47

Linda

On Friday, January 19, 2018, Linda walked up to the first tee at the Olympic Club, an elite golf course on the southern edge of San Francisco. The weather forecast had called for a predictable winter chill, but the sun shone and Linda felt warm in wool capri pants and a black turtleneck. She pulled out her driver.

She’d made a New Year’s vow. This was to be the year she was just going to have fun on the golf course.

It has been thirty-six and a half years since she won the Ulster Open. She carried that grace and elegance again, after a horrific interlude of crippling joint disease. Outwardly, there was no sign of the rheumatoid arthritis, but her hands did show the cruel angularity of osteoarthritis, which is a different degenerative joint condition, not autoimmune, due to wear and tear. The swelling and crooked turn at the end of both her right middle and index fingers were largely coincidental with the rheumatoid arthritis.

Linda is right-handed, and the fact that the damage impacted her right hand was perversely good fortune for golf. A right-handed golfer grips the club most tightly with the left hand, wrapping the right hand over the top. Linda pulled out her driver. The wet ground was a mixed blessing; the ball would stick easier on the putting green, but it wouldn’t roll as far on a drive, making the green tougher to reach in the first place.

Linda Segre, back on the tee. (Courtesy of Linda Segre)

Linda had been playing more since she’d retired in March of 2016. It had been a long journey to get to that place.

She and her husband had gotten a divorce many years earlier, her marriage suffering from all sorts of bumps and bruises, including her illness, the pace of their lives, the suicide of her ex-husband’s mother.

In 2009, Linda took the position of executive vice president and chief strategist at Diamond Foods. She thought it would be less stressful than consulting. She was wrong. In 2011, for instance, when Diamond Foods announced plans to acquire the potato chip brand Pringles, she and the executive team, in an effort to vet the deal, traveled the world in nine days, stopping at Pringles plants and making related stops in Tennessee, Brussels, Geneva, Singapore, and Malaysia.

She didn’t think much about whether the lifestyle would throw her back into disarray. “I was feeling good again. I thought: I’ve got this under control.”

She was, in a way, playing with fire. But Linda wanted to make her own way in the world. She’d worked hard in her life and had financial ambitions. She wanted to “hit her number” so that she could retire with comfort and without fear. Like many women who become single—and despite having a boyfriend—she wanted to make enough money so that she would be totally financially secure.

Her staying power seemed to be the very embodiment of the dream of scientists and drugmakers who had come up with targeted drugs like Enbrel to slow the immune system. “She is a remarkable case,” said her rheumatologist, Dr. Lambert.

Dr. Lambert made that comment during the very week Linda teed off at the Olympic Club, when they had met for her annual checkup. It was their nineteenth such annual review. The fact that Linda came in only once a year to see Dr. Lambert was itself extraordinary. Many people with rheumatoid arthritis see their doctors more often to deal with regular pain and debilitating symptoms.

At the visit, Linda got her lab results back. They were interesting only in how unremarkable they were. Nothing strange stood out. Doctor and patient went over the three drugs that Linda now takes: Enbrel, plus a second anti-inflammatory, and finally, a drug to keep the other two from upsetting her stomach. Linda asked for a refill of her Ambien to help her sleep when she travels. The sum is a quarter of the drugs that Linda took at the height of her symptoms.

Dr. Lambert marveled at her patient. “This is the vision I had for Linda,” she said. Dr. Lambert recalled when Linda had first come in, thirty-six years old, in a wheelchair, because she couldn’t walk. “She needed a miracle.”

Dr. Lambert explained that Linda was one of the first five of her patients who got Enbrel. “She’s the only one that’s left.” All four others have had to come off the drug because its effectiveness had ceased. This was news to Linda, who hadn’t heard before about the drug’s potential waning effectiveness.

Dr. Lambert explained that there are two theories about why the wonder drug can stop working. Either the immune system finds a way around the drug, or it develops antibodies that attack the drug.

The immune system, like an invisible pathogen, evolves too.

During the doctor’s visit, Linda ticked off the complaints she has now, and they are modest. The twisted fingers from the osteoarthritis. A touch of wrist pain from the rheumatoid arthritis. Sometimes, she said, her big toes have painful episodes. These were the toes that started it all.

“I’ll be walking fine, and all of a sudden the joint will lock up and the pain will be excruciating.”

“How long does it last?” Dr. Lambert asked.

“Ten minutes, and then it just suddenly goes away.”

“Not hours?”

“No.”

Dr. Lambert didn’t think this was a problem in the grand scheme of things.

Linda asked if she was doing so well she might even be able to go off the Enbrel.

“We don’t know whether you’re in complete remission or not,” said Dr. Lambert. She noted that the American College of Rheumatology recommends staying on treatment.

The mere question showed how far Linda had come.

“Her biggest problem,” Dr. Lambert jokes, “is that she complains about her handicap.”

Linda laced her opening drive that January morning. The wet ground kept it to 210 yards, plenty respectable, and straight. She pulled out a hybrid four-iron for her next shot to stop short of the sand traps that protect the green. But she didn’t hit the club squarely and still needed a seven-iron to get to the green.

Twenty-two years ago, Linda couldn’t have dreamed of hitting a golf club, let alone even walking to her ball or into the doctor’s office, her body was so gripped by the suicide mission of her immune system. Now she walked calmly to the ball, as she’d done on her approach in 1982 in Ulster.

Gracefully, she swung back and through the ball. The Callaway Chrome Soft ball sprang into the air, destined for the green. It fell two feet from the cup and stuck. She nailed the putt.

“A birdie,” she said. “Not a bad way to start.”