Elvis on the jukebox, meatloaf on the menu, the early dinner crowd heading in. It seemed like a regular afternoon at the Silver Diner in Clarendon on Monday, except for the small group gathered around a table in the back.

There were six restaurant workers, who on the one hand wanted to be with their friends at the immigrant rights rally on the Mall, but on the other wanted something else just as strongly: to learn English. There was their U.S.-born boss, who had set up the language class. And there was the instructor, a 35-year-old with a plastic tube snaking from her nostrils to a 3 1/2 -foot oxygen tank standing at her side.

"Today we are going to talk about the verb 'to be,' " Patrise Holden told the students, in this, the first of 12 scheduled on-site sessions. She switched into fluent Spanish. Whenever she drew oxygen through her nose, an aspirating clicking sound was emitted by the tank. As the class continued, workers stopped staring at the tank and moved on to their work sheets.

" 'Estoy cansado' is 'I am tired,' " said one, Milton Reyes, a 22-year-old Guatemalan cook.

"You got it!" Holden said.

Just being there was a remarkable achievement for Holden, a Prince George's County woman whose story is being witnessed firsthand around Washington as more clients sign up for her language-training house calls. Holden, who teaches English and Spanish, suffers from the most potent form of sickle cell disease, and she might not make it to her 40th birthday.

"While she doesn't make a big deal about her medical condition, it is nevertheless inspiring," said Ben McKay, an insurance industry lobbyist who hired Holden for two-hour midday Spanish lessons at his office.

Holden was born in Baltimore, where, she said, a doctor tried to be realistic with her parents, telling them: "Don't get too attached to her."

Unlike normal, rounded red blood cells, Holden's cells were shaped like sickles, making it hard for them to transport oxygen. And as they moved through her body, they would get clogged and tangled in capillaries, causing excruciating pain that lasted as long as four days. In the first 18 years of her life, she spent the equivalent of 13 years in the hospital.

Holden did slightly better in her twenties, but the disease continued to wreak havoc. In 1998, doctors diagnosed duel-lung failure. She stayed in an intensive care unit for six months and began living with an oxygen tank. Four years later, Holden's youngest sister, Pamela, who was born with the same kind of sickle cell disease, died in her arms.

By that time, Holden was living in Fort Washington, having mastered Spanish and picked up an associates degree in international business. She launched her own firm, The Language Key, offering language, translation and accent-modification services. At one point, to attract clients, she said, she stood atop the L'Enfant Plaza Metro stop, handing out fliers -- oxygen tank by her side.

She runs much of her business over her cellphone, driving a small Honda SUV to clients. She battles fatigue, trying to avoid long walks to buildings. Outside of work, the tank of course goes everywhere -- even on the occasional dance floor, where she joked that the seven-foot tube gives her a 14-foot dancing circle.

She tries to stay positive but said she is given to sad days if, for instance, she thinks a lot about her sister. To shake through it, she sometimes drives to a local hospital, wheels her tank to a nurses station, asks if there's a sick child who gets few visitors and then goes to sits with him or her.

Brandon Wright, the operating partner of the Silver Diner, didn't know any this. He employees a kitchen staff of primarily Guatemalans and Bolivians. Their lack of English is not a big problem when they prepare food, but it gets in the way when they have to be on the phone to order ingredients and supplies. As a result, Wright said, Silver Diner wants workers to know English before getting the top spots in the kitchen.

Wright said the class is open to all employees, and he plans to front the full price of the classes and ask his workers to reimburse him for about one-quarter of the cost.

At 3:38 p.m. Monday, Holden pulled into a handicap spot. Sitting in her front seat, she pulled the oxygen tube from her nose and flung it back toward the rear of her SUV. She can go several minutes without oxygen, breathing regular air.

She got out and walked to the rear hatch, lifted it and hooked the tube back into her nose. She changed into a new pair of shoes, hoisted the 30-pound tank out of the vehicle and wheeled it in. At the counter, she introduced herself. Two women didn't know why she'd come or what she could understand.

"Look, she's wearing oxygen," one said to the other in Spanish.

Holden remained silent. Fifteen minutes later, she was standing before the class, asking the workers, in Spanish, how much English they knew. "Put me down for a zero," one replied in Spanish.

To a worker, all six later said they wanted to learn English to better their livelihood. Betsy Velasco, 26, a salad prep worker, added that she wants to be able to help her 5-year-old son with his homework. He speaks English more than Spanish.

Holden stayed energetic to the end, slowly drawing out the students into smiles and laughter.

In an interview after class, Reyes, the Guatemalan cook, said becoming proficient in English would double his earning power. He said he didn't mind coming in before his shift for the class, even though he had friends at the Mall demonstrating what he too believes in. "I have a responsibility to work here," he said.

Holden doesn't like to talk about her mortality but when pressed said that given her disease and her lungs, the prognosis isn't good. "In a way," she said of language training, "it's a legacy that will live on."

To see a video featuring Patrise Holden and her students, visit http://www.washingtonpost.com/metro.