medicine

The Story of the Mystery Patient

~ Frank Hudson ~ 2 Comments

As I mentioned as January ended, this February has been challenging for me to keep up with this Project and it’s associated tasks. I still hope to have new pieces soon. In place of a new encounter and performance with a poem or other text, let me do one of those posts where I pretend this is a normal blog

I know nothing other than what I read in the news about the situation in Ukraine — and that news with Ukraine now is, in short, mostly about what is feared to be an imminent invasion. I’m sure this Internet is full of folks with takes and information and policy positions if you feel the need for that, but instead I’m going to tell you a little story from my youth.

Back in the 1970s I was working the overnight shift in an urban hospital’s Emergency Department. Overnight, those 11 PM to 7 AM shifts, are probably not good for one’s health or social life, but I rather liked them. Staffing is much lower, and there was in my day almost no administrative or support presence. No crowd of attending MDs looking for proper deference to their priorities, no administrators to set or enforce policy in between meetings. Therefore, hierarchies were radically flattened at night, and I got to see and participate in a lot of different medical things.

My ED then was staffed with myself, a registered nurse (RN), a clerk who typed in information to print up a chart and the handy labels that would be pasted on lab requests/samples, and a family practice resident*  Just down the hall from our suite of four treatment rooms was a door with a buzzer where anyone from the ambulance patients we’d expect after incoming radio calls, to those who’d called their doctor and clinic and were told to drive to the hospital for further evaluation that couldn’t wait until morning would appear. And then too, the walk in.**

I worked nearly 20 years in hospitals, most often in Emergency Rooms. This stock photo looks about the right vintage.

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On the night I remember, the buzzer rang and there was an older man at the door. He had apparently walked up alone, and I usually was the one who went to the door to see what was the matter. And that was the issue from the start: he was speaking some foreign language, and he seemed to have only a scattered understanding of English and almost no English words to reply with. He looked to be in his seventies, had no obvious injuries, no severe distress. He moved slowly, but was walking.

Our door had a big lit-up Emergency Room sign, we could only assume he’d come in for treatment, but for what? You might assume that any 1970s urban hospital would have multiple language interpreters on hand, but that was not the case in ours then. And frankly, we wouldn’t even know what interpreter to call because we couldn’t figure out what language the man was speaking. Some words sounded a bit like German to me, so we called up a nurse working that night who spoke some German to come down. The RN and I hooked our mystery man up to the cardiac monitor, and the resident MD did a quick exam to see if we could figure out why this man had come to us. I think I may have even done an EKG on him, with no obvious issues found.

We looked for an ID in his clothes once we’d put him in a hospital gown and on a stretcher. There was none.

The nurse who spoke some German arrived. She got to her first preliminary question, which might have been “What is your name?” “Or why are you here?” and the mystery man exploded. At least some of the reply was in German. And our volunteer nurse interpreter said his angry words were that Germans had killed his family. How much German did he know? Made no difference, he wasn’t going to answer questions when asked in German.

I next got a bright idea. One of that class of residents was a young doctor who had a great facility in European languages, speaking at least a half-a-dozen of them. He wasn’t on call, and it was 4 AM, but I thought we should call him in. Given the infamous hours that residents worked in those days (maybe still do) that was asking a substantial favor, but he agreed to come in early. I was busy with something when our multilingual resident MD arrived. At one point he thought maybe Russian, and tried that. Later, I heard that once again the mystery patient became angry. Our resident didn’t know the man’s native language, but he got back something that was similar to our German speaking nurse — Russian was not a welcome language to our mystery patient.

Our multilingual resident was a smart guy though. One of the old-guard attending doctors on the hospital’s staff was Ukrainian American and had written a book dealing with Ukrainian culture in Ukrainian, a copy of which was on the shelf in the hospital’s medical library. Our resident showed that book to our mystery patient he later told us, and there was a quick realization that that was his language. After the regular day got underway, the older Ukrainian American doctor found that the man was one of his patients who was somewhat confused and had wandered to the hospital thinking that his doctor might just be there in the middle of the night.

So, as I said at the start, I know nothing about Ukraine — but I do think of that man who appeared in the night at the door of my Emergency Department and demonstrated how little I knew of him and what his country had been through.

Long guns, a poetic example.

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What to bring forward for a musical piece today? How about this one about war and violence that combines a line or two of language expression from Afro-American singer Howlin’ Wolf with second generation Swedish immigrant Carl Sandburg’s poem about countries that pack those long guns. Player gadget below for some of you to play it, or you can use this highlighted link otherwise.

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*Family Practice was the improved modern evolution of the old school “General Practitioner,” and the program that our hospital had treated that generalism like any other specialist residency to give the doctors who went through it a great deal of practical experience in things they would encounter. Almost every one of the residents I worked with there and then were fine people, who would come in some degree of unsure in the Emergency Room and leave after three years as the kind of doctor that I would want for myself or my family. Doctors and regular medical educators ran that program, but experienced nurses were so important in that too. Each June brought in new residents who really needed the steady hand of nurses at night to guide them in practical medical logistics and solutions.

**There was an indoor hockey rink across the street that had a fairly full set of bookings that ran until midnight. Yes, we needed to keep a lot of suture kits in stock.

Continuing the story of Minerva Jones: Doctor Meyers and Mrs. Meyers

~ Frank Hudson ~ Leave a comment

These posts on Edgar Lee Masters’ Spoon River Anthology have run to the long side, so today I’ll be brief. I promised I’d tell you how the book of linked short epitaphs about a Midwestern town resolved the tale of Minerva Jones’ sexual assault.

Minerva Jones is possibly related to “Fiddler” Jones, the man who music had a hold of, and who the town wouldn’t let go of, for the joy of dancing to that music. She is the daughter of “Indignation” Jones, whose family including Minerva are jeered at for being poor and unkempt. Minerva is assaulted by a town rough, quite possibly one of the group that hoot at her because she is poor, not pretty, and yet she fancies herself “the village poetess.”

Music has utility, it’s entertainment, a movement in sound to dance with and loosen one cares. Poetry is pretension, it asks one to rise above everyday speech and outlook, and offends you when you don’t.

Sexual assault is often largely about power, not unbridled lust or desire, and this seems to be case here. Minerva’s rape is to teach her a lesson. No amount of understatement and fracturing of the story in Spoon River  can hide that this is one of the ugliest episodes in this book that contains full measures of hate, distrust, crooked deeds, hypocrisy, and crushed hopes.

So how does Masters’ resolve this story? Minerva’s epitaph has already alluded to her death, and Doctor Meyers is said to play a fateful part. You can read “Doctor Meyers”  here and his wife’s following epitaph here.

Masters, the lawyer/poet, wishes to prosecute this town’s crimes even further. Doctor Meyers tells us that he was a good man, maybe a touch proud of his good deeds and steadfast life as a father and husband, but that’s such a minor sin, and set out to set up his tragic fall. When Minerva comes to him after her rape the general reading of his poem/epitaph is that it’s for an abortion. It’s just slightly possible that the episode Doctor Meyers speaks of in his epitaph is her showing up at night right after the rape, injured from the assault. It’s even thinkable that she’s miscarrying a pregnancy when she arrives at his door.

Masters isn’t interested in making this clear. Doctor Meyers simply says Minerva Jones died that night she came to him “in her trouble.” In an odd fracturing of the story, in Minerva’s earlier-in-the-series epitaph we have a vivid two-line account of her going into shock from blood loss. Doctor Meyers’ account picks up intensity as he recounts what happens next. The town assumes his act was evil and criminal—the strongest evidence that what occurred that night was considered to be an abortion bolstered by the idea that “help her out” was a euphemism that would be understood as such by reader of the time.*  It’s slightly possible that he was presumed to be the rapist and then murderer of Minerva, or the father of the unborn child.**

I assume his “indicted me” is legally literal, but there’s no account of a trial, much less a verdict or sentence—and Masters the lawyer has lots  of trial and law stories in Spoon River.  Perhaps the “pneumonia finished me” event happened soon after the indictment and before any trial.***

Doctor Meyers and Mrs Meyer woodcuts from Spoon River Anthology

I don’t know if Masters had control over the line drawings/gravestone engravings used to illustrate Spoon River in the 1919 edition, but if he did, these may tell us how he viewed these two characters, or how the characters view themselves

 

Doctor Meyers says his wife died of a broken heart. Her epitaph follows his, and the divided heart seems to me to be between some existing love or duty to her husband and her strong sense of propriety and morality that largely blames the “fallen woman” for tempting her husband into something she assesses is against “law human and divine.” Her testimony more or less cinches the abortion assumption, at least in the mind of Mrs. Meyers. If the accused crime was that Doctor Meyers was the rapist and murderer of Minerva Jones, she wouldn’t also use the possible abortion euphemism  “he…tried to help her” in her epitaph. She ends her epitaph preaching that the rules of morality are absolute, an unfailing guide to avoidance of shame. In the context of the story, her view is that Minerva Jones, even if she had a pitiable soul,**** got what she deserved and her husband was justly accused. I won’t blame readers for thinking this a chilling statement of callousness, because it is. But Mrs. Meyers is the victim as well as part of the cause and maintenance of the town’s cruelty. It is at least slightly pitiable to hear her clutch at the protections of adherence to a strict and legalistic morality and probity that didn’t protect her from the town’s patriarchal prejudice nor Minerva Jones from her tragedy of a pretense to poetry and useless beauty.

Mrs. Meyers epitaph directly follows “Doctor Meyers,”  which is proceeded by Minerva Jones’ father’s (not presented here) which follows Minerva’s. “Butch” Weldy, the rapist/attacker’s follows “Mrs. Meyers,”  with Masters the lawyer giving us a black-humored joke that you can think of as the final resolution.*****  Masters wanted us to clearly follow this story in this order. Other stories and linkages in Spoon River are more separated. In general, reading the epitaphs has a certain likeness to an open-world video game, and in any order the mosaic of events remain the pieces of a Cubist jigsaw puzzle loose in the box.

I performed “Doctor Meyers”  and “Mrs. Meyers”  together for today. A mild finger malady was making it hard for me to play guitar this past weekend, so it’s mostly piano today, though I could work out a way to play electric bass for this short piece. The player is below.

 

 

 

*Much of the action in Spoon River  occurs in the later half of the 19th century, a period during which abortions were made illegal in much of the United States. Illinois law was early in this change, so it’s clear he could have been indicted on this in the legal sense that would have been clear to lawyer Masters.

**In another of the epitaphs tangled linkages, we learn that another townsperson Willie Metcalf is said by some to be Doctor Meyers illegitimate son. We aren’t told if that is cause or effect of the disgrace of Dr. Meyers. I can imagine an elaborate Serial-style podcast relitigating the entire Jones/Meyers/Weldy case.

***During the course of writing Spoon River,  Masters himself, likely weakened by stress and an unhappy life, was stricken with pneumonia and may have been close to death, so this choice for Doctor Meyers coupe de grace may have not been random. “Webster Ford,” the pseudonym that Spoon River  was first published under in serial form in Reedy’s Mirror,  gets an epitaph in Spoon River Anthology:  a longer, more hermetic and supernatural one than most of the book’s.

****Masters’ syntax in Mrs. Meyers epitaph is confusing, perhaps designedly so. Even with the semicolon separator, “The newspapers lied about him…” is linked in sentence with “That he was not at fault in Minerva’s fall….” The newspapers disgracing him were claiming the opposite, and the sentence seems to reflect Mrs. Meyers’ own ambivalence. Likewise, the sentence starting “Poor soul so sunk in sin he could not see” is ambivalent. I think she’s largely referring to Minerva, “poor” in her possessions of morality and wealth, though some read it as referring to her husband.

*****Read the book if you want to find out.

In The Drear-Nighted December

~ Frank Hudson ~ 1 Comment

200 years ago this month a 21 year old surgical resident decided to give up his studies to become a doctor and to instead concentrate on the writing of poetry. An interesting decision. He had already rolled up a considerable education debt, and while it’s possible that poetry’s earnings potential might have been greater in 1816 than today, greater than zero is not a high bar.

So how prudent was our young not-to-be surgeon? He had tried his hand at poetry and had published a couple of poems in magazines before his decision. Hmm. Not a great prospectus you might think. In a rough translation for our time, it’s as if the young student had ditched his studies and loan debt for a shot at touring as an indie-rocker, even though he’s only played in his dorm room and doesn’t have a band.

His friends thought he had promise. In the forthcoming year, and with their help, he would find a publisher for his first volume of poems, but his work was mostly unnoticed, and where noticed, the reviews were at best mixed. One reviewer had rich fun with this impudence:

“The spectacle of an able mind reduced to a state of insanity…. It is a better and easier thing to be a starved apothecary than a starved poet; go back to the shop, Mr. John, back to `plasters, pills and ointment boxes.'”

Another reviewer offered this judgement

“We regret that a young man of vivid imagination and fine talents should have fallen into so bad hands as to have been flattered into the resolution to publish verses, of which a few years hence he will be glad to escape from the remembrance.”

We know how this turns out, more times than not: the young fool will be unable to sustain a long career in the arts—and yes, that was the case here. The young surgeon turned poet was to have a career of less than 5 years—but that was because of his early death at age 25. Yup, he dies two years too young to make the 27 club. Our surgeon turned poet was John Keats.

Besides talent, and desire that was the equivalent of foolishness, Keats worked very hard reading poetry, thinking about it, and writing it in those less than five years, producing some of the best lyric poetry in English.

In my own twenties, this encouraged and discouraged me. On one hand, it said I could write and read fearlessly as a young poet in the first half of my twenties; and on the other, as I measured what I had accomplished, I often admonished myself: John Keats died at 25.

Almost exactly one year after he broke from medicine for poetry, John Keats wrote the words for this piece In the Drear-Nighted December. He wrote it after struggling for much of the year to write his first long piece, Endymion, a neo-classical epic in heroic couplets that he never thought he got right.

This is something many writers experience. You struggle mightily to create something. Something big, something impressive. You bring all your craft to it, but it doesn’t quite work. You finish it, or otherwise set it aside, and in the aftermath out pops another smaller-seeming thing that is much more perfect. It’s like the muse says to you “You don’t control me and direct this, and here’s the proof.”

What has Keats done here? First off, those words cannot be read and not sung. This kind of silent melody is not easy to do in English, yet here is the young Keats doing it brilliantly. His images? I’m deep in a minus 17 degree F. Minnesota afternoon as I write this this. His trees with their “sleety whistle,” those branches glued with ice, once flowing water frozen like mineral crystals—I know these things, but Keats has said them well to remind me that we both know.

Keatslifemask

John Keats encased in Carbonite by Jabba the Bad Reviews

And then his sublime last verse, so beautiful I could not help but repeat it. In two verses Keats has setup an nice lyric that doesn’t stray far from convention. To paraphrase: “Hey, look at nature in winter. Doesn’t look like it does in spring or summer at all. Even though we conscious beings know (more than dumb water and trees) that these trees will bud and the brook water will flow again, nature doesn’t care.” Now the third verse: “How smart are we compared to non-conscious nature? We will ‘writhe’ in pain as things are taken from us (and though unspoken: since the image has been of a repeating natural cycle, this will happen again and again). This is not a poem that says “Suffering? Don’t worry, spring will come again.” This is poem that says suffering will come again, as surely as winter. “The feel and not to feel it, when there is none to heal it.” What a line: “The feel and not to feel it!”

A good song for winter solstice, so to hear the LYL Band perform In the Drear-Nighted December, click the play button the player gadget that will appear below.