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.

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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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The boy’s broken spirit and body only made Raisa Altman more determined. Jeri Trabin, a hospital social worker who has worked with the family for nine years, said Raisa was always unyielding where her son’s treatment was concerned, eventually persuading the state’s medical bureaucracies to provide care they didn’t normally approve.

“She wasn’t about to accept things as they were,” Trabin said. “Anything that would increase his chances she would make sure it would happen.”

Altman did still have full use of his brain, and he started exercising it by reading a Sidney Sheldon book his mother had brought to the hospital in one of many attempts to re-engage her son.

Reading became his salvation, but if it brought the world to his bedside, it also made Altman want to rejoin that world. The ‘80s may be called the decade of greed now, but the economic barons who were the best at what they did captured the imagination of the bed-bound teen-ager.

“I was a kid reading the Wall Street Journal and writing (letters to) Malcolm Forbes,” said Altman, who was later invited to New York to meet his hero.

By this time, Altman had graduated from the gurney to a special, vertical wheelchair for those who cannot bend at the waist. He had also ceased to become a pain in the neck to his care-givers.

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Still, his reputation lingered.

Trabin said the legend of Altman and his persistent mother spread to other hospitals, which didn’t want to take him as a patient. Yet, Trabin said, she always saw that what made him a demanding patient could be turned around to work on his behalf.

“I always saw something bright and shining about him,” Trabin said.

The disease stopped progressing in 1986; no more calcium deposits grew, but plenty remained. “Since then, I’ve been trying to roll back all the things that went wrong,” Altman said.

That, among other things, meant “casting,” a seemingly primitive, but effective, way to increase range of motion. In Altman’s case, curled-up legs and arms were stretched to the point of torture, then put in a cast. The process is repeated until, inch by inch, range of motion is increased.

“It’s like trying to stretch a rock,” Bernstein said.

Ultimately, the casting, accompanied by exhausting work by Altman, paid off. He recalls using a walker. It took an hour to inch painfully across the family living room. Afterward, Altman said, he was so drenched with sweat, he looked like he had just gotten out of the shower.

Why did he put himself through this regimen? “I did it for my parents,” he said.

Finally, during his senior year, Altman was able to attend Santa Monica High full time. Though he needed a boost to get out of his wheelchair, Altman, using crutches, made it across the stage to pick up his diploma.

At UCLA, Altman said he was so excited to be there, he threw the crutches away in three months. To say that he blossomed at the Westwood campus is an understatement.

“Students tend to flock to him, drawn by his wonderful sense of humor, his dry wit and his exceptional knowledge and intellect,” said history Professor Mary Yeager in a recommendation. “I observed his intellectual and personal generosity toward others many times.”

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Though Altman’s intellectual and social life soared, his body still betrayed him.

Describing Altman’s condition, Thompson, the economic professor, wrote in his recommendation: “I have never seen a student attend lectures with physical ailments so bad that he could neither sit down, stand straight nor lean up against a support; that he could neither write nor hold his note pad straight or steady; that he could scarcely move without a wince from the pain.”

The pain was from abscesses that formed when some of the calcium deposits liquefied. Surgeries provided the only relief, but Altman insisted on postponing them, refusing to miss a test, after missing years of classes during his junior high years.

His mother said that often, she would pick him up after an exam and take him straight to the hospital for an operation. Despite all that, Altman made it through college in five years.

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This summer, Altman is working part time at the John E. Anderson Graduate School of Management Library while waiting for law school to begin. He expects to return to Childrens Hospital this month for yet another surgery aimed at improving mobility in his elbow joints.

Altman’s professional goal is to be the “J.P. Morgan of the super-information highway.” His personal goal is to work toward independent living, though his frozen back, locked shoulders and hips continue to preclude him from that--at least for now.

Those who know Altman are betting on him--even to overcome the one academic goal that has eluded him--entrance to Stanford University Law School.

Since he was 15, Altman has been telling everyone at the hospital that he was going to Stanford. To his perhaps naive astonishment, the law school did not admit him; despite his perfect score on the entrance exam, he was placed on the waiting list.

Reflecting on Altman’s reaction to earlier setbacks, Trabin said: “If there was anything else like that (rejection), it would mean absolutely nothing to him or his mother,” Trabin said. “They would just go on. Stanford may never hear the end of it.”