In a crowded New York subway on a hot summer day, Bill Chalmers loses his mind. It is the beginning of a downward spiral culminating in despair.

“The Diagnosis,” by Alan Lightman, exposes the trials of working in corporate America when you become ill. Bill Chalmers is going to work on what seems to him an ordinary day. He parks his car and enters the subway tunnel, and then everything starts to deteriorate. He forgets who he is, where he is, where he is going; he becomes the equivalent of a frightened child.

Unable to orient himself, Bill curls up in the corner of the train and ride it from the beginning to the end of the line all day. He encounters acquaintances from his past, and while sometimes being able to recall their faces, he is unable to remember how he knows them. He does not recall his wife when he confusedly attempts to call someone using his cell phone. He eventually loses the phone, his briefcase and all identification, and he becomes completely lost.

This opening passage grips the reader, pulling them into the deterioration of the life of Bill, an otherwise normal businessman.

Lightman’s prose draws the reader into Chalmers’ life. His descriptive tone makes every detail of Chalmers’ demise come to life.

After the events in the subway, Chalmers claims to have been mugged; gradually, his whole body becomes numb. Despite condolences and well-wishes from business partners, in a hectic business world, Chalmers cannot escape the entrapment even after his “mugging.” He decides to go to the doctor, only to have his confidence in the medical profession shattered by a fellow patient who tells of the arduous process of getting a diagnosis. First, tests, then more tests, then a possible diagnosis, which the doctor then rescinds in favor of more tests. But, Chalmers does not let this man dissuade his desire to gain a diagnosis for his numbness.

Chalmers enters the office of Dr. Petrov to find a distant, detached physician who offers no solution other than repeated testing. Bill doesn’t seem to get closer to a diagnosis with continual referrals and different specialists.

Lightman splices e-mails into some chapters, breaking the traditional form of a novel. The e-mails offer perspective on the situation not available from Chalmers or the narrator.

Rather than a continuing story, Lightman promotes the continuance of a theme and uses different stories or situations for each chapter. “The Subway” is Chapter One, opening the book with a chaotic scene of sheer confusion on behalf of Chalmers.

“The Office” portrays Chalmers first entrance into his workplace after his “mugging.” Lightman travels through the life of Chalmers with ease, depicting his most destitute and happy moments. He allows the typical businessman, who might mirror Chalmers prior to his sickness, to see the softer side because of Chalmers’ love for his son. Lightman sends a wakeup call to those who work too hard by informing them of the downside.

After Chalmers is fired from his job because of his lacking performance, he returns late at night to retrieve his belongings, only to find the vice-president of the company in shambles. Harvey Stumm is unable to handle the pressure of the workplace and must return in the evening to finish his work unbeknownst to anyone.

Lightman uses this as an example of the weakening personal infrastructure of businessmen who are too engrossed in their work. Chalmers never tells his employers he is ill; he simply stops coming to work in favor of doctor’s appointments.
“The Diagnosis” is a frighteningly true portrayal of life when it gets out of hand and all one can do is wait for a diagnosis, whether the problem is mental or physical.