Anatomy of an Illness as Perceived by the Patient

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by Norman Cousins


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  ACKNOWLEDGMENTS

  I must begin with my wife, Eleanor, who set me on this path and held me to it.

  My debt to Dr. William M. Hitzig is emphasized in the pages that follow. That debt
applies not just to the episode described in this book but to more than half a lifetime of friendship and caring.

  Hans Selye has been a source of limitless inspiration. Not just as a medical researcher but as a philosopher he has raised the sights of all who know him or have read him. His From Dream to Discovery is one of the most exciting intellectual autobiographies it has been my pleasure to read and reflects the creative intelligence at its best. Perhaps it is no accident that it calls to mind The Way of An Investigator, by Walter Cannon, who had infinite respect for the drive of the human body to right itself, and who was Selye’s teacher. I have a similar missionary zeal about the medical writings of Hans Zinsser, Dana Atchley, and Oliver Wendell Holmes. I am grateful to Lawrence Kubie for his painstaking efforts, many years ago, to impress on me the fact that the greatest advances in medical science will be tied to new knowledge about the workings of the human mind. Jerome Frank, also of Johns Hopkins, has held high Sir William Osler’s teaching about the role of faith in healing.

  Susan Schiefelbein was of limitless help, especially in providing the research underpinnings and the bibliography for this book. The chapters on “The Mysterious Placebo” and on “What I Learned from Three Thousand Doctors” would not have been possible without her collaboration.

  In the preparation of the manuscript and in proofreading, I had the assistance of Emily Suesskind, Mary H. Swift, Shannon Jacobs, and Caroline Blattner, to all of whom I express thanks.

  A BIOGRAPHY OF NORMAN COUSINS BY SARAH COUSINS SHAPIRO

  Norman Cousins in his office at UCLA, where he served as adjunct professor of psychiatry and biobehavioral science from 1978 to 1990.

  “No one gets out of this world alive. It isn’t dying we should fear, but rather, what dies inside us while we live.” —Norman Cousins

  Norman Cousins was an editor, author, lecturer, professor, and activist. His 1979 book, Anatomy of an Illness as Perceived by the Patient, is a revolutionary classic that fundamentally affected longstanding views held by traditional medical communities and encouraged generations of readers to make use of what Cousins called the natural pharmaceutical cornucopia in their own brains—a veritable chemical factory of medicinal enzymes and endorphins. Cousins discovered that the full range of positive human attitudes, attributes, and emotions—such as love, hope, faith, forgiveness, and courage—could promote physical healing. He found that laughter in particular triggered the production and delivery of his body’s own life-giving medicines.

  Cousins was born on June 24, 1915, in Union City, New Jersey, to Russian Jewish immigrants Samuel and Sara Miller Cousins. A frail child, he gravitated toward matters of the mind and was nicknamed “the professor.” At age eleven, he was mistakenly diagnosed with tuberculosis and placed in a sanatorium. That early encounter with painful isolation and loneliness would inform his future thinking about emotions and illness, and deepen his appreciation for all the joys of life. Upon his release from the sanatorium, Cousins consciously built up his physical strength so that he could play ball with the other boys—especially baseball—and have fun with the best of them.

  During the Great Depression, Cousins attended Teachers College, Columbia University, until financial circumstances forced him to quit. His first job was editor of the memorably titled Plumbers’ Weekly, after which he was named education writer at the New York Evening Post. In 1935, he joined the staff of Current History magazine, first as book critic, then as literary editor, and finally managing editor.

  In 1940, at age twenty-five, Cousins was named editor in chief of the Saturday Review of Literature, a job that would go on to define his career. When he joined the magazine, it was on the verge of financial collapse. He transformed the publication, shortening the name to Saturday Review and broadening its coverage of literary criticism to the full spectrum of human endeavor—music, painting, poetry, photography, and drama, as well as science, travel, current events, politics, and more. Saturday Review became America’s foremost cultural standard-bearer of journalism in the second half of the twentieth century, and its circulation grew from 20,000 to 600,000. The name Norman Cousins became synonymous with political and personal integrity, accurate reporting, and reliable artistic criticism. For more than three decades, Saturday Review readers could trust Cousins to publish only what he himself believed was truthful and socially constructive, without regard to political favor or commercial success.

  In 1971, Saturday Review underwent a corporate takeover. At the new owners’ request, Cousins stayed on as editor and provided his regular weekly editorial, but he increasingly felt that he was editor in name only, and left the magazine later that year, citing “creative differences.” He felt that commercial interests were trumping editorial interests, and he could no longer identify with the magazine’s direction. Cousins founded a new publication, which he dubbed World, but when the new Saturday Review began losing its subscription and advertising base, he was asked to return. From 1973 until his retirement in 1977, Cousins was once again at the helm.

  In 1964, Cousins was crippled, virtually overnight, by an unidentified autoimmune illness, a deadly form of rheumatic arthritis inconclusively diagnosed at the time as a streptococcal bacterial infection. Upon overhearing from his hospital bed his doctor’s murmured remark, “I’m afraid we’re going to lose Norman,” Cousins resolved in that moment to search for a different route to recovery—or if it was indeed his time to die, to make the final years of his life as happy and meaningful as possible, which would mean not staying in a hospital bed. He stopped taking the painkillers and the allopathic drugs. He had always loved comedy; he had a hunch that learning to laugh again would strengthen his will to live, and theorized that maybe humor could have a positive effect on his physical self. His wife, Eleanor, moved him out of the hospital and into a hotel room, where she set up a projector and home-movie screen. She facilitated a daily regimen of Marx Brothers films and Candid Camera, along with massive doses of intravenously delivered vitamin C, to bring down her husband’s soaring inflammation. It took more than two years, but to the surprise and befuddlement of his doctors, and to the delight of all who loved him, Cousins recovered.

  A turning point in his life came several years later when Saturday Review’s editorial board rejected a lengthy article Cousins wrote about his illness and its aftermath. They found its anecdotal thesis implausible and medically unverifiable as it was based on one man’s personal experience. Could a man’s good spirits really have that much of an impact on his physical self? One of the editors opined that the story would make Saturday Review “a laughing stock.” True to form, Cousins gracefully accepted his colleagues’ verdict and submitted the piece instead to the prestigious New England Journal of Medicine.

  The response from the national and international medical community was overwhelmingly positive. Anatomy of an Illness as Perceived by the Patient was snapped up by Norton Publishers, staying atop the New York Times bestseller list for months to come. Its bestseller status led to a made-for-TV movie, one whose Hollywood dramatization was not to Cousins’s liking, but to which he was nonetheless grateful for its popularization of the ideas the story contained.

  Norman Cousins was the author of more than twenty-two books, including The Good Inheritance, Modern Man Is Obsolete, In God We Trust, Dr. Schweitzer of Lambaréné, The Improbable Triumvirate, Present Tense: An American Editor’s Odyssey, The Celebration of Life, The Politics of Power, The Physician in Literature, and The Healing Heart: Antidotes to Panic and Helplessness, which documented Cousins’s recovery from a heart attack.

  After America became the first nation in history to use atomic weapons, Cousins was asked by author Pearl S. Buck to publicize through his magazine the plight of a particular group: young Japanese women who had survived the radioactive blast but were being ostracized by their society on account of their keloid scarring and disfigurement. Cousins accepted the challenge. He and Eleanor first visited Hiroshima in 1946. A fundraising campaign successfully directed to the Satu
rday Review readership brought twenty-five of these “Hiroshima Maidens” to the United States for plastic surgery, and also provided medical care and education to four hundred war-orphaned Japanese children. The Cousinses adopted and raised one of the Hiroshima Maidens, Shigeko Nimoto, alongside their four daughters. Shigeko Nimoto Sasamori went on to attend nursing school, worked as an RN, and for the past three decades has worked as an international lecturer on the perils of nuclear power. Cousins also awoke the Japanese government to its own responsibility toward the wounded: The Norman Cousins Law, so dubbed by the Japanese government, guarantees free lifelong medical care to all A-bomb victims.

  Cousins served as co-chairman of the Citizens Committee for a Nuclear Test Ban Treaty, and wrote regularly in Saturday Review about the urgent need to reduce the nations’ nuclear stockpiles. At the time of his death in 1990, he still believed that strengthening the United Nations was the key to the prevention of nuclear war. It was in large part thanks to Cousins, who wrote and negotiated tirelessly for the rest of his life as an advocate for nuclear disarmament and an opponent of nuclear testing, that the 1963 Nuclear Test Ban Treaty was ratified during the Kennedy administration. He founded the Dartmouth Conferences, an annual cultural exchange that brought together prominent Soviet and American citizens for the purpose of promoting communication between the two nations during the Cold War. As president of the United World Federalists, his diplomatic skills attracted the attention of Presidents Eisenhower, Kennedy, and Johnson, who all recruited Cousins for diplomatic missions during their successive administrations.

  After the widespread publication of Anatomy of an Illness, Cousins was invited by University of California Los Angeles Medical School to serve as the first lay professor in the school’s history to teach in its department of psychiatry and biobehavioral science. There he founded what became known as the Cousins Center for Psychoneuroimmunology to conduct research on the relationship between mind and body, and teach medical students the art of relating to their patients not as cases but as persons, whose experiential input must be recognized as necessary to successful treatment.

 

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