My father never phoned me, so when I got a phone call from him during my last year in graduate school, I knew it must be important.
"Your mother is having a biopsy, and you need to come to the hospital."
I reminded him that my mother had told me that it's only a biopsy, it wasn't serious, and I shouldn't worry.
"It's surgery, and surgery is always serious!" he replied sharply.
When my father was a teenager, his father had died on the operating table from the anesthesic, before the operation. One of his great-aunts broke the news to him by saying, "You're an orphan. Your life will be hard from now on." He never forgot that. One result was that he avoided doctors. (My mother, on the other hand, followed doctors' orders and did everything she was supposed to do. My father lived 10 years longer than she did. Make of that what you will.)
Soon after my father's phone call, K came down with a fever. The fever was accompanied by an enlarged lymph node in his groin (I would call it enormous, but the technical term seems to be "remarkable"). He went to a doctor who told him to get the lymph node biopsied.
Due to the conversation with my father, I freaked out. Surgery is always serious. I would do what I could to help K avoid surgery.
Princeton University doesn't have a medical school or medical library, so I went to the Princeton Public Library and found the Harvard Medical School Health Letter Book. I looked up "lymph node" in the index, and the first thing it led me to was a section on important things to tell your doctor if you have a cat or a dog. It said that young people with an enlarged lymph node and a young cat should know about cat scratch fever.
Toby, a grad student friend who was a year ahead of me, had been having severe backaches. He had decided that perhaps the cure was to get a cat.
Toby soon decided that the kitten, whom he named Topos, was making his back problems worse --- she snuggled against him under the covers at night to keep warm, and he was afraid to move for fear of rolling over and crushing her.
I couldn't stand the thought of sending her back to Landau's window, so Topos, whom I renamed Ceilidh, became my cat.
When K ate ice cream, Ceilidh would climb up his legs, giving him lots of scratches. As I soon learned, the lymph system drains upwards. The scratches on his legs led up to the lymph node in his groin. Cat scratch fever made a lot of sense.
When I mentioned cat scratch fever to Toby and other friends, they said, "Oh yes. That was a popular song. You must have heard it." I hadn't, but everyone else seemed to have.
We got an appointment with a family friend who was a doctor at a major cancer center in New York. He pressured K to have the lymph node biopsied. I vowed to do what I could to save K's lymph node.
Something Toby had learned in his adventures to cure his bad back was that it's important to be seen by the right specialist. "If you want to be diagnosed with cancer, go to an oncologist. If you want to be diagnosed with an infectious disease, go to an infectious disease specialist," he told me.
So we found an infectious disease specialist in Princeton.
At that time, not much was known about cat scratch fever. They didn't even know if it was bacterial, viral, or something else, and the specialist didn't know how to test for it. When we told him our theory, he ordered a bunch of tests, including one for toxoplasmosis. We looked up toxoplasmosis in a 70-year-old copy of the Merck Manual (a well-known medical reference book). It gave the memorable warning that you should never eat a rabbit that you can knock over with a stick.
Even though one could get toxoplasmosis from a cat, K didn't have the symptoms for it, so that blood test, like a lot of things K's doctors did, didn't make a lot of sense to us.
I no longer remember how K got the name and phone number of the expert on cat scratch fever (this was long before the Internet or Google). K still remembers the names of the expert and the infectious disease specialist, and he remembers being nervous about phoning the expert.
The expert told K that the Centers for Disease Control (CDC) had an experimental test for Cat Scratch Disease. We found out how to order the test, and K's infectious disease specialist ordered it. It was a simple pin-prick skin test, like the old tuberculosis tests.
I think the reason the infectious disease specialist took us seriously was that both he and K had been undergrads at Princeton, and the Princeton alumni bond is strong. (I was a Princeton grad student, but that doesn't count.)
Sure enough, a lump popped up on K's skin. We measured the diameter as one centimeter, which was the lower end for a positive cat scratch test. The infectious disease specialist gave a description and the measurement by phone to the expert, who said it should be considered a positive result.
The family-friend oncologist's reaction was, "Even if you have cat scratch disease, you might have cancer too! You should still get a biopsy."
The lymph node eventually returned to normal, with no biopsy or treatment.
The Princeton alum infectious disease specialist was impressed with the way we solved problems, and how thinking like a mathematician led to a faster solution than the problem-solving algorithms in which medical doctors were trained.
He warned us that, even though our way was better, we would have a lot of trouble with doctors in the future, because we thought like mathematicians. He was right.