Thursday, April 28, 2011

Jay Neugeboren: Writing for My Life

In 1957, at the age of 19, I was diagnosed with Hodgkin’s Disease—operated on, and irradiated—and, believing I had a year to live, I wrote a novel. Charles Van Doren had been my freshman English teacher at Columbia the previous year. This was before he was on the quiz show Twenty One. By the time I completed the novel, he had become, arguably, the most famous professor in the country. He had become a mentor and friend, and had encouraged me to write the novel; when it was done, I showed it to him. He was enthusiastic—compared it to Bunyan’s Pilgrim’s Progress, and recommended the book to several publishers on my behalf. For a brief while—until the rejections began coming in—I believed I might become, at 19, the American literary equivalent of France’s Francoise Sagan. I recall walking from class with him one afternoon (a class in 18th century English Literature), and telling him about the rejection I’d received the previous day. I said it hadn’t bothered me at all, and he said, “Really? I can’t believe that. Seems to me it would be as if someone had told you you your child was ugly.”

“Writing For My Life” appeared in the Spring 2008 issue of the Auithors Guild Bulletin.

by Jay Neugeboren.

In February, 1957, a few months before my nineteenth birthday, I was diagnosed with Hodgkin’s disease. The malignancy, in my neck, was surgically removed, as were adjacent glands, and I was irradiated on both sides of my neck. In the half-century since, I’ve never had a recurrence.

Chance, Pasteur famously wrote, favors the prepared mind. When it comes to medical survival, it would also seem to favor those whom it chooses to favor.

At nineteen, my life was saved because, rarely sick, I became concerned about some swollen glands that appeared during an ordinary winter cold and didn’t go away when the cold did. Visiting on a Sunday afternoon with a cousin who was doing her medical residency, I asked her if she’d take a look at my throat. She looked at my throat, palpated my neck, and suggested that I get things checked out at my college health service. The next day, I went to the Columbia College health clinic, which was housed at St. Luke’s Hospital, where a young resident felt my glands, after which he called in another doctor. This doctor--a tall, elderly man with white hair and a neatly trimmed straw-colored moustache--felt my glands, nodded once, then told me to make an appointment to come in to the hospital at the end of the week for a biopsy.

In 1957, I didn’t know what a “biopsy” was (I figured it was some kind of test for an infection connected to swollen glands) and so I was a bit taken aback when, after telling my mother and father that I’d be staying overnight at St. Luke’s Hospital on Friday for a biopsy, they cloistered themselves in their bedroom, where I heard my mother, who was a Registered Nurse, weeping hysterically while my father kept trying to calm her down. When my mother emerged from the bedroom, she told me that everything was going to be all right--I shouldn’t mind her tears, she’d had a hard day at the hospital--and that there was no reason for me to have the biopsy done at Columbia. Instead, she would make some calls to doctors she knew and worked with in Brooklyn.

She did, and two weeks later, a biopsy was performed at a Brooklyn hospital, and the surgeon, after opening my neck and seeing the glands, removed all that he could find--“stripped” them, in my mother’s words. When the results of the biopsy came through ten days later, and I asked my mother what the report said, she told me that the excised lymph nodes had turned out to be ‘completely benign’ and, again, that there was nothing to worry about. It was not until I had occasion to review my medical records twenty years later that I discovered, definitively, that two pathologists (one was Sidney Farber) had, in 1957, confirmed the diagnosis of Hodgkin’s disease.

On February 12, 1999, forty two years after the biopsy, and a few months before my sixty-first birthday, despite being physically fit (swimming a mile a day, playing full court basketball with teenagers), and having no conventional symptoms or risk factors (no chest pain, nausea, dizziness; I’d never smoked; I had normal blood pressure and cholesterol scores, and no positive family history of heart disease), and despite not having had a heart attack, an angiogram revealed that my coronary arteries were more than ninety-eight percent blocked.

I’d been experiencing some occasional shortness of breath while swimming (but if, while swimming my daily mile, I rested for thirty seconds or so, I could complete the mile), and some intermittent burning sensations between my shoulder blades (which I figured was ‘swimmer’s shoulder’). Still, I was concerned--I just didn’t feel right--and called my family doctor. His nurse, to whom I reported my symptoms, noted that I hadn’t been in for a check-up in two-and-a-half years, and she scheduled me for an exam. I went for the exam three weeks later, and given that I was sixty years old and had never had a stress test (or seen a cardiologist), my family doctor recommended I make an appointment with a local cardiologist. I went for the stress test/exam a week or two later, and although neither my family doctor nor the cardiologist saw any urgency in my situation, I did.

And so I telephoned several childhood friends who were physicians, reported what was happening and how I was feeling, and when the local cardiologist, after an electrocardiogram and an echocardiogram, diagnosed a virus of the heart muscle, one of my doctor friends, Rich Helfant, with whom I’d gone to Hebrew School and High School, shouted into the phone from three thousand miles away (he was in Palos Verdes, California, I was in Northampton, Massachusetts)--“It’s not viral, goddamnit! I want you in the hospital as soon as possible.”

Eighteen months later, visiting with this friend, and talking with him about his having gotten the diagnosis right by phone from across the country, he smiled. “Let’s face it,” he said. “You and I wouldn’t be sitting here today and talking if you hadn’t gone to high school with the right guys.”

We know many things--the percentages of those who survive cancer and heart attacks, and from which cancers and what kinds of heart attacks, and for how long, and how we can successfully treat some cancers and most kinds of coronary artery disease--but there remain many things we don’t know, and what we often overlook in our desire for answers and for “scientific” truths, are, simply, the facts of luck and of mystery. Why do some people who are in great shape and follow all the recommended rules (e.g., Jim Fixx) suddenly keel over in the prime of life, while others, who seem to follow none of them (e.g., Winston Churchill), live full lives into advanced ages?

And there’s this too: given my mother’s often histrionic penchant for dwelling on illness, and my parallel penchant, when I was growing up, never to allow that anything was wrong with me, what prompted me on that Sunday afternoon, with my mother nearby, to ask a cousin to check out what might, on another day, have seemed the ordinary aftermath of an ordinary cold? And why did I, forty-two years later, despite the lack of urgency expressed by doctors who physically examined me, persist in pursuing, with friends, what might, at another time, have seemed groundless anxieties?

When I was told at nineteen that I didn’t have cancer, part of me believed this was so. But if there was no cancer, why was I being radiated? Believing, then, in another part of me that I was going to die within a year, and, romantic soul that I was, wanting to leave something behind, I decided to write a novel. (The novel, two hundred pages long and satiric in intent, told the story of a young man who, convinced he is going to die within a year, feels compelled to deliver a message of hope to the world; through a series of improbable events he becomes a hero, dispensing homilies far and wide. At novel’s end, the rumor of his death has become non-existent.)

At twenty, I wrote a second novel, and by the time the magic five year period arrived when, supposedly, I didn’t have to worry about cancer anymore, I’d completed another three (unpublished) novels. It was as if I somehow believed that as long as I kept making up stories, I could stay alive.

So: grateful for the gift of life given back to me at last three times (doctors, operating on me for a ruptured appendix when I was two-and-a-half, lost my vital signs for thirty seconds), and without underestimating the supreme importance of surgical skill, biological luck, and the good fortune to have had access to doctors who knew me and listened to me, I sometimes think that the element of chance that favored me--that, against all odds, gave me life and kept me going--was enhanced, at least in part, by my desire, born fifty years ago, to spend my working hours imagining lives different from the one I was actually living.

For even even while I may occasionally receive, from within, physical signals of alarm unheard and unseen by others, when I sit down to write fiction--to make things up--I also see worlds nobody has seen: worlds of possibility, where anything, for good or for ill, and against predictability, might occur.

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