A STROKE OF GENIUS

The mind-body problem West (Love's Mansion, 1992, etc.) confronts in this pugnacious memoir owes more to Hippocrates than to Descartes. Physical deterioration inspires meditations on health care, aging, and death that orbit a central dilemma: intellectual inquiry in conflict with the Kierkegaardian leap of faith that modern medicine requires of patients. A migraineur since childhood, West suffers a succession of ailments—stroke, diabetes, heart trouble—that lead to Intensive Care and, eventually, a pacemaker. His convalescence is overseen by Dr. Obeid, an enlightened cardiologist who reads his patient's books and answers his hard questions with paternal forbearance. Not all of West's doctors are so accommodating. Most resent his appropriation of medical slang, preferring a ``secret society smugness'' that discounts the patient's need to influence his treatment; responding to a complaint, one doctor informs West that hospitals don't exist for the convenience of patients. West (who quotes the Physician's Desk Reference, Frankenstein, Wordsworth, and Milton with equal felicity) can be demanding. Mostly, though, his commonsense prescriptions are obvious: The last thing a hypersensitive patient needs is a confrontation with doctors to raise his blood pressure further. But physicians rarely see patients as sentient beings, West argues, and his insistence on being treated as such gives the memoir its endearing feistiness and dignity. It's no coincidence that the combativeness that makes him a testy patient also heightens his will to survive. Survival—and the compromises one makes for its sake—are of major concern here. So, too, is language. Unable to reason his way to health, West takes pleasure in wordplay (mining the etymology of medical terms and drug names) and proves—in his analysis of the careless, ambiguous language that often undermines living wills—that precision of thought and expression can mean, literally, the difference between life and death. West indulges a bit of ``secret society'' elitism of his own with his frequent literary fireworks but demonstrates that, even in sickness, the mind is restless and indomitable.