Perspectives in Biology and Medicine

Like its protagonist, Lawrence Henderson, Henderson’s Equation is many things, a biographical novel that is also in part autobiography and social commentary. In real life, Lawrence J. Henderson (1878–1942) was a pioneer in human physiology, who investigated how the acidity of body fluids is regulated. His career encompassed the disciplines of chemistry, physiology, and biology, as well as philosophy and sociology, and it was his belief that man is in dynamic equilibrium with his environment that made him one of the great thinkers of the 20th century. This also makes him a worthy subject for a novel.

The author, a nephrologist with deep interests in acid-base physiology and the doctor-patient relationship, has spent his life and work seeking connections between his medical science and the larger world of philosophy and metaphysics. This uniquely qualifies him to bring Henderson to life through a study of his unpublished memoirs and writings.

The year is 1908 and Henderson, a Boston Brahmin and member of an elite group of intellectuals, is already comfortably established at Harvard Medical School. Enter Aaron Weiss, who has come to Harvard from New York’s City College, and modest circumstances, radically different from Henderson’s. Yet Weiss is drawn to Henderson’s intellect and teachings (“It all begins with water”) and becomes his loyal defender among his doubting classmates as well as his laboratory assistant. So begins a dynamic interaction between Weiss and Henderson which forms the core of this book which spans much of the 20th century.

This relationship is tested when Weiss, having finished medical school, applies for a position at Harvard and is rejected based on his background and social standing. He appeals directly to Henderson, who not only fails to support him but points him towards Boston General Hospital, a public institution (“That’s the place for you”). Weiss, angry and humiliated, accepts the position at the public hospital and becomes not only an excellent clinician but also a humanistic one who sees each patient as a unique individual. This is in sharp contrast to Henderson’s evolving theory of social systems that places every relationship, including doctors and patients, in defined categories. Whereas Weiss sees each patient as his or her own universe, Henderson loses track of humanity amidst the order and precision of his theories.

Weiss leaves Boston after his training to return to his home and Brooklyn Hospital, establishing an acid-base research laboratory of his own. With the backdrop of World War I, the influenza pandemic of 1918, and the Great Depression, we see Weiss’s evolution as a physician and scientist, often forsaking his research to provide vitally needed patient care. In contrast to Henderson, for Weiss, “It all begins with patients.” [End Page 475]

The setting of the widespread death and tragedy of the Blue Death (Spanish flu) in 1918, followed by the famous Sacco and Vanzetti case of the 1920s, brings the contrast between the two men to the foreground. Enthused by the passion of his friend and mentor, DePodesta, an Italian immigrant that Weiss meets as he works summers to finance his studies, Weiss takes up the cause of whether Sacco and Vanzetti have received a fair trial. Once again, he appeals to Henderson to use his influence, and again he is rejected. In a stirring confrontation, Weiss’s anger from his previous humiliation explodes. Weiss tells Henderson the meaning of loyalty and that physicians can bring comfort and reduce suffering even if they don’t have all the answers. The student is delivering a profound lesson, even if the great teacher isn’t open to learning it.

There is no doubt that much of Weiss’s experiences and philosophy is the author’s own. Throughout his own evolution as a physician and writer, Lowenstein has been deeply influenced by the work and writings of Lewis Thomas and Gerald Weissman. It is also clear that Lowenstein was intrigued by Lawrence Henderson and would have leaped at the opportunity to meet and work with him...