bookshelf: Magnificent Medical Miracles

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Books: Magnificent Medical Miracles, and Everyday Ones, Too

By ABIGAIL ZUGER, M.D

MEDICAL MIRACLES: Doctors, Saints and Healing in the Modern World. By

Jacalyn Duffin. Oxford University Press. 285 pages. $29.95.

7 WHEELCHAIRS: A Life Beyond Polio. By Presley. University of

Iowa Press. 226 pages. $25.95.

Even diehard skeptics stumble across medical miracles all the time:

miracles disputed, miracles pursued, miracles that unfold against all

expectations. Two new books go a long way toward explicating the last

two categories. As for the first, consider the case of my patient Joe.

Joe had diabetes. Nothing kept it in check. Diet, insulin, pills — his

blood sugar stayed sky-high.

Then, a few years ago, we made one last-ditch attempt at treatment. Or

rather, as it turned out, we made two. One (mine) was to take Joe off

a few of his regular medications. The other (Joe's) was to pay a visit

to his long-neglected church the same Sunday he stopped his meds.

He never had another elevated blood sugar reading. He was cured.

Cured! Each of us was delighted and triumphant, and it was immediately

clear that we would simply have to agree to disagree on the mechanics

of the event. He had his theory, and I had mine. In our particular

context, all that really mattered was the outcome.

But in other contexts the mechanics are what matter. They are vested

with an importance that actually transcends the outcome, and are

examined with all the scrutiny and debate Joe and I purposely sidestepped.

These are the miracles that pave the road to sainthood in the Catholic

Church, miracles pursued in an age-old ritual that the Canadian

medical historian Dr. Jacalyn Duffin puts under her own microscope.

Readers as ill versed in Catholicism as I am may be surprised to learn

that the process of recognizing a saint has not changed much since the

16th century. One of the steps, beatification, requires at least one

confirmed miracle. Canonization, the final declaration of sainthood,

requires at least one more.

Most miracles involve healing from dire illness, with supporting

evidence carefully assembled sometimes centuries after the event, and

a designated prosecutor (the original " devil's advocate " ) questioning

every detail.

The process proceeds with vigor to this day: of the 1,400 individual

saint-making miracles Dr. Duffin presents in the form of a medical

case series, complete with tables and graphs, more than 500 were

validated in the 20th century. The most recent miracle healing on her

list took place in 1995.

You might think the story of these events would form a kind of

negative image of medical history, a mirror world of healing without

medicine. Far from it: doctors and orthodox medicine have always been

central to the process, their expertise needed to confirm that events

transcended the expected course of illness treated with the best

possible tools of the time.

Dr. Duffin, a physician, describes supplicants who walk away from most

of history's incurable diseases, from the suppurating wounds and

raging tuberculosis of the preantibiotic era to today's diagnoses of

metastatic cancer.

The supporting medical testimony is rich with squabbling as doctors

offer differing diagnostic opinions and trade accusations of

substandard practice. Occasional anger turned on a dying patient who

heads to church instead of the hospital always melts into humbled

surprise when the patient reappears, cured.

Miraculous? Perhaps. But even rationalists must acknowledge that this

series of the not-so-incurably ill forms a fascinating and neglected

part of medical history, a rare report from the cloudy borders of the

improbable and unforeseen.

Those who prefer their miracles in subtler and more secular form might

turn instead to Presley's extraordinary memoir of a life after

polio. No one rises from a wheelchair and walks again in this book,

yet the miracles clearly abound.

Mr. Presley was part of the last generation of polio patients in the

United States: he became sick in 1959, right after receiving a booster

shot of the old Salk vaccine. Whether the illness was from the vaccine

or despite it was never clear, and in the end made little difference:

within a week both legs were paralyzed, both arms drastically

weakened, and he could not breathe.

The primitive respirators of the time saved his life. For months, an

iron lung encased him like an oversize Tin Woodsman's costume, doing

the work his own muscles could not do. He was flat on his back, his

world limited to what he could see in a small mirror affixed to the

top of the machine. (With the mirror tilted correctly, he could watch

" noitartnecnoC " and " drowssaP " on television.)

Eventually he graduated to a smaller, more portable lung — a metal

carapace that let him sit upright. At night a rocking bed turned him

violently on his head and back again to force air in and out of his

lungs. Then the hospital sent him home to a small isolated Missouri

dairy farm. He was 18 years old.

Mr. Presley writes with candor and precision about every facet of the

next five decades. He learned to breathe without machinery, but he

never walked again. A voracious reader, he skipped college and settled

into a clerical job in a local insurance office. His wheelchairs

became faster and sleeker, but his parents helped him dress and bathe

until they died. As for toileting: Mr. Presley's chapter devoted to

the mechanics of urination and defecation in the face of paralysis is

a tour de force that should be required reading for all.

Who could predict that, finally living on his own in his late 40s, he

would fall in love with one of his hired aides? Or that, now

approaching 70, his anger and depression faced and pretty much

conquered, he would be happily married, healthy, vigorous, productive,

in his words, a lucky man? A miracle, indeed.

http://www.nytimes.com/2008/11/25/health/25book.html