Джеймс Глик - Genius - The Life and Science of Richard Feynman

sense of paths in space-time seemed somehow cleaner—

more direct. There seemed something quaint now about the peculiarly constrained oscil ations of the post-ethereal field, the wavy inheritance of the 1920s.

The White Plague

Twentieth-century medicine was struggling for the scientific footing that physics began to achieve in the seventeenth century. Its practitioners wielded the authority granted to healers throughout human history; they spoke a specialized language and wore the mantle of professional schools and societies; but their knowledge was a pastiche of folk wisdom

and

quasi-scientific

fads.

Few

medical

researchers understood the rudiments of control ed statistical experimentation. Authorities argued for or against particular therapies roughly the way theologians argued for or against their theories, by employing a combination of personal experience, abstract reason, and aesthetic judgment. Mathematics played no role in a biologist’s education. The human body was stil largely a black box, its contents accessible only by means of the surgeon’s knife or the crepuscular outlines of the early X

rays. Researchers were stumbling toward the first rudimentary understanding of diet. The modern-sounding w o r d vitamin had been coined and a few examples isolated in laboratories, but Feynman’s father, Melvil e, having been diagnosed with chronic high blood pressure, was being slowly poisoned with an enriched, salty diet of eggs, milk, and cheese. Immunology and genetics were

nothing but wel s of ignorance. The prevailing theory of the mind was less a science than a col ection of literary conceits blended with the therapeutic pal iative of the confessional. Cancers, viruses, and diseases of the heart and brain resisted even the first glimmers of understanding.

They would continue to mock medical science throughout the century.

Yet medicine was within reach of its first planetwide triumphs against bacterial epidemics, with the twin weapons of vaccination and antibiotic drugs. The year Feynman entered graduate school, Jonas Salk became a medical doctor; his assault on polio was just a few years away. Stil , the habits of large clinical trials and statistical thinking had yet to become engrained in medical research.

Alexander Fleming had noticed the antibacterial effect of the mold Penicillium notatum a decade before and then failed to take what a later era would consider the obvious next steps. He published his observation in a paper titled

“A Medium for the Isolation of Pfeiffer’s Bacil us.” He tried rubbing his mold onto the open wounds of a few patients, with unclear results, but it never occurred to him to attempt a systematic study of its effects. A ful decade passed, while biologists (and Fleming himself) dreamed futilely of a magic antibacterial agent that would save mil ions of lives, before final y two researchers happened upon his paper, extracted penicil in, and in 1940 crossed the line separating anecdote from science: they injected it into four sick mice, leaving another four untreated. In the context of 1930s medical science the lost decade was hardly noteworthy. Fleming’s contemporaries did not deride him as a bungler. They hailed him as a hero and awarded him

the Nobel Prize.

Tuberculosis—consumption,

the

wasting

disease,

scrofula, phthisis, the white plague—kil ed more people at its prime, in more parts of the globe, than any other disease. To novelists and poets it carried a romantic aura.

It was a disease of pale aesthetes. It was a disease of rarefaction, of the body squandering itself. Its long, slow fevers gave the false impression of life intensified, the metabolism heightened, the processes of existence stimulated. Thomas Mann, al owing tuberculosis to inspire his most famous novel, associated the ruin and inflammation of the tubercles with sin, with the Fal , with the creation of life itself from cool inorganic molecules—“that pathological y luxuriant morbid growth, produced by the irritant of some unknown infiltration … an intoxication, a heightening and unlicensed accentuation of the physical state.” He wrote those words in 1924, when the Magic Mountain resort-style sanatoriums of Europe were already dinosaurs of the past. To American public-health authorities faced with the reality of the disease, even then tuberculosis was more simply a disease of the poor.

Tuberculosis had infected Arline Greenbaum’s lymphatic system, perhaps having been carried by unpasteurized milk. Swel ing reappeared in the lymph nodes on her neck and elsewhere, the lumps rubbery and painless. She suffered fevers and fatigue. But an accurate diagnosis remained beyond the abilities of her doctors. Arline did not strike them as the typical tuberculosis victim; she was not poor enough or young enough. Nor was lymphatic tuberculosis as common as tuberculosis that began in the lung (it was twenty to thirty times rarer). When they

abandoned the notion of typhoid fever and considered the other standard possibilities, they focused on cancerous outbreaks: lymphoma, lymphosarcoma, Hodgkin’s disease.

Feynman was back in the library at Princeton, reading everything he could find. One standard book listed the possibilities. First was local infection. This was out of the question because the swel ings were traveling too far.

Second was lymphatic tuberculosis. This was easy to diagnose, the book said. Then came the cancers, and these, he read to his horror, were almost invariably fatal.

For a moment he mocked himself for jumping to the most morbid possibility. Everyone who reads such catalogues must start thinking about death, he thought. He went off to the Fine Hal tea, where the conversation seemed unnatural y normal.

Those months in 1941 were a blur of visits to hospitals, symptoms appearing and fading, consultations with more and more doctors. He hovered on the outside, hearing most news secondhand through Arline’s parents. He and Arline promised each other that they would face whatever came, bravely and honestly. Arline insisted, as she had when less was at stake, that honesty was the bedrock of their love and that what she treasured in Richard was his eagerness to confront the truth, his unwil ingness to be embarrassed or evasive. She said she did not want euphemisms or pretense about her il ness. Few patients did, but the weight of medical practice opposed forthrightness in the face of terminal il ness. Honest bad news was considered antitherapeutic. Richard faced a dilemma, because the doctors were final y settling on a grim diagnosis of Hodgkin’s disease. There would be

periods of remission, they said, but the course of the il ness could not be reversed.

For Arline’s benefit they proposed a camouflage diagnosis of “glandular fever.” Richard refused to go along with it. He explained that he and Arline had a pact—no lies, not even white ones. How would he be able to face her with this biggest lie of al ?

His parents, Arline’s parents, and the doctors al urged him not to be so cruel as to tel a young woman she was dying. His sister, Joan, sobbing, told him he was stubborn and heartless. He broke down and bowed to tradition. In her room at Farmingdale Hospital, with her parents at her side, he confirmed that she had glandular fever. Meanwhile, he started carrying around a letter—a “goodbye love letter,”

as he cal ed it—that he planned to give her when she discovered the truth. He was sure she would never forgive the unforgivable lie.

He did not have long to wait. Soon after Arline returned home from the hospital she crept to the top of the stairs and overheard her mother weeping with a neighbor down in the kitchen. When she confronted Richard—his letter snug in his pocket—he told her the truth, handed her the letter, and asked her to marry him.