by Abraham Verghese, 1998
Tragic true story by the author of ‘Cutting for Stone.’ He tells about his move to El Paso, Texas, to teach internal medicine at Texas Tech. He meets David Smith, a medical student who was a former tennis pro. They develop a deep friendship via the tennis court. Abraham is an avid, obsessed tennis player. David is the perfect tennis partner. Their tennis matches are what keeps Abraham afloat during the unraveling of his marriage and his moving out of the home he shares with her and his precious 2 sons. Unfortunately, David is a recovering cocaine addict, an “IVDA,” (intravenous drug abuser) and he falls back into using twice and the second time is his undoing – he is holed out in a motel room and the police come knocking on the door (called by Abraham and Emily to get him into detox) but David takes his own life with a shotgun in the mouth. Tragic, dark, wasteland of drug abuse. Very scary.
Here are some of quotes I want to remember:
Around the room, the litany continued: alcohol, amphetamines, crack, Valium, Lomotil, Xanax. Codeine in many forms. Every specialty in medicine seemed to be represented, particularly anesthesia. Fentanyl and sufentanil (both very potent narcotics) seemed to be the favorite of the anesthesiologists and surgeons.
from the beginning of the book where he is describing an AA/NA type meeting at Talbott-Marsh clinic for addicted physicians.
At the time of this book, Abraham considered Bill Tilden the greatest player ever.
Here’s quotes about Angelina, an IVDA admitted to the hospital:
Angelina’s clinical illness was straightforward. She was an intravenous drug user. Pus had welled out from injection sites on her leg. She had aloud heart murmur, and the conjunctivae of both her eyes showed tiny red dots–emboli. A raised red lesion on the pulp of her middle finger–Osler’s node–was evident, together with “splinter” hemorrhages in the nail beds. Her spleen was enlarged. There was blood in her urine. These disparate clues, if viewed as true and related, were relatively simple to put together. She had endocarditis, an infection of the heart valves…
…”Okay, then I use diabetic syringes. None of this eyedropper shit you see on TV. And then,” she said, settling back on the pillow, “you find a vein and pop it in.”
…I gently drew back the sheets. This was a difficult moment for Angelina. As long as her legs were covered, she did not have to acknowledge them, she could play the vamp. But now Jezebel’s spell was broken. For beneath the sheets, her legs looked like the swollen trunks of two Mexican elder trees, her skin having undergone a hide-like thickening. The exterior was dry and flaky. Scattered over the surface were sores the size of quarters. Some were scabbed over, others were recessed scars with concentric rings of peeling skin around them. All semblance of a pretty calf or a shapely ankle was obliterated by a jelly-roll swelling. Her tiny feet emerged from a puffy collar.
describing Angelina’s symptoms, an IVDA who uses diabetic needles and shoots up in her legs
“And when the tennis was over, I was empty. I had no crutch, nothing to make me feel special. The world was gray and dull. When she offered me the needle, from the very first shot, I was hooked, it just seemed to fill the hole,” he said, putting his fist over his chest. “Right here.”
from page 126 in which David is telling Abraham how he came to be an IVDA
He also describes chest x-rays of ribs that show a difference between a man’s ribs and a woman’s: men have cup-shaped depressions, women have a prong at the end of each rib.
In this book, he describes many a tennis match in detail. Here’s him describing Borg:
It was Borg’s comeback attempt in 1991 in Monte Carlo, after a layoff of almost ten years. The thought of his return to tennis had excited me–his off-court life after retiring had been a disaster: leaving Marianna for Jannike Bjorling with whom he had a son; leaving her for Loredana Berte, a faded Italian singer best known for “Non Sono una Signora” (and indeed there was nothing ladylike about her); the stomach-pumping overdose/suicide episode in Milan; the terrible business deals.
Talking with an addict:
“It’s a magnet, always out there, pulling you in. I was clean six years one time and then, just like that,” he said, snapping his fingers, “I saw something orange on the ground…”
Near the end of the book:
“Within your secrets lies your sickness,” Dr. Talbott had said to me when I talked to him long after David’s death. If David never sustained a lasting recovery, it was because he never let go of his secret, there were some bars that never came down. His secret is still with him. He still walks alone.
I cannot help but believe that David’s aloneness, his addiction, was worse for being in the medical profession–and not just because of ease of access, or stress, or long hours, but because of the way our profession fosters loneliness.
This was an excellent but heart-breaking book. He met and lost the best tennis partner ever, a dream tennis partner. I know how hard they are to find and how wonderful they are once you find them, because of Wayne and his love of playing the game of tennis. The addiction destroyed David. So, so scary to me – that addiction.