methotrexate and Enbrel,” says Dr. Moorthy. After starting the injections, Angela began to feel considerably better. She wanted to conquer what was ailing her. “I wanted to treat it aggressively,” Angela says. Dr. Moorthy and her team were constantly monitoring Angela’s condition using blood tests. Over the first four months, her inflammatory markers normalized. She also improved clinically and experienced less swelling, pain, and stiffness. Angela’s progress continues to be favorable. Both Angela and her parents realize this is an ongoing process. Angela is now leading a relatively normal life. Though she has dropped out of swimming, she’s back to doing other things she loves, including singing and playing piano. urrently, Angela goes for regular checkups with Dr. Moorthy. Medications are tapered as her condition dictates. “I hope she can pursue whatever she wants,” says Dr. Moorthy. “She is doing very well. But if she gets very tired or C What the Future Holds has pain, then she will need to limit, but for now, she can try different activities.” Angela realizes she’s going to have to take etanercept for the long term. She will attend the University of Maryland in the fall, and she has met with Dr. Moorthy to discuss her options as she begins life as a college student. Angela is realistic. “I realize arthritis will be with me for the rest of my life,” she says. Dr. Moorthy believes both Angela’s and her parents’ positive attitudes have helped Angela overcome some of the difficulties JIA typically presents. “They are very committed to understanding the disease and understanding medications,” says Dr. Moorthy. “They always ask wonderful questions and communicate very honestly, and I feel honored to have met all of them.” Thanks to Angela’s and her family’s dedication to learning about the disease, their fierce determination to fight it, their adherence to medications and treatments—and Dr. Moorthy’s guidance—Angela Pandit will have a chance to make a life for herself, even as she lives with JIA. M Robert Wood Johnson I MEDICINE 19