Knowledge Before the Fall

It would be nice to be a doctor, I’ve sometimes thought. If you began to feel something go wrong, you could diagnose yourself. You’d know what you were in for. There’d be no surprises, and all pain and discomfort would be mitigated by an awareness of the path ahead, the forks you’d come to, and the choices to be made. I don’t think being a doctor would make your stomach hurt less, or your head or your leg not ache, or your heart not break. But surely, with a fund of knowledge about symptoms, causes, effects, and—yes—pain, you would be better prepared. If not to cure your troubles, then at least to face them. This, anyway, was my feeling as I awoke one morning to what promised to be another day of pain. It wasn’t crippling, but it was limiting, and with each day, more draining, more demoralizing. It had started with two weeks of intermittent back and hip discomfort, which wasn’t bad enough to see a doctor about. Then I stooped to retrieve a pencil, and what had been discomfort now became constant pain, and after another two weeks, I was ready to give up. “Okay, you’ve got me, I’m a wimp. You win. Now take the pain away.” But the pain did not go away, and I couldn’t even wonder why, because all I knew was that it hurt. Why was this happening to me?

The doctor was of no help. This kind of complaint often cleared up, she told me. Patience. Meanwhile, there were painkillers. She also pointed out that many people evince similar pain with their slow gaits, their bent backs, their gritted teeth and grimaces. Surely I had noticed them? Join the crowd, she seemed to be saying. I stared at her. I’m active and fit. I’m never sick, and I never take medicine. I don’t eat meat. I hardly drink, don’t smoke, have coffee only in the morning, and run 50 kilometers a week. Run, not trot. You don’t know me, I thought.

It was true, she didn’t. I live in Asturias, in northern Spain, and because I had recently moved, this was my first visit to her office. My medical history was on her computer, but she hadn’t read it and couldn’t know that what I was suffering was not simply the trial of advancing age. Such is the reality of the overburdened Spanish medical system. But thanks to that same system, the painkillers I was prescribed were practically free. It hadn’t cost me a penny to see a doctor.

Knowing how long the trouble would last or whether it would ever clear up—or if, on the contrary, I was likely to be forever impaired—might have made it all easier to bear. After a month, the pain did seem to lessen slightly, and after another week, I could manage without painkillers. I began to believe my doctor. I cheered up. Had I been a doctor myself, though, I would have faced the ordeal with more equanimity. The weather forecaster who knows where a system has come from and how long before it will move on will get just as wet in a downpour, but the drenching won’t seem an insult on top of a hardship, as it might to me, not having realized I was in the path of the storm.

So when one day, as I was walking slowly down a sloping street and saw an elderly couple coming even more slowly up it, I paid attention. They shuffled along, shoulder to shoulder, as if holding each other up. As I got closer, I saw that the man was bearing the weight of the woman, who was tilted against him, not so much leaning on him as tipping over onto him, her body listing like a boat that’s taken on water. They paused beside a bench, and she looked around, her gaze vacant and dazed. Pulling on her hands to turn her toward him while keeping close to give her body the support of his, the man got her aligned with the bench and then seated, all apparently without her help. She was small, but even so, maneuvering her into place must have been awkward. Perhaps she was just too tired to collaborate, but it seemed that she was not even aware of what was going on. No words passed between them, and he did not seek eye contact, nor did she look at him. What was I witnessing? Rather than a sinking ship to succor, or a large package to transport, she was in her constant closeness more like an appendage: a useless arm in a sling or a bandaged foot to drag along as you move—a part of him that had now become burdensome and extraneous.

As he got her seated, the man, probably her husband, eased down beside her. He was still holding her hands. I imagined him facing the problem of his wife’s condition alone, and I felt sorrier for him then I did for myself. I hope, I silently said to him as I continued past, that you are a doctor and know what ails your wife, and haven’t got the stress of uncertainty on top of everything else.

And yet, a store of knowledge about a thing does not necessarily prepare you to experience it. The vet to whom we took our dog many years ago listened calmly as we described what happened when Chimbo had a seizure. On the history of the dog we were sketchy, because we’d found him abandoned beside the road 10 days earlier. Within 48 hours, we said, he’d had his first seizure. Then more.

The dog was quiet but anxious. The vet scratched Chimbo’s ears in a friendly way, which seemed to be a message to him: “Yes, I know about you, and your worries are over.” He was a beautiful dog, a German shepherd, strong and svelte like Rin Tin Tin, except that Chimbo’s eyes showed not pride and confidence but worry and confusion. He did not seem comforted by the vet’s caresses. I was, though. I believed her, even if Chimbo did not.

The vet’s diagnosis was epilepsy, and she gave us some pills to help with the seizures. We had gone for a solution to the problem but also to be reassured that what he was going through wasn’t too much to suffer, that he would get better, and that everything would turn out okay. Maybe also so that someone who knew about these things would hear our story and say, “Oh my!”

We thanked her, paid her, then turned to leave. Chimbo, fearful of going first and fearful of being left behind, was glued to my leg; he squeezed beside me through the door into the waiting room. He was as nervous as he always was. The only moment in the day when he appeared to be free of fear was when I put his bowl in front of him. It was as if his fear were tied to hunger. But the instant he finished, he looked nervously around, fearing an attack, which is what his seizures were. Although he had been visibly nervous in the vet’s examination room and then in her waiting room, he was not more so there than anywhere else. Yet before we’d opened the door to the street, Chimbo started to pant, then twitch. His legs tensed, his eyes rolled back, and he fell to the floor in the full throes of a seizure, his head already knocking against the hard, cold tiles while his limbs jerked. I crouched beside him, put my hands under his head to cushion it from the hard floor, and looked up at the vet, who had followed us from the examination room. Her mouth was hanging open. “This is what he does,” I said. “This is what happens.”

“Dios mío, Dios mío,” she said, staring at the dog as he thrashed on the floor. Then she turned her horrified eyes on me. “It never lasts more than a minute,” I said.

It did, however, last longer than usual. And even after we started the medication, the seizures kept getting worse. Adjusting the dosage didn’t help. We didn’t know then that nothing would.

In the waiting room, Chimbo’s legs were still, with an occasional twitch, and his head was no longer banging. He opened his eyes.

The worst of those months with Chimbo—worse than the shock of the first out-of-the-blue seizure, worse than witnessing and trying to alleviate subsequent attacks, even worse than the decision to put him down after a summer of pills and more pills that did not stop the seizures, worse than when the vet said she didn’t know what to try next, when we accepted that there was no cure—the worst was every time Chimbo opened his eyes and looked around after a seizure, and cringed, as if expecting a new seizure to start right up. When he looked around, first dazed, then fearful, and then looked at me. What’s happening to me? his look said. What’s happening to me? Old people shuffling slowly along; a child wailing in a downpour while his parents impatiently shove him along, seeking shelter; even people strong and healthy who seem to think the aging body is for the already old—they often have something of the same dismay, the same question. What’s happening to me? But it’s not. It’s just happening.