Upon her promotion to supervisor, Marcus spent approximately twenty percent of her time performing ECT duties. When the center later became underfunded and understaffed, Marcus assumed more ECT duties in addition to her supervisor work. In mid-1987, Marcus began to experience the onset of severe abdominal cramping, diarrhea, and constipation, and sought medical care from her family physician, Dr. Kaye. In the fall of 1987, Marcus took two weeks vacation; her symptoms abated after three days absence from her job. However, when Marcus returned to work following her vacation, she began experiencing the symptoms again. Typically, her symptoms would "lessen" on days she did not work, but would return on days when she worked. As the workload at the center increased, Marcus symptoms also worsened and included chest pains and headaches.
