CMDA's The Point

I’m a Slow Reader (Here’s Why), and Living on Borrowed Time

March 25, 2021
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by Amy Givler, MD

I’ve read novels ever since my youth, and I’ve had an enduring fascination with the side character of the rich elderly female relative who “took to bed” decades earlier. Even before I was a doctor I wondered, “What illness caused her to ‘take to bed’?” There are seldom enough clues to unlock the mystery of which exact medical diagnosis she had that kept her in her bedroom. Writers of novels one to two centuries ago didn’t focus on those clues. She was, after all, a side character.

My musings range from metabolic (thyroid disease, anemia, adrenal insufficiency), to neurological (multiple sclerosis, myasthenia gravis) to orthopedic (severe arthritis) to psychological (depression, secondary gain, or sheer orneriness). I thought a lot about those characters for the five years my hips ached before I finally underwent hip replacements. That was 10 years ago, and I assure you if orthopedic surgery had not been an option, I would have “took to bed” long ago. The last year before my surgeries, I couldn’t hobble across a room without tears coming to my eyes. The pain was intense.

One day after each of my hip surgeries, I had less pain than what I’d been living with for months. I now have zero pain. Every time I take a walk, I thank God for orthopedic surgery.

At age 62, I have benefitted from medical miracles in myriad ways, perhaps more than most folks. The most mundane is also the most impactful on my day-to-day life: Nasal steroids. Yes, nasal steroids keep my allergic rhinitis minimal. I remember using boxes of Kleenex—weekly—through my high school and college years. Now I can breathe through my nose (most of the time). With fewer allergic symptoms, I have fewer asthma attacks and sinus infections, though when those occur there are inhalers and antibiotics (more medical miracles!) to beat them back.

And when I stared death in the face, the year I was treated with eight months of chemotherapy for Hodgkin’s lymphoma (diagnosed at age 34 while 13 weeks pregnant), I often gave thanks to God that I was living in 1993 rather than 30 years earlier, when such a cancer was a death sentence. As it was, not only was my cancer eliminated, but our son John was born in the middle of those months of treatment. He graduates from medical school in a few months.

Beyond the fictional bedridden elderly relation, I also try to apply my diagnostic skills to the symptoms of writers who lived centuries ago. If I come up with a diagnosis, I think about what current treatments would have helped, and how I would have taken care of each issue had I been the doctor on the case.

The great systematic theologian John Calvin is a case in point. He had all sorts of ailments, which are summarized in this passage:

“From surviving documents and letters, we learn much about Calvin’s health and maladies. Because of his asceticism, it appears he was chronically malnourished, yet he survived the various epidemics that raged throughout Europe at that time, including the bubonic plague that had broken out in his city of birth in 1523. At other times he suffered from fevers, especially malaria. He was constantly overworked. During his life he wrote an enormous number of religious treatises, was always preaching, sometimes for more than an hour at a time and without notes. In Geneva he preached over two thousand sermons, once on weekdays and twice on Sundays.

“For most of his life he was made miserable by hemorrhoids. They often bled, causing him to be anemic and sapping his strength. At one stage he had kidney stones and infections, discharging purulent urine and suffering from painful renal colic. He also had painful gout, and sometimes had to preach sitting down. He was always constipated, took aloes ‘in an immoderate degree,’ and required frequent enemas. His spleen was enlarged. He had periodic facial pain, possibly trigeminal neuralgia. He suffered from heartburn and indigestion, roundworm infestation (Ascaris), migraines, nervous dyspepsia, chronic insomnia, and recurrent hemoptyses. At the age of fifty-five he died, probably from tuberculosis, although some authorities have considered subacute bacterial endocarditis.”

Reading that, I wish Calvin could time travel to my family practice clinic and become my patient. I’d have to look up how to treat bubonic plague, but malaria, hemorrhoids, anemia, kidney stones, UTI, gout, constipation, chronic pain, GERD, Ascaris, migraines and insomnia are all in my purview. It would probably take me more than one visit to address everything, though. And, of course, I’d be sending him to the public health clinic to manage his tuberculosis. I think I could have not only helped extend his life but made it more pain-free and pleasant as well.

Another quirk of mine while reading is to figure out how old people were when they died. That is, someone will quote, “Let me forget the world and be swallowed up in the desire to glorify God, (David Brainerd, 1718-1747)” and I will pause to do the subtraction and gasp, “He was only 29!” Then I want to know why he died, so I’ll look it up (it was tuberculosis), and only then do I get back to my reading. So now you know why I’m a slow reader.

Tuberculosis, now so treatable, has taken many deep thinkers at a young age over the centuries. Augustus Toplady, who wrote Rock of Ages, died of it in 1778 at age 38, and the poet Robert Burns was 37 when he died of tuberculosis in 1796. And, of course, Calvin. What would they have accomplished if they had lived longer?

I am acutely aware that I am alive today only because of modern medicine. Had I been born a half century earlier, my life would have ended 27 years ago. Even without the cancer, I’d have been hobbled by hip arthritis. Perhaps an infection would have taken me out even before my cancer, though, either one preventable (now) by a vaccine or one treatable with antibiotics.

My conclusion? I am living on borrowed time. Every minute counts. I’m alive—healthy, breathing through my nose and pain free—for a purpose.

Which makes me ask myself, “What am I accomplishing, since I have been given, through the blessings of modern medicine, this gift of time?”

About Amy Givler, MD

Amy Givler is a family physician in Monroe, Louisiana. She and her husband Don met in 1980 at a CMDA student event her first year of medical school, and they have both been active members of CMDA ever since. Amy graduated from Wellesley College and Georgetown University School of Medicine, and she then completed her family medicine residency at the same indigent-care hospital where she now works part time. She also works at an urgent-care clinic and is the medical director for a Shots for Tots clinic. Amy loves to write and has written many articles and one book, Hope in the Face of Cancer: A Survival Guide for the Journey You Did Not Choose. She and Don have a heart for missions, and hope to do more short-term trips now that their three children have launched from the nest.

2 Comments

  1. John Crouch on April 7, 2021 at 12:48 pm

    Really enjoyed this brief essay! I am a bit of a “slow reader” myself. And certainly not as thorough as you are, I am often given to speculation about the medical diagnoses in what I read. My sister was one of the early Kidney Transplant patients. In fact had two over a period of 25 years! Eventually died in part from Hepatitis C due to transfusions before that was tested. And even that is treatable now!

  2. R. Bowers on April 15, 2021 at 3:13 pm

    What about Rachel where a little oxytocin could have saved Jacob a lot of painful sorrow?

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