Doxycycline and Rifampin

The Deep Places: A Memoir of Illness and Discovery

Ross Douthat

Convergent, pp. 224, $21.99

“What is a poet?” asks Kierkegaard’s aesthete at the onset of Either / Or, that manual for milking beauty out of melancholy. “An unhappy man who hides deep anguish in his heart, but whose lips are so formed that when the sigh and cry pass through them it sounds like lovely music.” The difficulty with The Deep Places: A Memoir of Illness and Discovery is that Ross Douthat is a poet of rare potentialities, drawing soulful harmonies out of the dissonance of chronic Lyme disease, whose hosts are “above every other category of persistent pain” in terms of overall reported symptoms. But it’s a difficulty because he records confusion and loss with such visceral, often-lyrical precision that the reader can practically partake of this cup of sufferings. The inevitable question, then: why pay the price of an epicurean evening out to experience what one doctor called “exquisite pain”? 

Perhaps the answer is because “sometimes people subconsciously want to be sick.” That was what was said to Polly Murray, an early victim of Lyme who, unhappy with the condescending diagnosis of psychosomatic neurosis, pioneered an investigation into her Connecticut community, finding that the conspicuous cause behind a purported “cluster of juvenile arthritis” was in fact a flare-up of Lyme cases. Douthat, too, was supposedly sick in the head. Sure, his pain seemed to “impel [him] to stomp around, like a restless horse”; yes, whatever wracked him had reduced sleep to an hour per night; but with a thinning “façade of reasonability,” the diagnosis that “you have a disease that does not exist” became horrifyingly plausible. After all, Job’s friends said, “Well, your columns have been good . . . ” their tone doused with disbelief. The CDC, too, refused to lend its authoritative seal to the chronic variety of Lyme.

Prior to his (as yet unfinished) bout with the tick-borne terror, Douthat believed that chronic illness was comparable to “the aches and pains you feel after exercising for the first time in a few months—suffering that was challenging but manageable.” Prior to this unwonted passage, when confronted with a friends’ chronic suffering he “babbled cheerfully” before lapsing into “useless silence.” 

Many friends and souls of good will accompanied his staggered, shadowy steps through the valley. But Douthat does not dodge how fraught our human bonds become when tragedy comes to visit. Chronic drama becomes, for most, “a little boring” when dragged out over time. Often acquaintances’ self-protective expressions of “strong optimism” stoked “a savage pessimism” in his heart. (Did I mention that his descent into Lyme coincided with the births of two children, a season replete with strong evidence that if he lived to tell the tale he may well remain a sort of absentee father forever? Did I mention that his wife tested pregnant for the second child during an all-family trip to the ER? Did I fail to narrate the Douthats’ relocation to a dream house in Connecticut around the time the bacteria roosted, a dream house that they sold to a staggering loss for the salvation of their marriage?) 

But Douthat’s memoir does not drop into what novelist Jonathan Franzen calls “depressive realism”—that supposedly sobering reminder that “You are, after all, just protoplasm, and some day you’ll be dead.” Rather, The Deep Places comes closer to fulfilling what Franzen calls “tragic realism,” which “preserves access to the dirt behind the dream—to the human difficulty beneath the technological ease, to the sorrow behind the pop-cultural narcosis: to all those portents on the margins of our existence.” Tragic realism resists cheap sanguinity, insists that “improvement always comes at a cost,” and that unalloyed goodness is rarer than badness and evil—at least in the heart of man. And yet, “the formal aesthetic rendering of the human plight can be (though I’m afraid we novelists are rightly mocked for overusing the word) redemptive.” 

Resisting the redemptive potentialities of pain, the man of “privilege” first fought his slippage with “bouts of grandiosity”; “Maybe I had some actual historical part to play from my unique paper-of-record perch.” But soon, during a visit to CNN, he heard his own destabilized voice confessing to the Democratic strategist Donna Brazile “I’m having a nervous breakdown.” His public persona’s capacity for curated bonhomie dwindles. His writer’s pen has plenty of ink but at times it bleeds little more than ellipses or sound and fury, for, as Gerard Manley Hopkins puts it: 

O the mind, mind has mountains; cliffs of fall 
Frightful, sheer, no-man-fathomed. Hold them cheap 
May who ne’er hung there.

The symptoms started dizzying his put-together posture. He started vomiting in random bathroom stalls, sleepwalking through post-treatment supermarket aisles, retreating when guests arrived bearing kindness. He sweated and shook through the Lyme “die offs”—when the terminated spirochetes sear through a body before their final pirouette, drowning in antibiotics and expensive exotic herbs (Serrapeptase and Japanese knotweed, Nattokinase and Chinese skullcap). He let a woman affix magnets to the parts of his flesh pocked with pain. Desperate, he defied both his mainstream and maverick doctors, downing an admixture of doxycycline and rifampin with abandon, risking uninsured intravenous antibiotics and odd tinctures that could bust the cysts where Lyme bacteria hide, untouched by the medicines meant to oust them. Forcing the spirochetes into the bloodstream where he could eviscerate them, he greeted the ensuing tingling and terrifying chest pains as cherished victories in this weird new world. After he tucked his children into bed, Jekyll brought Hyde to life with a thrashing cycle of medicinals, “wandering the house like it was the Gothic mansion in my dreams.” 

Douthat grew “gaunt and strange,” deformed by an acidulous ache that convinced him “the invasion had literally displaced my normal consciousness, installing something despairing or rageful in its place . . . a nullity where the self should rightfully be.” Tempted by dualism, witnessing first-hand the body’s power over the mind, he found that “the mind is always carpaced by suffering flesh, like a balloon bobbing against a hard ceiling, free to move but not to soar away.” Tested, possibly even “chastised,” he opened his soul to others’ secret crosses, finding in radio studios and green rooms and chance encounters that “there was extraordinary suffering everywhere”; that not just the poor but the privileged too dealt with pains of untallied varieties—a truth he’d hidden from himself until Lyme initiated him into their number.

Before then, Douthat was a typical modern, believing that his buffered, bordered body had been taken out of the fearful, enchanted misconception that ruled the “porous self” of the past: whereas most of us experience illness as an external threat to a well-protected body, Lyme proves just how terribly permeable and vulnerable to invasion we are. It is, in this way, a microcosm of the coronavirus crisis that cowed even the most protected children of the modern world. Lyme’s persistently protean character can illumine our still-riddled grapplings with Covid-19, which is something like a “shattered mirror of the tick-borne epidemic and its controversies.” 

Intimately familiar with the medical establishment’s messy blend of amazing cures and career hubris, Douthat now hears the platitude “Trust the science” differently—as a deluded denial of the “reality that official science is filtered through fallible institutions, politicized processes, and bureaucratic incentives.” Disillusioned with “official narratives,” he is sympathetic with the paranoiacs who distrust the experts, even as he doesn’t “quite believe” their totalizing theories. If certain truths about Lyme disease can be found in the equivalent of internet dive bars for the brokenhearted, if the “weird shit” they and other maverick doctors recommended actually work, we desperately need a “synthesis between established medicine and its critics” if the countless chronically sick are to be salvaged from “the basement”—from, Douthat continues the metaphor, “underneath the basement” in that groping half-darkness that W.B. Yeats called the “rag and bone shop of the heart.” 

Except that the barely-containable Dionysian fallout does more than drum up a dithyrambic empathy for others. It does more than decimate the modern myth of medicine which led him to see chronic sickness as “some sort of ridiculous bureaucratic mistake.” Broken, dwelling underneath the basement, Douthat finds God “mucking around in the underground with broken things underfoot and strange machinery half-visible.” 

Though it pulsates with a tragic realism, The Deep Places is visited by Christian interventions that ransom miracles from the sometimes nightmare. Take the time he ducked into a church and uttered an Ave, asking for healing to an immediate answer of “head shaking, jaw chewing air, my legs kicking, a frantic urge to rub my hands all over my torso” before he hid on a staircase leading to the choir loft. Mary, it seemed, had answered his prayer by killing Lyme spirochetes right there, ushering in the herxheimer reaction that attends mass die-off. Then, ears buzzing and body itching, he listened as the lector began the day’s readings: “But stretch out your hand and touch his bone and his flesh, and he will curse you to your face.” Petered out in the back of the church, hearing of all things The Book of Job, he couldn’t help but “laugh out loud”—albeit with laughter loosened by tears. Sometimes when he begged the intercession of his patron saints and dead relatives he received the same healing reply—that blessed shaking and jerking and trembling that meant more Lyme had been given the death sentence.

Prior to his passport through “the country of suffering,” Douthat writes that his faith had been heady, “reasonable,” overly-intellectual. His approach to prayer had been “half-hearted.” So when the sickness struck he could not take refuge in habituated recollection; instead of retreating into the interior castle of his soul, he moaned with outbursts of “desperate begging.” And God did not hesitate to illumine his vision. Not settling for the more modest, pleasant prospect (that God is simply “testing” him, for instance), he raises the possibility that Lyme may actually be a “chastisement . . . my own hubris meeting its tiny crawling nemesis.” If this is the case, pain is not innately purposeless; yes, we must make a crucial distinction between arbitrary and redemptive suffering, but one of history’s great paradoxes merits meditation: the world of “mass infant mortality and rampaging disease . . . had more faith in God’s ultimate beneficence than the world of . . . effective pain management techniques” and longevity. Like an anachronistic citizen of that lost world, Douthat concludes that “it’s actually more mysterious that good things happen to good people than when bad things do, because if God gave His son to the cross, then a version of the same test is what every Christian should expect.” Seeing this numinous truth fulfilled in the death of two holy friends, he finds that “whatever story God is telling really does weigh down even the best human beings, or especially the best, with the heavy burden of a cross.”

When the poet finishes his dirge, says Kierkegaard, people flock around and ask him to “‘Sing again soon—that is ‘May new sufferings torment your soul but your lips be fashioned as before, for the cry would only frighten us, but the music is beautiful.’” Parts of The Deep Places are petrifying. But Douthat, whose final line is “And I am still alive,” is a lion-hearted fighter whose relentless, experimental onslaughts against the disease galvanize those of us who have grown weary of the next cure. Still, this memoir isn’t a recipe for the restoration of mere life. Visiting a hospice-bound, faithful friend, Douthat found not despair there but “a sense that she seemed to have already partially passed over, that she was looking at us, at our struggles, with an almost supernatural sympathy.” Douthat, however diminished, is still here, relishing the ordinary with a newfound abandon, fathering his daughters and pouring his life out for them. But one day death will come for him as (no news) it will for you and I, and, like his friend, we can either die without rancor, vestiges of grace on our faces, or whimper out with a last gasp, resentful despair. I swear this beautiful book will move to resolve that inescapable either / or with a deep and saving realism.

Joshua Hren is founder and editor of Wiseblood Books and co-founder of the Honors College at Belmont Abbey. He has published numerous essays and poems in such journals as First Things, Dappled Things, Evangelization & Culture, America, The University Bookman, and LOGOS. Joshua’s books include the story collections This Our Exile (Angelico 2018) and In the Wine Press (Angelico 2020), as well as How to Read (and Write) Like a Catholic (TAN 2021).