In Celebration of Life

By Paul Gray

Dr. Lewis Thomas has more good news about the human condition

There is nothing at all absurd about the human condition. We matter. It seems to me a good guess, hazarded by a good many people who have thought of it, that we may be engaged in the formation of something like a mind for the life of this planet. If this is so, we are still at the most primitive stage, still fumbling with language and thinking, but infinitely capacitated for the future. Looked at this way, it is remarkable that we've come as far as we have in so short a period, really no time at all as geologists measure time. We are the newest, the youngest, and the brightest things around.

--Lewis Thomas

Who is this man, and why is he saying all those nice things about the human race? The first question is simpler than the second. Lewis Thomas, 65, is a doctor and an administrator (currently president and chief executive officer of the Memorial Sloan-Kettering Cancer Center in New York City). He is a biologist, a researcher and a professor. He is a published poet and, quite possibly, the best essayist on science now working anywhere in the world.

This last accomplishment has brought Thomas more attention than all the others put together. A collection of 29 of his essays was published in 1974 under the title The Lives of a Cell: Notes of a Biology Watcher. No one expected much, least of all the author. For one thing, most Americans escape from the study of biology as fast as their teachers will let them; if they think of the subject at all, they are likely to remember rubbery dead frogs and the smell of formaldehyde. For another, Thomas made few concessions to the ignorance of laymen. He certainly did not obfuscate, but he gave complex matters the taxonomic precision they required: "It has been proposed that symbiotic linkages between prokaryotic cells were the origin of eukaryotes, and that fusion between different sorts of eukaryotes (e.g., motile, ciliated cells joined to phagocytic ones) . . ." Such is not the stuff that bestsellers are made of, but that is precisely what Thomas' book became. Novelist Joyce Carol Gates found the essays "remarkable . . . undogmatic . . . gently persuasive." John Updike praised Thomas' "shimmering vision." Reviewers picked up the applause; so did more and more readers. The book has now sold over 300,000 copies in hardback and paperback and has been translated into eleven languages. The Lives of a Cell was given a National Book Award in April 1975, but not in the category of science. It was honored as a contribution to the field of arts and letters.

Which is what it was. And so is The Medusa and the Snail (Viking; 175 pages; $8.95), a collection of 29 more Thomas essays to be published this month. If anything, the new book is better than its predecessor. Thomas' prose seems firmer, his conclusions surer, his voice more resonant. He ranges farther and farther away from the laboratory, and devotes his attention to larger chunks of society as well as to bacteria and viruses. Taken together, his two books form an extended paean to this, the best of all possible worlds.

That is the second riddle about Thomas and his philosophy. He bears no resemblance to the fatuous Dr. Pangloss, who chirped about this best world while stumbling through a series of catastrophes. Voltaire's doctor was an a priori optimist, and nothing that he saw or experienced could rattle his foolhardy faith. Thomas reverses this procedure and writes about things he has observed, grounding his conclusions in the tiniest material details that the world can provide. Because he has peered at nature's building blocks more closely than anyone but fellow biologists, and because he can translate his visions more gracefully than anyone but fellow writers, Thomas' good news about the human race is practically unique. Given the pessimistic tenor of our age the good doctor and his message could not have come along at a better time.

What in the world can he find to be hopeful about? As it turns out, almost everything. Most simply, Thomas argues that the overwhelming tendency in nature is toward symbiosis, union, harmony. The post-Darwinian view of life as a constant, murderous struggle, Tennyson's personification of nature "red in tooth and claw," do not match the facts that Thomas has seen. Even what looks like random slaughter may be the opposite.

Take, Thomas suggests, the case of the nudibranch (a sea slug) and the medusa (a jellyfish) that live in the Bay of Naples. The slug lives with a tiny fragment of the medusa permanently and parasitically attached near its mouth. The vestigial jellyfish apparently is still able to reproduce; its offspring swim off and become normal adult jellyfish. The slug also produces larvae, but these are rather quickly trapped and subsumed by the new jellyfish. Aha, one would think, the jellyfish are getting back at the slugs for prior mutilations. No such thing. "Soon the snails," Thomas writes, "undigested and insatiable, begin to eat, browsing away first at the radial canals, then the borders of the rim, finally the tentacles, until the jellyfish becomes reduced in substance by being eaten, while the snail grows correspondingly in size." At the end, the jellyfish are once again tiny parasites, and the whole cycle begins anew. Which one is the predator, then, and which one the prey? This underwater dance lends Thomas' new book its title and occupies the first essay; its implications echo through all that follows. Life may not be a matter of eat or be eaten; it may boil down to eating and being eaten.

This may seem cold comfort to some, but it is not the only one that Thomas offers. Other happy refrains are sounded and resounded as the essays (averaging only 1,200 words long) tumble forth. He seems bemused by the phenomenon of healthy hypochondriacs. Americans, for example, are needlessly "obsessed with Health." Thomas wonders why, particularly at a time when "we are free of the great infectious diseases, especially tuberculosis and lobar pneumonia, which used to cut us down long be fore our time." Humans are not frail organisms coveted by every death-dealing microbe in the world, as so much pop medicine would have it. Quite the contrary: "We are in real life, a reasonably healthy people. Far from being ineptly put together, we are amazingly tough, durable organisms, full of health, ready for most contingencies."

Similarly, Thomas suggests that death may not be the rattling, agonized event that humans fear. He is no stranger to the spectacle of death and its ravages. But he cites interesting evidence gathered from people who have slipped toward death before being rescued. Their testimony suggests a peaceful experience. When death is imminent, the brain apparently realizes that pain can no longer be useful as an alarm to spur escape. So the pain is turned off and replaced by a kind of blissful surrender. Thomas writes: "If I had to design an ecosystem in which creatures had to live off each other and in which dying was an indispensable part of living, I couldn't think of a better way to manage."

One of the charms of boarding Thomas' train of thought is the puckish delight he takes in turning beliefs or assumptions upside down. The current to-do about the likelihood of cloning humans? Not worth worrying about, Thomas says, and impossible besides. But (and most of his essays pivot merrily on that word) he has a suggestion for those who cannot resist tinkering: "Set cloning aside, and don't try it. Instead go in the other direction. Look for ways to get mutations more quickly, new variety, different songs." Continued genetic errors, after all, enabled the primeval strand of DNA to diversify into the vast spectrum of life. Humans have mimed this sloppy but productive process; "the capacity to leap across mountains of information to land lightly on the wrong side represents the highest of human endowments." With tongue in cheek, Thomas hails the arrival of the computer age; he looks forward to the bigger mistakes that the programming of bigger computers will make.

He believes that certain attempts to pierce the mystery of things are conducted backward: "Instead of using what we can guess at about the nature of thought to explain the nature of music, start over again. Begin with music and see what this can tell us about the sensation of thinking." He recommends an experiment, enlisting Johann Sebastian Bach to support his hypothesis: "Put on The St. Matthew Passion and turn the volume up all the way. That is the sound of the whole central nervous system of human beings, all at once."

Such imaginative leaps are typical throughout The Medusa and the Snail. Though the book is about science, its form is a demonstration of art. In fact, a Thomas essay blooms organically in much the same manner as a romantic ode or sonnet. A receptive mind encounters something in nature; the object out there is gradually drawn into the thinking subject; reflection occurs, hypotheses are put forward and tested, a pulse of excitement becomes audible; suddenly, everything coalesces, time stands still for a moment, an image is born out of matter and spirit. If Wordsworth had gone to medical school, he might have produced something very like the essays of Lewis Thomas.

What Thomas does is extraordinarily rare. It is hard enough to explain specialized scientific findings to scientists in other fields, and harder still to get it right and still hold the attention of untutored novices. Add touches of poetry, joyful optimism and an awe-inspired mysticism, and the job becomes impossible. Except that the impossible, like so many of the natural phenomena that Thomas describes, happens.

The doctor's prose and insights are unassailably his own, but the roll of physician-writer is nearly as old as the art of healing. St. Luke was probably a physician. One of Alexander Pope's close friends was Dr. John Arbuthnot, who dabbled in literature himself. A more modern roster includes serious practitioners like Anton Chekhov and William Carlos Williams, as well as others who had some medical training: Arthur Conan Doyle, Somerset Maugham and Walker Percy. In recent years, onetime doctors have turned to go-go careers on the edges of literature: Michael Crichton, from novels into film writing and directing The Great Train Robbery; Jonathan Miller, from comedy in Beyond the Fringe to medical reporting on the BBC's The Body in Question; Graham Chapman, into satire and lunacy as a member of Monty Python's Flying Circus. None of this surprises Thomas, as he told TIME Correspondent Peter Stoler last week: "The physician for quite a long time was quite well educated; in fact, he was often the best, sometimes the only, educated person in the community." The mere fact of literacy made those who possessed it writers. Thomas adds: "Doctors are trained to observe, and to express their ideas precisely. Medical training is good training for a writing career." True, but Thomas remains slightly beyond the circle of all the luminous names who have been taught medicine and also made up stories. When he began writing consistently, at the age of 57, he did not turn to plays, novels or poems. He wrote about what he knew: science.

It had been familiar to him since childhood. Medicine was in the family bloodline; his father was a general practitioner who later specialized in surgery. Some of Thomas' earliest memories are of traveling with his father in the family's Franklin: "When we made most house calls, we'd park right in front of the house. When he called on Christian Scientists, it was understood that he'd park his car a block away and walk to the house, so that no one would know that they were seeing a doctor." His father's job looked like fun to young Lewis, and he pointed himself in the same direction. After graduating from a private day school in Manhattan he entered Princeton. His interest in medicine flagged for a time; exposure to the poems of T.S. Eliot and Ezra Pound inspired him to try his own hand. He published works in the college magazine, but a senior-year course in advanced biology redirected him toward medicine.

He moved easily through Harvard Medical School, surprised at how little doctors in the 1930s actually knew about the illnesses they treated: "Doctors were never really taught to or expected to cure diseases. We were taught to learn the names of the diseases and make accurate diagnoses, so we could make accurate prognoses." After graduation, Thomas interned at Boston City Hospital, becoming especially interested in meningitis infections of the brain. He also continued writing poems; one of his works composed during this period was published in the Atlantic Monthly.

After Boston, he did his residency at the Neurological Institute in New York City. In 1941 he married Beryl Dawson, a Vassar girl he had met at a college dance; they were wed about a year when Thomas, then at the Rockefeller Institute, was called for service in the Navy. Lieut. Commander Thomas waded ashore during the dramatic invasion of Okinawa and collected a lifelong memory: "I went over the side of a troop transport with a case on my shoulder containing 50 white mice, bedded on white toilet paper. One soldier who watched me wade ashore with this load said, 'Now I've seen everything.' " Thomas' burden was not a secret weapon but a collection of research animals; the Navy feared that troops on Okinawa would be endangered by a disease called scrub typhus, and Thomas' assignment was to study the dangers. That threat never materialized, so Thomas had to make do with an outbreak of Japanese B encephalitis. It was, he remembers, "the only game in town."

After the war Thomas became an "academic tramp." His momentum carried him away from the practice of medicine and toward research, teaching and administration. He wound steadily up the helix of professional advancement: research at Johns Hopkins, teaching at Tulane and the University of Minnesota. Back in New York, he moved through lower posts to become dean of the New York University medical school. In 1969 Thomas moved to Yale as a professor and chairman of the medical school's department of pathology; three years later he was named dean of the medical school. He left after a year at that to take charge of the Sloan-Kettering complex in Manhattan, one of the most important cancer research and treatment centers in the world.

He also found time to teach medicine and pathology at the Cornell University medical college and to rejoin the faculty at Rockefeller University. Along the way, Thomas and his wife had three daughters. In spite of growing administrative burdens, he had published more than 200 technical articles on infectious diseases and related matters. The corner office, it turns out, was never Thomas' goal: "I made each change because it offered better opportunities for research, because I found the scientific opportunities irresistible."

Thomas' career had plotted an impressive arc. Though unknown to the general public, he was a successful and esteemed member of the U.S. medical Establishment; he had taught at the right places and run some of them as well. The rest of his life was his to live out in dignified, influential isolation. There was no reason to believe that any work bearing Thomas' name would ever appear on paperback racks in airports or drugstores. But then, as The Medusa and the Snail indicates, there is no reason for expecting many things to happen until they do; only then can the moving forces behind events leap into clarity.

Thomas' "error," a word he traces back to an old root meaning "to wander about, looking for something," occurred in 1970, when he put together a short, casual talk on the phenomenon of inflammation and what it might represent as a biological process. He delivered it at a symposium held at Upjohn Co.'s Brook Lodge in Michigan. A member of the audience passed a copy of the speech to Dr. Franz Joseph Ingelfinger, then the editor of the New England Journal of Medicine. Ingelfinger had already roiled the academic waters by warning potential contributors that medical research should be made compatible with good, clear writing. The graceful, straightforward style of Thomas' speech struck the editor as just what he had in mind, and he offered Thomas the chance to write a monthly column for the journal. There were two conditions: the columns could run no longer than one page (about 1,200 words), and they had to be submitted in time to meet deadlines. If these strictures were met, the editor offered a bonus: Thomas' pieces would be printed, with no changes or revisions, exactly as he had written them. "That was irresistible," recalls the columnist. "I had to say yes."

Thomas was at Yale at the time and maintained a house in Woods Hole, Mass., where he and his wife retreated on weekends. He used the driving time from New Haven to consider ideas; then he spent the weekends writing his column longhand on ruled pads, finishing it by the time he was ready to drive home on Sunday night. "I wrote three or four pieces this way," says Thomas. "Then I called Ingelfinger and told him that I thought I had done enough. He said that he wanted me to continue and persuaded me that I should, so I did." Very shortly afterward, Thomas' column began attracting a cult of pass-along readers. The evolution that led to The Lives of a Cell and The Medusa and the Snail had begun.

Thomas still writes his monthly column, one job among many in his crowded professional life. He is a familiar figure in the halls at Sloan-Kettering, walking quickly, the tall figure canted slightly forward at the waist, his lab coat billowing out behind him, Groucho-style. He is on the run elsewhere as well, making frequent trips to Washington for committee work and to testify at congressional hearings, and to Cambridge, where he serves on the Harvard Board of Overseers. In his laboratory he continues experimenting, currently studying two microbes that lack cell walls and observing how they interact with the body's immune system. He also reads voraciously, particularly poetry, and is teaching himself Greek so that he can read Homer in the original. The doctor's spare time is not wasted in worry; he smokes a pipe constantly, enjoys a drink before dinner, eats whatever he likes and refuses to undergo annual checkups.

After some 45 years in medicine, Thomas remains a carrier of infectious enthusiasm. "It's the greatest damned entertainment in the world," he says of his work. "It's just plain fun learning some thing that you didn't know . . . There is a real aesthetic experience in being dumbfounded." He is still astonished at things that others, mistakenly, take for granted. Why, he muses in The Medusa and the Snail, did people make such a fuss over the test-tube baby in England? The true miracle was, as always, the union of egg and sperm and the emergence of a cell that can grow into a human brain. "The mere existence of that cell," he writes, "should be one of the greatest astonishments of the earth. People ought to be walking around all day, all through their waking hours, calling to each other in endless wonderment, talking of nothing except that cell." Thomas' pyrotechnic conclusion demands the accompaniment of Bach, with the volume turned way up: "No one has the ghost of an idea how this works, and nothing else in life can ever be so puzzling. If anyone does succeed in explaining it, within my lifetime, I will charter a skywriting airplane, maybe a whole fleet of them, and send them aloft to write one great exclamation point after another, around the whole sky, until all my money runs out."

--Paul Gray

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