The Puzzle Solver

IN DECEMBER 2016, SOMETIME in the middle of the night, Whitney Dafoe slowly used Scrabble tiles to spell out this:

“Can’t take care of myself. Don’t know what to do.”

This was followed with five more tiles: D…Y…I…N…G.

Then he pushed a button next to his bed that rang a bell throughout the house to summon his parents, who were caring for him around the clock, to his room.

Later, when I asked his father, Ron Davis, a legendary scientist, how he responded when he saw what his son had spelled out in tiles, he simply said, “I did not answer him—he cannot tolerate anyone speaking to him.”

That week, Whitney was taken in an ambulance to the hospital to get a feeding tube inserted into his abdomen. He needed it to stay alive.

Two months later, I drove up to Ron Davis’s home in Palo Alto, California, for the first time on a chilly winter’s evening. A gentle breeze touched my cheek as I climbed out of my old, green Honda Civic, but my heart felt heavy. I had come to interview Ron and his wife, Janet Dafoe, to hear Whitney’s story. (Whitney’s parents, I would also learn, chose to share their last names between their two children. Whitney has his mother’s last name, and their daughter, Ashley, was given her dad’s.) Over several decades as a journalist, I had gained a reputation as the go-to writer for tragic stories, so it was natural my editor at Stanford Medicine magazine had assigned me this story about a father trying to save his severely ill son.

I’d written articles for the magazine before about amputees who survived the 2010 Haitian earthquake, Cambodian refugees with PTSD, the deplorable lack of health care on Native American reservations, and myriad other science stories about horrific medical conditions and the search for cures. I was proud to be able to give a voice to these often neglected stories, but I also had a personal motivation. I’d been devastated myself decades before by a late-term miscarriage. The grief eventually lifted, but it left me with a chronic case of insomnia that I struggle with still. Along with that came a growing obsession with writing stories about people living with chronic conditions. I wrote about cancer and Alzheimer’s disease, clinical depression and foster children living with PTSD. I’d look into people’s eyes when I interviewed them, searching for answers. How did they do it? How did they carry on?

Still, for some reason, when confronted with this story of the daily pain and suffering of a young man imprisoned in his own body with his grief-stricken family standing at his side, it unnerved me. Perhaps it was the years of his total and complete isolation that scared me most or the fact that his photos looked too much like my own grown son. Whitney couldn’t eat or speak. He was completely voiceless. Now thirty-one years old, he lived twenty-four hours a day, every day, in the back bedroom of his parents’ home. I’d talked briefly over the phone with both Ron and Janet when arranging the interview. They told me Whitney had been diagnosed with chronic fatigue syndrome more than five years before, but that for the past two years, his condition had deteriorated into a coma-like state. When I asked if I could interview him, they’d said no. His mother was the first to say it. Whitney was far too sick for anything like that.

“I understand,” I told her. Though at the time I didn’t fully.

At the time, I was working for Stanford medical school in an office building that happened to be across the street from Ron’s science lab, the Stanford Genome Technology Center, in Silicon Valley. As a science writer who often wrote about faculty research, I was aware of his reputation. I’d never met him before, but when my colleagues talked about him, it was with awe and respect. Some rumored he could be in line for a Nobel Prize one day. So it was big news that Ron Davis, PhD, had suddenly changed the course of his genomics research to study this little known disease and find a cure for his son.

I had read through the smattering of media stories about Whitney and Ron online. In a 2015 Washington Post article titled “With His Son Terribly Ill, a Top Scientist Takes On Chronic Fatigue Syndrome,” Ron Davis, the story said, developed techniques for gene mapping that were later used in the Human Genome Project. In 2013, the Atlantic ranked him on a shortlist of the world’s greatest living inventors alongside SpaceX founder Elon Musk and Amazon founder Jeff Bezos.

His son, on the other hand, had been an artist. Whitney used to be an award-winning photographer who traveled around the world. He had helped to build a nunnery in the Himalayan mountains, ridden a motorcycle across India, and visited all fifty American states. Now he was fed intravenously and could barely tolerate sounds. His parents, and the medical personnel who saw him, wore plain clothing when they entered his room because bright colors or any patterns could make him feel worse. I lingered over the before and after photos of Whitney that ran with the story. One showed a smiling Whitney in a red plaid jacket, tall and handsome, with bushy brown eyebrows and kind eyes, posing in front of the blue waters of the San Francisco Bay. In the next, an emaciated body lay on its side in bed. Ron knelt there, at Whitney’s side, shaving his son’s head because he had grown too weak to wash his own hair.

Standing in this family’s driveway, as a parent of two children myself and having many years ago lost a third, I just wanted to turn my head and drive away. The suffering of a child is so hard to bear. Instead, I chastised myself for being cowardly, took a deep breath, and turned to walk down the tree-lined driveway, pausing occasionally to stare up at the stately old house with columns on the front porch and wisteria climbing its walls. Somewhat hopefully, the house was decorated with twinkling white lights strung across a wide, green lawn and colorful Tibetan prayer flags hanging from a circular front porch. I would learn that back when it was first built in 1889 in the upscale neighborhood now known as Professorville, this house had a palm-lined circular driveway that curved past tennis courts, a coachman’s quarters, and an outside kitchen, a sign of old Palo Alto wealth. When Ron and Janet moved into the house in 1983, their son just an infant, the tennis courts had long ago disappeared, and the aura of old wealth had changed to a quaint nostalgia.

I walked across the front porch and paused to read a handwritten note stuck to the front door: “Please do not knock or ring a bell before 3 p.m. Call or text. Very sick person.”

Stupidly, I checked my watch, even though it was obviously well past 3 in the afternoon. I knocked softly. Janet opened the door and invited me inside.

Like many people, I knew little about chronic fatigue syndrome when I arrived at the house that evening. Reading through the Post story had jogged my memory about an old article I had written on CFS years earlier, back when I was working as a reporter for my hometown paper, the Santa Cruz Sentinel. It was a mysterious disease with no known cause or cure, often lumped together with other so-called contested diseases—like chronic Lyme disease, fibromyalgia, and Gulf War Syndrome. I’d heard it was a “woman’s” disease, which often meant, insultingly, psychological in origin. Therefore forgotten and tossed aside. I had no idea patients with CFS could get as sick as Whitney. Many people, including physicians, didn’t even believe it was a real disease. Some said these chronically fatigued “sick” people were just suffering from depression or were “malingerers” who wanted to collect monthly disability checks. I knew there was an active CFS patient community that protested such propaganda and cited science to back them up. I would hear more about it from Whitney’s parents that night.

I followed Janet into a large foyer, and she took me on a quick tour of their home. It was a house overflowing with a lifetime’s worth of science books, paintings, and Whitney’s photographs. The detritus from years of raising children filled every nook and cranny with baby photos, Whitney in Little League, and Ashley in ballet. I slowly began to relax. It reminded me of my grandmother’s home in Salt Lake City, with crystal doorknobs and those old-fashioned light fixtures that you had to push hard into the wall to turn on. I felt comfortable in Whitney’s home. Janet opened a door to the basement revealing a creaky-looking staircase just like my grandma’s, where my cousins and I used to play. Basements are a rarity in California. I wondered if Janet canned peaches like Grandma Deedee had.

Janet had short gray hair like my Grandma DeeDee. She was a child psychologist with a PhD from Stanford. And, at least that day, she had her guard up. She doesn’t trust me yet, I thought. We walked back through the foyer, then settled in the library, on comfy couches with shelves full of old books, a television, and their pet tortoise, Rex. This was obviously where the couple escaped to when they had a chance to relax.

“Ron feels a huge amount of responsibility and stress,” Janet said, as she sat down on the couch. I pulled out my reporter’s notepad. Ron joined us in the room and quietly sat by her side. I introduced myself, and we shook hands. He was wearing old jeans with a cowboy belt buckle and sneakers, his brown cowboy hat on the coffee table in front of him. Not a whiff of arrogance came off this man. He had a gray beard, glasses, and a kindly demeanor that lent him more of a grandfatherly air than any kind of snooty professor with long lists of big science awards. Mostly, he just looked tired. At seventy-one, Ron had undergone an aortic heart valve replacement two months earlier but returned to his CFS research as quickly as he could, Janet said.

“He also has to keep all his other grants up,” she told me. “He spends all the waking hours he can thinking about CFS research.”

Ron smiled sadly, then added, “It is enormous pressure. We have to figure this out very quickly because millions of people are suffering and my son is dying.”

I didn’t know how to respond. I tried not to think of how it might feel to have your grown child so sick, nearing death. Looking around the living room, I could see how well they’d seen to it that he and Ashley had a safe and grounded childhood. The thought of losing him to an illness with no cure and one that they did not have any control over—I felt a great sympathy for Ron especially. To feel the responsibility of finding a cure not only for his son but for so many other people’s loved ones who depended on him must’ve been a huge burden for this gray-haired man. My heart hurt for them as Janet began to tell me more about Whitney’s story. As she spoke, I had the feeling she had told this story many times and would tell it many more. It was as if it was her job as a mother was to make the world both understand and believe in her son’s story.

Maybe it first started with a case of mononucleosis in high school, Janet told me. They didn’t know for sure. Or it could have been at the age of twenty-one, after a trip to Jamaica during college when Whitney experienced dizziness, a severe headache, and nausea—symptoms that never seemed to completely abate. More signs of illness came two years later, when he traveled to India for the better part of a year.

Whenever he could, Ron veered the conversation back to the science. Talking about his son’s sickness was obviously painful for him, but he understood science. It made much more sense to him. He explained how the disease affected multiple systems of the body including the immune, nervous, and metabolic systems. He told me he had been part of the Institute of Medicine (now the National Academy of Medicine) committee that the year before had published a report on CFS. It listed symptoms that range from chronic pain to cognitive problems, brain fog, gastrointestinal issues, sleep disturbances, and extreme fatigue. The flagstone of the disease is a symptom known as post-exertional malaise, PEM, which means symptoms worsen after any kind of physical, mental, or emotional exertion—sometimes, in severe cases, it can be something as simple as brushing your teeth. Also, sleep doesn’t help the fatigue, and sleep cycles go haywire.

“So many people will ask us, ‘Has your son tried caffeine?’” Ron continued, shaking his head. “They think CFS just means you’re really tired. Caffeine does not help with this disease.”

At the sound of a faint bell, he suddenly stopped talking and stood up.

“That’s Whitney,” Janet told me. “He’s ready for his dad.” Whitney usually woke up in the late afternoon or early evening, Janet explained. Ron’s daily routine was to care for Whitney then, giving Janet, who stays up most nights with Whitney, a break. He’d clean up the room, pick up tissues, fill containers with water. It was his job to prepare the IV line that delivered the life-sustaining TPN, liquid nutrients, along with medications and supplements. The feeding tube inserted into Whitney’s abdomen a few months earlier was beginning to help add more nutrition, but each additional supplement still had to be tested carefully.

“When I walk in the room, he’s still as death,” Ron told me before he left. “If his feet are left uncovered, it means he wants me to change his socks.” Janet explained how it took awhile for Whitney to prepare mentally for someone to enter his room to prevent him from “crashing.” I didn’t know what this meant, but it sounded bad. She said they would sit in the hallway outside his door and peer through the keyhole to watch for Whitney’s signal that it was OK to enter. This was hard to imagine, so I asked if I could see how it worked. I followed Ron to the hallway that led to Whitney’s room; then he signaled for me to watch from there.

Ron didn’t enter Whitney’s bedroom right away. Instead he sat on a chair outside the door and peeked through a keyhole waiting for his son to find the strength to sit up and pull a blanket over his shoulders, signaling it was OK to come inside. I could see it was one of those old-fashioned keyholes big enough to see through.

“He can hear me sitting outside,” Ron explained to me later. “It can take him a long time to prepare. Sometimes I wait for hours at the door. I once watched him take thirty minutes to move his cap from his lap to his head.”

After some time had passed, I left Ron waiting there and returned to the library to join Janet on the couch. It was getting late, and I had a long drive back home to Santa Cruz that night. As I stood to go, Janet pointed to a book on one of the shelves titled Osler’s Web, which had been written decades ago by Hillary Johnson, an investigative reporter who had CFS herself. “The folks in the patient community think of it as their Bible,” she said. “It tells the story of how the medical establishment failed this disease.”

She told me that we should take another look at the back of the house before I left. When I entered the kitchen, I realized that it had basically been transformed into a hospital ward for Whitney. The large, wide-open space was filled with boxes of syringes and medicine bottles. Just off the kitchen, a closed door led down a short hallway to Whitney’s room. Janet put her finger to her lips telling me to shush and softly opened the door.

I followed her down the hallway, and ever so gently she opened the door to Whitney’s bedroom. From the hallway I caught a glimpse of him from behind. Ron was on his knees at his side fiddling with the IV line. Whitney didn’t see me. He was sitting up hunched over in bed, his bare spine a long string of white pebbles dripping down from thin neck to slender hips. That was in the spring of 2016, when his six-foot-three-inch frame weighed just 140 pounds, and he was starving to death. I wouldn’t see him again for two years.

The magazine article I was writing, “The Puzzle Solver,” was published that spring, but that was only the beginning of the story. Even after the article, I’d think about Ron’s words and Whitney’s years of complete solitude. I’d go home at night and hug my son, who was now at an age when he was thinking about his career and starting real life. I couldn’t imagine being in Janet’s place, but sometimes I thought about it. I wanted to do something to help. I needed to talk to more people who had the disease. Few in the medical community had taken it seriously, and there weren’t that many places to look. I needed to know if they were experiencing what I had seen in Whitney’s room. When I saw Whitney, I knew there was no way he could just be depressed, as some had suggested. He was suffering, and it was beyond mental anguish. Something was eating him alive.

I reached out to Laura Hillenbrand. In addition to being a CFS survivor, she is the best-selling author of Seabiscuit and Unbroken. She had written about her struggles with a similar severe case of CFS in a 2003 New Yorker article, “A Sudden Illness,” which I remembered reading. She had also written entire books while sick in bed. I emailed her publisher and received a response back quickly that she’d be willing to talk to me.

She was a nineteen-year-old student at Kenyon College in Ohio when she first got sick. One morning she woke up and couldn’t sit up in bed. There were chills, swollen lymph nodes, dizziness. The campus physician ran test after test but couldn’t find anything. As time passed, she grew too weak to continue her studies, dropped out of college, and moved home to Maryland to live with her mother. She lost twenty pounds. Her lymph nodes stayed painfully swollen. At night, she had chills, and the ground swayed.

“Sometimes I’d look at words or pictures but see only meaningless shapes. I’d stare at clocks and not understand what the positions of the hands meant.… Words from different parts of the page appeared to be grouped together in bizarre sentences: ‘Endangered Condors Charge in Shotgun Killing,’” she wrote in the article.

A doctor said the problem was in her mind and sent her to a psychiatrist. The psychiatrist told her to see another doctor. She saw more doctors. Medical tests all came back negative. Finally, a doctor diagnosed something called Epstein-Barr virus syndrome. I didn’t yet know what type of virus this was, but viruses, I knew, caused infectious diseases.

He gave her supplements, but they didn’t help. Finally, she began seeing different specialists. After a lengthy exam with an infectious disease specialist at Johns Hopkins, she was diagnosed with CFS. He too suspected that it was viral in origin. She was in her thirties when she wrote the article.

It had been more than a decade after the article was published, and I didn’t know how she’d feel talking about it when I called. All that pain and suffering, she told me, has brought with it at least one gift of which she’s proud.

“The experience of suffering has brought me great compassion for the suffering of others,” she said.

Then, matter-of-factly she described to me what it felt like to be trapped in bed with severe CFS.

“The exhaustion is so profound, it’s a struggle to breathe. It’s a struggle just to lie there. Every effort goes into just staying alive.” At first, she was angry at family and friends who had abandoned her. Angry at doctors who told her she was crazy. “It was arrogance paired with ignorance. The easiest way to deal with someone with this disease is to deposit them in the waste bin of psychiatric disorders.”

I thought of Whitney lying in bed. How had she survived all this?, I wanted—I needed to know. I asked her about suicide, and she said, yes, she had thought about it. But somehow she got better enough so that she could begin to form sentences in her mind and write stories from bed. It was excruciatingly slow work; CFS made everything she did slow. And so she chose to write about fast things. She used to be an athlete, and she missed motion so badly. So she wrote about a racehorse and an Olympic runner. And then, after being unable to leave Washington, DC, for more than twenty-five years, she very slowly began to make plans to move. It was a long, arduous path, she said, that led to her eventual limited recovery, a combination of new medications, constant restraint and patience, tiny steps forward over years. When I talked to her, she had just made a cross-country car trip from the East Coast to a new home in Oregon with her boyfriend. She prepared two years for that trip to deal with her vertigo, taking practice car trips beginning with five minutes, then adding a minute or two. Every trip, she said, was a whirling nightmare, but it worked.

“We drove 4,300 miles,” she told me, the amazement still lingering in her voice. “Through the Rockies and the Badlands all the way to Oregon.”

“That’s so wonderful” was all I said, but my mind went right back to Whitney.

The phone call had made me hopeful. If Hillenbrand could feel better, have a relationship, and travel again, so could Whitney, right? I had a number I had read in my mind: twenty million people worldwide suffering from CFS. If they could be cured, that would change so many lives, but there was so little known about a cure.

Bits and pieces about this mysterious disease continued to nag at me as time passed. I had read that a chronic fatigue syndrome “epidemic” had first started in Incline Village, a small tourist town on the shores of Lake Tahoe in the 1980s. That was just a short four-hour drive to the ski slopes for me, a trip I had done many times as a college student at Berkeley. Maybe there was a trail to unraveling Whitney’s illness, one that unknowingly started there, could circle back to Ron’s laboratory in the building just across the street from my office, and end with Whitney and whatever story was hiding with him inside that bedroom. If Hillenbrand got better, then there was hope for Whitney, wasn’t there?

Two years later

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