| The Neurobiology of the Arts |
The Defiant Muse Eduardo was 76 years old and, except for mild hypertension and diabetes, was remarkably well preserved. He wore his thick black hair combed back with a strong-smelling pomade, and in his suit jacket’s pocket a handkerchief folded as precisely as an origami figure declared his fastidiousness. He told me that he had once been a promising young writer in his native Ecuador, but unmentionable circumstances had forced him to leave the country. When he arrived in America he could only find work as a bellhop at an upscale hotel. He had stayed in that job for 40 years; it had been backbreaking work, leaving precious little time, he always said, for cultivating one’s mind. Now that he had finally retired, he vowed that would change. “Eduardo,” I said to him in Spanish, “it’s Dr. Campo, remember? We can talk in castellano.” I expected the flash of his smile, the perfect white teeth that I had learned were actually dentures when, to my surprise, he had popped them out into his cupped palm in a smooth, single-handed motion the day I first examined him; instead he stared at me vaguely, as though I were speaking in tongues. I didn’t make anything then of the faint tremor in his right arm. In another moment or two, he became his usual loquacious self again, telling me all about his beloved granddaughter’s recent piano recital. Out of his wallet came the latest picture of her, her pigtails tied in pink ribbons, her smile as brilliant as his, the flash of the camera reflected in one side of the shiny black piano against which she stood. He then segued to his grand plans to tour Spain, where he would visit the haunts of Federico García Lorca, Salvador Dalí, and other members of the avant-garde who had been the heroes of his youth. After a check of his blood pressure and a few marks on a lab requisition, I sent him on his way. In the ensuing few months, I diagnosed Eduardo with Parkinson’s disease, which progressed so rapidly that he never made his trip to Spain. He fell in his apartment while preparing his supper a few weeks later; he was unable to take the pot off the stove, and the burning arroz con pollo was what may have saved his life, by setting off the fire alarms in the building. The paramedics found him prostrate beneath the table in his kitchen, his left hip broken, his neck bleeding, gashed where the knife he’d been using happened to strike him as he crumpled to the floor. As they wheeled him out on a stretcher, he must have asked them to bring along his writing materials; perhaps he had been in the middle of composing a poem, taking a fateful break to slice some tomato for his salad while the rice simmered. He had pen in hand when I strode in to see him in the hospital the morning after the accident. Now I recognized that the blank stare was not so much disorientation as one of the subtler signs of Parkinson’s disease, which robs those it afflicts of most facial expression. A fat wad of gauze was taped to his neck. “Do you like my new friend?” he asked, referring to it with a downward motion of his chin. “It’s like a second head, only it has no brain.” With that, he mustered a broad smile, displaying his fine false teeth. But it soon vanished again. When he left the hospital for rehab, after a taxing two weeks of surgery complicated by post-op pneumonia, he presented me with a small packet of poems. They were difficult for me to decipher, line after line of tiny, shaky cursive in Spanish. Because the ink was blotched and uneven, I guessed he had used a fountain pen to write them. It was the first time he had ever shared his work with me, prompted, surely, by his sudden clash with infirmity. He asked me what I thought of his poetry when he returned to see me in the clinic. I was not especially inclined toward literary critique that day; he’d weathered a prolonged rehabilitation that had been hampered by a further steep decline in his neurological condition, and we had much new information to review. By now, almost four months later, his gait had become a slow shuffle; his head CT showed the possibility of multiple small basal ganglia infarcts that the neurologist thought might explain his dramatic deterioration. His forgetfulness had also worsened, to the point where when I asked about his granddaughter, whether she had played any new pieces for him, he couldn’t remember that he even had a granddaughter. Yet the poems, those he could remember. In fact, he told me he had set himself the task of memorizing them, to combat what he called “the stealing of my personhood.” I wasn’t sure whether he meant the disease itself, or the sedatives that were used to calm his agitation in the evenings—a common phenomenon called “sundowning” in medicalese (and a good if rare example of a medical term for something awful that tries to make it sound somewhat poetic). I sat dumbfounded as he went on to recite about a hundred lines of his verse, the tears coming to his eyes as he described, in one particularly moving section, his granddaughter at the piano, the same talented little girl whom he hadn’t been able to recall earlier during our visit. His words rose and fell with all the musicality of a Beethoven or Bach concerto, as if her inerasable presence in his mind had found a last remaining outlet. I wondered whether he had indeed once published his work, in the homeland he could no longer name, in a world that he was fast losing. Eduardo began to create poems that seemed to be attempts to graft himself back onto the life he had once known. He showed them to me when he came to his appointments, now accompanied by his new attendant, a jovial, buxom, copper-haired Haitian woman named Antoinette. He wrote a poem about what he liked to buy at the supermarket; another recorded the names of the streets in his neighborhood; still another, the names and relationships to him of various family members. There was even a love poem for Antoinette, which made her blush when he read it aloud, though I was quite sure she didn’t understand Spanish. I was struck by how the language of his poems flowed so effortlessly, no matter how mundane their subjects, animating his face again with the emotions he otherwise could no longer manifest. I noticed how they recollected information, much of it practically useful, some of it simply pleasing, that his faulty neurons could no longer store. A few more months passed; another springtime in Boston arrived, the golden daffodils like trumpeters heralding a dainty queen’s imminent visit. Eduardo failed to keep his morning appointment one day; the inevitable phone call came the same afternoon, from Antoinette. “Don Eduardo, he die,” she reported tearfully. She said she had found him utterly motionless in his bed when she’d come to bring him for his appointment; she had recognized immediately that the stiffness in his limbs when she tried to rouse him was very different from that caused by Parkinson’s disease—“No medicine help him now,” is how she put it. I thanked her for taking such good care of him. After a moment of silence, she told me that she had found something he had left in his apartment for me and that she would bring it to the clinic the next day. What she brought was a beautifully handmade book of his poems. Pasted on the cardboard cover was an old photograph of a handsome man with thick black hair combed back neatly. His expression was either very serious or a little scared. He sat at a small desk, upon which were assembled some sheets of paper, a stack of books, and a fountain pen with its inkwell; he had cocked his head, as though his concentration had just been interrupted. The desk was positioned before a window, through which I thought I could make out a view of distant mountains, and at their feet, a rim of beach and black water. “Poesía” was inscribed in a familiar, tremulous hand beneath the photograph. Later that week, at his funeral, I sat in a pew alone at the back of the church. After the service, I gave the book to a little girl in pigtails, who smiled at me so genuinely I felt as though I’d known her all her life. Rafael Campo ’92 practices medicine at Beth Israel Deaconess Medical Center. This essay was reprinted from The Healing Art: A Doctor’s Black Bag of Poetry, ©Rafael Campo, with permission of the publisher, W. W. Norton. This article appeared in the Autumn 2003 issue of the Harvard Medical Alumni Bulletin. Illustration: Richard Tuschman |
which was odd because we’d always conducted our discussions in Spanish at his semiannual visits. I noticed his English was halting and too formal, like the way my grandparents had spoken it; I assumed he had learned his second language relatively later in life, as they had. This linguistic rigidity would soon prove portentous. 
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