The Hypochondriac's Guide to Life. and Death. (6 page)

Fig. 3

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Emergency rooms can be a crucible for hypochondria, and a carnival of misunderstandings. People who use emergency rooms for primary medical care tend not to be the most knowledgeable patients. In medical schools, emergency room stories are legion. One woman is said to have informed an admitting doctor her baby was having a relapse of “the smilin' mighty Jesus.” Eventually, he figured it out: spinal meningitis. A Washington-area emergency medical technician reports that a patient told him
her
baby was on regular dosage of “peanut butter balls”—phenobarbital.

How Your Doctor Can Kill You

A doctors reputation is made by the number of eminent men who die under his care.

—GEORGE BERNARD SHAW

A number of doctors
have studied hypochondria, but very few openly specialize in its treatment. The only one I could find through a global search of the Internet was a Dr. Ingvard Wilhelmsen in Bergen, Norway. Norwegians are apparently prone to hypochondria because Norway has a high standard of living, meaning that people have a great deal of leisure time in which to contemplate their lives, which are spent in a dank, hellish place that could depress a hyena. Norwegians have it so bad that when they flee Norway in search of a more hospitable clime, they often head for North Dakota.

In my relentless search for information, as a service to hypochondriacs, I telephoned Norway. I had many questions. I wished to pool my commonsense knowledge of the subject with Dr. Wilhelmsen's professional expertise. Together, I hoped, we could bring a measure of solace to persons afflicted by this much maligned condition. This was my conversation, as reflected by my notes:

Me: Is Dr. Wilhelmsen in?

Norwegian Person:
Va? Schlift wann kumm?

Me: Er, is the doctor in? DO YOU SPEAK ENGLISH?

Norwegian Person:
Schmu? Isfaehrkt?

Me: OK, sorry. Never mind.

So, big shot Wilhelmsen proved no help at all.

This should not come as a surprise. Doctors are not always the most helpful people. The vaunted Hippocratic oath
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requires doctors to do no harm, hut medical texts are full of warnings about procedures that often go seriously awry. Some are minor. Some are not. For example, doctors treating you for hypernatremia, a serious electrolyte imbalance caused by dehydration, will sometimes accidentally overdose you on water and potassium. This creates a brain condition called central pontine myelinolysis, leaving you a quadriplegic, or a corpse.

Some years ago my father went to see a doctor for a routine physical exam. My father is a gentle, self-effacing man who does not wish to make a fuss or be a bother to others. He is the sort of man who, in a restaurant, will not ask for a translation prior to ordering a dish with a fancy French name. Then, rather than complain, he will consume it even though it appears to be rat fetuses in béchamel sauce.

A few hours after his medical exam, my father phoned me and reported that everything went well, and were the kids home from school yet, and he is dying. Now, my father is pretty old and his hearing isn't what it used to be.
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I figured he had misheard the doctor. So I called the doctor.

The doctor gave me good news and bad news. The good news was that there was apparently nothing additionally wrong with
my father's hearing. The bad news was that my father had a heart condition so severe it was a wonder he was still walking around, of apparently sound mind, and unaware of his predicament. The doctor said my father would progress rapidly into a nearly catatonic state in which he would need round-the-clock nursing care, his mind slowly deteriorating into an unpredictable form of dementia typically leading to slack-jawed insensibility and, inevitably, death, which would come as a mercy.

That was six years ago. My father has since celebrated his eighty-fourth birthday. He has won a national math-puzzle competition. He still does my taxes. He regularly beats me at poker, though he seems to lose fairly consistently to his grandchildren. He baby-sits for my dogs. I go to his place to watch football games because he lets me smoke cigars and swear. There is nothing wrong with his heart. Never was.

I do not mean to cast aspersions on the entire medical profession because of one bonehead's mistake. The medical profession is and has always been peopled by caring professionals operating at the very pinnacle of human achievement, though it does give one pause that the official cause of death of Warren Harding, soberly pronounced by the finest attending physicians of the day, was “a fit of apoplexy.”

My point is that doctors tend to be profoundly sure of themselves, even when they have no idea what they are talking about.
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I used to blame the arrogance of medicine on modernity, on the technologies that have elevated the physician to the role of divine mechanic: Mr. Godwrench. In my thinking, doctors of earlier, simpler times were probably just fellas, humble dispensers
of commonsense therapeutics, only a dram more sophisticated than the medieval barber-surgeon, painfully aware of the limitations of their science and of themselves.

That is what I thought until, recently, I happened upon a book published in 1902.
The Cottage Physician,
written by a consortium of “the best physicians and surgeons of modern practice,” was a popular home medical text offering sage advice on the prevention and treatment of disease. The most striking thing about this book is the authority with which it presumes to speak on medical matters large and small. Cautioning against placing yourself in the hands of charlatans, it promises “The Very Best and Most Approved Remedies and Methods of Treatment Known to Advanced Practitioners.”

To wit:

The diabetes sufferer is informed that his condition is of his own making, caused by sexual intercourse, by generally intemperate living, and by “copious evacuation of the bowels.” For treatment the licentious, poop-crazy scoundrel is advised to wear flannel clothing, to eat no vegetables, to vomit frequently, and to take suppositories carved from bars of soap.

A man's hair loss may be arrested through the application of a pomade of lard and rum.

Difficulty in urinating requires a marshmallow enema.

Women, the book informs us, are mysterious creatures, so constitutionally inferior that they must be coddled throughout life. Fortunately, aside from pregnancy—a time when the practitioner must deal with a woman's inexplicable, insatiable appetites for nonfoodstuffs such as clay, chalk, and charcoal—women's medical problems are fairly simple, and easy to diagnose and treat. Almost everything that befalls them occurs because of their womb. Sometimes the womb “falls.” Sometimes it swells. Women are particularly susceptible to hysteria; it is caused by the womb. Doctors recommend that the victim of hysteria be treated in the following manner: Her hands should be bound to prevent her from injuring herself. A piece of steel, heated in boiling water for two minutes and wrapped in silk, should be passed down her spine. And last, an enema should be administered consisting of
turpentine and stinkweed. During this procedure, it is essential that the woman be kept “tranquil.”

Tranquillity is also prescribed at other critical times, for men and women alike. “If within an hour or two of any violent mental emotion the impregnating act follows” the book cautions, “the offspring has that predominating trait throughout life.” The doctor-authors theorize that this explains how the villainous Aaron Burr could have been born to two parents of irreproachable character. At the instant of conception, they suggest, Mr. and/or Mrs. Burr must have somehow permitted their piety to slip, and entertained an impure thought.

Flipping through this wonderful book, one discovers that almost every ailment—rheumatism, cataracts, eczema, convulsions, sciatica—responds well to generous and sustained doses of laxatives. Cancerous tumors—thankfully confined mostly to persons of “scrofulous constitutions”—may be reliably eliminated by application of a poultice of warm milk and figs.

Proper nutrition is essential to good health; one must consume not only the egg but also the shell. Tetanus is cured by “pouring cold water on the head from a considerable height” and by turpentine enemas.

The discovery of this book set me on a journey to find others. It turns out almost every used-book store has one or two of them, and though they differ in content and philosophy, they are similar in the impressive medical pedigrees of their authors and in the certitude with which they deliver remedies. One of these, the
Obstetrical Journal of Great Britain and Ireland
(1873), reports favorable results from the treatment of constipation with arsenic.

The
Text-Book of the Principles and Practices of Nursing
(third edition, 1938) prescribes, for the treatment of a persistent cough, heroin.
Lessons in Physiology and Hygiene,
a medical text published in 1895, observes that the size of one's brain is directly proportional to one's intelligence and then dryly notes, without further comment, that women have smaller brains than men.

In the 1875
Nashville Journal of Medicine,
a Dr. Bowling advises that persons permanently refrain from eating any fruits or vegetables. They can be deadly, he says, citing several rather thin
case studies, including this one: “One of the most beautiful and accomplished young ladies in the city ate two or three pickles, and died.”

It was after reading some of these books that I entered the hospital for some minor outpatient surgery. There, I entrusted myself to an excellent doctor of my acquaintance, one of the very best physicians and surgeons of modern practice. He gave me a marshmallow enema.

Just kidding! That would have been ridiculous! We have come a long way since then. No, the doctor stabbed me in the side with a gigantic needle and yanked out a little plug of flesh, just to see what it was made of.

I was not at all concerned.

Why should I be?

He assured me this was One of the Most Approved Remedies and Methods of Treatment Known to Advanced Practitioners.

I am certain that a hundred years from now, it will not look at all foolish.

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Have you ever read the vaunted Hippocratic oath? It is loony. It begins by swearing allegiance to “all the gods and goddesses.” Then it promises to revere the person who taught you medicine and support him financially. Then it says abortion sucks. Only then does it get down to business, saying you should not be greedy, should cause no injury, should respect your patient's privacy, and should not sleep with her.

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Actually, his hearing was never much to begin with; when I was a lad, I would frequently make some innocuous statement at the dinner table-say, “I got a B on my final”—and find out weeks later that my father believed I'd said I had gotten beer on my vagina, but was too polite to inquire further.

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Medical quackery has a long and storied history. When King Charles II of England suffered a minor stroke in 1685, the finest medical minds of the time were summoned to the royal bedchambers. First, to rid the king's body of all poisons, they drained him of a quart of blood. Then they further desiccated him with emetics and enemas. Over the next few days they shaved the king's scalp and singed it with hot irons. They crammed sneezing powder in his nose and let him blast out his few remaining drops of liquid. They slathered his body with sticky hot plasters, and then, when they hardened, ripped them off; by this time, Charles was doubtless too weak to scream. The monarch was sinking rapidly. But the doctors were on top of it. They were giants of their profession. They drilled holes in his head, to drain off the bad humors and a few more pints of blood. Alas, it was no use. Five days after the treatment began, the king breathed his last, effusively thanking his physicians for their heroic efforts to save him.

Man. Woman. Birth. Death. Infirmity.