Re-Release: The Uncertain World of Chronic Lyme with Ross Douthat
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What is the premise of the Uncertainty in Medicine series and why is Ross Douthat’s story relevant?
Hey, Nocturnist listeners. We're super excited to be launching our Uncertainty series next week, and we've got some incredible stories, conversations, and reflections coming your way. But before we dive in, we wanted to share an episode that really sets the stage. It's one of our all-time favorites, and Uncertainty is at the heart of it. In this conversation, we talk with New York Times columnist Ross Douthat, who takes us through his experience navigating the healthcare system while dealing with a mysterious illness, chronic Lyme disease. It's a story that lives in the gray areas, diagnostic ambiguity, medical disagreement, and the emotional toll of feeling unseen by the system. Sound familiar? These are the exact types of themes that we'll be digging into in our upcoming series.
So take a listen, enjoy, and get ready for Uncertainty in Medicine, coming next week.
Medicine likes certainty. Diseases we can see and test for and treat. But what do we do when we can't see? When we can't help? Do we keep searching or do we look away? You're listening to the Nocturnist Conversations. I'm Emily Silverman. Today, I speak with Ross Douthit about his new book, The Deep Places, a memoir of illness and discovery. Ross has been an op-ed columnist for The New York Times since 2009 and previously was a senior editor at The Atlantic. He's the author of The Decadent Society, To Change the Church, Bad Religion, and Privilege, and a co-author with Rian Salam of Grand New Party. He's the film critic for The National Review and lives with his wife and four children in New Haven, Connecticut.
Before I spoke with Ross, I asked him to read an excerpt from his book. Here's Ross.
It was another rainy morning. I awoke with a stiff neck and went to the bathroom to find a red swelling, a painful lymph node six inches down from my left ear. I came out and sat on the bed, rubbing my neck and googling swollen lymph node on my phone. My wife came in, behind me, her voice unusual. Ross. She was holding a pregnancy test, the telltale strip faint but clear. Our third child. It should have been another signifier that we were on the right path, on the upswing. More kids, more life, more abundance. But after I fist pumped and we embraced, after I said all the right excited things, after I went out into the rain to take our daughters to their nursery school in pre-K, my mind and fingers kept circling back to the discomfort on my neck.
I had seen a dermatologist for a wart the previous year, but he didn't have an appointment available for a week, and I was impatient. I wanted the problem, however small, explained and resolved so that we could get back to basking in our triumphs. So instead of waiting to see him, I went that day to the urban walk-in clinic in the heart of Capitol Hill, walking through our dense neighbourhood with its pocket parks and carefully controlled daubs of natural green, and let a young internist take a look. It's just a boil, he said, after a cursory inspection. Nothing to worry about. He gave me a script for a few days of a mild antibiotic and sent me on my way. Nothing to worry about was exactly what I wanted to hear.
The next two weeks were less soothing. While we did paperwork and drove to Connecticut and back again, my neck began to feel intermittently stiff and painful, and I developed what felt like a vibration in my head. Still, the original swelling shrank and disappeared, and I told myself that the strange feelings, the tension and the almost tremor, were probably stress-induced, just all the life changes piling atop one another and giving me the jitters. Something like that had happened six years earlier, when we were first married and I was commuting back and forth from Washington to Baltimore. There had been a period of odd headaches, pain in my neck and back, that after a few inconclusive doctor's visits had simply vanished, unexplained but attributed shruggingly to the stress of my new life and the commute.
Now it was early June, and I was supposed to join a journalist's trip to Rome.
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Chapters
8 chapters
1
What is the premise of the Uncertainty in Medicine series and why is Ross Douthat’s story relevant?
0:00–5:38
2
How did Ross first notice the swelling in his neck and what was his initial reaction?
5:38–11:39
3
Why did early doctors dismiss his symptoms and what impact did that have on his search for answers?
11:39–18:09
4
Who are the “Reassurer,” “Maverick,” and “Grinder” doctors and how did each influence his treatment path?
18:09–24:18
5
What is the Herxheimer reaction and how did it shape Ross’s experiments with antibiotics and alternative therapies?
24:18–31:09
6
How do gender bias and patient advocacy affect the experience of chronic Lyme sufferers?
31:09–38:06
7
What research designs does Ross propose to better understand and treat chronic Lyme disease?
38:06–45:12
8
What final advice does Ross give to healthcare workers and patients dealing with chronic, uncertain illnesses?
45:12–50:43