by Linda Wolfe
It will forever be a stain on the history of medicine in America that the Marcus twins, whose psychological condition was known to their colleagues—if not fully recognized as a drug problem—were allowed to continue to practice and to remain on the staff of a major New York hospital. But they were. And although the hospital did eventually drop them, the decision was not made in time to prevent the brothers from jeopardizing the safety of several patients.
In March 1974, Cyril, sweating profusely and unsteady on his feet, undertook to circumcise a newborn infant. A technician who was in the room with him looked up to see that his hands were shaking and that he was trying to cut the baby’s foreskin by sawing it with the dull handle of his surgical instrument. Terrified, she ran for help. But when the help she had summoned—several other doctors, including the head of the department—arrived, Cyril was allowed, under their supervision, to complete the procedure.
A year later, in March of 1975, a similar incident occurred, but this time it was Stewart who, pale, weak, and with unsteady hands, undertook a circumcision. This time it was a nurse who intervened, and this time Stewart was enjoined from continuing the procedure and sent home.
Between these two incidents, the chairman of New York Hospital’s Department of Obstetrics and Gynecology did make an effort to restrict the activities of the brothers. Cyril, who one day collapsed outside an operating room and hurt his head so badly that he required hospitalization, was instructed to take a four-month medical leave of absence. And Stewart was asked to take a vacation, which he did—for a month. But even in the period that the brothers were theoretically personas non grata at the hospital, they somehow managed to continue to admit patients.
Why would patients continue to use them, continue visiting their intolerably dirty office, bearing their infuriating taunts and tantrums? In a way, this was the greatest mystery of all about the Marcus brothers’ case—or a tragic fact about women as consumers of medicine. Several of the women I spoke with who had remained patients of the twins until the bitter end explained to me that when the doctors flew off the handle, they’d assumed they themselves were somehow at fault, thus they’d accepted whatever rage was directed at them. Others told me that the opposite side of the brothers’ rages was reminiscence and revelation: with their waiting room no longer full, as it had been in the sixties, the doctors would often spend hours with their remaining patients, talking about their philosophy of life, their fear of death, their conviction that “the good die, the bad live on,” and they felt flattered by these attentions.
Susan S. Lichtendorf, a woman whose first child was delivered by Caesarean section by Stewart Marcus only weeks before the twins died, wrote an article in Ms. magazine in which she explained the insecurity and respect for medical authority that kept her seeing the Marcuses despite their obvious peculiarities: “I didn’t want to seem … like a ‘difficult’ pregnant woman by questioning my doctors, so I overlooked the fact that they kept forgetting to make my hospital reservation.” And, “I squelched suspicion.… I was glad that in a city famous for money-mad doctors who jam their waiting rooms and whiz through examining rooms, the Marcus twins appeared to be limiting their practice and took time with me.”
Why their hospital tolerated them is another matter. It may have been because their supervisors and colleagues, remembering their past accomplishments, felt a certain loyalty to them and cherished the hope that in time they would be rehabilitated. But more likely it was because, as several doctors have suggested, the machinery for dismissing a doctor is extremely cumbersome. Unless a hospital can prove that a doctor deserves to be dismissed, he can level a mighty lawsuit against his institution.
Nevertheless, by 1975 Dr. Fritz Fuchs, chairman of obstetrics and gynecology, seems to have at last decided to try to prove such an argument. Probably hoping to arm himself with sufficient evidence that the twins were addicted to drugs, he asked the other members of his staff, doctors and nurses alike, to keep the Marcus brothers under careful scrutiny and to alert him whenever they admitted a patient. He did not know at that time that they had already been dismissed—Cyril in 1973, Stewart in 1974—by Lenox Hill. But he did know that as a result of complaints from patients whose insurance forms hadn’t been filed, the twins were being investigated by the New York County Medical Society.
Fuchs’ staff watched the brothers closely, and one day in the spring of 1975 the chairman informed them that they were under suspicion of being drug addicts. Unless they did something about their habit, he warned them, New York Hospital would soon dismiss them.
They denied that they were addicts.
Fuchs repeated the charge, and offered them two choices. They could either take a medical leave of absence, and get treatment for the drug problem, or they could resign.
They were enraged. They argued with him. They pointed out that whichever course they took, they would lose their reputations.
The chairman was unmoved and repeated that they must get treatment or resign. If they did not, when their current appointment at the hospital expired on June 30, they would not be reappointed. He gave them until June 12 to let him know which path they would be choosing.
They didn’t get back to him, and on June 12 he called them, reaching Stewart. Stewart said they’d been unable to decide what to do and asked for more time. He’d call the chairman with their decision by June 16, he promised.
He never did, and the next day Fuchs recommended to the hospital’s board that the twins be dropped.
It was, unfortunately, a decision that was not made in time to prevent a near calamity. On June 17, one of the Marcus brothers’ pregnant patients arrived at the hospital’s emergency room bleeding severely and apparently aborting. Cyril admitted her, then left the hospital. She continued to bleed profusely. Three hours later, Stewart arrived. According to the woman’s husband, who had been waiting all this time for someone to staunch his wife’s hemorrhaging, Stewart was sweating, barely coherent, and “looked like a drunk who was just pulled to his feet and about to fall over again.” When he examined the patient, he seemed not even to notice that she was bleeding and directed the distraught husband to take her home.
The husband sought assistance. Other physicians assumed control of the patient. Stewart was directed to leave the premises. And that day was his and Cyril’s last at the hospital.
In the next few weeks, the brothers finally attempted to right their self-destructive course. Although they were callous men, reckless, self-centered, and irresponsible, one must in the end feel some pity for them, for they made a risky, dangerous stab at change. They holed up in Cyril’s apartment, laid in a stock of food, drink, and anticonvulsive medication, and tried, on their own and without assistance, to withdraw from barbiturates.
They must have suffered, even felt seizures coming on, for they consumed the anticonvulsant. Then they must have lost their will for withdrawal, for they went out and obtained additional barbiturates. Bottles of Nembutal with late June drugstore dates were found in the apartment—empty.
After this, they remained in the rooms together, speaking to no one, letting the phone ring unanswered, rarely eating, barely conscious, so drugged that one of them, at least, could not maneuver his way to the toilet and made use of the armchair.
On July 10, New York Hospital’s medical board met and discussed dropping the twins from the staff. And sometime between July 10 and July 14, Stewart took an overdose of Nembutal and died.
Cyril was still alive, and perhaps for a moment he considered saving himself. He left the apartment, took the elevator down to the lobby, and started to make his way out of the building and into the world. He was observed by the doorman, who, noticing how sick he looked, offered to help him negotiate his passage.
Cyril dismissed the doorman’s solicitude with astonishing rudeness and sudden strength. “I can manage on my own,” he said, brushing him away. But of course he couldn’t. He and Stewart had spent too many years managing as one person. After shrugging off the
doorman, he abruptly returned to his apartment. Perhaps he had realized that alive, he would forever be—like most other people in the world—an isolated, separate being, and the thought was odious to him.
Inside, he did all the things that suicides usually do. He left a kind of note, typing the name and address of his former wife on a piece of paper and tucking it into his typewriter. He even tried to leave a clue about his decision to die with Stewart. He placed a copy of Iris Murdoch’s novel A Fairly Honorable Defeat face down on a pile of papers in the middle of one of the rooms. The story of a cynical man who tries to break up the love affair between a homosexual and his lover, but succeeds in causing, instead, the suicide of the homosexual’s elder brother, it is a book about separation and loss; it was the only book found lying about in Cyril’s apartment. His other books, chiefly scientific works, were all neatly shelved when police entered the otherwise chaotic rooms.
After setting out the note and the book, Cyril seems simply to have sat still. Apparently he took no further drugs, for the autopsy revealed none in his system. And apparently, again according to the autopsy, he did not experience a seizure. He seems, rather, to have died as a result of remaining at Stewart’s side for several days, eating nothing and growing ever more emaciated, waiting for death to come and reunite him with his twin.
A day or two later, neighbors complained of a smell emanating from the apartment. “They thought there was a dead rat or something in there,” handyman Bill Terrell said.
He went to the door of the apartment—and then, without entering, summoned the police. “I knew at once what that smell meant,” he said. “I’d been in combat.”
Many people I spoke with after the twins died felt that there was something mystical about Cyril’s behavior and suggested that he had been, in effect, almost drawn against his will to share his brother’s fate. It made me realize that some primitive terror of twins still lurks in contemporary man. We have come eons away from the kinds of superstition that drove the aborigines of Australia to murder one or even both of a twin set at birth, that prompted some West African tribes to kill not just twin infants but the women who had given birth to them. But some of us (perhaps like the Marcus brothers themselves) nevertheless attribute to twins superhuman sensitivities like extrasensory perception or the ability to communicate without words. And when these doubles, born on the same day, die at the same time, their fate arouses in us an almost primordial anxiety.
How can it happen? It can’t, and yet it does. It happened in New York in 1952 when two ancient twin sisters were found withered from malnutrition in a Greenwich Village apartment, only to expire after their discovery within hours of each other. It happened in North Carolina in 1962 when twin brothers, hospitalized for schizophrenia, were found dead within minutes of each other at separate ends of the institution. The simultaneous or nearly simultaneous death of twins happens rarely, but when it does, it seems like some mysterious arithmetical proposition far beyond the ordinary computation involved in life and death, and it so frightens and unnerves us that we seek extrarational explanations.
But mysticism is unnecessary in the case of the Marcus brothers. The explanation for their nearly simultaneous deaths lies in the extraordinary attachment they felt toward one another and the extraordinary disregard they felt for the world of singletons.
THE DOWNWARD DRIFT OF A HIGH SCHOOL STAR
Torrington, Connecticut, and New York, New York
1981
I BECAME INTERESTED in the case of Gerard Coury, a young man from Connecticut who met his death in a New York City subway station, because there was something about the story that did not jell. Coury had been set upon by a gang of Forty-second Street regulars—pushers and panhandlers, the addicted and the addled—sometime in the red-eye hours of a summer Saturday in 1981. Shirtless when they surrounded him, he emerged from the crowd’s midst altogether naked. Then, in a state of panic, he began running down the street. The mob followed, jeering and pelting him with beer cans. Two transit police officers attempted to intercede, but Coury bolted from them, too. Racing, he ran into a Times Square subway station, leaped onto the tracks, touched the third rail twice, and died.
Many things about the story, at least as reported in the newspapers, were puzzling. For one thing, Coury had not, as might have been expected, died of electrocution but rather—according to the medical examiner, who found no burn marks on the body—because his heart had stopped. Further, it was reported that someone in the crowd told a transit officer that the mob had stripped Coury of his trousers. But it was also reported that detectives were unable to find anyone who’d actually witnessed the stripping. Additionally, several New York police officers said they’d seen Coury, shoeless and shirtless, dazedly talking to himself, earlier in the day. One officer, a transit patrolman in Grand Central Terminal, told reporters he’d even detained and questioned Coury, who said that he’d lost his clothes and all his money in a mugging that had occurred a week or two earlier and that he’d been trying to get home ever since. But Coury’s parents said that the young man had been home just three days before.
There was more that was perplexing. The transit officer who had detained Coury in the station had suggested that since he had no money for a ticket home, he call his family and ask someone to fetch him or get money to him. Coury in fact telephoned his parents in Connecticut, and soon afterward the police received a call from someone who said he was the young man’s uncle and that he’d be down shortly to take him home. Coury said he’d be in the waiting room. But later the uncle called the police and said he couldn’t come. The police went to give the young man this latest news, but they couldn’t find him. He wasn’t in the waiting room or, for that matter, anywhere in the station. Apparently, like someone with little grasp on reality, he’d wandered away without waiting for his anticipated rescuer. Yet, according to his parents, the young man had “no mental problems.”
None of the pieces of the story quite came together to make a comprehensible whole. Nevertheless, what had happened to Coury quickly came to be viewed as a sorry symbol of the inhumanity of New York, a Kitty Genovese case for the eighties. Several newspapers said Coury had been “frightened to death.” A national magazine, headlining its report NAKED VIOLENCE IN NEW YORK and terming Coury the “straight-arrow son of a middle-class family,” implied that the young man had been a kind of Everyman, Mr. Small Town America, an average citizen who met his death simply because of the callousness and cruelty of a big-city crowd. Soon, people everywhere began saying that but for the grace of God, what had happened to Coury on the streets of New York could have happened to you or me.
I didn’t believe it. I simply couldn’t rid myself of the impression that there was something odd about the incident. It just didn’t seem feasible to me that an ordinary citizen, pursued by a terrifying crowd, would have fled when police tried to help him. I began to feel certain that if I looked beneath the surface, I would discover that in some way Coury had been complicit in his own death.
Perhaps I wanted to discover this because, as psychiatrists who study the new field of “victimology” are always quick to point out, all of us like to believe that there are no innocent victims. If a victim can be found to have provoked or somehow contributed to his own destruction, then the rest of us can—theoretically, at least—learn to eschew the kind of behavior that did in the unfortunate fellow, and thus we can feel, somehow, safe. Safer, anyway. Of course, I know there are innocent victims. There are children playing on streetcorners who get shot by cruising snipers. Women are raped and beaten by strangers, men robbed and mutilated by macho marauders they have never before laid eyes on. Nevertheless, I couldn’t quite swallow that Coury’s ordeal had occurred simply because he’d been in the wrong place at the wrong time. It’s such a wrong place—Times Square, at least at that time—the middle of the night. Why had Coury been there? And what sort of man had he been?
I began by getting in touch with his mother, Mary Coury, an articulate, mat
ernal-sounding woman who had been devastated by the loss of her son but who nevertheless agreed to talk with me. She said it was because she wanted the world to know the kind of family Gerry had come from. It was a family that hailed from Torrington, Connecticut, a quiet town in the northwestern corner of the state. There, Mary Coury, and her husband, Nimar, a Lebanese American, had settled down more than forty years earlier. And there they’d raised seven children, six boys and a girl. Gerard had been the youngest. He was twenty-six years old when he died.
Mary Coury was proud of her family. “All our kids went to college,” was the first thing she pointed out to me. “My husband is a factory worker, and I never went further than high school, but we sent all our kids to college.”
It was easy to understand her pride. The Courys had often been hard pressed to make ends meet. But Nimar Coury had augmented his factory wages by servicing candy vending machines, and Mary had been an astute household manager. Somehow, the couple had begun to live out the American dream: to arrange for their children to have a better life than they had had. “All our children have done well,” Mary Coury said. “And their children will do even better.”
The eldest son, David, attended West Point and served in the U.S. Army until his retirement a few years before. Marcia, the only daughter, graduated from the University of Hartford and eventually entered the computer division of a large insurance company. (“She was one of the first people the company ever trained for computer work,” Mrs. Coury told me proudly.) The next child, John, went to Boston College, then on to American University for an M.A., and took a job with the Agency for International Development in Panama. Another son, Bill, went to Niagara College and then into business on the island of Barbados. Nimar Jr. had two years at Allegheny College, in Pennsylvania, on a scholarship. And Charles, the next son, had attended the University of Connecticut and was working at a school for troubled adolescents in nearby Litchfield.