Ashley Zink's eyes expressed everything the rest of her body could not. Pain. Fear. Exhaustion. Disappointment.
As the Roland Park senior lay in a hospital bed in January almost completely paralyzed by Guillain-Barre syndrome and breathing with the help of a respirator, her hazel eyes became the only quick link to her emotions.
"When you're incapacitated like that, the eyes tell so much more than you're used to seeing," said her mother, Jane Harlan. "We got to the point where we could look into her eyes, not always but most of the time, and almost feel what she was thinking."
Zink's eyes usually reflected the constant throbbing pain in her neck and back. GBS, which attacks the immune system, targets those areas.
All through her ordeal, however, Zink focused on one goal. She wanted to play lacrosse again for Roland Park.
"The whole time in the hospital, I was thinking all I want is to be able to run, all I want is be able to play lacrosse," said Zink, a three-sport athlete with a lacrosse scholarship to Vanderbilt.
For Zink, 18, GBS began with flu-like aches and then tingling in her feet. Doctors aren't sure how she got it.
"It's an inflammation of the insulating cells around the nerves outside the spinal cord. The immune system is tricked by the infection to think some of the cells are foreign invaders," said Dr. Lawrence Charnas, a neurologist who treated Zink at Greater Baltimore Medical Center.
On Dec. 26, three days after the first symptoms appeared, she could barely walk and was admitted to GBMC.
Given a diagnosis that day, she reached nearly complete paralysis in 10 days. Within the first week, she needed a respirator to breathe. She could not talk with the oxygen tube in her mouth.
"It was unbelievable, very scary," said Zink, who had been told to expect the pain and the paralysis although not all GBS patients end up on a respirator. "I just kept thinking, `Oh, I'll be better in a week. I'll be better in two weeks.' You can't imagine it until it happens."
Treatment included antibodies as well as plasmapheresis, which Charnas described as a kind of blood washing. Neither cures GBS, but each can lessen the severity and accelerate recovery.
Although the mortality rate for GBS is less than 5 percent, Zink couldn't help but fear, if only a few times, that she might not recover.
"I knew the doctors weren't going to tell me, `Oh yes, you're going to die.' I thought, `What if they're just not telling me?' "
Her parents knew when she was scared, but she relayed her fear of death directly to them only once -- through her fingertips, her only means of communication other than her eyes.
For the 16 days she remained on the respirator, her fingertips became her voice. With her fingers placed on another person's palm and that person reciting the alphabet, Zink pressed down at the correct letter eventually spelling out words and sentences.
One day in mid-January, Zink spelled out, `W-I-L-L I' on her mother's hand. She passed by the D her parents were expecting and waited for P. She spelled "Will I pull through?"
"That was her lowest point," said her father, Tom Zink.
His daughter couldn't even escape through a few hours of sleep. The pain, her inability to move and the nearly constant attention from doctors and nurses kept her awake. Tom Zink estimated that she did not sleep at all for three or four days straight and slept only an hour or two the other nights in GBMC's intensive care unit.
Disappointed and tearful when doctors told her that she would not recover in time for her senior season with the Reds, Zink decided to prove them wrong.
"She's just so strong," said teammate Elizabeth Ryan, one of Zink's closest friends. "Even if a couple of times she may have doubted and wondered why this was happening to her, she's so tough inside it wasn't going to beat her. Like she always said, she was going to come back for lacrosse season no matter what the doctor said."
Playing lacrosse seemed a long way off as she started to recover. When the paralysis finally retreated, she couldn't even stand up. Zink, who also played field hockey and squash, already had the lean frame of a multi-sport athlete. At 5 feet 4, she had lost nearly 20 pounds, mostly muscle mass.
Zink had to learn to walk and to use the most basic motor skills. She couldn't even pick up a quarter off a table. However, she could hold a lacrosse stick. Cradling the ball became one of her first forms of physical therapy.
Her motor skills returned slowly at first, then much more quickly.
"Ashley had a very rapid recovery," said Charnas, the associate director of clinical affairs at the Harvey Institute of Human Genetics at GBMC. He attributed her ability to bounce back so quickly to a combination of things including early diagnosis, early treatment, a little luck and Zink's own inner strength.
"Never underestimate the power of the human spirit," said Charnas. "She had this intense desire to play lacrosse and she had a lot of heart and that was a huge component of her recovery."