As we arrive before each incarnation of these things again (and again), if we come now to encounter them in person, in actuality, in drawer #133 of the Mütter’s cabinet, and especially if one knows their backstory, they take on a haunting volubility that cannot be undone by their arrangement (see figure 22). Witnessed, the things that the baby passed through his bowel seem to have traces of manipulation, as indices of some other human having acted upon them: she who forced the child to ingest them, to take them in. One safety pin, for example, seems disturbingly to have been bent entirely in half. This makes it hard to place but easy to swallow. This makes it seem as though she tried to make the object edible, swallowable, because certainly it is no longer usable in the way we know a safety pin to be. It has become something else, bent between two fingers, strong fingers, because it would seem to require a tool to do this—or did she crush the pin between her teeth before she fed it to the baby? What we can’t see in Jackson’s photograph of the objects but only “in the flesh” is how beautiful the buttons are, and how small: together they run the gamut from translucency to opacity, all in shades of white. Jackson has arranged them to ascend in size from smallest to largest, and then, in order to harmonize the whole, he’s arranged the burnt matches also in terms of scale, but now from large to small. The snap-piece, what Jackson calls a glove fastener, is alarmingly odd for its difference among these things; more like a sad nipple than a thing, it seems to comment on the rest. And then the whole ensemble resembles one of those activity boards made up of levers and shapes that babies are meant to push and pull and handle. Ah, but there is also an item that leaps out like a crazy squiggle—it’s a bunch of something, it’s static, it’s not happily arranged, it’s a trace of perverse expressivity—Jackson’s or the babysitter’s? It might just be the rubber band displaced after all these years, disintegrating.
A clump, a pile of regurgitated cigarettes. Along with these, Jackson admits, “some unidentified objects.” Placing, re-placing: the pins appear alone again, because we can also find these emblems of Jackson’s two most difficult cases—case #1071 and case #1173—extracted from their home within the drawers and thrown in with the mix of scores of safety pins, their kin, what I have called Jackson’s alphabet of pins, pins turned into cuneiform, piercing, punctuating, staying the page. Here, in this setting, the “most difficult” are now submerged—you have to search to find them, you have to know to know them—as if to say that every case is difficult, and most of these pins are open, even though Jackson closed them in order to remove them, he reopens them to show us what was what (see figure 23).
What will we use the case of Joseph B. to understand? How will we make meaning from it? What can we claim now to know because of it? If we turn to it in an attitude of amazement, does that mean we can’t also be interested in determining the truth of the matter, a handling and begetting of the underlying facts in the case?
Fig. 23. An alphabet of safety pins in which cases #1071 and #1173 appear. Chevalier Jackson Papers, 1890-1964, MS C 292, Modern Manuscripts Collection, History of Medicine Division, National Library of Medicine, Bethesda, Maryland.
What do you give to the man who has (kept) everything? What kind of object can a patient give Chevalier Jackson as a token of thanks? The rooms behind the doors that front the Judy Garland Wizard of Oz glass-slipper display in the Smithsonian Institute’s National Museum of American History harbor a paperweight, an ungainly thing, made out of 2,400 coiled wires, inscribed to Chevalier Jackson: “In grateful appreciation of faithful services rendered to Miss Ethel Hogan, 12/5/22, New York Telephone Company.” In Australia, on the grounds of the Melbourne Boys’ High School in Forrest Hill, South Yarra, a tree was planted in 1936 as official thanks to Chevalier Jackson by the Australian State Department after Jackson removed a nail from the lung of three-year-old Kelvin Rodgers.
The case of Joseph B. distinguishes itself in this: deftly sent, bestowed with gratitude, attached to the pages of the case study appears a gift. Someone has seen fit to send Chevalier Jackson photographs of the boy at various stages of his life to show how well he grew. Many years pass between each snapshot, each a sporadic sign of the continuance of life, each a marker of some moment of pause or of reflection on their bearers’ part, of cataclysm or crisis, some confluence of forces of an afternoon, or maybe it impresses them in the middle of a night, a moment powerful enough to lead the family to remember again and assign a meaning to the day that Chevalier Jackson saved their baby’s life. Here’s Joseph perhaps at eighteen months: he’s standing with the help of a nearby table upon which his left arm rests while the other hand squeezes the sides of his baby clothes, a one-piece outfit that balloons outward like knickers atop a very fancy pair of striped elastic socks and two-tone button-up shoes. He’s not exactly smiling but interpreting with his gaze what a figure outside the frame might be expecting of him. He’s reading a face we cannot see. “Hold on to the table”: he seems to hear this command, but one foot steps forward because he must want to toddle toward the voice that speaks to him rather than rely on something so hard as a table to hold him in the alone-space that is the photo. His family calls him Josie. This we learn from the inscription on the photo, and they send another one of the child in which he looks to be about six. Is there a word for the pose the boy takes in this photo, fetching as freckles (though he has none)? (See figure 24.) One leg is bowed while the other crosses over it in an attitude of adult nonchalance or breezy confidence. One arm rests upon a hip, akimbo, while the hand of the other arm settles once again upon a convenient piece of furniture. His black patent leather shoes are spic-and-span for the occasion of a portrait in a photographer’s studio arranged with urns and vases filled with flowers. It’s a sumptuously fashioned scene that seems to expect the wedding party of which he is a part any minute to arrive. He’s wearing shorts—too casual, perhaps, for a cherubic-seeming ring boy, but just right for a party that might happen upon a green. Someone has combed and then slicked down Joseph’s hair, someone has parted it for handsomeness with loving care. By age fourteen, Joseph appears to be nearing manhood; it’s November 15, 1936, according to the photograph’s penciled note, and he’s agreed to pose outdoors, this time wearing the argyle socks that were the fashion but apparently ill-at-ease and stiffly awkward: he’s arrived at adolescence and is much less darling for it.
Fig. 24. Joseph B., the nine-month-old victim of Case #1173, as a boy. Chevalier Jackson Papers, 1890-1964, MS C 292, Modern Manuscripts Collection, History of Medicine Division, National Library of Medicine, Bethesda, Maryland.
In X-ray, to the untrained eye, every body, including that of a baby or child, appears to be adult. The fact of the human skeleton either ages us or is timelessly opaque. The X-ray of Joseph B. (see figure 25) is a far cry from the photograph of the full-bodied boy. In X-ray, he is parsed into pins extruding out from bones. Their points and protrusions are horrifying; in bold relief, they seem to scream, and the baby’s opened mouth—he, too, must have been crying—is ghoulish without the features of the baby’s face.
Among Chevalier Jackson’s own personal effects, one might have found a lockbox, a container for keeping not radiographs but photographs of the people attached to the fbdy Things. Or maybe the pictures could have hung in the clinic’s waiting room, over-brimming the bulletin board the way any modern veterinarian’s office beams with photographs of treated cats and dogs even if only their owners can distinguish them by name. Paper-clipped to the case, such pictures function as part of the case’s proof-giving data. Held between the fingers of a biographer, they seem to exist in order to excite an intimacy with strangers poised on a bridge of unforgiving time. Root beer soda, buttered bread with honey, hard candy, lime. I imagine the boy imbibed such things, and heartily, well beyond his trauma.
Fig. 25. Fbdy 1173, the case of Joseph B., in X-ray. Radiographer, Dr. Willis F. Manges (1876-1936). Collection of the Mütter Museum, The College of Physicians of Philadelphia.
Jackson attached to th
e case but not the person, and that’s OK. If we reattach the boy in places, it can be to remark how at age six he stands unsubdued . If we attach not simply to a detail of these photos but to the spirit of them—these signs as life—we have to admit that being force-fed was not the only thing that ever happened to Joseph B., even if it was a truly horrible, possibly formative thing. These photos’ auras—I don’t know what else to call them for the way they attach to a part of consciousness more nearly akin to dreams—hover inside our cabinetry with a graceful insistence that, sigh and sigh and sigh, catastrophe was averted. Remaining steadfast to the case study as such, they take on the designation of Joseph-as-robust-specimen. Detached, reattached, remaining, they remind us of the heartbeat in a line: “Thorax: examined with difficulty because of patient crying.”
Fbdy #2440: A Perfect Attendance Pin
I shivered at the slightest pretext. I knew, for instance, that if the physician made a mistake it would be the end of him and of all those who came after him. What could one expect, after all, from a Negro physician? As long as everything went well, he was praised to the skies, but look out, no nonsense, under any conditions! The black physician can never be sure how close he is to disgrace. . . . I felt knife blades open within me.
—FRANZ FANON, “The Fact of Blackness”
The Thing that is “A Perfect Attendance Pin” attaches to story in ways that scores of fish bones never will (see figure 3). The pin lures and enchants and makes us want to manufacture a scene, and it is those two little words that inspire us to do this: “perfect attendance.” The presence of an inscription compels us to restore the sentence the pin has been struck from, to reconstruct a syntax, grand or banal, for the day that issued the pin into its recipient’s world and the day the pin fell out of place too meaningfully, rearranging that world irreparably. With the Perfect Attendance pin, we want to reattach the charm to its bracelet, and we want to laugh or cry at the irony of the accident—the sad twist of fate whereby that which was supposed to bestow honor brought calamity instead.
To hold the material trace of someone’s medical ordeal between your fingers is a sacrament, but the excitement I feel when I happen upon the actual case report for fbdy #2440 in the National Library of Medicine is anything but reverent at first. I’m seduced by the novelty of this object as fbdy and its oddly humorous aspect, until I begin to read this case’s sad details: that the pin belonged to four-year-old Fred J.; that he, unlike the vast majority of Jackson’s patients, did not survive the removal of the pin; that he was African American, unlike the vast majority of Jackson’s patients, who were white. To have the pin but to have lost the boy is horrifying. I become attached to the fact of Fred J.’s address, “24 Newcomb St. Phila., Pa.,” and try to locate it on Google Earth, but from the disappointing distance of a satellite, I mostly find dead ends and parking lots, no trees. I think about the tragedy as part of Fred J.’s family history. I wonder how or if it is remembered by his parents’ descendants, and who now lives in that house where his mother returned to mourn: a house whose rooms were tinted with calamitous death, the loss of a child. A preventable disaster?
Fred wasn’t feeling well when he swallowed the pin—he came to the hospital with pneumonia—and I picture him putting it in his mouth as a form of self-soothing. According to the report, his mother stated
that about 6:00 PM last night child had a pin-button in his mouth. He talked and then exclaimed “he had swallowed the pin.” She patted him on the back and he choked and gagged and “his chest heaved” but the foreign body was not recovered. Then mother rushed him to the hospital where he was referred to Dr. Jackson’s Clinic. No attempts at removal. Patient is having difficulty in getting his breath and complains of pain in his stomach.
I learn that Fred J.’s mother was named Agnes, and that she and his two sisters and one brother were “l. and w.” (shorthand for “living and well”). That she brought her son to Samaritan Hospital, not far from their home, a facility established in 1892 by Dr. Russell H. Conwell (founder and first president of Temple University) on the principles of Christian charity and with the intention of treating the city’s sick poor. In 1930, Chevalier Jackson established a bronchoscopic clinic there. Fred J. entered the hospital on January 14, 1930, and died the next day at 1:55 P.M. Chevalier Jackson was his endoscopist, assisted by his son, Chevalier L., Emily van Loon, and R.P. Smith. I can’t tell from the case history why they had to put the child through the ordeal of the extraction if the pin in his stomach wasn’t a threat to his life, an extraction that took twelve minutes and thirty-nine seconds, sans anesthesia.
In addition to “broncho-pneumonia,” Fred J.’s final diagnosis includes “mediastinal emphysema” (the usually painful condition of air trapped in the space between the lungs) and “acute mediastinitis” (inflammation and possible infection of the middle section of the chest cavity). In Diseases of the Air and Food Passages of Foreign-Body Origin, Jackson explains that “Mediastinal emphysema may follow a perforation of either the cervical or thoracic esophagus. It is usually associated with subcutaneous emphysema and may prove fatal whether infection follows the leaking air or not.” Was the leaked air in Fred J.’s chest the result of the pin’s perforating an already damaged esophagus, or had the instrument introduced a tear into Fred’s airway or foodway? Had increased pressure within the lungs or excessive coughing associated with the pneumonia ruptured an air sac inside the boy’s lung? The case history simply lists the conditions without venturing a precipitating cause. According to the report, a doctor named Harold F. Robertson, who attended Fred on January 14, wished to give the child molasses in small doses, thinking it would “do no harm . . . hoping to coat the opening over and stimulate a reparative process.” “The “opening” to which Robertson refers must be the otherwise unspecified tear, the source of which we cannot know since the details of the gastroscopy—“report attached”—is missing from this file.
Once having identified the boy to whom the pin belonged, it would seem unfair—though I’m not sure to whom—to yoke the peculiarly compelling case of the Perfect Attendance pin to a history of racism in the United States, but that’s the door it’s wedged beneath, that it holds in place, unopened. Jackson tried so hard to detach himself from the social body that the larger world begins to take on the power of a phantasm, but this particular object makes him part of it again, as if to re-embody the doctor precisely at those points at which he’d prefer to disappear.
Chevalier Jackson lived so long, so much longer than Fred J., that his life’s work spanned more than one major historical shift and change: he was born into Reconstruction and died on the eve of the civil rights movement. His first birthday coincided with the legalization of segregation marked by the Supreme Court in Plessy v. Ferguson, and in the very last years of his nearly century-long life, he saw that landmark race decision overturned. Racism manifests in different ways in Jackson’s life’s course and serves as a point of return in the letters he left behind. This racism with a capital “R,” which risks abstraction, is never simply anecdotal or ascriptive, but is available when he needs it—a cultural repertoire that he draws upon in times of stress. More profoundly, race is the foundation for a burgeoning selfhood in The Life of Chevalier Jackson, and later on, the sail he raises on those occasions, like an available expediency, when he is buffeted by life’s unpredictable winds.
What part does race play in scenarios of delicacy and trust at the site of the mouth? What happens if we bring race onto the stage of the history of endoscopy? Coinciding with the early rocketing of Chevalier Jackson’s career was the 1901 publication of a novel by Charles Chesnutt, the African American writer and practicing lawyer who could pass for white but chose not to. The Marrow of Tradition’s politics were so confrontational and real that the book ended Chesnutt’s career as a writer. Based on the 1898 Wilmington, North Carolina, riots carried out by whites against blacks whose voices and voting power the upper and lower crust hoped to suppress, the book hinged on an
episode in which the infant son of a white North Carolinian patriarch got something caught in his throat.
Depending on who is observing the boy, he can be understood as a sign of a bright (white?) future, even of life itself, or of an ominousness that must be guarded against and that manifests in the form of a birthmark, a mole that appears on his neck just beneath his left ear. His father, a Major Carteret who works daily against the changes announced by the conclusion of the Civil War, experiences his newborn’s “first cry as a refreshing breeze from the distant ocean” and a predictor of glorious days ahead, whereas the baby’s black nursemaid—Old Mammy Jane—regards the baby’s presence as foreboding. She thinks the mole might be the sign of something immanent but unspoken, and Chesnutt relies on a strangulated language to bring it into view—in short, the baby’s birthmark and (maybe too his birthright) leads Mammy Jane to consider that lynching might be in his future, but she doesn’t know how it could be if he’s white. “Had the baby been black, or yellow, or poor-white,” the narrator muses,
Jane would unhesitatingly have named, as his ultimate fate, a not uncommon form of taking off, usually resultant upon the infraction of certain laws, or, in these swift modern days, upon too violent a departure from established social customs. It was manifestly impossible that a child of such high quality as the grandson of her old mistress should die by judicial strangulation; but nevertheless the warning was a serious thing, and not to be lightly disregarded.
Mary Cappello Page 15
