Post Road Magazine #25

An Inherited Condition

Suzanne Koven

My mother was tall, thin, olive-skinned, brown-eyed, and charming. My father was fat and fair, with a large square head and green eyes: a recluse. I was a muddy mixture of the two: dirty blonde, hazel, a lonely little performer.

My father was a reader and my mother was not. Mom loved to tell this story: when she and my father had been married a year, she asked him whether he had been in any way disappointed by his bride. "Darling," he said, "Marriage to you has been heaven, except for one thing"—this was my mother's embellished version; though my father adored her he never called her "darling" and he never called anything "heaven"—"I wish you would read better books." She never did. Mom graduated from paperback romances to bestsellers by Leon Uris and James Michener rented for a nickel a day from the local stationery store to, towards the end of her life, Oprah's Book Club selections. When I was an English major in college and recommended Dickens or Virginia Woolf, she looked uneasy and said she didn't like lots of "description," which seemed a code word signifying the world my father—and now I—inhabited without her. I, too, had become a reader, though I was never consumed by books as my father was.

He was an orthopedic surgeon, but when I picture my father, I picture him reading. He had a worn red velour chair in the master bedroom of the house in Brooklyn where I grew up and it is there that I see him, in my earliest memories, a large man in a starched dress shirt, boxer shorts and black Ban-lon socks with garters, a powder blue mohair throw across his white and nearly hairless legs, smoking a cigarette and holding a book. When ash fell on the mohair and singed its fibers he reached down and pinched out the flame without taking his eyes off the page.

Dad read what I thought of as man's books: Arctic travel journals and Henry Miller and Philip Roth and J.P. Donleavy and, revered above all, James Joyce, whose Ulysses he read annually. The only book by a female author I recall seeing on Dad's shelf was Kate Millet's Sexual Politics, which I suspect he never read but whose cover I think he must have liked to display, that dangerous word so prominent on its wide spine.

My father loved books, and also words, the very sound of them. Though he, too, was born and raised in Brooklyn, he pronounced sexual in the British manner: sex-sual. He also liked "scotch broom," "Mercedes Benz," "greenstick fracture," and any number of other names and phrases that he snuck gratuitously into his sentences for the mere enjoyment of saying them aloud. When my mother's younger sister, Roberta, was diagnosed with leukemia in 1980, my father informed me that it was of the rare "hairy cell" variety. I am not sure that this was the precise diagnosis, but quite sure my father would have been unable to resist the pleasure of repeating that luscious name.

Of course I wanted to please my father, so at an early age I pretended to like to read what he liked to read. At one point, perhaps I was about twelve, I cleared off a shelf in my bedroom that had been devoted to the dolls brought back from the airports of the many countries my parents had visited and began accumulating books. They were either books my father had said I should read—Jon and Rumer Godden's Two Under the India Sun, for example—or books he had read whose jackets I found appealing, such as The Selling of the American President, a paperback featuring Richard Nixon's face on a pack of cigarettes. I never read any of them. Instead, I returned over and over to the predictable adolescent favorites that I feared would make me uninteresting to my father: A Tree Grows in Brooklyn, Catcher in the Rye, To Kill A Mockingbird. My father didn't notice though. For him, reading was solitary.

My mother noticed. Sometimes she stood at the door of my bedroom and, finding me in bed with a book, would exclaim, "How lucky you are to be a reader!" Or she would wave her hand to take in the light blue walls and matching shag carpeting I had picked out myself and say "This room is a blue lagoon!" stretching the last syllable as far as it could go. She, too, took pleasure in words but it was a different pleasure than my father's. Hers was the storyteller's pleasure: not in the words themselves but the delight of wrapping up life in them and presenting it to someone else. "You're sitting in a regular blue la-goooon!"

Like my mother, I'm a storyteller. For a long time I resisted recognizing this about myself because it didn't fit neatly into my belief that I had inherited my father's bookish self-containment. Perhaps it seemed shamefully conceited to me—even greedy—to imagine that I possessed what I saw as the most enviable qualities of both of my parents: my father's intellect and my mother's charm. Early in our relationship as we sat down at the small, teetering butcher block table that was the only new piece of furniture in our first apartment, I often began conversations by telling Carlo, "The most interesting thing happened to me today!" He would respond that he often went weeks without anything interesting happening to him.

Though my father often urged me to read more—which I took as an invitation to be more like him—he never encouraged me to be a doctor. In fact, he never spoke of his work at all. When I started medical school, and my father was nearing retirement, I thought I should watch him perform surgery at least once before he stopped doing it. The operation was an internal fixation of a fractured wrist. Before sending me to the ladies' locker room to change, my father explained that he would make an incision, isolate the vital nerves and blood vessels so as not to injure them, and then stabilize the broken bone by inserting a steel pin. When I joined him in the operating room wearing scrubs, a paper cap, and booties, the patient had already been anesthetized and his bare arm extended out to his side perpendicularly. I noticed that my father had a pack of Benson and Hedges 100's—the same brand that littered the ashtray next to his velour reading chair—in the breast pocket of the scrub shirt that strained to cover his belly. The thought crossed my mind, as a nurse directed a bright lamp to the patient's limb and my father took up the knife, that he might not know what he was doing.

Thirty years later I often feel that I am the same fraud at medicine I feared my father to be: an English major who somehow stole through an unmonitored side door of the hospital. Not long ago I entered an examination room in my internal medicine practice to see a woman I'd never met before, a patient of one of my colleagues, who had walked in off the street in distress. I found her, a skinny woman of about thirty in an oversized parka with the hood pulled down over her face, sobbing. I knew immediately that by the end of the day she would be on a locked ward in a psychiatric hospital. I asked her very few questions, sidestepping the usual queries about her past medical history, medications, and hospitalizations. She said yes, sometimes she did feel like killing someone. I put my hand on her arm and called her "Sweetie." I led her by the shoulders through the corridors of the hospital towards the psychiatric emergency room, my stethoscope slung around my neck, purring, "Sweetie you'll be safe here. Everything is all right." And the whole time I wondered if I had understood what this woman needed not by going to medical school, but by reading novels.

I struggled with the premedical science courses I crammed in during the two years after I graduated from college. It was a particular kind of struggle—maybe not so different from what my mother experienced trying to read Dickens. I had the feeling of doing something unnatural: something that I could do, even do successfully if I tried hard enough—and I did try very hard and got good grades—but which never became less of a struggle, never became part of me.

The only thing I remember from introductory chemistry is that Einstein confirmed Avogadro's number (6.02 x 1023) by counting grains of pollen. I never really understood what Avogadro's number was or how counting grains of pollen would help Einstein find it, but I could not get out of my mind the image of that loveable, wild-haired genius with his loupe and tweezers painstakingly dissecting the sex organs of hundreds of flowers. Carlo had also been an English major turned pre-med, with a grasp on science no firmer than mine. I recall lording it over him with my little gem of scientific acumen—a prodigious reader like my father, Carlo knew so much more about everything else than I did—and asked him if he could guess how Einstein had done it. He couldn't, but I was at a loss to tell him because I had no idea what I was talking about.

That second year after college, I took a biology class to finish up my pre-medical requirements, a seminar in virology. This was the spring of

1981, just a few weeks before Carlo and I were to be married. The class was taught by a young biologist—he must have been under forty, though, naturally, he seemed old to me. I think he was named Craig Something, though it may be that I simply associate the name "Craig" with this man's appearance: lanky with long straight hair brushed back from his high forehead and cut bluntly just below his ears. Anyway, Craig was tanned and favored wide wale corduroy pants and chambray shirts and wore a wedding ring, which, in those days, advertised heterosexuality. He was always leaning languidly against something—a desk, a lab bench, a wall—as if he couldn't bear to stand up unsupported. This posture gave me the impression that he didn't want to be where he was, and, so, I saw in him an ally.

The course required the usual midterm and final but, atypical for an undergraduate science class, also an essay, which was to be presented aloud to the class. There were no restrictions on the topic of the essay other than it had to relate, in some way, however tangential, to subjects mentioned in the course syllabus. In the middle of the semester we had learned about oncoviruses, viruses that can infect genes responsible for the normal growth and differentiation of cells, causing cancers. I don't recall how I happened to come upon Susan Sontag's Illness as Metaphor, which had been published a few years earlier, but I proposed to Craig that since Sontag argued in the book that language can be misused to victimize people with cancer ("cancer victim" is one of the examples she gives) and since we had, after all, discussed oncoviruses that can cause cancer, an essay outlining Sontag's argument would fulfill the assignment. Craig smiled broadly. I recall he had very white teeth, in an era before teeth whitening became popular.

In Illness as Metaphor Sontag writes disparagingly of our tendency to think of people with diseases as "types." She contrasts the so-called "tubercular personality" (sad, romantic, overly passionate) with the "cancer personality" (emotionally repressed, asexual, and, as Sontag, a cancer patient herself puts it unsparingly, "one of life's losers"). She quotes an Auden poem, "Miss Gee," about a spinster, "with her clothes buttoned up to her neck," who arrives at the doctor's office with a far advanced tumor. That evening over dinner, the doctor tells his wife:

'Cancer's a funny thing.
'Nobody knows what the cause is, Though some pretend they do;
It's like some hidden assassin
Waiting to strike at you.
'Childless women get it, And men when they retire;
It's as if there had to be some outlet
For their foiled creative fire.'

I didn't say this in my presentation, but the poem reminded me of my mother's younger sister, Roberta—the one who had been diagnosed with what my father called hairy cell leukemia. I was certain that her singleness, her childlessness, her sour unlikability, had, like Miss Gee's, brought her cancer on.

Roberta was three years younger than my mother. She lived, when I was very young, alone in a studio apartment in Manhattan and worked as an editor at—the irony didn't escape me even then—Parents magazine. She had been a tomboy as a girl, sometimes reconfiguring her signature as "Robert A." She looked like an altered version of my mother—as a child I couldn't exactly name what was missing—although now I see that it was sex appeal. Roberta was tall like my mother, with pretty eyes and thick wavy hair and good cheekbones. But she seemed brittle, bloodless. I hated hugging her when she arrived at my grandparents' apartment for holiday dinners, filling up glass ashtrays with lipstick-stained Parliament butts.

When I was eight or nine, Roberta moved to Maine with her friend Sarah, a compact and athletic woman with short, salty gray hair. Sarah was a potter and for several years the two of them raised dogs and grew vegetables. Roberta still came to New York occasionally, and I recall that one time she stood at the doorway to my room and did not remark on my "blue lagoon" as my mother always did, but, rather, puffed on a cigarette, swiping her mouth sideways to blow the smoke into the hallway in deference to my childhood. As she stood there and smoked, she patted her lower abdomen, announced that she had menstrual cramps, and grunted, "Ugh. How I hate this whole goddamn business."

By the time she got sick, Roberta had moved to Florida with a different friend, Nancy: a big, loud woman with acne pocked skin, mannishly cut silver hair and eyes perpetually slit against her own cloud of cigarette smoke. But there was somehow—again, I knew this, too—something attractive about her. She possessed some fire that Roberta lacked. Nancy used the word "dynamite" a lot. The restaurant was "dynamite" and the movie had been "dynamite" and, the surgeon who eventually removed Roberta's cancerous spleen was "dynamite," too.

As a couple they gave the impression of the charismatic, slightly shady businessman and his shy and homely girlfriend. I say "couple," but the fact that Roberta and Nancy were lesbians was never acknowledged openly by my mother. This was one story she didn't tell. My mother's mother, on the other hand, a short busty woman not given to mincing words, once wondered aloud in my presence, "So what exactly do they do to each other?"

In my mind, Roberta was, to use Sontag's words, "one of life's losers," a conclusion validated for me by the fact that my father clearly couldn't stand her. I could see him wince when she called him "Lee" instead of "Leo"—only my mother called him "Lee" and only when calling him to the telephone. Even worse, sometimes Roberta called my father "Lee Lee" in a baby voice, a grotesque caricature of flirtation. Worst of all, during and after my aunt's visits, my father sometimes mistakenly called me "Roberta." This seemed to me to be evidence that my father didn't like me, that he saw the Roberta in me.

I was not surprised and—God help me—there may even have been a part of me that was glad when, a few months before I took that class with Craig, my mother called to tell me that Roberta had leukemia. In the following months, Roberta grew sicker and her spleen became massively enlarged. When it was finally removed it weighed twenty-five pounds, my mother told me. Before the operation she looked nine months pregnant, a fact that my mother repeated several times to me over the phone.

I don't remember what I said about Sontag in my presentation or the response of the class—an assortment of undergraduate pre-meds who, though they were only two or three years younger than I, seemed dull and pimply and of a different generation. My talk was entirely pitched toward Craig, whom I wanted very much to impress. For one thing, I needed a recommendation from a science professor for medical school and, though my workmanlike performances in chemistry and physics had earned me good grades, they were, I was certain, unmemorable to my instructors. But, more importantly, I wanted some confirmation that I had crossed the void between what came naturally to me and what did not; that I had really made sense of science. Of course, offering my biology class a close reading of Susan Sontag could not really accomplish this. In fact, three decades later, I am still trying to bridge what is really unbridgeable by conducting a literature and medicine seminar at the hospital where I practice: an interloper carrying my Kafka past the blood bank.

My presentation was a success. I knew this because Craig, who stood leaning against a black lab bench, smiled that white smile throughout. His smile broadened when I threw in a charming personal story that even had some tenuous scientific relevance: a friend of my mother's had been interviewed for some reason on a local television news show and, soon after, she'd received a call from a geneticist at Columbia Presbyterian inviting her to be a research subject. She was puzzled. The geneticist explained that he was studying a rare familial syndrome that caused a dramatic white skunk-like streak in its sufferers' hair and that he had seen her on television and noted that she had such a streak. She laughed. She'd dyed it that way, she said. She was trying to look like Susan Sontag.

The class didn't laugh, but Craig laughed and that was all that mattered. I'd hit it out of the park, I told Carlo that night. I wasn't at all surprised when, at the end of the next class, Craig asked me to stay behind for a few minutes. My heart raced and my ego dilated. He's going to ask me if he can write me a recommendation! I thought. Craig invited me to sit down while he stood and leaned. "Suzanne," he said, "I have a concern I want to share with you." This was going to be even better than I thought! I thought. He's going to confide in me! "My concern is this," he continued, "and it's a very serious one." He folded his arms. "I'm concerned that what you presented yesterday is not your own work." I felt something inside me collapse. Nothing hit out of the park, no recommendation; if Craig pursued this, maybe, no medical school at all. "But why?" I asked. "I thought you thought it was good!" "It was good," he said. "Too good, in fact."

I gathered myself. I demanded nothing less than a complete exoneration and an apology, which, to my surprise, Craig offered without hesitation. "Yeah," he said, "it may be that I was reacting to the fact that your choice of subject matter was so unusual." Somehow his retraction seemed more insulting than his accusation had been.

A graduate student with an ill-fitting lab coat poked his head in the half-closed door just then. "President Reagan's been shot," he said. Craig turned back to me. "Well, I can't get too upset about that," he said, as if something had transpired that made me no longer his student but his peer. His coldness repelled me. The value of his approval plummeted. I never had any love for Reagan myself: that smugly dyed hair and that heh, heh, heh smirking about welfare queens. El Salvador. Ketchup as a vegetable. But learning he'd been shot was like learning that a disliked relative had suffered the same fate: there was no gladness, only distress at the spilling of shared blood.

Roberta died a few months later, not long after Carlo and I were married. A few years after that my grandmother developed a different form of leukemia. And many years after that, when I was a mature physician myself, my mother developed leukemia, too. I used my connections to get my mother an appointment with one of the best oncologists in Boston. He was, of course, interested in my grandmother's and my aunt's diagnoses. To the latter, my mother answered, turning to me, "Your father always said it was hairy cell, isn't that right?" Yes, I said. "Hairy cell." And then I said it again.

Sontag called leukemia the "white cancer," more sanitized, more ethereal, more "TB-like" than crude tumors of the breast, lung, and bowel. But when my mother first called to tell me her diagnosis, I didn't think of Sontag, who died of leukemia herself, or of that interesting observation. Instead, I thought, not with sadness or fear but with a kind of satisfaction: now I know how I will die.

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