Boston, MA | March 8, 2013

Episode 68: Illness as Muse: Ten Years of the Bellevue Literary Review

(Rafael Campo, Hal Sirowitz, David Oshinsky, Jacob Freedman, Amanda Auchter) The Bellevue Literary Review is the first literary journal to be published from a medical center. Based in the oldest public hospital in the country, and perhaps the most legendary, the BLR has ushered in an entire field of literary medical writing. Now at the ten-year mark, the BLR illuminates the human condition through the prism of health and healing, illness and disease, and relationships to the body and mind. BLR writers Rafael Campo, Hal Sirowitz, David Oshinsky, Jacob Freedman, and Amanda Auchter explore these themes via fiction, nonfiction, and poetry.

Published Date: October 9, 2013

Transcription

Speaker 1 (00:04):

Welcome to the A W P podcast series. This event was recorded, the 2013 A W P Conference in Boston. Recording features readings by David Osinski, Amanda Ter, Jacob Friedman, Hal Sitz with Minter Kratzer and Raphael Campo. You'll now hear Suzanne McConnell provide introductions.

Speaker 2 (00:25):

Thank you all for coming and welcome to Illnesses Muse, 10 plus years of the Bellevue Literary View. We started in September, 2001. We're thriving. We have this stupendous editorial team and vivid wise writing as you'll soon see. So I'm going to introduce our readers and we're going to start. David Osinski is our first reader. He holds the Jacks Blanton chair in history at the University of Texas and is a distinguished scholar in residence at N Y U. His books included conspiracy so immense, the world of Joe McCarthy, which was a New York Times book, book of the year. Another worse than slavery was awarded the Robert Kennedy book Prize for its distinguished contribution to human rights and polio. An American story won the Pulitzer Prize for history. So with no further ado,

Speaker 3 (01:29):

Thank you. I came up from Austin, Texas last night. I realized last night how much I missed Boston. I woke up this morning and realized why I had left. I'm going to read to you from a very short essay I wrote about Bellevue Hospital. Bellevue is quite literally a New York institution among the nation's oldest hospitals. It has served the city for nearly three centuries and its medical achievements are immense. Yet what we most know and remember about Bellevue, what our popular culture demands we know in the member is what one fragment of a fabled history. Its association with madness. It may be unfair and it does seem outdated, but this particular image has endured for generations. Enveloping the institution like a straight jacket. Bellevue we are told is where the world's greatest city has long deposited those two crazy to walk its streets making it sad to say the Alcatraz of hospitals.

Speaker 3 (02:38):

It's not hard to see why I'm calling Bellevue because you're nuts. Ralph Cramden would regularly tell his wife Alice and the honeymoon is when he wasn't threatening. Bang zoom to send her to the moon that millions of television viewers in the 1950s could knowingly laugh along without further explanation. Made Bellevue perfect for a comics punchline or a film director's set. Billy Wilder's last weekend in 1945, the Academy Award winner talked about extreme alcohol distress and took place at Bellevue so too did the 1947 Classic miracle on 34th Street in which the stubbornly proud Chris Cringle dressed in drab hospital garb and kept in a tiny cell with barbed windows purposely fails his psychiatric examination Weary Bellevue officials banned cameras from the facility after that, forcing producer Darryl. Zack actually shoot this set in Los Angeles and who could blame him Declaring Chris k Cringle incompetent is not exactly an image builder.

Speaker 3 (03:50):

It didn't help matters that Bellevue is a short ambulance right away from Greenwich Village. As such, it became a revolving door for legions of writers and artists in various states of mental distress. William Burrows spent time thereafter cutting off a finger to impress his lover. Delmore Schwartz arrived in the handcuffs following an attempt to strangle the critic Hilton Kramer. I'm sure there was a line for that one. Eugene O'Neill stopped in so often he was on a first name basis with the staff. Norman Mailer was committed after stabbing his wife. Some like Alan Ginsburg and Richard Yates memorialized Bellevue in their work. A few was smoking with packs of cigarettes in their pajama tops. Yates wrote in disturbing the piece then he saw they weren't wearing pajama tops but straight jackets and he wanted to whimper like a child. The list goes on. Malcolm Lowry, Gregory Caso, Sylvia Plath all wound up at Bellevue after suffering nervous breakdowns saxophonist.

Speaker 3 (04:58):

Charlie Parker committed himself following two suicide attempts in 1954. As you may know, he died the following year Bass Charlie Mingus also when voluntarily it was said to escape a business's dispute with a mobster Joey Gallo. Among the patients he met Mingus recalled was a man who kept calling Dwight Eisenhower on a fake telephone and a chess champion 15 years old, a sandy here teenager who spoke seven languages. He was a genius. I guess Mingus said his parents had committed him and he told me he didn't know why. Of course it was Bobby Fisher. Mingus later composed the jarring help you in Bellevue to reflect the mania he found inside historians like to get to the bottom of things. We know that New York's original arms house, the forerunner of Bellevue contained a separate for lunatics complete with a whipping post. We know as well that New York City opened an enormous facility in the East River in 1839, known as Blackwells Island.

Speaker 3 (06:09):

And Blackwells Island really became the main mental facility and Bellevue had the less secure of deciding who would be sent there. These evaluations would be done for years in an overcrowded facility at Bellevue, a pavilion no different from other parts of the crumbling hospital. How then did Bellevue singular reputation emerge? Enter Nelly Bly. She had come to New York from western Pennsylvania in the 1880s, determined to write her arrival. Coincided with a fierce newspaper circulation, war, featuring stories, splashy photos, simple words. Bly was fearless and inventive. Hooking up with Joseph Pulitzer's, New York world. She pursued subjects seen as too dangerous for a woman posing as an unwed mother to expose a baby buying ring, getting herself arrested to look at the police system. Bly became an international cessation in 1889 when inspired by Jules Verns around the world in 80 days. She got Joseph Pulitzer's very wealthy friends to fund her own trip and she beat Vern's record by a week.

Speaker 3 (07:24):

But her first story for the world was probably her most important appearing in two lengthy installments and then as a book titled 10 Days in a Madhouse Press Reports of Abuse in New York's various institutions were already common fair. They contained hair raising details as exposes often do and will particularly popular among the working classes. Who populated these mental institutions? The Luna Tickets Island at Blackwell's Island had been at target for years. Charles Dickens in his American notes published in 1842 wrote that quote, I've never felt subject deep disgust and measureless contempt is when I crossed the threshold of this madhouse blackwells island, but no one until Melly Bly had ever tried to write from the inside. From the patient's point of view, Li's plan was daring to say the least. She checked into a boarding house in New York City, famed insanity and was carted off to police court where the judge ordered her to go to Bellevue for observation.

Speaker 3 (08:34):

There she pretended to hear voices and clearly in her words appear deranged. Her strategy worked. The doctors at Bellevue concluded she was suffering from dementia, undoubtedly insane, and she was shipped off to Blackwell's Island. Bly portrayed Bellevue as the third station on my way to the island. The house and police court being numbers one and two, she vividly described the crowded wards at Bellevue, the freezing temperatures, the filthy bedding, the moth eaten clothing and she claimed that many of the inmates there had been wrongly deemed insane and incompetent, but Bellevue wasn't Blythe's primary target and a fl reading of her expose showed it to be more of a negligent institution than an intentionally brutal one. The real villain was Blackwell's Island, the grim expanse where sadistic staffers made the rules. My teeth chatted and my limbs were goose fleshed and blue with cold blue reported.

Speaker 3 (09:39):

I got one bucket of ice water in the face after the other. My eyes, my ears, my nose, my mouth. I think I experienced the sensation of a drowning person as they dragged men gasping and shivering and quivering from the tub. For once I did feel insane. All the doctors fooled, screamed the headlines. No attempt was made to separate one stop along the way from the other in Nelly Bly descent to hell. Bellevue and Blackwell's Island were fused together two snake pits equally culpable, equally grim. Worse the image played right into Bellevue's, already perilous reputation as a place for the friendless. Those with nowhere else to go In the coming years, Bellevue, psych woods would become a magnet for the tabloids overshadowing all else. Here are some of the headlines. Murder in a hospital, a man with delirium. Tremens kills another patient nurse for the insane goes crazy herself.

Speaker 3 (10:43):

Hospital patient, slain woman in a RAI jacket. Strangled same man held as crazy at Bellevue and the celebrities just kept on coming. Andy Warhol, Edie Sedgwick and Michael David Chapman, the deranged killer of John Lennon. It goes without saying that Bellevue deserves better. At 275 years and counting, it remains an essential public asset serving the poor as is always done and turning absolutely no in away. It is the place where the first ambulance service was deployed and where professional nursing began. It's a place where the first hospital in medical school was successfully combined revolutionizing patient care and clinical construction. If you look at the people, the doctors who went through there, they revolutionized American medicine in surgery, pathology, pediatrics and public health. If you look at the medical students who went there, you have Walter Reed who basically discovered the vector for yellow fever. Joseph Goldberger involved in the nutritional mystery of Pellagra and Jonas Salk and Albert Saban.

Speaker 3 (12:01):

The men who did the polio vaccine both came out of that hospital and there is something else lost among the punchlines in the headlines is the fact that Bellevue has long been in medical circles a model of creative psychiatric care in their time. The researcher people like Carl Bowman in Insulin Shock Therapy. Loretta Bowman on childhood Schizophrenia and David Wexler and intelligent measurement were widely acclaimed. Bellevue's psychiatric ward, particularly his prison ward, played a vital role in the growth of forensic medicine and its outpatients. Clinic for alcoholism and substance abuse are considered the finest in the world. Some reputations, however, appear unshakable when the Bellevue literary Review was launched 10 years ago, a leading newspaper made this all too clear. It seems fitting tease the New York Times that Bellevue Hospital where writers have been committed in the extreme of mental collapse will now have a literary journal. Another joke, another drum roll, but America's premier public hospital carries on. Thank you very much.

Speaker 2 (13:28):

Thank you so much. I realized I forgot to introduce myself before. I'm Suzanne McConnell, one of the two fiction editors at Bellevue Leader Review. So our next reader will be Amanda er. She's the author of the Wishing Tomb winner of the 2012 Perusia Press Award and the Glass crib which won the 2010 zone three press first book award. She's the editor at Pebble Lake Review and lives in Houston.

Speaker 4 (14:00):

Can you guys hear me okay? I'm going to read from right here because I am teeny tiny and you're not going to be able to see me over the eyes up so I'll be reading from right here. This is better. Yeah. Okay, so I want to thank actually before I don't have very many poems to read, just a handful, but I want to thank Bellevue for having me here. I was telling Rafael that they have a very special place in my heart. They were one of the first journals that ever took any of my work when I was actually an undergrad, so I'm greatly indebted to be Bellevue. Okay, so the first poem I'm going to read is called Nothing but the Shape in the Light. You can no longer see the light on the soap dish, the bottles of cologne and shampoo. I wanted to touch your hair, fill you on the floor, your last breath from the doorway.

Speaker 4 (14:58):

It didn't look like you face turned toward the clothes hamper one foot kicked into the garbage can hand still clutching your B toothbrush mouth slack, eyes open to counter tile ceiling. How is it that I have forgotten how many years your body has become white roots a box of ash at times you fill the room, I walk into the smell of you as though you've been there rocking in a chair, reading never dead, but waiting for me to enter with a basket of laundry, a plate of fruit, some toy left behind that we've both outgrown my hello, nothing but the shape my mouth takes the air you feel when you press your fingers to my lips.

Speaker 4 (15:56):

And the next poem is the bottom drawer tucked beneath my mother's shirts and camisoles a paper bag of prayer cards. I find my brother's pajamas. I want to take them out, understand how she can spend an afternoon and an empty house with them, her at the table with a cup of tea raising the sleeve to her cheek, her nose thinking of him how she kissed. His stubble cheek closed each eyelid. I wonder if she wears them or how often If at night she slips into bed with the shirt, cradles him back into her. I unfold him on the bed for her to find spread out as though he was still there brushing his teeth, water running in the bathroom. A glue towel shook dry each arm uncrossed and flattened the flannel pants scraped over the bed as though someone meant to wear them. That shows something else instead.

Speaker 4 (17:07):

And this is the thundering. Late August, you are a cigarette burn in radio lit dusk. The availability of means cold steel on your toe. Your mouth fills with what becomes massive history hole in the throat. Your punctured brain on a back wall, your name rain smeared, inking the street, every floor you've locked beside the door, a pair of shoes, an umbrella through black coat things in minutes you'll no longer need carried with you and the white of fan humm Car horns. You roll bullets in your palm. You want for a moment to still this a book left open on the table, the rain light, cold coffee and the glass pot. The first sign is early waking, the failure of sleep. The last is how you sit in your green chair and write your name At the end of a page crush paper and ash into a bowl. You move in and out of air. The thundering dark calls, you close the window and that poem actually I should say was for Liam Rector.

Speaker 4 (18:34):

This next poem is called The Disordered Body, and actually I should give you a little tiny bit of context. This entire book is a lyrical history of New Orleans called the bushing tube and the disordered body is one of my yellow fever, fever, yellow fever slash american plague poems. The disordered body falls from the black skies daily, the city, a shroud, a rott, garbage and heat and humidity. The bright stink of bodies, the body a branch after lightning, a language of fever delirium at the riverfront. Our children watch boats come and go, scratch their dark arms until they bleed. What language must we speak to keep them safe? Every prayer, a tongue of fire, every song a child's deep into the night, A child who unfolds her body into dark sweat damn hair. We are drowning in this mosquito dust our bodies inside a sea of stings.

Speaker 4 (19:56):

We are emptying our pales and wash buckets and still they settle into hairlines fingertips. We have long practiced disaster. We do not hide in our beds and closets close a door mouth. We do not say, it will not come, it will come. It will bring its terrible song hummed into our houses and it happens two more from a sort of manuscript in progress that Bellevue recently took. This is called the Sister Born Again, 1980. The sister comes into her new family as a cardboard box, a one-eyed animal with the tongues of her shoes smacking the concrete sidewalk of the adoption agency. She holds a bear in her right hand, the new mother's thumb in her left on the drive home, she pulls Kleenex from its cardboard sleeve, watches each one flutter down the highway. She listens to the wind blur. The green exit signs the sun setting in the distance as any small animal. She practices escape, finds the unlocked door too easy to resist. At 60 miles per hour, she reaches for the handle, presses her body against the door's weight until it flies open. One shoe tumbles away from her. One shoe remains on its tiny foot

Speaker 4 (21:38):

And the last one is December 16th. Six years later, my sister calls to tell the story again A dark road swerve of headlights, how she arched through the night air, the wheels that kept spinning a far red siren. Each detail pieced from accident, photographs, bystander reports, late night cop shows. I listened to the story and stir vegetables and oil on the stove. I want to say you died in the field for four minutes. You do not remember what you remember. I want to tell her of the bag of effects handed to me at the hospital. The blood stain bracelet, the brown sandals re in damp grass. I went to tell her of the hospital room and little window frosted with cold. How I went behind a curtain, placed my face in my hands, but I do not, I wait for the ending of this story for her to run out of memory of tall grass car horns. I wait to sit alone in the kitchen's slant windows for the silence to break inside my throats. Thank you.

Speaker 2 (23:13):

Thank you. Thank you Amanda. Our next reader is Jacob l Friedman. He's currently chief resident of inpatient psychiatry at the Harvard Longwood Psychiatric Residency training program in Boston. He's written a lecture on a broad range of topics and is a self-proclaimed world's expert on an exceedingly rare medication side effect called olanzapine induced, a gran new cytosis

Speaker 5 (23:48):

Job.

Speaker 6 (23:53):

Hopefully nobody here has that. Alright, this is a piece about my time working as a neurologist. When I was an intern at Brigham and Women's Hospital to the untrained eye, neurology can appear to be a sadistic profession. Many of our patients are comatose and our daily exams consist of pinching their fingers and toes as hard as we can, documenting that for the ninth straight day, there's no reaction to this painful stimuli. As I lament this to Duncan, my fellow psychiatry resident who has also been rented out to the neurology consult service, he completes a physical by hollering into a patient's left ear. It's obvious that our patient is unresponsive to verbal commands and when I tell Duncan to keep it down, he tells me that his wife screams at him just about every night. Why can't he have a turn to yell at some people, especially since they aren't able to yell back As we walk into a see our next patient, I tell Duncan that I'm discouraged with my experience as a neurologist.

Speaker 6 (24:53):

We always seem to be called to evaluate horrendous cases. After it's too late for any curative interventions, we then poke and prod our patients repetitively, pour cold water into their ears to see if their eyes spin around. We stick Q-tips into their noses and observe whether or not their grimaces are symmetrical. We have them memorize nonsensical lists of words like physicists, prism and amphibian. We then call the psychiatry team our true colleagues when they kick us out of the room because we need someone to make a professional comment on our patients' effective dysregulation as evidenced by opposition to a complete and thorough medical evaluation somewhere in between here and the physical torture of crushing people's toenails with a reflex hammer. The psychological stressors of making them count backwards from 262 in increments of 13. I wonder if we'll ever get more information out of our patients by water boarding them.

Speaker 6 (25:53):

Duncan suggests that we might use therapeutic lashings to help our patients who suffer from tremors. He suggests that maybe this will condition them to stop shaking when we tell 'em to touch their index fingers to their noses when I give him a quizzical look. He reminds me that'll work for Pavlov and his dogs. Our next patient is Mr. Stevens. He's a 78 year old veteran admitted to the hospital with a heart attack and he required bypass surgery, which subsequently caused a stroke. This in turn landed him on our list This morning we were consulted for something called pathological crime and when Duncan reads this, he suggests that they probably should have consulted the patient's mother. Instead, I remind him that the patient is in his seventies and that the patient's mother is probably deceased. Duncan notes that the patient's mother probably died from shame that her son was still crying like a baby even in his old age.

Speaker 6 (26:51):

I concur that the patient is likely yellow belied and we knock on his door and then enter. Mr. Steven smiles back at us and then barks, who the hell are you? I smile back and show him my ID badge, forgetting that it rats me out as a psychiatrist and he tells me I don't need any damn psychiatrist. I'm not crazy. The other doctors already told me that I apologize and I explained to him that Duncan and I have been exiled to the neurology consult services as part of our training and that while we are in fact psychiatrists most of the time today we're wearing our neurology hats even though we forgot to take off our psychiatry ID cards. Mr. Steven remarks that I also forgot to take off my psychiatry beard and he reemphasizes. I don't need any damn psychiatrist, so not crazy. I told you already.

Speaker 6 (27:40):

He then begins sobbing hysterically and I hand him a tissue from the box on the table next to him. He takes and dabs his cheeks and tells me a third time he's not crazy. It's just that there's some damn thing in my brain that's broken and I cry like a little girl scout for no damn reason. Duncan and I sit down and Mr. Stevens perceives to tell us the story of how he was diagnosed with a small stroke after his bypass surgery a few days ago. He's since experienced at least six episodes of bizarre crying every day. The only other neurological symptom he's experienced is a numbness in his right leg, but otherwise the stroke left him in pretty good shape. When Duncan and I pull out our reflex hammers, he shakes his head and starts crying. This is exactly what I mean. I just start crying for no damn reason. I'm not sad. I just start crying. It's ridiculous. I reached to hand him another tissue but he waves it away as he's already stopped his tears and seems back to his cantan for self. I ask him if we can examine him and he starts crying again. I don't need to be examined. Anyways. You idiots poked me just about everywhere Last time I was here after my first stroke and you didn't find anything that, and you're not going to find anything now. Why don't you go poke each other instead, you perverts

Speaker 6 (28:59):

Duncan and I nod to Mr. Stevens and bid him. Good day. We tell him that we'll discuss the case with our boss and that we'll make some appropriate recommendations to the primary medical team. Mr. Smiles and then cries and then smiles and waves us. Goodbye Duncan and I page our boss who happens to be the world's expert in epilepsy in pregnant women. This means that she has about 23 seconds to discuss any case that is unrelated to either pregnancy or epilepsy. She calls us back in exactly nine seconds. She then explains that we'll have to present the case quickly because she has four patients waiting in clinic, a lecture to give at the medical school later this afternoon and she's consulting with a pharmacology corporation on the other line to make some extra pocket money to pay for her stepdaughter's Suzuki violin lessons. She then explains that she really doesn't need to hear anything more about the case because she already received the chart online and knows that the patient clearly has what's called pseudobulbar affect.

Speaker 6 (29:59):

She tells us that we can treat it with any standard antidepressant like Zoloft or whatever else we want to do, but just to make the recommendations and move on because she also has to edit a review article on postpartum seizure evaluation for the American Journal of Neurology before it hits pressed tomorrow. Duncan wonders out loud after we hang up the phone. If our boss might've put in some extra thought had we told her that Mr. Stevens was 36 weeks pregnant with an epileptic fetus, he asked me what I know about pseudobulbar affect after this because all he knows is that it's abbreviated P B A, which is different from P B R, which is his favorite drink. I know even less about P B A, so we decide to look it up online and figure out what the heck it is so that way we can recommend an appropriate treatment as we sit down and log onto a computer to search for pseudobulbar affect. I asked Duncan if he thinks that the New York Times would run a front page article if they knew that the neurology consultants at the most prestigious teaching hospital in Boston were getting all their moves from Google Duncan remarks that they would only care if we were tea partyers protesting our socialist government takeover of the healthcare system. Wikipedia comes up first and says that pseudobulbar affect is characterized by pathological crying. Duncan suggests that maybe we should try getting Mr. Stevens some medical marijuana to induce pathological laughing and nacho beating.

Speaker 6 (31:27):

This would probably even things out, but I remind him that we aren't practicing medicine in California, so we continue our search online After brief stops at eHow Twitter health and finally WebMD. I find the first line medication for management of pseudobulbar and I send a page to Mr. Stevens primary cardiology team telling 'em to start the drug. I asked Duncan if he finds neurology to be two reductionists. He hands me a tissue and asks me if I'm going to pathologically cry. Duncan tells me that he misses psychiatry's taboo on touching patients, but that he finds it fascinating to pour over M r I scans and to correlate anatomy with sensory motor and mood related symptoms. Duncan is excited by the idea that we will map the brain and find the exact location to plant an electrode in someone's brain so that way every time their wife yells at them, they can turn.

Speaker 6 (32:21):

You haven't taken out the trash into how about a margarita is convinced this is happening soon and it will be better than cocaine without the risks of addiction and losing one's medical license. I ask him if as a psychiatrist he's concerned by the risk of breaking down human emotions into electrical currents, reducing paranoia, love and creativity into ions drifting across protein channels. Duncan tells me he's more concerned by the unchecked proliferation of nuclear technology and unstable Middle Eastern regimes. Subsequent risk of dirty bombs coming onto American soil through Canada and the recent unavailability, the recent unavailability of organic buffalo milk yogurt at the local Trader Joe's. I agree and he asked me if it's really any worse than the psychiatric medications that would take away Mr. Steven's tears but also neuter his personality. I asked Duncan why he keeps on talking about neutering and he said that he just saw a crisis rate rerun and Bob Barker reminded him to have his pet sprayed and neutered and he says, furthermore, neutering is a technically appropriate term because the pills we prescribe double as libido killers. I momentarily consider these grave problems within our field, but then I smile because I don't have to come up with any solutions until I finish my eight week contract with the neurologist. Duncan says, we should also appreciate these last precious weeks of caring for unconscious patients before we resume our request as psychiatrists. I agree and as we walk down the hall to see our next comatose patient, Duncan says that neurology can be reductionist and it can be sadistic, but at least we get to whack people with reflex hammers.

Speaker 2 (34:12):

This reminds me of the old adage, laughter is the best medicine and I just want to make a comment about that because people often ask, I often find myself reassuring. People who want to submit to us that it's not all somber and sober and about dying and dying can be quite funny too. We found out from reading pieces submitted to us. So our next reader is Hal Sorowitz. He's the former poet Lauret of Queens, New York. He's the co-winner of the noon 2012 Poetry Contest and the author of a new collection of poems, steri Cat Blues. He has written poetry in prose about his experiences with Parkinson's disease and has worked in the Bellevue Review and the anthology. Beauty is a verb, the new poetry of disability, and he is the author of 11 other books of poetry that have been translated into 14 languages. Thank you.

Speaker 7 (35:24):

You take presentation. I use a good same. You have a need to be famous, my rapist said, but I think you should get a job first. If you look at all these favorite people, we all had Job, Jen was not from somewhere. Otherwise you be in your own head like everyone out avoiding rigidity.

 


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