The Law of Similars

by Chris Bohjalian

  And so exactly how Carissa had formed her opinion--the way that she'd said it--would be a factor in what everyone thought. What was it she believed that she'd said?

  They're from the same plant family as your remedy.

  And then he'd said he was allergic to cashews.

  And she'd said she knew that. He'd told her.

  Then they had talked about what was in his remedy, the one that he'd taken already. That thing called Rhus tox.

  She'd explained to Richard it was poison ivy.

  At first, it seemed, he hadn't believed her. Had he really and truly eaten poison ivy? he'd asked. He was allergic to poison ivy, too, and not like most people were. He was really allergic to it!

  And she'd told him he had. Homeopathically, of course.

  But nothing happened to me! he had said. Astonished. Impressed.

  Of course not, she'd said.

  And then he'd asked what she meant by her remark that poison ivy and cashews were in the same family.

  She'd been in a hurry--shopping, after all, for her boyfriend, the prosecutor--but she recalled elaborating a bit. But just a bit. She'd said they were both in the Anacardiaceae family: Cashews and poison ivy, pistachio nuts and poison sumac. Mangoes. They all had resinous and sometimes poisonous juice, nuts or fleshy fruit, and small flowers.

  Like cures like, remember? The Law of Similars?

  And so he had asked what would have happened if she'd given him a small dose of cashews--and here, I decided, their exchange had the potential to get real muddy--and she'd answered, Nothing.

  Or, as precisely as she could recall, Probably nothing.

  She told me she had meant: It probably wouldn't cure you.

  She had not meant: Probably nothing will happen to you.

  But the thing was, if he had ingested cashews homeopathically--one part cashew, a million parts water--nothing would have happened, in all likelihood. After all, a dose that size probably would have been insufficient to cause an allergic reaction.

  What Richard had heard in her response, however--those simple words "probably nothing"--could mean everything. Perhaps he'd assumed she'd meant nothing would happen if he ingested them normally, as whole nuts--though still, of course, in what was in his mind just a small dose.

  He had, Carissa was quite sure, used those two words: Small. Dose.

  But what really constituted a small dose in his opinion? Was it what Jennifer, a veterinarian, would consider a small dose? Or what his homeopath would regard as one?

  Clearly they were very different. Jennifer told me she had once been treating a cat for diabetes and on the first day of therapy had given the animal the absolute minimal dose of insulin recommended: four units, or about an eighth of a syringe. And the cat's blood glucose level had plummeted from diabetic to normal to hypoglycemic within ninety minutes, faster than any of the vets in the practice had ever seen. Here they had barely begun to monitor the cat, and the animal was practically falling off a cliff to his death, and so an hour and a half after giving the cat insulin, they were actually giving him glucose to prevent fatal seizures.

  Eventually the cat would be getting a mere one unit of insulin a day: One quarter of the recommended dosage. About a thirtieth of a syringe. And the cat had responded.

  No, it was clear that no two individuals were likely to view a small dose in quite the same way.

  And for some people, a thirtieth of a syringe of certain homeopathic substances, undiluted--a small dose to some, a huge one to others--could be fatal.

  Nothing? Richard had asked her, trying to confirm what she'd said. Thinking, perhaps, that a cashew or two was a small dose.

  Nothing, she thought she might have repeated, shrugging.

  Really?

  She'd wanted to finish filling her own basket, she'd been in a hurry. She wasn't exactly irritated with Richard, but he had been phoning her off and on for almost two weeks, insisting that she give him another dose of his remedy. Whatever it was. Just a little bit more.

  And so she was growing tired of his questions. His persistence. His neediness.

  His demand for more medicine.

  Look, remember what I told you about Hahnemann and his provings? Well, pretend you're Hahnemann, and try some. Do the proving and record the results. We'll talk after Christmas.

  And then she had rolled her eyes to make it clear she was kidding. She was being sarcastic. Cashews, after all, had already gone through a proving. They already were a remedy. An obscure one, certainly--Anacardium occidentale, a cure in some cases for brain fog and hallucinations--yet a remedy nonetheless.

  But she hadn't said that. She had simply suggested the proving and moved on to the English muffins, while he had remained there by the nuts.

  Exchange over.

  Man's now in a coma.

  Was there more to it than that? Possibly. For all I knew, it really was a suicide attempt. Here Carissa and I had been sitting around her kitchen table, stewing about the likelihood that Richard Emmons had misunderstood what she'd said and mistaken cashews for his homeopathic cure, when it was possible he'd understood all along that cashews might be fatal for him, and been inspired by their conversation to choose them as his way out of this world. Agonizing. But creative.

  And the guy had asthma. I couldn't lose sight of that. Clearly that was a factor, too.

  Any way I looked at it, I decided, I had only a small part of the story.

  I put the cat down on the floor and went to the counter by Carissa's phone. People usually kept paper and pens by their phones. Indeed, right there beside the cordless receiver's cradle was a wicker basket of scrap paper--not unlike the basket outside her office door at the Octagon--and a promotional pen from some national homeopathic group. On a half sheet of paper I started writing a list of questions, scribbling the key words as they came to me. I had close to a dozen questions before the ideas even started to slow, and I realized I'd better phone my office to let them know I was alive and I'd be in later that morning. It was already past nine o'clock.

  When Carissa returned, her hair was still wet from her shower, but she'd managed to pull on a pair of khakis and a blouse and run something glossy and cheerful over her lips.

  "Any patients today?"

  "Uh-huh. But not till eleven."

  She dropped a handful of dry cat food into Sepia's bowl, and the animal raced out from under the kitchen table at the sound. She knelt by the cat, stroking the back of the animal's neck for a moment as she started to eat.

  "I assume you have malpractice insurance," I said.

  "I do. But as a psychologist."

  "Not as a homeopath?"

  "No. Few homeopaths do," she said, standing up. "They might as doctors, they might as dentists. They might as psychologists. But not, usually, as homeopaths. In theory, there isn't any need: The remedies can't hurt you."

  "You were treating Richard solely as a homeopath?"

  "That's right. That's why he came to me, so that's how I treated him."

  "Like me?"

  "Like you."

  "He came to you for asthma?"

  She nodded. "That was his chief complaint."

  "And Rhus tox is the cure for asthma?"

  "No."

  "No?"

  She shrugged. "Why would you think that?"

  "Oh, I don't know. Maybe because that's what ailed him."

  "You came to me for a cold; that was your chief complaint. A runny nose. A sore throat. Right?"

  "Right."

  "Well, if I'd decided that was indeed the problem, I wouldn't have prescribed arsenic."

  "But it worked!"

  "I understand. But if I'd wanted to simply treat your cold or your sore throat, I'd have given you something like aconite--"

  "Aconite?"

  "Wolfsbane. Or maybe Pulsatilla--a windflower. I wasn't treating your cold, Leland; I was treating your fear."

  "What was the Rhus tox...treating?"

  "Richard has a skin disorder that goes hand in
hand with his asthma," she said, opening a drawer in a cabinet beside the refrigerator. Then, as if I weren't in the room beside her, she reached inside for a dish towel and resumed drying her hair as she spoke. "It's not a horrendous disorder, but he thinks it is. In his mind, it's a profound disability--especially given the number of times every single week when he meets people for the very first time. It shows up mostly on his hands, and it makes him extremely self-conscious."

  When she was finished, she shook her head the way I imagined Sepia might if she'd just run inside from a cloudburst--vigorously, her hair a shampoo commercial in fast-forward--and then draped the towel over the sink.

  "Does it itch?"

  "Sure does."

  "And the Rhus tox treated it?" I asked.

  She nodded. "What he really wanted was his skin disease to go away. He might have been able to live with his asthma if he didn't have a kind of eczema that went with it. But Rhus tox wasn't simply the appropriate remedy because of Richard's skin complaints. It was also apt because of the joint pain he's had off and on this fall, and because of the type of person he is."

  "What's he like?"

  "I don't know, he's a patient. Our conversations are confidential."

  "And I don't want to violate that. I just want to know what kind of person he is."

  She took a deep breath and collapsed into a chair by the kitchen table. "He has his own little ad agency up in Burlington. I guess it's not so little--at least by Vermont standards. He probably has twenty or twenty-five employees."

  "Any partners?"

  "I don't think so."

  "Clients?"

  "The state lottery. A bank. A ski resort. A lot of business-to-business stuff."

  "Tell me about him."

  "Just how well do you think I know him?"

  I shrugged. "I guess about as well as you'd know me if we hadn't gone out to dinner last week."

  "Fine. Here's my sense of the man based on two appointments and some phone calls. He can be charming and funny and very fast on his feet. He can also be extremely self-absorbed."

  "Thoughtless?"

  "Not necessarily. Just self-absorbed. There's a difference. I think he's probably a very nice dad. A perfectly fine husband."

  "Is he smart?"

  "Certainly. He's smart and he's intense, and he's incredibly hard-working. Driven. He wants things now, and he's easily frustrated."

  "And he was frustrated with his skin thing and his asthma."

  "Yes."

  "But not, I assume, suicidally frustrated."

  "No."

  "Did you give him anything separate for his asthma?"

  "I know some homeopaths who'll administer a compound tincture or cure, but I'm not among them. I view myself as a pretty classical homeopath."

  "So you only gave him the Rhus tox."

  "Right."

  "In the form of little pills? Like my arsenic?"

  She nodded. "Four or five, I guess."

  "And it worked?"

  "It was working. His skin had cleared up completely."

  "And his asthma?"

  "It was under control."

  I glanced at the questions I'd written on the scrap piece of paper and considered not asking them. They might make it sound as if I doubted her. But someone was going to ask them at some point soon, and she might as well hear them from me.

  "I presume he's been seeing a regular doctor for his asthma."

  "Yes. I don't remember the guy's name, but it's at my office."

  "Asthma's one of those chronic things you keep under control with pills. At least that's what I've always thought."

  "Pills and inhalers. Most asthmatics use a combination of controllers and relievers--bronchodilators and inhaled steroids. Some are old-fashioned pills, and some are delivered by those little pumps that spray the medicine right into the lungs."

  "Prescription stuff?"

  "Uh-huh. Proventil. Vanceril. Theophylline. And that bothered Richard. He feared he was putting a pharmacy into his bloodstream."

  "Would that pharmacy affect the Rhus tox?"

  "Certainly it could," she said.

  "Dilute it?"

  "We use the term antidote. Were his regular drugs a possible antidote to his homeopathic cure? Yes. In theory they might have affected it. But when I gave Richard his remedy, I did not tell him to give up his regular asthma medications. And when we spoke on the phone a few days later, his skin had improved."

  "So his drugs weren't an issue."

  "They were an issue in his mind--not mine. It was one of the first things we..."

  "We what?" I asked when the pause had grown long.

  "I just shouldn't be telling you this, Leland. He's my patient. We have a relationship founded on trust."

  "You want to know whether you're in trouble, and I can't answer that if I don't know what happened."

  "Will other people ask me these questions?"

  "Probably."

  "Will I have to answer them, too?"

  "You'll have a lawyer."

  "It's that bad...."

  "I don't know."

  She sighed. Then: "One of the first things he told me was that he wanted to control his asthma without drugs. But that's not unusual. Half the asthmatics I see want to give up their drugs."

  "Why? Dependency?"

  "Dependency's part of it. But have you ever read the warnings that come with most asthma medicines?"

  "Nasty stuff?"

  "Not really, but they sound nasty--inhaled steroids, theophylline--and that's the point. They sound scary."

  "And homeopathy can help an asthmatic give them up?"

  "Sometimes. I can think of two asthmatics off the top of my head who I helped wean from their drugs."

  "What did you tell Richard?"

  "I told him we'd see what happened."

  "So you weren't concerned that his conventional medicines were preventing the Rhus tox from working?"

  "It was something we talked about. If you must know, it's something we talked about a lot, because Richard kept bringing it up. But they didn't seem to be affecting his remedy."

  I scanned my questions once more, and for a split second I had the sensation I was in Courtroom 3A. It was the way I was standing, the notes in my hand, the sense that my questioning was supposed to be going somewhere. Quickly I leaned against the sink--slouching intentionally--to help push the image from my mind.

  "How did he seem the other night at the store?" I asked.

  "He seemed fine."

  "Healthy?"

  "Yes."

  "Then why did he feel a need for the cashews?"

  "I don't understand what you mean."

  "If he was fine...if he was...healthy, then why did he try to medicate himself with the cashews?"

  She stared at me for a long moment, then reached behind her for the large shoulder bag hanging behind the kitchen door and pulled out her wooden hairbrush. I could see she wasn't happy with my question, but before I could open my mouth to apologize or explain, she said, "I'm a homeopath. I'm not a mind-reader."

  "I understand."

  She started brushing her hair almost angrily. "What are you suggesting?"

  "I'm not suggesting a thing. I just want to know why he was trying to medicate himself if he wasn't sick."

  "I didn't give him a complete physical in the health-food store Christmas Eve. But he didn't seem to be sick."

  "There were no lesions on his hands?"

  "I didn't notice any."

  "And his breathing was okay?"

  "Yes. Earlier in the week he'd said his chest felt a little tight, but he seemed perfectly fine that night."

  "Was he short of breath?"

  "No!"

  "Don't be mad--"

  "How can I not be mad? All of a sudden you're treating me like a criminal!"

  "I'm trying to understand what this looks like to--"

  "A state's attorney! That's what you're doing. You're interrogating me! Why don't you just arres
t me? We'll go to Burlington together, and you can indict me or arraign me or whatever it is you do with people you're arresting!"