Rays of Wonder

On a Friday evening in November 1895, in a basement laboratory in Würzburg, Germany, a physicist named Wilhelm Röntgen wrapped a glass tube in black cardboard, hoping to investigate a mysterious form of energy—the cathode ray—that had scientists around Europe buzzing. Researchers had learned that cathode rays were generated between charged electrodes, and they suspected that these rays might actually reveal a new understanding of what energy means. One enchanting quality of cathode rays was the fact that, when aimed at glass vacuum tubes, they produced mesmerizing colors: emerald, blue, aquamarine. Röntgen happened to be partially color blind, but he was nonetheless fascinated by what this color spectrum suggested. What else could these rays do? What were the limits, if any, to their power?

Tall and slender and with a piercing gaze, Röntgen was highly regarded among his university students for his humility and scientific integrity. His lectures tended to be fact-based and modest, if a little boring. Teaching was part of Röntgen’s job, but his personal laboratory was his sanctuary. On weekends with no student obligations, he relished the solitude of the lab, absorbed in his own experiments.

On this particular evening, Röntgen was curious to know how far the cathode rays could travel. Physicists had already explored this question and had determined that the rays couldn’t travel very far; but Röntgen often questioned others’ findings. He preferred to see results with his own eyes.

To conduct his experiment, Röntgen used a battery-powered induction coil wired to a pair of platinum-tipped electrodes to deliver energy into a pear-shaped glass vacuum tube. He wrapped the glass in black cardboard, sticking little pieces together to make sure every bit was concealed, then placed the encased tube next to another piece of cardboard dusted with barium platinocyanide, a chemical that can detect light invisible to the human eye. If the cathode rays escaped the confines of the glass, the nearby barium board would light up.

With everything in place, Röntgen darkened the room. He switched the battery on and heard the characteristic snapping of electrical discharge. The cardboard-wrapped tube stayed dark—the cover was light-tight. Time for the next step, setting the barium board in place.

As he reached to turn off the battery and pause the current, he noticed an unusual glimmer coming from a piece of cardboard dusted with the same barium but set a few feet away, on his workbench. Because of his color-blindness, he couldn’t see the exact yellow-green hue, but he realized he was witnessing something other than cathode rays—something eerie, something spectacular. Unseen rays were traveling through the glass tube and its cardboard shield, through the air—through all of what before had seemed impenetrable—and casting a strange kind of light.

The discovery was so unexpected that at first Röntgen didn’t trust his eyes. He wondered if his color-blindness was causing him to hallucinate. But then, ever the rigorous skeptic, he repeated the experiment, moving the barium board farther away each time. And each time, the board glowed.

Eventually he tore himself from his experiment and made his way up the spiral staircase to where he and his wife, Anna Bertha, lived, in the same university building as his lab. They ate a late dinner. He picked at his food and refused to speak, then descended back to the lab, where he spent most of the night. He sequestered himself there for weeks, asking Anna Bertha to bring his meals down to him, even setting up a cot where he could sleep amid the piles of tubes and wires and notebooks. He left the lab only when necessary and kept his experiments a secret from his students, his colleagues, even his wife. A grandfather clock marked the time. Röntgen felt an urgent need to understand the wild new rays he had stumbled upon.

As the days passed, Röntgen learned that these unusual rays shot through certain objects—a playing card, a piece of cloth, a book of a thousand pages. Other items—a thick block of pine, a set of weights—would cast faint shadows. A disc of lead made a dark, crisp shadow, as if the rays bounced off of it. One day, while firing rays at one such disc pinched between his fingers, Röntgen saw the outline of his own bones cast on the board behind them.

Three days before Christmas, Röntgen brought Anna Bertha downstairs to the lab to show her what had possessed him all those weeks. He positioned her hand on a photographic plate in front of the arrangement of tube, coil, and battery. For fifteen minutes, he ran a high-voltage current through the coil, to the tube, and through the air, then onto his wife’s hand on the photographic plate, thus producing the first human radiograph. The bones of her hand appear long and thin, the knobs of her joints almost translucent, her wedding ring a bulge like the burl of a tree. Anna Bertha couldn’t stop staring at the image. “Ich habe meinen Tod gesehen,” she said. I have seen my death.

Röntgen named the curious light Strahlen—German for “rays”—and added the letter X to signify the mathematical symbol for the unknown. X-rays: light of the unknown.

As 1895 came to a close, he wrote up his findings in a paper titled “On A New Kind of Ray,” and quickly published it in a German medical-society journal. On New Year’s Day, he walked to the mailbox with a thick stack of copies of his report, which he mailed to reputable physicists. In each envelope, he included a personalized New Year’s greeting and prints of the radiograph of Anna Bertha’s skeletal hand.

Soon enough, a frenzy over his findings erupted—what the press dubbed “Röntgen mania.” His results were published in scientific journals of several languages; within months, laboratories across Europe and America had created their own X-ray machines. Astonishing new photographs circulated in the news: in Paris, the delicate skeleton of a frog, legs splayed; in London, a fish with a lattice of thin, curved bones cupping its body like a corset; in Hartford, a human foot in a shoe. Stories spread of the X-ray’s miraculous applications: a surgeon curing a patient with abdominal pain after an X-ray showed snow-white gallstones; people having bullets extracted with precision instead of guesswork; a paralyzed sailor whose injury was a mystery until an X-ray revealed a knife blade in his spine. (With the blade removed, the sailor was saved.) The X-ray seemed to usher in a new age of invention and inquiry. At his New Jersey laboratory, Thomas Edison became so enamored with the X-ray’s potential that he hired a hand-organ player to keep his research team awake. In April 1896—just months after Röntgen’s announcement of the X-ray’s discovery—Edison’s team created the first commercially available fluoroscope, a device that enabled physicians to peer inside their patients’ bodies in real time.

When I first learned about the origins of the X-ray, I was sitting at my desk in an internet rabbit hole, my coffee gone cold. I was, again, trying to grasp something that perpetually haunts me: how medical care intended to help patients can inadvertently also cause significant harm. I am a pediatric rheumatologist, a doctor who cares for children with autoimmune diseases. The illnesses that impact my patients are complex and unpredictable. So are the treatments that save their lives. Medications that put out fires of inflammation can harm young bodies in other ways: stretch skin, melt bones, cause infections and blood clots and even psychosis.

To be a physician is to make difficult decisions about risks versus benefits of medical technologies and treatments. Recently, I’ve found myself thinking obsessively about the history of the X-ray, and how my own family has a long-running history with this technology. My family’s story with X-rays is one of innovation and harm, fascination and regret. When I graduated medical school, I vowed to “do no harm.” All physicians take this oath, and yet we all know, on some level, that it’s an impossible promise. My family’s X-ray history was one of my first exposures to the duality of the beauty and the wreckage that can come with medical care. I’m now at the end of my pediatric rheumatology fellowship, in the final weeks of a decade of medical training, and lately I’ve been returning to these histories. What might they teach me about what it means to pledge—and sometimes, to fail—to “do no harm”?

When I was a kid, my father kept his X-ray viewer in his upstairs office in our Iowa City home, next to a bulky desktop computer and a window looking out at my favorite oak tree. The X-ray viewer was a simple machine with a flat screen and fluorescent bulb. My father, an orthopedic surgeon, brought home stacks of slinky black films nearly every day. On weekends, when my brother and I weren’t playing soccer by the cornfields or begging to go downtown for ice cream, I sat spellbound in front of the X-ray viewer. My father would lift me onto his lap, place one of his patient’s radiographs on the screen, turn on the light, and trace his fingers along mine as he told me the names of various bones and joints: Here was the tibia and fibula, there the calcaneus and talus.

I discovered with delight that the machine also worked for picture books. I could drape a page of Stellaluna across the screen, put a piece of paper on top, and—Voila!—magically trace the illuminated bat and her bird friends. Sometimes my father had to wait to use the machine until I was done with my tracings. He’d sigh and stretch out on the office couch in his scrubs. “Five more minutes,” he’d say, and then his eyes would flutter closed, and I’d resume my work.

My parents were both physicians, which meant my brother and I were immersed from our earliest days in the world of medicine. I learned medical terms as soon as I could speak, doctor jargon mingling with my mom’s native Norwegian and my dad’s peppering of Yiddish, his father’s first language. (When I stubbed my big toe, I might shout, “Oy vey! My hallux!”) On weekends when both my parents were working, I’d sometimes join my father on his hospital rounds. I liked to sashay down the hall in his white coat, the starchy fabric skirting the floor like a ball gown.

In my dad’s hospital office, there was a framed, faded black-and-white photograph of a man posing in front of a headless human skeleton. This was my great-great-uncle Frank, stocky and balding, dressed in a dark suit and a striped tie. In the picture, he stands with one leg propped on a chair, elbow planted on his knee, hand holding a cigar. His brow is furrowed, his eyes coiled in shadows.

Frank worked as a radiologist starting in 1918, around two decades after Röntgen discovered the unknown rays that led to the field of radiology. Frank was, in fact, the first physician in my father’s family, as well as an X-ray pioneer. He inspired my grandfather to become a physician, then my father and, by proxy a generation later, me.

I grew up knowing Frank’s basic story. A penniless, Yiddish-speaking teenager at the turn of the twentieth century, he’d fled Russia and boarded a steamboat to New York, where he moved into a crowded tenement on the lower East Side and found work as an upholsterer. Within a few years, he’d somehow not only learned English but also enrolled in medical school. The X-ray captivated Frank, just as it had physicians around the world during  the early enthusiasm of “Röntgen mania.”

When he saved enough money, Frank arranged for his family to join him in America. First, he brought three of his sisters. Then his parents sold their home and the health-food store they owned in Russia and gathered their remaining five children to cross the Atlantic. Frank found his family members housing and jobs. He nurtured his parents’ cultural traditions, hosting boisterous Passover dinners during which he’d theatrically tell stories of survival over bowls of extra-oniony Matzoh ball soup. When I was older and became aware of the antisemitic violence my ancestors had escaped, I began to understand that Frank—and his decision to start a new life in a faraway place full of unknowns—was how my family survived.

Frank cared for his patients the way he cared for his family: ambitiously and boldly, with a headstrong belief that new advancements bring a better future. He saw the X-ray as a panacea. He used it to treat ailments ranging from sore throats to urinary infections to foot pain. Whenever a family member had a health concern, it seems, he blasted the afflicted body part with radiation until the problem vanished from sight.

Within months of Röntgen’s discovery, the unintended consequences of the X-ray began to emerge. In Tennessee, a boy came to the hospital after an accidental gunshot wound to his head. To test the equipment before trying it on his patient, his physician first conducted a prolonged X-ray of his own head. Three weeks later, the physician lost his hair. That same year, a New York doctor conducting X-ray experiments on himself noticed that his fingernails had stopped growing, his knuckles burned, and even the skin of his hand began to peel away. Blisters bloomed on other people’s bodies—on their hands and arms and chests. Thomas Edison started feeling cramps in his stomach; his vision began to blur. His glassblower, Clarence Dally, tested the quality of the fluoroscope tubes through daily X-rays of his own body. His hair started falling out, and his eyelashes and eyebrows burned away. His hands became red, swollen, and ulcerated. Knobs of deformed tissue bulged from his fingers. A biopsy of Dally’s pinky revealed cancer.

His left hand was amputated, along with four fingers on his right hand. The cancer spread nonetheless, stubbornly and quickly, such that Dally lost both arms before succumbing altogether. In 1904, less than a decade after Röntgen’s discovery, Clarence Dally became the first person known to die from X-ray exposure. He, too, had seen his death in his hands.

When Edison saw Dally’s tumors, he swore to never again expose himself or anyone else to radiation. In the year before Dally’s death, as the doomed glassblower lost himself to the disease, the New York World ran a story on the gruesome costs of this celebrated breakthrough. “Don’t talk to me about X-rays,” the prolific inventor told the reporter. “I am afraid of them.”

On Saturday mornings as a kid, when my brother and I curled up on the couch for cartoons, our dad’s favorite show was The Jetsons. He gestured wildly at the TV, spilling Cheerios down his shirt, unable to contain his excitement at the various inventions the cartoonists imagined. “If you were making The Jetsons,” he’d ask us, “what would you add?”

I enjoyed dreaming up ideas with him, but new technologies have always made me nervous, and so I preferred a show like The Flintstones, whose adventures felt more predictable. In one episode, a pet dinosaur gets sick and goes to the vet for an X-ray. The result is reassuring, and the dinosaur perks up after a nap. This was how I typically thought about illness when I was a kid: earaches and bellyaches and runny noses, sicknesses cured by naps and laps and pink medicine that tasted like bubblegum.

I was eleven when I learned that bodies could go wrong invisibly, from the inside, in ways that weren’t so easy to fix. My father had been diagnosed with testicular cancer. After an operation to remove the accessible parts of the tumor, he started radiation therapy (at the same hospital where my parents worked). My mother gave him a Natalie Merchant CD to help him relax during the treatments. “Doctors have come from distant cities / just to see me / stand over my bed / disbelieving what they’re seeing,” Merchant sings in “Wonder,” a song my father listened to again and again during these sessions, both monotonous and scary.

The ominous echoes of radiation therapy live on in my father’s body. He gets nauseous when he hears Natalie Merchant’s voice, and he remains at risk for new tumors caused by the radiation that saved him. And yet without it, cancer might have left me fatherless. Remarkably, his experience—his salvation and its side effects—is in part Uncle Frank’s doing:  Among other achievements, Frank’s obituary mentions a medal from the American Medical Editors and Authors Association for helping to pioneer radiation as a treatment for cancer.

All doctors cause harm. I am no exception. I can harm my patients with mistakes in my decisions, diagnoses, and sometimes-clumsy bedside manner. I can harm my patients simply through the fallibility of being human. I often wake at night with the fear of making a clinical error that could hurt someone. What scares me even more is knowing that I can harm my patients through doing what seems to be right. I prescribe medications that address one malady but carry the risk of causing something worse—the perilous side effects that pharma ads speed through while happy, healthy, medicated people enjoy their lives to the fullest. I order imaging tests that, with repeated exposure, can lead to long-term problems. I follow best-practice clinical guidelines that might someday turn out to have harmed more than they healed.

Two years after becoming a pediatrician, I became a mother, and my angst was amplified by an entirely new layer of instincts. In the throes of sleep deprivation and postpartum nerves, everything looked hazy with risk, even—or especially—things meant to help a baby. Pumped breast milk (What about the plastic cups the milk sits in?); walks in the stroller (What about air pollution?); crib mattresses (What about toxic flame retardants?). Even prenatal vitamins, I learned, are laced with lead.

My dad never shuffled or trudged to work. No matter how late he’d been up operating the night before, he bounded out the door the next morning. Once, while on vacation and gazing at the Rocky Mountains from a hotel window, he imagined a new X-ray approach for looking at ankles, a method that became widely adopted. In coffee shops, airports, and parks, he couldn’t help but notice the feet and ankles of people we encountered: the angle of their shoes against the hems of their pants, the subtle differences in how they walked or ran.

And yet he couldn’t see his own daughter’s abnormal gait. One day in junior high, I was playing soccer when my father’s colleague, whose daughter was on my team, pointed out that the way I ran looked unusual. By the time I was in high school, after my hips widened and my bones lengthened, I was in pain. My father took me to his office for an X-ray, which revealed that my femurs and tibias were curving the wrong way. The bones of my thighs darted in like a V, while my shinbones looped outward into the O of an open mouth.

“Miserable malalignment syndrome,” my dad’s partner diagnosed. “You’re a poster child.”

I wound up in the operating room—a first surgery, then another, a third, a fourth, a fifth. At the orthopedic hospital where my father worked, my surgeons sliced tight tendons and shaved overgrown bones. My dad reassured me with what he jokes is his life’s motto: “Better life through surgery!” But during my surgeries, he’d bite his fingernails and pace the OR hallway, peeking through the window to my room to watch his team operating on me, often unable to keep himself from barging through the door.

Decades later, I am beginning to understand my father’s selective blindness, how, despite his world-renowned expertise, he couldn’t see my orthopedic problem until somebody else pointed it out. In my work as a pediatric rheumatologist, I have a near-neurotic attention to detail when it comes to my patients’ illnesses. When my patients are on the exam table, my eyes and ears and fingertips notice abnormalities as subtle as bubbles drifting on a stream: a slight swelling of an elbow, a faint wheeze in a lung, a red loop of a capillary that I can see only by looking through a magnifying glass. I try to read my patients’ bodies with focus and presence, lingering when I am unsure, as if reading a line of poetry repeatedly until I can glimpse both the meaning and the limits to my understanding of that meaning.

But when I look at my own child, I find it difficult to trust my own senses. Sometimes run-of-the-mill symptoms like fevers and stomachaches cause spirals of angst about worst-case scenarios. Other times I don’t see things that clearly are happening. My son was small and yellow as an infant and spent much of his time screaming, but I didn’t register these as the problems his pediatrician named: low weight, jaundice, colic. Nor could I see how his eyes crossed when he was tired, or how eczema turned his skin red and raw. On anyone else’s kid, I might spot these problems from across the room. Yet for my own child, I was caught off guard by—and somewhat resistant to—each diagnosis. The same medical training that has led me to become an expert at spotting rare diseases in other people’s children seems, perhaps, to have clouded my vision when I look at my own child.

A few months into my fellowship, I walked down the hall from my desk to my mentor’s office for advice on caring for a patient with a challenging disease. I plopped myself down in her spare chair and wrung my hands like I could squeeze the uncertainty from my skin. She listened to my story and then shared what her mentor had told her: “Rheumatology is about living in the grays.” The immune system is a wild, intricate web, and rheumatology is known for its difficulty and its abundance of unknowns. There often is no clear right answer.

To navigate the grays, rheumatologists order blood and imaging tests—inflammatory markers and antibodies, X-rays and ultrasounds, CTs and MRIs—to look inside bodies in ways that once were unimaginable but now are routine. It’s easy for me to get imaging of my patients: All I have to do is click “order.” The more difficult part is deciding whether to order the tests in the first place. I bounce my knee and chew my lip while trying to decide whether the risks of radiation, anesthesia, and medical bills are worth viewing what’s happening on the inside, whether the gap between what I know and don’t is worth the risk of bridging it.

One winter morning last year, I was drinking coffee and procrastinating thinking about those questions for my afternoon patients when I found myself googling my ancestors’ names. To my surprise, I came across a research paper that Frank had published with his son Isaac—whom he fondly called Ike—in 1942. Frank’s two children, Ike and Sarah, grew up helping their father with radiology tasks. By that point, Frank had moved from a lower East Side tenement to a house in New Jersey to a Brooklyn brownstone, where he invited patients into his home and kept an X-ray machine in the basement for treatment and scientific experimentation. Like Röntgen, Frank loved to hole up in his downstairs lab on the weekends, immersing himself in the science of X-rays. Both of Frank’s kids became radiologists. Ike’s middle name was Roentgen.

In the research paper, Frank and Ike lamented how there was no way for surgeons to quickly identify the location of blood clots. At the time, doctors had to wait until tissue was damaged to see evidence of the clot that had caused that damage. By then, the patient likely would be dead.

Ike, who was only nineteen, wondered whether there might be a way to visualize the clot in real time. He conjured an idea of injecting contrast into blood vessels and seeing where it went. If, like a boulder in a stream, a clot was blocking the flow of blood, then the blood and its injected contrast would be unable to pass through. By looking for a shadow, Ike predicted, a doctor could see where the stream of contrast stopped. If the radiologist found the location of the clot, the surgeon could then remove it, and oxygen could return to the patient’s heart. Identifying the shadow would let physicians restore the light.

All doctors cause harm. I am no exception. I can harm my patients with mistakes in my decisions, diagnoses, and sometimes-clumsy bedside manner. I can harm my patients simply through the fallibility of being human.

When I realized what I was reading, my hand jolted; coffee spilled onto my desk. For the first time, Ike and Frank had envisioned the angiogram, an imaging technique essential to modern medicine and critical to my clinical practice as a rheumatologist. The through line of influence—the eerie coincidental confluence of profession and family—was stunning. Soon after I learned this history, doctors in the pediatric intensive-care unit where I work ordered an angiogram on a child with a facial droop and hand weakness who seemed to be having a stroke. The image revealed a storm of inflammation in the child’s arteries. Our medical team quickly started immune-suppressing medications. The next day, in a tangle of IV lines in an ICU bed, the kid sat up and ordered hashbrowns and a fat stack of pancakes. The angiogram—my ancestors’ vision—saved my patient’s life.

Wilhelm Röntgen’s unknown rays led to a cascade of scientific advancements. Scientists worldwide began imagining the unimaginable and creating the unthinkable. In Paris, Marie Curie coined the word radioactivity after discovering elements including radium. During World War I, Curie designed an X-ray truck that not only took images in the battlefield, but also doused soldiers’ wounds with radon, radium’s radioactive gas. By sterilizing infected tissue, the radiation truck enabled more than a million soldiers to receive X-rays and saved numerous lives.

Like Thomas Edison, Marie Curie noticed her eyes becoming blurry—a sign of radiation sickness. Unlike Edison, she brushed off the symptom. She became the first woman to receive a Nobel Prize. When my sixth-grade teacher asked our class to report on our heroes, my answer was easy: Marie Curie. I prattled on to my classmates about Curie’s scientific contributions. I didn’t yet understand that she had died from her passion, a paradox that the poet Adrienne Rich reflects on in “Power”:

…Today I was reading about Marie Curie: / she must have known she suffered from radiation sickness / her body bombarded for years by the element / she had purified / It seems she denied to the end / the source of the cataracts on her eyes / the cracked and suppurating skin of her finger-ends / till she could no longer hold a test-tube or a pencil /

She died a famous woman denying / her wounds / denying / her wounds came from the same source as her power

When my grandfather Abe got a sore throat as a young child, Frank peered into his nephew’s mouth and saw red, bulging tonsils. This was before antibiotics and vaccines—back when parents needed to panic if their child had a sore throat or a fever. Infections like strep throat were often fatal. Little Women depicts this reality when heroine Beth March dies from scarlet fever—a complication of strep throat—after caring for an infant who died from strep. Before penicillin, such tragedies were common, so I can understand why, when he saw my grandfather’s inflamed tonsils, Frank radiated them into decay.

Abe’s mother—my great-grandmother, Anna—became pregnant with no way to feed another mouth. Unsafe abortion methods often caused maternal death, yet Anna was desperate and made the difficult choice of going through with it. Afterward, she bled and bled. Frank took his sister to his basement, where he radiated her abdomen until the bleeding stopped, thus saving her life.

Years afterward, Anna was diagnosed with colon cancer. Decades after that, Abe developed polyps in his throat and cancer on his ear. Both cancers may have been a result of Frank’s treatments. Frank himself got bladder cancer, which he self-treated with his own X-ray machine. His wife, Rose, died of leukemia. And at the age of twenty-three, as a just-married new doctor, Frank’s son Ike—the inquisitive kid who spent his childhood learning about X-rays from his father, the vibrant young man who dreamed up the angiogram—noticed foul-smelling discharge coming from his ear: parotid gland cancer. Within months, Ike was dead. A generation later, my father survived his testicular cancer because of radiation therapy Frank had helped pioneer.

Perhaps my dad’s cancer wasn’t caused only by bad luck or unintentional radiation exposure at the hospital. Might my grandfather’s early-life radiation have altered his DNA and surrounding proteins in a way my father had inherited? Do those changes live in me? In my son?

In blank spaces and shadows, I see my worst fears. When my child’s leg bruises and aches, I picture cancer cells coursing through his blood and bones. Rationally, I know that he is achy from a virus or banged his leg at the playground. But my fear persists. My fingers tremble: I feel scared to even write these words, as if by writing them I will somehow summon his fate. I want to erase the words I’ve just typed, and I want to believe that erasing my fears from the page will erase the possibility of what has caused them.

I am learning that being a pediatrician can mean becoming a parent whose eyes fix on shadows of what could go wrong. If I try to clutch a shadow or hide it under my palm, it evades me, shape-shifts, cloaks the skin of my hand. Sometimes I wonder whether my worry—for my patients and for my child—has become the bigger problem, the concern itself tipping from helpful to harmful, just like the technologies and treatments I lie awake worrying about.

Medical training is “training for uncertainty,” the sociologist Renée Fox observed. I’m now finishing my tenth—and final—year of medical training, and I’m starting to realize that I’m still at the beginning of my education. My chosen career will mean a lifetime of grappling with the boundaries of what cannot be predicted, what cannot be known. A lifetime of accepting both the darkness that washes the day’s light and the starlight that pecks through the dark.

Yet isn’t training for uncertainty—and how, despite best intentions, we all sometimes harm the people we love—also a definition of what it means to live a life?

Doctors read X-rays by noticing how white and black braid with shades of gray. One critical point when learning to interpret X-rays is that what’s absent is as important as what’s present. Meaning arises from the gaps. And questions settle in there too. The same could be said of history and of family histories especially. Four months after Ike’s death, Frank died of a heart attack, which my ancestors’ letters describe as death by broken heart. Did Frank know that his passion for the X-ray likely killed his beloved son?

By 1945—the year of the atomic bomb, the year before Ike died—doctors had known for decades that exposure to radiation causes burns, tumors, and death. That year, the journal Nature published a piece titled “Röntgen Centenary and Fifty Years of X-rays.” The paper praises the benefits of X-ray technology, particularly how radiation therapy treats cancer. But the authors go on: “It must be confessed, however, that…the action of the X-rays on tissue cells, whether healthy or diseased, is, it must be understood, always destructive.”

Frank knew this. He used this knowledge to blast my grandfather’s infected tonsils and save my great-grandmother from bleeding to death after her abortion. And his medal-winning paper on radiation for treating cancer focused on how to destroy tumors while minimizing skin damage. So Frank must have known that radiating his family could cause harm. He must have thought that the risks were small and the benefits great.

Frank witnessed the X-ray’s beauty: how it enabled diagnoses of diseases that, left unseen, would kill. How it could rid the body of cancer. Perhaps Frank felt an awe toward the X-ray like I do when I see how immune-altering medications let my patients walk and play and reclaim their childhoods. Perhaps Frank’s infatuation with radiation’s potential for good made it harder for him to see the potential bad.

And maybe Frank—like my father toward me and me toward my son—fell shortsighted when he tried to be his child’s doctor.

Much like I used to enjoy looking at X-rays with my dad, my son likes to sit with me and watch bones flash on the computer. Our rheumatology team periodically meets for an early-morning video conference with a radiologist to review our patients’ images. One morning, when my son was a toddler, he sat on my lap in his footie pajamas, banana in hand, staring at a skeleton on the screen. He chewed slowly, transfixed by the pictures: leg, pelvis, hand. He held his chubby palm up toward the skeleton hand, looked back and forth between the two. Computer, palm; computer, palm.

With a shriek of startled delight, he suddenly saw it: The five-point star of bones was a hand, just like the hand holding his banana. In the skeleton on the screen, he saw himself.