Emmet Hirsch
The Zonule of Zinn
Philbert O’Toole IV, a twenty-one-year-old man who had not exited the basement of his parents’ bungalow in Skokie, Illinois for three years, reached for his medical dictionary. The act of consulting the medical dictionary never failed to evoke in Philbert IV the memory of his great-grandfather, Philbert O’Toole MD. It evoked that memory now.
Philbert O’Toole MD had died sixteen years earlier, when Philbert O’Toole IV was five years old. The young man shuddered at the recollection. On the first Saturday after the funeral, he had accompanied his father and grandfather to their deceased ancestor’s twelfth-floor apartment in a rental complex on Touhy and Western in Chicago. The apartment on the twelfth floor still smelled of Great-grandfather’s after-shave, a ghostly reminder of the old man.
To his horror, the boy discovered that the purpose of the visit was not, as he had supposed, to spend a few final moments in that venerable presence. No, the purpose of the visit was to eradicate the apartment of all evidence that Great-grandfather had ever occupied it. Philbert O’Toole II and Philbert O’Toole III savaged the place, emptying closets and cabinets and drawers, tossing or sweeping or upending their contents into a huge bin they wheeled from room to room.
Little Philbert O’Toole IV, beside himself with anxiety, followed Father and Grandfather through the apartment as they cast the old man’s worldly possessions into the trash bin with only slightly more disdain than they had cast the man himself into the earth two days earlier. When they gleefully parked the container in front of the built-in bookshelves, a multi-tiered superstructure into which countless volumes had been crammed haphazardly, totteringly, dangerously, magnificently, the boy felt he might faint.
Taking turns, either Father or Grandfather would position the trash bin under a stack of shelves, and the other would climb a stepladder, toss three or four volumes from the left-hand side of each shelf into the maw of the container, and then reach a long arm through the back to sweep ten to fifteen books forward at a time. They cheered when all the books cascaded into the receptacle, sending up great clouds of dust, and cursed when even one missed its mark.
One of these errant volumes was the medical dictionary, and when it bounced off the edge of the bin and out into the hallway, the boy ran after it and stuffed it into his backpack, a secret souvenir from the dreadful excursion. Little Philbert had no idea what the book was, but he knew it must be a significant work, for he had seen Great-grandfather thumb through it many times, and those occasions frequently resulted in an exclamation and a twinkle in the ancient eyes.
Philbert IV’s final memory from that last Saturday in the apartment on Touhy and Western was that the bookshelves prevailed over the vengeful heirs, for even the gigantic bin was no match for the trove of volumes. Young Philbert O’Toole IV could not imagine there was a receptacle on earth that could hold them all. The elder O’Tooles retreated in anger, and the boy did not accompany them on the subsequent visit, during which the task of annihilating the old man’s belongings was completed. Philbert IV never set foot in the apartment again.
The three surviving Philbert O’Tooles returned to the bungalow in Skokie, where Father and Grandfather consoled themselves with a couple of beers at the kitchen table, while Philbert IV slinked away to stow his treasure under his bed. At night he would take the book out and peruse it using a flashlight, and that is how he taught himself to read. While other children were learning that A is for apple and B is for banana, little Philbert soaked up words like circulation and dermatitis and elephantiasis.
Even at the age of five, Philbert IV had understood that Great-grandfather prized two categories of items above all the things, and these were, in descending order, his great-grandson and his books. If the books could be discarded with such gusto, what might happen to Philbert IV? The apartment on Touhy and Western had seemed to the child the most dependable place in the world, for it was at the door to that dwelling that he was handed off to Great-grandfather every Saturday afternoon by Philberts II and III on their way to a sports bar in Lincolnwood. On those Saturdays, little Philbert’s excitement would intensify with every chime of the rising elevator until the lad thought he might burst before the twelfth toll. Indeed, it was through this agitation that the boy learned to count by his second birthday. As the elevator doors began to open, Philbert IV would squeeze through, turn left and rush down the balding carpet. Great-grandfather would be stationed at the end of the dim hallway without fail, leaning on his cane within a rectangle of light streaming through the open door.
“Come to my arms, my beamish boy!” Great-grandfather would chortle, and Philbert IV knew by the broad smile on the aged ancestor’s face that he considered the phrase very clever, but the child wasn’t sure why. And as the lad came within range, Great-grandfather would step back into the apartment, his right hand supported by the cane and his left extended like a parkinsonian boat hook, grappling the boy by the shoulder and drawing him in, the door’s springs doing the rest to slam in the faces of Philberts II and III.
Great-grandfather would lead little Philbert to the bookcase and ask him to point to a volume, any volume at all. He would rest his cane against a cabinet, pull the indicated book from the stack, blow the dust off its top, and hobble to the rocking chair, where he would sit and beckon the child to climb up his boney legs and onto his lap. And then he would read, his dentures clacking over the words like a pushcart on cobblestones. Little Philbert understood almost none of it, but luxuriated in the old man’s reverent rhythms. After what seemed like a long time, they would leave the library and move to the small table in the kitchen, where Great-grandfather would pour a glass of milk and lay out two chocolate chip cookies, and the pair would sit in silence until the doorbell rang.
“Those feckless fucks,” Great-grandfather would mutter at the sound of the bell. Rising unsteadily, he would lead Philbert IV whence they had come, pausing by the door to heave a sigh before opening it and restoring little Philbert to the custody of Father and Grandfather, their countenances radiant and their breaths sour with booze. After the boy learned to read, he was unable to find either “feckless” or “fuck” in the medical dictionary, and that is why for a long time he associated both words with leave-taking.
Years later, Philbert IV came to understand the phrase’s true meaning, the verdict of an aged man for his own flesh and blood. Great-grandfather’s offspring had exchanged the birthright of an O’Toolean intellect for two used car dealerships, one in Highland Park and the other in Park Ridge, using them to underwrite the betrayal of their patriarch’s scholarly legacy with suburban houses, materialistic spouses, large-screen TVs, and other tacky acquisitions of the middle class.
By the time Philbert IV was in his teens, Great-grandfather had long been gone, but the derision Philberts II and III harbored for the old man lived on. Father and Grandfather relished mocking their ancestor’s bookishness and impracticality, his contempt for life’s tangible pleasures. This phenomenon of equal and opposite scorn passing from progenitor to descendants and back again was eventually christened by Philbert IV, bored to death one afternoon in a high-school Newtonian Physics class, as “Philbert’s second law of phamilies.” So pleased was he with this little witticism that he scribbled it in his notebook, along with an addendum: “Phather and Grandphather, those pheckless phucks.”
Over the years, other volumes joined the medical dictionary in Philbert IV’s collection, including three regular English dictionaries and a thesaurus, along with many digital resources. But the medical dictionary remained his favorite. The definitions and word origins seemed not so much printed on its pages as emanating from them like whispers from Great-grandfather, rasping, gasping as they used to do from behind the boy’s perch on the skeletal lap in the apartment on Touhy and Western. It wasn’t difficult for Philbert IV to reenact those Saturdays whenever he chose to do so. There was a photo of the aged ancestor on the hutch above Philbert IV’s desk, and all he had to do to have Great-grandfather look over his shoulder as he read was to swivel his desk chair one hundred eighty degrees.
With time, the ability to commune with the spirit of his great-grandfather became Philbert IV’s fixed point of reference in a universe that seemed to be spiraling away from him. For as long as he could remember, Philbert IV had been uncomfortable upstairs, whence the world’s unhappiness seemed to originate, and where his parents and grandparents and their friends denunciated people and things Philbert IV hadn’t realized were bad. Outside the bungalow’s front door, it got worse. There were noise and disorder, bullies, demanding teachers, the boys’ locker room, and other threats, the sum total of which generated in Philbert IV an unremitting nausea. Downstairs, in contrast, were a pool table and a television and a game console, and eventually a computer with high-speed Internet, and from time to time a small circle of childhood friends.
Over the years, Philbert IV’s unease at emerging from the basement expanded and his circle of friends contracted until he was its only member. He managed to finish high school and attend a semester at the University of Illinois, but declined to go back after winter break despite the pleading of his parents. And when Mother acquiesced over Father’s objections to leave food or folded laundry or a credit card number with expiration date and three-digit security code outside the closed door of his room in the basement whenever he needed them, Philbert IV experienced a new sensation. He was at peace.
The only thing he might have wished for that he didn’t have was a girlfriend, but even in that domain he made do. Philbert IV had learned enough about the world to know that without major rehabilitation he was unlikely to attract any member of the opposite sex who was less of an oddball than he. Online chats, gaming communities, and pornography were helpful but unsatisfying. Eventually, he conjured up an imaginary French girlfriend, who pronounced his name “feel-bear” (accented on the second syllable and with the “r” all garbled up in the back of the throat).
The French pronunciation of his name was a multidimensional joke Philbert O’Toole IV regretted not being able to share with anyone except his imaginary girlfriend, but he accepted her imagined appreciation of the gag for what it was worth. Father and Grandfather were fond of recounting how “Philbert O’Toole” had become the family name, embellishing the story at each retelling. According to family lore, when Great-grandfather, a destitute and blinky-eyed fourteen-year-old orphan, disembarked at Ellis Island in 1922 from the steerage compartment of a rat-trap steamer from Odesa, he was still in possession of his birth name, Feivel Ostrovsky. The Irishman on duty behind the immigration desk hadn’t gone to the trouble of asking the tattered creature trembling before him to repeat his first appalling utterance of the words “Feivel Ostrovsky” in response to being asked his name. Instead, the Irishman scribbled “Philbert O’Toole” into the logbook and ripped out the carbon copy, jabbing it with his forefinger and barking “Philbert O’Toole” at Great-grandfather until the immigrant was able to repeat a fair approximation of the syllables. Thus, it was Philbert O’Toole, not Feivel Ostrovsky, who boarded the ferry to Manhattan in possession of little more than the clothes on his back and a slip of paper bearing the sum total of his American vocabulary: his own name. And it was Philbert O’Toole who operated a sewing machine on the Lower East Side during the day and completed his secondary education at night, eventually putting himself through medical school and taking a job as an internist in Rogers Park, Chicago.
Why, Philbert IV mused, if they considered the name so reprehensible, had Philbert O’Toole II passed it on to his son, Philbert O’Toole III, and why had that individual named his own son Philbert IV? Maybe the irony was too delicious to ignore, or perhaps they sensed that the name’s unequivocal goyishness could be leveraged to move used vehicles throughout the Chicago suburbs. Every ad they ran included at least seven mentions of the words “Philbert O’Toole.” Even Philbert IV, eight years old at the time, was featured in a commercial as evidence that generations upon generations of Philbert O’Tooles stood ready to assist the people with their transportation needs, stretching as far back and as far forward in time as anyone could imagine.
~
Philbert IV persuaded himself that Great-grandfather would have sympathized with his great-grandson’s need to take refuge in the basement in Skokie. But young Philbert was pretty sure the aged ancestor would have condemned his descendant’s preoccupation with the Internet. To fill the long hours, Philbert IV posed as a right-wing influencer, using the handle “PatriotCrusader” to post torrents of vitriol to his two hundred-thousand followers on a variety of social media platforms. Mindful of his progenitor’s sensibilities, he would rotate Great-grandfather’s photo toward the shelved dictionary during his lengthy sojourns in cyber-space. And when he was done venting, Philbert IV would turn Great-grandfather’s photo back to face the room, swivel one-hundred eighty degrees in his chair so the old man could peek over his shoulder, and soothe himself with selected readings from the medical dictionary.
In addition to this purely devotional use of the dictionary, Philbert IV consulted it whenever he needed to make a self-diagnosis, which was often. There was always one thing or another ailing Philbert O’Toole IV. Though he might have easily Googled his symptoms, and though after sixteen years of communing with the spirit of Great-grandfather through the dictionary’s pages, he had come near to memorizing the book, he found solace leafing through the gossamer pages in search of a label he could apply like a bandage. In Philbert IV’s experience, furthermore, there was no distinction between diagnosis and cure. As soon as he had identified an appropriate term to affix to the ailment, the symptoms would disappear. Every time.
Philbert IV applied his self-diagnoses creatively, embracing unlikely afflictions, such as aneurism (page 81), tuberculosis (page 1,770), or pleurisy (page 1,309). Yet he also evoked more common maladies, especially when their names thrilled him, like verruca vulgaris (page 1,830). But never had he diagnosed himself with one of the book’s final entries—inflammation of the zonule of Zinn (the bottom of page 1,865).
And thus it was with a practiced hand that Philbert O’Toole IV opened the medical dictionary on the morning he awoke with swelling of his left orbit (he congratulated himself on his appropriate use of the word “orbit” to refer to the eye socket). He ran his finger down the right side of page 1,865 until it came to rest near the bottom. And there it was, the etiology (a terrific word) of his orbital edema: inflammation of the zonule of Zinn. Alternative, and far more likely, diagnoses would have included allergic reaction, chalazion (another good one), cellulitis, trauma, insect bite, and conjunctivitis, but this bothered Philbert IV not in the least. Neither did the fact that the most probable cause was “idiopathic” (page 815, a term meaning of unknown causation). Philbert IV wasn’t fanatical about accuracy. No, he had been holding the zonule of Zinn in reserve for a long time, and he was not about to squander this opportunity. The diagnosis was inflammation of the zonule of Zinn, he insisted, also known as zonulitis, also known as inflammation of the ciliary zonule, the “zonule” being an alternative name for the suspensory ligament of the lens of the eye.
He snapped the book shut, and in the time it took him to turn toward the desk and restore the dictionary to its place on the shelf, he sensed both resolution of his swelling and the onset of melancholia. Now what? He had completed a cycle of sorts. Was he to spend the next sixteen years repeating it? Maybe this time from back to front?
No.
The occasion called for a gesture, something grand and unprecedented. The kind of thing, in other words, that was difficult to accomplish below ground. The basement had been good to him over the years, true, but suddenly Philbert O’Toole IV yearned to leave it, and that’s what he did. He glanced out the ground-level window to confirm that it was a bright day, something he had already learned from his screensaver, along with the fact that it was September 21 and seventy-two degrees outside. He opened the closet, extracted a light jacket, pounded it a couple of times to clear the dust, reached up to the top shelf to retrieve a pair of sunglasses and, with the fluidity of a man who did this sort of thing on a regular basis, opened the basement door, climbed the stairs and exited the house.
The first thing he observed was the smell: it was mostly clean and piney, but someone nearby was smoking a cigarette. The second thing he noticed was a pleasant breeze caressing his face. There were noises in the neighborhood—children playing, a dog barking and a lawnmower in operation a few streets away—but Philbert didn’t linger. He walked down the path and turned right, allowing the picket gate to bang shut behind him.
Hardly aware of what he was doing, Philbert IV wandered west on Foster Street. Fossa, he hummed, supraclavicular fossa, ischiorectal fossa, ethmoid fossa. Arriving at the corner of Crawford, he headed north. Craw-craw, he thought to himself, a term used for onchocerciasis in West Africa. He turned left on Old Orchard Road. Orchidoepididymectomy, excision of the testis and epididymis. After a mile or so he found himself outside the gates of a cemetery. He wandered onto the grounds, its grass green, its plots well-tended, and fresh-cut flowers at a remarkable number of tombstones and obelisks. He passed by some McHughs and Pennicuts, Shrivers and Bowers, and soon found himself among Levines and Goldbergs and Feldmans. Instead of prominent markers and flowers, these graves bore flat headstones studded with loose pebbles. Suddenly he was standing at the foot of a thin granite slab bearing an inscription:
Philbert O’Toole, MD
1908-2008
Philbert IV was stunned. He recalled attending Great-grandfather’s funeral but had not visited the grave since. And here was a second shock: next to Great-grandfather’s stone was another:
Bessie Grossman O’Toole
1914-1980
She was a mensch.
He had never considered the existence of a great-grandmother. He imagined the two of them holding hands beneath the surface of the earth, and smiled. Surrounding the two graves was a radius of undisturbed grass. He figured it must be reserved for other O’Tooles to occupy when their times came, an eventuality he considered improbable given how annoyed a reunion with their predecessor was likely to make Philberts II and III.
Philbert O’Toole IV stood a respectful distance before the graves. He would have liked to park himself right in front of Great-grandfather’s stone and run his fingers over the lettering, but if he did so he might be sitting on the old man’s chest, which seemed disrespectful. He decided to position himself cross-legged facing the headstone from the top, the letters upside down.
It occurred to him that by speaking softly to Great-grandfather thus, he would be the one whispering into the other’s ear. He swept the sleeve of his left arm across the tombstone, wiping off its layer of dust and dead leaves.
“It’s me…Philbert…Philbert O’Toole IV” he began. “I know you can’t hear me, and I know there is probably nothing left of you in there, but all the same I want you to know that I think about you every day. And I miss you.” He paused. “I miss our time together, and I think it’s really great how you used to read to me. I’m sorry we didn’t have more time to spend with each other. I wish we had, because…because…I think I might have turned out a little better.” Tears welled in his eyes, and he wondered whether his zonule of Zinn was acting up again.
“I’m going to be OK, though,” he continued. “I think I’m starting to figure things out. It’s true that I don’t know how to do much of anything useful yet, but that can be fixed, don’t you think? I think that must be true.
“Anyway, I just came by to say hello, and to let you know that I am thinking of you. Don’t worry. Thanks.”
He gave the tombstone another wipe with the sleeve of his left arm. As he did so he felt a heavy weight in his lap and, looking down, saw that without realizing it he had brought the medical dictionary with him.
He lumbered to his feet and gazed at the grave. Then he stooped and laid the volume on the corner of the stone. Great-grandfather would probably enjoy having it nearby for a while one last time. Philbert O’Toole IV turned and walked away. He had no use for the dictionary anymore. He knew he would never find within its pages the diagnosis that ailed him most: heartbreak.
Emmet Hirsch is a physician, scientist, educator, and author of the novels The Education of Doctor Montefiore and the upcoming The Wolf Shall Dwell with the Lamb. His fiction and creative non-fiction have appeared in The Examined Life, The New England Journal of Medicine, The Chicago Tribune, and other outlets.
