Their Eyes Were Watching God

Humans often ascribe moral meaning to scientific events—be they global or microscopic—that defy easy explanation.

MARIA DE LA O

Last spring Florence Nightingale, the founder of modern nursing, was the subject of the Ninth Annual Historic Clinicopathologic conference at the University of Maryland School of Medicine. There, a University of Pittsburgh psychiatry professor, Kathy Wisner, M.D., presented a paper that described Nightingale’s illnesses, which began with extreme fever and fatigue during her stint in the Crimea, and over the years expanded to spinal pain, insomnia, anorexia, nervousness, and depression. She also heard voices and worked tirelessly, even manically.

Nightingale’s symptoms, Dr.Wisner argued, suggest a diagnosis of bipolar disorder. This hypothesis is not very startling, considering that, for years, manic depression has been associated with great historical figures, from Joan of Arc to Virginia Woolf. One reason such posthumous diagnoses are popular is quasi-therapeutic: they provide people unfortunate enough to be born with a stigmatized disease a measure of comfort. And although manic depression is one of the most common afflictions attributed to historical figures, it’s not the only one. Many notable people—with much overlap, as suggested by the above examples of Nightingale, St. Joan, and Woolf—have been glorified by the gay rights movement for similar reasons.¹

“I think retrospectively diagnosing distinguished Victorian invalids is a positive parlor game,” British historian Lesley Hall told the Associated Press upon Dr. Wisner’s presentation of Nightingale as bipolar.

Deborah Hayden, in her book Pox: Genius, Madness,and the Mysteries of Syphilis,seems all too aware of the pitfalls of retrospective diagnosis. Still, it is the underlying premise of Pox. And it is a difficult premise for two reasons. First, as with mental illness, few would admit to suffering from syphilis. Second, syphilis was known as the Great Imitator until it became widely treatable with penicillin during World War II, because the disease mimicked a variety of conditions as it progressed. A syphilitic could survive perhaps 30 years after the initial chancre and fever, and during that time, might think himself cured despite periodic suffering from mysterious symptoms that could include headaches, joint pain, gastrointestinal problems, insomnia, and eye or vision problems. Alternative diagnoses for syphilis ranged from rheumatism to gout, eczema, hypertension, and epilepsy. If the sufferer lived to late-stage syphilis, the brain would likely be affected, beginning with uninhibited, paranoid, or megalomaniacal behavior and then progressing to complete insanity. Schizophrenia, depression, or mania was often the misdiagnosis at that point.