The Evening of Life   /   Fall 2018   /    Thematic: The Evening of Life

Off-Label Scripts

Physicians-as-Writers, Patients-as-Readers

James VanOosting

Ancient Egyptian text detailing prescriptions and diagnoses, from the Ebers Medical Papyrus; Science History Images/Alamy Stock Photo.

[Pain]…cannot recollect
When it began, or if there were
A day when it was not.

Emily Dickinson, Part One: Life, XIX

My favorite opening line of any novel comes from War in Heaven (1930), by the English writer Charles Williams: “The telephone bell was ringing wildly, but without result, since there was no-one in the room but the corpse.” Lionel Rackstraw, a book editor, rushes into his office to answer the phone and, while chatting, notices two boots and a pair of trousered legs protruding from the kneehole under his desk. He bends down to see who’s there, thinking it must be a repairman. “Shall you be long?” he asks. Taking off hat and gloves, he repeats the question, and grows impatient when he receives no reply. “Hallo! Hallo! What’s the idea?” Then it occurs to him: “Damn it all, is he dead?”

So begins most every murder mystery: the discovery of a body, followed by an investigation of how it came to be there and, more importantly, how it came to be dead. Diagnosis of a fatal disease proceeds along the same basic lines: the discovery of a body, though not yet dead, followed by an investigation backward through time to assemble a patient’s history. The telling distinction between diagnosing a disease and solving a murder lies in how one may interrogate the body. The first allows for Q&A; the second relies on autopsy. Benefits accrue to both approaches.

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