"Cholera and Fear" / "Die Cholera und die Furcht"

"'Tis the season," said one of my colleagues, to explain the sudden influx in gifts from patients in a single morning clinic session. One woman who "stress bakes" brought her provider a veritable pyramid of goodies. Others picked up pre-packaged chocolates: foil-covered milk-chocolate balls, Ghirardelli squares, locally famous Sarris chocolate-covered pretzels. You can see that by the end of the day, we had made significant in-roads.

The same morning, the parents of one of my special-needs patients gave me a jar of home-made, preservative-free plum jelly. His father reassured me that he was evidence it was safe, as he had eaten it for years. I did once throw away the fish spread a patient made because my colleague pointed out it was made from "bottom-feeders" who consume who-knows-what, but I felt safe putting this on a bagel with cream cheese. It has an interesting sour-sweetness, and I am delighted they thought of me. Why, then, did I photograph it with my most recent column in the local medical society magazine? Because the parents mentioned they had seen my name in it while picking up the mail for a friend, read the poem and my translation, and were impressed. Since it has already come out, I will share it with you here.

„Die Cholera und die Furcht.“ Von Hermann Friedrichs.           

Schwüle Nacht—Am Thor der heil’gen Stadt,
Die einst Welt und Geist geknechtet hat,
Pocht ein Fremdling mit dem Schwertesknauf:

,,Hollah, Pförtner, schlieβ daβ Thor mir auf!“
            Schaurig dröhnt der Ruf durch Nacht und Graun,
Und des Wächters helle Augen schaun
Forschend in des Pilgers Angesicht:
,,Deiner Stimme, Fremdling, trau‘ ich nicht!

Harre drauβen bis der Morgen graut—

Diese Stadt hat Gott mir anvertraut!“
,,Gott ja sendet mich!“ ruft Jener wild.
,,Komm und prüfe meinen Wappenschild,
Hab‘ vor kurzem erst ihn aufgefrischt,
Wo der Nildunst mit dem Smum sich mischt—
Emsig mäht mein Schwert, wenn ich es schwinge,

Fiebergluthen stählen seine Klinge!“

            ,,Doch der Pförtner, vor Entsetzen bleich:

,,Dennoch,‘‘ spricht er, ,,wehr‘ ich dir mein Reich,
Leistet du mir nicht den heil’gen Schwur,
Mir zu nehmen tausend Seelen nur.
Denn ich weiβ, du bist ein Nimmersatt,

Schafft gern mehr, als Gott geboten hat.“
            Jener schwört. Der Pförtner läβt ihn ein.

Düster schleicht ein Schatten hinterdrein—
Eine Alte, bleich und abgezehrt,
Mit des Allgewalt’gen Schild beschwert.
            Fragend miβt der Pförtner die Gestalt,

Doch ihr Blick durchzuckt ihn meh und kalt—
,,Gott, erbarme dich der tausend Seelen!“
Spricht er schauernd, ,,laβ sie dir empfehlen!“

            Wochen flohn—Die Stadt füllt Schreckt und
Graus.

            Wild, verzweifelnd schaut der Pförtner aus

Nach den Bahren, die vorüberziehn,
Nach den Bürgern, die der Stadt entfliehen.
Heiβ durchwühlt die Adern ihm der Zorn,
Ihn verwundert bangen Zweifels Dorn.
Immer neue Bahren ziehn vorbei,
Immer lauter hallt das Wehgeschrei.
Ach! schon fünfmal tausend liegen todt,
Und noch immer mehrt sich Leid und Noth.
            Endlich kehrt der Gottgesandte wieder,
Läβt zur Rast sich mit der Alten nieder;
Doch der Pförtner fährt ihn grimmig an:

,,Tausend, schwurst du, ungefüger Mann!
Und du brachst den Eid?“

                                                Der Andre spricht:

,,Nein! Denn mehr als tausend schlug ich nicht!
Was darüber, nahm dir diese da,
Stets, auf Schritt und Tritt, war sie mir nah—”
            ,,Und wer ist dies Scheufel?“
                                                ,,Blicke hin,
‘s ist die Furcht, die schlimmste Würgerin!“

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“Cholera and Fear.”  By Hermann Friedrichs.

On a humid night that oppressed matter and spirit, a stranger banged on the door of the holy city
with the pommel of his sword. “Hollah, porter, unbar the gate for me!”
            The shout boomed gruesomely through the night, and the guard’s bright eyes looked searchingly at the pilgrim’s countenance: “I do not trust your voice, stranger! Wait outside until the morning dawns—God has entrusted me with this city!”
            “It is God who sends me!” replied the other roughly. “Come and examine my escutcheon [crest]. I’ve just cleaned it where the Nile miasma and desert sandstorm mingle. My sword reaps assiduously when I swing it, [for] the heat of fever hardens its blade.”
            The porter blanched at the horror: “Nevertheless,” he said, “I will defend my territory against you, if you do not render me the holy oath, that you will only take a thousand souls. Because I know that you are a glutton who likes to do more than God has allowed.”

            The other swore. The porter let him in. Grimly skulked a shadow behind him—an old woman, pale and emaciated, burdened with the shield of the omnipotent one.

            Questioningly the porter eyed the figure, but her stare seared through him, painful and cold. “God, embrace the thousand souls!” he shuddered, “May they be commended to your care!”

            Weeks flew by, and the city filled with terror and dread. The porter watched with fury and despair as the stretchers passed by and as citizens fled the city. Hot anger coursed through his veins, as the thorn of doubt deeply wounded him. Always new stretchers went by, always louder rang the painful cries. Ach! Already five times a thousand lay dead, and the suffering and need continued to increase.

            Finally, the One sent by God returned with the old woman and sat down to rest; grimly the porter rounded on them: “A thousand, you promised, reckless man! Didn’t you break your oath?” And other replied: “No!  Because I felled no more than a thousand!  What is more, you must understand, she was always close on my heels—”          

            “Who is this monster?”  

            “Look over there, ‘tis Fear, the most terrible destroyer!”

 
Citation: Hermann Friedrichs, “Die Cholera und die Furcht,” Die Gegenwart 26 (1884): 86.

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Miasmata, citizens fleeing in panic, a plague sent from God, a moral punch line warning of the evil of fear itself—surely these are not imagery one would associate with a modern, industrial, scientifically-advanced country. And yet, this poem was written not when Europe first encountered cholera in the politically restive early 1830s, nor in 1848 when revolution also broke out (again), nor even during repeat epidemics in 1853-55 or in 1866-75. “Cholera and Fear” appeared in the weekly family magazine Die Gegenwart in 1884. From Calcutta (now Kolkata), Dr. Robert Koch (1843-1910) had just announced that he had identified the cause: Vibrio cholerae. Coming so soon after his identification of Bacillus anthracis in 1896 and Mycobacterium tuberculosis in 1882, it was yet another triumph for himself and the German state that financed his research in Germany, Egypt, and India.

Interestingly, at the dawn of the “bacteriological revolution” (c. 1880-1930), popular imagery of cholera included both reproductions of drawings of comma-shaped bacteria as seen through a microscope and vivid, medieval imagery like exotic mists and sword-bearing phantoms. Hermann Friedrichs’ (1854-1911) poem drew heavily from motifs of colonialism, Orientalism (West vs East, Europe vs Asia), and militarized nationalism then circulating in Imperial Germany

I thought a lot about this poem at the beginning of the COVID-19 pandemic. I considered how older means of coping with disease and societal disruption mingled with new discoveries, such as the SARS-CoV-2 genetic sequence and then mRNA vaccines. While hand washing, mask wearing, and quarantine (or “social distancing”) are tried and true, we have had a hard time giving up xenophobia and the kind of isolationist mindset that hoards vaccine until it expires instead of sending it to low-resource countries. I wonder what future historians will think when they look back to this period and its ubiquitous spiky virions.

"Sew" excited!

In the first year of the pandemic, I played a lot of Settlers of Catan online. (A LOT.) Since there was a lot of swearing at the other players, or the computer, or our internet connection, in the second year I dropped that and picked up DuoLingo, in order to improve my German. I kept that up for 366 days in a row (give or take a few freebies). That eventually began to feel like a chore, so I'm taking a break. Also last year I decided to return to a childhood hobby of cross stitch, which I recently realized is so satisfying because it's a lot like coloring, but slower. There's also a geometrical angle that satisfies the Tetris-lover in me.

Anyway, one reason I decided to cross stitch was because I could do it quietly during Zoom meetings, and the other is that I found a cause to which I could donate the final products, the annual student auction to benefit the Birmingham Free Clinic. This way I get all of the fun of making them without having to figure out how to display or store them!

Here's the entrance to the clinic and the view of the South Side from the porch. The administrator who accepted the pieces was very excited and thinks the students will bid against each other for them.

The canvas for the "wash your hands" signs held up pretty well, so I just set them in hoops hung with some red ribbon. The anatomical body parts I have stuffed with cotton batting with brown velvet behind. I'm working on the lungs right now, which are even trickier than the eye ball.

I've also finished a golden honey bee, which I framed and gifted to a local friend who keeps bees, and I sent syphilis (aka Treponema pallidum) through the U.S. postal mail to a senior historian of medicine in Massachusetts who spent her career researching the Tuskegee Syphilis Study.

What have you made during the pandemic?

What Attending Looks Like

I know I said back when I finished residency and shared my last bloopers post this summer that I wouldn't start a new series about attendinghood. However, every once in a while I would like to give you a window into my world.

Despite how incredibly over-busy I was this week, I made time to look up the tracking number for a parcel that the email that showed up in my work in-box claimed was from the American Board of Internal Medicine. I didn't end up reporting it as phishing, but it sure seemed fishy to get an unsolicited shipping announcement with a link. (Instead of clicking on it, I copied the purported tracking number and entered it into the USPS web tracker. It appeared legit.) Lo and behold, on Friday a big flat package arrived in the mail with my certificate in Internal Medicine. (Photo altered from my real name + MD to "Frau Doktor Doctor, MD PhD.")

The other package that arrived at the same time contained three Lyrica "surgical caps" from Etsy. I started my first two weeks as a ward attending in the hospital today, and I wanted to take extra precautions not to bring COVID home with me. In addition to wearing scrubs (which I don't do when I see patients in the clinic), I bought the caps to cover my hair. They say "one size fits most," but I am unfortunately in the minority: if I pull them all the way forward, the front edge reaches my eyebrows! (My child-sized head is the reason I failed all N95 mask fittings until Thursday, when a special set-up showed that there is exactly one model that fits my petite jaw. The nurse running the test told me I should have eaten more ice cream, because the masks fit better with a double chin.) Dear Husband even demonstrated his remarkable attachment to me by walking 4 miles round trip through Homewood Cemetery on an unseasonably warm Sunday afternoon to a locally owned shoe store so I could try on Dansko clogs to wear instead of my usual sneakers. The risk of me bringing COVID home on my shoes is honestly pretty low, but the risk of me bringing home a drug-resistant bacterium is actually pretty high. They didn't have the fancy punched-out leather ones from their website, so I went with a matte black, waterproof pair that were very comfortable for the 12 hours I wore them on my first shift.

I don't work directly with COVID patients, but I might take care of some while their tests are pending. And there are plenty of others with chest pain, back pain, cancer, asthma exacerbations, bloodstream infections, unexplained kidney failure, delirium after a prolonged hospitalization, and everything else I'll see between now and Thanksgiving. Low person on the totem pole again as junior faculty, I am working on Thanksgiving, just like intern year. I suppose it's just as well, because 2020 is not the year to travel across state lines to eat with other people, not matter how much we love and miss them. (I'm also working Christmas.) Please stay safe out there, wear your masks, and distance as much as you can. Yesterday we got a briefing from the Chair of Medicine about new bed spaces being opened up and asking for volunteers to staff them. We're seeing the aftermath of indiscretions on Halloween weekend, but also coworkers, church members, and households not taking as much as care as maybe they could have. Maybe scrubs, caps, and clogs are "hygiene theater" like having your temperature taken when you walk into the hospital building--today I was so cold after my hike from the far parking garage that the automated robot reader couldn't pick up my temperature at all--but maybe the fact that I'm willing to dress like the virus is serious will help someone else take it seriously too.

The Great American Relay

Thanks to the pandemic, there are no marathons or other running races happening. Then Dear Husband stumbled across the Great American Relay. It is a partnership between the Boston Running Club and the American Association for Cancer Research with 379 stages between Boston and Los Angeles over 36 consecutive days. Because this is a topic that affects DH personally, and because he has missed the chance to do any competitive running this year, he invited our church's new pastor to join him. The legs close to Pittsburgh were already subscribed, so he signed them up for an 8-mile stretch an hour east of here in the Laurel Highlands.

Luckily, I did not have clinical responsibilities on that day, so I drove the two of us out there. It was a beautiful day for a drive sunny. I just wish there had not been a pandemic, so we could have explored the cute little towns of or Ebensburg. As it was, I dropped DH off at the Sheetz, where he met up with the race organizer, Vince, and his running partner. This is the starting line. They set off along the county route, and I drove to the local public library, where I had quiet and free internet to chart review on my patients for the week. I wished I could have visited the local historical society.

On my way to the exchange point, I drove past Ebensburg's war memorial, the namesake of the park in which he would be handing the baton off to the next runner. It was originally planned in 1912, then dedicated in 1915. There are 5,500 names of wartime veterans from Cambria County. A time capsule was buried in 1975, and the park was rededicated in 2011 to veterans in peacetime, too. You can see some pictures here. 

Unfortunately, they made excellent time AND I took a wrong turn getting back, missing the triumphal arrival and baton exchange. Luckily Vince and the guys got some photos; here is a backlit one of them at the parks sign. Unfortunately, DH had wrenched his ankle after stepping into a hole while running on the berm. This made the run less satisfying for him then it might have been, because it kept him off his feet for several weeks afterward. However, he was able to follow the progress of the other relay runners on Facebook.

The last leg ended yesterday with a dip in the Pacific Ocean. We feel sympatico with the final runners, as we visited the Santa Monica Pier in the last week or so before everything shut down for COVID-19. Here are some photos from our spring break trip.