What Killed Jane Austen?: And Other Medical Mysteries (19 page)

Moreover, PHS doctors convinced their private colleagues not to treat the experimental subjects for their syphilis. Instead, as the men fell ill, their doctors should just refer them to the hospital to ensure that they came to autopsy. Undeterred by blindness, paralysis, dementia and early death in some of their patients, the private doctors readily agreed to all this.

Once the story broke,
The Atlanta Constitution
newspaper condemned the ‘moral astigmatism that saw these black sufferers simply as subjects in an experiment, not as human beings’.

One citizen called the experiment ‘but another act of genocide by whites … that again exposed the nature of whitey: a savage barbarian and a devil’.

Another asked: ‘How in the name of God can we look others in the eye and say “This is a decent country”?’

Though he worked for the VD division of the Atlanta Centre for Disease Control, Dr Donald Printz said: ‘A literal death sentence was passed on some of those people.’

But Dr John Heller, who had directed the VD division between 1943 and 1948, bluntly told reporters there had been nothing unethical or unscientific.

Some other doctors were just as blind. Dr R.H. Kampmeir of the Vanderbilt University admitted that many patients with syphilis would die if not treated: ‘This is not surprising. No one has ever implied that syphilis is a benign infection.’

Apologists claimed that, in 1932, the available treatments (mercury, arsenic and bismuth) were worse than the disease. They said the drugs were painful, slow to act, toxic, and sometimes even fatal.

But no possible rationalisation could justify withholding penicillin after 1943 when it proved to be effective for syphilis.

Public pressure led to an independent inquiry. A panel of nine (of whom five were black) damned the experiment as ‘ethically unjustified [even] in 1932’.

Senator Edward Kennedy held hearings on human experimentation. Two survivors, Charles Pollard and Lester Scott, told their story of illiterate blacks trusting the educated whites who had betrayed them. Each had been told that his blood was bad; each had gone along for 40 years with doctors who said they were treating him.

Outraged citizens of Tuskegee elected their first black mayor. Legislators passed tough regulations to protect subjects of medical experiments.

Over a century ago, Boston physician Dr Oliver Wendell Holmes noted: ‘Medicine, professedly founded on observation, is as sensitive to outside influence, political, religious, philosophical, imaginative, as is the barometer to the atmospheric density.’

Even today, the Tuskegee study should sound a warning to researchers who argue against the need for ethics committees to oversee medical research.

(GB)

Reports in the medical Press of the effects of hallucinogenic drugs on imagery and the spatial experience began early this century. But descriptions of similar blowouts had been part of literature long before that.

It is no secret that opium, usually taken as laudanum, affected the writings of such luminaries as Samuel Taylor Coleridge, George Crabbe, Francis Thompson, even the sublime John Keats himself. Thomas De Quincey’s well-known narrative on the narcotic experience is brazenly entitled
Confessions of an English Opium-eater
(1822), and in it he describes its pleasures thus: ‘Thou hast the keys of Paradise, oh just, subtle, and mighty opium.’ Mind you, he also damns the pain as ‘An Iliad of woes’.

Coleridge (1772–1834) is perhaps the best-known opium taker in this medley, and apparently it gave him the impetus to write his famous ‘Kubla Khan’. The story goes that during a drug-induced sleep the author imagined life’s impenetrable secret had been revealed to him. He woke, feverishly began to set it all down, was interrupted by an inopportune visitor, and never recaptured the mood when he departed. Nonetheless his last lines are significant:

Keats, Crabbe and Thompson were all medically trained, and their recreational use of opiates is revealed in some of their verses, though none attempts an objective account of the definitive drug experience.

Clinically, hallucinations vary with dosage and frequency of use. The most common is a distortion of space and time in which both can seemingly expand to infinity. Visual hallucinations are more common than auditory and olfactory ones, and can range from bright lights to bizarre but recognisable images. A sense of depersonalisation and terror can be identified in several poems. All in all, true addiction is more often seen in poorly socialised and dependent personalities than in well-structured ones, and in poets no less than in anyone else.

George Crabbe (1754–1832) became a surgeon apothecary after apprenticeship in the country. Travel to London to pursue a literary career was the preferred choice, but eventually he became a parson. He began taking opium in 1790 after having been given it for vertigo, and continued to imbibe it daily for the remaining 42 years of his life. The resulting delusions were mainly concerned with terror and pursuit. Crabbe’s most famous literary work is
The Borough
, on which Benjamin Britten’s 20th-century opera
Peter Grimes
was based.

Francis Thompson (1859–1907) was first given laudanum on prescription for ‘lung fever’ while a medical student at Manchester. He was a somewhat withdrawn and unstable person, and became habituated for the last 27 years of his life. He came from Preston, a cotton-spinning town in darkest Lancashire, seemingly a most unlikely place for a sensitive poet to emerge. Anyway, Thompson never enjoyed studying medicine, failed continually for as long as his doctor father would support him, until after six meaningless years he took himself off, together with a goodly supply of laudanum, to London. There he lived as a derelict, moving between monasteries, writing of his drug-induced fantasies until he died, not of opium poisoning but tuberculosis.

His terrifying dreams he described as ‘in part the worst realities of my life’. He wrote one poem which with touching frankness he called ‘The Poppy’. It is full of narcotic-induced fantasies where the poppy emerges as ‘the withered flower of dreams’.

Of all the English poets who dabbled in drugs his was the talent it most profoundly affected, reaching its apotheosis in
The Hound of Heaven
, where, in his mind, he is pursued by God:

In Thompson’s evocative piece ‘At Lords’, he describes a visit to watch his old county, Lancashire, play Middlesex at cricket at Lords. It finishes with these famous lines, which, notwithstanding the inferred symbolism, are very moving:

John Keats (1795–1824), the son of a livery-stable keeper, was an occasional laudanum taker, not an addict. He was apprenticed to a surgeon in Edmonton, Middlesex, but moved to Guy’s Hospital where he qualified as an apothecary in 1816. He abandoned medicine for literature after six months.

In 1819 he was hit in the eye by a cricket ball, and his housemate, Charles Brown, wrote that he received opium after this event, as he had done on occasions before. The poet, though never admitting to taking the poppy, wrote the next day how he had slept in, felt languid, and was indifferent to pain and pleasure.

If any of Keats’s poems imply the effect of opium, it is his ‘Ode to the Nightingale’. It was written within six weeks of the cricket-ball incident, and the first few lines are pretty explicit:

In a trance-like state he hears the nightingale—possibly an auditory hallucination and later pleads for escape:

Later Keats has thoughts of death:

And he concludes, as though rousing from an opium-induced sleep, confused over reality:

William S. Burroughs, 20th-century author (
The Naked Lunch
) and self-confessed drug taker, has said that drugs heighten the awareness and imagination of a writer. Yet it seems to be a constant grievance of those who take hallucinogenic drugs that it is impossible to communicate in words the transcendental effects they produce. The great poets probably got nearer than anyone.

(JL)

It makes you hyper and smarter, faster and better…you know, sort of like the Six Million Dollar Man (25-year-old male, in Dan Waldorf’s
Cocaine Changes
)

In 1860 the German pharmacologist Albert Niemann isolated cocaine, one of the ingredients in the leaves of the South American coca plant. He wrote that it leaves ‘a peculiar numbness, followed by a sense of cold when applied to the tongue’.

Despite this observation, Niemann overlooked cocaine’s potential as a local anaesthetic. Only a few years later, a French pharmacologist did suggest that cocaine might be a useful local anaesthetic. But he did not follow it up either.

One of the first doctors to experiment with cocaine on humans was Dr Sigmund Freud. In 1884 he was only 28, a poor, little-known but ambitious doctor at the famous General Hospital in Vienna, when he wrote a letter to his fiancée Martha Bernays in which he enthused about cocaine, ‘which some Indian tribes chew to make themselves resistant to privation and fatigue’.

Freud ordered one gram of cocaine, but was outraged to be charged about ten times the expected price. But before sending the cocaine straight back, he took one-twentieth of a gram. After a few moments, all his anger evaporated and he felt dramatically brighter: ‘nothing at all one need worry about’.

One month later, Freud noted: ‘I take small amounts regularly against depression and indigestion and with the most brilliant results.’ He sent Martha cocaine to ‘make her strong and give her cheeks a rosy colour’.

Soon Freud was mailing cocaine to relatives, sharing it with colleagues, and prescribing it for digestive disorders, weight loss and asthma, for morphine and alcohol addiction, and even as an aphrodisiac. Just on the strength of ‘some dozen experiments’, he wrote an enthusiastic paper.

His biographer Dr Ernest Jones called him a ‘public menace’ on cocaine.

One of Freud’s friends, Dr Fleischl, had become a morphine addict. American doctors were treating morphine addicts with cocaine, and Freud did the same for his friend. Fleischl did well at first.

Another friend, Dr Carl Koller, was searching for an effective local anaesthetic for eye surgery. He wrote about a colleague who ‘partook of some cocaine with me from the point of a penknife and remarked ‘How that numbs the tongue.’ The observation was not new, but it was Koller who took it further.

Would cocaine numb the eye as it numbed the tongue?

We [Koller and Freud] trickled the cocaine solution under the upraised lids of each other’s eyes. Then we put a mirror before us, took a pin in hand and tried to touch the cornea with its head … We could make a dent in the cornea without the slightest awareness of the touch …

Soon Koller presented his findings to the Viennese Medical Association. As the news spread, wags called Dr Carl Koller ‘Coca Koller’.

Freud’s own father was one of the first patients to enjoy a painless operation for glaucoma, with Koller and Freud giving a local anaesthetic of cocaine. An American cavalry officer even wanted Koller to sail for the United States and examine his horse!

William Martindale, future president of the Pharmaceutical Society of Great Britain, advised the English to give up tea and take coca instead.

But by July 1885, Freud’s addicted friend Dr Fleischl was taking a full gram of cocaine each day. Worse, he had convulsions and hallucinations of white snakes. Freud sometimes sat up all night with his friend.

The man who had hoped to become the first European to be cured of morphine addiction by cocaine was now the first European cocaine addict.

Freud may have believed that cocaine was not addictive because it did not produce the dramatic withdrawal crisis of opium or morphine. One critic called cocaine ‘the third scourge of mankind’. The fiasco shattered Freud’s early reputation. But he reportedly continued not only to use, but also to prescribe cocaine until at least 1895.

Was Freud just unlucky in this early cocaine phase of his career? Had he, like Koller, concentrated on its anaesthetic effects, would he have become a famous anaesthetist instead of the father of psychoanalysis?

In his last paper on cocaine, Freud finally admitted that it did harm morphine addicts and produce:

… physical and moral deterioration, hallucinatory states of agitation similar to delirium tremens, a chronic persecution mania … hallucinations of small animals moving in the skin and cocaine addiction instead of morphine addiction.

Four years after Fleischl’s death, Freud was still blaming himself: ‘I had been the first to recommend the use of cocaine … The misuse of that drug … hastened the death of a good friend’.

But later, Freud omitted references to some of his early papers promoting cocaine. Was this deliberate? Did he just happen to forget? Or was the great Freud himself subject to Freudian slips?

(GB)