Reading The Deep Places, the new memoir from New York Times columnist Ross Douthat, I was reminded of a conversation I’d had with a friend back home in Connecticut. As I slugged one beer after another, my friend explained, for what felt like an hour, about the pitiless war between good and bad toxins constantly raging in every human body. He told me how the toxins spread, how they affected our health, and, crucially, how we could fight them. His weapon of choice in this conflict was the coffee enema, which, he helpfully informed me, was “super helpful with detoxing the liver and helping with the entire immune system, clearing yeast and parasites.” I told him I’d take his word for it.
Suggestion is an immensely powerful thing, and for the skeptic, it can explain nearly all of what Douthat relates over the brisk 200 pages of The Deep Places. You see, my friend and Douthat have something in common; they both fall into a category that does not officially exist: the chronic Lyme patient.
Most who receive a Lyme diagnosis take a round of antibiotics and return to full health within a month. Chronic Lyme is more difficult to pin down because, if it exists, it eludes blood tests and exhibits an extraordinary range of diffuse symptoms, some of which can last for years. Neither the Centers for Disease Control and Prevention nor the National Institutes of Health recognize the disease, though they acknowledge its prevalence well enough to classify it as something called “Post-Treatment Lyme Disease Syndrome.” Douthat, and others, believe their symptoms arise from a persistent lingering infection that is hard, if not impossible, to detect. Some doctors believe it’s psychosomatic, others that it is a runaway immune response to the original, cured Lyme infection. A few “maverick” doctors concur with Douthat and administer months to even years of antibiotics, which carry their own hazards.
Douthat is not the sort of person one typically associates with chronic Lyme. Growing up in rural Connecticut, I had heard of people who claimed to suffer from it, but they were typically eccentric townies and hippie types, the same people who might dabble in acupuncture and homeopathic medicine. Douthat, by contrast, is a believing Catholic and perhaps the most eminent conservative columnist in America.
The three principal characters in The Deep Places are Douthat, the land that spawned the alleged tick that bit him, and the swarming spirochetes — the bacterium Borrelia burgdorferi — that carry the Lyme pathogen. Douthat has a field day with the ensuing metaphors, drawing from them elegant, latticed truths about landscape, illness, and pain.
To trust what is ultimately his self-diagnosis, you must trust Douthat himself. This is not difficult. He writes with seemingly effortless grace, like a figure, forgive the cliche, from another era: an earnest striver, classically educated, almost gentlemanly, and utterly tragic. We find Douthat Job-like, staggering from ER visit to doctor’s appointment and back again, as his life unravels in the face of debilitating pain caused by an unexplained illness, begging a silent God for deliverance.
In this story, financial ruin follows bodily ruin; bounty is stalked by corruption. Douthat falls ill just as his family is moving from D.C. to Connecticut, having sold the row house that “appreciated absurdly” after the 2007-08 crash. Able to fulfill only his barest writing commitments, he hemorrhages wealth pursuing expensive new treatments and financing the endless necessary repairs to their 1790s farmhouse: “For the first time as an adult I had to ask my father for a gift of money.”
You almost wonder if the rural estate that pains him is not some literary device, a fitting albatross for a once-prosperous man on the brink. Despair and gallows humor mingle often:
The overgrown land around us […] was now a dark territory, a landscape of peril. I forbade the girls to play beyond a narrow strip of upper lawn. I fantasized about shooting the deer that loped, uncaring, across our pasture.
For those willing to believe, or cursed into believing, that they are sick, the internet offers confirmation of the diagnosis and endless suggestions for a cure. There is seemingly no limit to what Douthat will try: intravenous vitamin C, magnetization therapy, even an obscure frequency emitter known as a “Rife machine,” which claims to shake the bacteria apart, and which is most prominently associated with hucksters and pyramid schemes. Douthat believes it worked for him. This he piles atop heroic doses of antibiotics, some of which he procures from online pet stores.
We laugh with, not at, him in these moments because we have all experienced pain, confusion, and absurdity in our own lives. We cannot help but believe him, even as he forgives us for disbelieving, because he is always eminently trustworthy, constantly aware of just how crackpot the whole story sounds, even as he brings us further into it.
The book’s high action is the repeatedly described onset of the “Jarisch-Herxheimer reaction”: a phenomenon that attends the mass death of bacterial spirochetes in the blood, typically due to antibiotic treatment:
There was often an all-but-irresistible urge to move the affected portion of my body, to pinwheel my arms or stomp my feet, to tense and squeeze my stomach, to thrust my hips like a lewd automaton, or to rub furiously at whatever place the pain was burning.
Douthat is a desperate gymnast, executing high kicks by the interstate, hamboning and flapping to exorcise the demons that haunt him. He comes to crave the reaction because, he reasons, it means that he is infinitesimally closer to health. Nearly every medical practice that might cause the “Herxheimers,” however dubious, is legitimate, and so the only sin a character can commit in The Deep Places is to lack belief, or to doubt, not in Douthat’s pain, which is clearly very real, but in his chosen diagnosis.
Because of his facility with language, Douthat is impossible to distinguish from an extremely convinced, and convincing, hypochondriac. The Deep Places pits empathy against skepticism, making it not the perfect book about chronic Lyme but the only book that perfectly embodies the dilemma of the concerned nonsufferer. To walk away from this beautiful book denying its premise is tantamount to cruelty, but to accept its premise, that chronic Lyme exists and Douthat is only one of many sufferers, is an act of faith that lends credence to what is potentially false knowledge.
The Douthat we meet in The Deep Places is like a creature out of Henry James: gifted with language, cursed with pain, and plagued by the unseen and unseeable. He is advised numerous times to seek counseling for what is evidently, to his physicians, a mental breakdown. This book will prove incapable of swaying those already decided against chronic Lyme — most of the medical establishment — and so, Douthat’s journey back to quasi-health is legible mostly to those who already share in the core precepts of the chronic Lyme community.
But if you read this book without bias, you will come away believing that chronic Lyme is real, such are the skill and sensitivity of Douthat’s narration. He is, ironically, the least reliable narrator imaginable for this sort of tale and the only one that could have produced it in the first place.
The Deep Places is, at the very least, a mighty and deeply touching account of chronic illness and what it means to take in the world through eyes jaundiced by constant pain. Those who live with disease, tick-borne or not, will find the book deeply consoling, and those of us who haven’t misplaced what Douthat calls the “superpower” of good health can only count ourselves among the lucky.
Chronic Lyme, in the meantime, is still a figure on a dark landscape — a ghost in the wood.
Brendan Ruberry is a writer living in New York City.
