My Not-So-Near-Death Experience

I am a hypochondriac. My medical degree offers me no immunity to this common ailment. My case is not a bad one, but I have it nonetheless. As a practicing oncologist for nearly 20 years before taking a generalist's job with the government, I empathized with my patients and became convinced regularly that I, too, had a malignant condition. Once I went so far as to walk into the reading room of my good friend, the local radiologist, and admit that I thought I might have male breast cancer, metastatic to bone, because I had discomfort in both the breast and the anterior knee. The knee films were negative, and the symptoms immediately resolved.

This time it was different. About a year ago, the fasciculations started. At first they were mainly in my calves and occurred after tennis or similar vigorous activity. At this stage, I passed them off as insignificant. But soon they began to spread, first up my legs, then into my torso and my arms, and finally to my face. Night and day, at rest and after exercise, they were there. Thirty seconds rarely elapsed without a twitch somewhere.

Oncologists don't often see amyotrophic lateral sclerosis (ALS), but the memories gleaned in medical school of twitching, bedridden patients with tracheostomies were still vivid. Incurable. Untreatable. Invariably fatal. I remembered those words and phrases, but I certainly did not recall reading of any recent positive developments. I became more than a bit frightened. Previously, my thoughts of impending death had never lasted for more than a few hours, but these persisted from days to weeks to months. I was able to function; I continued to see patients and dealt with them in a professional, competent, and caring manner. Between patients, however, my thoughts turned to my own body …