Mary Cappello

by Swallow: Foreign Bodies

  Table of Contents

  Also by Mary Cappello

  Title Page

  Dedication

  AUTHOR’S NOTE

  I. - WHO WAS THAT MAN?

  “Alone on Floor with Pile of Buttons”

  Remembering Forward: The Idea of a Legacy

  Fbdy #C804, Case #3268, X-rays #48451C and #48460C: The Case of Andrew C.

  A Peculiar Chap

  The Life of Chevalier Jackson : Early Prototypes of Rescue

  II. - HOW DOES SOMEONE SWALLOW THAT?

  Between Carelessness and Desire: Getting Objects Down

  Chevalier Jackson’s Traumatic “Phases”

  A Catastrophe of Childhood: Gastric Lavage

  Chevalier Jackson’s Tears: The Case of the Boy Who Cried

  Fbdy (Multiple) #1173; Gavage: The Case of Joseph B.

  Fbdy #2440: A Perfect Attendance Pin

  “Strange Things Were on the Run from Mary’s Deepest Depths”: Hardware, Swords, Scopes

  III. - WHAT ARE THESE THINGS?

  Fbdy #565, the Case of Margaret Derryberry: Objects Lost and Found and Lost Again

  Instrumentality and Instruments as Things

  Modernist Portals and Secular Tabernacles: Chevalier Jackson Meets Joseph Cornell

  IV. - MYSTERY BONES AND THE UNRECOVERED BOY

  SELECT BIBLIOGRAPHY

  Acknowledgements

  INDEX

  Copyright Page

  Also by Mary Cappello

  Night Bloom

  Awkward: A Detour

  Called Back: My Reply to Cancer, My Return to Life

  For Jeannie and Jim,

  for Malaga, and for Russell.

  I gulp. You gulp.

  We are always at, or on, the oral stage wherever else we are.

  —ADAM PHILLIPS, The Beast in the Nursery

  AUTHOR’S NOTE

  I use the following abbreviations throughout this book to refer to texts by Chevalier Jackson that I rely on most frequently: LCJ for The Life of Chevalier Jackson: An Autobiography; DAFP for Diseases of the Air and Food Passages of Foreign-Body Origin; NMP for “New Mechanical Problems in the Bronchoscopic Extraction of Foreign Bodies from the Lungs and Esophagus”; B&E for Bronchoscopy and Esophagoscopy: A Manual of Peroral Endoscopy and Laryngeal Surgery. I rely throughout on Jackson’s abbreviated coinage “fbdy” to refer to “foreign body.” I capitalize the word “thing” when I want it to refer to an object that has undergone a transformation once it has been swallowed, retrieved, studied, and placed in Jackson’s collection, or for objects that, by way of over-valuation, exert an auratic charge.

  I.

  WHO WAS THAT MAN?

  What was so potent about these protected objects? Was it that my world was kept out? Or that some imaginary world was kept in? . . . It took very little time to see that the objects spoke to one another, and to me.

  —ALLEN KURZWEIL, The Case of Curiosities

  “Alone on Floor with Pile of Buttons”

  This is a book about stowage and retrieval.

  A book made of things found in a cabinet—not just any cabinet, but a recess containing a plenitude beyond all human measure. Not just any things, but wondrous, weird, and even sacred things. Many things that had one thing in common: a strangeness that conjoined them without making them into twins. Common objects turned into mysterious markers because of what they’d been through, where they’d gotten lost, and how they were later found. Here are capital Things, and so I will capitalize them. Here are trinkets not reducible to trifles.

  The regularity of living (or its pretense) seems at odds with the fabulous specimens in Philadelphia’s Mütter Museum, a repository of medical curiosities created to instruct nineteenth-century practitioners. The building is unprepossessing—it could be an elementary school with its Aladdin lamp insignia and shoe-buckle window designs, offset by its stately marble floors; the edifice is small, not grand, made intimate by its adjacent medicinal garden and cherrywood doors. But does anyone who enters its hallways afterward forget what he has seen? In 1858, Thomas Dent Mütter, a prominent Philadelphia surgeon who specialized in treating cases of clubfoot and harelip, endowed the museum and contributed his collection of seventeen hundred anatomic and pathological specimens and other assorted items to the College of Physicians of Philadelphia. One of the oldest private medical societies in the country, the college included Benjamin Rush among its founders; it was at Rush’s suggestion that the garden was created to stock doctors’ individual medicine chests and to inform a pharmacopoeia-in-the-making.

  What’s the distance between a face caught in a cornice on an apartment building across the way and the human skulls arranged on shelves inside the Mütter Museum’s glass cabinets? Across the street from the museum on Twenty-second Street, there’s a facade made of bodiless singing baby heads stuck inside bonnets made from their cut-off arms—or are they the wings of angels into which their heads are nestled, out from which their open mouths protrude? I think they are diminutive gargoyles, hark-the-herald pudge-ims who have forgotten their origins as gargoyles, hewn from gargouille (Old French) and gurgulio (Old Latin), words that refer to the throat, or to the gurgling sound of water a gargoyle displaces through the spout that is its mouth.

  It’s impossible to escape a sense of the uncanny here—the sudden recognition of what was once believed, later strenuously forgotten, and now again confirmed, and I wonder how many are tempted to follow a particular item in the museum to an end and a beginning and back again. Toward multiple beginnings, and multiple ends. Even those who haven’t been to the Mütter Museum may have heard of its “horned woman” replica, its displays of Siamese twins, its “wall of eyes,” or its numerous anatomical figures in wax that so closely approximate human flesh they animate that all-too-narrow threshold between the living and the dead. On the ground floor of the museum, as I round a bend past the skeleton of a “giant,” my eyes widen to take in, in adjacent glass cases, an enormous bowel, better suited to a dinosaur than a man but nevertheless extracted from a diseased human body, and the tiny, handsomely articulated bones of a fetal skeleton arranged in perfect rows of white against black. Between the bowel in its waterless aquarium and the baby bones inlaid into velvet like a set of numbered jewels sits an unremarkable oaken girth, a solid piece of furniture that you might have to be bookish to notice at all. In fact, in my fascinated stupor, I had missed it; I was busy examining an ill-lit collection nearby that seemed to contain a cross between seashells and miniature musical instruments but that was actually a gathering of cartilaginous labyrinths and cochleas, the significant bits of bone that govern balance, when my friend called to me: “Get a load of this! Take a look at this!”

  The case, at the time of this writing, is awkwardly situated beneath a staircase, so if you stand to one side of it, you can hear the patter of other visitors on the stairs; in order properly to view it, you might have to bend so as not to hit your head on the stairway’s metal underside. Resembling an old waist-high library card catalog, the cabinet is heavy and windowless but features rows of handles waiting to be pulled. The Mütter Museum isn’t, like Philadelphia’s children’s museum, a “Please Touch” museum, so one might feel wary of the invitation offered by a placard to OPEN the drawers.

  Might the slender crypts be filled with slabs or parts of bodies? The crude and unpliable instruments of early medical practice? The scarily heavy shackles used in the eighteenth century to subdue the mad? The jaw tumor of Grover Cleveland? Human placenta? No. These items are all on plain view in other corners of the museum’s small rooms and alcoves, whose wooden cabinets loom in chorus as if to echo the seriated arches of the Unitarian ch
urch next door. Could the cabinet be the apothecary accompaniment to the medicinal garden? A pullout drawer whirs on its ball-bearing casings to reveal a carefully arrayed collection of small objects mounted inside little squares, numbered, secured in place with a thread or a wire, and framed. But what order of things are these, and who could have been responsible for their steadfast arrangement? What form of wondrous derangement have we here?

  The objects in this set of drawers are items that have come into unnatural contact with the human body: not butterflies, moths, or beetles, these are indigestible and undigested things, Things that people have swallowed or inhaled. A pioneering laryngologist named Chevalier Jackson and the colleagues whom he trained extracted nonsurgically more than two thousand “foreign bodies” from people’s airways and stomachs and then preserved them in this cabinet, and in this way gave back to them a local habitation and a name. (See figure 1.)

  A placard perched atop the set of drawers explains that Jackson, who died in 1958 at the age of ninety-three, wished for the collection of “Foreign Bodies Removed from the Air and Food Passageways” to be “accessible to whomever the [Philadelphia] College of Physicians Deemed Proper.” “These specimens,” he had insisted, “are not mere curiosities.”

  Feeling mighty curious, eager to open an unexpected drawer, I am clearly not the intended audience for these Things. My eyes swim with delighted interest, not just in the objects themselves and their imagined sojourns, but also in Jackson’s dedicated arrangement. Not curiosities, Jackson repeats; “with the accompanying data,” these foreign bodies “are, in my opinion, of enormous clinical value to the physician and surgeon.” The data reside in a barely liftable, several-inches-thick Xerox copy of a portion of a book that also sits atop the drawers: Classified Tabulation of Various Foreign Bodies Endoscopically Removed from the Air and Food Passages with Illustrations of the Foreign Bodies and All Data Pertaining to Their Removal. Using the text as a cross-reference, a reader can match any of the objects in the drawers with a grid of information that Jackson provides: following each item and drawer number, we can learn the age and sex of the person belonging to the object, the type of foreign body removed, where in the upper torso it was lodged and for how long, the type of anesthetic used (usually none), the type of tube used to extract it, any problems that presented themselves, the type of forceps used, the point of seizure of the object, the result (mostly in bald terms “cured” or “died”), the length of time it took to remove the object, and further remarks about the case.

  Fig. 1. The cabinet of drawers containing the Chevalier Jackson Foreign Body Collection. Collection of the Mütter Museum, The College of Physicians of Philadelphia.

  Lean down toward a drawer and marvel at the categories of lodged and swallowed things:

  Coins and other disks

  Hardware

  Pins and needles

  Jewelry

  Seeds, nuts and shells

  Meat

  Bones

  Wool and cotton

  Buttons

  Minerals

  Dental and surgical objects

  Utensils

  Toys

  Open a drawer and feel your heart arrested by the shapely particularity of each foreign body and the question heralded of “How?” Here are double-pointed staples, a pair of tooth roots shaped like a tiny pair of pants, the brass foot of an alarm clock, Buffalo-head nickels and Mercury dimes, a half dollar dated 1892. A toy goat, an Audubon Society pin, a tin steering wheel from a toy automobile, a bottle cap, rivets and woodscrews and nails. One toy wristwatch and one real wristwatch; a crucifix with several rosary beads still attached; the metallic letter Z from a toy airplane, one tiddlywink, and a handful of gruesome endogenous objects—substances, like hardened pus, produced by the body itself. Pins, silvery blue, and in each case opened, splayed, an alphabet of angles, upside down or right side up; bones, some slender as a lock of hair. Hairpins and bobbins, hooks and nails, collar buttons, and wire. A two-inch long nail. A padlock. Meat in the form of owl pellets, mosaic indices of onetime food. Jacks the color of their many-pointed shadows on a floor. A radiator key, tiny binoculars (or opera glasses) (see figure 2), a lead-alloy horse, a metallic greyhound, a donkey, a plastic binky doll, the eye of a teddy bear, an umbrella tip, a bundle of string. Numerous peanut kernels—a fraction of which can kill a man. A poker chip, a coffee berry (unroasted), several cockleburs, a carpet tack, a pin (common), a pin (with a white glass head), fragments of eggshell, a campaign button. A beauty pin and a brooch. A canna seed and a Christmas tree ornament. Orange pulp, a prune seed, the ear from a toy horse. Rubber bands, a burrlike mass, a Job’s tear. Birdshot, a shawl pin, a toothbrush bristle, mutton bone, beans, a sixpenny nail, a cambric needle, a toothpaste cap, some oyster shell, a stove bolt, grapeskins, a bullet. A nib of crayon. A glass bead intact. A Perfect Attendance pin (see figure 3).

  Fig. 2. Fbdy 914, the case of E.R.S., age four, a pair of toy opera glasses in esophagus. Radiologist, Dr. Willis F. Manges (1876-1936). Collection of the Mütter Museum, The College of Physicians of Philadelphia.

  Each object found its unhappy place in a person’s trachea, larynx, bronchus, esophagus, stomach, pleural cavity, lung tissue, pharynx, or tonsil. No region of the aerodigestive tract was beyond this doctor’s ingeniously delicate reach. But time played its role in cruelly indelicate ways, because while some removals took four seconds, others took forty minutes, and while some objects had been lodged for a mere four minutes, others lived inside a body for as long as forty years.

  Fig. 3. A selection of fbdies from the Chevalier Jackson Foreign Body Collection that includes a Perfect Attendance pin and another inscribed, “B-A-2-WAY Looker says Care Fu Lee.” © Rosamond W. Purcell, 2009.

  What’s more marvelous? The fact of swallowing a foreign body? Its nonsurgical extraction by Jackson? Or his inserting it into an arrangement of things? What exactly occasions the collection of objects, as such? Their retrieval by Jackson and subsequent rescue; the acts of unusual swallowing to which they refer; their transformation from quotidian items to aura-laden Things; or the precarious tightrope they perform upon the stuff of indeterminacy, caught as they are between will and accident, between voluntary and involuntary acts?

  The Chevalier Jackson collection of foreign bodies confronts us with different orders of the marvelous, competing orders of the strange, each of which draws us into a fascinational field whose foreground seduces us but whose vanishing point is out of reach. While the Jackson collection doesn’t exactly share the same kind of jaundiced limelight that most other specimens in the museum do—what Oliver Wendell Holmes called “the pathological sublime”—it does conjure what I’d like to call a “visceral sublime,” a combination of fascination and disgust (let us not forget the gustatory in the word dis-gust) that is felt . . . well, in the gut! A repulsion and attraction toward, a temptation and a terror around incongruity is what moves us, a boundary exceeded, a physiological rule broken: a battleship caught in a thorax, a jackstone stuck in an esophagus, a padlock not quite at home inside a stomach. We’re afraid to think of how those things might have gotten inside a body, we’re alarmed by the admixture and more disgusted (or intrigued) by the thought of how they were extracted—and maybe we’re bemused or overwhelmed with unnamed wonder by the fact of their arrangement into a cosmology of Things.

  Our bodies are implicated as we peer into these drawers; it’s a visceral and never merely an intellectual encounter. Most of all, we are reminded of our mouths, the part of our bodies where there is the most going on, our most visible and vulnerable of orifices, the seat of so much that is essential to our staying alive. Jackson’s peculiar collection demands that we contemplate the complex physiology of the human swallow (we might even gasp or gulp before his display), but it doesn’t end there, because once brought into unseemly contact with the maw by virtue of his maddeningly endless exhibition, we remember the mouth as a site of nurture, breath, aggression, appetite, language, and even knowledge:
through our mouths we originally come to know the world and differentiate ourselves from it. Thumb in a mouth, or hair (do you remember the pleasure in chewing on it?), pens and pencils, sweet and sour (when it comes to hard candy, are you a biter or a sucker?). Words—strange, new, or dirty—sometimes piercings, the inability to get things down (have you ever felt as though your heart were in your throat?). Do you talk while you are eating? Do you cover your mouth? What have you never been able to swallow? “There was an old woman who swallowed a fly, / I don’t know why she swallowed a fly, / Perhaps she’ll die.”

  What’s more freakish? The twists and turns of human deformation, or human beings’ scrupulous classification of such? Historian Jan Bondeson tells how, according to one account, the famous Tocci brothers’ father had to be institutionalized after first seeing his two-headed boy. The freakish and the sublime have the ability to derange and not just disarm us. But it didn’t take long for Mr. Tocci to come to his senses and use his boys to make himself rich (they were first put on display when they were four weeks old). Let us recall that fascination and astonishment, while they seem like states of mind worth courting, take as their point of origin forms of benumbment, shock, and deprivations of sensation, rather than a surfeit of true feeling. Fascination in its original sense is something that witches do to their enemies and animals exert toward their prey. It’s a form of paralysis. I wonder what it would mean to fail to “regain one’s senses” and not consider that mad? The forms that our returns to normalcy take are always telling.

  Meraviglioso. I’ve always loved the extra syllables in the Italian version of the word “marvelous.” The oral gymnastics required to bring the word across, its extension into space. The subtle effort—a push of breath—by which it causes me to linger. So much better than the empty-headed “marvey,” by which the marvelous is tamed, or the high-camp “mahvelous,” by which it is ironized. There is no question that Chevalier Jackson’s foreign body collection is a playground for the imagination, a stimulus for investigation and for art, and Jackson knew this and fought against it. He devoted his life trying to convince fellow doctors that a foreign body in the body is not a rarity, an exception, or a wonder, but a commonplace event: “Of the 1485 cases of foreign bodies that have come to our bronchoscopic clinic during twenty years, there have been over 200 that had been overlooked for periods of from one month to forty years.... Foreign bodies have been regarded as curiosities of medicine rather than as routine possibilities for exclusion” (DAFP, 43).