Death Takes A Holiday (II)

to wit, a middle-aged peripatetic shrink undertakes the Great American Cross-Country Road Trip with help from little leaguers, German bikers, the King of Rock ‘n Roll, porn stars and an abandoned brothel, a flock of domesticated ducks, the Department of Homeland Security and the West Memphis police, a decommissioned atomic warhead, some dodgy motels… and a strange rider in the back of a 2013 Ford Fusion.

Prior to the passage of the Anatomy Act of 1832 (2 & 3 Will. IV c.75), it was illegal in Great Britain and the empire to own, possess, or dissect any human body except that of a convicted felon who had been sentenced to death and post-mortem anatomization. As the number of capital sentences was far outstripped by the demand for bodies, however, there had developed a robust and entirely illegal trade in human remains since the late middle ages.

The sensational crimes of Burke and Hare

brought the need for legal bodies to a head. With the passage of the Anatomy Act which permitted wider procurement of bodies, the black market began to wither. Other countries soon followed suit with similar laws. Before long, guards no longer had to be posted at cemeteries to prevent the resurrectionists from snatching grandma before she had turned to dust.

And although the trade in human remains remained tightly regulated at first – individual bodies were numbered and tracked by the UK Office of the Home Secretary – at last there existed in the English-speaking world a means by which physicians, surgeons, and students could study anatomy without having to sneak around at night with shovels and lanterns after paying bribes to night watchmen.

At first the corpses obtained were those of the unclaimed dead, mostly from poorhouses and jails. But in time, progressive individuals began to will their mortal remains to medical science for this expressed purpose.

Predictably, it wasn’t long before a commercial market in anatomic specimens developed. An early example is seen through Millikin & Lawley, a company located in London that sold medical “teaching tools” during the Victorian era. M&L became the largest supplier of human skulls and skeletons by the turn of the 20th century, its location in Pall Mall near the medical school of King’s College helping growth in no small part.

M&L marketed their bones by stressing the quality – that the skulls and skeletons were from the continent, especially Italy and France (do those countries produce better bones?) Apparently many medical students bought their study aids at M&L and then a robust secondary market sprung up as those nearing graduation sold their items to incoming students. Thus, the bones were recycled year after year and class after class as a form of educational hand-me-down.

In add’n, M&L sold medical and surgical supplies, and they rented “magic lanterns” and slides for both didactic and amusement purposes. If that weren’t enough, M&L also contracted with entertainers such as conjurors (magicians), ventriloquists, and handlers with trained animals for parties and other festive gatherings.

But back to the bones. In the 1880s and ’90s, M&L’s most popular item amongst medical students was the “half skeleton.” This consisted of a latched pine box containing a set of human bones – a full skull and vertebral column, along with half (i.e., one side) of the rest of the bones of the body: one hand, one foot, one humerus, one radius, one ulna, one femur, one tibia, one fibula, one scapula, one patella, one clavicle, seven ribs, and a sawn-half each of a sternum, a pelvis, and a hyoid bone. On the inside of the lid of the pine box was glued the company’s label, and M&L also advertised with applique logos on the bones themselves!

While a less costly half-skeleton might have worked for students on a budget, there was even greater demand for whole articulated skeletons. Ads for such can be found in late 19th century publications on both sides of the Atlantic. And after a while such ads weren’t aimed merely at the medical community. The tracking of individual bodies to licensed clinicians, seen at first in the 1830s in the UK, gave way in latter years of the century to a lucrative commercial trade in bones to just about any interested party.

Artists comprised one non-medical group that sought bones. Another was the Independent Order of Oddfellows (IOOF).

IOOF was a fraternal order of the 17th and 18th centuries (UK) and 19th century (US), second in prominence and membership only to the Freemasons. Part of the secret IOOF initiation ceremony required the presence of a human skeleton in a mock coffin; a candidate would be blindfolded, draped with chains, and led to a place after which the blindfold would be removed and the frightened neophyte found himself in the flickering candlelit presence of Old Boney (the allegorical setting used to impress upon the initiate the ephemeral nature of life, his own mortality, death-as-the-great-equalizer, and the need to do charitable work and walk the straight and narrow).

Some of the less-affluent IOOF lodges used plaster models of skeletons

old plaster IOOF

old plaster IOOF

but most lodges wanted the real deal.

Boney-M, the real deal

Boney-M, the real deal

Many times, the desired authentic skeletons were obtained from medical schools which had gone defunct or were upgrading the specimens in their collections. Perhaps some skeletons were pilfered by faculty members who were also Oddfellows. There is even rumor that Oddfellows’ regalia catalogues in the 1880s sold initiation skeletons by mail order.

early IOOF catalogue

early IOOF catalogue

Although far from common, these vintage IOOF skeletons still periodically surface. As lodges fold because the current membership is dying off, their property is sold to settle taxes and other debts… only for someone to find a skeleton in the closet. Literally. And though often in rough condition from years of storage neglect, more than one estate liquidator or realtor has come unexpectedly face to face with a dusty but still-grinning skeleton in its original silk lined coffin emblazoned with the IOOF emblem on the lid.

There have even been times in which a local police department was summoned to investigate the uncovering of an “unknown body,” but once no signs of foul play are uncovered by the men in blue and the medical examiners office, the bones are good to go. If ever determined to be of native American origin (which has happened, albeit rarely), the bones are repatriated to the nearest federally recognized tribe. Other skeletons of unknown provenance are sometimes buried. But more times than not, such skeletons wind up at auction. And from there they have found their way to Halloween parties, bars, galleries, libraries, dens, museums, and antique shops. One IOOF skeleton is even said to have enjoyed a prop-cameo in George Romero’s classic 1978 film, Dawn of the Dead, though I’ve been unable to confirm that at present.


“Bones are all that survive of the body. They are keys to our collective past and reminders of our own mortality, so it is no mystery that they have a magic aura for artists, for the faithful of many religions, for collectors, for all of us.” ~Barbara Norfleet (1993)

While I didn’t go into surgery, throughout my medical education I was always fascinated by anatomy and osteology. And readers of this blog will not be shocked to learn of my interest in the slightly macabre. Being a physician with such tastes, it seemed only natural that I should locate an old skeleton for my office. But it had to be an old one. I didn’t want a recent import from China or India. I wanted a delicate patinated 19th century specimen that probably hung in the corner of an anatomy lab while men in bowler derbies and starched collars with handlebar moustaches went about their work.

The old skeletons, by the way, can be identified by the salt-cured cartilege of the rib cage (modern skeletons use rubber or synthetic composite instead) and the articulation with brass (modern bones having stainless steel attachments). Plus the IOOFs look old and weathered. You can just tell.

After some inquiry, I contacted a dealer in the LA ‘burbs who had located the very type of old skeleton I wanted. He was said to have started life (death?) at a California medical school before moving into the fraternal world. He was then uncovered in a now-defunct IOOF lodge in the Bay area, found in the basement in his coffin lined with the San Francisco Chronicle from the 1880s. He was in marvelous shape, missing only one tooth, though his coffin was no longer available. I negotiated for him, and before long I was Boney-M’s new owner.

Now I just had to get him back to the east coast in one piece. Shipping was inadvisable given his age and fragility.

So on the morning of the second day of the trip, I was sitting in my rental car, the engine turned off, outside the appointed meeting place at 5:00 a.m., in the pitch black. Why? Because I had to make it to Las Vegas by midday, and the Los Angeles morning traffic threatened to be interminable if I (we?) were to get a late start. The seller was kind enough to meet me at an ungodly hour to allow for an early start. Thus we connected, we loaded in darkness – it all had a slightly illicit feel to it, carrying bones out into an alleyway with the sun not even up – and before long the car was pointed to Sin City, almost 300 miles distant, with Boney-M secured in the back seat.

Plus there were six days and almost 2000 miles to go before we would reach Mecca.

[to be continued…]

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Theatre Shooting

The sullen appearing patron in the back row became angry when a group of kids started making noise in a movie theater during the show. He threatened them if they didn’t hush, but instead of compliance, the audience started laughing at his apparent bluster. Drunk and enraged, the man began yelling and then produced two large-caliber handguns from inside his jacket, pistol-whipping one nearby adult who had been laughing, and then shooting him thrice in the head as he lay stunned on the floor. The murdered man’s son, sitting nearby, was himself armed and shot at the attacker, who was uninjured because he was wearing a bulletproof vest. An exchange of gunfire ensued, several more were wounded, and one more killed in the crossfire. Then, for some time after the attack, the drunken shooter stalked the auditorium, brandishing and reloading his pistols. He kept all of the filmgoers in a state of terror while ranting, threatening, and taking pot-shots at convenient targets who peered over seats. He threatened to kill everyone. The police arrived after what seemed like an eternity and were finally able to subdue and arrest the assailant without further loss of life.

We hear all too commonly today about senseless shootings in public venues – it seems that weekly there is a new story of innocents cut down while going about their business. Our 24-7 news cycle permits us to learn of events from around the world in real-time. But despite appearances, there is really nothing new under the sun. The shooting above took place in Robbins, TN, on 5 March 1927, and the drunken assailant was one Ben Fowler, an off-duty deputy sheriff who was carrying his service sidearms. Justice did, however, move more swiftly in those days. The murders happened on a Saturday night, Fowler was indicted on Monday, his trial started on Thursday, and the jury got the case the following Monday. Fowler’s defense was (admittedly voluntary) intoxication, as he claimed he was too sauced to know what he was doing; if successfully argued, that would have reduced his charges to two second-degree murders, non-capital offenses. This diminished capacity defense went nowhere, though, and the jury convicted Fowler of capital murders after two minutes of deliberation. He was then electrocuted in the state prison in Nashville on this date in 1928.

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Death Takes A Holiday (I)

to wit, a middle-aged peripatetic shrink undertakes the Great American Cross-Country Road Trip with help from little leaguers, German bikers, the King of Rock ‘n Roll, porn stars and an abandoned brothel, a flock of domesticated ducks, the Department of Homeland Security and the West Memphis police, a decommissioned atomic warhead, some dodgy motels… and a strange rider in the back of a 2013 Ford Fusion.


The day was clear and sunny as it began its fade into impending twilight. I was driving along a secondary road in the far southwestern corner of Arizona, less than a dozen miles north of the Mexican border. There was little traffic, just clear sailing, no obstacles, and a tank of gas as the sun started to dip behind the nearby hills. In short, a perfect and relaxing early evening for a drive. That is, until I saw it up ahead – ‘it’ being a U.S Border Patrol check-point. A sign by the side of the road commanded those traveling north to stop ahead to submit to inspection, and I could see that the armed federal agents had a dog which was sniffing each and every vehicle.

Normally, this wouldn’t present a problem. I wasn’t in a hurry to reach my next destination, the car wasn’t stolen, I don’t do drugs, I wasn’t intoxicated, and I’m a natural-born U.S. citizen.

I did, however, wonder if the revolver sitting on the passenger seat next to me might present a problem. That… and the human remains boxed up in my back seat.

But I’m getting ahead of myself. I need to turn back and start at the beginning.

Sustenance. Procreation. Self Preservation. All basic instincts that have allowed the human species to survive over the millennia. I would add another to the list: Wanderlust. Ours is a species that travels. From those first tentative steps from the Cradle of Civilization, humankind has desired to confront the unknown – to the far corners of the Old World, across the unknown seas, throughout the new continents, to the frozen poles, deeply into the bowels of the earth, and thence into outer space. “To boldly go where no man has gone before,” in the words of Gene Roddenberry.

For the ancients this drive was often spurred by the need for new hunting grounds and other natural resources that were in short supply, or that were being contested by other groups of hominids. But in time, the drive became a journey unto itself. And from that evolved… the Great American Road Trip.

I would argue that GART is no less primal, but merely involves the automobile and affordable petrol, the roadside tourist stop, and the ability to burn one’s own CDs more than the ancients could have understood. GART may have its roots in the grand tours of the continent undertaken by well-heeled 18th Century Europeans, but it has evolved in a special way given the vastness of North America, the grind of the 21st century workplace, and the trailblazing of visionaries like Jack Kerouac, Hunter S. Thompson, and P.T. Barnum.

Many years ago, my erstwhile spouse and I traveled by minivan from Vancouver to Toronto over a week’s span. I’m not certain how she enjoyed it, but for me it was an eye-opener. I mean, how many other reasons would one have to visit places like Moose Jaw, Saskatchewan, and Medicine Hat, Alberta? I saw fields of canola that stretched to the horizon, emerald-green mineral lakes that were indescribably clear and cold, and I ate more Caesar salads than I thought possible (Canadians have an odd affinity for the Caesar salad out west for reasons that remain unclear, though they sadly eschew the anchovy). Alas, there are few man-made attractions ‘up there.’ It’s mostly the beauty of the great outdoors. And knowing firsthand that the inhabitants south of the border are natural hucksters, and enticed by books like Roadside America, I wanted at some point to repeat the epic driving journey in the lower 48.

Recently, the stars aligned correctly. Work responsibilities, bills, a conference I wanted to attend, and family duties all fell obediently into place. The Wild called, and I answered. Impulsively, I sent a few confirmatory emails, registered for the meeting, bought a ticket on Southwest Airlines, arranged for a one way rental car, told my office they’d see me later, and took off.

The trip got off to an inauspicious start. For those of you who have traveled Southwest Airlines before, you know that boarding number is all-important. Your seat is not assigned, but instead you board like cattle with the number assigned to you at check-in, and then take whatever seat is still available. There are three boarding groups – A, B, and C – with each having sixty numerical slots. Southwest likes to joke that “all of our seats are first class,” but road warriors know better. “All of the seats are degrees of purgatory,” is more like it, but there are some that are far worse than other.

The sufferer-to-be can check-in online 24 hours – to the second – before the scheduled time of take-off. A delay of even a minute can mean the difference between a tolerable numerical assignment, and a center seat in the back of the bus so to speak. Usually I’m good at this, and time my online check-in perfectly, even if I’m in a meeting and have to do it via smartphone. On the day in question, though, I was distracted by uncooperative patients, and was mistaken to the exact time of my departure. Unfortunately, I logged onto my Southwest account ten minutes after the desired time. B49. Not good, as that number put me only 11 seats in front of a Hellish C-group assignment. And as veterans of Southwest know, anything ‘C’ is a guaranteed lousy seat.

The next day when I arrived at RDU, there seemed to be a lot of large people lined up for my flight to Burbank, California. Large people with what looked like impossibly oversized carry-on luggage. Of course this was my imagination fed by B49. But it seemed that the boarding process took longer than usual as wave after wave of large people holding A and low-B boarding passes filtered down the gangway. Finally it was my turn. Were there even any seats still available? I made my way along the ramp and finally turned the corner inside the plane to see what was left. It didn’t look like much. Bulkheads filled. The first half of the plane filled except for cramped center seats. Luckily I had checked my bag, so overhead bin space was not at issue. I slowly squeezed my way past those straining to stuff their belongings under seats. I was still scanning, against hope, for something available and tolerable. I knew that a window seat, my preferred, was almost certainly impossible this far back in the boarding parade.

But then I spied it: one remaining window seat. Granted, it was in the very last row, but it was open, and it was window. Some quick mental calculus revealed that there were three potential ‘takers’ ahead of me in the narrow aisle, but they all seemed preoccupied with analyzing overhead bin space above other seats, and were ignoring my intended. With newly found enthusiasm I squeezed past those would-be spoilers and made it to the seat!


Well, not exactly.

While blueprints of the Boeing 737-300 don’t show it, and Southwest denies it, I swear that the walls of the interior begin to taper ever so slightly to parallel the fuselage as it approaches the tail of the plane. My window seat was in the furthest rear echelon, right by the galley and restroom. Over the years, Americans have gotten larger and planes have gotten cost-conscious (read: packed with more human flesh). The Golden Age of Air Travel has joined the Dodo Bird. And when you’re dealing with seats that are cramped at the best of times, the loss of even an inch of shoulder clearance is bad news. Add to this my dismay when the coup de grâce was delivered – a fellow who looked like a Duck Dynasty extra squeezed into the center seat next to me. I felt palsied and was unable to move from the unnatural position my limbs had to assume to accommodate the unnatural space. There were medieval tortures not unlike this.

And to think, this segment of the flight, to Denver, was ‘only’ four hours long.


There was no chance of sleep, or even of holding a book and turning pages, in such a space, so I’m not certain how I passed the time. Perhaps I was in a pain-induced delirium? But survive I did, and luckily the Duck Commander got off in Denver. I was able to unfold myself and move to a bulkhead seat with some legroom, and no discernible wall issues, before the plane boarded its next complement of passengers. And just as the old adage notes that if you’ve been hitting yourself on the head with a bottle it feels good when you stop, that new bulkhead seat felt sublime for the second leg of the journey. Which is perhaps part of Southwest’s evil plan all along?

And then, Providence rewarded my earlier torment – a baby seated near me was totally silent during the second flight, and next to me was a possibly anorectic female passenger who didn’t spread over onto the armrest as had the Duck Commander. The ability to partially doze and stretch. Some modest breathing room. Heaven.

The terrain passed 35,000 feet below as we headed further west. ‘Vast’ is the word that comes to mind, especially when I knew that I’d be driving that same endless expanse headed east before long. The snow-capped Rockies gave way to brownish hills and plains, and then finally the suburban sprawl of the coast with the Pacific in the distance. After a brief stop in San Jose, the plane made its way to Burbank, and as we landed, the thermometer read 89’F (compared to sub-freezing temps when I had left North Carolina earlier that day).

Bob Hope Int'l Airport

Bob Hope Int’l Airport

Bob Hope International Airport sounds impressive – perhaps it has a single flight to Mexico or Canada? – but is a small complex compared to LAX. However, it’s easier to navigate than its neighboring behemoth. They unload passengers from both the front and the rear of the plane via moveable stairs, and then you pick up your luggage on the tarmac – very 1950s. I was able to grab my bag and walk to the off-site car rental shuttle without difficulty as the sun was setting. And lo! Budget Rent-A-Car had reserved for me a new Ford Fusion. I had never driven one before, but as a previous owner of two Priuses, I know the cost savings of driving hybrids over long distances. And blessedly, the Budget staff didn’t badger me for additional rental car insurance as they always do, and which I always refuse as they shake their heads in sad disbelief. They just handed over the keys and bade me farewell. The gods again were smiling.

But there was no time to bask in these good turns of fortune. I stopped at an Albertson’s to get deli cold cuts and other provisions, but as traffic was heavy on I-5 south, I had to proceed post-haste to the Capistrano Inn 70 miles south before it was late. My body, recall, was still on eastern standard time.

In the morning – the very early morning – I had to meet my rider and begin the journey east.

[to be continued…]

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Observations on Elected Office

I heard on NPR earlier this week that, for the first time, a majority of those serving in Congress each has a net worth that exceeds $1,000,000. The story surprised me… I would have assumed that such a milestone had long since been reached. A few populists of modest means notwithstanding, politics has always appeared to be a game for those with (considerable) disposable income.

Read the story here:

The U.S. Senate was called “the millionaires’ club” back in the 19th century when only bluebloods blessed with inherited wealth or surnames that opened purses, or perhaps those backed by the robber barons and captains of industry, could aspire to membership. But now it seems that persons who aim for the even lower strata of the political food chain must come armed with bountiful war chests.

Case in point: a while back there was a vacancy on my local town council. Keep in mind that this wasn’t an elected federal position, or even a statewide office. It was one of nine part-time seats on the governing board of a medium sized suburban township, dealing with subjects like trash collection and traffic bottlenecks. Nevertheless, I thought that serving might be interesting; ever since I was an intern on Capitol Hill back in the late 1970s, I’ve found politics appealing, and this seemed to be a way in which to ‘test the waters’ rather unobtrusively.

I must add that I hate fundraising. I’ve always been reluctant to ask for any monetary assistance from family members. I detest negotiating for a car purchase. I try not to loan to, or borrow from, friends. And I hate the expected haggling of domestic estate sales and foreign bazaar merchants. For that reason, I knew that becoming a glad-handing salesman to raise money for a political run would be anathema to me. “But this is just town council,” I thought. “It can’t cost that much for some yard signs, flyers, and ads in the local paper?!” My intention was to finance my run myself. Perhaps a couple of thousand dollars out of my eBay slush fund – along with a lot of shoe leather – would propel me to victory without the need to panhandle?

Boy, was I mistaken.

I sought the advice of two colleagues who have firsthand experience with this sort of thing. One is married to a woman who has run for town council in a neighboring jurisdiction. The other currently serves herself on my town’s council. I found from both that candidates for these positions had spent tens of thousands of dollars, and weren’t even always successful. In the case of the councilwoman in my town, she told me that she had spent more than $30,000 on her initial bid several years back, “and by now I’d probably have to spend more as a non-incumbent trying to win a seat.”

It goes without saying that offices higher than town council are exponentially more expensive. Those amounts were far more than I could afford to self-finance, and the thoughts of begging for funds to raise such loot gave me the willies. Thus came an end to my nascent political career.

It’s sad, though, to know that educated and motivated aspiring (non-career) politicians who want to become involved – the very theoretical nucleus of our democracy – have been essentially priced out of the market.

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the Hennin (Boqta)

Of what do you immediately think when you hear, “princess”? Castles and jewels and thrones? What about clothing? Just about everyone has seen the pointy, cone-shaped hats that princesses (used to) wear – from kids in Halloween costumes to 700 year old paintings – and nothing screams “princess!” quite as loudly.

Princess wearing Hennin (van der Goes)

Princess wearing Hennin (van der Goes)

There’s actually a name for such a hat. It’s called a “hennin,” and what is particularly unusual about it is its source. Despite being commonly worn by early European blue-bloods, the style actually hails from thousands of miles to the east, in Mongolia of all places.

You see, the European hennin is modeled directly after the boqtas worn by Mongol queens. Boqtas were cone-shaped hats that were made of willow and felt, and could reach heights of 7′, which is really impressive when you remember that the Mongols of the 14th century were not particularly tall. And the boqta wasn’t meant to be wholly decorative. In Mongolian society, the genders were traditionally treated more or less equally, and this extended to similar forms of dress (think: unisex Mao suits from later Red China). The boqta, therefore, identified a royal female from a distance.

Marco Polo is said to have brought back at least one boqta from his travels. The Mongol Empire was respected (and feared) in Europe, and it wasn’t long after Polo’s return that pointy headwear became the rage in royal courts. Those westerners tended to wear their hennins further back on the head, at an angle, while Mongols wore them vertically. And, without a good source of peacock feathers, always present on true Mongolian boqtas, the western versions had instead gauzy streamers flowing in the wind at the top as substitutes.

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The Kennedy-Kassebaum Act, otherwise known as the Health Insurance Portability and Accountability Act (HIPAA), was passed by Congress and signed in 1996 by then-President Bill Clinton. It is a law with many good features; for example, it protects health insurance coverage for workers and their families when a breadwinner changes jobs or loses a job.

But it is also a many-headed beast, and has been both lauded and vilified almost since the day it became law.

One ongoing conundrum is its treatment of patient privacy. HIPAA establishes national standards for “covered entities” (think: providers and their agents) regarding the security of “protected health information” (think: medical records). These standards cover not only collection and storage, but also all subsequent transactions involving protected information. With very few statutory exceptions – court-ordered searches for missing persons or criminal investigations of child abuse are two – this information cannot be released by a covered entity without the written consent of the subject.

On the surface, that sounds good in an age in which privacy is eroding daily, Big Brother is watching, and identity theft is an ever-increasing problem.

But the pendulum always seems to swing too far.

*Recently, I accompanied a family member – who shares the same surname – to a doctor’s office, with the plan that I would go shopping and return later for pick-up. When I asked at the desk – the same desk at which I had stood less than 90 minutes previously – I was told that not only could the staff not tell me when my relative would be done, but they couldn’t even confirm that my relative was, in fact, in the office at all, “because it would be a HIPAA violation.”

*On one maximum security (locked) psychiatric unit that I once supervised, all of the patient charts were kept in a rolling cart at the nurses’ station for easy access of clinical staff. The cart was often turned toward those seated at the station’s desk, meaning that, if one had really good eyesight or even cared, the names on the charts could be seen by a person standing at the station’s window. Keep in mind that this was a locked unit, and the only people present were staff, committed patients, and the occasional escorted visitor. Still, we were told that we could be cited for a HIPAA violation if the cart remained facing the window where visitors could potentially see the names.

I mention these scenarios because it’s easy to lament how ridiculous rules and regulations have become… until one remembers what it was like in the past.

My maternal grandparents were married at the turn of the 20th century and then lived in the tiny hamlet of Appley, in far western Somersetshire, England. I’m not even sure how large is Appley today, mainly because I can’t find it in any recent census roster. Having visited once, I’m certain, though, that there are no more than a few dozen full time residents, if that many. In 1890 it must have been even smaller.

In good English form, though, there is a pub in town called the Globe Inn, which is still in business after more than a century. Appley is so small that the Globe is the only landmark that shows when the village is searched on Google Maps.

Apparently in the late 1890s, there was also a physician who called Appley home. I don’t know his name or anything about his practice, except that my grandmother talked about going to see him when she was a young woman.

If any of the locals had a perceived medical problem, they would have to walk to the doctor’s house and wait outside, rain or shine, until 9:00 a.m. At that time, a woman would emerge from the house and begin to interview the crowd that had gathered. This was not done in private. It was done on the sidewalk. The woman would listen, and then either tell the potential patient, “go home,” or else, “come inside.” Those admitted to the house would wait in the parlor until the doctor was able to see them.

So who was the woman screener? A nurse? A midwife? Someone in medical training? No, it was the doctor’s housekeeper, a resident of town with no formal education or experience who was making triage decisions as to who needed help and who didn’t!

I’m sure that much gossip started from those sidewalk screenings, and then traveled like wildfire in the confines of small-town Somerset. And that makes me think that HIPAA, properly implemented, ain’t such a bad thing after all.

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In recognition of how most of you felt yesterday morning, I thought a few words on veisalgia might be in order.

Veisalgia – known in the non-medical vernacular as the hangover – is the cumulative physiologic and psychological effect of over-consumption of alcohol. It is characterized by severe discomfort involving a pounding headache, dry mouth, dizziness, fatigue yet insomnia, nausea and vomiting, occasionally diarrhea, hyper-sensitivity to environmental stimuli.

Lautrec's 'The Drinker'

Lautrec’s ‘The Drinker’

Given how much veisalgia is discussed, little formal medical research has been done on the subject. This is likely a reflection that it’s not considered a pressing public health concern – no one usually dies from a hangover alone, despite the fact that many sufferers probably wish they would. Most observers see it as “just deserts.”

There are many contributors to the feelings of death-warmed-over – a lack of restorative sleep, altered glucose metabolism, vasodilatation, dehydration and electrolyte disarray, cortisol imbalances, hyperuricemia, and metabolic acidosis all play a role.

After consumption, alcohol (ethanol) is first converted to acetaldehyde, a substance that is far more toxic on the cellular level than is the alcohol itself. Acetaldehyde is then converted to acetate by oxidation. Genetically, some individuals accumulate these two metabolic toxins more quickly than others, which bodes poorly since high acetate levels then cause adenosine concentrations to rise in the central nervous system, and that markedly contributes to the classic bad headache.

Women are more prone to hangovers than men, and the older one gets, the more one is susceptible to hangovers. Not much you can change about that.

So what is one to do? Aside from abstain?

Well, choice of beverage does play a role. Congeners are chemical byproducts of the production of alcohol or the flavoring process, and many people are very sensitive to their presence. Dark liquors have up to thirty times higher concentrations of congeners than do clear liquors. So drink vodka over whisky.

But dark and clear alcohols alike contain small quantities of methanol, a very potent congener that arises during the distillation process; methanol is metabolized in part into the toxin formaldehyde. Needless to say, this will make you feel as if you’ve been embalmed, which in a sense is what formaldehyde is doing inside your body while you’re lying in bed moaning and lamenting that last round of drinks.

If you can avoid smoking, that will help. Studies have shown that the additive effects of acetaldehyde and nicotine can be most unpleasant in many who imbibe.

aspirin bottle 1899

aspirin bottle 1899

And while hydrating thoroughly and taking aspirin might help with some symptoms such as dry mouth and headache, there is little that can be done to shorten the duration of the hangover itself. That said, the myriad folk remedies of which one hears all share one common root – a placebo effect. Many of the more inventive ones border on sheer quackery.

Take heart, though: those before you have tried, and have failed, to find the magic bullet.

In ancient Rome, Pliny the Elder favored raw owl’s eggs or fried canary for those who had over-consumed. The “Prairie Oyster” restorative, introduced at the 1878 Paris World Exposition, called for raw egg yolk mixed with Worcestershire sauce, Tabasco sauce, and salt and pepper. By 1938, the Ritz-Carlton Hotel provided a hangover remedy in the form of Coca-Cola and milk. Ernest Hemingway relied on tomato juice and beer. And a 1957 survey by a folklorist at Wayne State University found widespread belief in the efficacy of heavy fried foods and post-binge sexual activity to stave off a hangover.

But there is one thing NOT to do: saunas and steam baths can be very dangerous by combining the effects of hyperthermia and dehydration and yielding possibly fatal cardiac arrhythmias in susceptible individuals.


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[Copyright 2013 @ The Alienist’s Compendium]

A Medieval Quarrel

The winter months are a time in which many pay homage to creation and regeneration. In November, Hindus celebrate Diwali, the festival of the return of Lord Rama from exile. The Muslim holiday of Eid al-Adha celebrates, in part, the miraculous discovery of the Zamzam Well. Bodhi is recognized in December as the day on which the Buddha finally achieved perfect enlightenment. In the Northern Hemisphere, the winter solstice – called Dongshi amongst the Chinese, Yalda amongst the Persians, Modraniht amongst the Anglo-Saxon pagans, Saturnalia amongst the ancient Romans, and Soyal in Hopi and Navajo lands – is the point at which the days incrementally grow longer. Christians celebrate the birth of their savior in late December. On Hanukkah, the Jews regained control of Jerusalem and rededicated the Temple.

In all of these traditions, a cycle begins anew.

In that spirit, I present to you the story of a resurrection of a more temporal nature, albeit one impossible to have predicted, and most unusual. But to fully appreciate this tale, we need first to turn back the clock a bit… say, seven centuries.

~ ~ ~ ~ ~

Medieval improvements in the crossbow represented in that era a military advance arguably as important as that of firearms in the 17th century or airplanes in the 20th century. It was in many respects a game-changer. While weapons similar to crossbows, or arbalests as they were then called, existed far into antiquity, the classical medieval crossbow gained wider use, especially amongst troops of minimal training and discipline – think conscripts. The most common form of the weapon consisted of a horizontal limb, the lathe, as well as a push-lever and a ratcheted drawing mechanism, the crannequin, all mounted on a sturdy stock – wood and whalebone at first, and iron later. This contraption was designed to fire metal projectiles, called bolts or quarrels, with much greater velocity and kinetic energy than could be produced by longbows powered only by an archer’s upper extremities. The earliest arbalests were comparatively light and could be ratcheted by hand while the stock was braced against the body. Later variants were much heavier and required that the stock be placed on the ground with the bowman’s feet holding it down as both arms and the back were used to mechanically retract the string and hook it over the nut in preparation for shooting.

But it wasn’t just the increased energy behind the crossbow’s projectile that was so significant. The training of those skilled in the use of longbows took years, and constant practice and physical training was required. The crossbow could be mastered by draftees with a mere week’s instruction. As they were simple to operate, and deadly, suddenly mounted and armored troops became far more vulnerable. By the 12th century, arbalests were in wide use throughout Europe. Seeing the potential decimation of ancient noble families (read: supporters), Pope Innocent II at the Second Lateran Council in April 1139 forbade the use of such weaponry against the faithful:

Artem autem illam mortiferam et Deo odibilem ballistoriorum et sagittariorum, adversus christianos et catholicos de cetero sub anathemate prohibemus” (we prohibit under anathema that murderous art of crossbowmen and archers, which is hated by God, to be employed against Catholics from now on)

In 1215, the Magna Carta also made mention of crossbows and the need to rid the realm of them:

Et statim post pacis reformacionem amovebimus de regno omnes alienigenas milites, balistarios, servientes, stipendiarios, qui venerint cum equis et armis ad nocumentum regni” (as soon as peace is restored, we will banish from the kingdom all foreign-born knights, crossbow men, sergeants, and any mercenary soldiers who have come with horses and arms to the kingdom’s hurt)

These proscriptions were widely ignored.

~ ~ ~ ~ ~ ~ ~ ~

Saint Severin was the third Bishop of Cologne, living there in the late 4th century. His earthly dust is today preserved in a golden reliquary in the choir of the city’s church that bears his name. In his honor, too, one of the gates of Cologne’s fortified city wall was named for him. The Severinstorburg, or Severin’s Gate, was first documented as a portal and defensive bulwark in the early 13th century. It was used not only to protect the city, but also as the formal entrance for the wealthy and powerful approaching from the south. Today it remains one of the only extant portions of the wall.

Cologne was a major economic and political center in medieval times. It was a vital harbor and transportation hub on the Rhine, and it also served as an important center of religious pilgrimage. Cologne and its environs, however, were in a near-constant state of internecine warfare during the 13th through 15th centuries. A fortified city wall was therefore very much needed.

The now-nameless individual in question might have been a peasant conscript or a nobleman. He might have been on foot, or mounted. He might not even have been a combatant – perhaps he was a priest? But what we do know is that he was present during one of the many battles at Severinstorburg, and he was struck by a crossbow bolt in his left anterior thigh. The deadly iron projectile hit the limb a few inches above the knee. Because we don’t know from how far away the weapon was shot – crossbows of this type were often rampart weapons, raining death upon combatants below – we don’t know the exact force at impact. However, a typical crossbow of the era could produce up to 1200lbs of draw-weight, far greater than any longbow of the Middle Ages, and would have yielded significant damage upon striking.

One can tell from the location of the subsequent skeletal injury that the bolt pierced the vastus medialis, rectus femoris, or vastus lateralis – all major muscles – and could have lacerated the quadriceps bursa, quadriceps femoris, and synovial capsule on entry as well. Regardless, the bolt failed to exit at the linea aspera of the posterior aspect, instead remaining lodged firmly in the bone’s marrow. The bolt probably missed the femoral nerve and artery, though it is near-certain that large branches of the lateral femoral circumflex artery, and possibly the femoral vein, were severed by the hit, causing profuse bleeding.

One also suspects that our subject died at the same time and place that he sustained the crossbow injury, though we don’t know if that wound was the fatal insult, or merely one of many. This is because, had our subject been moved from the field of battle and succumbed later, it seems highly improbable that he would have been carted back to the site of his mortal injury for interment.

Instead, our subject was not apparently carried from the field, but instead wound up in the city moat, at the site of battle.

Not a particularly good way to go.

He became embedded in the muck at the bottom of the moat. Or at least did his injured limb. And there it remained. For a very long time.

~ ~ ~ ~ ~ ~

In the early 1920s, the canal around what was left of the city wall of Cologne was drained in preparation for construction. In the course of dredging at Severinstorburg was found a human femur with a crossbow bolt embedded in it. The relic was obtained by a private collector and, almost a century later, displayed in the exhibit, “Aufruhr 1225: Das Mittelalter an Rhein und Ruhr” at the Archaeological Museum of Mainz in 2010. The curator’s catalog lists the relic thusly:

“#124. Human Femur with Hole from Crossbow Projectile. 13th century. Severinstoburg. 42.5cm length. Inv. No. A67. The iron tip has frontally penetrated halfway into the bone above the knee. Surrounding the entry wound, tiered comminuted fractures are visible, which resulted from penetration of the blunt tip into the bone surface. The projectile has a solid forged-iron rhomboidal head with a short shaft. Crossbow projectiles were in the Middle Ages feared long-range weapons that could pierce through ones armor, and the massive spikes often caused lethal damage. One of the numerous combat operations in connection with the feuds of the 13th century in Cologne produced this serious injury.”

femur and bolt/ quarrel, 13thc

femur and bolt/ quarrel, 13thc

With unpredicted preservation and chance discovery, a long-forgotten death has achieved unexpected curated immortality.

~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~

Postscript: my medical training has rendered me a person of rational thought, and I do not consider myself superstitious in the least. However, after negotiating with the museum during its deaccession process and bringing the femur-and-bolt back to my cabinet of medical curiosities, I washed my denim jeans… and a jagged rip developed in exactly the same location as would have been the entry wound 750 years ago. These were new jeans, and had not been abused doing yard work or heavy lifting. And the rest of the denim was undamaged. The tear spontaneously developed while all of the other clothes in the same wash load were spared. Same leg, same spot.

Laugh if you must, but even for a man of science, this is a bit too coincidental.

Happy New Year!

[Have an idea for a post topic? Want to be considered for a guest-author slot? Or better, perhaps you’d like to become a day-sponsor of this blog, and reach thousands of subscribers and Facebook fans? If so, please contact the Alienist at]

[Copyright 2013 @ The Alienist’s Compendium]