Get Well Soon

by Jennifer Wright

  And yet many persist in believing Wakefield’s conclusions.

  So for people who do not wish to vaccinate their children, let me say that raising children seems very difficult. My job, as I see it, is to support my friends in their child-rearing decisions. They want to send their toddler off to a Swiss boarding school? That’s great! Four-year-olds who know how to play polo inspire not only admiration but terror, which in my mind means respect! They’re going to let their daughter choose her own name and send her to a hippie academy where the students learn to draw instead of read? Also great! It sounds like Princess Jellybean Frostina Elsa will be very creative or, as she would write, “!!☺ ☺****☺!!”

  The only time I think it is worth expressing anything other than support is if people are actively putting their children in danger. So if someone leaves their child vulnerable to deadly diseases like measles by not vaccinating, I will speak up. Parents refusing to vaccinate their children are doing something akin to allowing their kids to run about in traffic because they are irrationally afraid of sidewalks or they believe being struck by an oncoming car might be good in the long run. And it’s not only their own children they are putting at risk. If you have children, they’re also putting your children at risk. Vaccinating most of the population protects the very young and vulnerable people of all ages who cannot be safely vaccinated. And for those who think, for instance, measles, which we vaccinate against, is an antiquated disease they don’t need to worry about, according to the World Health Organization it still kills nearly 115,000 people a year globally.37 Vaccines don’t result in hundreds of thousands of deaths. But they only work if everyone who can be is vaccinated. If one child gets measles because of a parent’s foolishness, that child might risk infecting the children of better informed parents.

  It seems that some antivaccination proponents are under the impression that the past was populated with beautiful, strapping men and women who had naturally robust immune systems made hardier because of their exposure to childhood diseases. Those people have watched too many movies. When you think of unvaccinated people, do not think of the hunks in the Starz TV series Outlander (2014). Those are today’s actors playing old-timey people. (You can tell because they have all their teeth.) Think instead of the large numbers of people who were left blind from their exposure to smallpox. Or the people who were pockmarked for life. Or think instead of the Aztecs and the Incas, their civilizations decimated, their homes pulled down on their dead bodies. Think of what it might have been like when 30 to 90 percent of your friends and family died, because that was the world before vaccines. Ask the Aztecs and Incas whether or not they would have liked to have vaccines available to them. Oh, wait, you can’t, they’re dead.

  Vaccination is one of the best things that has happened to civilization. Empires toppled like sandcastles in the wake of diseases we do not give a second thought to today. If taking a moment to elaborate on that point will make this book unpopular with a large group of antivaxxers, that’s okay. This feels like a good hill to die on. It’s surely a better one than the Incas got.

  Syphilis

  “WHORES.

  Necessary in the nineteenth century for the contraction of

  syphilis, without which no one could claim genius.”

  —Flaubert’s Parrot, JULIAN BARNES

  If you believe the many biographies of great men and women, none of them ever had syphilis.

  Which would be a remarkable stroke of luck on their part. Since its discovery in Barcelona in 1493—supposedly brought back from the New World—the sexually transmitted disease just mowed down Europeans. Its effects were so devastating that some regard it as an equal trade for the measles and the smallpox Europeans exported to the Americas. The initial outbreak is estimated to have killed over one million Europeans, prompting the sixteenth-century artist Albrecht Dürer to write: “God save me from the French disease. I know of nothing of which I am so afraid … Nearly every man has it and it eats up so many that they die.”1

  To avoid syphilis, if you time travel to a year before 1928, you should marry a very religious person who has never had sex. Also, you should never have sex, even with your spouse, for there’s a chance he or she is untrustworthy and has had or is having extramarital sex, and will bring the disease back to your home, where your beloved will pass it to you. Just be a sexless but healthy person.

  This insane woodcutting shows baby Jesus merrily shooting syphilis rays at people like he’s a comic book super-villain.

  If you are thinking, I am going to try, but I am not 100 percent certain I can live like that, well, neither did anyone else in history. Even the Catholic Church fell into disgrace following the outbreak of syphilis in Europe as evidence of its symptoms began to mar the faces of the clergy.

  Everybody (possibly a slight exaggeration) contracted syphilis. Really, just name a famous person between the years 1520 (when written records of the disease are first available) and 1928. They probably had syphilis. I will get you started … Beethoven is thought to have had it. So is Napoleon. Schubert almost certainly did. Flaubert definitely did. It’s suspected that Hitler had it. Columbus is thought to have died from it. Even Mary Todd and Abraham Lincoln are believed to have had syphilis.

  The fact that we may never know how widespread the disease actually was has a lot to do with the reluctance of sufferers to admit they had syphilis or to suggest others had it. Claims about how many people and specifically which individuals had syphilis are still controversial. For instance, many biographers dispute that Lincoln was syphilitic, despite his friend W. H. Herndon’s report in 1891: “About the year 1835–36 Mr. Lincoln went to Beardstown and during a devilish passion had connection with a girl and caught the disease. Lincoln told me this and in a moment of folly I made a note of it in my mind.”2 I suppose there is a chance that longtime friends and business associates make up very specific lies about their friends’ medical conditions because … well, who knows why people make stuff up? Maybe W. H. Herndon secretly hated Lincoln and his history of nice letters and kind words was just a long con. Still, I tend to believe actual acquaintances over people who live hundreds of years apart from the figures they profile. Some of those biographers are very invested in preserving the reputation of their heroes. When the explorer Meriwether Lewis’s biographer, Stephen Ambrose, was asked by the New York Times if Lewis had syphilis, he primly replied, “Not even his biographer has a right to know that.”3 I think that, as a general rule, biographers should know what diseases their subjects had. Otherwise all biographies would conclude, “Then they died. Who knows why? I sure don’t.”

  Part of that reluctance to label anyone as syphilitic likely has to do with the fact that the disease is called “the great imitator.” Syphilis presents so many symptoms that it can be mistaken for numerous other diseases. More likely, though, that hesitance is because syphilis carried—and continues to bear—the stigma of being a sexually transmitted disease. STDs can often be the most difficult diseases to combat because no one wants to admit to having them. Why would you, when STDs are viewed by some as punishment for sin or lust? A recent health-care awareness campaign on Twitter encouraged those with STDs to #shoutyourstatus. Those brave enough to do so were met with responses like “If I had herpies [sic] I’d slit my arm open eat a bullet run in traffic … I hope you try at least one of these cures ☺ Sincerely 99% of the men in America.”

  That is the kind of response people get for saying that they have an irritating but not at all deadly sexually transmitted skin infection in 2016. (Also, if anyone sincerely, albeit bizarrely, believe that herpes is a fate worse than death, they should really be out trying to fund a cure and not yelling death threats at strangers online.)

  No wonder people didn’t want to talk about having syphilis.

  Which did not stop them from contracting it.

  The means of transmission in the case of syphilis is simple. A syphilitic sore contains the spirochete bacterium Treponema pallidum, which can work
its way into your body through mucous membranes, like those that line the anus, urethra (on a penis), vagina, or mouth—essentially every area of potential sexual contact. Syphilis first presents about three weeks after infection with a little sore (or sores) called a chancre (or chancres), which appears in the area where syphilis entered the body. That chancre is generally painless, and it will heal. Many people won’t even notice it. However, five to twelve weeks after the sore has healed, patients often experience a fever or a rash (often on the palms of the hands and soles of the feet), which in some cases looks like chicken pox. The rash is usually painless, but it is extremely infectious, as any secretions contain the bacteria. This is a sign that syphilis is spreading through the body and will begin to affect the skin, lymph nodes, and brain.

  If you have these symptoms, you have syphilis. Go to your doctor right away. Get a penicillin prescription. Make some phone calls to your past partners and go on with your life absolutely unimpeded.

  One hundred years ago there was no penicillin, which was very unfortunate if you had syphilis.

  After the initial stages, the disease enters a period of latency where the bacteria just hangs out in the spleen and lymph nodes. In some people, syphilis remains latent for decades. Those people are very lucky. However, for 15 to 30 percent of people who don’t receive treatment, syphilis advances to the positively terrifying tertiary stage.4 Symptoms can include joint problems and serious headaches. Sufferers’ irises can become inflamed, leading to vision problems and sometimes blindness. Others might experience tremors and seizures. Some can become partially paralyzed. Many also develop a condition called tabes dorsalis, which causes intense, shooting pain throughout the body as the nerves along the spinal cords degenerate.

  Neurosyphilis, when the disease invades the nervous system, can occur at any stage, though it’s most often associated with tertiary syphilis. It involves an inflammatory response in the brain that leads to the destruction of bundles of nerve fibers. In some cases, the symptoms of neurosyphilis are mild, like headaches. However, many patients experience mental problems, like bouts of mania, changes in personality, and severe dementia. Sometimes, these mental problems lead to great creative outbursts. The philosopher Friedrich Nietzsche likely suffered from syphilis during his later period, when he wrote works such as Ecce Homo (1888). There’s some controversy over whether he was syphilitic, because there is always controversy over whether someone was syphilitic. Except, weirdly, with regard to the composer Franz Schubert. His friends burned all of his letters and diaries after he died in an attempt to cover up his illness, and every biographer is still saying, “Yep, the one thing we’re certain of is that guy for sure had syphilis.”

  Despite claims to the contrary, I am 99.9 percent sure Nietzsche had syphilis. As in the case of Schubert, Nietzsche’s family engaged in a massive cover-up after his death. Nietzsche’s extremely moralistic sister called the suggestion that he had syphilis a “disgusting suspicion.”5 Since then, neurologists have speculated that Nietzsche’s madness might have been due to conditions ranging from CADASIL (an inherited stroke disorder) to a brain tumor. Finding alternate explanations for diseases seems like fun. But it’s also absurd. Nietzsche was actually diagnosed with syphilis at the end of his life. That’s rare to begin with because most people did everything possible to deny having the disease. But in the year 1889, eleven years before his death, Neitzsche was admitted to a clinic and officially diagnosed with syphilis (after admitting to himself that he’d been exposed to syphilis decades earlier). That seems to point very clearly toward his condition. He had a tiny scar on his penis from a healed syphilitic sore. And his mania, blindness, and illegible handwriting in his later letters, if they do not absolutely prove his illness, at least seem to do a very good imitation of syphilis’s symptoms.

  The psychiatrist Carl Gustav Jung later stated, “That exceedingly sensitive, nervous man had a syphilitic infection. That is a historical fact—I know the doctor who took care of him.”6 Jung made this claim when explaining his interpretation of one of Nietzsche’s dreams wherein Nietzsche ate a toad in front of a lady. He reassuringly went on to say that if you have bad dreams, they aren’t necessarily because you have been infected with a venereal disease. So that’s good, and, also, let’s conclude that Nietzsche did have syphilis because that is the correct conclusion.

  The neurologist Sigmund Freud suspected the mania of syphilis could have benefited Nietzsche’s work. Freud remarked: “It is the loosening process resulting from the paresis [syphilis-induced inflammation of the brain] that gave him the capacity for the quite extraordinary achievement of seeing through all layers and recognizing the instincts at the very base. In that way, he placed his paretic disposition at the service of science.”7

  Freud wasn’t the only one who thought that having syphilis could allow for works of genius. The early twentieth-century poet Marc La Marche wrote in his poem “Syphilis”:

  Are you not, Syphilis, the great go-between

  Working to put man in touch with his genius

  The source of powerful thoughts, the transmitter

  Of the seeds of art and science, the inspirer

  Of delightful follies?

  If we must put up crosses

  To get them, we accept your laws

  O Syphilis, salt of the earth!

  This kind of glamorization is foolish. You know what no one ever says now? “Let’s bring back syphilis because it makes people more creative!” If you want to be inspired, you don’t contract a disease that’s going to blind you and give you shooting pains all over your body. You just buy one of those books with bold, blocky print on the cover that explain how to have seven ideas every seven minutes.

  In battle, when people are faced with a terrifying enemy, some think they can increase their chances of survival by defecting and befriending the enemy. You can’t do that with a disease. You can’t decide to be on its side in order to be spared or treated kindly by it. And yet some people try. Silver linings we attribute to diseases—whether those linings are that syphilitics have moments of manic genius, or tuberculosis sufferers become angelically beautiful, or people with Alzheimer’s learn to live in the moment—are total bullshit. They do not lessen the horrors of the disease for anyone suffering from it. Instead they demean the very real suffering of victims and can make society less motivated to find a cure.

  The way Nietzsche died was gruesome. He was institutionalized for mental illness brought on by syphilis. Although he was lucid for periods of time, during the last part of his life, the Oxford Roundtable Scholar Walter Stewart notes, “he drank urine, he ate feces, he saved feces, smeared feces on the walls and on himself.”8 The historian Deborah Hayden paints a similar picture: toward the end of his life, “he gesticulated and grimaced continually while speaking … he continued to be agitated and frequently incoherent. He smeared his feces and drank his urine. He screamed.”9 He was paraded in front of classes of medical students as a case study of what inflammation of the brain does to a person. What a horrific juxtaposition with the days when Nietzsche lectured in front of eager students as the youngest classics professor at the University of Basel. In his final days, Nietzsche was released from the clinic into his mother’s care. His friend Franz Overbeck, who had earlier wondered if he should put Nietzsche out of his misery by euthanizing him, recalled their last meeting, when Nietzsche was huddled, “half crouching in a corner,” desperate to be left alone.10

  Nietzsche was one of the greatest philosophers of the twentieth century. And he was only age fifty-five when he died in such a terrible way.

  Many syphilitics suffered similarly grim ends. The painter Theo van Gogh (the brother of Vincent) became violent in his dementia and attacked his wife and child. The author Guy de Maupassant lost his mind in a more gentle fashion and, in his last days, anxiously asked everyone if they knew where his thoughts had gone: “You haven’t seen my thoughts anywhere, have you?” He believed they might be like butterflies that he could
catch as they flitted through the air if he moved quickly enough. He ultimately had to be restrained and died murmuring, over and over, “the darkness, the darkness.”11

  There’s no good way to die, but these seem like such stunningly dark ends for some of the brightest minds of their time.

  The only upside might be that these victims still had lips to murmur with when they died. Another horrifying aspect of syphilis is that it could make your skin rot. In Upton Sinclair’s novel about syphilis, Damaged Goods, a doctor describes the physical effects of the disease: “I have watched the spectacle of an unfortunate young woman, turned into a veritable monster by means of a syphilitic infection … Her face, or rather let me say what was left of her face, was nothing but a flat surface seamed with scars … Of the upper lip not a trace was left; the ridge of the upper gums appeared perfectly bare.”12 And that doesn’t even mention what the disease did to noses.

  Sufferers of syphilis developed a “saddle nose.” The bridge of their nose would cave in—giving it the curved appearance of a saddle. This may not sound like that big a deal, but the rest of the flesh, say, around the nostrils, would also rot away, so they might be left with just the tip of their (decaying) nose exposed.

  Just as those on #shoutyourstatus today are bombarded with messages telling them they are undeserving of respect, noseless people of the past were not treated with kindness. In the 1890 text Surgical Experience Dealing Especially with the Reconstruction of Destroyed Parts of the Human Body Using New Methods, the surgeon Johann Friedrich Dieffenbach wrote: “A blind man arouses pity, but a person without a nose creates repulsion and horror. And what’s more, the world is still used to regarding this unfortunate disfigurement as a punishment … the unfortunate man who has lost his nose enjoys no pity at all, least of all from bigots, homeopaths, and hypocrites.”13