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By Root 2204 0

was still 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 word vitamin had been coined and a few examples isolated in laboratories, but Feynman’s father, Melville, 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 wells of ignorance. The prevailing theory of the mind was less a science than a collection of literary conceits blended with the therapeutic palliative 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. Still, 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 Bacillus.” 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 full decade passed, while biologists (and Fleming himself) dreamed futilely of a magic antibacterial agent that would save millions of lives, before finally two researchers happened upon his paper, extracted penicillin, 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—killed 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, allowing tuberculosis to inspire his most famous novel, associated the ruin and inflammation of the tubercles with sin, with the Fall, with the creation of life itself from cool inorganic molecules—“that pathologically 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. Swelling 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.