Orwell’s Cough, by John Ross
This book offers a series of social histories and biographies with an emphasis on specific medical maladies various famous authors endured. It reads a bit like gossip. Much of this focus is hypothetical, without evidence of proof but nonetheless fascinating to an old retired doctor.
I did not think Shakespeare would be all that controversial. His biography and the various conspiracy theories about who wrote what are presented. His body of work, plays and sonnets, are dissected with sex and STD’s as a theme. Of course, in Shakespeare’s time, syphilis was as grave an affliction as HIV has been in our time. This topic finds the author speculating on the possibility that Shakespeare had syphilis. For me, there was no there, there, but of interest, I learned that many doctors put together the fact that tertiary syphilis (most severe outcome of the infection) could be prevented if an infected individual developed high fevers. In Shakespeare’s time, being immersed in an enclosed tub of hot water to drive up the core body temperature was a, “thing,” with this goal in mind. Later, Wagner Jauregg, the only psychiatrist to ever win a Nobel Prize (1917) perfected a treatment for prevention of tertiary syphilis by inoculating patients with malaria…..
I have never read Jonathon Swift. He was an important figure in English literature during the enlightenment. He was a difficult and unaccountable man who, “was a parson without piety, a chaste adulterer, an Irish patriot who longed to be an English bishop, and lamented that he would die in Dublin like a poisoned rat in a hole; a grave man who rarely laughed but wrote outrageous satires; a misanthrope capable of great kindness to individuals; a social climber who habitually sabotaged himself; a fussy man obsessed with order, notorious for his disorderly relations with two women; an establishment man with the bomb tossing instructs of an anarchic. ‘If every joke is a tiny revolution,’ as Orwell said, ‘then Swift is one of our most dangerous and unlikely revolutionaries…’”. The author’s medical evaluation suggest he had Meniere’s syndrome for which there were not treatments we would recognize. Treatments he did undertake had clear side effects and ill health associated with them. In addition, he had behavior associated with OCD. For example, he had a fastidiousness about his personal appearance—he actually washed his body and clothes—and was as a result, known to be attractive to women. And yet, it is thought that he never actually consummated sexual relations……..germs, you know. Whether true or not, he did develop some odd preoccupations. When writing about the first night after being married his poem, “Strephan and Chloe”:
Strephon who heard the foaming rill
As from a mossy cliff distill
Cried out, “ye gods, what sound is this?
Can Chloe, heavenly Chloe piss????
But, e’er you sell yourself to laughter
Consider well what may come after;
For fine ideas vanish fast,
While all the gross and filthy last.
His focus on scatological interests was associated with an evolving dementia whose cause is unknowable. The pattern suggests Pick’s disease which is associated with aggressive and obvious behavior changes along with loss of memory. He feared he had a form of “Irish dementia”: ie lost all memory but that of old grudges…
The Bronte sisters are presented. They (four in all) attended a boarding school that was impoverished and there, they were subject to great physical, emotional, and nutritive abuse. Their mother died when they were young and they were raised by an emotionally difficult vicar-father in rural isolation—their ability to engage socially with peers was limited as they were too poor to mingle with gentry —as their father aspired to do— and too proud to mix with common folk. The father decided to help their prospects in life by sending them to a Clergy Daughter’s school to improve their prospects for employment or marriage. Jane Eyre borrows from the experiences in this school, a place of cold, hunger, loneliness, and violence. One sister died of TB at age 11, having been sent home from school. The school shut down shortly after. Another died within months. Both Emily and Charlotte would die of TB which was a common affliction. In their day, 1% of the population of London died of TB and in New England during the same years, 1.6%.
American authors are included in the book: Nathaniel Hawthorne. Right at the outset, that Nathaniel died a slow wasting death with abdominal pain finds his doctor, Dr. Oliver Wendell Holmes Sr. writing an article in the Atlantic regarding his likely demise—so much for HIPPA in the days of giants. Nathaniel went to Bowdoin college when its enrollment was 114 students. It was chosen because Harvard had become a hotbed of godlessness and liberalism. There, he was fined for drinking, gambling, not attending church services and for, “walking unnecessarily on the Sabbath.” Despite this apparent gregariousness, he was notoriously shy which was commented on by many peers. His wasting disease was likely stomach cancer though no autopsy confirmed this.
Herman Melville was mentally ill with symptoms apparent much of his life. He could be the poster boy for the belief that mental illness is associated with creativity. A related association: his father was no Mr. Cleaver; he died of complications of bipolar disease. The author concludes that Herman likely suffered from bipolar disease as well. Moby Dick was written at the peak of a period of mania. His follow-up novels however, got, “weird” exposing for the inquiring mind, signs of fragile mental health. His books often bring up sanity as a theme. In Billy Budd, he poses a reflective point: “ Who in the rainbow can draw the line where the violet tint ends and the orange tint begins? Distinctly we see the difference of the colors, but where exactly does the one first blindingly enter into the other? So with sanity and insanity.” His failure to reproduce the success of his early novel (Typee—Moby Dick did not become successful until after his death) found him writing short stories which were successful. Alcohol was ever-present as a challenge and perhaps, a form of self-medication. He had significant pain and the author suggests he may well have suffered from Ankylosing Spondylitis (“rheumatic back pain in cycles, erect posture, and recurring iritis). His death was attributed to heart failure, a product of post streptococcal valvular disease.
Herman Melville: “Herman Melville is not well. Do not call him moody, he is ill.” Sarah Morewood, Melville neighbor, 1859
Of interest, his read on the USA: “Intrepid, unprincipled, reckless, predatory, with boundless ambition, civilized in externals but a savage at heart, America is, or may yet be, the Paul Jones of the nations.”
6) William Butler Yeats—I have little knowledge of Yeats but was interested to learn that he likely was dyslexic, had lousy handwriting, but had superb skills recalling the spoken word and when reciting poetry, he did it as though in a trance waving his hands in the air which did attract attention with which he could have done without. He became famous for his writing in time, and when applying for the Chair of English Literature at Trinity College in Dublin, was not considered when he misspelled “professorship” in correspondence. His interests aligned with the “Celtic revival” of his times as well as the occult. He had symptoms of Asperger’s syndrome — he was aloof and interacted with people concretely ie he related more to what they did or wrote. He was a virgin until age 30. He fretted endlessly about cleanliness. This complicated his hemoptysis and desperate treatments offered — included inhaling creosote smoke—thought to have antiTB properties. This was all done in vain as he did not have TB. He traveled to Italy and while there began to experience spiking fevers for weeks and fearing the worse, he completed a will. Testing was negative for common causes of such fever, Salmonella for example. On consultation, a local doctor treated him with serum for Brucellosis or Febre di Malta which over time seemed to provide him relief. He took arsenic compounds as well-as did virtually every author reviewed in this book. With this illness and treatment, his uncontrolled hypertension improved. Unhappily, as the fever and illness regressed, he became impotent. He subscribed to a treatment suggested by a doctor Steinach: a vasectomy —which was thought by some to allow for a refocus of the genitals on making more testosterone. This treatment was also offered up as a cure for homosexuality…..Steinach never earned a Nobel prize for his work but he was nominated six times…..
Jack London—I have splurged lately on some of Jack London’s writing. His was a non- academic background to say the least. His return from the Alaskan gold fields found him writing for 19 years and in that time, he completed 49 books! This was in part, aided by having —you guessed it—Bipolar disease which provided him psychic and physical energy and creativity in between episodes of depression and nihilism. Self treatment included lots of alcohol and at least one suicide attempt. His books often reflected this. Being bipolar, he spent his money foolishly and had adventures, one of which found him on an expensive and poorly built yacht in the Solomon Islands where he acquired Yaws. Yaws is for a North American doctor, a never seen weird disease of the tropics caused by a syphilis like bacteria. To a layperson, someone with this condition might as well have leprosy……it is foul. He would obsess about the syphilis connected and self treated —dramatically—and often with prevention in mind—like Michael Jackson, his celebrity and drive found a doctor working for him willing to prescribe many drugs which were self managed. He became a physical wreck in his latter years. He died of a morphine overdose, likely accidental. His near terminal poem of note:
I would rather be ashes than dust!
I would rather that my spark should burn out in a brilliant blaze than it should be stifled by dry-rot.
I would rather be a superb meteor, every atom of me in magnificent glow, than a sleepy and permanent planet.
The function of man is to live, not to exist.
I shall not waste my days trying to prolong them.
I shall use my time.
James Joyce: Ireland keeps coming up! Joyce was raised by difficult parents and his Portrait of a Young Man reflects the environment he grew up in well. His education was that of the Jesuits (who may or may not want to claim him as their own). He had a reputation for “wenching:”
There is a young fellow named Joyce
Who posseseth a sweet tenor voice
He goes down to the kips
With a psalm on his lips
And bideth the harlots rejoice…..
Joyce was infected with Gonorrhea and the various cures of the time we’re not pleasant. With time he developed an iritis which finds the author suggesting he may have had Reiter’s syndrome which can be brought on by Chlamydia. HIs eye problems were dramatic and long- term requiring multiple surgeries, leeches being applied to the eyes (!), and of course, the coke bottle glasses that have come to be associated with his face. Joyce’s daughter was schizophrenic and was institutionalized in France which became occupied by the Germans in WWII. Fearing a German final solution to his daughter’s status, he moved to Switzerland hoping to facilitate her transfer and while there, perforated his duodenum (from ulcer disease) and required abdominal surgery, done too late; he died of peritonitis following surgery. His daughter survived the war.
George Orwell: TB is the focus of his story but apparently his stint in private boarding schools in England was documented with his having a chronic cough throughout his life. He did not qualify for University and so lived in Burma as a 19 year old who would be the only European police officer in a city of 200,000 people. He came down with Dengue fever and recovered back in England. His reading of Jack London and the politics of the time found him living the life of a vagabond, seeking material for his writing and commiserating with the masses who lived in poverty. Some thought he got TB in this setting. He married and lived an austere life style and then volunteered to fight the fascists in Spain where he was wounded in the neck by a bullet that should have killed him. His recovery in Spain under a “political microscope” introduced him to the material that would lead to 1984. He became disillusioned with Stalin styled Communism……Recovering in England, he coughed up blood, lost weight, and appeared chronically ill and yet his TB testing was negative. The author suggests chronic bronchiectasis as a diagnosis, consistent with his lifetime of coughing illnesses and smoking. Late in WWII, he was convalescing in a remote Scottish Island while writing 1984 and he had a pulmonary crisis at which time it was clear he did have active TB. He died of a wasting disease and hemoptysis.
A theme of the book that is obvious lies in the romantic notion that mental illness and stress are the fertilizer for creative writing. In the 1980’s NPR featured letters to the editor after an article presented a movement among Yuppies to have their children coached and taught in schools that would focus on creative writing. To paraphrase the letter: “Anyone who has studied the authors that provide us with great writing should see that such schools do not serve the intended end. If you want your child to be a good writer, abuse alcohol, smoke, send them to poor houses, or abuse them emotionally and physically. THAT will help them find something worth writing about.”
Or, from one of my administrative teachings: if you want to build great ships, don’t send the young men to ship-building apprenticeships, teach them to love the sea!
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