Read Online The Hypochondriac's Guide to Life. and Death. by Gene Weingarten - Free Book Online

medulla of the brain. Cardiologists will not rule out an oncoming heart attack or an aortic aneurysm. Nephrologists will suspect kidney failure. Gastroenterologists know hiccups can indicate an “irritation” of the diaphragm or of some other organ, particularly one that touches the vagus or phrenic nerves, which control the swallowing and breathing reflexes.
    On the outside of the body, an irritation is often a minor matter. On the inside, it often isn’t. On the inside, it is often a tumor. Hiccups have been associated with tumors in or around the lung, in the diaphragm, the liver, the pancreas, the stomach, and even the sigmoid colon, which is down near the butt and should not, by the grace of God, have anything to do with breathing.
    Insomnia. In the absence of other symptoms, excessive fatigue or excessive sleep can be an indication of many serious diseases, but insufficient sleep generally isn’t. Most of the time, the insomniac knows or suspects why he can’t sleep: He is worried or depressed, or he has a toothache, or asthma, or a goiter the size of a microwave oven. Insomnia seldom stands alone, but when it does, it is out there in the hellish regions of Things You Wouldn’t Wish on Your Worst Enemy Even If He Ate Garbo, Your Dachshund.
    The most dramatic of these is fatal familial insomnia. This is a disease caused by prions, which are proteins that act exactly like ice-nine, the instrument of the apocalypse in Kurt Vonnegut’s
Cat’s Cradle.
Ice-nine was a molecular template. If it mixed with water, it would turn the water molecules into ice-nine molecules, rock hard and useless for sustaining life. This was not good when it spread across the oceans of the world. That’s how prions work. They get into your body and take other proteins and reorder their structure to resemble themselves. In fatal familial insomnia, prions take up residence in the sleep center of your brain and slowly destroy it. You start out being unable to sleep well. Then you cannot sleep at all. In desperation, you see a top neurologist like Dr. Anthony Reder of the University of Chicago.
    A few years ago, a man came to see Dr. Reder. The patient was tired and grouchy—not tired and grouchy like a bus driver at the end of his route, but tired and grouchy like the people from
Invasion of the Body Snatchers
immediately before the dull-eyed pods took them over. This patient looked disheveled. His hair was askew, like Beethoven’s after a night of carousing. Reder had seen this before; he is a research scientistand had seen it in laboratory rats with sleep deprivation. He diagnosed fatal familial insomnia. There is no treatment. There was nothing that could be done. Within weeks, the patient was hallucinating, making up grandiose stories about himself. His appearance deteriorated. Beethoven lost a lot of his charm. He gave way to Dr. Irwin Corey. Then he died.
    Laughing So Hard You Pee in Your Pants. There is actually a medical term for this. Urologists call it “giggle incontinence.” It can mean nothing, or it can be a very early indication of neurologic disease, in particular multiple sclerosis.
    The Sniffles. Sometimes a cold is nothing to sneeze at. It could be the first sign of Wegener’s granulomatosis, a rare, fulminant, whole-system body breakdown that often starts with coughing, congestion, and blood-streaked nasal discharge. Looks just like a cold! Then, when it doesn’t go away, it looks like chronic bronchitis, maybe with an ear infection. Small wonder that Wegener’s granulomatosis is sometimes not properly diagnosed until it is too late to treat. By that time it has progressed to kidney failure, lung damage, and body deformities, including “saddle nose,” in which the nose cartilage collapses like a rotted jack-o’-lantern.
    Or your “cold” might mean you have anthrax. Anthrax is a bacillus carried by livestock; an airborne, inhaled form of it starts