ALS is a degenerative motor neuron, mostly idiopathic disease. The acronym (ALS) stands for Amyotrophic Lateral Sclerosis. There are a few potential causes of ALS. The first is mitochondrial dysfunction, which is when the mitochondria do not produce sufficient energy, resulting in muscle weakness. Second is inflammation. Next is apoptosis, which translates to cell death. Two other possible causes of the disease are protein aggregation and free radicals. Diagnosing ALS is based on history and examination of patient and family members. In a patient with early onset ALS, one would see progressive upper and lower muscle weakness of motor neurons. Most commonly this is seen in hands, arms, feet and legs. Some people may experience twitching, cramping. Eventually, the patient will have impaired use of arms and legs. In the later stages, one has shortness of breath, difficulty swallowing and thick speech. For example, In Tuesdays with Morrie, the main character Morrie suffering from ALS began falling, tripping, and had to begin using assistive devices such as a cane, then a walker, and eventually was wheelchair bound. Morrie eventually needed a respirator at night by nasal cannula. Very close to the time he passed, Morrie was unable to speak and swallow (“Symptoms”). A diagnosis for early signs and symptoms of ALS in Morrie’s case would be; walking impairment related to insufficient muscle strength as evidence by tripping, falling, and use of assistive devices (Ackley 2010 p. 894). This diagnosis applies because in almost every case, all patients suffer from motor weakness. This pertains to Morrie as seen on page 8 of Tuesdays with Morrie when Mitch narrates, “he keeps tripping, so he purchased a cane. That was the end of his walking free” (Albom 1997 p. 8). Also, on page 6, Mitch mentions that Morrie has trouble walking, he often would stumble, and even feel down a flight of stairs. This diagnosis for early onset ALS is extremely common in those suffering from this disease. A later stage diagnosis for Morrie would be impaired swallowing related to muscular degeneration as evidence by aspiration and coughing, (Ackley 2010 p. 828). An example of this from the text that Mitch narrates is on page 101 when Charlotte, Morrie’s wife, explains, “Morrie can’t eat most of this food. It’s too hard for him to swallow. He has to eat soft things and liquid drinks now.” Mitch had brought some of Morrie’s favorite solid foods to the house, and realized how impaired Morrie had become. Aspiration is typically one of the last symptoms to appear as seen with Morrie (Albom 1997 p. 6). One agency that supports this disease today is the ALS Association. This association takes donations and has a website and any information that one would need when inquiring about the disease. They have helped to raise millions of dollars towards research to hopefully one day find a cure or a way to slow down the disease process. Genetic testing is available to any person who shows signs and symptoms. If disease is present in close family history one will get tested. Ninety percent of adult onset ALS with no family history of the disease will not get tested because in their case, it is idiopathic. Ten percent of those with ALS have had a family member with ALS. And in that ten percent, half have normal genes and half will have the mutated gene (“Genetic testing for ALS). One significant event from Tuesdays with Morrie that impacted us was in the chapter called, “Orientation” where Mitch pulls up to Morrie’s house and sees Morrie for the first time in sixteen years in his wheelchair outside on the porch with two of his caretakers. Mitch was on the phone with a producer from work, and froze when he saw Morrie. He mentally felt unprepared for the reunion. It almost seemed like Mitch was embarrassed because he knew his life was run by work and money. And there sitting on the porch was, “this new, withered version of a man I had once known so well.” When Morrie saw Mitch, he smiled and said, “My old friend, he whispered, you have come back at last” (Albom 1997 p. 28). This was so heartfelt and showed Morrie’s ability to love unconditionally, something that can be so hard in everyday life with work and commitments. The reader can see that Mitch realizes that there is more to life than work, love and family is more important, and Morrie really shows Mitch this. Another significant event in the book was when the fourteenth Tuesday when Mitch said goodbye to Morrie. Morrie teaches Mitch on one of their Tuesday lessons that, “”Everyone knows they are going to die,’ he said again, ‘but not everybody believes it. If we did, we would do things differently’ (Albom 1997 p. 81). This is significant to us because everybody knows that they will die eventually, but they may not necessarily accept and understand. It is hard for one to accept this, but as Morrie says, “Once you learn how to die, you learn how to live” (Albom 1997 p. 82). We are most reminded of ourselves through the character Mitch. Like Mitch, we get caught up in work and school, and may not fully grasp the importance of maintaining and appreciating relationships. Because in the end, relationships and love, like Morrie says, is what life is all about.