Of Medicinal Leeches and Sophia Hawthorne

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“Those incomparable, lovely, delicate, gentle, tender, considerate, generous, fine, disinterested, excellent, dear, elegant, knowing, graceful, active, lovely, animated, beautiful leeches have done me a world of good.”

That’s what Nathaniel Hawthorne’s future wife, Sophia Peabody, said of leeches when she was a teenager. I don’t think I’d ever be able to speak of a leech with such exuberance, but… I’m happy for Sophia that they gave her such delightful relief, or that she at least thought they did.

Sophia Peabody Hawthorne (1809–1871)

Sophia Peabody Hawthorne

Sophia was an invalid of sorts, starting in her youth. Headaches plagued her. Loud noises set her head throbbing, and she was the sort to languish about with the typical 19th-century melodrama of her suffering. She tried numerous treatments — leeches among them. Pursuing art brought relief as well, and I personally believe it was this distraction from her malady that did her more good than any bucket of leeches.

I recently laid eyes upon my first live medicinal leeches at a local science museum. Knowing their significance in medical history, I was excited to see those two serpentine, blobby beasts clinging to the side of their little watery aquarium. Certain Youtube videos of the Mütter Museum’s director and his pet leeches came to mind (I admit they make me cringe to watch and make me feel somewhat faint, but I do think it’s cute that their names are Harvey and Hunter). And as I watched those real-life leeches, I was so thankful that I’m not living in the heyday of blood-letting via leeches (not that I’d want to endure any sort of blood-letting for that matter). Of course, you cannot forget mechanical leeches, either!

Leeches: Interesting enough to look at from a safe distance. But I’d rather not have them clinging to me. And no, I would not like to have one for a pet.

As for Sophia… she ought to curb her enthusiasm, or all the leeches will be after her.

Hirudo medicinalis. Leeches for bloodletting

Medicinal Leech: “I’ll alleviate your ills and you’ll give me dinner in payment. What’s not to like?”

Of Surgery in Melville’s “White Jacket”

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I love reading surgical narratives — factual or fictional, old or new, but that of the 1800s definitely intrigues me the most, as folks who have traipsed by here already know. I was delighted to find an entertaining example of such in Herman Melville’s novel White Jacket. In fact, I think this particular scene is a literary gem, dripping with darkly comical mockery of nineteenth-century surgery in general.

Aside from the surgery, it is a very good book as a whole for those who enjoy things of the Melvillian, nautical sort (as I obviously do). I’m amused by the woes that befall the poor narrator because of his unfortunate, less-than-practical white jacket, the lavender-infused Selvagee who ought not have gone to sea, and the “fire it right into ’em” method of publishing. As for the beard massacre, however — the poor fellows! Rather distressing. There are many passages that are either informative or chuckle-inducing, much like the case with Moby Dick, except White Jacket lacks strong a driving motive like the obsessive hunt in his better-known tome. In White Jacket, the Neversink is simply…  going home.

Herman Melville, American author. Reproduction...

Herman Melville

Ah, but the surgery! — and what makes it the most fun and satirical, the surgeon. His name is Cadwallader Cuticle, M. D., and he is the learned surgeon of the fleet who loves to dive in the teaching role in the midst of operations. His person is mangled. His teeth — artificial. His eye — well, he only has one. He’s bald, scrawny, and could look much more lively. As expected, Cuticle is a devout collector of medical specimens and curiosities that have a tendency to horrify everyone but himself. And although he says he likes to avoid amputations if possible, he cannot hesitate when he sees a chance to take up the saw. Besides, it’s dull work for a surgeon on a man-of-war when there are no battles. This is his first major case in three years.

And Cuticle isn’t the only surgeon mentioned in the book. One cannot forget the aptly named surgeons Bandage, Wedge, Sawyer, and Patella. And while Cuticle’s colleagues are against the operation, all it takes is one lop-sided, deferential “yes” from young, obsequious Patella to encourage him to pronounce that an operation must take place immediately — at 10:00 tomorrow morning.

There are certain aspects of the scene that make it particularly entertaining to me. The surgery is performed not on a traditional operating table, but on a death-board. And, of course, a reference is made to the surgeon’s negligence of hand-washing — Cuticle offers Sawyer to wash at a basin after the procedure since it is time to eat dinner, but admits that he never uses it. A mere wipe of a handkerchief is suffice.* A sprinkling of anatomical jargon spills forth from Wedge, much to Cuticle’s annoyance, and much to my pleasure. Plus, there is the cadaverous appearance of the toothless Cuticle coupled with the presence of a skeleton (used for an educational prop) that sends the patient into a state of terror, who has a strong tendency to faint.

I did wince when one of the younger surgeons noted that Cuticle can remove a leg in one minute and ten seconds. All I could think was, “Liston could have done that so much faster, you sluggard!” But, sadly for the majority of non-fictional patients, Robert Liston’s speed was far from the norm.

Robert Liston (1794 - 1847), Scottish surgeon

Robert Liston–swiftest saw in 19th-century surgery

Melville ended up poking fun and pointing out lamentable realities at the same time in a very skillful manner. It got me excited, especially considering that many authors of fiction from that time period would shy away from the amount of grisly detail that Melville was brave enough to portray. (NOTE: The description of the amputation itself is not for the squeamish.)

*Now, Melville was obviously disturbed by this breach in hygiene. Bear in mind this book was written in the late 1840s… And it took several decades after that for hand-washing to fully catch on in the medical profession, even though Melville’s mentioning of this makes it obvious that some contemporaries of the general public found these habits disgusting. Very interesting.

Of Liszt, Csárdás Macabre, and His Other Late Works

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I’m saddened by Liszt’s low opinion of his later works, particularly Csárdás Macabre. I understand they weren’t received well at the time and many of them he kept to himself — they were too futuristic, too different from what the world was accustomed to hearing (not to mention that it got to the point that he begged his students not to play his works in public for fear that they would become the brunt of great ridicule). A bit cacophonous at times, I suppose, but I like that now and then. They had great depth, plunging into realms that music had never touched before.

I was struck that on Csárdás Macabre, he wrote the following dismal words:

May one write or listen to such a thing?

How disheartening — it amazes me that he even went through the effort of composing these works if he had such negative thoughts about them. It almost sounds as if he was ashamed to have written such music. True, it was a dark time of his life, and this must have served as a release for him. But he did “write such a thing,” however, and as he foresaw, more unusual works were to be composed by others in the future.

What surprises me about his reaction to Csárdás Macabre is that it isn’t one of those later works that wander into atonality, like Nuages gris or Bagatelle sans tonalité, and it isn’t as desolate as his La Lugubre Gondola pieces (I’ve heard some call Macabre atonal; I disagree). The csárdás almost reminds me of some of his earlier works, like some of the Hungarian Rhapsodies, or even Totentanz, which definitely shows glimpses of what his music would become in the future, especially in the opening bars. But he wasn’t that harsh to Totentanz, scrawling such pessimistic things on the manuscript! And I even feel that parts of his Sonata in B Minor seem futuristic — another piece that was received with some consternation at first, but again, he was not harsh about that piece.

Openings bars from totentanz piano solo version

Openings bars from Totentanz piano solo version: nice, explosive stuff for a piano! I personally think it’s far better, and much more powerful than the orchestral version. Then again, I usually favor a solitary piano over an orchestra. (Photo credit: Wikipedia)

I suppose Liszt would think me a deranged person, considering that, yes — I actually listen to such things with great pleasure. One of the first pieces I ever heard by him was none other than Csárdás Macabre. I thought it a very intriguing and dichotomous piece of music with its interesting mixture of levity and sinister qualities (it’s actually quite catchy), and it was that work that he had such gloomy misgivings about that sparked my interest in Liszt’s music in the first place. So it can’t be that dreadful!

I’m thankful he didn’t toss it, even though he might have had a burning desire to do so.

Franz Liszt (1811-1886)

Franz Liszt

Learning to Love the 5th Symphony

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I’ve been neglecting music here, so I think I’ll turn the focus from writing and medicine for once…

As for the 5th Symphony, for most of my life, I hated it, especially the first movement. Mostly because it’s so overplayed, and for many people (sadly) it’s the only exposure they’ve ever had to classical music.*

I’ve listened to classical music since I was a child, and two things would always annoy me (musical misfit that I was in comparison with the other kids on the block). One was the name Beethoven. There have been many great composers, and Beethoven is not the only one who ever lived. But… he was the only one my peers were aware of. The second source of vexation was that melody — that succession of notes that make up the main theme of the first movement of the 5th. It was down there with nails on a chalkboard and rakes on sidewalks to my ears.

Beethoven Symphony No.5. "Fate" Motif

Beethoven Symphony No.5. “Fate” Motif (Photo credit: Wikipedia)

The third movement, on the other hand, I have always liked — something about its victorious and supremely sneaky-sounding sections always struck me as being visceral. But in regard to the first movement, my “ailment” afflicted me for many years.

Portrait Ludwig van Beethoven when composing t...

Then, post-college, I started to actually read about Beethoven. I have a soft spot for grumpy characters, and quite frankly, I can’t blame Beethoven for being a little short-tempered from time to time (I know I wouldn’t be a bundle of cheer if I were in his situation and state of health). I considered him an interesting person — definitely more interesting to read about than Bach, whose music I always loved. And I suppose you could say I began to feel sorry for him. I liked Beethoven enough, but as for Symphony No. 5…! And I understand one need not like everything by a given composer. I don’t universally like everything by anyone, whether it concerns music or literature. But something made me feel as if I was missing something. The rest of the world had to think it was fantastic for some reason, and I was missing out.

And then came the realization of something I had always overlooked — the 5th Symphony is in C minor. C minor happens to be be my favorite key (Surely you have a favorite key! Doesn’t everyone?), and that along with my new-found Beethoven sympathies coaxed me to listen to the 5th Symphony in a new light.

I started to realize that it isn’t so bad. In fact, it’s better than merely “not so bad.” The 5th is a powerful piece of music. Its aggressive nature is invigorating. It is very rich, once I actually listened to the piece rather than relate it to a pile of hackneyed childhood associations. I’ll admit it isn’t one of my personal favorites — it’s not Chopin’s Military Polonaise or his Nocturne Op. 27 No. 1 in C# minor, and it’s not Liszt’s Dante Sonata or Bach’s Passacaglia in C minor BWV 582 — but I have grown to appreciate and enjoy it a great deal. I can now say I actually like it.  Finally. I’m sure Beethoven’s glad I made the change.

English: Photograph of bust statue of Ludwig v...

“There are and always will be thousands of princes; there is only one Beethoven!” …he had a valid point!

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*NOTE: While using the terminology classical music in this case, I am using it in the broad, common sense. I am not referring specifically to the Classical period, but am encompassing that with the Romantic and Baroque periods, etc. I’m well aware of the wide confusion (I personally think someone ought to come up with a better term just to prevent further confusion and make things a little more precise, neat-freak that I am), especially since I’m partial to the Romantic era… but I’m not the sort of person to walk around saying that I listen to “Romantic” music. People will get the wrong idea. It’s bad enough that people automatically assume I write romance novels when I say I’m a writer. But that’s another story in itself.

Of Animal Medicine

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I’m used to human medicine. I read about it often, historically and in the modern sense, often comparing the two. It’s amazing to see the great progression made from just the 1800s. And some things don’t change much at all. Medical history fascinates me. I’m not certain as to why, but it’s one of those strange facts in life that I won’t waste any time analyzing.

But animal medicine — that’s when I get weak and start to whimper. They don’t complain like humans. On a frustrating note, animals cannot tell us when or how they are hurting. And those innocent faces, the imploring, sad eyes that humans have yet to truly master. I’m used to the fact that people get sick. But I just can’t bear an ailing animal.

I do, however, have a deep respect for those who have the strength to help animals that are feeling poorly. And I also love James Herriot’s stories. Who doesn’t?

My cat recently had another medical adventure. Going in for a dental cleaning, it was discovered that he had a bad case of tooth resorption* — 15 teeth had to be extracted, mostly from the upper jaw. The little guy ended up being under anesthesia for about two and a half hours, factoring in cleaning time and surgery time. That’s longer than I’ve ever been under, and the most teeth I’ve had removed at one time was two. He experienced something more intense that I ever had in the dental department, and I don’t know which one of us was more shaken by it. And seeing his teary eyes when I picked him up from the vet office didn’t help matters at all.

muchheadsketch

He was obliging enough to pose for a sketchy portrait the day after his procedure, and hooray! — he actually looks content.

Thankfully he is recovering well. He’s taking it easy, of course, and it will take some adjusting with his new lack of teeth, but I am very relieved that he is on the mend and is pretty much back to his usual happy self.

Cat skull and teeth drawing

Cat skull and teeth drawing (Photo credit: Wikipedia)

*For those not familiar with tooth resorption, it is, most simply put, breaking down of the tooth from the inside, exposing the root. It is painful. And it is very common in cats, moreso than in dogs, and extraction is all that can be done — at least at this point in history.

Of Rereading Books

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I own books because I go back to them. I own nonfiction books because I need to refer to them often. I own fiction that I enjoy because I know I’m going to want to read it again in the future — in a couple years, many of the details of a given story are forgotten, and many details are discovered that were missed the first time.

I’m surprised and saddened when I hear people say that they can only read books once, even when they are favorites. It’s a strange concept when you really think about it. It’s common enough for people to watch movies multiple times. We also listen to favorites pieces of music over and over. Why should books be shunned from repetition? Nobody says, “I’ve already heard Beethoven’s Große Fuge once, why should I hear it again?” So why give this harsh treatment to books?

I’ve heard of people who read certain favorites on a yearly basis — actor Sir Christopher Lee, for example, reads The Lord of the Rings annually. I know I wouldn’t want to read something that lengthy each year, but to each his own. From time to time I have considered what I would pick to read each year if I were to take up such a practice. Moby Dick and Hamlet immediately come to mind, both favorites that I don’t think I could ever get tired of. But, again — Moby Dick falls under that too long category.

English: Illustration from an early edition of...

English: Illustration from an early edition of Moby-Dick (Photo credit: Wikipedia)

Then other books come to mind. Many other books. Some for pleasure. Others are nonfiction that I think would be wise to brush up on annually. And once I start thinking about it, the list eventually gets so long that I’d be doomed to reading the same handful of books over and over again for the rest of my life without getting to read anything new (besides, one only has time to reread Patrick O’Brian’s Aubreyad so many times in life). I think it’s best for me to stick to my whims and just read what I want when I want, rather than forcing myself to read favorites yearly.

Of Thorwald’s “The Century of the Surgeon”

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Of every book relating to medical history I have read thus far, my favorite and the one I most highly recommend is Jürgen Thorwald’s The Century of the Surgeon. Now, there’s a good side and a bad side to it.

The good side is that it is a very entertaining and informative read.  And it doesn’t strip history into a dry list of discoveries, milestones, names, and years (certain books come to mind that I will refrain from mentioning). Thorwald presents the history via first-person narrative so that it reads like a novel, and it also gives the historical figures greater depth and personality. Thorwald creates the fictitious Mr. Hartmann, a surgeon who watches the advancements of surgery unfold throughout the nineteenth century. It starts with Hartmann witnessing his first surgical procedures, performed by none other than John Collins Warren.  Hartmann is also present for the first ether operations both in America and in England (he is even invited by Liston himself!). A young Joseph Lister personally shows him through his hospital ward. An exciting description of an early heart surgery on a patient suffering from a stab wound is saved for the conclusion.

Perhaps it is not for the faint of heart or weak of stomach due to the detail in which some procedures are described, but I’ll toss the warning out there because the average person would consider some of the material to be graphic, and I admit there are some intense sections. Nevertheless, I still consider it a fantastic introduction that breathes much life into medical history.

English: Jürgen Thorwald, german writer (1916-...

Jürgen Thorwald, author of Century of the Surgeon 

The negative aspect to The Century of the Surgeon is that it is extremely difficult to find. It was first published in 1957, is currently out of print, and at the time of writing this post, the only copy of it I see for sale at Amazon costs over $500. I was fortunate enough to borrow a copy from my university’s library when I was a student. I remember waiting for my December finals to be all out of the way so I could read Century at leisure! And it was worth the wait. The sad part was returning it. And the frustrating part — trying to find my own copy.

I did manage to find a Reader’s Digest condensed version of it reaching behind some books in a public library. It was used as a mere spacer — clearly  not a wanted book. So I bought it for $2. It is indeed something. Complete with a cover that creaks like a neglected door when I open it. But it simply isn’t the same, so the search continues.

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The Reader’s Digest 1957 condensed version of The Century of the Surgeon, which also contains Lobo, By Love Possessed, Duel with a Witch Doctor, and Warm Bodies… works of fiction that I could live without.

For those interested in borrowing Century of the Surgeon, it is not a total impossibility. See if your local library system owns it. If not, ask about getting it through inter-library loan (I have a feeling that university libraries are more likely to own it than public libraries). I also found one ebook copy at Open Library that can be borrowed. And if it ever gets back in print — what a blessing that would be!

I was happy to learn that I’m not the only person around to recommend this book as a starting place for learning about med history. Sherwin B. Nuland, author of How We Die (and one of my favorite medical writers), gave it a thumbs-up in an interview here: http://www.americanscientist.org/bookshelf/pub/sherwin-nuland. And I have to admit, if you can’t get your hands on Century of the Surgeon, his book Doctors: The Biography of Medicine is another excellent starting place.