Freddie deBoer’s review of Ross Douthat’s The Deep Places, a memoir of Douthat’s illness, is impressively balanced and justified (I say justified because the definition of balance has shifted from what I can tell from “reasonable opposition” to “any opposition” as if every view holds equal merit. No doubt a side effect of “democratization” of distribution. Look, just because there are a few ghouls who deny the Holocaust or rationalize slavery doesn’t mean the school library should grant them shelf space).
deBoer’s praise of the book is as profound as the experience he had reading it. Yet his well-founded criticisms are never watered down. It’s hard to imagine a reviewer who found so many problems with the narrative taking the effort to extol, with equal sincerity, its virtue. The review is a lesson in seeing and communicating. The nuance stands in such relief to the binary discourses that at this point have left us haggard at best but more likely numb. Reading this review left me feeling that integrity was a fringe value, because it was jarring to see a sweaty writer say “good game” and actually mean it.
You can read the full review here.
My highlights are below (boldface is mine).
The nature of the internet
In the internet era, likeminded people will find each other, including those that are suffering from ailments the conventional medical system can’t treat or even define. It’s therefore no surprise that since the whole world went online the number of people claiming to suffer from disputed diseases with shifting symptoms and complex etiologies has risen dramatically. All of those people, I have no doubt, are in some kind of pain, and we are compelled by decency and shared humanity to confront that pain. But it’s also true that the internet creates conspiracists, it heightens distrust of institutions, it magnifies paranoia. On the internet, no matter how fanciful your sneaking suspicions might be, no matter how disordered and unhealthy, someone will emerge from the digital fog and whisper to you that all of it is real. From this stems gangstalking, stems QAnon, stems people who think they’re getting sick from 5G. It’s a problem from hell and one I don’t know how to fix.
When one group of people in society feels unheard for so long, in time they form a crusade, and the object of that crusade is the most human of all demands: feel our pain. It is natural to want the world to understand our suffering as something different, something deeper, something special. The cacophony of our political lives stems in no small part from the ceaselessly multiplying number of groups that ask that their suffering be seen as something transcendent and unique. The trouble, of course, is that we’re all suffering, and in fact to suffer is the least special, most ordinary thing any person can do.
Why Douthat is an interesting narrator to this story:
I have also known a fair number of people who claimed to suffer from chronic Lyme, and they have all been… crunchy. The diagnosis and its inherent antagonism to the medical establishment fit very well into a kind of bourgie hippie boomer counterculture. Chronic Lyme advocates insist that all manner of people believe they suffer from the disease, and I have no reason to doubt them. But it’s also the case that there is a decided cultural slant to their community, and I associate it more with the world of acupuncture and reiki than dissident conservatives.
And yet Douthat proves himself to be the right guide, I think precisely because he’s likely never paid money to have his chakras aligned. He so clearly does not want the answer to be found in the types of medicine that are so often superficially ridiculous, but has been moved to by unrelenting illness, and the consequence is that he is open-minded but never credulous.* 2. Douthat seems to attract more progressive ire, I suppose precisely because he refuses to occupy the stereotype of the snarling right-winger. (I can tell you from long experience that there are many people whose first demand is not left-wing politics or right-wing politics but political comprehensibility, for everyone to dutifully sort into teams.) On balance I can think of few writers who have paid more of a price for being thoughtful than Douthat. His recent book The Decadent Society is an often compelling, occasionally meandering collection of complaints that I can imagine emerging from no other writer.
Why deBoer’s affection for the book does not relieve him from his critical duty
What we have in The Deep Places, I think, is the most compelling and moving version of a bad argument; it provoked my admiration again and again even while I shook my head in concern on every page.
I also take Ross Douthat seriously, and to take an author seriously is to subject their books to real critical evaluation, which means that I can’t simply enjoy the elements I liked and ignore those I didn’t. A less fair reason for my critical sympathy is that I suspect The Deep Places may well become a new bible for the chronic Lyme movement. And if so, like all bibles this one will find its considerable nuance and restraint drained from it as it becomes a holy object to a group of people who, whatever the truth of their medical conditions, are looking for someone to tell them that the world has been uniquely hard on them.
The author is excused for loading the dice. But the book is not.
Skepticism towards a particularly story about the origins of pain is not the same as skepticism towards the pain itself.
Setting aside its unjustifiable placement in scare quotes, the use of the word hypochondriac is notable here because, though I have not counted, the word cannot have appeared in the text more than a handful of times. I don’t believe the term Munchausen appears at all. But these are real, documented, prevalent conditions that have serious negative consequences for our overtaxed healthcare system. I spent the entire book wondering when Douthat would confront those conditions directly and with research, rather than expressed as his fleeting fears about the legitimacy of his own feelings. But it never arrived, and if there is one part of this book that I would name a serious flaw, it’s that.
The chronic Lyme community, as sympathetic as I find them, makes difficult demands of the rest of us, including surrendering empirical rigor in the field where it is most essential… I have tried to separate my skepticism towards the illness from my impressions of the book, but I haven’t been able to. I am left with a long record of pain, a man who has responded to that pain in profoundly human and sympathetic ways, and a mess, a terrible mess of illness and medicine and science and conspiracism, and at its core a tangle of bodies and the people who no longer recognize them. And a book I do not know how to evaluate.
deBoer’s logic at work
But I am compelled to point out that, again and again, Douthat shares something that would seem to point firmly against his working theory of his suffering and yet seems not to notice. He references Pamela Weintraub’s Cure Unknown, another chronic Lyme memoir, and notes that “her family of four were all infected in the same yard, the same woods, the same neighborhood – and yet she, her husband, and their two sons followed completely variable paths toward recovery.” Douthat mentions this uncritically and takes it as evidence for the mysterious nature of Lyme. I, on the other hand, hear such a thing and think that a disease that supposedly springs from the same infection by the same bacterium carried by the same parasite in the same geography and yet results in totally dissonant outcomes for treatment and recovery is not one disease in any conventional sense. At times I wanted to say to some imaginary listener, “Isn’t an illness that can seem to have any symptoms imaginable at any given time a little hard to believe?”
At one point, Douthat recalls that his wife asked a skeptical doctor if Lyme’s prevalence in the region meant it was an unsafe place to raise children. I am trying to summon all of my charity here: this is a little much. It’s hard to entertain the notion that a disease that is serious but treatable, and a potential variant that is incredibly rare if it exists at all, poses such a serious threat to children that it might make the 70,000 square miles that constitute New England an irresponsible place to raise a family. Such questions emerged from a harried and exhausted family that had been brought to its breaking point, and I have no desire to mock the sentiment, at all. But the question also has appeared now in an important work of nonfiction by a prominent and successful writer, and it is my responsibility to point out that it is this type of excess that has done so much to discredit chronic Lyme advocates. I recognize that this aside is meant, in part, to demonstrate the degree to which fear of Lyme had crept into their lives. But Douthat clearly saw it as a sensible question, describing the doctor’s response, “he looked at her as if the question had never even occurred to him.” Well, yes, I imagine he would. Skin cancer kills 15,000 people a year. The incidence of skin cancer is significantly higher in regions with a higher UV index. Yet no one has declared the Southwest an irresponsible place in which to raise children. The doctor was surprised by the question because it was not a sensible one.
Well, Occam’s razor can be a cold thing, and it is far from an infallible guide. But I must invoke it here: can it possibly be the most direct, most parsimonious explanation that a disease runs rampant among some of the most affluent and well-connected people in the country, and yet for reasons that remain inscrutable to me, the medical establishment has conspired to belittle and ignore them? Medical researchers live to discover new diseases and doctors flourish professionally when they treat them. So why the conspiracy? For what purpose? Who profits? Both because of the incentives of malpractice law and the fact that more treatment means more money, our doctors tend to over treat, over diagnose. But the chronic Lyme narrative requires us to believe that doctors refuse to take it seriously, despite such suffering… for what?
deBoer’s undiluted praise
But boy, it’s beautifully rendered. Thus my dilemma, as a reviewer. Despite how harsh the above might sound, I experienced this book as a brave and brilliantly-realized cry of pain and loss, and that’s worth the purchase price itself.
It’s autumn, as I write this. Like any good stereotypical white dude from New England, fall is my favorite season. Pretentiously I tell myself that it’s because fall is the beginning of an ancient ritual of death and rebirth, because it helps me access the most visceral elements of human life, because it helps me imagine that everything I loved that has died will sometime return, flowering and green. More accurately I love fall because the weather is pleasant and the leaves are pretty and football is the only sport I really follow anymore. But either way, fall is my time of ritual. In fall I read old books by dead writers who were unafraid to sift through the silt of mundane experience to find those things that survive the cruel and steady passage of time. I drink dark beer and let pot roast braise for hours on the stove. I curl up into myself.
The Deep Places is a book for fall; I wandered today through Prospect Park and saw stubborn leaves at last beginning to change, and I thought about old gods and Christ’s love and chronic Lyme and those families that suffer from it, whatever “it” really is. The book’s manner is as spartan and tangled as the denuded trees that grace its cover. Douthat walks a narrow line, depicting a story that must by its nature invite sympathy without appearing to seek it, and he achieves this beautifully. He writes about pain, famously hard to put into words, with clarity and poise. The book is one of those rare few that tread in mourning without the constant reassurance of a happy ending soon to come. And its palette is somber and rich.
I am one of those untrustworthy types who looks for craft first in anything I read, and I respect degree of difficulty. Writing about suffering is not easy, putting yourself out there so nakedly to a public that seems crueler by the day is not easy, and wandering through such a tangled story of the heart is not easy. For that reason alone, I commend The Deep Places.*
- Writing on suffering:
But the moral imagination does not have limits. Our capacity for compassion cannot be overtaxed. What’s immensely clear in The Deep Places, and rendered beautifully, is that Ross Douthat has suffered, terribly, and his suffering has seeped out into his family and his home and his work. As so many have, he has been forced to deal with frequently uncaring doctors and a Byzantine and cruel medical system when he was least equipped to deal with them. He has seen people close to him express doubts about his sanity, he has questioned whether he will be well enough to continue his career, he has worried ceaselessly about leaving his family fatherless or, worse, of being a permanent burden on them. All of that deserves not just sympathy but understanding, adult and rigorous and friendly and honest understanding. For that reason, above all else, I’m glad that The Deep Places exists and I’m glad to have read it.
The late Ram Dass once wrote to grieving parents, “something in you dies when you bear the unbearable, and it is only in that dark night of the soul that you are prepared to see as God sees, and to love as God loves.” I do not know what it’s like to love as God loves. But I do know what it’s like to suffer, and then to suffer more, and at last to feel something die inside me. The note of uplift at the end of The Deep Places, uncertain but real, is a record of Douthat’s willingness to let that something die inside of him too, in order to move on. That’s a thing of beauty, and though it’s difficult that Douthat cannot declare himself healthy at the end, it’s the kind of difficulty that should be faced by any adult. In that, his book triumphs.