“There are days when I can hardly make it out of bed. I find it an effort to speak. I measure progress in steps, the next one and the next one, as far as the bathroom. These steps are major accomplishments. I focus on taking the cap off the toothpaste, getting the brush up to my mouth. I have difficulty lifting my arm to do even that. I feel I am without worth, that nothing I can do is of any value, least of all to myself.”