Inundated by Silliness: Noah, 2014

By Dale D. Dalenberg, M.D.

November 7, 2014

Darren Aronofsky’s 2014 film Noah inspired me to plumb the depths of the Dalenberg Library,  find the great flood stories of human history,  and re-read them.  While there are many flood legends from many cultures, the three biggies of Western civilization are 1) Noah’s flood from the Book of Genesis in the Hebrew Bible, 2) Deucalion’s flood from ancient Greek and Roman sources, most notably from Ovid’s “Metamorphoses,” and 3) Utnapishtim’s flood from the ancient Babylonian “Epic of Gilgamesh.”  The relationships between these three versions of the “universal flood” that was sent by a God or gods to wipe out humanity are uncanny.  The more you read these three versions, and the more you study them, you realize that they are really all three the same story, for the most part.  Well, I suspect that Darren Aronofsky read these sources too, before writing his Noah movie, but it doesn’t look like he relied much on the old writings.  Aronofsky’s film is not so much a re-telling of the Noah story or an explication of what the Noah story means in human history; the film is rather a free fantasia on Noah-related themes, and frankly it is more about modern stuff than ancient stuff altogether.  In fact (and Aronofsky readily admits this), Noah isn’t even a particularly religious movie, despite being based on a Bible story.  The film is firmly rooted in a modern, agnostic Hollywood liberal ethic.  The impulse that caused it to be made was a curious desire to put Star Wars/Lord of the Rings-style special effects in a biblical epic and try to draw a blockbuster crowd.  All the more of a Hollywood in-joke if you could convince gullible fundamentalist Christians (many of whom actually believe the Noah story more as fact than as legend) that you were actually making a Bible movie with a big Hollywood budget.  But rather than being a gift to the Born-agains, the moral imperative that drives this film is a subliminally preachy liberal subtext about the virtues of vegetarianism and the sins of destroying the environment, and the financial imperative was a desire to put CGI to work super-sizing a Sunday School story.   

Noah has been done before as a Hollywood film. John Huston tackled it in his mostly forgotten 1968 film The Bible, which I recall from a childhood family drive-in theater outing, and which was a straight-ahead retelling of The Creation through Abraham that would have been approved by any group of Southern Baptists who were willing to swear (on the Bible, of course) that God actually whispered this stuff in Moses’ ear so he could write it down.   And then there was Walt Disney’s whimsical 1959 stop-motion animation short subject, which was very cutesy with people and animals made of pieces of felt and string and buttons.  My main problem with the Disney version is how light-hearted and tuneful it is about the wholesale destruction of the human race.  The Sunday School version of the Noah story has always been more interested in the animals than in the humans, presumably to keep the story kid-friendly.  It’s not cool to talk about evil and sin and people drowning to death in Sunday School.  Aronofsky’s film is certainly more realistic, because it is more about the people than the animals.  To be sure, the animals are in this film, for a minute or two, but they are mostly forgotten on the lower decks of the ark while the people go about having people-conflicts that move the contrived story along.  

I was put off by this film from the get-go.  From Frame 1 it was clunkily obvious that the film was carefully designed not to offend Christians, atheists, or agnostics.  God is carefully referred to throughout as “The Creator,” and the film is very careful not to delve too deeply into The Creator’s nature.  Noah has a vision, which could be from God or could be a crazed delusion, we are never really told.  After the initial vision, Noah is pretty much left to his own devices without any real dialogue with “The Creator,” so at first he almost arbitrarily decides that all of mankind should die,  and then he reverses himself by the end of the story to declare his family free to repopulate the flooded world.  While we never hear the voice of God talking to Noah (because the film-maker is at pains to allow us to believe--if we are so inclined--that maybe these voices are all inside his head), there are miracles depicted in the film, such as the sudden sprouting of a forest to provide wood for the ark and the almost supernatural migration of the animals to the ark.  It is this lack of religious conviction, this money-mongering act of catering to the widest possible audience, atheists and Christians alike, which puts the film on a shaky foundation from the outset.  Aronofsky is torn between making this Noah a revisionist agnostic version of a human myth and making an all-out fantasy film with monsters and special effects and a Yoda-like shaman who lives in a mountain (that role filled by Methuselah, who delivers wise pronouncements and at one point works a bit of magic to make Shem’s betrothed fertile again after a childhood injury had left her barren.)  By casting off the religious vestiges of the story in order to turn it into a 21st Century California-style allegory about vegetarianism and going green, Aronofsky leaves gaping moral and ethical holes in his story logic.  For example, if Methuselah is so holy that he can cure a barren woman of her infertility with a mere touch, why is he allowed to die in the flood?  And what was so special about Noah that he was chosen by The Creator to be spared?  The story does nothing to make Noah look especially virtuous, and in fact he descends into an Ahab-like madness in the course of the story, at one point coming perilously close to stabbing his newborn baby grand-daughters to death to keep them from propagating the human race.  

It is difficult to convey exactly how dreadful this movie really is, because it is horrendous on so many planes at once.  The prehistoric clothing looks like it came from a chic mail-order catalogue, only a little more rough-hewn around the edges, like it was sewn a year or two before the advent of commercial sergers.  It looks very comfy and very “Lands End,” down to the fur lined boots.  Aronofsky has Noah being assisted by fallen angels who look like rock robots that have been borrowed from every other CGI effects-laden picture we have seen in the past few years.  It was hard not to see flashes of the tree-people (Ents) marching on Orthanc from Peter Jackson’s Lord of the Rings, as these rock angels move with the same gait and make the same gestures.  Perhaps God (excuse me—The Creator) used the same software for his fallen rock angels.  When the movie descends into melodrama, it gets worse and worse.  As the film wears on, the characters get speechier and deliver some real agonized moments right out of the Stanislavski Method, which would have been fine except that all the histrionics are in the service of this particular plot.  This crazy screenplay has Tubal-Cain (a name plucked from the pages of Genesis and grafted onto the Noah story for this movie) stowing away on the ark for the express purpose of having a climactic showdown with Noah.  And Noah’s son Ham turns against him and conspires with Tubal-Cain simply because Noah fails to secure Ham a woman for the long sea voyage.  As tensions mount and everyone gets their Stanislavski moments, one can’t help but wish this all-star cast of Russell Crowe, Jennifer Connolly, and Emma Watson were in a different, better movie.  

Still, I did pick up one thing from Aronofsky’s film that I hadn’t previously remembered about the Noah story from Sunday School.  In one of the more grandiose moments, the water is spurting out of the ground as well as falling from the sky.  I was thinking, that’s a bit ridiculous and over-the-top.  But, it turns out, that story detail actually does come from the Bible:  “. . .all the springs of the great deep burst out, the windows of the heavens were opened, and rain fell on the earth for forty days and forty nights.”  

For me, the fascination of the Noah story is its anthropological and literary implications.  Where do the flood stories, ubiquitous in human cultures, originate?  Are they all related, or have many of them, such as the ones in the New World, arisen independently?  Do they have to do with the seasonal flooding of the river deltas in Mesopotamia in Neolithic times, or the filling in of the Persian gulf destroying the original human settlements, or the observations by ancient people of fossil sea life far from shore, or other local floods, like the creation of post-glacial lakes in the receding Ice Ages?  Re-reading and studying the three big flood stories (Noah, Deucalion, and Utnapishtim) is a fascinating exercise in comparative literature and myth.  One assumes that the Hebrews appropriated the story from the Babylonians, most likely during the Captivity.  Ovid probably didn’t have anything like the Old Testament at his fingertips, but the similarities between Ovid and the Genesis account are too great to be coincidence.  Later, as the Deucalion story in Ovid morphed into a version told by Lucian in the 2nd Century, the story had obvious borrowings from Genesis.  For instance, Deucalion and his wife didn’t save any animals in the Ovid version, but Lucian has them saving pairs of animals, just like Noah and Utnapishtim before him.  Robert Graves also points out in The Greek Myths that Deucalion’s name means “new-wine sailor” and he was likely originally associated with the invention of wine, although that invention was later ascribed to Dionysus, so Deucalion’s claim to wine was suppressed (except that he got to keep his name.)  This relates Deucalion to Noah, who (after the flood) was described in Genesis 9:10 as the “first tiller of the soil,” and the fact that he planted a vineyard and became drunk on his own wine has led to the tradition that Noah invented wine.  Thus, Deucalion and Noah are really one and the same mythologically.  It might be that the Babylonian and Hebrew stories were fused with some local Greek flood legend (or legends, as Deucalion’s ark came to rest on one of no fewer than four peaks, depending on which version of the Greek myth you read), but there are so many parallels that Utnapishtim, Deucalion, and Noah are either all the same guy or at least mythological cognates of each other.  

In the final analysis, the Aronofsky Noah leaves the broader implications of the story unexplored as it plies us with a weak Californian vegetarian go-green message beneath a mere excuse for Lord of the Rings-style CGI overkill.  A more interesting film is waiting to be made, one which tackles the topic of a deity questioning His/Her creation to the point of wanting it destroyed, or at least one which explores the universality of this legend.  There is ample opportunity here for a special effects bonanza—the ark, and all the animals, and the logistics of such an impossible voyage are ripe materials to work from.  No doubt those are the things that attracted Aronofsky to the story.  Problems are he didn’t tackle any of the interesting questions, and his soap opera plot and rock-robot fallen angels make the whole watery  production bubble over with a surfeit of silliness.  

The Holkham Bible is a 14th Century story Bible, present in the Dalenberg Library in a beautiful Folio Society facsimile.  Depicted here is Noah releasing a raven and a dove from the ark, which is floating above a harrowing scene of two drowned humans, a drowned cow, and a drowned horse.  The raven is seen again below, plucking at the eyes of the dead; the dove is seen picking the olive branch that she returned to Noah.  The language is Anglo-Norman French, which existed alongside Middle English and Latin during this transitional period in the English language, not long before Chaucer.  The Holkham Bible devotes a disproportionate number of pages to the Noah story, showing that its appeal as a Bible story goes way back.  However, death was more ubiquitous in those days when there were bad things like the Plague about, so even a Bible story-book like this provided rather graphic depictions of the Final Judgment and a world engulfed by the wrath of God.  The Disney-fication of the Noah story came much later.

1931: The Earliest Seuss in Hardcovers

 By Dale D. Dalenberg, M.D.

October 13, 2014

In 1931, well before Theodor Seuss Geisel published the childrens’ books for which he achieved his fame, he was drawing ads for Flit insect spray and publishing cartoons in magazines, most notably Life and the long-defunct humor and satire magazine Judge.  This exposure prompted an editor at Viking Press to call Seuss and offer him the chance to illustrate an American edition of something that had been called Schoolboy Howlers in Britain.  Seuss’s first illustrated childrens’ book, And to Think that I Saw It on Mulberry Street, was still five years in the future.  Seuss (who still in those days pronounced his name in good German fashion to rhyme with “voice” instead of “moose”) ended up illustrating two volumes for Viking Press, titled Boners (which came out in  February, 1931) and More Boners, which appeared that April.   According to Judith & Neil Morgan’s book Dr. Seuss and Mr. Geisel, the original Boners “swept through four printings in two months to lead The New York Times non-fiction bestseller list.”  Buoyed by this success, Seuss tried to sell Viking on his idea to write and illustrate an alphabet book using very strange animals to illuminate the ABC’s, but Viking didn’t bite, and it would be twenty-four more years (1955) before Seuss would put out the closest thing to his old idea in On Beyond Zebra!

The Boners books were collections of purportedly authentic bloopers from classrooms and exam papers of school-children.  These were allegedly submitted by teachers and others for consideration, and the editor would choose the most hilarious ones for inclusion in the books.  There were four Boners books from February, 1931, to March, 1932, the first two illustrated by Seuss and the others credited to Virginia Huget.  They must have been very popular, because not only did they show up on the best-seller lists, various omnibus editions of the books were packaged and re-packaged over the years. In fact, some of the unintentional puns, youthful but unintended wisdom, and malapropisms that appear in the Boners books have become somewhat legendary.  A book from 2007 called Must Try Harder! The Very Worst Howlers by Schoolchildren includes a lot of the boners (“howlers” in Britain) from the Boners books alongside newer, more modern ones.  

 Many of the funniest jokes simply substitute an incorrect word for a correct word.  Thus, we are given the observation:  “Adolescence is the stage between puberty and adultery.”  A simple word substitution can have the effect of causing a child to make what seems like a very adult observation, such as:  “In Christianity, a man can only have one wife.  This is called Monotony.”  Another rather adult observation in the same vein:  “The Bible is against bigamy when it says that no man can serve two masters.”  Often these “boners” have the unintended, but hilarious, effect of turning innocent school-child mistakes into rather ribald jokes.  For example:  “A census taker is a man who goes from house to house increasing the population.”  Sometimes, a child just gets things backwards, as in:  “1066 is in the ninth century because centuries always for some reason or other fall back one.”  Other times, a child, not knowing the correct test answer, is just innocently honest:  to the request “Write what you know of the Last Supper” one child answered, “I was away for that.  I had the measles.” And sometimes, a child can just cut to the chase like no adult ever could:  when asked “Where was the Declaration of Independence signed?,” the answer given was “At the bottom.”  

 An unintended effect of the Boners books is to show those intellectuals among us today how deprived our children are in the era of “No Child Left Behind” (read: EVERY child left behind), which is also the era of teaching to the standardized exam to the detriment of all else.  The school-children of 1931 who wrote the “boners” may not have understood everything they were being taught in school, but there was at least an attempt being made to expose the material to them. These children were studying (and yes, making lots of funny mistakes along the way) topics as diverse as classical history and mythology, science, mathematics, religion, literature, and more.  Most schoolchildren today couldn’t read the Boners books and laugh, because modern education has not provided them with a matrix for interpreting the humor.  And that is lamentable.  

Victorian Artisan/Author/Activist: William Morris (1834-1896)

By Dale D. Dalenberg, M.D.

The Dalenberg Library blog was created (in part) to highlight unique books, or forgotten books, or collectible editions in the Library.  I have often digressed from that task to discuss music or art or films.  But I have a lot of un-read books in this Library to discover before I die, so it is time to start reporting on them here.  

J.R.R. Tolkien has always been central to my reading mission in life.  Back in the 1970’s, when my young mind was fascinated by the discovery of Tolkien, Ballantine Books set about re-discovering and re-publishing many of the great (but mostly neglected) works that had preceded Tolkien, under the imprint of their Adult Fantasy series, the ones edited by Lin Carter and bearing the unicorn colophon.  Together, these books form a core to the Dalenberg Library fantasy collection.  We at the Dalenberg Library detest many of the post-Tolkien “fat fantasy” books published in trilogies, and tetralogies, and other over-lengthy series formats.  We think most of those authors could use an editor.  But we love Tolkien and pre-Tolkien (and a few select later science fiction/fantasy hybrids, such as the works of Gene Wolfe.)  

Dalenberg Library copies of 1970 Ballantine Adult Fantasy 2-volume paperback edition of “The Well at the World’s End.”  Best taken in small doses, Morris’s prose is rife with archaisms and quasi-medieval diction, much like those two other great pre-Tolkien fantasists, E.R. Eddison and Lord Dunsany.

William Morris (1834-1896) stands tall as a founder of modern adult fantasy fiction (meaning, fantasy as a literary sub-type that has moved beyond fairy tales), although he is almost never read today. Morris’s writings had a profound impact on Tolkien in his early days.  That impact is indelibly evident in Tolkien’s earliest stabs at fantasy fiction, writings that preceded The Hobbit, which have come to light in the years since Tolkien passed away and the effort began to publish every scrap of his tales in every stage of their evolution.  As for Morris, his collected works, published between 1910 and 1915, run to 24 volumes.  They are once again available from the Cambridge Library Collection (re-published in October, 2012).  I would like to say that I own the collection, but that would require a small matter of $820.00.  However, the Dalenberg Library has invested in two very fine Folio Society facsimiles of William Morris, and each of them cost about that much or more.  These books are works of art in their own right and are certainly in the “Top 10” of collectible books that we own.   

A few years ago, Folio Society put out a limited edition of The Kelmscott Chaucer, which was Morris’s  luxurious large format hardbound edition of the works of Chaucer, featuring his unique calligraphy & text illuminations, with enhancements contributed by his close friend, Victorian artist Edward Burne-Jones.  Morris had made his name as a founder of the Arts & Crafts movement, which much like in his fantasy stories, looked back to an idealized medieval period when artisans and craftsmen worked together to create things of value.  This was the antithesis to the mass production, grease, and grime of the industrial revolution that Morris disliked.  In the last decade of his life, after mastering many artistic techniques through diligent study, Morris turned to producing print runs of artistic books with meticulous calligraphy and illuminations through his Kelmscott Press. The Press did not much outlive him, however, because these books were, by nature, expensive to produce and could only be afforded by the very rich.  But in over 50 volumes, Morris produced the finest editions ever released in the Victorian era, utilizing self-designed typefaces, handmade paper, and printing by hand. Other than the 17th Century Dutch family Bible, the Folio facsimile of the Kelmscott Chaucer, the production of which occupied much of the last 6 years of William Morris’s life, is the largest, most beautiful book in the Dalenberg Library.   

Aside from not being a scientist, and from being more interested in the Middle Ages than the Renaissance, William Morris was the closest thing in the 19th Century to a Renaissance man.  He was famous as a designer of textiles, tapestries, and wallpapers, as well as being a poet, novelist, translator (of Icelandic sagas), and socialist political activist.  He is one of the most distinctive and influential artists of repeating decorative designs.  Many of his designs are still available commercially today, with their repeating, interlocking floral motifs.  Morris & Company, with sales of textiles, wallpapers, stained glass and other interior decorating needs, made William Morris famous and rich in his lifetime.   And perhaps it was not quite correct to say that he was not a scientist, because much of Morris’s contribution came from improving techniques of production.  He was intimately involved in the technical aspect of his products, down to fine details, such as favoring organic dyes over chemical dyes for the textiles.

Prior to The Kelmscott Press, when Morris started creating fine books in press runs for general purchase, he had toyed with the illumination of texts on a hobby basis.  In the 1870’s, he illuminated 18 books, harking back to the style of illuminated medieval manuscripts.  The latest Folio Society special edition, put out this year, is a facsimile of a volume now in the Bodleian Library, William Morris’s illuminated text of the Odes of the Roman poet Horace, in Latin.  The Folio edition is a wonder to behold, bound in goatskin on fine paper, and looking for all the world like the hand-produced work of the artist himself, down to the gold leaf used in the illuminations.  The book is stored in a special presentation box and is accompanied by a separate volume with an essay on Morris’s production of the book and a translation of the Odes into English.  The Odes of Horace was probably illuminated as a gift for a friend, possibly the wife of artist Burne-Jones.  It is actually only three-quarters complete, but the last portion of the book is still charming, as it has many of the outlines that were later to have been turned into the completed illuminations, which gives it the quality of an artist’s work-in-progress.  

The Odes of Horace is a beautiful volume, with a rich leather aroma, and each page is eye candy for a book-lover.  After handling it and studying it, I now covet Morris’s storied illuminated edition of “The Rubaiyat of Omar Khayyam”, and I wonder if the Folio Society will attempt that one and whether I’ll have the $900 or so that it will inevitably cost.  

I have chosen here to display the page featuring Horace’s most famous quote, “Carpe diem quam minimum credula postero,” which can be translated as “Seize the day, for you cannot trust what tomorrow might bring.” My Latin is almost non-existent, so don’t completely quote me on the rest of the line, but I can vouch for the fact that “seize the day” is the most often quoted translation of “carpe diem.”   Horace is a more personal writer of odes than his Greek predecessors, such as Pindar, who were writing poems in praise of the gods and for various ceremonial occasions.  Another of my favorites is Horace’s  faintly ribald ode to Lydia, who is growing old enough that the young men are no longer calling, and yet she still lusts despite her years.  The calligraphy, the emboldened capital letters, and the extreme ornamentation of the initial letter of each poem is vintage William Morris.  

Robin Williams: 1951-2014

By Dale D. Dalenberg, M.D.

August 12, 2014

This has been a sad week for the movies as we lost iconic performers Robin Williams to suicide (at age 63) and Lauren Bacall to an apparent stroke (at age 89). 

Williams’ death by suicide hits hardest.  If any movie actor of our era could fairly be described as “beloved,” it would have to be Robin Williams.  His mission was to make people happy.  He even made a movie about making sick people happy, called Patch Adams.  If Robin Williams, of all people, could be unhappy, where does that leave the rest of us? How are we to go on?  Movies featuring Williams grossed 5.5 billion dollars worldwide (in non-inflation-adjusted dollars).  That’s a lot of money.  Can’t money buy happiness?  Doesn’t comedy equate with happiness?  Williams’ death is unsettling.  He worked all his life keeping the rest of us from killing ourselves. Didn’t he?  

As a physician, and as somebody who has been depressed, I know a little about what happened to Williams.  His suicide scene was exactly the type of low altitude hanging that I learned about in medical school in the lecture where the county medical examiner showed just how little altitude was required to hang yourself with a belt.  The M.E. had a series of slides where people had successfully hanged themselves sitting in chairs, hanging from doorknobs, in their own bedroom closets.  They were followed by a series of slides showing just how little water was required to drown yourself.  Williams’ death was just like twenty or thirty slides that I watched in my medical school lecture.  It takes me back.  I’ve seen this death before.  

Unlike Robin Williams, I have never struggled with cocaine or alcohol abuse (or with massive fame, for that matter.)  But I have been clinically depressed for maybe 3 full years of my 53--two years around one divorce, and about one year around a second divorce.  Thankfully, my  depression has therefore only consumed 5.7% of my lifespan.  But it was enough to give me insight into the plight of people like Robin Williams.  When I was depressed the world was black and nothing could cheer me up.  I would walk down the street and hope for a car to jump the sidewalk and take me out.  It didn’t matter that there was so much to live for.  Robin Williams had a lot to live for.  He was worth 5.5 billion non-inflation-adjusted dollars to the film industry, and he had the adulation of millions.  In the final reckoning, it didn’t matter.  He reportedly didn’t even leave a suicide note.  He didn’t want notoriety for this, or to have the last word, or to get back at anybody—he just wanted it over with—he couldn’t stand the pain, the black outlook, the teetering on the abyss.  

This suicide should remind us that depression is a disease, and all too often a fatal disease. People do not always realize that.  Take, for instance, my second wife, who was a harsh woman who rejected the notion of depression.  She felt like depression was a state of mind that you could snap into or out of at will, as if it were just a way to get sympathy from those around you.  She had no tolerance for me or any of her children making claims of depression.  She exemplified the kind of ignorance that overlooks serious disease until it is too late.  Depression leading to suicide is a biochemical state over which one has little control, whether or not it also has situational stressors associated with it.  With all respect to Robin Williams’ mourning family, I have no idea whether they suspected he was at risk or not.  But this death should be a reminder to us all to take this disease seriously, to watch out for it in our loved ones, and to sound the alarm when necessary.  

A lot will be written about Williams in the coming weeks and months.  Some of it will seem disrespectful.  The saturation media coverage will become nauseating.  We are already starting to hear that he had money problems, that his two divorces had gutted his bank accounts, that he was depressed over the cancellation of his latest TV series, that to make ends meet he had been forced to get involved in a sequel (though he disliked the idea of sequels) to his hit film  Mrs. Doubtfire.  

Instead of the tabloid angles, let’s remember the performer and how he made us laugh and generally just feel good.  I personally enjoyed Williams at his edgiest, when he was being a stand-up comic, or when he was rattling on hilariously as Mork from Ork, or when he was doing frenetic voice-overs for films like Aladdin (as the Genie) and A.I. (as Dr. Know).  Perhaps my favorite Robin Williams moment ever was in an uncredited role, as the King of the Moon in The Adventures of Baron Munchausen (1988), the scene where his head kept becoming detached from his body.  I liked him less well as his career wore on, and you knew when you saw Robin Williams in the cast, that something about the film was going to be a little too precious and cutesie and over-sentimental.  I really didn’t care to see him in dramatic cameos, like when he showed up as Dwight D. Eisenhower in The Butler.  I kept expecting him to deliver a clever one-liner and get a rim-shot.  

As I look back, I have spent a lot of enjoyable hours in the past 35 years watching Robin Williams’ performances.  Aside from various stand-up comedy, TV, and awards show appearances, I can come up with 17 performances on my personal lifetime Robin Williams list.  My best homage is to recount them here, followed by a moment of silence.   

1978-1982    Mork & Mindy (TV)

1980        Popeye (see pic above with co-star Shelley Duvall)

1982    The World According to Garp (still Williams’ best film, in my humble opinion)

1987    Good Morning, Vietnam

1988    The Adventures of Baron Munchausen

1989    Dead Poets Society

1990     Awakenings

1991    Hook

1992    FernGully: The Last Rainforest (voice-over)

1992    Aladdin (voice-over)

1993    Mrs. Doubtfire

1996     The Birdcage

1997    Good Will Hunting

1998    What Dreams May Come

1999    Bicentennial Man

2001    A.I. (voice-over)

2013    The Butler

. . . .God rest Robin Williams. 

Bow-Tied and Brilliant: My Memories of Leonard Peltier, MD, PhD (1920-2003)

Portrait from Asclepiad 1987 (University of Arizona College

of Medicine yearbook).  

By Dale D. Dalenberg MD

June 17, 2014

​There have been four great mentors in my professional life. They are:  Leonard Peltier MD PhD, Marc Asher MD, Edward H. Simmons MD, and William H. Pickett JD.  As a group I owe them my career in orthopedics, any modicum of respect and credibility I have as a practicing physician and as a medico-legal consultant, and the inspiration to be what pale shadow of a Renaissance man that I can hope to be.  Today, I exist professionally on the crossroads between the arts & the humanities, clinical medicine, and that zone of overlap between medicine and the law.  Without the inspiration of these four great men, I would never have had the notion to try to combine all that in one life.  

I owe a great debt to Dr. Peltier, who is quite simply the main reason that I am an orthopedic surgeon today.  I met him when I was a third-year medical student (1985-86) at the University of Arizona doing a rotation in orthopedic surgery at the Tucson VA Medical Center.  Peltier was at that time the elder faculty member in orthopaedics at Arizona, having recently stepped down from the chairmanship of orthopaedics and handed that job to his former resident Bob Volz.  He was shortly to be saddled with the designation of Acting Head of Surgery, which is a job I don’t think he sought out but which was thrust upon him.  In that brief window of time when he wasn’t head of anything, he found time for teaching students, and part of that was weekly teaching rounds at the VA.  I remember that a commotion ran through the orthopedic ranks of residents and students as the hour approached for Peltier’s visit.  It was as if a visiting dignitary were coming.  We were admonished to be on our best behavior, to pay rapt attention, and to speak only when spoken to.  I was immediately enthralled by him.  He was erudite, impeccably bow-tied, and seemed like one of the medical gods that I had worshipped in all my reading about famous doctors up to the time I entered medical school, which included names like Jenner and Lister and Pasteur.  It’s actually a good thing I’d done all that reading, because that’s how Dr. Peltier got to know me, how I stood out of the crowd to him, and why he wrote me that all-important letter of recommendation to the program (University of Kansas) that enrolled me as an orthopedic surgery resident.  

My medical school classmates clearly got the message that I was an immediate convert to the Leonard Peltier, MD, PhD, fan club.  I was definitely a Peltier follower after those VA rounds.  In my medical school year-book, Asclepiad (1987), my classmates wrote the following caption under my senior portrait:  “A disciple of the Leonard Peltier school of charm, Dale would give anything to inherit Dr. Peltier’s bow tie collection.  His serious demeanor suggested to many ill-fitting underwear, when in fact he long suffered from an overdose of Ingmar Bergman films.  Having fathered a son, and thus rediscovered the Wonderful World of Disney, a full recovery is expected prior to beginning Ortho at Kansas.”  My classmates were perceptive about my attachment to Peltier, my study of the arts along with medicine, and they predicted the day when I would be co-authoring this arts blog with that same son referenced in the yearbook, Alexander David Dalenberg.  Due to my middle-aged spread, the underwear is still ill-fitting, but I am much less serious these days than the yearbook entry would suggest.  

Anyway, about Dr. Peltier, and how he noticed me enough to recommend me for a residency:

Peltier’s Big Thing was the history of medicine. Granted, he wrote a lot of original scientific papers, some 200 of them, most notably about fat embolism syndrome, but his great passion was history.  

When we students were all standing at the scrub sinks washing our hands (at his behest) before entering a VA ward, he asked the group why we were doing what we were doing (namely, handwashing.)  After an unpleasant silence by the group at large, I could not contain myself any longer, so I blurted out the answer:  Ignaz Semmelweiss.  And I proceeded to relate the story about how Semmelweiss, without knowing anything in those days (circa 1847) about bacteria or infectious organisms, figured out by sheer epidemiological reasoning that women on the obstetrics ward at his Vienna hospital were dying from exposure to “cadaver particles”  that were being taken to the maternity ward by the medical trainees doing autopsies, whereas the women on the midwives’ ward were only rarely getting “childbed fever” because the midwives’ didn’t go to the morgue to do autopsies.  Semmelweis also noticed that women who gave birth in the street also rarely died.  Semmelweiss instituted a policy of handwashing and slashed the death rate (unfortunately, the medical establishment didn’t believe his research, and Semmelweiss spent the rest of his life railing against the ignoramuses and murderers who were allowing the women to die for want of proper handwashing; Semmelweiss died in an insane asylum and his research wasn’t resurrected until decades later after Pasteur and Lister had popularized the “germ theory” of infectious disease).  

When I related this story on the orthopedic ward at the VA, Dr. Peltier was silently impressed.  Peltier was rather lofty from the students’ perspective and seemed very un-approachable, so his silence was widely mis-interpreted.  I remember that Bradley Brainard (a resident at the time) assumed Peltier’s intent had been to stump us all, and he whispered in my ear that Peltier was pissed off that I knew the answer.  However, the fact is that Dr. Peltier never forgot who I was after that.  When I asked him later for a recommendation letter for my orthopedic residency applications, he was eager to help.  Thus Dr. Peltier kick-started my orthopedic education and career, and I am forever grateful to him for that.  I used to hesitate to say hello to him at the American Academy of Orthopaedic Surgeons annual meetings, where I would run into him even after he was fully retired and Dr. Volz had started replacing his joints.  I always thought he would have forgotten who I was, but he always remembered.

The thing I loved most about Peltier was his Renaissance quality.  He was never focused on the picky little details of orthopedic surgery, but rather he conveyed a sense of the over-arching place of modern orthopedics as it existed in the context of historical medicine.  And on the clinical side of things, he propagated the message that orthopedics did not exist in a vacuum, but that the orthopedic problems of a patient existed in the context of a greater world of general surgery and an even greater world of the whole organism.  Peltier was one of those giants who used to populate the orthopedic world, but have since become a vanished breed, who were  trained as general surgeons and only later specialized as orthopedists.  I loved going to the orthopedic radiology conference with Peltier presiding.  A typical Peltier tactic was to get an unsuspecting student in front of the crowd and show him a pelvis radiograph and ask, “What systemic disease does this patient have?”  You were supposed to scrutinize the radiograph and notice the vascular clips in the lower corner of the film from saphenous vein harvest for coronary artery bypass, and you were supposed to say something like “atherosclerosis” or “coronary artery disease.” Peltier didn’t want to hear about the pelvis—he wanted you to glean from the pelvis radiograph something more general and more important about the whole patient.  

About the time I was finishing my orthopedic surgery residency, Peltier came out with his two fine, illustrated books, one on the history of fractures, and the other one on the history of orthopedics.  I couldn’t afford them at the time, but I have since made up for that with the financially successful career that Dr. Peltier made possible for me.  A small corner of the Dalenberg Library today is devoted to historically important medical books, and Peltier’s two volumes (that I have since acquired) are a fine addition to the Library, right alongside the books Peltier himself would have wanted me to read--like Mercer Rang’s pediatric fracture book and Henry’s Extensile Exposure, to name just a couple from Dr. Peltier’s era.  

A couple of things impress me as I read back through Fractures: A History and Iconography of Their Treatment (1990) and Orthopedics: A History and Iconography (1993).   Nowadays, the orthopedic literature is preoccupied with economics.  We read about the economic impact of total knee arthroplasty and lumbar discectomy.  We read about the lack of efficacy of non-operative spine care and spine surgery as related to the public policy burden of paying for it.  But historically, the quest was more directed at defining disease and the solutions to disease.  One senses that expensive, but not always efficacious, technologies (and—perhaps--expensive doctors commanding six-, bordering on seven-, figure incomes) have changed the dialogue and buried good science. In Dr. Peltier’s books, we can experience a refreshing return to a more innocent time when there were problems to be solved, like tuberculosis of the bones and joints, like infantile paralysis.  The other thing that impresses me about Dr. Peltier’s books is the vast expanse of orthopedics that existed BEFORE arthroscopy and arthroplasty.  These days, entire careers are spent doing only arthroscopy or only arthroplasty (in many sub-specialty practices), but those two disciplines merit barely a chapter out of the two books, and only the infancy of each are touched upon.  It is humbling to realize what a vast and varied field is orthopedics, and how little of it any one of us modern orthopedists really has a grasp upon.