How it happened that I wrote Pox:

In the introduction to Lou Salome’s study of Friedrich Nietzsche, published in 1895, the author mentions Nietzsche’s headaches and Oliver Sacks’ study Migraine: Understanding a Common Disorder. I had been fascinated with Lou, reading everything about her that I could find, especially her friendship with Nietzsche in 1882, and the disputed question of his syphilis. When the professor in a class I was taking at U.C. Berkeley mentioned that he was writing a letter to his friend Oliver Sacks, I asked if he would mind asking Oliver if he thought Nietzsche’s headaches might have been caused by syphilis.

Oliver responded: tell her to talk to my friend, neuropsychiatrist and Nietzsche scholar,  Jonathan Mueller. Coffee and an afternoon talking about Lou and Nietzsche led to a long friendship. Jonathan introduced me to Craig Van Dyke, chair of the department of neuropsychiatry at UCSF, who asked me if I would give a Grand Rounds Lecture on the question of syphilis in the case of Robert Schumann. Since it was a year away, I agreed. I did give the lecture, which was not a small group as I expected, but hundreds of psychiatrists as well as the Bay Area History of Medicine Club and the San Francisco Conservatory of Music. (I had never spoken in public, imagine terrified.)

Soon after, I received a letter from Rosalie Siegel, an International Literary Agent, suggesting that I write a book about syphilis. One of her authors had written about Manet’s syphilis. After she walked me through writing a book proposal, I got a contract with Basic Books. Fifty years before Basic had published Lou’s correspondence with Freud. I was thrilled. When I told my friend Mark Dowie that I had a book contract, he said, “And now your troubles really begin."