The Diagnosis

The Diagnosis

by Alan Lightman


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From the bestselling author of Einstein’s Dreams comes this harrowing tale of one man's struggle to cope in a wired world, even as his own biological wiring short-circuits. As Boston’s Red Line shuttles Bill Chalmers to work one summer morning, something extraordinary happens. Suddenly, he can't remember which stop is his, where he works, or even who he is. The only thing he can remember is his corporate motto: the maximum information in the minimum time.

Bill’s memory returns, but a strange numbness afflicts him. As he attempts to find a diagnosis for his deteriorating illness, he descends into a nightmarish tangle of inconclusive results, his company’s manic frenzy, and his family’s disbelief. Ultimately, Bill discovers that he is fighting not just for his body but also for his soul.

Product Details

ISBN-13: 9780375725500
Publisher: Knopf Doubleday Publishing Group
Publication date: 02/05/2002
Series: Vintage Contemporaries Series
Edition description: Reprint
Pages: 384
Sales rank: 1,204,246
Product dimensions: 5.20(w) x 8.00(h) x 0.90(d)

About the Author

Alan Lightman lives in Boston.

Read an Excerpt

People must have been in a great hurry, for no one noticed anything wrong with Bill Chalmers as he dashed from his automobile one fine summer morning. Earnest and dressed in a blue cotton suit, he was immediately swept up by the mass of commuters also galloping from their cars toward the elevators and down to the trains of the Alewife Station, a cavernous structure of concrete and crisscrossed steel struts, one end of the Red Line through Boston. At the ground floor, Chalmers presented his pass and rushed through the turnstile. He was halfway down the stairs to the platform when he heard the taut string of electronic beeps and the doors began sliding on train Number One. A woman groaned. Another commuter, a tall nervous man with squeaky shoes, lunged ahead and ran alongside the train, shouting and slapping his magazine against the red paneled doors. But the train was already in motion, its steel wheels scraping and squealing so fiercely that several people had to turn up their head sets. The tall man swiveled and shot Chalmers an accusing stare, as if his lack of sufficient speed through the turnstile had caused a half-dozen people to miss their trains. What a jerk, Chalmers thought to himself and looked down at his watch. It was 8:22. Twenty-three minutes to his stop, a nine-minute walk to his building, two minutes on the elevator, and he'd be sitting at his desk by 9:00. Assuming the train on Track Two arrived and departed within four minutes, as it should. With some satisfaction he reminded himself that, unlike the ridiculously agitated man with the magazine, he had calculated his morning commute so that he could miss the first train and still arrive at the office on time. Abruptly, he began worrying that the train on Track Two might be late. Never had that happened when he'd missed train Number One, but it was certainly a possibility. Stroking his mustache, he continued down the stairs and looked again at his watch. He mustn't waste the four minutes. However, he slowed his descent to drop fifty cents into the cup of a homeless woman sprawled on the edge of the stairs. She looked disturbingly like his old piano teacher. "Thank you, kind sir," she said. "Please don't thank me," he answered, embarrassed. "I thank everyone who is more fortunate than me," she called to him as he hurried down to the platform. Waves of people flowed around him, jostling and crushing from all sides, shoving each other to gain an advantage for the next arriving train. Gulped down in seconds were muffins and rolls, hard-boiled eggs, bananas, coffee, and crackers. Some commuters tried to unfold newspapers in the cramped space but gave up and contented themselves with staring at the digital sign on the kiosk, where bits of news and the correct time scrolled by in bright glowing dots. The dozens of upturned faces were waxy and yellow beneath the underground fluorescent bulbs.

Even in that pale yellow light, if any of those waiting had looked carefully into Chalmers's eyes, they might have observed a faint petrifaction, a solidification, some sign that all was not well. But they did not, occupied with their own busy schedules and the marching dots on the sign. Chalmers himself felt perfectly fit, aside from the normal stresses and aches of a man just past forty, arguably overweight but by no means fat. He glanced at his watch, 8:23, and forged a path to the kiosk. Above his head, the digital sign flickered and hummed and something clattered repeatedly against the high concrete ceiling and the air sagged with the burnt smell of hot brake fluid. Several radios blared, jumbling their throbbing bass notes in competing rhythms. Huddled against the kiosk as if battling a strong wind, a woman in a smart linen suit was delivering instructions into a cellular telephone. Chalmers couldn't help noticing that her phone was a new model, considerably smaller and sleeker than his. He took out his own phone from his briefcase. As he began dialing, he found that he was still shaken by the poor woman on the stairs. Her misery had cast a gloom over him, which he tried to forget by pushing the tiny buttons as fast as he could. First, he called Jenkins, to make sure that the proper documents would be ready for his 9:15 meeting. All was in order. He hung up and stood on his toes, peering down the dark tunnel of Track Two. Over the track, hundreds of glowing red neon tubes dangled down from the ceiling, one of them broken and blinking like a Christmas tree light. His telephone rang. Two men reached inside their briefcases, thinking it theirs. "Mr. Chalmers, this is Robert again. You didn't tell me if you wanted the Lehman file for the meeting." "No. Thank you, Robert." "Just checking to make sure everything is in order, Mr. Chalmers. We're set for TEM at ten-thirty." That Jenkins was an excellent young man, Chalmers said to himself. He would remember to compliment him when he arrived at the office. People didn't compliment each other nearly enough. Everyone was too quick to criticize. Chalmers looked at his watch and dialed his voicemail. As the connection was being relayed through space or wherever--who knew exactly where cellular transmissions were at any one instant?--he twisted his neck and gazed up at the digital sign: "8:24 . . . Introducing a new feature of Providential Services: Providential Online . . . Get stock quotations on your pager, minute by minute . . . Think of Providential Online as 'Work wherever, whenever'™ . . . . . . 8:24." Chalmers fumbled with a pencil and hurriedly copied down the e-mail address before it fled from the screen while a feminine voice crooned from his telephone receiver, "The Plymouth voicemail system will be disabled for twelve hours, beginning at midnight on June 26, while Telecom performs an upgrade of the system. At Telecom, progress is our business. You have three messages." Which must have arrived in the previous twenty minutes, since Chalmers last checked his voicemail. A dog barked. What were dogs doing down here? he wondered. People should be more considerate. Last week he had come within inches of stepping in dog poop. He retrieved his first message. "Jasper Olswanger calling. I need to talk--hold it a moment, please. . . . Sorry, that was call waiting. I need to talk to you as soon as possible. You've got my number." Someone was shouting Chalmers's name over the roiling of voices and music and dogs. He removed his ear from the receiver and went up on his toes. Twenty feet away he spotted the shouter, now waving and grinning. "Yes," Chalmers answered, trying to make out the man's head in the ocean of pale, fluorescent faces. Gradually he recognized the sunken eyes of Tim Cotter, his neighbor across the street. He didn't know Cotter very well. Cotter worked in a small bank somewhere downtown and came home late every night to the loud reprisals of his wife. Chalmers waved back good-naturedly and started to retrieve his second message. Someone elbowed him, shoving the phone into the side of his head. The neighbor continued waving and shouting "Bill, Bill," with a definite note of urgency, as if there was something he needed to tell him that moment. "What?" Chalmers shouted back, still standing on his toes. His neighbor didn't seem to hear him, then removed one of his earphones and yelled, "What did you say?" "I thought you wanted to tell me something," Chalmers shouted back, realizing at once that he had used far too many words under the circumstances. "Lower your voice," yelled a cheeky college boy standing next to him. "You're destroying my eardrums." The student made a face and slapped his hands over his ears. Chalmers glanced at his watch. He had only two minutes or less to retrieve his messages. With a sigh, he began working his way through the concrete thick crowd toward his neighbor. Cotter shouted something else, which Chalmers didn't hear, and refastened his headphones. Now Chalmers could see that his neighbor was sitting on some kind of fancy foldable chair, like a beach chair or a country lawn chair. He made a mental note that he should get one for himself. "Guess what I'm doing," said Cotter, keeping one of the earphones pressed against his ear so that he could listen and talk at the same time. His fingers tapped on his briefcase. "I don't know. What are you doing?" "I'm reading," said Cotter, grinning broadly. He paused, to let the announcement sink in. "Books on Tape. The Bridges of Madison County." Chalmers made a thumbs-up sign. For the first time, he realized how much he disliked Cotter. In a hundred little ways, Cotter always tried to make him feel like a slacker. Cotter was just envious of anyone seriously engaged in their profession. It was Cotter who was the slacker. The dog was barking again and Chalmers began coughing, having inhaled an invisible cloud of the burnt brake-fluid air. In addition, the morning's usual indigestion had just slammed into his stomach. "Nice to talk to you," said Cotter. "I haven't seen you since Phil's thing." He put his second earphone back on. At that instant, with a high shriek of metal on metal, the train on Track Two arrived. Chalmers looked at his watch, 8:26, and surged forward with the torrent. By the time he had squeezed through the doors and been shoved to a spot in the middle of the car, the seats were long gone. The upright commuters, pressed hard against each other, clutched their coffee cups and muffins close to their bodies and searched in vain for handrails to grasp. Chalmers began brooding over his unretrieved messages. Maybe one of his appointments had been rescheduled. He could have an important call from New York. Those people got to their desks early. As he was considering the various possibilities and their dark implications, with the knowledge that he would be incommunicado for the next several minutes, an extremely loud alarm bell rang, then the series of electronic beeps, the doors slid together, and the train jolted into motion.

It was between Harvard and Central that Chalmers forgot where he was going. This realization did not arrive suddenly but seemed to trickle up slowly into his consciousness, like a trapped bubble of air rising from the bottom of a deep pond. At first, he was calm. He was most likely suffering from a momentary lapse of memory, as when he'd forgotten Morla's name at the last New Year's party.

He took a long breath and maneuvered himself between bodies to the front of the car, where he could read the list of stops on the wall. They were all familiar, but he could not remember which one was his. He pronounced the name of each stop softly, so as not to draw attention to himself, and ran his fingers through his thinning brown hair. When the train screeched to a halt at Central Square, he peered out the window and studied the token booth and the passageways and the stairs. Commuters hurried forcefully in every direction. Could this be where I get off? he asked himself, trying to jog his memory. He couldn't decide. The doors slid shut and the train was in motion again. He looked at his watch. It was 8:39. If he didn't straighten himself out soon he'd be late. But he was not late yet. No, he was not late yet. If he could just remember his stop before he reached it, no time would be lost. With that logical deduction, he seemed to relax slightly and gazed out the window into the black tunnel flying by. He remembered that he was due at his office at 9:00, that he had appointments at 9:15, 10:30, and noon. Then, with alarm, he became aware that he couldn't recollect precisely where he had to be at 9:00, or who he was meeting. The meetings, the meetings. He strained to remember. They were probably important. In fact, it was quite possible that his meetings were critical, that a great deal hung in the balance. His grip tightened on the overhead rail. Nothing like this had ever happened before. He had worked in his office a long time, he was certain of that, and he had always met his responsibilities with efficiency and speed. In a sickening premonition, he imagined the vice president smiling sympathetically at him and then quietly transferring away his better accounts. A sweat broke out on his cheeks and the palms of his hands.

So distraught was Chalmers by this time that he didn't think to open his briefcase, which contained, among other items, his appointment book and dozens of letters and office memoranda bearing the name of his company and its address. Instead, he looked anxiously into the faces of the two men standing on each side of him. One sported a faint smile, as if amused by the crush of humanity around him, and was dictating something into a tiny recorder. The other had lightly closed his eyes, possibly engaged in one of those new business visualization techniques. The two seemed so confident and self-assured in their plans for the day. He could not bring himself to ask them for help. Maybe he could locate his neighbor. Standing on his toes again, he looked in both directions without success. Then he noticed that a man in a green plaid suit, occupying one of the scarce seats on the car, was gazing intently at him through the thicket of torsos and arms. As soon as the seated man saw that his gaze was returned, he quickly went back to typing on a computer in his lap. He seemed vaguely familiar. Perhaps he was a professional colleague, or possibly an employee. His computer screen was tilted at such a wide angle that Chalmers could see some kind of spreadsheet, with a colored graph shimmering at the top. After a few seconds of purposeful typing, the man looked up again, apparently to verify that Chalmers still saw him profitably at work, then returned with a smirk to his computer. Looking about, Chalmers noticed that other people, even those standing, were reading reports, making memos, checking off columns of figures and lists. Everyone was busy at work. He took a piece of paper from his pocket and began thinking of something to write on it. Immediately, the man in the green plaid suit craned his neck nearly out of his collar to see what Chalmers was doing. This unwelcome surveillance made Chalmers even more upset and moist.
Avoiding eye contact with the green-suited man but feeling his gaze, Chalmers once more pushed to the front of the car to ponder the list of stops. This time he pronounced the name of each stop out loud. "Do you have a problem?" said a huge woman with blue frizzy hair and two silver rings in her nose. She looked him up and down, her chin remaining hidden in the rolls of fat around her neck, then offered him some of her blueberry muffin. The train pulled into another station. People raced off, people raced on. There were still twice as many commuters as seats. Without recognition Chalmers gaped at the fluorescent terrain. Men and women fled toward the exits at both ends of the station. Between the tracks hung long silver chimes, and an enamel map of some kind covered the wall. He was beginning to feel nauseous. Could this be my stop? he said to himself, again trying to shake loose his memory. A sign on the wall said "MIT." MIT? Could he possibly work at MIT? He examined his clothes and tried to recite some school math formulas to himself.

It now occurred to him to look in his briefcase. "My briefcase," he shrieked when he realized that it was not in his hand. At his exclamation, people rotated their heads to stare at him. When he succeeded in groping his way back to the middle of the car, his briefcase was gone. And with it, all identification, since he routinely carried his wallet in his briefcase on the advice of his chiropractor. For the last several years, he had been told that his tight muscles and little pains were caused by his wallet pressing against certain cartilages and nerves. "Has anyone seen a leather briefcase?" he shouted without thinking. The train lurched forward and he grabbed for a hold bar. "Has anyone seen a briefcase?" he repeated more softly. The commuters nearest him glanced down at the tiny bit of bare floor and shrugged. Two briefcases were discussed, but they belonged to other people. A woman wearing a blue running suit and a black beaded cap took off her headphones and asked Chalmers what he was saying. He looked at his watch. It was 8:42.

Chalmers glanced at the faces of the other commuters. He'd made a fool of himself. Only people totally out of control lost briefcases. Were they all mocking him behind their self-satisfied activities? Who were they, to mock him? he thought angrily. Although he could not at the moment remember exactly his job, he knew that he was somebody important, a specialist of some kind. Slowly, he made his way down the car, searching for his briefcase. The other commuters grudgingly moved aside, momentarily folding up their memos and pads of papers. At several points he stooped down to survey the floor and was thrown into backpacks and purses and knees as the train swayed from one side to the other. Then the train was suddenly above ground, in the bright sunlight, traveling over a river. He blinked in the light and looked out the window. The view was not unfamiliar. On either side of the bridge stood ancient stone towers, shaped like salt and pepper shakers, beyond which dozens of sailing masts huddled in a curved inlet in the distance. A little boathouse with an orange roof. Tiny figures on rollerblades slid along the shore. Behind the boathouse, an angular tower gleamed blue in the early morning sun, and next to it some office building. On the side of the river they were leaving, two massive triangular buildings like pyramids, and two white domes on either side of an edifice with a spire. He felt that he knew these sights well, he must have passed this way often. The train pulled into another station, high above the streets of Boston. Charles/MGH, Massachusetts General Hospital. Chalmers looked down at the busy street and the rush-hour traffic, then toward the hospital. Hospital, hospital, he said to himself and searched his pockets. No stethoscopes or hospital things to be found. He did produce car keys, a "to do" list, some coins, his subway pass, and a Post-it note that said "Call Mary Lancaster." He finished with his inventory just in time to see the green-suited man hurrying off the train with his computer and down the metal stairs to the street. For an instant, the man peered over his shoulder and then disappeared. The wheels screeched and the train dove underground.

Chalmers was now obsessed with finding his briefcase. It struck him that perhaps he had left it on a neighboring car. At a previous stop he might have gotten off briefly to study the station and could have reboarded a different car. Next stop, as his train pulled into the station, a pulsating beat blasted him like a cannonball. A group of wiry-haired musicians was installing itself and its amplifiers on the platform between the outgoing and incoming tracks. Chalmers leaped off the car and hurried onto the one behind it. "Coming through," he heard himself shout. A mass of people huddled in the aisle of the new car. He was sweating pretty heavily now and wiped the perspiration from his face. Over the door, a sign in red letters read: "in case of emergency please follow directions of the train crew." "I'll report my missing briefcase to the train crew," he said out loud. He glanced out the window and noticed a sign pointing to the direction of transfer to the Green Line. Green Line, Green Line, he repeated to himself, without recognition.

As the train left the station, he miraculously sighted his neighbor, standing at the end of the new car. "Tim," he shouted. Cotter took off one earphone and waved. Chalmers gasped with relief and began pushing his way down the aisle. He felt like throwing his arms around Cotter, but of course he could never do such a thing. "I've lost my briefcase," he blurted out. "Gosh. I'm sorry," Cotter said and turned off his headset completely. "On the train?" "Yes," said Chalmers, "I'm almost certain that I had it when I got on at . . ." "I'm so sorry," repeated the neighbor. "You look terrible. Need anything?" Tears came to Chalmers's eyes, and he quickly looked away, into a woman's sunburned back. He began rehearsing to himself how he could describe his predicament. Then, unexpectedly, he had a vision of being laughed at. After that, he couldn't get any words out. With a sudden stab of shame and anger at himself, he wished he had said nothing to Cotter. He had never confided anything to his neighbor before, he didn't at all care for the man, and here he was making an idiot of himself. God knows who Cotter would tell about the lost briefcase. The train rolled into the next station, and Chalmers looked out the window. Downtown Crossing. "Well, this is my stop," said Cotter, checking the time on his watch. "Got to go. You should report your briefcase to somebody. Bummer." He patted Chalmers on the shoulder, turned his headphones back on, and bolted off the train. Chalmers stared at Cotter as he raced down one of the hallways and disappeared around a corner.

At the next station, which reeked strongly of urine, more people got off than got on. As the train flew away, Chalmers looked at his watch. 8:48. Almost certainly now he would be late for his 9:15 appointment. He remembered that he was to meet a man and a woman at 9:15. He'd met them before. The woman had blond hair and wore scarves and took notes on a laptop during meetings. He began imagining various scenarios. In scenario one, the visitors would show up and be asked to wait until he arrived. When he didn't, the appointment would be rescheduled, possibly after lunch. What was on his agenda today after lunch? He would worry about that later. In scenario two, the president would ask that cocky Harvard fellow to fill in for him. There would be an unpleasant scene and some posturing the following day. In scenario three, the visitors would express their annoyance by taking their business elsewhere, bringing down on Chalmers the wrath of the entire company. And who could blame them? Their time was valuable. Time was money. Chalmers struggled to remember the nature of the meeting. The phrase "the maximum information in the minimum time" suddenly came to him. It was the motto of his company. His company. He strained to remember its name, pulling at his mustache. What was happening? What was happening to his mind? Was he having a nervous breakdown? Frantically, he glanced at the people around him, complacently going about their business of the day. He was feeling more and more ill and needed to sit down, but no seats were available. With a groan he took out his handkerchief and held it to his mouth. Then, he saw with astonishment that he had been carrying his cellular phone all of this time. "Oh, thank you, thank you, cellular phone," he said out loud, to the stares of other commuters around him. Forgetting that his phone was inoperative in the tunnels, he pushed the power button. A red light reading "No Serv" flashed on the digital display. He wiped his sweating hands with his handkerchief and began to push other buttons, but the red "No Serv" light continued to flash and the receiver whined like a miniature police siren.

"Doesn't work underground," said a man wearing chino pants and a Red Sox cap. Chalmers remembered who the Red Sox were--he had even attended some games--and he clung to this small bit of recognition as he slammed his No Serv phone shut. The man in the Red Sox cap proceeded to swallow a hot dog in two gulps.

"They're coming out with one that works anywhere," he said, wiping his mouth. "I think it's fiber optics, or ultrasound." He paused, looking at Chalmers. "Here, take my seat, bud, you look wiped." Chalmers smiled weakly and sat down, his hands shaking. He began going over what he knew of the morning. He remembered arriving at Alewife at 8:20. He remembered billboards with fish and cottontail rabbits. He remembered making a telephone call to Jenkins, who spoke in a high-voltage, caffeine voice. In fact, he could even see Jenkins, a nervous young man, prematurely bald, with a carefully tended two-day beard. What was Jenkins's first name? He began running down possible names and matching them with Jenkins. Abandoning this line, he attempted to focus on his appointments. One was at 9:15--he was certain of that--one at 10:30, and one at noon. A man and a woman were to meet him at 9:15. He stared outside the window at the darkness flying past. Every few seconds, a smattering of light from a fluorescent tube. What was happening to him? He gazed at the man in the Red Sox hat, who was mindlessly turning the pages of a magazine. The train coasted to a stop, and Chalmers had the prickly sensation that he might be starting to remember things. He squinted at the walls of the station. A "Wanted" poster showed a man in two profiles. Another said: "Socrates? Plato? Why not? At Metropolitan College Online." It was 8:50. With a whoosh, the train left the station.

After the next stop, which Chalmers didn't recall ever having seen in his life, the crowd on the train diminished substantially. Now there were only a dozen people in his car. He examined each seat and its occupant, as if somehow hoping to uncover a clue to his identity. In one sat a man with braided dreadlocks, listening to music on a portable CD player and counting subway tokens. In another, a skinny young mother with a phosphorescent blue-green halter top sipped on a Diet Coke and fed some of it with a straw to her baby. An older woman, wearing a black leather coat despite the heat, gazed absently out the black window and rocked back and forth in her seat. The train vibrated and twisted down the tracks. Chalmers searched for the man in the Red Sox cap, but he was not on the car. Two pimply teenage girls with beach towels, dark glasses, a radio. An elderly man and woman, both with long white hair and canes, were arguing about something while eating Egg McMuffins. Their voices were thin and breathy and faint, wind moving through dry reeds.

Suddenly, the train lit up with sunlight and was again above ground. Trees flew by like flailing arms. Beyond the vegetation, a mixture of residential and commercial buildings, parked cars, telephone poles, a brown building, a Burger King. The train stopped and several young people darted off, carrying books. They must have been students. Chalmers peered at the sign on the wall. JFK/UMass. The train was now far from the downtown area, heading farther from Boston. Chalmers remembered his cellular phone. He extended its antenna and pushed buttons: 617-567- . . . He couldn't remember what came next. Continents of memory had been lost. He began dialing random numbers, hoping to connect with someone. In the process, he accidentally entered the security code that prevented the phone from sending or receiving further calls. A "Phone Lock" sign began flashing. He stared at the useless instrument. "Good God, I can't remember any telephone numbers," he said out loud. "I can't remember my name." One of the passengers glanced quickly at him, then returned to her magazine. Sweat streaming down his face, Chalmers closed up his phone. Railroad tracks fluttered by like matchsticks. Trees, white and gray clapboard houses with paint peeling off, junkyards with stacks of flaccid tires and crumbling cars, four-story apartment buildings with children playing in the narrow alleys between, laundry hanging from windows. An expressway looped in from somewhere, flying alongside the train, cars shot by in both directions. After the next stop, they passed water, a bay, a huge cylinder with red and yellow stripes. Suddenly the train entered some small town and stopped under a green awning. Along the concrete sidewalks, pedestrians floated, cars stood at red lights, everything seemed frozen. A few passengers embarked and the train was in motion. Leafy green trees, then the light dimmed two octaves and the train had again flown below ground, blackness outside. At the next station, which said Shawmut, a strange silence. No one got on or off. Then a woman's voice singing, You're gonna want me . . . A voice on a speaker said, "Next stop, Ashmont. End of the line. Ashmont. Thank you for riding the T. Don't forget your belongings." Shortly thereafter, the train pulled into Ashmont Station and stopped.

Chalmers sat dazed in his seat, holding his handkerchief to his mouth. The train was empty and silent. In the distance, an automobile groaned, sliding its sound into the muffled hum of the station. After a few moments, an attendant walked over, stood glaring down, and said, "No passengers beyond this point. You'll have to get off." It was 9:09 by a giant white clock in the station.

Wobbly on his legs, Chalmers walked out of the train and sat on a bench. It felt hard after the padded seat. Ashmont Station, bottom end of the Red Line. The station, at street level, opened to real air. Pigeons flew in, just under the arched roof, swooped down to the brick floor, and pecked for food. Peanuts, scraps of sandwich meat, pieces of bread. He gazed at the birds as they jerked their heads right and left. On the other side of the station, a bus whined and exhaled a tuft of acrid gray smoke. A woman in a blue beach hat got on. Chalmers looked at his watch. There was no doubt now that he would lose a good part of the morning. Unconsciously, he began panting in rapid, shallow breaths. Closing his eyes, he tried to visualize the place where he was going, he pictured office buildings, shops, department stores, corporate campuses, any place he might possibly be employed. Various people that he had met flickered in his mind. His hands trembled and he couldn't keep from rocking like the woman on the train. Still shaking, he spotted the stairway to the train in the opposite direction, back through Boston. Immediately, he flung himself from the bench and hurried up the stairs. "I'm going to put an end to this craziness," he said out loud, taking a deep breath of bus exhaust. "People are waiting. I won't allow myself to get further behind. Go. Go." He slammed his hand against the rough concrete wall. On the second time around, he would recognize his stop, he would remember, he would have to remember where he was going, he would remember.

At the beginning of the return trip through Boston, Chalmers regarded each stop even more intently than before. At two stations, he leaped from the train and paced the platform, hoping to feel some glimmer of memory in the concrete and brick. The train was now about half full with people, who appeared to be shoppers and tourists and college students going to midmorning summer classes. Someone giggled at the far end of the train, where a man in unlaced hiking boots was embracing a woman. At Charles Street, Chalmers threw up. "Are you all right?" asked a spectacled college girl sitting across from him. He looked at her blankly. She moved a few seats away. Grimacing, he lay down across three seats, then sat up when the train went over the river. Now sailboats dotted the water, their white sails fluttering and curved in the wind. In the distance, a line of cars, bumper to bumper, oozed across a bridge. Kendall Square/MIT. Central. Harvard. Porter Square. Davis Square. Chalmers no longer got out of the train at each stop. He would simply sit up and peer out for a few seconds, then lie down again. "What's happened to me?" he mumbled, over and over. He held up his hands and examined the veins near the surface, fragile and faint like the strings of a puppet. "What's happened to me?"
Then he was at Alewife, the end of the line, where he vaguely remembered starting that morning. Mercifully, no attendant told him he had to get out of the train. He could just remain lying down in his three seats, wait until he started moving in the opposite direction, back toward the station with the swooping pigeons. With a half-dozen people in his car, the train began once more flying south. It was just after eleven o'clock on the morning of June 25.

Unaccountably, he felt like walking. He had a noon appointment. He had a noon appointment. With a grunt, he sat up and wandered down the car, holding on to the overhead rail and gazing idly at the signs on the wall. Outside, the darkness flew past in black streams. By now, his demeanor was attracting attention. His hair was matted with sweat, his tie dangled loosely around his neck, his shirt was soggy and stained. He didn't know where his suit jacket was. "What's happening to me?" he said to anyone who would look at him for longer than know where his suit jacket was. "What's happening to me?" he said to anyone who would look at him for longer than a second. He had now grown accustomed to stares. Yet he could not bring himself to ask any of those faces where he was going, where he was supposed to be. A man with a baseball cap on backwards began mimicking him: "What is happening to me? Like, what's happening, man? To me. What's up, Doc?" The man followed Chalmers to the end of the car and began inspecting his cellular phone. Chalmers tightened his grip on the phone and hastened toward the other end of the car. A young man and woman were holding hands and laughing. When they saw him, they turned and began whispering. Newspapers and food wrappers covered the floor. The fluorescent light hammered. Two men in identical headphones and identical gray silk shirts looked at him curiously. "What's happening to me?" he asked them. They shrugged. From behind, someone tapped him on the shoulder. He turned. A woman, middle-aged, green light in her eyes. She handed him a green dollar bill and walked away. He let his tie fall to the floor. "My briefcase," he said. At the next stop, he changed to a neighboring car. "do not lean against doors." He looked down and saw that his shoes had become untied. They were becoming a nuisance. With a flick of his ankles, he kicked off his shoes and left them behind. The train braked sharply around a turn and he was thrown to the floor, his cheek landing hard against a fresh wad of gum. "You should sit down, please sit down," came a voice. He got up and continued walking, cooler now without his shoes and socks. He took off his shirt and tossed it onto a seat. A woman's face dissolved. There was shouting. He hurried up the aisle of the car.

When the police boarded the train at South Station, they found him curled up on the floor in a fetal position, clasping his phone to his bare chest.

What People are Saying About This

Norman Mailer

I know of no novel that captures the technological horror and pervasive spiritual poverty of our wildly prosperous land in so powerful a way as The Diagnosis. It is haunting.

Annie Proulx

The Diagnosis is packed with dark power and awful humor. Lightman's intelligence, imagination, and clarity of style mark him as one of the most brilliant contemporary American writers.

Reading Group Guide

The introduction, discussion questions, suggestions for further reading, and author biography that follow are designed to enhance your group's reading of The Diagnosis, a darkly comic exploration of our modern obsession with speed and information.

1. Why does the novel begin on the subway? What are the mythological or metaphoric implications of Bill losing his way on an underground journey?

2. How do Bill's encounters with the homeless woman [p. 4] and with his neighbor [p. 7] reveal what kind of man he is? How do the descriptions of the station and the train ride establish the atmosphere for the rest of the novel?

3. As his panic mounts, Bill reflects on what is happening to him [p. 15]. Why can he recall the times of his appointments but not the first name of his coworker, Jenkins? What does the order in which he forgets things reveal about modern society?

4. In his attempt to rediscover his identity, Bill escapes from the hospital, wanders through Boston neighborhoods, and eventually ends up in a church. Why does his search follow this particular path? Both hospitals and churches are commonly thought of as sanctuaries. To what extent, if any, do they serve this purpose for Bill?

5. One of the most bizarre events of the evening is Bill's confinement in the cash booth [p. 61]. What images, metaphors, and even individual words give this scene its power and resonance? Why does it mark the turning point for Bill?

6. When Bill returns home, why is he so secretive about what happened to him? What does his reluctance to admit his memory loss reflect about his relationships with his family and coworkers? About how he perceives himself? Are his actions understandable? In light of their initial reactions, do you think Melissa and/or Alex could have provided an emotional anchor for him? If he had confided in them immediately, would it have changed the course of events? What other opportunities does Bill have to reconnect with his emotions throughout the course of the novel? Why doesn't he take advantage of them?

7. Alex greets his father "outfitted in a steel-mesh face mask, white jacket, white glove, and white shoes . . . and he brandished a foil" [p. 72]. Why is the reunion between father and son portrayed in this way? How does Alex's interest in fencing, a fairly esoteric activity, add another dimension to the story? In what ways is it linked to his subsequent fascination with PLATO ONLINEª?

8. Why does Lightman give so much space to the e-mail messages circulated among the characters? Beyond a convenient (and often amusing) way of recording events, what purpose do they serve?

9. What does the relationship between Anytus and his son, Prodicus, have in common with the relationship between Bill and Alex? In what ways do the sons challenge their fathers' beliefs about life, either implicitly or explicitly? Is alienation between fathers and sons an inevitable part of life, or are Anytus and Bill "bad fathers," guilty of abnegating their moral responsibilities to their sons?

10. In brooding about his situation, Bill thinks, "Of one thing he was certain: that he had been afflicted far beyond what he deserved. . . . He, who played by the rules, who was more intelligent and able than most, who wanted only a nice house in the suburbs with a family who loved him, an adequate income, an eventual senior partnership and position where he could hold his place in the world" [p. 149]. Do you think this passage describes what most of us are looking for in life? What elements are missing?

11. Why does Melissa say, "I've caused everything. I'll never forgive myself" [p. 365]? Is this an expression of the guilt she feels about her online relationship with the professor and her failure to support Bill emotionally? Is it possible that she is actually in some way responsible for Bill's illness?

12. In the "Anytus Dialogue," Prodicus says, "Sokrates has drawn what he is too modest to speak. He has revealed his true self and the selves of us all" [p. 95]. How do the images Socrates draws relate to the themes of the book? What do the drawings Bill scrawls across his bedroom reveal, perhaps inadvertently, about his true self and the selves in all of us? If you are familiar with Plato's Republic, how can the "Allegory of the Cave" be used as a key to understanding the underlying meaning and message of The Diagnosis?

13. Lightman juxtaposes the stories of Socrates and Bill Chalmers without drawing explicit comparisons between them. In what ways are the two stories parallel? How does Bill's eventual acceptance of his fate echoe the attitudes Socrates expresses to Anytus in talking about his imminent execution?

14. The Diagnosis can be seen as a "dystopian" novel, a portrait of a society that has distorted the most basic principles and values of humankind. What elements does it share with George Orwell's 1984, Margaret Atwood's The Handmaid's Tale, Alan Nourse's Bladerunner, and other visions of dystopia presented in literature and film? What aspects of the novel are the most disturbing?


What's in a Name
As both a writer and a scientist, I've been fascinated by differences in the practice and art of these occupations. A big distinction I've found between scientists and novelists, or scientists and artists generally, is in what one might call the naming of things. Roughly speaking, the scientist tries to name things and the writer avoids naming things. To name a thing, you've gathered it, you've distilled and purified it, you've attempted to identify it with clarity and precision. You've put a box around it and claimed, "What's in this box is the thing, and what's not is not." For example, consider the word "electron," a type of subatomic particle. As far as we know, all of the zillions upon zillions of electrons in the universe are identical. There is only a single kind of electron. And to a modern physicist, the word "electron" means a particular equation, the Dirac equation. That equation summarizes, in precise mathematical and quantitative form, everything we know about electrons, every interaction, every blip that will be measured by our atom smashers and gauges and magnetometers. You can discuss this or that aspect of electrons, whether an electron spins like a top or turns inside itself, whether it orbits or hovers, whether it spreads out like a wave or concentrates itself like a poppy seed, but the Dirac equation has a much more precise and objective representation of the electron. In a real sense, the name "electron" refers to that equation. Modern physicists know and love the Dirac equation. Every physical object in the universe the scientist aims to express with such precision. It is a great comfort, a feeling of power, a sense of control to be able to name things in this way.

The objects and concepts the novelist deals with cannot be named. The novelist might use the word "love" or "fear," but those names don't summarize or convey much to the reader. For one thing, there are a thousand different kinds of love: there's the love you feel for a mother who writes you every day during your first month away from home in summer camp, there's the love you feel for a mother who slaps you when you stumble into the house drunk after driving home from the prom and then embraces you. There's the love you feel for a man or a woman you've just made love to, there's the love you feel for a friend who calls after you've just split up with your spouse. And on and on. But it's not just the different kinds of love that prevent the novelist from truly naming the thing. It's that the sensation of love, the particular sensation out of the thousands of different kinds of love, the particular ache, must be shown to the reader, not named, but shown through the actions of characters.

And if love is shown, rather than named, each reader will experience it, and will experience it in her own individual way. Each reader will draw on her own adventures and misadventures with love. Every electron is identical, but every love is different. The novelist doesn't want to eliminate these differences, doesn't want to clarify and distill the meaning of love so that there is only a single meaning, like the Dirac equation, because no such distillation could represent love -- and any attempt at such a distillation would destroy the authenticity of the reactions of readers, would destroy that participatory creative experience that happens when a good reader reads a good book. In a sense, a novel is not completed until it is read by a reader. And each reader completes the novel in a different way.

--Alan Lightman

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Diagnosis 3.1 out of 5 based on 0 ratings. 14 reviews.
Othemts on LibraryThing More than 1 year ago
This books starts well, but drags as it goes along. I love the descriptions and satires of corporate life in metro-Boston. The email dialogue complete with misspellings is annoying. The scene with the debilitated father and anxious son is very close to the heart for me.
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Guest More than 1 year ago
So much promise in my heart that this would amaze me like his two previous fictional novels. I read 'Diagnosis' to the end, and though I love the flashbacks to Socrates, I was immediately depressed when I was back in the world of a man with a self-inflicted illness that was obviously caused by the worn out 'people are not machines' theme. It never made real sense. It was as if Kafka came back from the dead but found himself composing a novel while mentally splintered. I am sure there was some deep connection here, but it missed me. I still can't figure out what Socrates had to do with this whiney business man whose wife is so bored with him she starts a computer affair to have some relief. Terrible in the talent Lightman usually shows. I will read his new novel to give him another chance.
Guest More than 1 year ago
This is a great book with a mix of contemporary issues and history. I liked its set up, detail, imagery and writing style. If you like to step back and observe the world, this is the book for you. Some things might seem cliche, but it's worth the read.
Guest More than 1 year ago
'Einstein's Dreams' got me to read 'The Diagnosis.' 'The Diagnosis' will keep me from reading his next book.
Guest More than 1 year ago
This book is a rip-off. It seemed to me like the author read a newspaper story about someone losing their mind/memory in a subway and decided to write a rambling disconected comentary about our society, wrap in around the losing memory theme, oh yeah and throw in some greek history for good measure. I hated this book! It got me mad because he had a good story idea here and he went nowhere and left us hanging. Too bad too, he's a gifted writer.
Guest More than 1 year ago
I received this book as a Christmas present and thoroughly enjoyed it. If you like Don DeLillo (White Noise), you¿ll love Lightman¿s new style. In contrast to the rarefied atmosphere of his highly successful Einstein¿s Dreams, Lightman¿s Diagnosis is pulsing with blood, sweat, tears and laughter. Long story short, this is a darkly humorous look at our modern predicament, a view that reminds us of the wisdom of that ancient philosopher, Socrates, who warned us that the unexamined life is hardly worth living. And so it is with the main character of the story, Bill Chalmers, whose desperate need for a proper diagnosis is thwarted by modern forces so common in our lives - office politics, urban inhumanity, suburban paranoia, and at every turn a technology that precludes with ubiquitous urgency any chance of our snatching a single moment for much needed contemplation. Overwhelmed by an environment of cell phones and the complex systems that make our modern lives possible, the main character temporarily loses his mind. By itself, the early scene of his going insane in the Boston subway is well worth the price of admission. His own failings resonate with the failings of the very institutions that are in place, theoretically, to save his sanity - his doctors, his therapist, even man¿s best friend, his family¿s pedigree dog, nothing seems to provide much help. Only his young son seems to be reaching out with any real line back to life. By reading to his (by now) crippled father some very dramatic scenes from the death of Socrates, the son provides the only clue to the source of his father¿s bizarre deterioration. Yet, despite his son¿s (unconscious?) efforts to impart some ancient wisdom, Bill Chalmers asymptotically approaches a platonic pinpoint in the backwater of his brain, a sense-less isolation, confinement to a bedroom bedazzled with strange artwork, shadowy images on the walls and floor. Can such a collapse lead to revelation, a look beyond the shadows of our modern cave? Can a paralysis of this sort lead to the self examination necessary for psychological salvation? Read Lightman¿s Diagnosis of our society and decide for yourself.
Guest More than 1 year ago
In this intelligently-written, dark and brooding novel, the author leaves the reader feeling unclear about his intentions or message. Cumbersome storylines do not wrap things up in a neat package. Thought-provoking, but rambling.