Freireich was eighty-four years old when we talked. But it would be a mistake to call this an age-related memory lapse. Jay Freireich does not have memory lapses. I interviewed him for the first time one spring and then again six months later, and again after that, and every time, he would recall dates and names and facts with clocklike precision, and if he went over the same ground as he had on some previous occasion, he would stop himself and say, “I know I said this to you before.” He could not retrieve the name of the woman who raised him because everything from those years was so painful that it had been pushed to the furthest recesses of his mind.
2.
In the years leading up to the Second World War, the British government was worried. If, in the event of war, the German Air Force launched a major air offensive against London, the British military command believed that there was nothing they could do to stop it. Basil Liddell Hart, one of the foremost military theorists of the day, estimated that in the first week of any German attack, London could see a quarter of a million civilian deaths and injuries. Winston Churchill described London as “the greatest target in the world, a kind of tremendous, fat, valuable cow, tied up to attract the beast of prey.” He predicted that the city would be so helpless in the face of attack that between three and four million Londoners would flee to the countryside. In 1937, on the eve of the war, the British military command issued a report with the direst prediction of all: a sustained German bombing attack would leave six hundred thousand dead and 1.2 million wounded and create mass panic in the streets. People would refuse to go to work. Industrial production would grind to a halt. The army would be useless against the Germans because it would be preoccupied with keeping order among the millions of panicked civilians. The country’s planners briefly considered building a massive network of underground bomb shelters across London, but they abandoned the plan out of a fear that if they did, the people who took refuge there would never come out. They set up several psychiatric hospitals just outside the city limits to handle what they expected would be a flood of psychological casualties. “There is every chance,” the report stated, “that this could cost us the war.”
In the fall of 1940, the long-anticipated attack began. Over a period of eight months—beginning with fifty-seven consecutive nights of devastating bombardment—German bombers thundered across the skies above London, dropping tens of thousands of high-explosive bombs and more than a million incendiary devices. Forty thousand people were killed, and another forty-six thousand were injured. A million buildings were damaged or destroyed. In the city’s East End, entire neighborhoods were laid waste. It was everything the British government officials had feared—except that every one of their predictions about how Londoners would react turned out to be wrong.
The panic never came. The psychiatric hospitals built on the outskirts of London were switched over to military use because no one showed up. Many women and children were evacuated to the countryside as the bombing started. But people who needed to stay in the city by and large stayed. As the Blitz continued, as the German assaults grew heavier and heavier, the British authorities began to observe—to their astonishment—not just courage in the face of the bombing but something closer to indifference. “In October 1940 I had occasion to drive through South-East London just after a series of attacks on that district,” one English psychiatrist wrote just after the war ended:
Every hundred yards or so, it seemed, there was a bomb crater or wreckage of what had once been a house or shop. The siren blew its warning and I looked to see what would happen. A nun seized the hand of a child she was escorting and hurried on. She and I seemed to be the only ones who had heard the warning. Small boys continued to play all over the pavements, shoppers went on haggling, a policeman directed traffic in majestic boredom and the bicyclists defied death and the traffic laws. No one, so far as I could see, even looked into the sky.
I think you’ll agree this is hard to believe. The Blitz was war. The exploding bombs sent deadly shrapnel flying in every direction. The incendiaries left a different neighborhood in flames every night. More than a million people lost their homes. Thousands crammed into makeshift shelters in subway stations every night. Outside, between the thunder of planes overhead, the thud of explosions, the rattle of anti-aircraft guns, and the endless wails of ambulances, fire engines, and warning sirens, the noise was unrelenting. In one survey of Londoners, on the night of September 12, 1940, a third said that they had gotten no sleep the night before, and another third said they got fewer than four hours. Can you imagine how New Yorkers would have reacted if one of their office towers had been reduced to rubble not just once but every night for two and a half months?
The typical explanation for the reaction of Londoners is the British “stiff upper lip”—the stoicism said to be inherent in the English character. (Not surprisingly, this is the explanation most favored by the British themselves.) But one of the things that soon became clear was that it wasn’t just the British who behaved this way. Civilians from other countries also turned out to be unexpectedly resilient in the face of bombing. Bombing, it became clear, didn’t have the effect that everyone had thought it would have. It wasn’t until the end of the war that the puzzle was solved by the Canadian psychiatrist J. T. MacCurdy, in a book called The Structure of Morale.
MacCurdy argued that when a bomb falls, it divides the affected population into three groups. The first group is the people killed. They are the ones for whom the experience of the bombing is—obviously—the most devastating. But as MacCurdy pointed out (perhaps a bit callously), “the morale of the community depends on the reaction of the survivors, so from that point of view, the killed do not matter. Put this way the fact is obvious, corpses do not run about spreading panic.”
The next group he called the near misses:
They feel the blast, they see the destruction, are horrified by the carnage, perhaps they are wounded, but they survive deeply impressed. “Impression” means, here, a powerful reinforcement of the fear reaction in association with bombing. It may result in “shock,” a loose term that covers anything from a dazed state or actual stupor to jumpiness and preoccupation with the horrors that have been witnessed.
Third, he said, are the remote misses. These are the people who listen to the sirens, watch the enemy bombers overhead, and hear the thunder of the exploding bombs. But the bomb hits down the street or the next block over. And for them, the consequences of a bombing attack are exactly the opposite of the near-miss group. They survived, and the second or third time that happens, the emotion associated with the attack, MacCurdy wrote, “is a feeling of excitement with a flavour of invulnerability.” A near miss leaves you traumatized. A remote miss makes you think you are invincible.
In diaries and recollections of Londoners who lived through the Blitz, there are countless examples of this phenomenon. Here is one:
When the first siren sounded I took my children to our dug-out in the garden and I was quite certain we were all going to be killed. Then the all-clear went without anything having happened. Ever since we came out of the dug-out I have felt sure nothing would ever hurt us.
Or consider this, from the diary of a young woman whose house was shaken by a nearby explosion:
I lay there feeling indescribably happy and triumphant. “I’ve been bombed!” I kept on saying to myself, over and over again—trying the phrase on, like a new dress, to see how it fitted. “I’ve been bombed!…I’ve been bombed—me!”
It seems a terrible thing to say, when many people were killed and injured last night; but never in my whole life have I ever experienced such pure and flawless happiness.
So why were Londoners so unfazed by the Blitz? Because forty thousand deaths and forty-six thousand injuries—spread across a metropolitan area of more than eight million people—means that there were many more remote misses who were emboldened by the experience of being bombed than there were near misses who were traumatized by it.
“We are all o
f us not merely liable to fear,” MacCurdy went on.
We are also prone to be afraid of being afraid, and the conquering of fear produces exhilaration.…When we have been afraid that we may panic in an air-raid, and, when it has happened, we have exhibited to others nothing but a calm exterior and we are now safe, the contrast between the previous apprehension and the present relief and feeling of security promotes a self-confidence that is the very father and mother of courage.
In the midst of the Blitz, a middle-aged laborer in a button-factory was asked if he wanted to be evacuated to the countryside. He had been bombed out of his house twice. But each time he and his wife had been fine. He refused.
“What, and miss all this?” he exclaimed. “Not for all the gold in China! There’s never been nothing like it! Never! And never will be again.”
3.
The idea of desirable difficulty suggests that not all difficulties are negative. Being a poor reader is a real obstacle, unless you are David Boies and that obstacle turns you into an extraordinary listener, or unless you are Gary Cohn and that obstacle gives you the courage to take chances you would never otherwise have taken.
MacCurdy’s theory of morale is a second, broader perspective on this same idea. The reason Winston Churchill and the English military brass were so apprehensive about the German attacks on London was that they assumed that a traumatic experience like being bombed would have the same effect on everyone: that the only difference between near misses and remote misses would be the degree of trauma they suffered.
But to MacCurdy, the Blitz proved that traumatic experiences can have two completely different effects on people: the same event can be profoundly damaging to one group while leaving another better off. That man who worked in a button factory and that young woman whose house was shaken by the bomb were better off for their experience, weren’t they? They were in the middle of a war. They couldn’t change that fact. But they were freed of the kinds of fears that can make life during wartime unendurable.
Dyslexia is a classic example of this same phenomenon. Many people with dyslexia don’t manage to compensate for their disability. There are a remarkable number of dyslexics in prison, for example: these are people who have been overwhelmed by their failure at mastering the most basic of academic tasks. Yet this same neurological disorder in people like Gary Cohn and David Boies can also have the opposite effect. Dyslexia blew a hole in Cohn’s life—leaving a trail of misery and anxiety. But he was very bright, and he had a supportive family and more than a little luck and enough other resources that he was able to weather the worst effects of the blast and emerge stronger. Too often, we make the same mistake as the British did and jump to the conclusion that there is only one kind of response to something terrible and traumatic. There isn’t. There are two—which brings us back to Jay Freireich and the childhood he could not allow himself to remember.
4.
When Jay Freireich was nine years old, he contracted tonsillitis. He was very sick. The local physician—Dr. Rosenbloom—came to his family’s apartment to remove his inflamed tonsils. “I never saw a man in those years,” Freireich said. “Everyone I knew was a woman. If you saw a man, he was dirty and in overalls. But Rosenbloom—he had a suit and tie and he was dignified and kind. So from the age of ten I used to dream about becoming a famous doctor. I never thought of any other career.”
In high school, his physics teacher took a shine to him and told him he should go to college. “I said, ‘What do I need?’ He said, ‘Well, probably if you get twenty-five dollars, I think you can make it.’ It was 1942. Things were better. But people still weren’t very well off. Twenty-five dollars wasn’t small stuff. I don’t think my mother had ever seen twenty-five dollars. She said, ‘Well, let me see what I can do.’ A couple of days later, she appeared. She had found a Hungarian lady whose husband died and left her money, and believe it or not, she gave my mother twenty-five dollars. Instead of keeping it, my mother gave it to me. So here I am. I’m sixteen years old. And I’m very optimistic.”
Freireich took the train from Chicago to Champaign-Urbana, where the University of Illinois was located. He rented a bedroom in a rooming house. He got a job waiting tables in a sorority house to pay his tuition, with the added bonus that he could feed himself from the leftovers. He did well and was accepted to medical school, after which he began his internship at Cook County Hospital, the major public hospital in Chicago.
Medicine in those years was a genteel profession. Doctors held a privileged social position and typically came from upper-middle-class backgrounds. Freireich was not like that. Even today, in his eighties, Freireich is an intimidating man, six foot four and thick through the chest and shoulders. His head is oversize—even for a body as large as his—making him seem bigger still. He is a talker, fluent and relentless and loud, his voice inflected with the hard vowels of his native Chicago. In moments of special emphasis, he has the habit of shouting and pounding the table with his fist—which, memorably, once resulted in his shattering a glass conference table. (The immediate aftermath was later described as the only time anyone had ever seen Freireich silenced.)
At one point, he dated a woman from a much more affluent family than his. She was refined and sophisticated. Freireich was a bruiser from Humboldt Park who looked and sounded like the muscle for some Depression-era gangster. “She took me to the symphony. It was the first time I’d ever heard classical music,” he remembered. “I’d never seen a ballet. I’d never seen a play. Outside of our little TV that my mother purchased, I had no education to speak of. There was no literature, no art, no music, no dance, no nothing. It was just food. And not getting killed or beaten up. I was pretty raw.”1
Freireich was a research associate in hematology in Boston. From there, he was drafted into the army and chose to complete his military service at the National Cancer Institute, just outside Washington, DC. He was, by all accounts, a brilliant and dedicated physician, the first at the hospital in the morning and the last to leave. But he remained never more than a step away from his tumultuous beginnings. He had a volcanic temper. He had no patience, no gentleness. One colleague remembers his unforgettable first impression of Freireich: “a giant, in the back of the room, yelling and screaming on the phone.” Another remembers him as “completely irrepressible. He would say whatever came into his mind.” Over the course of his career, he would end up being fired seven times, the first time during his residency when he angrily defied the head nurse at Presbyterian Hospital in Chicago. One of his former coworkers remembers Freireich coming across a routine error made by one of his medical residents. A minor laboratory finding had been overlooked. “The patient died,” the doctor said. “It wasn’t because of the error. Jay screamed at him right there in the ward, in front of five or six doctors and nurses. He called him a murderer, and the guy broke down and cried.” Almost everything said about Freireich by his friends contains a “but.” I love him, but we nearly came to blows. I invited him to my house, but he insulted my wife. “Freireich remains to this day one of my closest friends,” said Evan Hersh, an oncologist who worked with Freireich at the beginning of his career. “We take him to our weddings and bar mitzvahs. I love him like he is a father. But he was a tiger in those days. We had several terrible run-ins. There were times I wouldn’t speak to him for weeks.”
Is it at all surprising that Freireich would be this way? The reason most of us do not scream “Murderer!” at our coworkers is that we can put ourselves in their shoes; we can imagine what someone else is feeling and create that feeling in ourselves. We can take that route because we have been supported and comforted and understood in our suffering. That support gives us a model of how to feel for others: it is the basis for empathy. But in Freireich’s formative years, every human connection ended in death and abandonment—and a childhood as bleak as that leaves only pain and anger in its wake.
Once, in the middle of reminiscing about his career, Freireich burst into an attack on the idea that t
erminally ill cancer patients be given hospice care at the end of their lives. “You have all these doctors who want to do hospice care. I mean, how can you treat a person like that?” When Freireich gets worked up about something, he raises his voice, and his jaw sets. “Do you say, ‘You’ve got cancer, you’re certainly going to die. You’ve got pain and it’s horrible. I’m gonna send you to a place where you can die pleasantly’? I would never say that to a person. I would say, ‘You’re suffering. You’ve got pain. I’m going to relieve your suffering. Are you gonna die? Maybe not. I see miracles every day.’ There’s no possibility of being pessimistic when people are dependent on you for their only optimism. On Tuesday morning, I make teaching rounds, and sometimes the medical fellows say, ‘This patient is eighty years old. It’s hopeless.’ Absolutely not! It’s challenging, it’s not hopeless. You have to come up with something. You have to figure out a way to help them, because people must have hope to live.” He was nearly shouting now. “I was never depressed. I never sat with a parent and cried about a child dying. That’s nothing I would ever do in my role as a doctor. As a parent I might do it. My kids died, I’d probably go crazy. But as a doctor, you swear to give people hope. That’s your job.”
Freireich continued on in this vein for several more minutes until the full force of his personality became nearly overwhelming. We all want a physician who doesn’t give up and who doesn’t lose hope. But we also want a physician who can stand in our shoes and understand what we are feeling. We want to be treated with dignity, and treating people with dignity requires empathy. Could Freireich do that? I was never depressed. I never sat with a parent and cried about a child dying. If we were asked if we would wish a childhood like Freireich’s on anyone, we would almost certainly say no because we could not imagine that any good could come of it. You can’t have a remote miss from that kind of upbringing.
David and Goliath: Underdogs, Misfits, and the Art of Battling Giants Page 11