I’m too big a skeptic to put much faith in the circularity of life, with deeds done long ago coming round years later to haunt us or make us whole. But I began to think about the possibility recently, during a visit to Columbia University’s College of Physicians and Surgeons. One of the lectures that day was about the art of listening to patients’ stories with an almost literary ear, as a way of treating them with greater insight and sensitivity.
The speaker was looking at things only from the doctor’s perspective. But it struck me that there are at least two sides to every medical story. And it got me thinking back 30 years, to when I was a young man dying of no apparent cause.
My symptoms then included listlessness, faint-headedness, an inability to climb stairs without resting and unquenchable thirst. Twice, I took home a jug for a 24-hour urine test, and both times I came back with an extra bottle on the side. It didn’t seem to signify much to my doctor. The heart was his specialty, and he kept doing electrocardiograms suggesting something wrong there, but no particular diagnosis. I wasn’t much interested, in any case. I was only 26 years old, but the idea of dying seemed perfectly fine.
Then one afternoon on my parents’ front porch, I stood up in front of my father and briefly passed out. My parents arranged for me to see an endocrinologist named Robert Modlinger, who got hold of my ample test records, phoned me, and started to talk in a strangely unmodulated voice. His wife April was also on the line, repeating my answers to his questions so he could read her lips. I learned later that he’d gone deaf a decade earlier, in his mid-twenties, when he was a student in medical school. Finally, he said, “I want you to come into my office. I think you have Addison’s Disease.” It sounded more like, “I THINK you have AHHHH-dison’s Disease.”
The idea of a deaf man diagnosing my problem by phone, when a seeing, hearing physician had repeatedly failed to do so in person, has stuck in my head ever since as the Miracle of St. Modlinger.
I went to see him on a beautiful Saturday afternoon in May when my blood pressure was 60 over 40. He spent three hours doing tests, asking questions, listening (that is, lip reading) and having the good sense to question more closely when my answers didn’t fit the evidence he was seeing. He confirmed that it was Addison’s Disease, a failure of the adrenal cortex that is fatal if untreated, and put me on the course of drugs I have taken ever since.
Within a day, I felt better, it seemed, than I had ever felt in my life. Within a few months, I was running five miles a day. I began to travel and to write articles, and later books, about the natural world, human behavior and other topics. In the years since, I have collected tarantulas in the Amazon, tracked leopards with !Kung San hunters in Namibia and trekked in the Himalayas of Bhutan in pursuit of tigers and a mythical beast called the migur. I remained Dr. Modlinger’s patient for years after the diagnosis, and he seemed to take vicarious delight in these far-flung adventures.
Eventually, though, I relocated, and we lost contact. My career in journalism gave me a garden for cultivating my native cynicism, and the business of making a living as a writer brought out an inclination to be blunt and not much good at social niceties. So when my oldest child announced a few years ago that he wanted to spend his life helping people, I said, “That’s a strange idea.” When he added, in college, that he had decided to become a doctor, I expressed horror.
“Think of the snot-nosed children,” I said. “Think of being stuck in an office seeing the digestive complaints, the migraine headaches, the depression, the vague symptoms of possibly imaginary origin.” I did not say, “Think about me on that Saturday afternoon in Dr. Modlinger’s office.”
In the face of this paternal discouragement, my son persisted, and it has been interesting to watch. He volunteered at a hospice and genuinely seemed to enjoy caring for people who were old, incontinent, terminal. I’d been telling him it was naïve, in modern medicine, to expect to get to know patients as much more than symptoms. Everything had become too impersonal. But then, by an odd coincidence, his childhood piano teacher showed up at the hospice and together they helped make her husband comfortable as he died.
I probably should have known that the stories of patients and the people who care for them can still circle together in strange ways. A few years ago, I looked up Dr. Modlinger to ask a question, and with April on the phone as always, he told me that on top of being deaf, he’d lost the vision in one eye and developed problems with his balance, forcing him to give up his practice while he was still in his 50s.
I expressed my sorrow. It seemed like a terrible loss, not least to his patients. And it seemed wrong that the doctor who had given me back my life should be losing the pieces of his. I thought gloomily of a book I used to read to my kids, Edward Gorey’s “The Dwindling Party,” in which the guests mysteriously vanish one by one.
When I phoned Dr. Modlinger again more recently, he was in a wheelchair. But he was also full of a characteristic quality of delight, bordering on ebullience. I reminded him of my miracle cure, and I could hear him beaming. “I must have been very good,” he said.
And he was. I thanked him for everything — that is, for keeping me alive long enough to marry, to travel, to write, to raise three fine children. In August, I told him, my son will become a medical student at Columbia.
“That’s wonderful,” he said. And the inexplicable note of happiness in his voice made me think that spending Saturday afternoons healing sick people might not be such a bad life, after all.
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End Note: This is the last column in my stint as a guest writer for TimesSelect, and in the spirit of giving thanks, I would like to say what a pleasure it has been to read your comments, which have been remarkably thoughtful and well-informed.
Thanks especially to the reader who pointed out that the Germans, bless them, do indeed have a word, gluckschmerz, or luck-pain, for what I called the “un-schadenfreude.” Thanks also to the reader who noted that my Rule of the Decent Interval dates back at least to Dante, who consigned deathbed confessors to the first circle of Purgatory (“During life they made God wait for them; so, after death, they must wait for God.”) I even enjoyed the comments catching me on factual errors, and the nice turn-of-phrase from a reader who accused me of writing from my “own towering mountain of naive assumptions.”
For writers of books and magazine articles, the relationship with the page often feels one-sided. It’s like wandering alone in a forest from which all the animals have disappeared. The thrilling thing about this blog or online column or whatever you want to call it is the chance to hear readers roar back, almost instantly, from the other side of the computer screen.
So, yikes! And thank you.
