Round and round.

I know all about vertigo. As a primary care doctor who cares for myriad elderly patients, I treat dizziness all the time. I can distinguish between central and peripheral causes, I know when it’s benign and when it’s concerning, I can recite the pathophysiology of the disorder, I know when to use meclizine and can skillfully instruct people in performing the Epley maneuver. But none of this was of the least use to me at 3:00 in the morning as I lay clutching my wife and hoping that I didn’t plunge from the side of my bed into an abyss as dark and scary as death itself. It’s said that experiencing illness can make one a better doctor—that it builds character, helps one develop empathy, and humbles the arrogant. But I have my doubts. Debility as I experienced it has a diminishing effect; it shook my confidence, eliminated the prospect of productivity, and magnified my irritability. None of this would seem to equip me to be a better doctor. Illness is also transformative. The experience is not simply a new quality added onto a fully functioning person; instead, illness fundamentally changes the individual, and it is not the healthy person who must cope with the debility, but a diminished one who may no longer possess all the requisite tools and abilities to do so. I recall that someone once compared this to race—that a white person cannot understand what it’s like to be black by imagining a new skin color covering his or her white self. To understand what it is to be black is to have the totality of the experience that goes along with the pigment, and this is impossible to imagine for someone who is white. Some people are able to put a positive spin on illness. Joseph Cardinal Bernardin, the late Archbishop of Chicago, considered his lethal pancreatic cancer a gift from God and was appreciative for ways that it helped him grow as a person. I always found that perplexing. While I don’t doubt his sincerity, I have never felt better about myself when I’ve been ill, nor more spiritually inclined, and I certainly have not felt grateful. All things considered, I, like most everyone else I have ever known, vastly prefer good health to illness, and I suspect it has always been that way. I realize that the Cardinal was grateful that his illness afforded the opportunities to slow down, appreciate the bounties of life, and deepen his personal and spiritual relationships. But that wasn’t in my repertoire when my head was spinning about maniacally. That night, more than anything, I felt scared. Did I have a brain tumor? Would I be able to get on the airplane tomorrow for my trip to Chicago? How will I work if I’m still dizzy next week? How can I possibly manage when I feel so out of control? I suspect that many patients have similar concerns when they become ill, and I hope that as a doctor, I can help answer their questions and put their fears to rest. But let’s not fool ourselves. Sometimes, people fail to get better, their condition progresses, and they lack the skills to cope effectively. These people are truly miserable, and ending up like one of them, I suppose, was my biggest worry. I cancelled my trip to Chicago and spent the weekend resting. My family and friends offered all sorts of unsolicited advice, and I got to hear about everyone else’s misfortunes and ailments. So in a strange way, illness brought us together, but not in a way that I invited or enjoyed. After the spinning had stopped, I returned to work and was surprised when the first patient on my schedule had a chief complaint of “dizziness.” Empathizing and relating more than I cared to admit, I wondered whether my own experience helped me be more present and focused during our encounter. But even so, these days, I’m just a bit less sure of myself, and I feel unsettled. If I move my head in a certain way, I’m immersed in the memories of that night, I am left wondering if the spinning will return, and if it does, what will happen next.