Discussion at this meeting is freeform, touching on far-ranging topics. Frances, who has lupus and Sjögren's syndrome, moderates and keeps the discussion flowing.

She's been having a tough week. "They upped my steroid, and I've had the kind of fatigue where you feel drunk, you're so tired," she says. Then she laughs, "But today they're having the opposite effect. I'm really wired: I'll be cleaning the dust bunnies from behind the refrigerator tonight."

There's sympathetic laughter around the table; just about everyone here has been on the steroid roller coaster at one time or another. Several people joke about the housekeeping benefits of steroid jitters. Someone asks Frances why her medication was increased and she says, "I'm having a flare. Fortunately, I've finally trained my doctor to quit saying, 'Oh my God!' when he looks at my tests!"

The talk turns to dealing with health professionals, then to dealing with people in general. Kathy speaks of her frustration at being treated as if she's lazy because she had to leave her job as a computer programmer. "It makes you feel like such a failure," she says.

Jeanie left her job, too. "I'm tired of hearing, 'Don't give up!'" she says. "I haven't given up. It came down to a choice between my job and my family. I just couldn’t' do both anymore, so I chose my family. That decision is hard enough as it is without people implying that if you just tried harder you could do it all."

Lisa chimes in. "Most people just don't realize how serious it can be," she says. "It's hard to explain the disease to someone who says, 'Well, my grandmother has that.' You're always on the defensive."

Finally Ruth speaks, timidly. It's her first meeting, and she's obviously nervous about being here. But something about the group has strengthened her already, has bolstered her courage enough to allow her to speak out. "I went a long time knowing something was wrong before I was diagnosed with lupus. My family still doesn't understand what's going on with me…," she trails off; The others sense there's much more that she's not saying.

Lisa says, "Don't you just want to say to them, 'I wish you could understand how I feel right now?"

The dam bursts, and the words rush out. "They don't even believe I have it, they think it's all in my head. They keep saying, 'There's nothing wrong with you.' They think I'm just trying to get attention. Sometimes it has even made me doubt myself."

The relief she gets from having sympathetic listeners encourages her to go on. "My health has gotten a lot worse lately. The other day, I just needed to talk to someone, so I called my mother and …," her voice falters and the story is never finished because long pent-up tears come instead. But these tears seem born more of relief than of frustration. When you've gone for years thinking that no one could ever really understand, it's a shock and a surprise to find a room full of people who truly do. These people are virtual strangers, yet instinctively they understand Ruth's deepest sadness better than her own family ever can. They are survivors of battles that, for all their differences, share remarkable similarities.