Stizzer, knowing if and when to sell is so difficult. I'm sure we all hear you loud and clear, it's a dilemma for most of us, and, eventually, if the stock continues to surge, will become a dilemma for darn near everyone long on the stock!
My experience is when a stock like this stops rising, the fall can be pretty ugly, but, like you, I feel that something out of the anticipated range of events may be behind this move. The volume is quite high, but a bunch of traders, drawn like moths to flame, could be the cause of the last dollar or so of price rise. The press, save AF, has been very kind to MNKD lately, and that surely has helped.
You could always sell some covered calls against a small portion of your shares, kind of an in between way of playing it. You'll get some cash, but you'll give up some upside on a portion of your shares if some mega-price-moving news is around the corner. It would have to be pretty good news, as the price has already risen substantially.
Partnership? Buy-out? One thing about a buyout, the "knowing when to sell" thing is taken care of!
Good luck!