ALS, which is known nationally and internationally as Lou Gehrig’s disease. Today, Gehrig’s legacy is not only as a baseball legend. He also serves as an inspiration for the 30,000 Americans with Lou Gehrig’s disease through his strength of character.