1923: Dr. Michael Cisco Memories of Dr. Lambshead
(County Coroner (retired); Chief Archivist--Benign Patristic Order of Exhumationists; President Emeritus--San Veneficio Society of Embalmers.)
I first met Dr. Lambshead in 1916, in Berlin. I was preparing myself for my first year of medical school by studying privately with Dr. Brosius, and Thackery had made a brief trip from England to treat my cousin, and good friend, the poet Simon Rheiner, for his addiction to morphine. Even at the tender age of 16, Thackery was a powerhouse of medical knowledge.
The night of May 15, I, Thackery, and Felixmüller were visiting Simon in his apartment, when he rose to recite to us his new poem, "An Exodus," and flung himself ecstatically through the open window, a syringe still held lightly between his fingers like a pen. He recited the single stanza as he fell (I later wrote it down from memory--it can be found in his collection entitled The Clitoris of the Zodiac). Thackery and I were both disconsolate, and our mutual mourning I suppose cemented our friendship.
When I completed my residency, I became a peripatetic doctor in my own right, due chiefly to Thackery's influence. Our paths crossed at least once a year for the next decade or so, often in places where such chance meetings were highly unlikely. For the most part, when we met, we would arrange to call on each other, but as Thackery never liked discussing medicine socially we were left with little to talk about. He labored in vain to interest me in cricket scores, and, when I felt I had the energy, I would try to engage his interest in Asian art, with comparably nugatory results. However, on one occasion, in the autumn of 1923, we happened across each other in Kraków--simply knocked shoulders in the street--and, with little evidence of surprise, he told me that he was rushing out to Kazimierz (the Jewish ghetto of Kraków) on an urgent call to an old friend. He asked if I would accompany him, and I said I would.
This is the first time I have ever ventured to tell this story, and I do so now only because I have every expectation of my own death; my anti-typhoid is in its tertiary stage, and I am confined to the vaulted stone sewer beneath the Hôtel du Tond in Paris, the unwholesome air of which alone I can breathe comfortably. That night, Thackery and I penetrated the wilderness of ghetto streets, which seemed to me piled high with mounds of massive, broken furniture; a door swam into view in a dingy plaster wall as smooth as a woman's thigh, and we were admitted somehow. Even then, I had considerable experience with house calls, and I intuited the gross outlines of the circumstances right away, as I am certain Thackery did; the girl before us, whose moon face was deeply scored by alien marks of anxiety, raw and fresh, was plainly the middle sister. The elder sister would be the sick one, and the parents were, for some reason, unable or unwilling to tend her. The girl conducted us back into the warrens of the house; we passed the moonlit kitchen, where I saw what must have been the father sitting at the table, his head resting on the back of his hand, and his hand resting on the table.
The girl opened the door at the head of the stairs and stood aside, looking at us. When the door had closed behind us, I saw, by the light of the moon, a white room, pale and dim. On the bed, a pregnant woman lay, whose long regular breath we could hear, and whose sunken eyes and vacant, rigid smile were like smudges of powder on her pale face, and whose nerves hung in the air, rippling like sea-kelp in a weak current. They were like elastic, white branches, which emerged from beneath the one filmy blanket and diverged and split until they dwindled to fine white filaments. Thackery advanced to the bedside with his instruments, and I could hear him speaking, with effort, words intended to comfort her. He asked me to pour her a glass of water from the white ewer on the table, and as I walked forward to get it, one of her nerves brushed my face with a contact like a tiny, cold star. Now I was another character altogether, but my memory had no information for me. The trees were fantastically old, and vast, and black; they grew along what I suppose was the "bottom" of a blood vessel--I never knew which one--as though it were a dry riverbed. I had to make my way in a particular direction through the trees against the current of the blood, which was like a hot, red wind. The black branches of the trees rose and fell dreamily in the blast, and I walked for a long time. Eventually, I found a street and followed it. I found the house, and opened the door. I went inside, and down the hall. As I passed the kitchen door, I knew the old man would be there at the table to my left, but I knew, as everything I knew then I knew right away as if it were being told to me, that if I looked at him I would see him in the wrong way, and I would be too frightened by that to go on. I opened the door at the head of the stairs, and saw the woman who lay in the bed, her serrated lips still furled in a crisp, mummy's smile, gazing up at a white figure that stood erect at the foot of her bed, caressed by her long nerves.
After a long time, I was told again who I was and where I had been taken. Thackery had cut me free--my nerves had been, I was informed, caressing hers, and knitting with hers in the air--and dragged me downstairs. Subsequently I was conveyed, without my knowledge, to a private clinic, where I recovered completely. Thackery wrote to me some time later; the young woman had died shortly before we had entered the room.
In 1953 in Buenos Aires, the illustrious Argentine author Jorge Luis Borges sought anxiously for an effective treatment for his persistent ear aches. This search led to Borges's encounter with Dr. Thackery T. Lambshead, whose accounts of his work in medical research made a great impression on the blind literary artist and library administrator.
The two men's mutual admiration and their ensuing correspondence over the next 30 years led Borges to edit his one and only medical work, The Pocket Guide to Metaphysical Diseases (sometimes known as the Compendium of Rare and Fantastical Afflictions), which was released in 1977 and featured important articles by 21 distinguished Latin American physicians. The sole European contributor to this volume was the reclusive transcendental pathologist, Dr. Nathan Ballingrud of Norway. Dr. Ballingrud's report on the "malady of ghostly cities," translated into Spanish by Borges and Gabriel Mesa, marked the first time information about this apparently venerable disease appeared in print.
The Pocket Guide to Metaphysical Diseases has languished for two decades as an out-of-print curiosity, avidly sought by collectors of first editions, but ignored by the medical community. (A cheap mass market paperback English-language version did appear in 1982. However, it contained only half of the material from the original Spanish edition, omitting Dr. Ballingrud's disease. The translations from the Spanish were so incompetent that Borges himself disowned the edition.)
The editors hope that this valuable collection will someday be reissued in an English translation. Apart from the book's obvious value as a springboard for further research into rare tropical diseases, it constitutes a glowing tribute to the impact that Dr. Lambshead makes on the life of nearly everyone he encounters.
We are proud to make the following excerpt available in English for the first time, translated from the Spanish version by Diego Funes. "The Malady of Ghostly Cities" proves once again that in the realms of disease, truth is often stranger than fiction. - The Editors
The Malady of Ghostly Cities
Translator's Note: Before his disappearance in 1978, Dr. Nathan Ballingrud was enjoying a return to international prominence, albeit in an unfamiliar capacity, due to the anticipation brewing in medical circles surrounding the imminent publication of the third edition of Jorge Luis Borges' Compendium of Rare and Fantastic Afflictions. Previously, Ballingrud had served as the Royal Medical Officer in the Kingdom of Norway from 1960 until his unceremonious dismissal in 1971, after it was revealed that he had collaborated with the Nazis during their occupation of Norway during the Second World War. His research into what he called the Malady of Ghostly Cities, soon after its discovery in 1976, aroused the interest of Borges, who arranged to fly him to Argentina so that he could visit the site in person. Alas, the notorious criminal Jack Oleander beat him to the punch, and the results are described herein. It is believed that Ballingrud was prepared to follow Oleander to Libya when he was abducted by the Argentinean government in 1978, a victim of their infamous "dirty war." What follows is the only written record of the disease. - Diego Funes
The first known case of the Malady of Ghostly Cities was discovered in 1976 by the Argentinean Navy during their efforts to establish a base on Cook Island, the southernmost of the South Sandwich Islands, just off the coast of Antarctica. The victim was one Ivar Jorgensen, a member of Norwegian explorer Roald Amundsen's 1910-12 expedition to the South Pole.
According to Amundsen's diaries (Vol. XXIV: Racing the Empire, Bk. 3, pg. 276), Jorgensen abandoned the party under cover of night, stealing a sledge and four dogs to aid his flight. Amundsen makes little mention of any change in Jorgensen's demeanor or appearance before this incredible event, noting only that "(h)e seemed to be suffering from a sort of delirium. The poor fool won't last two days on his own."
In fact, he lasted considerably more than two days. He managed to travel several hundred miles over Antarctica's brutal country, even crossing the narrow scope of the Weddell Sea, until he beached himself on Cook Island, where he succumbed to his disease. His remains abided in frozen silence for 64 years.
Since then, three other cases have been discovered, making possible a rudimentary definition of the disease's manifestations, if not its causes. Simply put, it is a malady that transforms the victim--seemingly overnight--into a city populated by phantoms. The identity of the victim, along with a record of dreams, fears, and geographies of the body, are contained in a small series of bound volumes, located in a hidden cellar, buffered against intrusion like a brain in a skull.
In each case, the victim was apparently a traveler far from home, and indeed, far from any substantial civilization. Otherwise, characteristics vary dramatically.
The Jorgensen city resembled, naturally enough, a turn-of-the-century Norwegian fishing village. It was populated by a host of spectral figures, solid in appearance but breaking into little whirlpools of cloud and mist if one attempted to touch them, coalescing again moments later as if nothing out of the ordinary had happened. They interacted freely with one another, but did not seem to notice in any fashion the Argentinean soldiers who stood in their midst and demanded, at great volume, to know how long they had been there, and what it was they thought they were doing.
The Jorgensen city is one of only two cases in which the secret library has been discovered. The small series of books that compose these libraries give a detailed account of the victim's life. This is not an account, however, of the mundane aspects of that life (although it seems those can be gleaned from the comprehensive footnotes that supplement the texts); they are instead a precise record of the imagination. As such, they are filled with the exploits and terrors of the victims' dreams, secret thoughts, and the potential resolutions of their lives. Esoteric knowledge is also contained here, often at a level of scholarship far exceeding that which the victim could have reasonably attained during his lifetime (for example, Jorgensen's library is reputed to have contained a moving map of the night sky visible from Cook Island, one for every day of the year since his birth in 1882; the stars crawled across the pages as they would the natural sky; clouds floated past, rain and snow rose from the pages of stormy days in a fine mist).
The other known city is Colleen Norton, a discontented college student from Columbia University in New York City, who disappeared from her classes and the lives of her family and friends without a word of warning. She traveled to North Africa, taking up with a band of Bedouin wanderers, ingratiating herself to them with her uncanny ability to pick up languages and her extensive knowledge of their culture. Evidently, she already carried the disease, however, and within weeks a mysterious new city was half buried by the roaming dunes of the Sahara Desert: it is a city built entirely of glass; its silent occupants can be glimpsed only through the reflections they cast.
The books here were discovered in an underground chamber cleverly disguised by a series of angled mirrors. The books revealed a tempestuous inner life of longings and ambitions. Among them were a series of novels that she might have written depicting the histories of dream cities fashioned by a secret society of architects who have severed their ties with the material concerns and restrictions of human life, as well as a two-volume catalogue of the Libraries of Heaven and Hell that included the half dozen locations on earth where some of these books can be acquired.
Two other recently discovered cities are believed to be results of the disease, although as of this writing their libraries have yet to be discovered. One is located in the Ghost Forest in central Brazil. This city, fog-garlanded, rain-haunted, is constructed from the bones of exotic birds of the area, and is the only city that seems to have a discernible relationship with its immediate environs. Its fragile construction is the principal reason for the continued mystery surrounding the location of the library: the hollow bones of the birds are easily crushed by even the lightest explorer. For now, we must stand in frustration at its borders, gazing into its complicated arrangements and listening to the whispered, melodic conversations of its hidden inhabitants, which emerge from the city in glowing, gossamer loops and coils, illuminating the wet green foliage and our own astonished faces.
The other city exists in a labyrinth of caves, tunnels, and abandoned mine shafts in the southern Appalachian Mountains of West Virginia. The city is a dark, sprawling arrangement of stunted buildings, suffused with the perpetual sound of grinding machinery. The inhabitants of this awful place have been stripped of all their skin: the glistening tangles of muscle and tendon flex and surge in absolute darkness, staggering around on broken limbs, hustling to and fro in an excited caper. They are prone to sudden, spectacular acts of violence, rending their fellow citizens into shivering slabs of meat. The muted sound of angry exertions, grunts of rage and effort, follow these monsters around like dogs on chains.
There is much disagreement regarding the length of time this disease has been with us. Some maintain that it is a product of the Industrial Revolution, depicting in bold strokes the subjugation of the soul to the mechanized muscle of unbounded greed and arrogance. Others suppose it is a traveler's disease, in which the victim's profound desire for home manifests itself in this unearthly architecture, although the fantastic nature of most of these cities seems to undermine this theory. Others posit that the Malady of Ghostly Cities has afflicted humankind for thousands of years, that we have in fact made homes of the corpses of its victims, and that what we perceive as ghosts are the world's true citizens, the ones left here by the memory of the dead.
Until recently, no cure was believed to exist. In early 1978, however, the case of Ivar Jorgensen was finally laid to rest by Jack Oleander, an infamous book thief who chartered a boat to take him to Cook Island so that he could steal the city's secret library and sell the books on the black market. He succeeded in spiriting the books out of the city, but when the hired pilot failed to rendezvous with him at the agreed-upon time, he was forced to burn the books in order to survive the Antarctic night.
According to the statement he gave the Argentine authorities (who had, incidentally, arrested Oleander's boat captain and were on their way to arrest him when he consigned the library to flame), as he turned to watch the cascades of glowing cinders carried away by the snowy wind, his gaze fell upon the city, and he fell to his knees in astonishment. Two great wings arose from the humble skyline, beating mightily, and the city was carried away into the deep night.
Oleander escaped from the authorities shortly after giving this statement. It is believed he is headed to Libya to pillage the Norton city.
The Jorgensen incident has since given rise to the Society of Urban Transcendence, whose members have declared their intentions to seek out and destroy the secret libraries of all the cities of the earth, so that the iron- and concrete-clad ghosts that have turned our world into a forest of tombs might finally be free, and rise like God's breath into the stars which beckon them.
--Nathan Ballingrud, M.D.
Motile Agglutinate Snarcoma of the Subperineal Pondus.
Countries of Origin:
Oncologists have identified this uncommon fibroid tumor in several of the industrial nations. The etiology of snarcoma remains unknown, although anecdotal evidence gathered by the American Congress For Cancer links the malignancy with compulsive eating of spent paper matches.
First Known Case:
In 1921, Mr. Lumpur Kos, a flax dyer of Khulna Bengal, developed an aggressive snarcoma which is now a treasured specimen in the permanent collection of the Provisional Pathology Museum of the Audrey Nickers Memorial Teaching Hospital of Bombay.
Prior to ultrasound readings and exploratory biopsy, the diagnosis of snarcoma hinges on somatic indicators such as shortness of breath, flocculence of the urine, running sores of the nasal procus, bleeding from the ears, prolonged epiductoid olomony of the distal grottum, spitting, fainting spells, intrafusile vomiting, and adhesive bed sores.
Pondal snarcoma can be surgically excised with great success, but is often treated chemically as a second choice, for no better reason than that the attending surgeon "couldn't find the pondus." This situation is inexcusable.
After a standard transcolonic approach to the postpubic oversum has been established, the first and third inguinal veins and the fontiform lymphatic spinkos can be distended ventrally using a pair of Vega's lateral forceps, thus exposing the purple infoldings of the pylophancus or organ of Gorki.
Dissect the porensic artery, slice it diagonally, and insert 30 centimeters of sterile latex shunt. Apply your Forke's scalpel to the juncture of the pylophancus with the yellowish lobar tabuclomen. Expect copious drainage of Cowlick's fluid into the surgical field. Have plenty of suction tubes on hand. They tend to clog. Slocotomize and displace the tabuclomen by a succession of deepening incisions. Now you can utilize your perforated elbow retractor (1) to draw aside the main prutenoid mass of the pylophancus. This procedure should provide access to the pondus and its snarcomal extrusion.
Grip the snarcoma firmly in the jaws of a pair of Poker's tongs. Use Benway shears to snip the tumor free from the pondus. Drop the extracted snarcoma into a steel basin of saline.
Now here's where the procedure can get a bit hectic. You may withdraw your tongs and find only a scrap of the snarcoma in its jaws. Pondal snarcomas are known to sacrifice pieces of themselves in order to avoid capture.
And that's the least of their little tricks. Your snarcoma may turn out to be a motile snarcoma. A motile snarcoma exhibits mobility under stress. In layman's terms, it can crawl. In fact, it will stretch out its fibrous mycelia like tentacles and drag itself around your patient's guts like a beached baby octopus on Benzedrine.
It may suddenly hide behind a kidney. If you flush it out again, it may head for the small intestines. At all costs keep it away from the intestines. Hunting it down in there makes a terrible mess.
As a last resort, it may even fling itself from the abdominal cavity. I have personally retrieved two snarcomas from the floors of operating theaters. (One of them went safely from a butterfly net into a preserving jar. My nurse stepped on the other. An accident, or so she said.)
In any case, a snarcoma can't survive in the wild. Just keep it away from any patients with open body cavities who might be nearby, and it will die a natural death.
When the snarcoma is under control, examine the surgical field for corruption and use Plook's tweezers to extract any glybolic granulation. Disclevature or oblation of the hemophragmic orphule typically indicates opportunistic inspusal of the peripheral mesencrum by infragort C-cells. Be aware that mumblision of the cocapsular endosucrament can eventuate in slethonular blucoposis.
Rinse and close. Don't forget to remove the arterial shunt.
And always remember to take off your gloves before eating.
Dr. Stepan Chapman, holder of the Osstrich Chair of Polysurgical Practices, Institute For Further Study
(1) Popular Surgical Instruments: Classics and Collectibles, Wendell Ortt, Green Dog Hobby Press, Boojum Florida USA, 1996.
Turkish Bone Leprosy, or Saint Calamaro's Leprosy.
Hansen's disease, commonly known as leprosy, is a long-acting microbial infection. Its lengthy dormancy period has created confusion regarding its modes of transmission. However, the active organism, mycobacterium leprae, has been isolated, and many modern cases can be reversed by antibiotics. In medieval Turkey, things were very different.
In the Christian year 1510, Bayezid the Second ruled the Ottoman Empire. On the shores of the Black Sea, at the mouth of the Sakarya River, there was a colony for lepers called Saint Augustine's Retreat. The lepers grew barley and made goat cheese. Their needs for commerce with the outside world were met by an adjacent community, the Franciscan monks of The Order of Saint Augustine, who maintained the leprosarium.
Throughout the existence of the colony, it attracted a steady stream of pilgrim lepers, who walked there from as far away as Greece and Persia. In roughly 1520 a new form of Hansen's Disease appeared among the pilgrims. The Franciscans called it bone leprosy.
The basic distinction here is easy to grasp. The hallmark symptom of normal leprosy is that necrotic flesh falls from the bones of the extremities. In bone leprosy, the bones of the extremities fall from the flesh.
First the blackened bones of the fingers and toes would poke themselves bloodlessly through the skin and detach. Next the metacarpals and metatarsals disassembled themselves and emigrated. At this stage the victim could still walk on his ankles with the help of crutches. But then the long bones of the four limbs would emerge into the light of day and discard themselves.
The chronicle of Father Ambrosius, the last abbot of The Order of Saint Augustine, reports that there was one bone leper who also lost his pelvis, scapulars, and clavicles, and got along with only a skull, a spine, and some ribs. This man called himself Vecchio Calamaro, "the old squid." He may have been born in Italy.
By 1530 many bone lepers could be seen among the hovels of the colony, squirming across the earth like giant sea stars. But the "Normal Lepers" distrusted "the Boneless Ones" and finally attacked them with clubs and drove them from the colony.
The Boneless Ones slithered away and formed their own settlement on a barren plateau that overlooked the monastery, the leprosarium, and the river. They drew water from a mountain stream and grew vegetables and spices. At the instruction of Father Ambrosius, the monks brought them barley and milk on the sly. An uneasy truce ensued between the two leper colonies.
In 1534, during the reign of Suleiman the Magnificent, Old Calamaro experienced a religious epiphany. He communicated this vision to his fellow pariahs with such force that they reorganized themselves as a lay brotherhood. They committed their lives to penance, holy poverty, and the contemplation of Christ's mercies. Calamaro went to live in a pit lined with stones, like a shallow well shaft or a lidless oubliette. He dug this pit himself, using only his teeth and a wooden spoon.
As the years progressed, more and more of the Boneless took vows and became visionary hermits, living in the sunken circular cells that dotted the plateau. They seldom spoke, but their echoing chants at dawn and dusk could be heard by Father Ambrosius at Saint Augustine's. Certainly the Boneless Ones had surpassed the Franciscans in their pursuit of austerity. Ambrosius felt no temptation to envy them their accomplishment. (1)
The only existing record of The Order of Saint Augustine and the two leprosariums concludes with the death of Ambrosius. The monastery walls have been toppled by earthquakes.
But Old Calamaro is remembered to this day as Saint Calamaro of the Russian Orthodox Church. A few of the "prayer pits" of his brotherhood have been preserved for visitation near the modern town of Karasu.
A hagiography is not, of course, medical data. I present this excerpt from Saint Calamaro's notwithstanding, freely translated from an anonymous Latin parchment. Please consider it as a curious footnote to the social history of leprosy.
The miracles of Saint Calamaro were three in number, and three in number were his trials, the first being a trial by hunger.
It came to pass that the hearts of the Normal Lepers were enflamed against their bone-bereft neighbors. And the Normals didst resolve to accost those gentle Franciscans who went forth each day to pass among the Boneless. For the Normals deemed it folly to risk contagion from such an unnatural affliction as bonelessness. And they shouted at the monks, saying, "Shun the unclean! Your charity could get us all deboned!"
And they didst smite those humble monks, and lo they broke many heads. For they grew cruel when they got a little wine into them. And Father Ambrosius didst resign himself to abandon the Boneless.
And further the Normals didst rip up the Boneless One's gardens and didst foul the pure water of their stream.
For 40 days and nights, the Boneless drank only the morning dew that condensed on the walls of their cells, and ate only the tiny creeping things that they found within their clothes. And yet they thirsted not, nor didst they hunger. For the grace of Saint Calamaro's first miracle was upon them.
The second trial of the saint was a trial by drowning. For indeed the Normals didst arise again against him and didst drag him from his pit. And none of his followers resisted the Normals, but rather they prayed more loudly to drown out his cries for help. For the Boneless were sore afraid.
And in consequence the Normals didst bind the saint within a sack, and drag the sack across sharp rocks to a boat, and row this boat a great distance across the Black Sea. And there they didst abuse the saint and kick him in his private parts and throw him overboard and leave him to drown. And the Normals were well satisfied, even though an ear, a nose, and several of their fingers had been lost in the scuffle.
In his aquatic extremity, the saint lost not his faith in his Savior, but didst call out loudly to the Lord, with many Italianate profanities, in fear and in trembling and with evil-tasting water in his mouth. And his prayers were answered, for like unto the rainbow-dappled jellyfish, he didst float upon the sea, nor did he sink.
The Normals didst row to shore and make straight for their dining hall, for drowning cripples always made them thirsty. And lo the second miracle! At their dining hall, they found their cook in great dismay. For Saint Calamaro had appeared in her largest stew pot and was eating all the stew.
Then the saint's final trial was upon him, which was a trial by boiling in oil. For the outraged Normals didst pour much olive oil into that soup pot and didst clamp down the lid with great force and three carpenter's vices. And they didst convey the soup pot to an open space between their hovels, where they soon amassed the makings for a bonfire. Mightily that conflagration raged about the soup pot. And the Normals danced and shouted, saying, "This is how we cook a squid in Turkey!"
But when the fires died, and the soup pot was opened, there was nothing inside. And just as the Normals saw this ominous emptiness, a chuckling was heard.
And lo the third miracle! It was Old Calamaro. He was inside the dining hall again, feasting on almonds and custards and wine. And seeing this, the Normals didst flee in fright from the doings of this leprous magus.
And though he was never seen again, peace reigned forever after between the Normals and the Boneless. For it was said among them that Old Calamaro had melted into the shingle at the shore, like unto an icicle in the sunshine. And they said that he dwelt now in the earth beneath their sandals, and that he watched all the lepers of the world, lest they ever again mistreat the wretched.
But in truth the Old Squid ascended to the Land of Light and sits now among the choirs of the angels in the throne room of the Lord. Perhaps he even sits on a velvet stool beside the Savior's giant golden throne.
Or perhaps--who can say?--he reclines more comfortably on the white marble floor beneath the throne, peering out from his special place between the four golden legs. Perhaps he reclines on a tasteful Persian rug, eating stewed prunes with a silver spoon. Perhaps he smiles down toothlessly on all the prostrate supplicants arrayed before God's throne. Perhaps he shakes his head and chuckles, as they beg for mercy.
Stepan Chapman, Doctor of Pandemics
(1) Father Ambrosius wrote the following scrap of Latin verse into a margin of his chronicle.
Shunned by their unclean brethren,
Who are shunned by the monks of my order,
Who in turn are barely tolerated
By the Moslem that surround us.
Who is the lowliest of the low?
Who is most outcast?