I did feel stressed now, but the illness felt like the reason rather than the symptom, and my mind was the only part of me that worked. I could still write columns, normally enough that I didn’t have to tell my editors how awful I was feeling. (That was the summer when Donald Trump descended the Trump Tower escalator and politics became a fever dream as well.) And I could analyze my symptoms with what seemed like my old familiar reasoning powers, even if my self-diagnosis kept shifting based on which online source I read.
Around this time, New York magazine published an interview with a physician who had lived with undiagnosed Lyme disease for years, eventually acquiring a heart condition that required a transplant. The article came with an illustration of a man’s body spider-webbed with filaments, like something out of H.P. Lovecraft.
His symptomology resembled mine; the “boil” could have been a tick bite. My Lyme test had been reported as a negative, like the other blood tests, but I obtained a copy and saw that one of the “bands” that appear in the presence of Lyme antibodies had appeared in my test. You need five bands to appear, according to recommendations from the Centers for Disease Control and Prevention, for an official diagnosis. But with exaggerated reasonability, I persuaded the primary care physician I’d been assigned after my E.R. visit to prescribe me the antibiotic doxycycline.
She gave me 10 days’ worth — easily enough, she said, to clear up a Lyme infection. I took it. A few days into the course I began to feel incredibly strong waves of pain, stronger than before, concentrated especially in my joints, my knees and elbows.
Reading online, I encountered descriptions of the Jarisch-Herxheimer reaction, flares of symptoms that may accompany the large-scale death of bacteria inside the body. Named for two European doctors who identified it in patients treated for syphilis, it was supposed to be common in Lyme patients. So I took the surge of symptoms as a possible confirmation of my guessed-at diagnosis.
Around this time we drove from Washington to Pittsburgh to visit my wife’s sister. Halfway there, somewhere in the Appalachians, I began getting crushing pain across my chest, running up through my left shoulder. At a certain point the blaze was unbearable, and there was nothing to do but tell my wife — quietly, so that the kids couldn’t hear us — that I was having really bad chest pain, and she had to take the wheel. Which she did, maintaining a maternal calm that was more terrifying than panic, and when we reached Pittsburgh she dropped me at an emergency room while she rushed to settle the girls at our hotel.
There was nothing wrong with my heart, the doctors said, no problems they could see. They pushed liquids through my system, rolled me under sensors, talked sympathetically to me and skeptically to one another. I lay wrecked in the E.R. bed. Surely this was the low point, I thought; surely now recovery would begin.