The Anatomy Lesson Read online

  Philip Roth

  THE ANATOMY LESSON

  1983

  The chief obstacle to correct diagnosis in painful conditions is the fact that the symptom is often felt at a distance from its source.

  —Textbook of Orthopaedic Medicine

  JAMES CYRIAX, M.D.

  > 1 <

  THE COLLAR

  WHEN he is sick, every man wants his mother; if she’s not around, other women must do. Zuckerman was making do with four other women. He’d never had so many women at one time, or so many doctors, or drunk so much vodka, or done so little work, or known despair of such wild proportions. Yet he didn’t seem to have a disease that anybody could take seriously. Only the pain—in his neck, arms, shoulders, pain that made it difficult to walk for more than a few city blocks or even to stand very long in one place. Just having a neck, arms, and shoulders was like carrying another person around. Ten minutes out getting the groceries and he had to hurry home and lie down. Nor could he bring back more than one light bagful per trip, and even then he had to hold it cradled up against his chest like somebody eighty years old. Holding the bag down at his side only worsened the pain. It was painful to bend over and make his bed. To stand at the stove was painful, holding nothing heavier than a spatula and waiting for an egg to fry. He couldn’t throw open a window, not one that required any strength. Consequently, it was the women who opened the windows for him: opened his windows, fried his egg, made his bed, shopped for his food, and effortlessly, manfully, toted home his bundles. One woman on her own could have done what was needed in an hour or two a day, but Zuckerman didn’t have one woman any longer. That was how he came to have four.

  To sit up in a chair and read he wore an orthopedic collar, a spongy lozenge in a white ribbed sleeve that he fastened around his neck to keep the cervical vertebrae aligned and to prevent him from turning his head unsupported. The support and the restriction of movement were supposed to diminish the hot tine of pain that ran from behind his right ear into his neck, then branched downward beneath the scapula like a menorah held bottom side up. Sometimes the collar helped, sometimes not. but just wearing it was as maddening as the pain itself. He couldn’t concentrate on anything other than himself in his collar. The text in hand was from his college days. The Oxford Book of Seventeenth Century Verse. Inside the front cover, above his name and the date inscribed in blue ink, was a single penciled notation in his 1949 script, a freshman apercu that read, “Metaphysical poets pass easily from trivial to sublime.” For the first time in twenty-four years he turned to the poems of George Herbert, He’d got the book down to read “The Collar,” hoping to find something there to help him wear his own. That was commonly believed to be a function of great literature: antidote to suffering through depiction of our common fate. As Zuckerman was learning, pain could make you awfully primitive if not counteracted by steady, regular doses of philosophical thinking. Maybe he could pick up some hints from Herbert.

  … Shall I be still in suit?

  Have I no harvest but a thorn

  To let me blood, and not restore

  What Ihave lost with cordiall fruit?

  Sure there was wine

  Before my sighs did drie it: there was corn

  Before my tears did drown it.

  Is the yeare only lost to me?

  Have I no bayes to crown it?

  No flowers, no garlands gay? all blasted?

  All wasted?

  … But as I rav’d and grew more fierce and wilde

  At every word

  Me thought I heard one calling. Childe: And I reply’d. My Lord.

  As best he could with his aching arm, he threw the volume across the room. Absolutely not! He refused to make of his collar, or of the affliction it was designed to assuage, a metaphor for anything grandiose. Metaphysical poets may pass easily from trivial to sublime, but on the strength of the experience of the past eighteen months, Zuckerman’s impression was of proceeding, if at all, in the opposite direction.

  Writing the last page of a book was as close as he’d ever come to sublimity, and that hadn’t happened in four years. He couldn’t remember when he’d written a readable page. Even while he was wearing the collar, the spasm in the upper trapezius and the aching soreness to either side of the dorsal spine made it difficult to type just the address on an envelope. When a Mount Sinai orthopedist had ascribed his troubles to twenty years of hammering away at a manual portable, he at once went off to buy an IBM Selectric II; however, when he tried at home to get to work, he found that he ached as much over the new, unfamiliar IBM keyboard as he had over the last of his little Olivettis. Just a glimpse of the Olivetti stowed away in its battered traveling case at the back of his bedroom closet and the depression came rolling in—the way Bojangles Robinson must have felt looking at his old dancing shoes. How simple, back when he was still healthy, to give it a shove and make room on his desk for his lunch or his notes or his reading or his mail. How he’d loved to push them around, those silent uncomplaining sparring partners—the pounding he’d been giving them since he was twenty! There when he paid his alimony and answered his fans, there to lay his head beside when overcome by the beauty or ugliness of what he’d just composed, there for every page of every draft of the four published novels, of the three buried alive—if Olivettis could talk, you’d get the novelist naked. While from the IBM prescribed by the first orthopedist, you’d get nothing—only the smug, puritanical, workmanlike hum telling of itself and all its virtues: I am a Correcting Selectric II. I never do anything wrong, Who this man is I have no idea. And from the look of things neither does he.

  Writing manually was no better. Even in the good old days, pushing his left hand across the paper, he looked like some brave determined soul learning to use an artificial limb. Nor were the results that easy to decipher. Writing by hand was the clumsiest thing he did. He danced the rumba better than he wrote by hand. He held the pen too tight. He clenched his teeth and made agonized faces. He stuck his elbow out from his side as though beginning the breast stroke, then hooked his hand down and around from his forearm so as to form the letters from above rather than below—the contortionist technique by which many a left-handed child had taught himself how not to smear his words as he proceeded across the page from left to right back in the era of the inkwell. A highly recommended osteopath had even concluded that the cause of Zuckerman’s problems was just this: the earnest left-handed schoolboy, straining to overcome the impediment of wet ink, who had begun microscopically to twist the writer’s spine off the vertical axis and screw it down cockeyed into his sacrum. His rib cage was askew. His clavicle was crooked. His left scapula winged out at its lower angle like a chicken’s. Even his humerus was too tightly packed into the shoulder capsule and inserted in the joint on the bias. Though to the untrained eye he might appear more or less symmetrical and decently proportioned, within he was as misshapen as Richard III. According to the osteopath, he’d been warping at a steady rate since he was seven. Began with his homework. Began with the first of his reports on life in New Jersey. “In 1666 Governor Carteret provided an interpreter for Robert Treat and also a guide up the Hackensack River to meet with a representative of Oraton, the aged chief of the Hackensacks. Robert Treat wanted Oraton to know that the white settlers wished only peace.” Began at ten with Newark’s Robert Treat and the euphonious elegance of interpreter and representative, ended with Newark’s Gilbert Carnovsky and the blunt monosyllables cock and cunt, Such was the Hackensack up which the writer had paddled, only to dock at the port of pain.

  When sitting upright at the typewriter became too painful, he tried leaning back in an easy chair and doing the best he could with his imperfect longhand. He had the collar to brace his neck, the firm, uncus
hioned, back of the upholstered chair to support his spine, and a piece of beaverboard, cut to his specifications, laid across the arms of the chair to serve as a portable desk for his composition books. His place was certainly quiet enough for total concentration. He’d had his big study windows double-glazed so that nobody’s television or phonograph would blare through from the building backing onto his brownstone apartment. and the ceiling had been soundproofed so he wouldn’t be disturbed by the scratching of his upstairs neighbor’s two Pekinese. The study was carpeted, a deep copper-brown wool, and the windows were hung to the floor with creamy velvet curtains. li was a cozy, quiet, book-lined room. He’d spent half his life sealed off in rooms just like it. Atop the small cabinet where he kept his vodka bottle and his glass were favorite old photographs in Plexiglas frames: his dead parents as newlyweds in his grandparents’ backyard; ex-wives blooming with health on Nantucket; his estranged brother leaving Cornell in 1957. a magna cum laude (and a tabula rasa) in a cap and gown. If during the day he spoke at all, it was only small talk to those pictures; otherwise, / enough silence even to satisfy Proust. He had silence, comfort. time, money, but composing in longhand set off a throbbing pain in his upper arm that in no time at all made him sick to his stomach. He kneaded the muscle with his right hand while he continued to write with the left. He tried not thinking about it. He pretended that it wasn’t his upper arm hurting but somebody else’s. He tried to outwit it by stopping and starting. Stopping long enough helped the pain but hurt the writing; by the tenth time he’d stopped he had nothing left to write, and with nothing to write, no reason to be. When he tore off the neck collar and threw himself to the floor, the ripping sound of the Velcro fastener coming undone could have been emitted by his guts. Every thought and feeling, ensnared by the selfness of pain.

  In a children’s furniture store on Fifty-seventh Street he had bought a soft red plastic-covered playmat that was permanently laid out in his study now, between his desk and his easy chair. When he could no longer bear sitting up, he stretched supine upon the playmat, his head supported by Roget’s Thesaurus. He’d come to conduct most of the business of his waking life on the playmat. From there, no longer laden with an upper torso or saddled with fifteen pounds of head, he made phone calls, received visitors, and followed Watergate on TV. Instead of his own spectacles, he wore a pair of prism glasses that enabled him to see at right angles. They were designed for the bedridden by a downtown optical firm to which he’d been referred by his physiotherapist. Through his prism glasses he followed our President’s chicanery—the dummy gestures, the satanic sweating, the screwy dazzling lies. He almost felt for him, the only other American he saw daily who seemed to be in as much trouble as he was. Flat out on the floor, Zuckerman could also see whichever of his women was seated upright on the sofa. What the woman in attendance saw were the rectangular opaque undersides of the protruding glasses and Zuckerman explaining Nixon to the ceiling.

  He tried from the playmat to dictate fiction to a secretary, but he hadn’t the fluency for it and sometimes went as long as an hour without a word to say. He couldn’t write without seeing the writing; though he could picture what the sentences pictured, he couldn’t picture the sentences unless he saw them unfold and fasten one to the other. The secretary was only twenty and, during the first few weeks particularly, got too easily caught up in his anguish. The sessions were torture for both of them, and generally ended with the secretary down on the playmat. Intercourse, fellatio, and cunnilingus Zuckerman could endure more or less without pain, provided he was supine and kept the thesaurus beneath his head for support. The thesaurus was just the right thickness to prevent the back of his skull failing below the line of his shoulders and setting off the pain in his neck. Its inside cover was inscribed “‘From Dad—You have my every confidence,” and dated “June 24, 1946.” A book to enrich his vocabulary upon graduation from grade school.

  To lie with him on the playmat came the four women. They were all the vibrant life he had: secretary-confidante-cook-housekeeper-companion—aside from the doses of Nixon’s suffering, they were the entertainment. On his back he felt like their whore, paying in sex for someone to bring him the milk and the paper. They told him their troubles and took off their clothes and lowered the orifices for Zuckerman to fill. Without a taxing vocation or a hopeful prognosis, he was theirs to do with as they wished; the more conspicuous his helplessness, the more forthright their desire. Then they ran. Washed up, downed a coffee, kneeled to kiss him goodbye, and ran off to disappear in real lives. Leaving Zuckerman on his back for whoever rang the belt next.

  Well and working, he’d never had time for liaisons like these, not even when he’d been tempted. Too many wives in too few years to allow for a consortium of mistresses. Marriage had been his bulwark against the tremendous distraction of women. He’d married for the order, the intimacy, the dependable comradery, for the routine and regularity of monogamous living; he’d married so as never to waste himself on another affair, or go crazy with boredom at another party, or wind up alone in the living room at night after a day alone in his study. To sit alone each night doing the reading that he required to concentrate himself for the next day’s solitary writing was too much even for Zuckerman’s single-mindedness, and so into the voluptuous austerity he had enticed a woman, one woman at a time, a quiet, thoughtful, serious, literate, self-sufficient woman who didn’t require to be taken places, who was content instead to sit after dinner and read in silence across from him and his book.

  Following each divorce, he discovered anew that unmarried a man had to take women places: out to restaurants, for walks in the park, to museums and the opera and the movies—not only had to go to the movies but afterwards had to discuss them. If they became lovers, there was the problem of getting away in the morning while his mind was still fresh for his work. Some women expected him to eat breakfast with them, even to talk to them over breakfast like other human beings. Sometimes they wanted to go back to bed. He wanted to go back to bed. It was certainly going to be more eventful in bed than back at the typewriter with the book. Much less frustrating too. You actually could complete what you set out to accomplish without ten false starts and sixteen drafts and ail that pacing around the room. So he dropped his guard—and the morning was shot.

  No such temptations with the wives, not as time went by.

  But pain had changed it all. Whoever spent the night was not only invited to breakfast but asked to stay on for lunch if she had the time (and if no one else was to turn up till dinner). He’d slip a wet washcloth and a bulging ice pack under his terry-cloth robe, and while the ice anesthetized his upper trapezius (and the orthopedic collar supported his neck), he’d lean back and listen in his red velvet chair. He’d had a fatal weakness for high-minded mates back when all he ever thought about was toiling away; excellent opportunity, immobilization, to sound out less predictably upright women than his three ex-wives. Maybe he’d learn something and maybe he wouldn’t, but at least they would help to distract him, and according to the rheumatologist at NYU, distraction, pursued by the patient with real persistence, could reduce even the worst pain to tolerable levels.

  The psychoanalyst whom he consulted took a contrary position: he wondered aloud if Zuckerman hadn’t given up fighting the illness to retain (with a fairly untroubled conscience) his “harem of Florence Nightingales.” Zuckerman so resented the crack he nearly walked out. Given up? What could he do that he hadn’t—what was left that he was unwilling to try? Since the pains had begun in earnest eighteen months before, he’d waited his tum in the offices of three orthopedists, two neurologists, a physiotherapist, a rheumatologist. a radiologist, an osteopath, a vitamin doctor, an acupuncturist, and now the analyst.

  The acupuncturist had stuck twelve needles into him on fifteen different occasions, a hundred and eighty needles in all, not one of which had done a thing. Zuckerman sat shirtless in one of the acupuncturist’s eight treatment cubicles, the needles hanging from him, and rea
ding The New York Times—sat obediently for fifteen minutes, then paid his twenty-five dollars and rode back uptown, jangling with pain each time the cab took a pothole. The vitamin doctor gave him a series of five vitamin B-12 shots. The osteopath yanked his rib cage upward, pulled his arms outward, and cracked his neck sharply to either side. The physiotherapist gave him hot packs, ultrasound, and massage. One orthopedist gave him “trigger-point” injections and told him to throw out the Olivetti and buy the IBM; the next, having informed Zuckerman that he was an author too, though not of “bestsellers,” examined him lying down and standing up and bending over, and, after Zuckerman had dressed, ushered him out of his office, announcing to his receptionist that he had no more time that week to waste on hypochondriacs. The third orthopedist prescribed a hot bath for twenty minutes every morning, after which Zuckerman was to perform a series of stretching exercises. The baths were pleasant enough—Zuckerman listened to Mahler through the open doorway—but the exercises, simple as they were, so exacerbated all his pains that within the week he rushed back to the first orthopedist, who gave him a second series of trigger-point injections that did no good. The radiologist X-rayed his chest, back, neck, cranium, shoulders, and arms. The first neurologist who saw the X-rays said he wished his own spine was in such good shape; the second prescribed hospitalization, two weeks of neck traction to alleviate pressure on a cervical disc—if not the worst experience of Zuckerman’s life, easily the most humbling. He didn’t even want to think about it, and generally there was nothing that happened to him, no matter how bad, that he didn’t want to think about. But he was stunned by his cowardice. Even the sedation, far from helping, made the powerlessness that much more frightening and oppressive. He knew he would go berserk from the moment they fastened the weights to the harness holding his head. On the eighth morning, though there was no one in the room to hear him, he began to shout from where he was pinned to the bed, “Let me up! Let me go!” and within fifteen minutes was back in his clothes and down at the cashier’s cage settling his bill. Only when he was safely out onto the street, hailing a cab, did he think, “And. What if something really terrible were happening to you? What then?” Jenny had come down from the country to help him through what was to have been the two weeks of traction. She made the round of the galleries and museums in the morning, then after lunch came to the hospital and read to him for two hours from The Magic Mountain. It had seemed the appropriate great tome for the occasion, but strapped inert upon his narrow bed, Zuckerman grew increasingly irritated by Hans Castorp and the dynamic opportunities for growth provided him by TB. Nor could life in New York Hospital’s room 61Ibe said to measure up to the deluxe splendors of a Swiss sanatorium before the First World War, not even at SI ,500 a week. “Sounds to me,” he told Jenny, “like a cross between the Salzburg Seminars and the stately old Queen Mary. Five great meals a day and then tedious lectures by European intellectuals, complete with erudite jests. All that philosophy. All that snow. Reminds me of the University of Chicago.”