The Hypochondriac's Guide to Life. and Death. (4 page)

These books are characterized by the use of humongously scientific Latin-influenced terms such as “sternutation”
1
and “epistaxis”
2
and “cutis anserina”
3
and “pyrexia”
4
and “diaphoresis”
5
and “singultus,”
6
which are too important and complicated to be understood by unschooled morons such as yourself.

Many of these medical books also contain pages of photographs, such as this one, reprinted from
French's Differential Diagnosis
(1979):

So these books can be highly entertaining, though they cost much more than my book and make you vomit.

The third type consists of books arranged on endless shelves labeled “alternative medicine” These usually begin with solemn advice against succumbing to quackery, followed by a simple nine-step formula for curing lymphomas via the teachings of Mohammed Ibn Rajneesh and the use of beet suppositories.

Alternative medicine books take elaborate measures to appear serious and scientific. I am right now leafing through
Alternatives in Cancer Therapy,
by Ross Pelton and Lee Overholser, featuring an endorsement on the cover by Linus Pauling, the two-time Nobel laureate.
Alternatives in Cancer Therapy
soberly evaluates treatments that include eating mistletoe, taking enemas made from strong coffee, and drinking urine.

My book is like none of those.
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Unlike the family medical guides, this book will dispense no practical medical advice whatsoever. Unlike the alternative medical books, it will advance no mountebank cures. Unlike the medical texts, it will not be condescending to the reader.
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It will mention thrombotic thrombocytopenic purpura only for the purpose of observing that, among all diseases the author has encountered in the course of his extensive medical research requiring many, many footnotes,
9
it has the second-funniest name.
10

Last, let me say that although this book will raise some legitimate concerns about health, it will not use scare tactics to inflame the public's fears in the manner that, say, untreated
appendicitis can inflame the appendix until it bursts, choking the bloodstream with deadly toxins and snuffing out your life in fifteen minutes of writhing agony. We are living in an era of fabulous preventive medicine. After all, it is not every day that some guy goes to the doctor because he is peeing a lot and learns he has a prostate the size of a bagpipe, though I personally know of two people this happened to.

They did not buy this book either, and now they are dead.

1
Sneezing.

2
Nosebleed.

3
Goose bumps.

4
Fever.

5
Sweating.

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Hiccups.

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It is also unlike
Hystories,
a popular 1997 book by Elaine Showalter suggesting that many trendy diseases of the modern era-such as chronic fatigue syndrome—are not real, but hysterical reactions to the tensions of modern life. This book led to strong opposition by CFS sufferers, who claimed it belittled them and their affliction. Their opposition dramatically increased sales of
Hystories,
an obscure scholarly treatise, because chronic fatigue syndrome sufferers kept showing up to picket Ms. Showalter's public appearances. I wonder if they wore bunny rabbit slippers and Dr. Denton's pajamas, with the little tushy flap in the back. I hereby express my solidarity with CFS sufferers and other whining nutcakes, including victims of “seasonal affective disorder.” I will fight to the death for their right to picket my book.

8
“Condescending” is a great big word that means “talking down to.”

9
Some of my footnotes even have footnotes.
11

10
The funniest name: “beer potomania.” See
Chapter 12
, “Are You an Alcoholic?”

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Like this one.

Relax, Hypochondria Never Killed Anyone. Oh, Wait. Yes, It Did.

People have always
been worried about their health, and some people have always been more worried than others. The ancient Greeks coined the term
hypochondrion
to indicate the part of the torso beneath the rib cage, which is where most early hypochondriacs imagined their pains. Typically, the sufferer never got better, attributing his condition to what the ancient Greek doctors considered fanciful, even laughable causes.

Think about that. These were primitive times. If you had a
real
case of, say, influenza, the finest medical minds in the world would consult on your case and decide you had an evil salamander dwelling in your spleen. What could the hypochondriac possibly have imagined that seemed bizarre to these people?

First Greek Doctor: I'm at my wits' end with Eucalyptus. He blames his sore throat on-get this-teensy invisible creatures that entered his body through the nose when someone
else
sneezed!

Second Greek Doctor: Har har har. What a bozo. But he does seem to be ill. Just to be safe, I would follow established medical procedure.

First Greek Doctor: Agreed. We shall flay him with the tailbone of an ass.

Thousands of years later, hypochondria still poses a diagnostic dilemma for the medical practitioner. On the one hand, taking seriously the brooding of an obvious hypochondriac compromises the noblest tenets of medicine and, by giving credence to his complaints, may even aggravate the poor wretch's condition. On the other hand, the poor wretch is a potential source of tens of thousands of dollars in fees over many, many years.

Faced with this dilemma, most doctors have adopted the following checklist for evaluating a suspected hypochondriac and deciding whether to treat him:

1. Does this person have medical insurance?
   

The fact is, attention from a doctor may make a hypochondriac feel better, but it won't cure him. Over the years, well-intentioned physicians have tried everything, to no avail.

In his 1961 book,
Minds That Came Back,
Dr. W. C. Alvarez reports on the case of a man who was convinced he had a frog in his stomach: “We gave him an emetic, and while he was vomiting, we slipped a frog into the basin. The man was thrilled; he felt so justified, and he was grateful. The only trouble was that he returned the next day to tell us we had been a bit too late—a dozen baby frogs had hatched out and were hopping about in his stomach.”

Many famous people were hypochondriacs: Molière, Voltaire, Jonathan Swift, Rudyard Kipling, Ludwig van Beethoven, Immanuel Kant, Robert Burns, Jesus Christ.
1
Enrico Caruso used a dentist's mirror to examine his vocal cords every day, convinced against all medical evidence that he was subject to alarming growths and swellings. John Adams, our second president, predicted his own death at thirty-five, and then again at forty, because he felt himself afflicted by ill humors. He somehow survived his fifties convinced he could not possibly make it into
his sixties, so infirm was he. He lived through his seventies with the chill of death's gnarled hand upon his rheumy shoulder. He spent his eighties with one foot in the grave and the other in a pot of Epsom salts. At last, his fears proved sound. Adams died midway through his ninety-first year and remains the oldest ex-president ever.

During a journey in which he shared a coach compartment with a woman with swollen legs, the poet Percy Bysshe Shelley
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imagined he had caught elephantiasis. For months afterward, he would examine himself for signs of the illness, which causes grotesque enlargement of the legs and, in men, the scrotum. He policed his acquaintances scrupulously to make certain no one could possibly transmit the illness to him. Shelley's biographer Thomas Hogg reports this singular event:

When many young ladies were standing up for a country dance, he caused wonderful consternation among these charming creatures by walking slowly along the row of girls and curiously surveying them, placing his eyes close to their necks and bosoms, and feeling their breasts and bare arms, in order to ascertain whether any of the fair ones had taken the horrible disease. He proceeded with so much gravity and seriousness, and his looks were so woebegone, that they did not resist, or resent, the extraordinary liberties.

James Boswell, the eighteenth-century Scottish essayist and biographer, would lie in bed at night unable to sleep, convinced his testicles were swelling. Once, he ordered a doctor to bleed him to relieve him of the poisons he felt were making him ill and causing him nightmares. He confessed he enjoyed watching public hangings because it distracted him from the fear of contracting venereal disease.

Hypochondria afflicts the famous and the obscure alike, though most of our best anecdotal evidence concerns celebrities.
That is because there is no shortage of jealous, petty ingrates hanging around famous people, willing to betray their privacy for a couple of bucks or a cheap laugh. There are name-droppers everywhere.

This reminds me of the day I personally drove Dick Cavett and his producer to an event in the South Bronx. It was 1972. I was twenty-one. Dick sat in the backseat of my car. His producer sat next to me. Doggedly, I tried to engage the famed talk-show host in conversation. I asked him something suitably sophisticated, such as, “So, Mr. Cavett, what do you think about the state of stand-up comedy in America?” and he answered, “Mrphrprm.” This surprised me because Dick Cavett's diction is ordinarily quite elegant, as anyone knows who has ever heard those old ads for Hormel meat products, in which he makes processed hog snouts sound like
boeuf bourguignon.

I tried again with a less boring question. Something about underpants.

“Mrphrc,” he said.

Finally, I looked in the rearview mirror. Dick Cavett, the master TV interviewer, was talking with a handkerchief clapped over his nose and mouth. He looked like an actor endlessly rehearsing his great vomit scene.

“Dick is a little concerned about catching cold,” the producer informed me with the determinedly cheerful expression of a mom assuring a neighbor that little Jason's consumption of sidewalk pigeon shit is perfectly normal.

In terms of risk taking, however, Dick Cavett is a bomb-squad demolition expert compared with Marcel Proust.
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The nihilistic French novelist was so afraid of catching cold that he became a lifelong recluse, spending all his time in a bedroom with walls lined in cork to muffle the insalubrious sounds of civilization. When called upon to serve as best man at his brother's wedding, Proust forced himself to go, but only after fortifying himself with three overcoats and several mufflers, and padding his chest and
collar with layers of cotton. He was so immobilized that he could not sit down and had to stand in the aisle during the service.

The Greatest Hypochondriac of All Time, however, was the American poet Sara Teasdale.