Buried underneath some large headlines about the Beijing Olympics, John Edwards' Affair, and Russians killing Georgians was the sad news that Bernie Mac died at the young age of 50.  And, of all things, from pneumonia. 

 How could someone so young be afflicted with and die of a disease that is so easily treatable with antibiotics?  It turns out Mac's wasn't a case of garden variety pneumonia-he actually had a rare and serious underlying problem that led to it.

 Mac suffered from a disorder called sarcoidosis--a disease which, like Bernie's untimely death, doesn't get a lot of headlines.  In doctorspeak, sarcoidosis is an "idiopathic granulomatous disease" in which a person can develop "non-casseating granulomas" in just about any organ system (particularly the pulmonary system).  

 Now, in English:  Sarcoidosis is a disease we don't know a lot about (idiopathic), but one in which different organs (particularly the lungs) begin to get infiltrated with inflammatory nodules (non-casseating granulomas).  It's a fairly rare disease, and in the US disproportionately affects African-Americans more than other groups. 

 It's also hard to diagnose, mainly because the symptoms are so general that we doctors are apt to think that they're something else.   For example, if a person were to come to see me becasue they had a cough, a little shortness of breath, and I heard them wheezing, I'm more likely to say they have asthma or bronchitis and treat them with an inhaler.  Most of the time, that'll do the trick, but if this person actually has sarcoidosis, it won't.  The second, third, or fourth time they come to see me, I'm liable to do a chest xray--but guess what?  It's often normal.  So then, after another visit or two, I'll refer him to a specialist or do a CT scan of his chest.  And I'll see this:

What you're looking at is a cross-section of a person's chest--think of a person lying down and you looking at them with x-ray goggles from the feet up:  Those black colored areas on both sides are the person's lungs extending North to South in this picture.  they're supposed to be all black if they're healthy.  but those whitish/gray areas are all divits in his lungs caused by sarcoidosis.  Inflammed nodules that are the real cause of his symptoms. 

 Sadly, we don't know much about the causes of sarcoidosis, which means we don't know a lot about how to treat it.  It's thought to be an autoimmune disease (an often throwaway etiology), which means the therapy of choice are steroids (the throwaway drug of choice for throwaway diseases that there aren't enough celebrities/politicians/athletes stricken with to throw money at). 

 In reality, sarcoidosis can affect just about any organ system--liver, heart, kidneys.  One can even get nodules on the skin (I'll spare you all pictures of that).  On a more positive note, the vast majority of times, it doesn't get bad enough to even require therapy.  Bernie Mac just wasn't one of those fortunate many. 

I'm assuming that Mr. Macs lungs just got too sick to breathe for him, and perhaps were weak enough that he sucummed to infection (immunosuppression is also a side effect of steroid therapy).  I don't know if all of this how he went, though. 

 R.I.P. Bernie--you were a funny, talented man and you deserved better than to be stuck on page 3.