Random House: Bringing You the Best in Fiction, Nonfiction, and Children's Books
Newletters and Alerts

Buy now from Random House

  • The Diagnosis
  • Written by Alan Lightman
  • Format: Trade Paperback | ISBN: 9780375725500
  • Our Price: $18.00
  • Quantity:
See more online stores - The Diagnosis

Buy now from Random House

  • The Diagnosis
  • Written by Alan Lightman
  • Format: eBook | ISBN: 9780375421198
  • Our Price: $11.99
  • Quantity:
See more online stores - The Diagnosis

Buy now from Random House

  • The Diagnosis
  • Written by Alan Lightman
    Read by Scott Brick
  • Format: Unabridged Audiobook Download | ISBN: 9781415910870
  • Our Price: $20.00
  • Quantity:
See more online stores - The Diagnosis

The Diagnosis

    Select a Format:
  • Book
  • eBook
  • Audiobook

A Novel

Written by Alan LightmanAuthor Alerts:  Random House will alert you to new works by Alan Lightman


List Price: $11.99


On Sale: March 13, 2001
Pages: 0 | ISBN: 978-0-375-42119-8
Published by : Vintage Knopf

Audio Editions

Read by Scott Brick
On Sale: November 08, 2000
ISBN: 978-1-4159-1087-0
More Info...
Visit RANDOM HOUSE AUDIO to learn more about audiobooks.

The Diagnosis Cover

Share & Shelve:

  • Add This - The Diagnosis
  • Email this page - The Diagnosis
  • Print this page - The Diagnosis


From the bestselling author of Einstein’s Dreams comes this harrowing tale of one man's struggle to cope in a wired world, even as his own biological wiring short-circuits. As Boston’s Red Line shuttles Bill Chalmers to work one summer morning, something extraordinary happens. Suddenly, he can't remember which stop is his, where he works, or even who he is. The only thing he can remember is his corporate motto: the maximum information in the minimum time.

Bill’s memory returns, but a strange numbness afflicts him. As he attempts to find a diagnosis for his deteriorating illness, he descends into a nightmarish tangle of inconclusive results, his company’s manic frenzy, and his family’s disbelief. Ultimately, Bill discovers that he is fighting not just for his body but also for his soul.


People must have been in a great hurry, for no one noticed anything wrong with Bill Chalmers as he dashed from his automobile one fine summer morning. Earnest and dressed in a blue cotton suit, he was immediately swept up by the mass of commuters also galloping from their cars toward the elevators and down to the trains of the Alewife Station, a cavernous structure of concrete and crisscrossed steel struts, one end of the Red Line through Boston. At the ground floor, Chalmers presented his pass and rushed through the turnstile. He was halfway down the stairs to the platform when he heard the taut string of electronic beeps and the doors began sliding on train Number One. A woman groaned. Another commuter, a tall nervous man with squeaky shoes, lunged ahead and ran alongside the train, shouting and slapping his magazine against the red paneled doors. But the train was already in motion, its steel wheels scraping and squealing so fiercely that several people had to turn up their head sets. The tall man swiveled and shot Chalmers an accusing stare, as if his lack of sufficient speed through the turnstile had caused a half-dozen people to miss their trains. What a jerk, Chalmers thought to himself and looked down at his watch. It was 8:22. Twenty-three minutes to his stop, a nine-minute walk to his building, two minutes on the elevator, and he'd be sitting at his desk by 9:00. Assuming the train on Track Two arrived and departed within four minutes, as it should. With some satisfaction he reminded himself that, unlike the ridiculously agitated man with the magazine, he had calculated his morning commute so that he could miss the first train and still arrive at the office on time. Abruptly, he began worrying that the train on Track Two might be late. Never had that happened when he'd missed train Number One, but it was certainly a possibility. Stroking his mustache, he continued down the stairs and looked again at his watch. He mustn't waste the four minutes. However, he slowed his descent to drop fifty cents into the cup of a homeless woman sprawled on the edge of the stairs. She looked disturbingly like his old piano teacher. "Thank you, kind sir," she said. "Please don't thank me," he answered, embarrassed. "I thank everyone who is more fortunate than me," she called to him as he hurried down to the platform. Waves of people flowed around him, jostling and crushing from all sides, shoving each other to gain an advantage for the next arriving train. Gulped down in seconds were muffins and rolls, hard-boiled eggs, bananas, coffee, and crackers. Some commuters tried to unfold newspapers in the cramped space but gave up and contented themselves with staring at the digital sign on the kiosk, where bits of news and the correct time scrolled by in bright glowing dots. The dozens of upturned faces were waxy and yellow beneath the underground fluorescent bulbs.

Even in that pale yellow light, if any of those waiting had looked carefully into Chalmers's eyes, they might have observed a faint petrifaction, a solidification, some sign that all was not well. But they did not, occupied with their own busy schedules and the marching dots on the sign. Chalmers himself felt perfectly fit, aside from the normal stresses and aches of a man just past forty, arguably overweight but by no means fat. He glanced at his watch, 8:23, and forged a path to the kiosk. Above his head, the digital sign flickered and hummed and something clattered repeatedly against the high concrete ceiling and the air sagged with the burnt smell of hot brake fluid. Several radios blared, jumbling their throbbing bass notes in competing rhythms. Huddled against the kiosk as if battling a strong wind, a woman in a smart linen suit was delivering instructions into a cellular telephone. Chalmers couldn't help noticing that her phone was a new model, considerably smaller and sleeker than his. He took out his own phone from his briefcase. As he began dialing, he found that he was still shaken by the poor woman on the stairs. Her misery had cast a gloom over him, which he tried to forget by pushing the tiny buttons as fast as he could. First, he called Jenkins, to make sure that the proper documents would be ready for his 9:15 meeting. All was in order. He hung up and stood on his toes, peering down the dark tunnel of Track Two. Over the track, hundreds of glowing red neon tubes dangled down from the ceiling, one of them broken and blinking like a Christmas tree light. His telephone rang. Two men reached inside their briefcases, thinking it theirs. "Mr. Chalmers, this is Robert again. You didn't tell me if you wanted the Lehman file for the meeting." "No. Thank you, Robert." "Just checking to make sure everything is in order, Mr. Chalmers. We're set for TEM at ten-thirty." That Jenkins was an excellent young man, Chalmers said to himself. He would remember to compliment him when he arrived at the office. People didn't compliment each other nearly enough. Everyone was too quick to criticize. Chalmers looked at his watch and dialed his voicemail. As the connection was being relayed through space or wherever--who knew exactly where cellular transmissions were at any one instant?--he twisted his neck and gazed up at the digital sign: "8:24 . . . Introducing a new feature of Providential Services: Providential Online . . . Get stock quotations on your pager, minute by minute . . . Think of Providential Online as 'Work wherever, whenever'™ . . . PO@Provins.com . . . 8:24." Chalmers fumbled with a pencil and hurriedly copied down the e-mail address before it fled from the screen while a feminine voice crooned from his telephone receiver, "The Plymouth voicemail system will be disabled for twelve hours, beginning at midnight on June 26, while Telecom performs an upgrade of the system. At Telecom, progress is our business. You have three messages." Which must have arrived in the previous twenty minutes, since Chalmers last checked his voicemail. A dog barked. What were dogs doing down here? he wondered. People should be more considerate. Last week he had come within inches of stepping in dog poop. He retrieved his first message. "Jasper Olswanger calling. I need to talk--hold it a moment, please. . . . Sorry, that was call waiting. I need to talk to you as soon as possible. You've got my number." Someone was shouting Chalmers's name over the roiling of voices and music and dogs. He removed his ear from the receiver and went up on his toes. Twenty feet away he spotted the shouter, now waving and grinning. "Yes," Chalmers answered, trying to make out the man's head in the ocean of pale, fluorescent faces. Gradually he recognized the sunken eyes of Tim Cotter, his neighbor across the street. He didn't know Cotter very well. Cotter worked in a small bank somewhere downtown and came home late every night to the loud reprisals of his wife. Chalmers waved back good-naturedly and started to retrieve his second message. Someone elbowed him, shoving the phone into the side of his head. The neighbor continued waving and shouting "Bill, Bill," with a definite note of urgency, as if there was something he needed to tell him that moment. "What?" Chalmers shouted back, still standing on his toes. His neighbor didn't seem to hear him, then removed one of his earphones and yelled, "What did you say?" "I thought you wanted to tell me something," Chalmers shouted back, realizing at once that he had used far too many words under the circumstances. "Lower your voice," yelled a cheeky college boy standing next to him. "You're destroying my eardrums." The student made a face and slapped his hands over his ears. Chalmers glanced at his watch. He had only two minutes or less to retrieve his messages. With a sigh, he began working his way through the concrete thick crowd toward his neighbor. Cotter shouted something else, which Chalmers didn't hear, and refastened his headphones. Now Chalmers could see that his neighbor was sitting on some kind of fancy foldable chair, like a beach chair or a country lawn chair. He made a mental note that he should get one for himself. "Guess what I'm doing," said Cotter, keeping one of the earphones pressed against his ear so that he could listen and talk at the same time. His fingers tapped on his briefcase. "I don't know. What are you doing?" "I'm reading," said Cotter, grinning broadly. He paused, to let the announcement sink in. "Books on Tape. The Bridges of Madison County." Chalmers made a thumbs-up sign. For the first time, he realized how much he disliked Cotter. In a hundred little ways, Cotter always tried to make him feel like a slacker. Cotter was just envious of anyone seriously engaged in their profession. It was Cotter who was the slacker. The dog was barking again and Chalmers began coughing, having inhaled an invisible cloud of the burnt brake-fluid air. In addition, the morning's usual indigestion had just slammed into his stomach. "Nice to talk to you," said Cotter. "I haven't seen you since Phil's thing." He put his second earphone back on. At that instant, with a high shriek of metal on metal, the train on Track Two arrived. Chalmers looked at his watch, 8:26, and surged forward with the torrent. By the time he had squeezed through the doors and been shoved to a spot in the middle of the car, the seats were long gone. The upright commuters, pressed hard against each other, clutched their coffee cups and muffins close to their bodies and searched in vain for handrails to grasp. Chalmers began brooding over his unretrieved messages. Maybe one of his appointments had been rescheduled. He could have an important call from New York. Those people got to their desks early. As he was considering the various possibilities and their dark implications, with the knowledge that he would be incommunicado for the next several minutes, an extremely loud alarm bell rang, then the series of electronic beeps, the doors slid together, and the train jolted into motion.

It was between Harvard and Central that Chalmers forgot where he was going. This realization did not arrive suddenly but seemed to trickle up slowly into his consciousness, like a trapped bubble of air rising from the bottom of a deep pond. At first, he was calm. He was most likely suffering from a momentary lapse of memory, as when he'd forgotten Morla's name at the last New Year's party.

He took a long breath and maneuvered himself between bodies to the front of the car, where he could read the list of stops on the wall. They were all familiar, but he could not remember which one was his. He pronounced the name of each stop softly, so as not to draw attention to himself, and ran his fingers through his thinning brown hair. When the train screeched to a halt at Central Square, he peered out the window and studied the token booth and the passageways and the stairs. Commuters hurried forcefully in every direction. Could this be where I get off? he asked himself, trying to jog his memory. He couldn't decide. The doors slid shut and the train was in motion again. He looked at his watch. It was 8:39. If he didn't straighten himself out soon he'd be late. But he was not late yet. No, he was not late yet. If he could just remember his stop before he reached it, no time would be lost. With that logical deduction, he seemed to relax slightly and gazed out the window into the black tunnel flying by. He remembered that he was due at his office at 9:00, that he had appointments at 9:15, 10:30, and noon. Then, with alarm, he became aware that he couldn't recollect precisely where he had to be at 9:00, or who he was meeting. The meetings, the meetings. He strained to remember. They were probably important. In fact, it was quite possible that his meetings were critical, that a great deal hung in the balance. His grip tightened on the overhead rail. Nothing like this had ever happened before. He had worked in his office a long time, he was certain of that, and he had always met his responsibilities with efficiency and speed. In a sickening premonition, he imagined the vice president smiling sympathetically at him and then quietly transferring away his better accounts. A sweat broke out on his cheeks and the palms of his hands.

So distraught was Chalmers by this time that he didn't think to open his briefcase, which contained, among other items, his appointment book and dozens of letters and office memoranda bearing the name of his company and its address. Instead, he looked anxiously into the faces of the two men standing on each side of him. One sported a faint smile, as if amused by the crush of humanity around him, and was dictating something into a tiny recorder. The other had lightly closed his eyes, possibly engaged in one of those new business visualization techniques. The two seemed so confident and self-assured in their plans for the day. He could not bring himself to ask them for help. Maybe he could locate his neighbor. Standing on his toes again, he looked in both directions without success. Then he noticed that a man in a green plaid suit, occupying one of the scarce seats on the car, was gazing intently at him through the thicket of torsos and arms. As soon as the seated man saw that his gaze was returned, he quickly went back to typing on a computer in his lap. He seemed vaguely familiar. Perhaps he was a professional colleague, or possibly an employee. His computer screen was tilted at such a wide angle that Chalmers could see some kind of spreadsheet, with a colored graph shimmering at the top. After a few seconds of purposeful typing, the man looked up again, apparently to verify that Chalmers still saw him profitably at work, then returned with a smirk to his computer. Looking about, Chalmers noticed that other people, even those standing, were reading reports, making memos, checking off columns of figures and lists. Everyone was busy at work. He took a piece of paper from his pocket and began thinking of something to write on it. Immediately, the man in the green plaid suit craned his neck nearly out of his collar to see what Chalmers was doing. This unwelcome surveillance made Chalmers even more upset and moist.
Avoiding eye contact with the green-suited man but feeling his gaze, Chalmers once more pushed to the front of the car to ponder the list of stops. This time he pronounced the name of each stop out loud. "Do you have a problem?" said a huge woman with blue frizzy hair and two silver rings in her nose. She looked him up and down, her chin remaining hidden in the rolls of fat around her neck, then offered him some of her blueberry muffin. The train pulled into another station. People raced off, people raced on. There were still twice as many commuters as seats. Without recognition Chalmers gaped at the fluorescent terrain. Men and women fled toward the exits at both ends of the station. Between the tracks hung long silver chimes, and an enamel map of some kind covered the wall. He was beginning to feel nauseous. Could this be my stop? he said to himself, again trying to shake loose his memory. A sign on the wall said "MIT." MIT? Could he possibly work at MIT? He examined his clothes and tried to recite some school math formulas to himself.

It now occurred to him to look in his briefcase. "My briefcase," he shrieked when he realized that it was not in his hand. At his exclamation, people rotated their heads to stare at him. When he succeeded in groping his way back to the middle of the car, his briefcase was gone. And with it, all identification, since he routinely carried his wallet in his briefcase on the advice of his chiropractor. For the last several years, he had been told that his tight muscles and little pains were caused by his wallet pressing against certain cartilages and nerves. "Has anyone seen a leather briefcase?" he shouted without thinking. The train lurched forward and he grabbed for a hold bar. "Has anyone seen a briefcase?" he repeated more softly. The commuters nearest him glanced down at the tiny bit of bare floor and shrugged. Two briefcases were discussed, but they belonged to other people. A woman wearing a blue running suit and a black beaded cap took off her headphones and asked Chalmers what he was saying. He looked at his watch. It was 8:42.

Chalmers glanced at the faces of the other commuters. He'd made a fool of himself. Only people totally out of control lost briefcases. Were they all mocking him behind their self-satisfied activities? Who were they, to mock him? he thought angrily. Although he could not at the moment remember exactly his job, he knew that he was somebody important, a specialist of some kind. Slowly, he made his way down the car, searching for his briefcase. The other commuters grudgingly moved aside, momentarily folding up their memos and pads of papers. At several points he stooped down to survey the floor and was thrown into backpacks and purses and knees as the train swayed from one side to the other. Then the train was suddenly above ground, in the bright sunlight, traveling over a river. He blinked in the light and looked out the window. The view was not unfamiliar. On either side of the bridge stood ancient stone towers, shaped like salt and pepper shakers, beyond which dozens of sailing masts huddled in a curved inlet in the distance. A little boathouse with an orange roof. Tiny figures on rollerblades slid along the shore. Behind the boathouse, an angular tower gleamed blue in the early morning sun, and next to it some office building. On the side of the river they were leaving, two massive triangular buildings like pyramids, and two white domes on either side of an edifice with a spire. He felt that he knew these sights well, he must have passed this way often. The train pulled into another station, high above the streets of Boston. Charles/MGH, Massachusetts General Hospital. Chalmers looked down at the busy street and the rush-hour traffic, then toward the hospital. Hospital, hospital, he said to himself and searched his pockets. No stethoscopes or hospital things to be found. He did produce car keys, a "to do" list, some coins, his subway pass, and a Post-it note that said "Call Mary Lancaster." He finished with his inventory just in time to see the green-suited man hurrying off the train with his computer and down the metal stairs to the street. For an instant, the man peered over his shoulder and then disappeared. The wheels screeched and the train dove underground.

Chalmers was now obsessed with finding his briefcase. It struck him that perhaps he had left it on a neighboring car. At a previous stop he might have gotten off briefly to study the station and could have reboarded a different car. Next stop, as his train pulled into the station, a pulsating beat blasted him like a cannonball. A group of wiry-haired musicians was installing itself and its amplifiers on the platform between the outgoing and incoming tracks. Chalmers leaped off the car and hurried onto the one behind it. "Coming through," he heard himself shout. A mass of people huddled in the aisle of the new car. He was sweating pretty heavily now and wiped the perspiration from his face. Over the door, a sign in red letters read: "in case of emergency please follow directions of the train crew." "I'll report my missing briefcase to the train crew," he said out loud. He glanced out the window and noticed a sign pointing to the direction of transfer to the Green Line. Green Line, Green Line, he repeated to himself, without recognition.

As the train left the station, he miraculously sighted his neighbor, standing at the end of the new car. "Tim," he shouted. Cotter took off one earphone and waved. Chalmers gasped with relief and began pushing his way down the aisle. He felt like throwing his arms around Cotter, but of course he could never do such a thing. "I've lost my briefcase," he blurted out. "Gosh. I'm sorry," Cotter said and turned off his headset completely. "On the train?" "Yes," said Chalmers, "I'm almost certain that I had it when I got on at . . ." "I'm so sorry," repeated the neighbor. "You look terrible. Need anything?" Tears came to Chalmers's eyes, and he quickly looked away, into a woman's sunburned back. He began rehearsing to himself how he could describe his predicament. Then, unexpectedly, he had a vision of being laughed at. After that, he couldn't get any words out. With a sudden stab of shame and anger at himself, he wished he had said nothing to Cotter. He had never confided anything to his neighbor before, he didn't at all care for the man, and here he was making an idiot of himself. God knows who Cotter would tell about the lost briefcase. The train rolled into the next station, and Chalmers looked out the window. Downtown Crossing. "Well, this is my stop," said Cotter, checking the time on his watch. "Got to go. You should report your briefcase to somebody. Bummer." He patted Chalmers on the shoulder, turned his headphones back on, and bolted off the train. Chalmers stared at Cotter as he raced down one of the hallways and disappeared around a corner.

At the next station, which reeked strongly of urine, more people got off than got on. As the train flew away, Chalmers looked at his watch. 8:48. Almost certainly now he would be late for his 9:15 appointment. He remembered that he was to meet a man and a woman at 9:15. He'd met them before. The woman had blond hair and wore scarves and took notes on a laptop during meetings. He began imagining various scenarios. In scenario one, the visitors would show up and be asked to wait until he arrived. When he didn't, the appointment would be rescheduled, possibly after lunch. What was on his agenda today after lunch? He would worry about that later. In scenario two, the president would ask that cocky Harvard fellow to fill in for him. There would be an unpleasant scene and some posturing the following day. In scenario three, the visitors would express their annoyance by taking their business elsewhere, bringing down on Chalmers the wrath of the entire company. And who could blame them? Their time was valuable. Time was money. Chalmers struggled to remember the nature of the meeting. The phrase "the maximum information in the minimum time" suddenly came to him. It was the motto of his company. His company. He strained to remember its name, pulling at his mustache. What was happening? What was happening to his mind? Was he having a nervous breakdown? Frantically, he glanced at the people around him, complacently going about their business of the day. He was feeling more and more ill and needed to sit down, but no seats were available. With a groan he took out his handkerchief and held it to his mouth. Then, he saw with astonishment that he had been carrying his cellular phone all of this time. "Oh, thank you, thank you, cellular phone," he said out loud, to the stares of other commuters around him. Forgetting that his phone was inoperative in the tunnels, he pushed the power button. A red light reading "No Serv" flashed on the digital display. He wiped his sweating hands with his handkerchief and began to push other buttons, but the red "No Serv" light continued to flash and the receiver whined like a miniature police siren.

"Doesn't work underground," said a man wearing chino pants and a Red Sox cap. Chalmers remembered who the Red Sox were--he had even attended some games--and he clung to this small bit of recognition as he slammed his No Serv phone shut. The man in the Red Sox cap proceeded to swallow a hot dog in two gulps.

"They're coming out with one that works anywhere," he said, wiping his mouth. "I think it's fiber optics, or ultrasound." He paused, looking at Chalmers. "Here, take my seat, bud, you look wiped." Chalmers smiled weakly and sat down, his hands shaking. He began going over what he knew of the morning. He remembered arriving at Alewife at 8:20. He remembered billboards with fish and cottontail rabbits. He remembered making a telephone call to Jenkins, who spoke in a high-voltage, caffeine voice. In fact, he could even see Jenkins, a nervous young man, prematurely bald, with a carefully tended two-day beard. What was Jenkins's first name? He began running down possible names and matching them with Jenkins. Abandoning this line, he attempted to focus on his appointments. One was at 9:15--he was certain of that--one at 10:30, and one at noon. A man and a woman were to meet him at 9:15. He stared outside the window at the darkness flying past. Every few seconds, a smattering of light from a fluorescent tube. What was happening to him? He gazed at the man in the Red Sox hat, who was mindlessly turning the pages of a magazine. The train coasted to a stop, and Chalmers had the prickly sensation that he might be starting to remember things. He squinted at the walls of the station. A "Wanted" poster showed a man in two profiles. Another said: "Socrates? Plato? Why not? At Metropolitan College Online." It was 8:50. With a whoosh, the train left the station.

After the next stop, which Chalmers didn't recall ever having seen in his life, the crowd on the train diminished substantially. Now there were only a dozen people in his car. He examined each seat and its occupant, as if somehow hoping to uncover a clue to his identity. In one sat a man with braided dreadlocks, listening to music on a portable CD player and counting subway tokens. In another, a skinny young mother with a phosphorescent blue-green halter top sipped on a Diet Coke and fed some of it with a straw to her baby. An older woman, wearing a black leather coat despite the heat, gazed absently out the black window and rocked back and forth in her seat. The train vibrated and twisted down the tracks. Chalmers searched for the man in the Red Sox cap, but he was not on the car. Two pimply teenage girls with beach towels, dark glasses, a radio. An elderly man and woman, both with long white hair and canes, were arguing about something while eating Egg McMuffins. Their voices were thin and breathy and faint, wind moving through dry reeds.

Suddenly, the train lit up with sunlight and was again above ground. Trees flew by like flailing arms. Beyond the vegetation, a mixture of residential and commercial buildings, parked cars, telephone poles, a brown building, a Burger King. The train stopped and several young people darted off, carrying books. They must have been students. Chalmers peered at the sign on the wall. JFK/UMass. The train was now far from the downtown area, heading farther from Boston. Chalmers remembered his cellular phone. He extended its antenna and pushed buttons: 617-567- . . . He couldn't remember what came next. Continents of memory had been lost. He began dialing random numbers, hoping to connect with someone. In the process, he accidentally entered the security code that prevented the phone from sending or receiving further calls. A "Phone Lock" sign began flashing. He stared at the useless instrument. "Good God, I can't remember any telephone numbers," he said out loud. "I can't remember my name." One of the passengers glanced quickly at him, then returned to her magazine. Sweat streaming down his face, Chalmers closed up his phone. Railroad tracks fluttered by like matchsticks. Trees, white and gray clapboard houses with paint peeling off, junkyards with stacks of flaccid tires and crumbling cars, four-story apartment buildings with children playing in the narrow alleys between, laundry hanging from windows. An expressway looped in from somewhere, flying alongside the train, cars shot by in both directions. After the next stop, they passed water, a bay, a huge cylinder with red and yellow stripes. Suddenly the train entered some small town and stopped under a green awning. Along the concrete sidewalks, pedestrians floated, cars stood at red lights, everything seemed frozen. A few passengers embarked and the train was in motion. Leafy green trees, then the light dimmed two octaves and the train had again flown below ground, blackness outside. At the next station, which said Shawmut, a strange silence. No one got on or off. Then a woman's voice singing, You're gonna want me . . . A voice on a speaker said, "Next stop, Ashmont. End of the line. Ashmont. Thank you for riding the T. Don't forget your belongings." Shortly thereafter, the train pulled into Ashmont Station and stopped.

Chalmers sat dazed in his seat, holding his handkerchief to his mouth. The train was empty and silent. In the distance, an automobile groaned, sliding its sound into the muffled hum of the station. After a few moments, an attendant walked over, stood glaring down, and said, "No passengers beyond this point. You'll have to get off." It was 9:09 by a giant white clock in the station.

Wobbly on his legs, Chalmers walked out of the train and sat on a bench. It felt hard after the padded seat. Ashmont Station, bottom end of the Red Line. The station, at street level, opened to real air. Pigeons flew in, just under the arched roof, swooped down to the brick floor, and pecked for food. Peanuts, scraps of sandwich meat, pieces of bread. He gazed at the birds as they jerked their heads right and left. On the other side of the station, a bus whined and exhaled a tuft of acrid gray smoke. A woman in a blue beach hat got on. Chalmers looked at his watch. There was no doubt now that he would lose a good part of the morning. Unconsciously, he began panting in rapid, shallow breaths. Closing his eyes, he tried to visualize the place where he was going, he pictured office buildings, shops, department stores, corporate campuses, any place he might possibly be employed. Various people that he had met flickered in his mind. His hands trembled and he couldn't keep from rocking like the woman on the train. Still shaking, he spotted the stairway to the train in the opposite direction, back through Boston. Immediately, he flung himself from the bench and hurried up the stairs. "I'm going to put an end to this craziness," he said out loud, taking a deep breath of bus exhaust. "People are waiting. I won't allow myself to get further behind. Go. Go." He slammed his hand against the rough concrete wall. On the second time around, he would recognize his stop, he would remember, he would have to remember where he was going, he would remember.

At the beginning of the return trip through Boston, Chalmers regarded each stop even more intently than before. At two stations, he leaped from the train and paced the platform, hoping to feel some glimmer of memory in the concrete and brick. The train was now about half full with people, who appeared to be shoppers and tourists and college students going to midmorning summer classes. Someone giggled at the far end of the train, where a man in unlaced hiking boots was embracing a woman. At Charles Street, Chalmers threw up. "Are you all right?" asked a spectacled college girl sitting across from him. He looked at her blankly. She moved a few seats away. Grimacing, he lay down across three seats, then sat up when the train went over the river. Now sailboats dotted the water, their white sails fluttering and curved in the wind. In the distance, a line of cars, bumper to bumper, oozed across a bridge. Kendall Square/MIT. Central. Harvard. Porter Square. Davis Square. Chalmers no longer got out of the train at each stop. He would simply sit up and peer out for a few seconds, then lie down again. "What's happened to me?" he mumbled, over and over. He held up his hands and examined the veins near the surface, fragile and faint like the strings of a puppet. "What's happened to me?"
Then he was at Alewife, the end of the line, where he vaguely remembered starting that morning. Mercifully, no attendant told him he had to get out of the train. He could just remain lying down in his three seats, wait until he started moving in the opposite direction, back toward the station with the swooping pigeons. With a half-dozen people in his car, the train began once more flying south. It was just after eleven o'clock on the morning of June 25.

Unaccountably, he felt like walking. He had a noon appointment. He had a noon appointment. With a grunt, he sat up and wandered down the car, holding on to the overhead rail and gazing idly at the signs on the wall. Outside, the darkness flew past in black streams. By now, his demeanor was attracting attention. His hair was matted with sweat, his tie dangled loosely around his neck, his shirt was soggy and stained. He didn't know where his suit jacket was. "What's happening to me?" he said to anyone who would look at him for longer than know where his suit jacket was. "What's happening to me?" he said to anyone who would look at him for longer than a second. He had now grown accustomed to stares. Yet he could not bring himself to ask any of those faces where he was going, where he was supposed to be. A man with a baseball cap on backwards began mimicking him: "What is happening to me? Like, what's happening, man? To me. What's up, Doc?" The man followed Chalmers to the end of the car and began inspecting his cellular phone. Chalmers tightened his grip on the phone and hastened toward the other end of the car. A young man and woman were holding hands and laughing. When they saw him, they turned and began whispering. Newspapers and food wrappers covered the floor. The fluorescent light hammered. Two men in identical headphones and identical gray silk shirts looked at him curiously. "What's happening to me?" he asked them. They shrugged. From behind, someone tapped him on the shoulder. He turned. A woman, middle-aged, green light in her eyes. She handed him a green dollar bill and walked away. He let his tie fall to the floor. "My briefcase," he said. At the next stop, he changed to a neighboring car. "do not lean against doors." He looked down and saw that his shoes had become untied. They were becoming a nuisance. With a flick of his ankles, he kicked off his shoes and left them behind. The train braked sharply around a turn and he was thrown to the floor, his cheek landing hard against a fresh wad of gum. "You should sit down, please sit down," came a voice. He got up and continued walking, cooler now without his shoes and socks. He took off his shirt and tossed it onto a seat. A woman's face dissolved. There was shouting. He hurried up the aisle of the car.

When the police boarded the train at South Station, they found him curled up on the floor in a fetal position, clasping his phone to his bare chest.
Alan Lightman|Author Q&A

About Alan Lightman

Alan Lightman - The Diagnosis

Photo © Michael Lionstar

Alan Lightman is the author of six novels, including the international best seller Einstein’s Dreams and The Diagnosis, which was a National Book Award finalist. He is also the author of two collections of essays and several books on science. His work has appeared in The Atlantic, Granta, Harper’s Magazine, The New Yorker, The New York Review of Books, and Nature, among other publications. A theoretical physicist as well as a writer, he has served on the faculties of Harvard and MIT, where he was the first person to receive a dual faculty appointment in science and the humanities. He lives in the Boston area.

Author Q&A

Q: As a professor of both physics and literature, your fiction (EINSTEIN'S DREAMS and THE DIAGNOSIS,) is a combination of both your passions. How do they compliment one another? Do you ever feel they are working against one another?

A: I feel that the great push and pull in my writing life, and in my life as a whole, has been the tension between the rational and the intuitive, logic versus illogic, linear versus nonlinear, deliberate versus spontaneous, predictable versus non-predictable. I experience this tension as constant twisting of my stomach and as a mental commotion. I've learned to live with the discomfort. In fact, I think it may be a source of strength in my writing.

I've actually been passionate about both creative writing and science from a young age. As a teenager, I wrote poetry and I also built rockets. At many times, I felt that my bi-polar interests segregated my friends. My rocket friends would get angry with me when I stayed at home to write a poem instead of going out with them to the launching pad. And my literary friends (those who were always reading unassigned books) would get irritated with me when I tried to logically analyze a poem. Over time, I've come to realize that the sciences and the arts represent different ways of understanding the world. Both are true, but the truths aren't the same. I think that both certainty and uncertainty are necessary in the world. My writing, whether I want it to or not, expresses this conflict. But it is a beautiful conflict. It is what makes us human

Q: THE DIAGNOSIS begins with an incredibly frightening scene in which protagonist Bill Chalmers loses his memory, his briefcase, and to some extent his sanity on a subway train. How did you come up with this terrifying scenario?

A: I wanted an opening scene that would draw in the reader, plunge the reader into the frenzied state of the modern world, and announce in miniature, like a prelude, the themes of the entire novel. To research this scene, I rode for many hours on the Boston subway and tried to put myself in the mental state of the main character. I thought of every frightening and disorienting experience I've had in my own life. In fact, I believe that a fiction writer must draw on his own emotional experiences to write truly. You can create characters, you can create new circumstances, but you cannot create out of thin air an emotional state of mind. I think you have to have experienced it to write it.

Q: I understand THE DIAGNOSIS began as a work of nonfiction--How did it become a novel? And did you have input from anyone along the way?

A: I've been working on THE DIAGNOSIS for five years. I initially conceived of the book as a nonfiction book about the modern American obsessions with speed, information, and money, all mediated by modern technology. I actually wrote a first chapter of the proposed nonfiction book and sent it to Dan Frank, my long-time editor at Pantheon. Dan and I had lunch and he gently told me that the chapter didn't work, confirming my own suspicion. I didn't have enough originality of point of view, the issues sounded tired. As Dan and I discussed the various themes more, I realized that what I really wanted to do was to explore the psychological dimensions of the societal problems I was writing about. I wanted to explore the spiritual and mental cost of these modern obsessions with speed, information, and money. A novel would be a much more appropriate medium. I think that fiction is the medium in which to explore emotional and psychological questions and issues, and that's what I really wanted to write about.

When I finished the first draft of the novel, in the fall of 1998, I sent a copy of it to my old high-school English teacher, LaRose Todd Coffey, who had taught me 35 years ago in Memphis. LaRose had followed my career as a writer and we had stayed in loose touch over the years. She read the draft and had some insightful comments. So I invited her to fly up to Boston, from Memphis, and she spent a week helping me with the book, listening to me ramble about the characters. She sat at my desk and I sat in a chair in front of her.

Q: THE DIAGNOSIS is a devastating look at what could go wrong in a world increasingly run by technology. Are you optimistic about our future, or are we destined for more "Chalmers-esque" scenarios in the future? What does the book say about our future?

A: I am not particularly optimistic about the mindless rush of our modern world. If there is any salvation, I think it lies in raising the consciousness of how we are living, of who we are, of what we believe in, of what is truly important. This awareness and examination must happen at the level of the individual. Each person must become aware of how he or she is living -- the true cost, in terms of mind and spirit, of each item of our daily existence. The benefits of high-speed communication and transportation, of money, of gigabytes of information are clear. But the costs are largely hidden.

Q: As a professor of physics at MIT, you're guiding our future scientists: Any predictions? Where are we headed?

A: The world is becoming increasingly interdisciplinary. These days, a study of the environment, for example, requires engineers and scientists to explore water tables and gaseous emission, economists to study the costs of new technologies, city planners to study the urban impacts of new programs, social scientists to study the attitudes of residents, and so on. All of our scientists and engineers must be able to communicate their understanding to a wide variety of people. For these reasons, I think it is increasingly important that our technical institutions give students a good grounding in the humanities. Science does not take place in a vacuum, it involves people, with human problems and aspirations.

Q: I hear you still use the good old-fashioned U.S. postal service as opposed to email --This is a little surprising for a writer who seems quite tech-savvy. And email plays a role in THE DIAGNOSIS, as well (Chalmers communicates with his son via email, even though they live in the same house; his wife communicates with her lover via email). What do you make of this?

A: I don't use e-mail, as a symbolic stance against the mindless onslaught of modern technology. I'm one of the very few people at MIT who does not use e-mail, and I often find myself in an awkward position because of that fact. Of course, e-mail, and most other modern technologies, can be extremely beneficial. Like everyone else, I personally benefit from many of these technologies. But they can also be abused. I have many friends who spend an hour and a half each day sorting through their e-mails. I'd rather spend that hour and half taking a walk, or talking to friends, or trying to have a creative thought.

Q: In THE DIAGNOSIS you incorporate the interplay of the ancient philosopher, Anytus, and his role in the murder of Socrates. Tell us about this interesting technique.

A: The novella about Anytus and Socrates, embedded within THE DIAGNOSIS, plays an important counterpoint to the novel proper. In conceiving of this technique, I think I was partly inspired by Mikhail Bulgakov's masterpiece, THE MASTER AND MARGARITA, which also has an embedded novella, namely the story about the execution of Jesus. It was a pleasure researching this section of the book. I read the Dialogues of Plato, Thucydides's History of the Peloponnesian War, the plays of Aristophanes, researched the latest excavations of ancient Athens, and had some wonderful chats with professors of classics at Harvard, MIT, and elsewhere. I recall reading a couple of other novels in which there is an embedded novella. I think John Irving has one. I think this technique works best when there are resonances and counterpoint between the embedded novella and novel itself. Themes and characters can be echoed, silences and cadences can be placed in juxtaposition. Most importantly, the embedded novella can build a subterranean world that the reader feels unconsciously and reacts against while reading the rest of the novel.

Q: The medical sequences in THE DIAGNOSIS are so realistic--what sort of research did you do to create such an authentic feel?

A: For the medical research, I spent time in the Harvard Medical School Library and I consulted with a half-dozen specialists in various fields. I've found that when you're researching an area that you don't know well (and fiction writers are often doing this), you can get only so much from your own reading. Then you have to go talk to the experts. I also spent a fair amount of time snooping around the hospitals in Boston. I'm sure that I sometimes went to floors and rooms where I wasn't supposed to be, hiding behind carts or in hallways. I really wanted to see things up close, the smells, the sounds, colors. Sometimes you come across completely wonderful and unexpected things this way, like the photograph of the nurses that appears in the chapter titled 'Plasmapheresis." I just happened to pass this photograph on a wall at Massachusetts General Hospital. I couldn't possibly have imagined it from scratch. And there it was, in front of me, and I knew that it was perfect, it would have to appear in my book, so I took out my notebook and took notes on it.

Q: Could what happened to Bill Chalmers' actually happen outside of fiction?

A: All of Bill Chalmers's symptoms have happened to people, amnesia, spreading numbness, etc. Furthermore, many illnesses go undiagnosed for long periods of times, sometimes forever. So, I suppose that what happened to Bill Chalmers could actually happen.

Q: Doctors, unfortunately, are ineffectual in your novel. They order multitudes of tests and are unable to find anything conclusive about Chalmers' increasing serious illness. Are you making a pointed comment about the medical establishment in THE DIAGNOSIS?

I have many good friends who are doctors, including a brother, so I'm certainly not going to say that doctors are ineffectual. Although the medical establishment is ineffectual in THE DIAGNOSIS, it is not treated much differently in the novel than the business establishment, the legal establishment, and so on. These establishments are all part of our modern world and its obsessions with speed, information, and money.



“Original and grimly unsentimental…. A major accomplishment, written in austerely beautiful prose.”–The Washington Post Book World

“A funny, troubling story about our culture’s devotion to technology
at the expense of humanity…. Clever and wise, a rare combination.”–San Francisco Chronicle

“Although the world around Bill ‘is diminished to the most feeble red light,’ the novel, at last, burns brightly.”–The New Yorker

“A searing vision of our helter-skelter and spiritually debilitating technocracy.”–The Chicago Tribune
Reader's Guide|About the Book|Author Biography|Discussion Questions|Suggestions

About the Book

The introduction, discussion questions, suggestions for further reading, and author biography that follow are designed to enhance your group's reading of The Diagnosis, a darkly comic exploration of our modern obsession with speed and information.

About the Guide

Alan Lightman, author of the widely acclaimed Einstein's Dreams, portrays a man caught in the grip of a mysterious affliction that affects his ability to function and undermines his most basic assumptions about the world. Bill Chalmers, a junior executive at Plymouth, is on his way to work when he suddenly forgets his name and his destination. Remembering only his company's motto--"The maximum information in the minimum time"--he rides the subway, his panic mounting until it reaches the breaking point. When the police board the train they find Bill in a fetal position, stripped of socks, shoes, and shirt, clasping his cell phone to his chest. Later, Bill escapes the hospital in which he is summarily deposited and wanders the streets of Boston with vague, tantalizingly familiar images and names flickering through his mind. Then, in a moment of sheer joy, he is flooded with memories. Within twenty-four hours, he's back at his laptop, clicking on e-mail and checking his watch, desperate to recapture lost time. But his apparent recovery is cut short by a new horror: a tingling numbness renders his hands and arms nearly useless. Forcing himself to disconnect from the electronic universe and the barrage of missives from the office, he goes to his doctor in search of an explanation.

Bill's quest for a diagnosis becomes a journey into a modern-day hell. He is given tests by detached doctors who rely on the latest technology and massive medical data banks, yet cannot account for the inexorable degeneration of his body. His colleagues at Plymouth regard his incapacity as an opportunity to surge ahead of him on the corporate ladder. His wife, consumed with guilt over an online affair with a man she has never met, accuses Bill of conjuring up his symptoms. His teenage son, Alex, finds refuge in cyberspace. Intrigued by the story of Socrates' final days on PLATO ONLINEª, he sends it via e-mail to Bill. It becomes, along with maddeningly inconclusive bulletins from an army of doctors and urgent updates and instructions from Plymouth, part of a constant flow of communications of which Bill vainly struggles to make sense. As his body succumbs to complete paralysis and his mind fills with thoughts of lost joys and pleasures, Bill comes face-to-face with the emotional and spiritual repercussions of a life spent in the mindless pursuit of the maximum information in the minimum time.

Alan Lightman interweaves the story of Bill's frightening descent into helplessness and hopelessness with passages from the "Anytus Dialogue," an original, beautifully crafted narrative of Socrates' death from the perspective of the man responsible for the great philosopher's trial and execution. Evoking through humor, satire, and poignant insight the malaise of our times, The Diagnosis asks us to contemplate the import of Socrates' conviction that "the life which is unexamined is not worth living" in a world in which information overload literally leaves us no time to think about who we are and where we are going.

About the Author

Alan Lightman is a professor of humanities and a lecturer in physics at MIT and lives in Boston. His previous books include Einstein's Dreams, Good Benito, and Dance for Two.

Discussion Guides

1. Why does the novel begin on the subway? What are the mythological or metaphoric implications of Bill losing his way on an underground journey?

2. How do Bill's encounters with the homeless woman [p. 4] and with his neighbor [p. 7] reveal what kind of man he is? How do the descriptions of the station and the train ride establish the atmosphere for the rest of the novel?

3. As his panic mounts, Bill reflects on what is happening to him [p. 15]. Why can he recall the times of his appointments but not the first name of his coworker, Jenkins? What does the order in which he forgets things reveal about modern society?

4. In his attempt to rediscover his identity, Bill escapes from the hospital, wanders through Boston neighborhoods, and eventually ends up in a church. Why does his search follow this particular path? Both hospitals and churches are commonly thought of as sanctuaries. To what extent, if any, do they serve this purpose for Bill?

5. One of the most bizarre events of the evening is Bill's confinement in the cash booth [p. 61]. What images, metaphors, and even individual words give this scene its power and resonance? Why does it mark the turning point for Bill?

6. When Bill returns home, why is he so secretive about what happened to him? What does his reluctance to admit his memory loss reflect about his relationships with his family and coworkers? About how he perceives himself? Are his actions understandable? In light of their initial reactions, do you think Melissa and/or Alex could have provided an emotional anchor for him? If he had confided in them immediately, would it have changed the course of events? What other opportunities does Bill have to reconnect with his emotions throughout the course of the novel? Why doesn't he take advantage of them?

7. Alex greets his father "outfitted in a steel-mesh face mask, white jacket, white glove, and white shoes . . . and he brandished a foil" [p. 72]. Why is the reunion between father and son portrayed in this way? How does Alex's interest in fencing, a fairly esoteric activity, add another dimension to the story? In what ways is it linked to his subsequent fascination with PLATO ONLINEª?

8. Why does Lightman give so much space to the e-mail messages circulated among the characters? Beyond a convenient (and often amusing) way of recording events, what purpose do they serve?

9. What does the relationship between Anytus and his son, Prodicus, have in common with the relationship between Bill and Alex? In what ways do the sons challenge their fathers' beliefs about life, either implicitly or explicitly? Is alienation between fathers and sons an inevitable part of life, or are Anytus and Bill "bad fathers," guilty of abnegating their moral responsibilities to their sons?

10. In brooding about his situation, Bill thinks, "Of one thing he was certain: that he had been afflicted far beyond what he deserved. . . . He, who played by the rules, who was more intelligent and able than most, who wanted only a nice house in the suburbs with a family who loved him, an adequate income, an eventual senior partnership and position where he could hold his place in the world" [p. 149]. Do you think this passage describes what most of us are looking for in life? What elements are missing?

11. Why does Melissa say, "I've caused everything. I'll never forgive myself" [p. 365]? Is this an expression of the guilt she feels about her online relationship with the professor and her failure to support Bill emotionally? Is it possible that she is actually in some way responsible for Bill's illness?

12. In the "Anytus Dialogue," Prodicus says, "Sokrates has drawn what he is too modest to speak. He has revealed his true self and the selves of us all" [p. 95]. How do the images Socrates draws relate to the themes of the book? What do the drawings Bill scrawls across his bedroom reveal, perhaps inadvertently, about his true self and the selves in all of us? If you are familiar with Plato's Republic, how can the "Allegory of the Cave" be used as a key to understanding the underlying meaning and message of The Diagnosis?

13. Lightman juxtaposes the stories of Socrates and Bill Chalmers without drawing explicit comparisons between them. In what ways are the two stories parallel? How does Bill's eventual acceptance of his fate echoe the attitudes Socrates expresses to Anytus in talking about his imminent execution?

14. The Diagnosis can be seen as a "dystopian" novel, a portrait of a society that has distorted the most basic principles and values of humankind. What elements does it share with George Orwell's 1984, Margaret Atwood's The Handmaid's Tale, Alan Nourse's Bladerunner, and other visions of dystopia presented in literature and film? What aspects of the novel are the most disturbing?

Suggested Readings

Margaret Atwood, The Handmaid's Tale; Paul Auster, The New York Trilogy; Ray Bradbury, Fahrenheit 451; Don DeLillo, White Noise; William Gibson, Neuromancer; Aldous Huxley, Brave New World; Franz Kafka, The Trial and The Metamorphosis; Jonathan Lethem, Amnesia Moon; Margot Livesey, The Missing World; George Orwell, 1984.

Your E-Mail Address
send me a copy

Recipient's E-Mail Address
(multiple addresses may be separated by commas)

A personal message: