You ever have a friend, a relative—someone you work with, maybe—who has been in a car wreck? What you discover is that, for some good while, they can’t not talk about the accident. All the details are laid out, sorted and resorted. How it felt at each moment. How it didn’t feel at each moment, for that matter, with mon trope the report of not knowing about an injury till later, when the car-wrecked friend, standing at the side of the road in shock, looks down and sees blood.

TheNew York Timescolumnist’s account of his struggle for a diagnosis, then a treatment, for Lyme disease is instructive not only in negotiating the modern American healthcare system but also in what friends are for.

The Deep Places: A Memoir of Illness and Discovery

By Ross Douthat

(Convergent, 2021)

You want to be sympathetic. You are sympathetic. This is a person, after all, who’s been through a traumatic event and is still in pain: the twinges and aches, the click of misaligned bones and the stuttering steps of the battered, that linger long after discharge from medical care. And you learn from your friend about all the misadventures of that medical care. And all the pains, spasms, and wrenches that remain as well.

Last fall, Ross Douthat published The Deep Places, a brief account of his struggles with chronic Lyme disease. The book is lyrical in places, fascinating in its investigations of the self’s sense of its own diseased state, and serious in its efforts to understand the moral theology implicated by illness. It’s also annoying. Douthat is that friend who just won’t stop talking about his car wreck, long after your attention has begun to bang on the back of your eyelids demanding a respite.

The truth is that Ross Douthat actually is a friend—not just to me, who know him slightly, but to nearly everyone in the publishing world who’s met him, even in these over-politicized days that seem to resent the existence of people who aren’t perfectly aligned with the proper ideologies. And friends let friends drone on about their troubles. That might even be the definition of friendship.

Douthat can be your friend, too, for he has the gift, shared by fewer authors than you might imagine, of making readers feel an affinity: a sense of closeness and shared feeling. To read The Deep Places is to know, yes, the author is running on a bit, but you put up with it because he’s e a friend. Pain, he writes, makes your body “feel like a cage around your consciousness.” A chronic illness such as Lyme disease “dramatically clarifies just how much this world of surfaces and curated selves lies to its inhabitants, to both the healthy and the sick.”

A columnist at The New York Times, Douthat undertook The Deep Places, his sixth book, as a “memoir of illness and discovery.” And he means both the illness and the discovery, for he tells the story not just of his suffering but also of his maniacal search for treatment once the ordinary doctors he consulted more or less dismissed his symptoms (and often the disease itself) as something like a psychosomatic disorder in those too stressed by the demands of modern life to live at peace with themselves: a first-world disease, in the parlance of the day, suffered by those without any actual suffering.

The story begins in 2015, when Douthat and his wife, Abigail, came to realize how much they hated Washington, D.C. Abigail Douthat, with her baby in a stroller, had been robbed on Capitol Hill. A few days later, she was nearly run down as she leaned into her car to unbuckle a child’s seat.

Enough was enough, and the boom in Washington real estate prices meant that sale of their Capitol Hill house would give them the money to act on a dream. The Connecticut natives would go to the land—that idyllic land imagined in the idles of city folk—and buy a countryside place in Connecticut. They found a 1790s farmhouse, out in the tulies, with a barn, some pastures, and fruit trees. Bucolic heaven, in other words, for a successful young man with a growing family.

The bucolic hell soon descended. Just a few days after buying the farmstead, Douthat found a crackling in his spine and a boil on his neck—a result of a tick bite he had received while looking over the property. Seeing deer in the meadow, he thought to himself, “Yes, this is what I want.” What he got was not just the deer but also an infection from the insects they carry.

Perhaps the first doctor Douthat consulted was not to blame for waving away the early symptoms of Lyme disease. Readers of The Deep Places will get a crash course in the rigid conditions the Centers for Disease Control have laid out before it will accept a report of the tick-borne disease, with the result that many early cases are missed.

Even with clear evidence of Lyme disease—obtained from Connecticut doctors only after a dozen D.C. doctors refused the diagnosis—Douthat discovers that the medical establishment refuses to accept the existence of chronic Lyme disease: the lingering and even escalating symptoms that sufferers insist they have. He feels as though he and his wife (carrying their third child while she tries to write her own book) are wandering through a set of The Shining, haunted by ghosts and too exhausted from pain’s theft of sleep to undertake the repairs that a 1790s house needs. Their charming country life has turned to squalor, and the medical world keeps trying to tell them it’s all in his mind.

So Douthat takes to the internet to find others like himself and learn the treatments they have tried—nearly all of which he tries himself. He purchases a Rife device, which uses an “oscillating beam ray” to kill bacteria in a patient’s body. He hooks himself to an antibiotic drip. He buys more antibiotics at pet stores, pouring as many as a dozen a day down his throat, along with “every non-prescription antimicrobial substance that any study, however obscure, suggested,” as he notes with conscious irony. Still, his self-treatment, he insists, was systematic: “the most empirical work … I have ever attempted.”

In the end—but there isn’t really an end for chronic disease. It lessens, sometimes, and life goes on. Douthat’s subsequent bout of COVID confirmed what his chronic disease had taught him: a pronounced suspicion of blithely offered public-health declarations and the too-quick, too-programmatic pronouncements of doctors.

And his sufferings confirmed his faith as well. God is a luxury good for the healthy. God is a basic necessity for the ill. The intellect will not abolish pain and exhaustion. “The mind is always carapaced by suffering flesh,” Douthat writes, “like a balloon bobbing against a hard ceiling, free to move but not to soar away.” The will cannot save us, either. Only something above us can lift us out of ourselves.

The reviews received by The Deep Places last fall are instructive. Ross Douthat seems a friend even to those who’ve only read him, and many reviewers had actually met him. The New York Times, reviewing its own columnist (as some journals do, while others do not), went out of its way to be nicer to the book than the reviewer clearly felt—although, in the monovision of the day, she repeatedly mentions that it would have been a different book, and probably a better book, if it were written by a sensitive woman rather than a man who must, by nature, be a brute. The Wall Street Journal lauded the book, in a distant way, and the Los Angeles Review of Books snarked at it a little before admitting that, yes, it helped make clear, like one friend talking to another, the chronic drag of chronic disease and the spiritual teaching it can impart.

I’m less confident in the spirituality The Deep Places lays out. It’s earthy and bodily, which an illness by definition forces one to be, but it never reaches much beyond into the mystical, the way Simone Weil’s accounts do, or into the terrible gift of suffering, the way St. Therese shows.

“Affliction is a treasure, and scarce any man hath enough of it,” John Donne wrote in his Devotions. It’s one of those poetic lines that the healthy all nod sagely at, while the sick feebly reach up to throw a bedpan across the room at the poet’s head. Ross Douthat has suffered enough—he even had to sell the farmhouse, at a loss—that he’s earned the right to take a few potshots at sententious and fatuous efforts to make pain useful.

Our job is just to shake our heads in sorrow as we listen to the details. That’s what friends are for.