Sunday, December 19, 2010
Chapter 11 "CASTENATA" & CHAPTER 17 "SISTER MYSTERIES": VILLAINOUS DOCTORS, and VILE MEDICAL TREATMENTS
NOTE TO READERS: It was only when I went to post the following chapter this morning on the Castenata site, that I realized that FOR THE FIRST TIME THAT THE TWO BOOKS I'M WRITING HAVE CONVERGED in a number of rather remarkable ways. In this chapter, Sister Renata (writing in her diary on July 30, 1883) is enraged at the physician, Astorga, for the cruel mercury treatments he inflicts on Antonie in an attempt to cure Antonie's syphilis.
Readers of "Sister Mysteries" will surely be reminded of Chapter 16, and my own outrage at the doctor at Sloan Kettering, who in July, 2003, INSISTED THAT I NEEDED A STEM CELL TRANSPLANT when I didn't. A specialist at Dana Farber in Boston confirmed a few weeks later that the doctor at Sloan had screwed up, and that this outrageous physician was motivated to put me through the hellish and life-threatening stem cell perhaps because he was DOING A RESEARCH PROJECT AND I FIT THE BILL. The rage that Sister Renata feels toward Astorga is precisely the rage I felt, and still feel, toward the oncologist at Sloan, who was at best, inept, and at worst, unethical.
It is remarkable to me that I wrote all of this fictional material in Renata's voice seven or eight years BEFORE my cancer, and before my deeply disturning encounter with the oncologist at Sloan and all of the issues attendant on brutal medical treatments.
There are a few other remarkable coincidences, too:
1) I saw the doctor at Dana Farber on July 30, 2003. Meanwhile, I had written this Sister Renata chapter many years ago and I had dated it JULY 30, 1883. It is only this morning, again, as I went to post Renata's diary chapter here, in its logical order, that I realized this astonishing convergence of dates.
2) The conversation that Sister Renata has with Dr. Astorga addresses the issue of mercury treatment for syphilis. By at least one historical account, mercury treatment is part of a long tradition of "unethical" medical treatment/research. According to the medical journal Dermanities, "mercury is the earliest known chemotherapy for syphilis."
3) Readers of "Sister Mysteries" will recall, in Chapter 16, that my cousin Carol is now suffering desperately from the after effects of TWO stem cell treatments that she got for non-Hodgkin's lymphoma. I REALIZED JUST THIS MORNING AS I WAS POSTING RENATA'S DIARY, that Renata's cousin, Antonie, and my cousin Carol, are BOTH in San Francisco suffering from the horrific medical treatments that were supposed to help them.
I wish I understood these "coincidences," but at some point, it doesn't really matter. It is just remarkable that they keep happening!
July 30, 1883
It is well past two in the morning as I sit down here to write in the diary, but I am still trembling and quaking after my encounter with Astorga. It shames me to think that he could make me so enraged, that at one point I thought I would kill him with my bare hands. And so now, before I sleep I must write my thoughts. I must tell what hell I have been through and how it all came to spill over.
I am so terribly weary of San Francisco. It may serve Antonie’s purpose, although that too now looks doubtful. But clearly this is no city for a lady, let alone a nun. I have never spent so much time away from the convent, and the simple routines of country life.
I miss the hazy blue views toward the coast, the golden hills to the east, the smell of fresh air everywhere around me. San Francisoo is crowded, dirty, and life is rowdy, to say the least, and our hotel, while the most comfortable the city has to offer, still attracts a rough and uncultivated lot, particularly to its first floor bar. Most of the time, I walk the city streets with my head bowed, staring into the wooden slats of the sidewalk.
We have been here now past one week, but still there is no predicting how much longer we will stay. There is no saying either how the quicksilver treatments will go. We are living one grueling day, one hour, to the next. We are unsure whether anything in Doctor Astorga’s bag of tricks – bichloride of mercury injections, the mercury rubs and plasters, the ungodly concoctions by mouth that mix potassium iodide into syrup of sarsaparilla or zingiberis—will work. Indeed, all these bizarre treatments and odd brews may fix nothing, and only make my cousin worse. Dr. Astorga won’t admit it, being the proud man he is, but I believe that the mercury and iodide treatments may in fact kill Antonie faster than the syphilis itself will.
So far, the doctor claims, it seems that the injections – or perhaps it is the ointment – have helped. The lesions do seem better. But in exchange, Antonie is coated in gleaming circles of silver ointment, making him into a quilted patchwork of thin mirrored coins. Worse, he has now begun to salivate, and even occasionally, to vomit blood. When that happens, I only wish I could run away. But I continue to do my duty and stay, and mop my cousin’s face and remove his soiled gown and take away all evidence of his wicked illness.
Lately, he has begun complaining of constant burning pain. A dark and putrid diarrhea rains from his bowels, and he describes a taste of slippery metal taking over his tongue. His gums have the characteristic blue line that Dr. Astorga described, and the tissues of his mouth are far more red and sore than before we came. Antonie moans constantly in his sleep, and when he’s awake he says it is his whole body, aching.
This morning, though, he had one of his clear periods. A miracle happens, and for a time, he seems almost himself. His appetite returns in force, and he begs me for something hearty to eat, “a thick steak, a breast of chicken.” Ah, but just as soon as I go to the hotel kitchen, and return with such a meal, he is feeling ill again. His appetite slackens, and he claims that he can feel a rapid loosening of his teeth, and indeed, one of his molars freed itself up in the grits I mashed into his soft-boiled egg this morning.
I shiver to think what will become of him. I keep praying, asking the Lord to show mercy toward my cousin. Despite all that he has done to me, all that has gone wrong between us, Antonie is still family, and he is, right now, so desperately sick and in need of some relief. “Thy will be done,” I say, over and over again. “Oh please, dear Lord, come to the aid of my cousin, relieve him of all pain and suffering, free him from this earthly burden. He has paid for all the sins committed against me. I release him from all past responsibility.”
Sometimes I pray that way. But sometimes I ask the Lord simply to take Antonie. Put him out of his constant misery. One thing is a certainty, I have prayed more in the last week than I ever have before. But are my prayers helping? Will they work? I dare to wonder. I know that having doubts in my Almighty God’s power is in itself sinful. But there are times, lately, when I have begun to ask, where is my Lord?
This brings me to what happened earlier today. It was about four o’clock when the distinguished physician knocked at the door, announcing one of his two daily visits. Senora and I were kneeling, as we so often are, on either side of Antonie’s bed. Before we could respond, the doctor opened the door and strode inside, indifferent to the fact that we were deep in the rosary. We hurried to complete our final Hail Mary even as the arrogant doctor leaned between us and laid his stethoscope to Antonie’s slick chest.
“Can you tell me please, Dr. Astorga, when my cousin’s fever might break?” I whispered. Astorga remained silent as he continued with the stethoscope. When the doctor finished, he answered abruptly, and in a callous and discourteous tone. “I have no way of knowing that,” he announced. “We are waiting to see if the mercury treatments will help.”
Folding the stethoscope, he dropped the instrument into his leather bag. Lifting Antonie’s thin white wrist, he began counting my cousin’s pulse against the gold timepiece he had removed from his vest pocket.
“Does he sleep much?” Astorga inquired, letting go of Antonie’s wrist as if it was a fish he was casting back to the sea.
“Well, yes, I believe so, but he seems more tired each day,” I said, trying to find words to characterize my cousin’s almost constant stupor.
“What do you mean, you believe so?” Astorga asked, accusing me with his eyes. He lifted the bed sheet and rolled it back, exposing the full length of Antonie’s pathetic emaciated body. The simple white gown my cousin wears cannot hide his arms, which are as thin as wooden canes. His legs resemble slightly thicker poles. His sickly white feet lay one on top of another, the same way Christ’s feet did when He was nailed to the cross.
“Antonie does sleep much of the time, but he keeps waking now and then, too,” I replied, angry that Astorga would question how carefully I was observing my cousin. “And when he does wake, he keeps saying strange, almost nonsensical things. This morning, for example, he pointed to the window and called out, ‘The blue wolf, the blue wolf, I will follow the blue wolf as it races through the forest into the pale moonlit sky.’”
Astorga snorted. “Ah, so the hallucinations are worse,” he mused, pulling the bedclothes back up to Antonie’s chin so rapidly that the sheet snapped as if was a sail in the wind. “I am not at all surprised by that. But pay no heed to what he says.”
“Doctor, in those moments when he speaks, and particularly when he speaks of me, it is quite difficult not to pay attention,” I murmured.
Astorga glanced at me, annoyed, I suppose, that I would once again challenge his medical wisdom. “May I suggest that when he yells out, that you simply pretend that he is a dog barking, or a bird chirping. Or perhaps even a baby crying. Yes, think of him as an infant who has been fed, bathed, burped and freshly diapered. At some point, my dear, you must ignore the baby, and his crying, because there is nothing more to be done.”
My teeth set together and my face reddened. My head swirled. What was he saying? How could he possibly suggest that we simply ignore Antonie? And what business did he have comparing my cousin to a dog, a bird, a baby? I studed Astorga’s crisp white ruffled shirt beneath his jet black waistcoat. I noticed, too, the doctor’s string tie, how it ran vertically, and how his dark pencil mustache ran just as thin but in the horizontal direction above his upper lip.
“I would also suggest that it is probably fruitless to try to fight this fever,” Astorga said. He spoke in a short, peremptory tone. He was snapping shut the clasp on his black bag, his fingers long, brown and tapered. “I would in fact suggest that in cases like this one, that the heat, the intense fever, may actually be of some help, in conjunction of course with the mercury injections. Assuming of course that the mercury works at all.”
“I see,” I said, nodding, as if agreeing with Astorga’s point of view. But in fact, I wasn't seeing at all. OR, I was seeing in still one more way how terribly blasé this physician was toward his patient’s suffering. How could he be so absolutely indifferent to Antonie’s desperately-intense fevers? And how could he visit the horrors of mercury on this poor man without any qualms whatsoever?
Once again it struck me: my cousin should not be here. He should not have to continue to endure this villainous doctor, and the horrors of the mercury. The liquid white metal is hardly a cure. Antonie has deteriorated considerably since we arrived. The cousin I have known all my life has, in the last few days, all but disappeared. He is transformed into a haunting shadow, one that once had a body attached, but has none anymore. His flesh has burned away, his arms are but living stems of pain and agony, and he complains of headaches that make him cry out, bellowing over and over again, ‘please tell the doctor to kill me please, so it will be over, please.”
Just after the doctor departed, Antonie woke with a jolt. His skin was clammy and hot and he was trembling with such force that I was not sure I could keep him on the bed. Señora brought a fresh bowl of crushed ice, and filled a washcloth and set it to his head. He fought her, though, and didn’t know where he was. He clung to me, but didn’t remember my name. He called me Adelaide, which made me cringe, for Adelaide was the prostitute that my cousin consorted with for years, the woman who made him ill.
Apparently, Antonie had been dreaming a particularly nasty nightmare, something about Adelaide coming to him at night, all he would say was, ‘she was smoking one of her thin cigars, and I asked her, ‘why are you here?’ and she smiled in that way she does and said, ‘I am here, to end your misery,’ and then she threw the cigar to the bed and began to choke me and the cigar lit the sheets on fire and I was burning up, and she was choking me and there was smoke, dark dark smoke everywhere.”
There was nothing I could do to ease his delirium. He was sweating so profusely that Señora and I rolled him, as we so often do, in the sheets and stood each of us at an end and heaved him up and lowered him to the floor. As she kneeled and sponged his rubbery limbs, I laid a new towel on the feather mattress and tucked a new sheet into the corners. All the while he kept yelling, “No Adelaide, no, please, let me go, let me go…”
When we finally had him back in bed and we had his head propped on an extra pillow, I fed him sips of weak tea, heavily sugared. After a while, he seemed to calm down, and spoke of the dream. “I was desperate to get out of her bed, but she laughed, so this is how you repay me for the way I have given you pleasure? And afterward, was when she smoked and the fire, the fire, the smoke it was choking me, and I couldn’t get out…” And now he was sobbing, and I held a cup of cold water to his lips.
“It was only a dream,” I said.
He nodded, and I set him into the pillow. And then I sang to him. I held his hand and I hummed one of the soleares we both knew. Every time his eyes opened, I would reach over to gently close his lids again. Finally, he drifted into sleep, and Señora took my place at the bed. She told me to leave, and I decided I would pay a visit to Dr. Astorga, to say the things that I hadn’t said. I decided to tell Astorga that we would discontinue Antonie’s mercury treatments immediately. We all need to return home.
It was close to five when I reached Astorga’s office. I knocked, and he admitted me, but then he kept me waiting for almost an hour. I spent the time in prayer, but there were moments when my anger surfaced nonetheless. Finally, he brought me into his office, only to inform me that he would have no more than a few minutes to spend in conversation.
“So please, my good Sister, get right to the point.”
I blushed, and my anger and humiliation crested together at my lips. I tipped my head forward and would have lost my voice, except then I had a vision of Antonie’s ravaged body. Instantly I found my focus, and my voice.
“When we came here a week or so ago, we had no idea what the mercury would do, or what to expect, or whether it would help,” I began, trembling.
“True, one can never know those things,” he replied.
“Well, so, now that I have seen how…how, well, how absolutely brutal the mercury can be, I want to discontinue Antonie’s treatments. I want to bring him home to die in peace.”
Astorga’s eyes widened to two black coins and he lifted his chin in that arrogant and defiant way that he often does. “Are you saying, my good Sister, that you are prepared to take your cousin’s life?”
“I said nothing of the sort,” I said, struggling to maintain a steady tone. “I said only that he isn’t getting any better with the mercury. And in fact, he is suffering desperately, more than he ever has before. In light of that, I believe that it may be the most humane thing to do, to let him be. And to let God’s will be done.”
“Ah yes, so now I see that you are the one to decide God’s will in this matter, is that it? You are choosing for your cousin? You are willing to discontinue the only treatment that may prolong your cousin’s life? Let me ask you this, what does your cousin say? How does he feel about this matter? Because of course, it is his life that is at stake. Make no mistake.”
“We have discussed it briefly. He has at times begged for someone to put him out of his misery. I believe that I can say with confidence that Antonie has now begun to realize that the mercury is hopeless. He has screamed on numerous occasions that he would prefer to die rather than to continue to suffer. So I would suggest that he has accepted the possibility that death may follow his return home.”
“Oh yes,” Astorga said, clasping his fingertips together beneath his chin. “So in other words, you have convinced him to give up?”
I stood, flooded suddenly with anger that I could not control. “How dare you say that to me. I have spent weeks caring for my cousin. I have remained closeted in a room with him, attending to his every need, mopping his brow, swabbing him when he bleeds, feeding him whenever he can take the food. You have no right to accuse me this way.”
My voice rang through the office, and my hands trembled so much that I could barely hold them in my lap. “I have simply told Antonie that the misery won’t end until he decides to end it. And I have prayed for him, and prayed that the suffering will be over, and now, it is clearly time that we return home so that he can live out his final days in the tranquility of the home where he grew up. And if you knew anything about human dignity, Doctor, you would agree.”
Astorga ignored my insult, and smiled his thin wicked smile. One thing I know, I have come to hate that smile.
“How very kind of you, Sister, to take such a benevolent attitude toward your cousin,” he said. “Are you always so convinced that you know the appropriate time for someone to die? Or did someone at the convent, or in the church, perhaps, endow you with a special privilege in this matter, that you should know when it is right and proper for your cousin to give up on life, to die in what you call tranquility…”
I will be truthful. What occurred next should not have happened. I am not proud of my behavior. I deeply regret letting my temper get the better of me. All I can say by way of explanation is that I have endured more from Astorga –and Antonie-- than anyone should have to endure. And that I have been living under enormous strain especially this past week.
Simply put, I was transformed, in that moment in Astorga’s office, into a raging bobcat or maybe a vicious mountain lion. I grew claws and I flew at his face. I began screeching and scratching, and I raked his cheeks bloody and pounded my fists into his white ruffled shirt. I screamed until my throat felt bloody. I pulled his pomaded black hair.
The rest, well, the rest I don’t remember. I hadn’t eaten, or even had anything to drink, all day. And that may explain it: I fainted, you see, at that very moment. The rage in me, thankfully, closed me down. I say thankfully because if I had remained conscious, and on the attack, there is no telling what black havoc I might have wrought that night. I end this now, pulled heavily toward sleep. But still frightened at the rage that lies within me. I lose all sense of civility, every ounce of devotion to the Lord’s cause. Something inside me snaps and I turn grizzly, and my victim is at my mercy, and I am not responsible for what happens, deep within my skin.