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After receiving no useful care at an emergency room, she went to see our local GP who referred her to the local teaching hospital. There, based on nothing more than a conversation and superficial examination, the UK equivalent of a new resident correctly diagnosed the disease. Since then, she has been hospitalized for many weeks, given two very expensive courses of IVIG treatment, and had her thymus removed in major, open chest surgery. Thankfully she is now much better and about to head off for a Ph.D. program in England.
Recently, we flew back to New York to consult with perhaps the world expert on Myasthenia. After reviewing her symptoms and treatment he declared that the doctors in Scotland were doing all the right things. He then asked how much this cost. He had a bit of a hard time understanding that the cost was exactly zero. By the way, I spent about two months paying various bills associated with that one visit to his office. Quite a contrast I'd say.