Mary Cappello

by Swallow: Foreign Bodies

  If you submit yourself to a regime, anything is possible—from the training of the body to do things it doesn’t seem capable of to learning how to insert a rigid instrument into a body’s intractable folds. Thus, he took a line from Matthew 6:3 and said that every child should be taught “Let thy left hand know what thy right hand does and how to do it” (LCJ, 205). Jackson trained himself to become perfectly ambidextrous. He is quick to remind us that his hands were not the product of a genetic endowment or a natural predilection but the reward for his “total abstinence from alcohol and tobacco” (LCJ, 138). (He called alcohol a “diluted poison.”) He was proud of the fact that he was the only person he knew capable of not breaking the lead of his very soft pencils (LCJ, 169).

  He boasted of an ability to eat nothing but “postage stamp” sandwiches for lunch consisting of paper-thin slices of bread with a single lettuce leaf in between. He paints a self-portrait of a man who is proud of his “abstemiousness,” his “self-denial,” and his ability to “leave the table hungry” (LCJ, 171). Some of the most delicious sentences in the Life, those infused with the brightest dashes of humor and pleasure, are those in which he described the minimalist diet on which, as a student, he was able to survive:

  A creamless cup of Arbuckle Ariosa coffee and the butterless butt of the previous day’s French loaf at four-thirty in the morning started the day’s work.... At noon an apple from home and two not overclean, much handled, costermonger’s pretzels took but a few minutes from the two hours’ work in the dissecting room that preceded the first afternoon lecture.... Dinner consisted of vegetables boiled with a bone. (LCJ, 57)

  Going to bed at 9 P.M. and rising at 4:30 A.M. was a habit he maintained throughout his life. The flip side to his abstemiousness (or maybe part and parcel of it)—he was also a pack rat and an inveterate collector of junk. He was a lover of objects, of course, but he didn’t make the connection between this tendency at home and the impulse that drove his life’s work, instead lamenting, “If there has been any part of my life misspent, it has been due to the tyranny of chattels” (LCJ, 173).

  His clinical-sounding description of his diminutive constitution—“slightly undersized but free from physical defect” (LCJ, 167)—might explain why he didn’t spend his college days on the gridiron. Instead, he carried coal from one room to the other in the house at 925 Walnut Street, where, as a student, he rented an attic room for one dollar a week (see figure 10).

  Self-discipline is one thing and a fastidious devotion to the idea of a self in absentia is another. In combination, they provide the essential ingredients for an ontological recipe imbibed by many of the world’s mystics. Whether Jackson’s sundry quirks of character render him more vivid as a person in the world or more opaque, his practice of detachment seems to have upset many of his colleagues, who hoped to forge an intimacy with him but who ultimately found him impossible to know. He told his father in a letter from 1884: “I do not know nor do I want to know a man in the college except Proffessors [sic].” In his adult life, his peers, even though they revered him for his work, described him as sadly unknowable, cold, recoiling, socially unavailable, inaccessible, even phobically incapable of company, and cut off from pleasure in the extreme.

  Fig. 10. Jackson’s pen-and-ink illustration of the attic room he rented at Ninth and Walnut streets while a student at Jefferson Medical College. Smithsonian Institution, National Museum of American History.

  Perhaps Chevalier Jackson was a person who didn’t let himself be touched, entered, or swallowed. Here is a figure who recoiled from intimacy with most other people but who entered numerous of his fellows on a daily basis, profoundly, through a tube. “If you want me again look for me under your bootsoles.” If you want to find me again, look inside the human throat. Jackson might have been paraphrasing Whitman in the way he carved his initials into some of his illustrations. Beautifully crosshatched, the letters C and J loop and lace inside and atop one another like a perfect Chinese woodcut, but it’s odd indeed to find those letters not in the corner of a drawing but inside the throat that he’s depicting (see figure 11). It could be a way of saying, I was here, this is mine, here’s my flag, but with a twist. Obscuring the anatomy, the letters suggest that we have to see through Jackson to get to the body.

  What a peculiar chap, who wanted people to find him in their throats. This is the only place where he could meet you, and the only place where he felt sure.

  Fig. 11. Chevalier Jackson illustration of carcinoma of the larynx with his initials inlaid. Reprinted with permission of the American Academy of Otolaryngology Head and Neck Surgery Foundation, © 2009. All rights reserved.

  The Life of Chevalier Jackson : Early Prototypes of Rescue

  I characterize my own soul as a glowing blue orb, about the size of a marble, in my stomach.

  —STUDENT BRIAN FORSBERG, “Why Did I Just Say That?”

  “At the center of each person,” Winnicott writes, “is an incommunicado element, and this is sacred and most worthy of preservation.”

  —ADAM PHILLIPS, Winnicott

  In his autobiography, Jackson tried to narrate the story of his origins and recover the conditions that made his later peculiar history-making practice possible by identifying a series of intriguing prototypes of rescue as early harbingers of interest in endoscopic work. The prototypes are strangely like and unlike each other, and they accumulate in the autobiography like a collection. They can be substituted for each other—they are metonymic—and are radically distinct from one another. Taken together, they bifurcate into two distinct types: instances of detached problem-solving, engineering feats, and uncommon ingenuity that show Jackson liberating things caught inside (other than bodily) systems; and scenes of tremendous physical and emotional struggle, life-or-death situations from which Jackson must extricate himself—as he would foreign bodies in later life—in order, literally, to survive. The saving of Things—in the sense of rescuing and stowing inside a collection—is linked in the autobiography with efforts to save oneself from the cruelty and torment of others.

  When Jackson was twelve years old, his father entered into a business venture that involved drilling for oil. At a certain point in the excavation, a number of tools got lost inside the well, leaving the foreman to declare that the well was bewitched, cancel the job, and suggest they start over. Knowing that his father was depending on the success of the expedition to get out of debt (the story starts to take on the existential proportions of De Sica’s Bicycle Thieves), Jackson, still a boy, devised an instrument for retrieving the tools. He had to visualize the depth, intricate turns, and shape of the well; the attitude of the tools; and the various pieces of drilling machinery already at his disposal. Presenting his idea for a multibarbed harpoon to the local toolsmith, he was told that the plan was sound but its manufacture wasn’t possible, so he went home and made a wooden version of what he had in mind that convinced the craftsman to make the harpoon. To everyone’s overwhelming surprise, the twelve-year-old boy-wonder then used his invention to retrieve the tools lost in the well, and the instrument, though never patented and never yielding income for Jackson, became a standard implement for the fishing industry thereafter.

  The retrieval of a cork caught inside one of his mother’s olive-oil bottles counts as Jackson’s second foreign-body prototype—to everyone’s amazement, he fished out the cork in a few minutes with a wire loop. On another occasion, Jackson figured out a way to rescue valuable papers from a planing-mill fire, but the analogy between gullets and architectures, stomachs and landscapes, bodies and machines, physiological arrangements and man-made mechanisms comes fully to light in his description of his work as a plumber’s cub at Idlewood, the home-turned-summer hotel run by his father and the family. The gas-driven light and water system would occasionally get clogged by an array of culprits as generically vast as an object stuck in a maw, which Jackson listed: “sand, gravel, rotten wood, leaves, grass, algae, worms, larvae, insects, crayfish, and the like” (LCJ, 18)
. Usually the lines would become obstructed just on the evenings when social events and entertainment were planned for the hotel guests, plunging the entire estate into darkness. Preferring work clothes to evening clothes, Jackson relished the opportunity to feel his way around in the dark—truly pitch dark, before the days of flashlights and without the advantage of fire-light, which was too dangerous—while being lowered by a rope into the bowels of the system. This early work with tubes and valves “led to the later discovery that in the bronchial tubes there are vitally important pathologic mechanisms parallel to the stop valves, by-pass valves, and check valves fundamental to pipes, pumps, and plumbing. My whole life’s work with the air and food passages seems curiously parallel in its fundamentals to those boyhood days as a plumber’s cub” (LCJ, 49-50).

  These were some of the felicitous facsimiles of his later work as a plumber of physiological depths, a training ground that might seem anomalous for future work with bodies—mightn’t Jackson have become an engineer instead?—but the examples enjoy a handsome fit with Jackson’s later medical practice, a link more poetic than formulaic, a charming precedent, an enchantingly imaginative correspondence. The conditions of possibility become both affectively darker and more relationally opaque, however, when they involve prototypes of entrapment and rescue that occur at the site of Jackson’s own body and that implicate his very being, his psychological and physiological welfare. Among the many persecutions Jackson suffered at the hands of the bullying boys who were his neighbors in the countryside outside of Pittsburgh was being choked with both hands around his neck “until unconsciousness approached,” “choked into submission” (LCJ, 30). Later on, Jackson would make a life’s practice of only nearly cutting off somebody’s air supply in order, ultimately, to help them breathe. En route to the Greentree School, where he was mocked for being both smaller and smarter than most of his male peers, he was regularly “waylaid, tormented, and tortured” (LCJ, 29).

  The first of two prototypical episodes involved the boy Jackson’s lunch pail. Some days, it was confiscated altogether; other days, the food was rendered inedible by the sand, coal ashes, or rotten eggs the other boys concealed inside a bread-and-butter sandwich. Sometimes the bullies attached “the little tin luncheon bucket” to a dog’s tail and sent the dog running until the food landed in the mud and the container was lost. In one example, Jackson revisited the lunch pail as a metaphor for the bodily passages, the “bread basket” he would later excavate with a tube. The pail had been purposely crushed by a wagon wheel and Jackson’s “painful, fruitless efforts to get [his] little hand into the crimped top and extricate some morsels of bread” (LCJ, 31) delighted his tormentors. When he, “ravenously hungry,” hit upon the idea to pry the bent top open with a woodman’s iron edge, borrowed from a rail-splitting farmer, he discovered that the sandwich still could not be eaten because its insides had been “sprinkled with earth” (LCJ, 31). He concluded with a kind of moral: “This was a curious parallel to hundreds of happenings in the bronchoscopic work of later life, in that the reward for the solution of a difficult mechanical problem was the satisfaction of achievement, nothing with which to satisfy hunger” (LCJ, 31).

  The lesson is a peculiar one that recurs in the autobiography—that satisfaction must be had through the solving of a mechanical problem rather than the satiation of hunger, and it stands as an impetus for Jackson’s lifelong asceticism, as though he mastered the fact of forever tainted, inedible food by fasting: by proving he could live without it. Or by proving that he could meet his hunger by climbing to a higher level—by cultivating an appetite for achievement rather than for food. He also proves his aggressors wrong and thwarts their own satisfaction, because in the end he not only reaches the inedible sandwich (a fbdy in the making) but spends his life demonstrating that nothing is beyond his reach.

  Jackson’s abuse at the hands of others takes on extreme proportions in a second episode that lodges like an unforgettable centerpiece to the entire autobiography. Always there is an extra, over-the-top element of pathos in these scenarios, as if to heighten the abjection: school was dismissed early because of some falling plaster, and Jackson was “elated” with the thought of getting his chores done before dark so he could work in his “little shop” before supper, but he was attacked from behind by a group of boys, blindfolded, bound at feet and hands, and dropped into a coal pit.

  Like a living foreign body, a foreign body embodied, he was stuck deep within a mine that apparently had no exit. The darkness was absolute, he was freezing-wet and cold, the ceilings were too low for him to stand upright even after he had untied himself, and the more he groped inside the labyrinth, the more lost he became. Woozy and numb, faint with exhaustion, he dropped to the ground and lapsed into unconsciousness until he was awakened by the feeling of a “rough tongue licking [his] cheek.” A “harnessed pit dog” had happened upon him, but, rather than initiate a Disney-style rescue, the scene unfolded into further violence and frustration: the miner who owned the dog called after him and thrashed him brutally for running away while Jackson became overcome by aphonia—he was entirely unable to cry out or to cry out loud enough to be heard (LCJ, 34).

  The dog was persistent, however, and, escaping his “flogger,” returned to Jackson in the mine, finally prompting the miner, whom Jackson describes as a kind of fairy-tale giant, to crawl in. “Welsh Davy, the champion prize-fighter, and champion blasphemer of the whole mining district” lifted Jackson’s stunned and stricken body out of the mine. Thereafter he was watched over for weeks by Davy’s wife, Jackson’s mother, a doctor, and a group of nuns; extremely ill, he lapsed into deliria, crying out to his dog-savior, “Jack, don’t leave me. Oh, don’t leave me here, Jack.... I’m so cold. It’s so dark” (LCJ, 36). (Does it matter that Jackson’s animal savior is his namesake?) Welsh Davy couldn’t be properly thanked when the boy recovered because he had been captured by police who were hunting him for a murder committed in another town. Neighbors reported, “It tuck ten officers tuh kill him, ’n six tuh carry him away” (LCJ, 37). The image that stays with Jackson of Davy, “indelibly fixed in memory” though Jackson was “dazed and semiconscious,” is of a (proximally) illuminated miner: “the vivid picture of the smoking lamp swinging to and fro on Davy’s oily cap as he crouched and swung his huge frame along” (LCJ, 35).

  It’s one thing to imagine things stuck in oil wells or bottles as prototypes for foreign bodies that need to be removed from people’s airways and stomachs, and quite another to be oneself trapped inside the horrific many-mouthed body that is a mine. Perhaps it was this element of his own body as the thing that needed to be solved that took Jackson from plumbing to doctoring. Mining, of course, was the bedrock for his future work, but there’s a class element at play. Throughout the autobiography, Jackson presented coal miners as if they were a different species of human than himself—brutish, crude, violent, alcoholic, illiterate, and profoundly not him. He, on the other hand, became a miner who didn’t get dirty, a more refined sort of miner who valued work and was a laborer to the end but who distinguished his work as a source of self-cultivation and self-making.

  He was a miner who didn’t get dirty, who didn’t suffocate underground, who mined the body rather than the earth, but sometimes he found himself awash in someone’s spittle, and other times he saw through his scope what it looked like for a person to drown in her own secretions, which he then illustrated in oils.

  When Jackson was still a medical student, he experienced his own fbdy when the bone of a reedbird he had eaten for dinner lodged in his tonsil. The fbdy was removed without incident at the college, and did not inspire his later work removing foreign bodies, though it did put him off meat (LCJ, 59).

  Jackson’s prototypes of rescue fall neatly into two classes: early experiences rooted in curiosity or in dread. Juxtaposed, they traverse a space between interest and terror, between the experience of being intellectually curious and that of being entirely overwhelmed, between being animated and b
eing paralyzed. Somewhere in the space between these poles of fascination, each of us arrives at our own embodiment as desiring beings in the world, however haunted. The results are never swell or whole or true: like the foreign body collection that it is an answer to, The Life of Chevalier Jackson is full of ghosts, and it leaves its readers with images of lingering horror. For me, it is the picture of “a little pit mule blinded with a sharp-pointed coal pick because of the refusal to enter the black darkness of the pit mouth into which it was required to drag the pit cars” (LCJ, 15). All of the mules in the pit were blind. It’s an image that Jackson himself can’t shake, the “shocking cruelty” of innocent creatures punished for their refusal to enter in, carrying the burden of man’s progress in the dark. It might be why he lighted passageways.

  II.

  HOW DOES SOMEONE SWALLOW THAT?

  If I wish to describe a little child, . . . I must show you something of his oral interests.

  —ADAM PHILLIPS, quoting D.W. Winnicott

  A button box is a dangerous plaything.

  —CHEVALIER JACKSON, Diseases of the Air and Food Passages of Foreign-Body Origin

  Between Carelessness and Desire: Getting Objects Down

  Sometimes if I’m reading at the computer, like now, I hold my pen between my teeth, the way a dog holds its bone, but then I might also move it out from my teeth and enjoy the feeling of its cool plastic and rubber parts resting between my lips alone. Chomping gently down, head erect, serene, I read a line from Jackson: “Putting inedible objects in your mouth increases your risk of choking.”