In 1996, at the age of 31, David Biro is preparing for his specialty examinations in dermatology and is set to share a practice with his father. But he develops a visual disturbance. After repeated testing, he is found to have the rare blood disorder of paroxysmal nocturnal hemoglobinuria. The diagnosis was problematic, but the treatment choices are overwhelming. His youngest sister is a suitable donor, and he opts for a bone marrow transplant. He realizes that his decision was influenced not only by the diagnosis, but also by his personality and his reaction to the physicians.

Advance preparations are hectic and sometimes comic, especially his deposits at a local sperm bank. The pain of the transplant and the six weeks imprisonment in a small hospital room are told in graphic detail. The athletically inclined doctor suffers many complications: exquisitely painful ulcers of the scrotum, mouth, and esophagus; inflammation of the liver; unexplained fever; drug-induced delirium; weakness and weight loss.

His parents, sisters and friends leap into action to provide round-the-clock presence, but his independent wife, Daniella, resents the invasion. While David’s body is wracked with drugs and radiation, his family and his marriage are subjected to destructive forces too. Yet all--body, family, and marriage--emerge intact, though changed, by their experience.


This book is a physician-written autopathography. Biro knows that he is not the first doctor to learn that being a patient can be an unpleasant surprise. He recognizes that he has been sheltered, naive, privileged, and perhaps even spoiled. He learns self-awareness and empathy from his encounter. The tale is interspersed with lucid clinical explanations of bone marrow function and transplantation, useful for those about to face this procedure.

But the power of his work comes from the superb portraits of the people whose lives are equally disrupted by his illness. The two (very real) physicians are juxtaposed: shy, cold but determined Castro; warm but cautious Luzzatto. The anxious mother and father, whose diaries are excerpted, reveal their individual fears and distinctive reasons for guilt. The remote, beautiful wife, who provides Biro’s greatest strength and joy. The title is a conscious reference to Bonaparte’s One Hundred Days, a military comeback that ended not in death, nor in victory, but in the nether world of an island prison, a state between health and disease.



Place Published

New York



Page Count