Dr. Richard Olney is racing to finish what is almost certain to be his last research paper.

The 63-year-old UCSF neurologist is considered one of the country's top clinical specialists for amyotrophic lateral sclerosis, or ALS, popularly known as Lou Gehrig's disease. ALS is also the reason Olney is in a hurry to finish his paper: He was diagnosed with ALS in 2004, and after a long period of relative stability, the disease appears to be rapidly winning out over the doctor.

Olney has almost no muscle function left.

"He's at the end stages now, certainly," said Dr. Catherine Lomen-Hoerth, once Olney's medical trainee, now his doctor. "I'm hopeful he may have at least a few months."

Olney hopes the disease he is studying will spare him at least long enough to finish his research on it. His son, Nicholas, 33, is assisting with the final write-up.

Their goal is to show how certain clinical readings of the muscles and nerves, recorded over a three-month span in the early stages of ALS, might help identify which patients will lose all muscle control quickly and which might have years before they succumb. That kind of information would be invaluable for patients and their families. It also could point researchers toward new genetic clues and treatment strategies for at least some of the many ALS subtypes.

Results are based on only 26 cases. The value of the findings will take time to determine. The study author will have to leave the follow-up to others.

Breathing problems sent Olney to the UCSF emergency room in March, followed by a few days in the intensive care unit. He has lost virtually all muscle control. He communicates by moving his pupils. Sweeping his gaze over a computer tablet, he selects letters and key words one by one, blinking to record each choice.

The computer reads out his sentences in his own voice, which he recorded for this purpose, back when he was still able to speak. As one of the country's top ALS specialists, Olney knew, right from the start, what he was in for.

He founded the ALS Treatment and Research Center at UCSF in 1993 and served as its director until he became a patient of his own center, now headed by Lomen-Hoerth.

Trial subject for drug

Lomen-Hoerth also wound up leading a placebo-controlled clinical test of two ALS drug candidates that Olney had designed and planned to run. He served as a trial subject instead. The drugs proved to be ineffective. One of the compounds in the study - which happened to be the one Olney was assigned to take - even showed toxic effects in the ALS patients.

That may have contributed to Olney's rapid deterioration during the early months of his disease, Lomen-Hoerth said, but she insisted such bitter outcomes are unavoidable if the research is ever to move forward.

Considering the notoriety of a disease nicknamed for one of the legends of baseball, treatment of ALS is still largely a guessing game. It arises in nearly all cases without any known genetic risk or link to pathogens. Researchers suspect ALS actually should be considered a catchall category of many different conditions.

Frustratingly elusive disease

Unfortunately, no one is certain how to tell one type from another - there was even some speculation, now quashed, that Lou Gehrig didn't have the disease that bears his name. While the medical fine points are being debated, for most people stricken with ALS-type symptoms, doctors can offer little beyond supportive care.

Olney's most enduring contribution to the ALS field may have less to do with the details of his final study than the commitment he has shown, relentlessly attacking a disease that soon will kill him.

It's a lesson of persistence and personal bravery that clearly has impressed his own doctors.

"I think about it every day," Lomen-Hoerth said. "How he continues to work, his will to work."

During an interview in the family living room at home in Corte Madera, Olney was characteristically matter-of-fact about his deteriorating condition.

"My quality of life is becoming compromised," he said. "Sometimes I feel tired."

He works on his medical paper with his head pitched to one side, a restraint strapped across his forehead to steady his gaze. Midway through the interview, he had to take a break, asking that the restraint be removed for a time.

The data on which his last study is based - results of neurophysiological tests, combined with clinical markers from patients recorded as their cases progressed - were collected over many years, starting long before Olney was stricken.

He has made it a point to keep his professional detachment, so nothing of his own case is included in the study. Nor would he discuss the findings in detail, lest he break journal embargoes before peer review.

Collaboration with son

His collaboration with Nicholas, who is about to complete his medical degree at UCSF, is one reason behind his drive to finish what he started.

"In part," Olney said, "I want to write a paper with my son."

The fact he still has the capacity to do medical research surprises almost everyone - including Olney, who said he had never seen the course of ALS in anyone "change so substantially as his own." His UCSF doctors gave him maybe two years to live when they observed his symptoms during the early months after diagnosis in 2004. But Olney said his longevity is no surprise now, in view of his own unpublished research findings.

He sent an e-mail - also achieved through eye movements alone - to clarify this "main point" he wanted to make.

"After about 2 years from onset of symptoms, I had findings to imply I would live for 8 or more years, he wrote.

He will be starting his eighth year this summer - if he survives that long.

Mental acuity isn't affected by ALS, a point underscored by Olney's work. Little else, however, is spared other than eye movement and sphincter control. Mechanical ventilators can extend life for years, but eventually ALS claims even the breath.

Olney has opted against invasive life-support measures. Other compromises couldn't be avoided. He spends some time each day on a portable ventilator and takes nourishment by tube to avoid trouble swallowing.

"I miss the taste of food," he said.

Strength from family

He and Nicholas spend a lot of time working, a slow-going process now that their paper is undergoing final writing and editing. To combat fatigue, they watch goofy movies. Olney insisted that he experiences no depression, saying he drew strength from his work and his spirituality, his son's new medical career, his daughter Amy's wedding and the expected imminent birth of his and wife Paula's first grandchild.

"I enjoy my children," he said.

That drew a good-natured rise out of Paula, sitting next to him. She frequently jumped in during the many long pauses of his interview.

"What about your wife?" she demanded.

Long pause for more eye movements.

"I enjoy my children and wife," he said.