ALL THE ACHES, PAINS, AND MALADIES ONE COULD WANT, AND MORE

Author: By Katherine A. Powers

Date: SUNDAY, December 21, 1997

Page: E4

Section: Books

I am looking now at the sinister stripe that represents the summer I diagnosed myself as having contracted rabies from a cat scratch: ``The disease commonly begins,'' I read, lymphocytes pounding in my ears, ``with a short period of mental depression, restlessness, malaise, and fever.'' Dear God, I mused in horror, this is bad. No fever -- yet -- but plenty of ``malaise'' in the spiritual sense, and, certainly, depression and restlessness were present in spades. When the rabies virus failed to take hold (I guess I was lucky), it was replaced with a mycobacterial infection (``pathologically similar to TB'') in my leg (``response to drug treatment [being] virtually nil''). Oddly, that fearsome blight never came to much either, but the dark band of pages it left on my Merck's melds into the one commemorating parasitic infections: a teeming chapter that is part of the history of my two sons, both generous hosts to a bevy of nematodes and protozoa -- all, I'm afraid, indisputably real.

The only drawback to the manual was that it is written for medical professionals who do not or will not speak English. This lends the prose a certain Greco-Latin exoticism and a lot of mystery; but it's plain speaking you want when you could very well have deadly gallstones clawing at your vitals, to say nothing of their complications (acute and chronic choleystitis, cholangitis, internal biliary fistula [!] choledocholithiasis, . . . ).

The demand for common parlance in a big book addressing disease has finally been met in the new ``The Merck Manual of Medical Information: Home Edition'' ($29.95). When I first heard of it, I simply assumed that it would turn out to be yet another condescending, good-news tome about wellness and lifestyle and consulting your ``health professional''; that it would be long on positive attitude and short on clinical detail. But nosiree. Merck's ``Home Edition'' is the goods; only, in this case, written in lucid, straightforward English and equipped with clear, informative diagrams of the peccant parts. For my own purposes, I also welcome its treatment of ailments that were so notably absent, or at least unnoticed, in 1977 when my old Merck's was published. These include AIDS, of course, as well as Lyme and mad-cow diseases, Hanta, Marburg and Ebola viruses, and sports injuries.

I think I should say, before I do a disservice to this excellent work by associating it with my own fascination with maladies, that it has a bright, intelligent presence and is an invaluable reference work. It is also a wonderful book to sit and read for enlightenment and pleasure, whether you are prone to symptoms or not.

Unsurprisingly, I am drawn to fiction in which disease figures -- not only to the great works with serious metaphoric purpose such as Solzhenitsyn's ``Cancer Ward,'' Tolstoy's ``Death of Ivan Ilyitch,'' or Camus's ``The Plague'' but also to amusing ones such as Richard Dooling's black comedy ``Critical Care'' (Picador, $12), and Anthony Burgess's exquisite farce ``The Doctor Is Sick'' (Norton, $9.95). I am also partial to junky medical thrillers and have, in fact, just read a couple.

``Life Support'' (Pocket Books, $23) is Tess Gerritsen's second novel of medical suspense and follows the superb heart-stopper ``Harvest,'' which is now available as a very cheap paperback (Pocket Books, $6.50). Her new book begins with a masterly emetic event: a surgeon at work at his trade, about to perform an appendectomy, suddenly loses his mind and . . . and . . . no, I can't tell you. Suffice it to say that it will, at the very least, make you think twice about coming down with appendicitis. Like Gerritsen's last novel, which dealt with the illegal sale of organs for transplant and perfectly captured the atmosphere of desperation and greed that surrounds it, this book is sickeningly believable. That and its terrific pacing make it really high-quality junk, worthy of my seal of approval for mindless pleasure.

I contracted similar hopes for Richard Preston's ``The Cobra Event'' (Random House, $25.95), having found ``The Hot Zone'' terrifying and disgusting beyond my wildest dreams. I still mouth with awe the expressions I found in those pages: ``Bleed out,'' ``amplification,'' ``sludging of the brain,'' and ``hemorrhagic'' itself. But ``The Hot Zone'' was nonfiction; ``The Cobra Event'' presents itself as a novel, a cautionary novel at that. Its worthy purpose is to alert the reader to the perils of ``black biology,'' the development of deadly viruses for biological warfare. The plot involves a villainous sicko who has released a very bad bug that causes people to eat their own tongues and lips and what all. Then they die, their brains ``glassy, swollen, speckled with tiny spots.''

Well, that's all well and good, but even though the disease is modeled on a real one (Lesch-Nyhan syndrome), it here gives rise to episodes of fulminant, bungled invention, even to the single stupidest scene I have come across in a lifetime of reading. A medical examiner, infected with this ghastly virus and having gone loco, removes his scalp and face with a few deft sweeps of his scalpel, plops the resulting cloche (as it were) back on his head inside out, and begins to dine on it. Yeah, sure. The great error of nonfiction writers is to believe that fiction, even sensational fiction, is somehow less rigorous than nonfiction, that it can support the improbable, when in fact the opposite is true. As it happens, nothing is more far-fetched than some of the agents of disease that are now known to exist. (Prions?!) Outlandishness is better cultivated in nonfiction, where the incredible becomes credible, before jumping species to fiction.