Bernard Lown, MD
Whenever I read of an Iraqi war veteran’s suicide or of a soldier afflicted with post-traumatic stress disorder, I feel a frisson of anguish. My emotional reaction may be due to the many Holocaust victims whom I have doctored. They have taught me that some remembrances of pain and savagery are so deep and tautly embedded that the passage of time can only dilute, not purge.
One memory that frequently surfaces and fills me with desolation does not concern a Holocaust victim. This singular memory I wish to extirpate, but it leaves me helpless. My tormentor is a small, elderly housewife who was never a victim of Auschwitz, Buchenwald or the other charnel places of horror that had pockmarked Europe. This event happened so long ago that I have forgotten much else of that time.
The event I am about to relate occurred 61 years ago. The place was the Montefiore Hospital in New York City, where I was a medical resident. The hospital was then the city’s leading institution for the treatment of chronic disease, with its mostly elderly patients suffering from multiple intractable problems. Jack K., the intern working at the time on my service, was heavyset, ponderous, uninterested, and invariably complaining of indigestion. More annoying was his contempt for these elderly patients. He was impatient to complete the “stinking” internship and get on with his life’s commitment to psychiatry.
That singular day, the medical service was inundated with numerous admissions. During evening rounds, Jack provided a brief overview of those who, as he put it, ” had checked into the house.” Among those admitted was a Jewish woman from the Bronx whom he identified as a “crock.”
“Why the ugly label?” I asked angrily.
“She complains of waves in her head,” was the derisive response.
“What sort of waves?”
“Ocean waves on a Pacific atoll,” was his matter-of-fact answer.
“You got to be kidding. How does an elderly Jewish housewife in the Bronx get to the Pacific?”
“I didn’t ask. She sounds like a turkey.”
I completely lost my cool, berating him with a series of unmentionable expletives. “And you are aiming to be a shrink? They should run you out of the psychiatric profession before you set foot in it.” I marched off to learn about the Pacific atoll.
Mrs. G., a slight, involuted, birdlike woman, sat beside her bed in the dark, staring listlessly at a dirty window facing a brick wall. A somber Chirico painting came to mind, every image recoiling unto itself, with the only meaningful link to life a distant train pulling away beyond the horizon. She seemed intent on capturing an elusive image. Gently I probed why she had come to the hospital.
“I can’t stand the rush of waves. Doctor, it is driving me crazy. Yes, I am going crazy. If only I had loved my boys as much as my husband, I would be spared this suffering.”
How to inquire without probing a scalpel into a festering wound? Slowly I teased out the strands of the following tale: Mrs. G. had three sons. After Pearl Harbor they all volunteered, one in each of the three military services. The parents, poor Bronx Jews, the husband disabled by a heart condition, she with hypertension, depended on their children, but they nonetheless welcomed with pride the knowledge that their boys, like other patriotic Americans, were in the war against that “Jew exterminator, Hitler.” One son was killed, and then another was killed. Her husband nearly lost his mind with grief. She went to the Red Cross to get the last remaining son, her youngest, out of the Marines. The lady at the Red Cross was moved to tears by her tale and promptly sent a telegram to Washington. She assured Mrs. G that her pride and joy would be returned safely home.
Mrs. G. was elated and could not wait to bring the happy tidings to her husband. She was certain that the good news would help overcome his deepening depression. Upon arriving home she found her husband slumped over dead, clutching in his hand a piece of paper. The paper was a telegram from the War Department expressing regret that their youngest son had died heroically storming a Pacific atoll.
As she related this tale, her voice was without inflection, in the deadly monotone of a dirge. There were no tears. This tragedy had long ago dried out all tears. She repeated over and over, “My husband loved the boys. But why do I remain alive?” She clutched her head to shut out the drumbeat of waves hurtling against a distant shore. She rocked her body as though she was cradling a child in her arms. “Doctor, help me die. Please, please quiet the waves!”
The next morning I waited impatiently for morning rounds with the wise physician in chief, Dr. Louis Leiter. I was distraught and anxious to unburden myself. Rounds were at the bedside. I presented the patient’s story in detail. Dr. Leiter, usually calm, shifted from one foot to the other. When I finished, he looked far away, his face puckered in a grimace as though straining desperately to control a sob. He turned abruptly away from the bed, without uttering a word, and rapidly walked out of the ward.
The Spanish poet and dramatist Federico Garcia Lorca, murdered by Franco, addressing similar unfathomable human pain, wrote in one of his plays, “A scream tiptoes in my heart.“
What is a doctor to do? What can a doctor do? Where can the balm be found to heal? Before the enormity of such pain, medical science appears helpless.
Dr. Marc Agronin, a geriatric psychiatrist who has treated many Holocaust victims, has written, “What some survivors seek is not medicine or therapy: it is the attentive presence of a doctor and others to serve as the next generation of witnesses.” (1)
Why do these tales need to be told? In whatever direction one looks in our troubled world, whether at Darfur or Gaza, Afghanistan or Guatemala, there is torment beyond human imagining. In listening, one remembers and one shares. The deeper purpose is not vicarious suffering, but action. Light a candle rather than merely deplore the darkness. The stains of injustice cannot be wiped away. Moral equilibrium demands that we engage, so that the future is not a replica of the past. Herein medicine has much to offer. Doctors have long ago concluded that a disease that cannot be cured must be prevented. (2)
The essential sickness afflicting the global order is war. The strong thereby exact tribute from the weak. Prodigious sums of money are diverted from human needs to killing, maiming and oppressing. The environment is degraded more by war than by any other human activity, hastening global warming and making the planet inhospitable to all life. What is proscribed in individual human behavior and severely punished is permitted for nation-states. The leading terrorists of our day are not Muslim suicide bombers but the nation-state. The outlawing of war is the foremost issue on the agenda confronting humankind. Only then will we prevent ocean waves on a distant atoll deranging the mind of a bereaved mother.
*Originally posted (29 March 2009) on ProCor (www.procor.org), a global communication network promoting cardiovascular health in developing countries. ProCor was founded by Dr. Lown in 1997 to encourage knowledge sharing among a global community about preventive strategies.
1. Agronin M.E. From a place of fire and weeping, lessons on memory, aging and hope. New York Times,December 23, 2008.
2. Lown B. Prescription for Survival: A Doctor’s Journey to End Nuclear Madness” Berrett-Koehler Publishers, San Francisco, 2008.