‘on caring for sick people’

 

on caring for sick people (and why the health care system often fails them) … plus, what I have learned about same from experience and reading; and from Walt Whitman, Florence Nightingale, and the heroic nurses of the Civil War

by Roger W. Smith

 

“I start off with a prejudice against doctors anyway.”

— Walt Whitman; quoted in Horace Traubel, With Walt Whitman in Camden (July 12, 1888)

 

“I love doctors and hate their medicine.”

— Walt Whitman; quoted in Horace Traubel, With Walt Whitman in Camden (July 8, 1888)

 

There is much common sense and medical wisdom (as well as human insight) in what nineteenth century writers wrote about health care. Much of this comes from the writing of nurses and volunteers in Civil War hospitals, including Walt Whitman, and outstanding nurses who wrote memoirs. And also, the English social reformer Florence Nightingale, the founder of modern nursing. I have quoted amply from Whitman; from Nightingale; and from the Civil War nurses Louisa May Alcott, Mary A. Livermore, and Jane Stuart Woolsey.

Some may find these copious quotations tedious to read. They merit attention, however, because they are full of good sense and insight into patient care based upon experience, as well as intelligent reflection. And, what is remarkable (indeed, undeniable), as I hope to prove, is that there is much valuable in these writings that would be ignored by the medical practitioners of today, should they ever bother to consult such works. Be assured they haven’t. And will not.

 

*****************************************************

Quotations from Nineteenth-Century Medical Practitioners

 

WALT WHITMAN (1819-1892)

Turn the bedclothes toward the foot of the bed,
Let the physician and priest go home.

I seize the descending man … and I raise him with resistless will.

O despairer, here is my neck,
By God! you shall not go down! Hang your whole weight upon me.

I dilate you with tremendous breath … I buoy you up; …
I am he bringing help for the sick as they pant on their backs,
And for the strong upright men I bring yet more needed help.

— Walt Whitman, “Song of Myself” (draft version)

 

By the cot in the hospital reaching lemonade to a feverish patient,

— Walt Whitman, “Song of Myself”

 

Druggists mix their psychic stuff, and paper their doses, and shake their potions and lotions. How many wry faces are they the cause of—the ipecac and castor oil creatures! Why do folks take so much physic?

It is now pretty well established that not the mere taking of drugs cures disease. … We are not sure but the very means we consider necessary to stop illness often and often lead to greater illness. … We submit to almost any of our readers, who may be “ailing,” in any way—who may have that worst curse on earth, a ruined constitution—whether he or she cannot look back through a long career of medicine taking?

The violent stimulants and narcotics which are favorites with a majority of the physicians, cannot be used without the most serious and permanent effects on the system—both present and in time to come! … How much of the fevers, aches, rheumatisms, chronic and acute complaints, which we are so fond of assuming that “flesh is heir to,” are in reality not our heritage, but come to us through the physic vial, and the pestle and mortar! And the consciousness of this fact is starting up all kinds of medical humbugs—some of them possessing a few points meritorious, but none of them, in our opinion, worthy to take the place of that universal, that remedial rule for every complaint, which nearly all of them claim to be.

Indeed there is much humbug in the pompous pretensions of the medical art. … Doctors and apothecaries pretend to know altogether too much. It will go down among those who understand very little of physiology and anatomy, and whose eyes cannot take in any more than the nearest points of the field—but to all others, much of the loftiest pretensions of either of the “regular” doctor, or “quack” doctor, is but a matter of sounding brass and a tinkling cymbal.

— Walt Whitman, “Is Not Medicine Itself a Frequent Cause of Sickness? ,” Brooklyn Daily Eagle, April 16, 1846

 

“I can testify that friendship has literally cured a fever, and the medicine of daily affection, a bad wound.”

— Walt Whitman, Brooklyn Daily Eagle, March 19, 1863

 

I remain here in Washington still occupied among the hospitals—I have now been engaged in this over seven months. … I seldom miss a day or evening. … The doctors tell me I supply the patients with a medicine which all their drugs & bottles & powders are helpless to yield. … [italics added]

— Walt Whitman, draft of letter to James Redpath (?), August 6, 1863

[In Walt Whitman: The Correspondence, Volume I, 1842-1867, edited by Edwin Haviland Miller, it is stated that the most likely recipient of this letter, which exists as a draft in Whitman’s hand, was James Redpath (1833-1861), author of The Life of John Brown. Redpath had met Whitman personally and was one of his admirers.]

 

LOUISA MAY ALCOTT (1832-1888)

Wherever the sickest or most helpless men chanced to be, there I held my watch, often visiting the other rooms, to see that the general watchman of the ward did his duty by the fires and the wounds, the latter needing constant wetting. Not only on this account did I meander, but also to get fresher air than the close rooms afforded; for, owing to the stupidity of that mysterious ‘somebody’ who does all the damage in the world, the windows had been carefully nailed down above, and the lower sashes could only be raised in the mildest weather, for the men lay just below. I had suggested a summary smashing of a few panes here and there, when frequent appeals to headmasters had proved unavailing, and daily orders to lazy attendants had come to nothing. No one seconded the motion, however, and the nails were far beyond my reach. …

— Louisa May Alcott, Hospital Sketches (1863)

 

… though a capital surgeon and a kindly man, Dr. P., through long acquaintance with many of the ills flesh is heir to, had acquired a somewhat trying habit of regarding a man and his wound as separate institutions, [italics added] and seemed rather annoyed that the former should express any opinion upon the latter, or claim any right in it, while under his care.

— Louisa May Alcott, Hospital Sketches

 

FLORENCE NIGHTINGALE (1820-1910)

In watching disease, both in private houses and in public hospitals, the thing which strikes the experienced observer most forcibly is this, that the symptoms or the sufferings generally considered to be inevitable and incident to the disease are very often not symptoms of the disease at all, but of something quite different—of the want of fresh air, or of light, or of warmth, or of quiet, or of cleanliness, or of punctuality and care in the administration of diet, of each or of all of these.

— Florence Nightingale, Notes on Nursing: What It Is, and What It Is Not

 

The very first canon of nursing, the first and the last thing upon which a nurse’s attention must be fixed, the first essential to the patient, without which all the rest you can do for him is as nothing, with which I had almost said you may leave all the rest alone, is this; to keep the air he breathes as pure as the external air, without chilling him. Yet what is so little attended to? Even where it is thought of at all, the most extraordinary misconceptions reign about it.

— Florence Nightingale, Notes on Nursing: What It Is, and What It Is Not

 

The art of nursing, as now practised, seems to be expressly constituted to unmake what God had made disease to be, viz., a reparative process.

— Florence Nightingale, Notes on Nursing: What It Is, and What It Is Not

 

True nursing ignores infection, except to prevent it. Cleanliness and fresh air from open windows, with unremitting attention to the patient, are the only defence a true nurse either asks or needs. Wise and humane management of the patient is the best safeguard against infection.

— Florence Nightingale, Notes on Nursing: What It Is, and What It Is Not

 

Is it not living in a continual mistake to look upon diseases, as we do now, as separate entities, which must exist, like cats and dogs? instead of looking upon them as conditions, like a dirty and a clean condition, and just as much under our own control; or rather as the reactions of a kindly nature, against the conditions in which we have placed ourselves.

— Florence Nightingale, Notes on Nursing: What It Is, and What It Is Not

 

It is the unqualified result of all my experience with the sick, that second only to their need of fresh air is their need of light; that, after a close room, what hurts them most is a dark room, and that it is not only light but direct sun-light they want. You had better carry your patient about after the sun, according to the aspect of the rooms, if circumstances permit, than let him linger in a room when the sun is off. People think the effect is upon the spirits only. This is by no means the case. … Without going into any scientific exposition, we must admit that light has quite as real and tangible effects upon the human body. But this is not all. Who has not observed the purifying effect of light, and especially of direct sun-light, upon the air of a room? Here is an observation within everybody’s experience. Go into a room where the shutters are always shut, (in a sick room or a bedroom there should never be shutters shut), and though the room be uninhabited, though the air has never been polluted by the breathing of human beings, you will observe a close, musty smell of corrupt air, of air, i.e. unpurified by the effect of the sun’s rays. The mustiness of dark rooms and corners, indeed, is proverbial. The cheerfulness of a room, the usefulness of light in treating disease is all-important.

— Florence Nightingale, Notes on Nursing: What It Is, and What It Is Not

 

So also as to all the advice showered so profusely upon such sick, to leave off some occupation, to try some other doctor, some other house, climate, pill, powder, or specific; I say nothing of the inconsistency, for these advisers are sure to be the same persons who exhorted the sick man not to believe his own doctor’s prognostics, because ” doctors are always mistaken,” but to believe some other doctor, because “this doctor is always right.” Sure also are these advisers to be the persons to bring the sick man fresh occupation, while exhorting him to leave his own.

— Florence Nightingale, Notes on Nursing: What It Is, and What It Is Not

 

How little the real sufferings of illness are known or understood. How little does any one in good health fancy him or even herself into the life of a sick person.

— Florence Nightingale, Notes on Nursing: What It Is, and What It Is Not

 

If you knew how unreasonably sick people suffer from reasonable causes of distress, you would take more pains about all these things. An infant laid upon the sick bed will do the sick person, thus suffering, more good than all your eloquence. A piece of good news will do the same. … You will relieve, more effectually, unreasonable suffering from reasonable causes by telling him “the news,” showing him “the baby,” or giving him something new to think of or to look at than by all the logic in the world.

— Florence Nightingale, Notes on Nursing: What It Is, and What It Is Not

 

Pathology teaches the harm that disease has done. But it teaches nothing more. We know nothing of the principle of health, the positive of which pathology is the negative, except from observation and experience. And nothing but observation and experience will teach us the ways to maintain or to bring back the state of health. It is often thought that medicine is the curative process. It is no such thing; medicine is the surgery of functions, as surgery proper is that of limbs and organs. Neither can do anything but remove obstructions; neither can cure; nature alone cures. [italics added] Surgery removes the bullet out of the limb, which is an obstruction to cure, but nature heals the wound. So it is with medicine; the function of an organ becomes obstructed; medicine, so far as we know, assists nature to remove the obstruction; but does nothing more. And what nursing has to do in either case, is to put the patient in the best condition for nature to act upon him. [italics added] Generally, just the contrary is done. You think fresh air, and quiet and cleanliness extravagant, perhaps dangerous, luxuries, which should be given to the patient only when quite convenient, and medicine the sine qua non, the panacea.

— Florence Nightingale, Notes on Nursing: What It Is, and What It Is Not

 

MARY A. LIVERMORE (1820-1905)

The effect of her [Mary Safford’s] presence was magical. It was like a breath of spring borne into the bare, white­washed rooms—like a burst of sunlight. Every face brightened, and every man who was able, half raised himself from his bed or chair, as in homage, or expectation. It would be difficult to imagine a more cheery vision than her kindly presence, or a sweeter sound than her educated, tender voice, as she moved from bed to bed, speaking to each one.

The baskets were unpacked. One received the plain rice pudding which the surgeon had allowed; there was currant jelly for an acid drink, for the fevered thirst of another; a bit of nicely broiled salt codfish for a third; plain molasses gingerbread for a fourth; a cup of boiled custard for a fifth; half a dozen delicious soda crackers for a sixth; “gum-drops” for the irritating cough of a seventh; baked apples for an eighth; cans of oysters to be divided among several, and so on, as each one’s appetite or caprice had suggested. One man wished to make horse-nets, while his amputated limb was healing, and she had brought him the materials. Another had informed her of his skill in wood-carving, but he had no tools to work with, and she had brought them in the basket.

From the same capacious depths she drew forth paper, envelopes, postage stamps, pencils, ink, Atlantic Monthlies, Chicago Tribunes, checkers, and a folding checker-board, a jack-knife, needles, thread, scissors, buttons, music books, for the musically inclined, of whom there were many in every hospital; a “waxed end” and a shoemaker’s awl, for one to sew up rents in his boots; knitting-needles and red yarn, for one who wished to knit his boy some “reins” for play,—every promise was remembered by Miss Safford.

“Oh, Miss Safford!” said one bright young fellow,” you are the good fairy of this hospital! …

In one ward, two men were weeping bitterly; and when she inquired the cause, it appeared that the surgeon had given them permission to drink a tumbler of milk, night and morning. But the hospital funds were lacking for its purchase, and “French Maria,” the milk-woman, who had just passed through the ward, had refused to let them have it on credit. This was too much for the fortitude of the feeble sufferers, and they were weeping like children. Miss Safford hurried out, and, recalling the milk­maiden, obtained the milk for the day, directing her to leave the same quantity every day, and come to her for payment.

— Mary A. Livermore, My Story of the War: A Woman’s Narrative of Four Years Personal Experience as a Nurse in the Union Army, and the Relief Work at Home, in Hospitals, and at the Front, During the War of Rebellion

 

JANE STUART WOOLSEY (1830-1891)

… the little rest and talk, and the newspaper or magazine, and some trifle of a “comfort-bag,” or pocket-comb, or the like, with the suggestion that the women at home are working and thinking for him, send a poor fellow back to his ward with a little freshness in his weary day. Many a glimpse of family history we get in this way; many a simple, pathetic story of suffering and unconscious courage; sometimes, very seldom, a wondrous tale—a tale to “make your flesh creep”—of more than human valor and endurance.

— Jane Stuart Woolsey, Hospital Days: Reminiscence of a Civil War Nurse

 

Mrs. B—showed the advantage of some previous training in a civil hospital in Massachusetts. Although of lower grade in refinement and education than most of the other nurses, she came in more intelligently to system and worked more efficiently under it. She was keen and wary. … Trim and neat as wax in person and work, her qualities soon told on her ward. Bed-quilts hung no more awry, and blankets were folded over straight and smooth. Crusts and parings, sloppy and cloudy cans and tumblers, crumpled newspapers and greasy cards disappeared from the little bedside tables. A glass as clear as light, with a flower in the season, or a little green spray, a smooth napkin, a freshly-washed feeding cup for the drink, a game-box, a book from the library, took their places. White curtains appeared in the windows, or green where the light needed softening to the sick eyes, prints on the walls, rocking chairs swinging with heroes, up and down the long board doors.

The cups and plates in the little ward-room glistened with cleanliness, and even the ugly stoves began to shine. “Loud conversational blasphemy” and the banging of doors went out of favor. One of the first things she “drew” from the “Sanitary”—why do so many honest people always use the qualificative instead of the noun?—was a lot of soft, light slippers for the men-nurses in the ward. She knew that the heavy creak of a boot is almost as intolerable to a patient as a “sympathizer” sitting on the edge of his bed. She knew what to ask for and what to do with it. … No crowd of new patients came in, in ever so great confusion, without a quick, discriminating survey of their real and immediate wants and a similar report and supply. She possessed what many better educated women never attain—the ability to postpone the non-essential to the essential, and to distinguish clearly between them.

— Jane Stuart Woolsey, Hospital Days: Reminiscence of a Civil War Nurse

 

There was never a critical case in hospital on which G.’s intelligence was not brought to bear in some shape. On one of these nights a nurse came hurriedly up with the word: “There’s a man dying in Ward —; we can’t do anything for him.” “Has he taken anything since he came in?” “No’m, can’t eat nothin’; doctor says mustn’t give him no stimulants, stomach’s too weak.” “I’ll have a look at him,” says G.; and after the nurse goes out—”the surgeon doesn’t know a bronchitis from a broken leg. There’s not a man in that ward who ought to die. If he is dying, he is dying of starvation.” She hunts up the doctor and asks if wine-whey, the lightest of stimulants, may be tried. Doctor didn’t know what it was, but had no objection; “man couldn’t live anyhow.” The man took the cup full eagerly, was “out of danger” in the morning, got well,—the doctor directing the nurse to be very particular to “give him his wine-whey regular,”—went back to the field and helped to take Richmond.

It was delightful to see what changes rest, clean clothes, and a few good meals often made. Miserable heaps brought in on stretchers might be found in a week’s time sitting up in dressing-gowns with newspapers in their laps; and in a week more with paper collars and pomatum in their hair.

— Jane Stuart Woolsey, Hospital Days: Reminiscence of a Civil War Nurse

 

S. was a dear boy, patient, cheerful, and lovely-tempered. He was very anxious to get well, and faithfully followed all instructions. The nurses heard him softly praying in the night, “Dear Saviour, give me strength to see the morning.” His serene temper was in his favor, and to the surprise of all he began to improve slowly and was able at last to get home. David W. died of fever and scorbutic disease, exhausted by long hardship and neglect. He was courtly even in his last agony. I fanned him a great deal, as he liked it, but he said repeatedly, ”Your arm must be tired, pray don’t tire yourself.” “Do you like it?” I asked. “Oh, yes! It is delightful, but don’t tire your arm for me. I couldn’t bear that.”

— Jane Stuart Woolsey, Hospital Days: Reminiscence of a Civil War Nurse

 

Illness is itself an occupation. [italics added] These men, able to get about, but too weak and spiritless to do anything or care for anything, sickened by the sight of food in quantity, fretted to pain by noise and by the very light of day, thrust aside by busy nurses, rather condemned by surgeons as “lame-backs” and “good-for-nothings,”—how did they ever get through the long and weary hours?

— Jane Stuart Woolsey, Hospital Days: Reminiscence of a Civil War Nurse

 

*****************************************************

A Deeper Look at Walt Whitman’s Hospital Experiences and His Views of Medicine

 

Such an examination seems warranted, as the quotations from Walt Whitman’s writings below show.

Beginning in late December 1862, Whitman obtained part-time work in Washington, DC and served as a volunteer — a comforter and sort of unofficial nurse — in army hospitals. He continued his hospital work there, ministering to both Union and Confederate soldiers, for the duration of the Civil War and for several months after the war had ended.

Whitman achieved remarkable results as a volunteer aide in Civil War hospitals. This was the result of: (1) the way Whitman approached his patients, reflecting his views of humanity and the human condition in general, as well as of health and medicine; (2) his attention as a caregiver to detail; (3) his kindness and compassion; and (4) his steadfast devotion. He would sit by a patient’s bedside all night without the sick man necessarily talking with him, and no request was brushed aside by him.

In an article by Whitman, “Our Wounded and Sick Soldiers” published in The New York Times on December 11, 1864, he described his hospital visits as follows:

My custom is to go through a ward, or a collection of wards, endeavoring to give some trifle to each, without missing any. Even a sweet biscuit, a sheet of paper, or a passing word of friendliness, or but a look or nod, if no more. In this way I go through large numbers, without delaying, yet do not hurry. I find out the general mood of the ward at the time; sometimes see that there is a heavy weight of listlessness prevailing, and the whole ward wants cheering up. I perhaps read to the men, to break the spell; calling them around me, careful to sit away from the cot of any one who is very bad with sickness or wounds. Also, I find out, by going through in this way, the cases that need special attention, and can then devote proper time to them. … I always confer with the doctor, or find out from the nurse of ward-master, about a new case. But I soon get sufficiently familiar with what is to be avoided, and learn also to judge almost intuitively what is best.

And, in a letter to his mother, he wrote:

He who goes among the soldiers with gifts, etc., must beware how he proceeds. It is much more of an art than one would imagine. They are not charity-patients, but American young men, of pride and independence. The spirit in which you treat them, and bestow your donations, is just as important as the gifts themselves; sometimes more so. Then there is continual discrimination necessary. Each case requires some peculiar adaptation to itself. It is very important to slight nobody—not a single case. Some hospital visitors, especially the women, pick out the handsomest looking soldiers, or have a few for their pets. Of course some will attract you more than others, and some will need more attention than others; but be careful not to ignore any patient. A word, a friendly turn of the eye or touch of the hand in passing, if nothing more. (quoted in Walt Whitman: The Wound Dresser: Letters Written to his Mother from Hospitals in Washington during the Civil War, edited by Richard M. Bucke)

Whitman’s Civil War service provided the basis for two books by him (Drum-Taps and Memoranda During the War), with the poems of the former book expanding the content and scope of Leaves of Grass and Whitman becoming, it could be asserted, not only America’s poet, but our Civil War poet — it has been the focus of many books and articles. (These include Harold Aspiz, Walt Whitman and the Body Beautiful; Robert Leigh Davis, Whitman and the Romance of Medicine; and Philip W. Leon, Walt Whitman & Sir William Osler: A Poet and His Physician.)

Whitman’s experiences as a volunteer in military hospitals during the Civil War are a major factor in his biography. His experience as a hospital volunteer has influenced much of my own thinking about medicine. They greatly influenced his writings (as I have noted above) and contributed, ultimately, to a decline in his own health.

Walt Whitman’s friend the naturalist John Burroughs wrote in his Walt Whitman: A Study:

[His] principles of operation, effective as they were, seemed strangely few, simple, and on a low key,—to act upon the appetite, to cheer by a healthy and fitly bracing appearance and demeanor; and to fill and satisfy in certain cases the affectional longings of the patients, was about all. He carried among them no sentimentalism nor moralizing; spoke not to any man of his “sins,” but gave something good to eat, a buoying word, or a trifling gift and a look. He appeared with ruddy face, clean dress, with a flower or a green sprig in the lapel of his coat. Crossing the fields in summer, he would gather a great bunch of dandelion blossoms, and red and white clover, to bring and scatter on the cots, as reminders of out-door air and sunshine.

 

*****************************************************

WHITMAN’S CIVIL WAR LETTERS

 

Walt Whitman, letter to his sister-in-law Martha Whitman

January 3, 1863

Yesterday I went out to the Campbell Hospital to see a couple of Brooklyn boys, of the 51st. … O my dear sister, how your heart would ache to go through the rows of wounded young men, as I did—and stopt to speak a comforting word to them. There were about 100 in one long room, just a long shed neatly whitewashed inside. One young man was very much prostrated, and groaning with pain. I stopt and tried to comfort him. He was very sick. I found he had not had any medical attention since he was brought there—among so many he had been overlooked. So I sent for the doctor, and he made an examination of him—the doctor behaved very well—seemed to be anxious to do right—said that the young man would recover—he had been brought pretty low with diarroeha, and now had bronchitis, but not so serious as to be dangerous. I talked to him some time—he seemed to have entirely give up, and lost heart—he had not a cent of money—not a friend or acquaintance—I wrote a letter from him to his sister—his name is John A. Holmes, Campbello, Plymouth county, Mass. …he said he would like to buy a drink of milk, when the woman came through with milk. Trifling as this was, he was overcome and began to cry.

[In an article by Whitman in the New York Times of February 26, 1863, Whitman describes meeting Holmes at Campbell Hospital in January 1863. “As I stopped by him and made some commonplace remark (to which he made no reply), I saw as I looked that it was a case for ministering to the affection first, and other nourishment and medicines afterward. I sat down by him without any fuss; talked a little; soon saw that it did him good; led him to talk himself; got him somewhat interested.”

 

Walt Whitman, letter to Nathaniel Bloom and John F. S. Gray

March 19-20, 1863

I [have] got very much interested in some particular cases in Hospitals here—go now steadily to more or less of said Hospitals by day or night—find always the sick and dying soldiers forthwith begin to cling to me in a way that makes a fellow feel funny enough. These Hospitals, so different from all others—these thousands, and tens and twenties of thousands of American young men, badly wounded, all sorts of wounds, operated on, pallid with diarrhea, languishing, dying with fever, pneumonia, &c. open a new world somehow to me, giving closer insights, new things, exploring deeper mines than any yet, showing our humanity, (I sometimes put myself in fancy in the cot, with typhoid, or under the knife,) tried by terrible, fearfulest tests, probed deepest, the living soul’s, the body’s tragedies, bursting the petty bonds of art. To these, what are your dramas and poems, even the oldest and the tearfulest?

 

Walt Whitman, draft of letter to Nicholas Wyckoff or Daniel L. Northrup

May 14, 1863

I adapt myself to each case … some need to be humored, some are rather out of their head—some merely want me to sit down [near] them, & hold them by the hand—one will want a letter written to mother or father, (yesterd[ay] I wrote over a dozen letters)-­some like to have me feed them (wounded perhaps in shoulder or wrist) perhaps a few bits of my peaches—some want a cooling drink, (I have some very nice syrups from raspberries &c.)—others want writing paper, envelopes, a stamp, &c.—I could fill a sheet with one day’s items—I often go, just at dark, sometimes stay nearly all night—I like to go just before supper, carrying a pot or jar of something good & go around with a spoon distributing a little here and there. Yet after all this succoring of the stomach (which is of course most welcome & indispensable) I should say that I believe my profoundest help to these sick & dying men is probably the soothing invigoration I steadily bear in mind, to infuse in them through affection, cheering love, & the like, [italics added] between them & me. It has saved more than one life. There is a strange influence here. I have formed attachments here in hospital, that I shall keep to my dying day, & they will the same, without doubt.

 

Walt Whitman, letter to his mother, Louisa Van Velsor Whitman

June 30, 1863

One soldier, brought here about fifteen days ago, very low with typhoid lever, Livingston Brooks, Co B 17th Penn Cavalry, I have particularly stuck to, as I found him in what appeared to be a dying condition, from negligence, & a horrible journey of about forty miles, bad roads & fast driving—& then after he got here, as he is a simple country boy, very shy & silent, & made no complaint, they neglected him— … I called the doctor’s attention to him, shook up the nurses, had him bathed in spirits, gave him lumps of ice, & ice to his head, he had a fearful bursting pain in his head, & his body was like fire—he was very quiet, a very sensible boy, old fashioned—he did not want to die, & I had to lie to him without stint, for he thought I knew everything, & I always put in of course that what I told him was exactly the truth, & that if he got really dangerous I would tell him & not conceal it.

The rule is to remove bad fever patients out from the main wards to a tent by themselves, & the doctor told me he would have to be removed. I broke it gently to him, but the poor boy got it immediately in his head that he was marked with death, & was to be removed on that account—it had a great effect upon him, & although I told the truth this time it did not have as good a result as my former fibs—I persuaded the doctor to let him remain—for three days he lay just about an even chance, go or stay, with a little leaning toward the first—But, mother, to make a long story short, he is now out of any immediate danger—he has been perfectly rational throughout—begins to taste a little food, (for a week he eat nothing, I had to compel him to take a quarter of an orange, now & then)—& I will say, whether any one calls it pride or not, that if he does get up & around again, it’s me that saved his life.

 

Walt Whitman, draft of letter to Mr. and Mrs. S. B. Haskell

August 10, 1863

Dear friends, I thought it would be soothing to you to have a few lines about the last days of your son Erastus Haskell of Company K, 141st New York Volunteers. I write in haste … I thought any thing about Erastus would be welcome. … From the first I felt that Erastus was in danger, or at least was much worse than they in the hospital supposed. As he made no complaint, they perhaps [thought him] not very bad—I told the [doctor of the ward] to look him over again—he was a much [sicker boy?] than he supposed, but he took it lightly, said, I know more about these fever cases than you do—the young man looks very sick, but I shall certainly bring him out of it all right. I have no doubt the doctor meant well & did his best—at any rate, about a week or so before Erastus died he got really alarmed & after that he & all the doctors tried to help him, but without avail—Maybe it would not have made any difference any how—I think Erastus was broken down, poor boy, before he came to the hospital here. … Somehow I took to him, he was a quiet young man, behaved always correct & decent, said little—I used to sit on the side of his bed—I said once, You don’t talk any, Erastus, you leave me to do all the talking—he only answered quietly, I was never much of a talker. The doctor wished every one to cheer him up very lively—I was always pleasant & cheerful with him, but did not feel to be very lively—Only once I tried to tell him some amusing narratives, but after a few moments I stopt, I saw that the effect was not good, & after that I never tried it again—I used to sit by the side of his bed, pretty silent, as that seemed most agreeable to him, & I felt it so too—he was generally opprest for breath, & with the heat, & I would fan him—occasionally he would want a drink—some days he dozed a good deal—sometimes when I would come in, he woke up, & I would lean down & kiss him, he would reach out his hand & pat my hair & beard a little, very friendly, as I sat on the bed & leaned over him. …

I was very anxious he should be saved, & so were they all—he was well used by the attendants—poor boy, I can see him as I write … He never complained—but it looked pitiful to see him lying there, with such a look out of his eyes. He had large clear eyes, they seemed to talk better than words—I assure you I was attracted to him much—Many nights I sat in the hospital by his bedside till far in the night—The lights would be put out—yet I would sit there silently, hours, late, perhaps fanning him—he always liked to have me sit there, but never cared to talk—I shall never forget those nights. …

 

Walt Whitman, draft of letter to William S. Davis

October 1, 1863

I go every day or night in the hospitals a few hours. … As to physical comforts, I attempt to have something—generally a lot of–something harmless & not too expensive to go round to each man, even if it is nothing but a good home-made biscuit to each man, or a couple of spoonfuls of blackberry preserve, I take a ward or two of an evening & two more next evening &c—as an addition to his supper—sometimes one thing, sometimes another … then, after such general round, I fall back upon the main thing, after all, the special cases, alas, too common–those that need special attention, some little delicacy, some trifle—very often, far above all else, soothing kindness wanted—personal magnetism [italics added]—poor boys, their sick hearts & wearied & exhausted bodies hunger for the sustenance of love or their deprest spirits must be cheered up … it is comfort & delight to me to minister to them, to sit by them—some so wind themselves around one’s heart, & will be kissed at parting at night just like children—though veterans of two years of battles & camp life—

I always carry a haversack with some articles most wanted—physical comforts are a sort of basis—I distribute nice large biscuit, sweet-crackers, sometimes cut up a lot of peaches with sugar, give preserves of all kinds, jellies, &c. tea, oysters, butter, condensed milk, plugs of tobacco, (I am the only one that doles out this last, & the men have grown to look to me)—wine, brandy, sugar, pickles, letter-stamps, envelopes & note-paper, the morning papers, common handkerchiefs & napkins, undershirts, socks, dressing gowns, & fifty other things—l have lots of special little requests.

 

Walt Whitman, draft of letter to Margaret S. Curtis, October 4, 1863

I try to distribute something, even if but the merest trifle, all round, without missing any, when I visit a ward, going round rather rapidly—& then devoting myself, more at leisure, to the cases that need special attention. One who is experienced may find in almost any ward at any time one or two patients or more, who are at that time trembling in the balance, the crisis of the wound, recovery uncertain, yet death also uncertain. I will confess to you, madam, that I think I have an instinct & faculty for these cases. Poor young men, how many have I seen, & known—how pitiful it is to see them—one must be calm & cheerful, & not let on how their case really is, must stop much with them, find out their idiosyncrasies [italics added]— do any thing for them—nourish them, judiciously give the right things to drink—bring in the affections, soothe them, brace them up, kiss them, discard all ceremony, & fight for them, as it were, with all weapons. I need not tell your womanly soul that such work blesses him that works as much as the object of it. …

It is now between 8 & 9, evening—the atmosphere is rather solemn here to-night—there are some very sick men here—the scene is a curious one—the ward is perhaps 120 or 30 feet long—the cots each have their white musquito curtains—all is quite still—an occasional sigh or groan … the walls, roof, &c are all whitewashed—the light up & down the ward from a few gas-burners about half turned down. … I have been in the hospital, one part or another, since 3 o’clock—to a few of the men, pretty sick, or just convalescing & with delicate stomachs or perhaps badly wounded arms, I have fed their suppers—partly peaches pealed, & cut up, with powdered sugar, very cool & refreshing—they like to have me sit by them & peal them, cut them in a glass, & sprinkle on the sugar— (all these little items may-be may interest you).

 

Walt Whitman, letter to Louisa Van Velsor Whitman, October 6, 1863

Mother, it is lucky I like Washington in many respects, & that things are upon the whole pleasant personally, for every day of my life I see enough to make one’s heart ache with sympathy & anguish here in the hospitals, & I do not know as I could stand it, if it was not counter­balanced outside—it is curious—when I am present at the most appaling [sic] things, deaths, operations, sickening wounds (perhaps full of maggots), I do not fail, although my sympathies are very much excited, but keep singularly cool—but often, hours afterward, perhaps when I am home, or out walking alone, I feel sick & actually tremble, when I recal [sic] the thing & have it in my mind again before me—

 

Walt Whitman, draft of letter to Hugo Fritsch, October 8, 1863

I still live here as a hospital missionary after my own style, & on my own hook—I go every day or night without fail to some of the great government hospitals—the sad scenes I witness—scenes of death, anguish, the fevers, amputations, friendlessness, of hungering & thirsting young hearts, for some loving presence—such noble young men as some of these wounded are—such endurance, such native decorum, such candor—I will confess to you, dear Hugo, that in some respects I find myself in my element amid these scenes—shall I not say to you that I find I supply often to some of these dear suffering boys in my presence & magnetism that which nor doctors nor medicines nor skill nor any routine assistance can give? [italics added]

 

Walt Whitman, letter to Abby H. Price, October 11, 1863

I am continually moving around among the hospitals. One I go to oftenest the last three months is Armory Square, as it is large, generally full of the worst wounds & sicknesses, & is one of the least visited—to this, or some one, I never miss a day or evening. I am enabled to give the men something—add perhaps some trifle to their supper all round. Then there are always special cases, needing something special. Above all the poor boys welcome magnetic friendship, personality (some are so fervent, so hungering for this)—poor fellows, how young they are, lying there with their pale faces, & that mute look in the eyes. O how one gets to love them, often, particular cases, so suffering, so good, so manly & affectionate—Abby, you would all smile to see me among them—many of them like children, ceremony is mostly discarded—they suffer & get exhausted & so weary—lots of them have grown to expect as I leave at night that we should kiss each other, sometimes quite a number, I have to go round—poor boys, there is little petting in a soldier’s life in the field, but, Abby, I know what is in their hearts, always waiting, though they may be unconscious of it themselves—

I have a place where I buy very nice home-made biscuits, sweet crackers &c—Among others, one of my ways is to get a good lot of these & for supper go through a couple of wards & give a portion to each man—next evening two wards more, & so on—then each marked case needs something to itself—I spend my evenings altogether at the hospitals—my day, often. I give little gifts of money in small sums, which I am enabled to do. All sorts of things indeed, food, clothing, letter-stamps (I write lots of letters), now & then a good pair of crutches &c &c. Then I read to the boys—the whole ward that can walk gathers around me & listens—

 

Walt Whitman, letter to James P. Kirkwood, April 27 (?), 1864

I have now been over a year among the wounded. I find that personal application, tact, & insight, with entire sympathy, are the only means effectual in hospitals [italics added]—every case wants some peculiar adaptation—to some, some little article purchased—many the tender hand & word, oft repeated, never slacking up, till danger is past. … The soldiers are nearly altogether young American men of decent breeding, farmers’ sons ordinarily educated, but well behaved & their young hearts full of manliness & candor. Their condition makes deepest attachments under their sufferings & wounds often brought right to the bitterness of death. Some, indeed, one feels to love deeply, & they return it with interest.

 

*****************************************************

Whitman’s Hospital Experiences, as Recounted and Analyzed by Whitman Scholars

When practicable, he came to the long and crowded wards of the maimed, the feeble, and the dying, only after preparations as for a festival,—strengthened by a good meal, rest, the bath, and fresh underclothes. He entered with a huge haversack slung over his shoulder, full of appropriate articles, with parcels under his arms, and protuberant pockets. He would sometimes come in summer with a good-sized basket filled with oranges, and would go round for hours paring and dividing them among the feverish and thirsty.

— John Burroughs, Walt Whitman: A Study

 

Nothing is of any avail among the soldiers except conscientious personal investigation of cases, each for itself; with sharp critical faculties, but in the fullest spirit of human sympathy and boundless love. The men feel such love more than anything else. I have met very few persons who realize the importance of humoring the yearning for love and friendship of these American young men, prostrated by sickness and wounds.

To many of the wounded and sick, especially the youngsters, there is something in personal love, caresses, and the magnetic flood of sympathy and friendship, that does, in its way, more good than all the medicine in the world [italics added] … Many will think this merely sentimentalism, but I know it is the most solid of facts. I believe that even the moving around among the men, or through the ward, of a hearty, healthy, clean, strong, generous-souled person, man or woman, full of humanity and love, sending out invisible, constant currents thereof, does immense good to the sick and wounded.

— Walt Whitman; quoted in Roger Asselineau, The Evolution of Walt Whitman

 

Although [Whitman] sometimes helped the doctors and nurses to change bandages, he was never, in a literal sense, a “wound-dresser,” as [Richard Maurice] Bucke called him. Nevertheless this title suited him perfectly; if he did not attend the wounds of the body, he brought to the wounded or sick soldiers something which was as necessary to their recovery as medical care, but for which the regulations had not provided: the comfort of a loving presence, the sweetness of an almost maternal affection, the delicate attentions [italics added] of an ingenious kindness. He had already rehearsed this role in the New York hospitals where he had often visited sick omnibus drivers. He fulfilled it with perfect tact.

— Roger Asselineau, The Evolution of Walt Whitman

 

These are the principles that he put into practice. He went from bed to bed, distributing oranges, lemons, sugar, jam, preserved fruit, tobacco (which the soldiers rarely had) …. and even small sums of money which permitted them to buy some comforts. But, above all, he paused at the bedside of one or another to listen to their stories. He was passionately interested in the fate of each one. … Many of the young soldiers felt abandoned and deprived of affection, and he performed the function of a family and gave them back the will to live. … To those who were too ill to listen or to speak, he offered his silent presence, the presence of a body which from the first days of the war he had consecrated to purity and health. He remained at their bedside for hours if necessary. Thus took place a mysterious transfusion of strength. It was as if his serenity and health were contagious; at his contact the wounded regained hope. He gave them the desire to recover. [italics added]

— Roger Asselineau, The Evolution of Walt Whitman

 

… his presence and care sometimes worked miracles. Doctors themselves were obliged to admit it, and in a letter to his mother, he told the story of a cure which he had effected in after several days’ battle with death:

By the power of patience and tenderness he had in fact succeeded in tipping the balance toward the side of life. And he saved the lives of many sick and wounded soldiers the same way:

“Mother, [he wrote a few months later,] I have real pride in telling you that I have the consciousness of saving quite a number of lives by saving them from giving up—and being a good deal with them; the men say it is so, and the doctors say it is so—and I will candidly confess I can see it is true, though I say it of myself.”

— Roger Asselineau, The Evolution of Walt Whitman

 

Whitman and his friends fashioned the myth of a hospital visitor endowed with limitless health, spirituality, and “incredible and exhaustless” magnetic-curative powers. “It is no figure of speech, but a fact deeper than speech,” [Whitman’s friend, the naturalist John] Burroughs asserted, that the “lusterless eye [of the suffering soldiers] brightened up at his approach, his commonplace words invigorated; a bracing air seemed to fill the ward and neutralize the bad smells.” Indeed, Whitman was said to possess a “new and mysterious” bodily quality which was indescribable, “but which none who come into his presence can escape, and which is, perhaps, the analogue to the intuitive quality of his intellect.”

Whitman’s efforts to arouse the soldiers’ recuperative powers were consistent with the nineteenth-century medical theory of vitalism, according to which every person possesses, in addition to his physical and chemical organization, an electric life force that is linked to his will and that governs his ability to overcome sickness. It is true that Whitman helped soldiers to survive essentially by rallying their will to overcome illness. But the well-publicized charisma of the healer-persona was compounded, in part, of mystical elements and seasoned with a generous dash of poetic imagination. In sentiments, if not words, that are the poet’s own, [Richard Maurice] Bucke’s Walt Whitman (1883), a joint venture in mytho-biography, declared that Whitman had buoyed up the ailing soldiers “with a few words, with caresses, with personal affection; he bends over them, strong, clean, cheerful, perfumed, loving, and his magnetic touch and love sustain them.” Whitman’s touch, Bucke explained, had “a charm that cannot be described, and if it could, the description would not be believed except by those who know him either personally or through Leaves of Grass. This charm (physiological more than psychological), if understood, would explain the whole mystery of the man, and how he produced such effects not only upon the well, but among the sick and wounded.”

— Harold Aspiz, Walt Whitman and the Body Beautiful

 

As Aspiz notes, Whitman “advocated … the treatment of patients in terms of their total personality and organic being.” He “insisted that genuine cures can result only from a careful investigation of the whole person.” He felt that doctors were guilty of having an insufficient reverence for the human body.

It is further noted by Aspiz of Whitman that

… his ministrations were efficacious. Going on his rounds, carrying the familiar leather knapsack filled with gifts and with items the soldiers had asked for—jams and jellies, fruit, tobacco, and coins—writing letters, chatting, sitting beside the sick and dying, changing the dressing on a wound, or reading poetry to the ‘boys’ — white and black, soldier and teamster—he soothed them by his very presence.

The journalist and historian John Swinton, who accompanied Whitman on a tour of the hospital wards, told of the curative effect of Whitman … he said that Whitman’s personality seemed to light up the wards … he handed out comfits and oranges, wrote letters, and delivered messages; he conferred touches, words of cheer, or “a manly farewell kiss.” He seemed to leave a benediction for everyone as he passed along.

[Whitman] took justifiable pride in his efforts to rouse the natural recuperative powers—the vis medicatrix naturae—of the soldiers.

 

*****************************************************

“Nothing is of any avail among the soldiers except conscientious personal investigation of cases, each for itself; with sharp, critical facilities, but boundless love,” Whitman wrote in one of his letters. “The men feel such love more than anything else. I have met very few persons who realize the importance of humoring the yearnings for love and friendship of these American young men, prostrated by sickness and wounds … that does, in its way, more good than all the medicine in the world. … I have the consciousness of saving quite a number of lives by saving them from giving up—and being a good deal with them; the men say it is so, and doctors say it is so.”

[This quote appears in several sources. It appears that the quotation is from a letter from Whitman to his mother, Louisa Van Velsor Whitman, written in 1863, when Whitman was in Washington. I could not find the letter in books published about Whitman or a precise reference to it, and cannot therefore verify the source.]

Have doctors ever given (or thought about giving) this kind of love, let alone affection? Of course not. They would, I would imagine, consider it ridiculous. They are committed to what they view as unshakable “scientific” detachment. To which I would reply. Fine — who am I to say? Except that, absent the kind of care Whitman provided (doctors will say their patient load doesn’t permit it) patients will not get better. This seems to me as certain as the diagnostic facts upon which doctors base their decisions about treatment.

 

*****************************************************

Respect for the Patients’ “Personhood”; The Vis Medicatrix Naturae

As Whitman scholar Harold Aspiz notes in his monograph Walt Whitman and the Body Beautiful, the physicians who treated Whitman in his later years, notably William Osler, “demonstrated a wholesome respect for the total organism and personality of their patients and a skepticism toward drugs.”

Doctors want to treat the symptom and do not want to be bothered with the individual.

It was Whitman’s belief that a physician should treat the whole person rather than some localized aspects of his illness. Osler was, like Whitman, skeptical of drugs. He reflected the renewed esteem in the medical world at that time for the vis medicatrix naturae, which has been called (in an article by Max Neuberger in the journal Medical Life, 1932) “the defensive and prophylactic apparatus and the healing powers of nature.” Whitman saw Osler (in Aspiz’s words) as “the born healer who is instinctively aware of the curative powers of nature.”

Aspiz notes:

Ever since Whitman’s newspaper days, the poet had cherished the Hippocratic principle that the innate natural powers are the principal healers of disease. Like the homeopathic and eclectic doctors of an earlier era, he still denied that disease is usually a distinctive condition affecting a specific organ but held that it most often is a derangement of the vis medicatrix naturae. According to an authority [Max Neuberger], this principle meant that ‘the final decision’ between sickness and recovery ‘depends in most cases on the healing powers of nature, and … even the most ideal activity of the physician must find its fulcrum and measure in this regulative-compensatory reaction of the organism, in the natural defensive and protective apparatus.

Whitman declared in later life to Horace Traubel (who kept a record of his conversations with the poet): “By nature, by observation, by the doctors, I have learned that the thing to do when I am really down is to rely upon the vis, as it is called—the inherited forces.” He said that the vis either comes to the sufferer’s rescue or “all may as well be given up at once.”

“[Whitman’s] medical intuitions were sound,” Aspiz writes:

Progressive medical practice, as Richard H. Shyrock points out (in his book Medicine in America), has learned to respect the “concern about complete physiological reactions to disease and injury.” Whitman esteemed Dr. Osler because Osler “treated the whole man rather than his localized aliments, because he applied the principle that a doctor must know the natural course of a disease before he can know his patient’s reaction to any medication used in its cure, and because he was skeptical of drugs. He would have cheered Dr. Osler’s advice to his medical students “to cultivate a keenly skeptical attitude toward the pharmacopeia as a whole, remembering the shrewd remark of Benjamin Franklin that ‘he is the best doctor who knows the worthlessness of most medicines.’ ”

Whitman told his literary friend John Townsend Trowbridge that when he was living in New York in 1860, he could “cheer up” and “strengthen” a sickly lad living in his boarding house by charging him with his (Whitman’s) own “magnetism.” He attributed his success in healing “sick and affection-starved soldiers” (in the words of Aspiz) to what Whitman called his “magnetic personality” — “freely bestowed,” as Aspiz notes — and “the simple matter of [his own] personal presence, and emanating ordinary cheer and magnetism [italics added]. It is, he said, “the most solid of facts that “even the moving around among the men, or through the ward, of a hearty, healthy, clean, strong, generous-souled person, man or woman, full of humanity and love, sending out invisible currents thereof, does immense good to the sick and wounded” (in Whitman’s Specimen Days).

“According to Whitman’s reasoning,” Aspiz notes, “once the solider has regained his will to survive, he activates his vis medicatrix naturae (vis is Latin for power or force) — the body’s natural recuperative powers — and begins to regain his health. There is an important principle here. It is that sickness involves not only pathology, it also affects the mind and often involves a sort of paralysis of the will.

How many such persons does one see in hospitals today?

Perfect health is the right relation to nature, Whitman believed. Somehow, in sickness, the relation has become disjointed.

 

*****************************************************

Quotations from Contemporary Critics of Medicine/Healthcare

Medical school was a long, dark tunnel. I barely survived it, and I thought of quitting daily — literally. It was not only the grinding, tedious, endless cacophony of minutiae to be swallowed, nor the traumatic rites of passage in morgue, O.R., etc. that wore me down; the worst part was the stifling (intellectually, creatively, personally) atmosphere created by the Priests of Medicine, my teachers, would-be role models — and, finally, even my cohorts. There are tremendous pressures to conform, assume, the aloof Demigod role, “think” only in ritualized patterns. Metaphysical, epistemological – even ethical — questions are ignored or treated as so much offal from the morgue. A righteous, “scientific” detachment is developed and refined. The only way I survived was to withdraw from the whole scene as much as possible. The ultimate effect on me was a complete radicalization of my thinking. …

— John Dana Ferris MD, letter to Roger W. Smith, January 21, 1978

 

[T]he conventional wisdom is that more diagnosis–particularly, more early diagnosis–means better medical care. The logic goes something like this: more diagnosis means more treatment, and more treatment means better health. This may be true for some. But there is another side to the story. More diagnosis may make healthy people feel more vulnerable–and, ironically, less healthy. In other words, excessive diagnosis can literally make you feel sick. And more diagnosis leads to excessive treatment for problems that either aren’t that bothersome or aren’t bothersome at all. Excessive treatment, of course, can really hurt you. Excessive diagnosis may lead to treatment that is worse than the disease. … an overdiagnosed patient cannot benefit from treatment. There’s nothing to be fixed–he will neither develop symptoms nor die from his condition–so the treatment is unneeded. An overdiagnosed patient can only be harmed. And the simple truth is that almost all treatments have the potential to do some harm. … a substantial portion of my patients … avoid elective surgery. They are hesitant about taking medicines for what they perceive to be minor problems. And they are predisposed to be skeptical about preventive interventions, interventions for conditions that aren’t problems now but might become so in the future. I call it the “if it ain’t broke, don’t fix it” school of thought.

— H. Gilbert Welch, Lisa M. Schwartz, and Steven Woloshin, Overdiagnosed: Making People Sick in the Pursuit of Health, 2011

 

“Rather than being fearful of not detecting disease both patients and doctors should fear healthcare. The best way to avoid medical errors is to avoid medical care. The default should be: I am well. [italics added] The way to stay that way is to keep making good choices — not to have my doctor look for problems.”

— John M. Mandrola, “Redefining the Annual Physical: A (Broken) Window into American Healthcare,” Medscape, January 15, 2015 (quoted in Barbara Ehrenreich, Natural Causes; An Epidemic of Wellness, the Certainty of Dying, and Killing Ourselves to Live Longer, pg. 9)

 

I am no longer interested in looking for [medical] problems that remain undetectable to me.

— Barbara Ehrenreich, Natural Causes; An Epidemic of Wellness, the Certainty of Dying, and Killing Ourselves to Live Longer

 

I refuse to accept a medicalized life, and my determination only deepens with age. As the time that remains to me shrinks, each month and day becomes too precious to spend in windowless waiting rooms under the cold scrutiny of machines.

— Barbara Ehrenreich, Natural Causes; An Epidemic of Wellness, the Certainty of Dying, and Killing Ourselves to Live Longer

 

It still amazes me that there is still such a concern about the continued use of a more natural approach to one’s health care, as if the current medical model is so perfectly safe, cost effective, accessible and successful. It is not. Why do you think that so many are trying alternative methods? I recently lost two friends (both younger than myself) who went into the hospital (our alleged medical miracle complex) for relatively minor treatment and never came out. I never read articles about the dangers of medicine — and there are MANY. I, myself, am over 70 on NO medications (oh there were times I could have been, but was more concerned about side effects and costs) and have been able (thus far) to keep all aches, pains, transient sicknesses at bay using alternatives. … Please stop scapegoating them, and if you are concerned about research, FUND IT. Until you do, let people use what they find effective, NOT what someone else thinks they should use. P.S. There are numerous studies done on homeopathic treatment that are positive.

— reader’s comment re an op-ed, “ ‘Natural’ doctors face skepticism from practitioners of conventional medicine,” The Washington Post, April 9, 2018

 

*****************************************************

My Experience

 

The following are my own thoughts, based upon my experience of medical care as an occasional “nurse” in my own family, during a period when I worked as in a hospital as an orderly, and as the recipient of medical care from my parents when I was ill as a child. And, as an occasional visitor to doctors’ offices as an adult.

Doctors do not want to hear what you think your illness might be or how you think it might be treated. They regard your illness as their problem (to solve).

There were many old-fashioned ideas and popular medical theories in Walt Whitman’s time that were quack brained or based on pseudoscience. The same applies to many current medical fads.

Whitman was influenced by such views. But not all of them, past or present, are quack brained. Much is or was based on common sense and wisdom (notably Whitman’s views and those of like-minded advocates of what might be termed holistic medicine) and has, unfortunately, been neglected or disregarded. There is a lot of nonsense and wishful thinking in alternative or folk medicine today. Yet, I trust my own intuitions, as Whitman did his.

 

*****************************************************

Treat the person, not the disease.

 

The fundamental question, the matter about which I feel the experts know practically nothing, is how to care for sick people. It starts, at least for me, with one’s family and home.

Treat the PERSON, not the disease. Treating the disease is actually nurturing/fostering it.

This is what you do first, dear reader.

You give the sick or indisposed person your full, undivided attention, no matter how trivial (or serious) the complaint seems to be. As doctors almost never do, you listen. Patiently. And sympathetically. Without interruption.

You will be surprised how therapeutic this can be.

The patient is caught up in a web of misery. Due to being sick. There may be suffering or acute pain, or it could be that someone just doesn’t feel well.

But the miserable feelings have become predominant. The patient feels overwhelmed and unable to cope.

You do little things to alleviate the sense of oppression, miserableness, and powerlessness. To relieve or soothe the miserable feelings. The things the sick person feels too exhausted to do.

The patient begins to feel a little better. Is able to summon, call upon, his or her own curative propensities. And, perhaps, ultimately (it happens more often than one would imagine), face the disease and overcome it.

How does one help people get better?

Attend to their needs.

I believe that illness is, fundamentally, more emotional in nature than physical, which is not to deny or pretend that there is not — as there obviously is — a physical basis. Can one distinguish between etiology and cause? Some germs lodged in one’s throat. They breached the ramparts of the immune system because the victim was feeling tired and rundown.

I also believe, absolutely, that sick persons, including the sickest, have — as part of their makeup and constitution — “health factors” which can combat germs and disease. Restorative capabilities. The focus is always on pathology. Not to be a flat earth type denier of the scientific consensus (the opposite view), but how about looking at the capability we all have to feel well? The “health factors” inherent in our constitutions and the environment. There are curative (non-medical) factors all around us in our environment: in foods and drink, in the outdoors; in rest and sleep; in various little comforts as simple as a bed, clean sheets, a blanket, or a pillow; which diversions can get one’s mind off one’s illness or misery and can lead to physical healing. (I have observed it often).

And I believe that attentive care and alertness to complaints and needs, as well as sympathy and empathy, can work miracles. That a sick person needs these the most.

 

*****************************************************

Personal Examples; Home and Family

 

My father and mother were great with our illnesses. They responded with compassion, sensitivity, and empathy to all sorts of childhood maladies, from a sore throat or upset stomach to measles or chicken pox. They didn’t distinguish between a discomfort or something more serious. Paid minute attention to the needs, discomforts/comforts of myself and my siblings. I experienced this with my own parents and applied their “treatment methods,” which were mostly “extra medical,” to my own sons.

My older son was feeling wretched. Prostrate on his bed with a pail to vomit in. Nauseous and feeling clammy. I was advised to give him something or other. Pepto-Bismol? Cough medicine? (As if that would do any good for an upset stomach, but when someone is sick, others want to supply a remedy, any remedy, making them feel that they’ve done something, and something supposedly drawing upon readily available, effective curatives. If all the advertisements say it works wonders, it can’t do any harm, right?) What my son took I don’t recall. What I did, as is my wont, was to give him sympathy and, most importantly, my full attention. “How do you feel? What can I get for you?”

He recalled somehow that I had once given him Tom Collins Mix (because my parents used to use this remedy on me for an upset stomach). It works somehow. We had ginger ale at home, but Tom Collins Mix works better. It was late. Any stores still open? Would they have it? I didn’t hesitate. I got myself in gear and rushed to a local supermarket before closing time. I knew what he wanted and needed exactly; he had to have it right then. Not the next day, which would have meant going through another night of misery. A small thing, but — this is key — it was what he wanted and needed to bring him relief. That’s where one can be effective. At the ground or micro level. Not frantically calling doctors or rummaging through the medicine chest.

How about the bed sheets? He was feverish and sweaty. Let’s change them and make him more comfortable. Clean and straighten up the room.

Fussiness over, attention to, such details seems to have an ameliorative effect. When one is sick, the simplest task can seem onerous. Changing the sheets, taking a shower (just getting out of bed to do so), grooming, a change of one’s undershirt: These simple things can seem like too much effort. One is lying in “helpless squalor.” A “good angel” comes along and does these things. The sick individual starts to feel that the situation is not hopeless, and the little things, such as replacing a sweaty T-shirt with a fresh, clean one, can have tangible benefits that are felt immediately.

I’ve seen it numerous times. The patient, my son, your son or daughter, begins to feel a bit better. Or a little less miserable. Some kind of mutually reinforcing series of ameliorative phases, or intermittent intervening stirrings of “betterness,” set in. The “patient” gets better. Dr. Smith has worked his magic.

All it takes (no special training required) is assiduous attention to the patient’s needs as he or she sees them.

The sick person heals himself.

The person tending to him or her is a sort of intermediary, a facilitator, who by providing comfort and encouragement makes this possible.

 

*****************************************************

Mr. Falkenburg: a successful outcome resulting from attention to the individual patient

 

I stated above that attentive care and alertness to complaints and needs, as well as sympathy and empathy, can work miracles. That a sick person needs these the most.

Mr. Falkenburg is a case in point.

In the early 1970’s, I was employed as an orderly in the cardiac intensive care unit at Columbia Presbyterian Hospital in New York.

An elderly man was admitted. He was confused and disoriented. His behavior was somewhat erratic. He would get out of bed at the wrong time, seen unsure where he was or whether to dress or undress, things like that.

The nurses responded by treating Mr. Falkenburg, and speaking to him, in condescending, patronizing fashion. Lecturing and sort of scolding him in a falsetto voice as you see parents do with an errant child, e.g., “watch where you’re going!”; “eat your food, don’t play with it!”

I was assigned male patients and had a routine to follow: bathe them, make bed, etc.

Along with the routine, I talked with Mr. Falkenburg. He had a frightened, haunted look in his eyes. I treated him with respect and took my time with him.

The nurses couldn’t believe the change. He calmed down and acted normally. He was no longer the crazy patient.

Not only did his attitude and demeanor change, but within a couple of days he was discharged, the medical emergency over.

His wife came to visit him a couple of times prior to his discharge. They were taking calmly and did not seem alarmed. I could see great relief on her part that his “delirium” had passed and his condition was under control. She expressed gratitude to me several times. She realized what I had done.

I did not feel like a hero — I did feel very pleased. It gladdened me too to see the change; my focus all along had been on the patient as a person, not myself or my role.

I reacted instinctively. That is how I had always treated people, how I myself would want to be treated, and how my parents had treated me when I was sick. I was doing what to me seemed elementary, irrespective of whether it would be taught in a nursing course.

(This goes to show: It seems that some of the most important things we learn in life are by example and not by precept.)

To the extent that I was keenly aware of and focused on my role in Mr. Falkenburg’s sudden improvement, it was that it seemed to corroborate my ideas (and Whitman’s) about treating the person rather than the disease and putting empathy first.

 

*****************************************************

Essential Restorative Factors; Why Are Fresh Air and Sunshine Ignored When It Comes to Modern Health Care?

 

Has it ever occurred to doctors that the elements, which are omnipresent and free, available to everyone — namely, fresh air and sunshine — are superior to and much more efficacious than all their medicines?

Walt Whitman describes this in his poem “Song of the Open Road,” in which he portrays himself as the supremely healthy and health-giving poet/persona:

Healthy and free-footed, … the persona takes to the road and absorbs its lessons. Invigorated and energized by the electrical and spiritual qualities of the open air, … He interchanges his own magnetism with that of others. … his astounding assumptions are not unfounded. Before this poem was composed, [Bronson] Alcott and others had cited Faraday’s discoveries concerning the electric properties of oxygen in order to show that fresh air imparts physical and psychic revitalization. Health, electrical biologists argued, is a condition characterized by abundant body electricity, properly balanced between positive and negative charges. In the open sunlit spaces, the person’s blood can become oxygenated and electrified by his deep breathing, and his body can be vitalized by the atmospheric currents.

— Harold Aspiz, Walt Whitman and the Body Beautiful

Chief among these: the benefits of fresh air. As Walt Whitman put it: “I think I could stop here myself and do miracles”; “I inhale great draughts of air.” (Leaves of Grass, 1860 edition.)

And sunshine. As Whitman wrote in Leaves of Grass: “Why are there men and women that while they are nigh to me the sunlight expands my blood?” The women he admired, he said were “tanned in the face by shining suns and blowing winds.” And he preferred, he said, faces “well-tann’d to those that keep out of the sun.”

The best medicines, healing factors, restoratives, curatives are omnipresent in the environment, everywhere around us, and are free, such as fresh air, breezes, sunlight, and water. No prescriptions, medical insurance, or claim forms are required. You won’t find them in hospitals, and this is a problem, because in hospitals people are denied the very things they require to be able to get well. As Louisa May Alcott remarked in her Hospital Sketches, she experienced considerable frustration trying to provide fresh air for hospitalized men: “the windows had been carefully nailed down above, and the lower sashes could only be raised in the mildest weather.”

 

*****************************************************

There seems to be something to the idea — to me it is incontrovertible — that the ability to help unhealthy or sick persons depends upon intuition, sensitivity, and personal magnetism. And upon minute observances (including the utmost decorum and considerateness towards the sick person/sufferer) on the part of the would-be healer (as discussed above). And, equally, upon the health and “wholeness,” the “inner integrity,” of the would be nurse or healer. It is notable how Walt Whitman prepared for hospital visits with a bath and attention to his grooming and dress.

The healthy among the sick. Ministering to them. Imparting wholeness and health. They are very efficacious. Or, to put it another way, the sick should not be segregated, any more than is absolutely necessary; they should be among the healthy. Not in a hospital. Not in a hospital, if there is any way to avoid it. Sick people should not be shut up with other sick people. A hospital is (it sounds and is counterintuitive) not the place for sick people. Sick persons should not be segregated with other sick persons. The risk of nosocomial infections is reason enough to say this.

It is not good for sick persons to be immobilized. They need to get up if possible. (Medical personnel recognize this.) Move their limbs.

And sweat out the toxins. That’s where sunshine comes in. What Henry Ward Beecher called “a good perspiration and a breath of fresh air.”

 

*****************************************************

Medical Meddlers

 

For some reason, in discussing health and wellness issues and various remedies and treatment modalities, people become very opinionated, defensive about their own views, and easily angered.

They also feel entitled to give advice and are easily offended when they experience disagreement or find their advice to be either not welcome or not fully appreciated. (And, sometimes, resented.)

As Florence Nightingale observed, “No mockery in the world is so hollow as the advice showered upon the sick.”

As an instance of this, a reader of my post

“Roger’s rules for staying healthy (disregard at your peril!)”

Roger’s rules for staying healthy (disregard at your peril!)

wrote: “I thought it was ironic that someone with your medical condition was writing to tell others how to take care of theirs.”

[Readers of this blog whose native language is not English may not be aware of the connotation of the word condition as used here. One might say, “I am in good condition,” meaning good physical condition, in which context the word condition has a neutral connotation. But condition can also have a negative connotation, as it did here. It can mean a serious medical problem such as cancer or heart disease that requires attention. You will sometimes here someone saying, “I am concerned about your condition.” It is a way of hinting at a serious medical problem “delicately,” without coming right out and saying it.]

I thought to myself that, as far as I know, I am in good health: No doctors have raised alarms. Why the mention of “your condition”? I had recently experienced stress during what was actually a short period of a week or less. I had gone to a dentist during this time, my blood pressure was taken, and it was unusually high. I told this to my acquaintance, not by way of saying, I am concerned about my own health, but rather: “If you don’t believe I have had a stressful past few days, let me tell what my blood pressure was this morning.” Blood pressure can fluctuate wildly due to various factors.

I wrote back to my acquaintance, saying:

I have had no BP readings since the most recent one at my dentist’s. I have no doubt that high BP is hereditary in my case and runs in the family, ditto heart disease. Staying off meds seems to work for me, in general. (I am sure a critic would say, it depends which ones and that some meds are more important than others.) I feel good in general about my overall health and lifestyle. I do not presume to generalize from my own experience. I realize there may be hereditary factors predisposing me to hypertension and heart disease. I am doing something which is mentioned as recommended for controlling blood pressure: exercising and controlling my diet and weight. Because I see walking not as a chore, but something enjoyable, I continue doing it. I have never had a good experience with meds. I don’t believe in them. I feel that doctors are ignorant about or ignore the harmful side effects they can produce. I actually feel that I’m in good health. Natural treatment, should I need it, is the way to go for me.”

My correspondent wrote back to me, in a message with a mean-spirited undercurrent: “I don’t agree with any of your positions on this, but that’s OK — I do agree that it’s your life to live or lose in any way you see fit.”

My “life to live or lose”? I hadn’t been contemplating losing it. Death is a certainty for us all. I don’t enjoy contemplating the prospect, but I do do so from time to time. I prefer, however, as does Barbara Ehrenreich, not to dwell on it, not to obsess about it. The medical meddlers want to scare you, hector you with unasked for advice, and if you are not inclined to listen, they can become enraged. I ask: What good does such medical meddling do for anyone? Is it helpful to arouse one’s anxiety about the possibility of their becoming horribly ill at some future time when it is now only a hypothetical?

 

*****************************************************

CONCLUSIONS

 

All medications (including over-the-counter ones) are inimical to the body’s homeostasis. They should be avoided.

The best and only cures are the natural ones, available to all, for free: fresh air and sunshine, fluids, food, rest and sleep.

The natural environment is the best place for sick as well as healthy persons, meaning the outdoors in all seasons and under all weather conditions. Hospitals are the worst place. They should be avoided.

Avoid surgery. “Every single time you do surgery and cut into tissue, you damage nerves. It doesn’t matter if it’s breast surgery or eye surgery,” Dr. Anat Galor (an associate professor of clinical ophthalmology at the Bascom Palmer Eye Institute at the University of Miami) was quoted as saying in a recent New York Times article (June 11, 2018) on adverse side effects experienced by patients undergoing laser eye surgery, which had been advertised as virtually risk free. I have seen similar things in the case of surgeries undergone by my own family members. I had a painful tonsillectomy when I was around five years old, and have always regretted it. My wife had a similar experience and feelings. As a reader commenting on a New York Times article:

“Blurred Vision, Burning Eyes: This Is a Lasik Success?” by Roni Caryn Rabin, The New York Times, June 11, 2018

put it: “I try to live by a motto with respect to surgery: I consider it a last resort when all other modalities of treatment have failed. … Every surgery has potential complications and sequelae.”

Attitude is as important as any other variable in determining the outcomes of illness. This includes the attitude of health care providers and that of the patient. I am not necessarily advocating mind over matter, but much illness seems to be as much psychological as physical: a depression of spirits accompanying pain or physical debility. One should not ignore physical complaints or pretend they do not exist, but one’s attitude and outlook can often help one to cope with and even overcome physical problems. Dwelling on symptoms and “illness” can often be counterproductive.

The healer must be healthy and have the will to help his subject. Another way to put this is that the health of the healer is equally important to the state of the patient — neither is a negligible factor. One can see this in Walt Whitman’s case, as a healer or facilitator of healing during the Civil War. Personal magnetism can work wonders, as can compassion and concern. Regarding the latter, it is a matter of empathy, which most doctors, sadly, seem to lack. As Walt Whitman said in a letter of his quoted above: “I sometimes put myself in fancy in the cot, with typhoid, or under the knife.” That’s empathy. I saw it occasionally in the hospital where I worked, but rarely.

Advice of would be doctors (family, friends) and “medical meddlers” should be taken with a grain of salt. Doctors, while deserving respect, should not be treated as priests of medicine. Their advice should be taken warily. Which is to say, unless they have already established confidence, ask yourself if you yourself agree and are prepared to submit to a recommended treatment, operation, or procedure. One should always remember that it is your body, not the doctor’s. The body should be treated as a sort of sacred temple, not to be breached or compromised. The patient should demand respect, and, if it is not given, should look elsewhere for a doctor.

It goes without saying that expertise and competence (to say nothing of the knowledge resulting from years of study) are de rigueur when it comes to health care — I hope I do not seem to be implying that they don’t matter or are less important than, say, compassion. But, I firmly believe that the essential ingredient of health care is not treatment of symptoms or of disease — it is treatment of the person. And this means that what the patient needs most is to be treated as a person and not as a nuisance, or just another case (or as an abstraction, such as a “mastectomy”). Which means that the doctor or nurse should first listen to the patient, to ascertain the nature of their complaints and what their needs are. And, if this does not occur, treatment will not be effective.

 

— Roger W. Smith

    June 2018

 

*****************************************************

Addendum:

Regarding the quotes from Walt Whitman with which I began this essay, Whitman’s sentiments pretty much match my own. My feelings towards doctors are mixed. Like Whitman, I am skeptical of doctors, while at the same time I venerate their calling, considered as such.

I don’t as a rule have that much respect for doctors as practitioners. I have had encounters with too many whom I found seriously wanting: in patient care, humanity, and what I would call “medical common sense.” This includes encounters with doctors I have consulted for my own medical issues and those I have consulted or had interactions with because a family member was being treated by them. My experience with doctors has not been positive, for the most part.

And yet, the profession of physician, considered in the Platonic sense, as an ideal, is one I greatly respect. It seems to me to be one of the noblest callings one can imagine.

Along with my disdain for doctors I have had great admiration for quite a few whom it has been my privilege to get to know either through personal acquaintance or because of a long association with them as health care providers. They range from pediatricians, general practitioners (including one who has treated my entire family at different times who essentially practices holistic medicine), several ophthalmologists whom I have consulted (including one who treated me when I was very young), a psychiatrist, an obstetrician-gynecologist whom a family member consulted, an oncologist who treated my mother, and others. They exhibited the epitome of medical knowledge and skills; total dedication; genuine humanity; often wide-ranging inquisitiveness and intelligence; and warmth and empathy. They are some of the persons I have admired the most as professionals during my lifetime and considered myself privileged to have met.

 

*****************************************************

Addendum, March 2022:

Whatever I said about blood pressure above, my assessment of my condition proved to be wrong. I neglected the problem of a very high blood pressure, lost contact with my internist (who had decreased by blood pressure medication), and did not do anything when my blood pressure became dangerously high. This lead to serious medical problems affecting my vision. I am now taking blood pressure meds regularly, and my condition of high blood pressure is under control.