The vajra (Tibetan: Dorjie) and bell (Sanskrit: ghanta; Tibetan: drilbu) are the most important ritual objects of Tibetan Buddhism. Most every lama has a pair and knows how to use them. They represent “method” (vajra) and “wisdom” (bell). Combined together they symbolize enlightenment as they embody the union of all dualities: bliss and emptiness, compassion and wisdom, appearance and reality, conventional truth and ultimate truth, and male and female, etc.
What is meant by method and wisdom?
Method indicates the compassionate activities of the bodhisattva that relieve living beings of their miseries. It is the skillful means that brings about the elimination of ignorance, greed, cruelty, etc. in living beings and causes them to follow the path to enlightenment. Wisdom is the direct insight into ultimate reality; it is the wisdom that realizes emptiness. By combining method and wisdom, the bodhisattva accumulates merit and insight and eventually attains Buddhahood.
What is the symbolism of the Vajra and bell?
Most vajras have five prongs that symbolize the five wisdoms that are attained through the transcendance of five kleshas (greed, anger, delusion, pride and envy). The hub between them signifies emptiness. This one has eight prongs plus the central hub. Vajra is a Sanskrit word, in Tibetan it is called a dorje. It is related to the word for diamond, and appears to be similar to the thunderbolt weapon carried by the Vedic god Indra, and the Olympian Zeus. As a thunderbolt weapon it destroys both internal and external enemies. As a diamond it symbolizes the indestructible and all-penetrating mind of enlightenment.
The sound of the bell calls to mind the empty nature of all things. That is, according to the Buddha, nothing whatsoever can exist independently, all phenomena are empty of true or inherent existence. By being profoundly aware of the empty nature of all things, we become free of attachment and aversion, and are liberated from the painful cycle of birth and death (samsara). The bell is also a musical instrument Its sound, together with other sacred instruments such as the hand-drum (damaru), are played in rituals as musical offerings to the Buddhas and other gods.
How are they used?
The vajra and bell are often seen represented in the hands of deities in art, and in practice are held in the hands of the monks during rituals, the vajra in the right hand, the bell in the left. They are moved in prescribed movements. When the arms are crossed this symbolizes that the two are united—representing enlightenment. The sound of the bell is considered by Tibetan Buddhists as the most beautiful music. This music is presented as one of eight offerings to the deity that is invoked during the ritual.
What are the eight offerings presented in rituals?
When Tibetans Buddhist begin meditation, they will invoke the presence of the deity, bow, and make offerings. For peaceful deities, the offerings are as follows:
pure water for the deity to drink
water for the deity to wash with
scented oil for the deity to be anointed with
music, played on the ghanta (bell) and the damaru, a small two-faced drum with clappers attached by string, played by twisting back and forth in the hand
This thunderbolt and bell were cast for the Chinese Emperor Yongle (1403–1424) as a gift for a distinguished lama of Tibet. The Emperor possibly wished to gain merit for the commission. This and other gifts like it show the relationship between the Tibetan lamas and the emperors of China. Known as the priest-patron relationship, this was one way that ideas and artistic styles spread between China and Tibet. Artists working in China in imperial workshops were ordered to make Tibetan style objects for either the personal use of the emperor or to send to important lamas in Tibet, who were often considered to be their spiritual teachers.
Tibetan Drum (Damaru)
The Tibetan drum, or Damaru, might seem a little familiar. That’s probably because of the way in which you play this instrument. You take the drum and roll it from side to side, whilst small beads on the end of strings will ‘bang’ the leather drum heads. Estimates guess that this instrument reached the Himalayas in around the 8th century, and this wood and leather object has been a staple in the Buddhist faith ever since. Within Buddhism, these Tibetan ritual items hold immense significance during tantric practices.
There are actually three different types of Damaru, each one holding its own properties and purpose. The most widely used is the Chöd Damaru. This tends to be made from wood and covered with leather skins for the drum surface. Usually, they are 8 to 12 inches in diameter, although in rare cases this has been known to vary. The purpose of the Chöd Damaru is to be used during the tantric practice of Chöd, where a believer tries to ‘cut through’ the problems that face them and hinder their quest for enlightenment.
A slightly more grotesque Damaru is that of the Skull Damaru. This is certainly one of the more unusual Tibetan ritual items, and takes the form of a human skull, shaped into that of a drum. This version tends to be used in temples and large festivals, so keep an eye out when visiting Tibetan religious festivals. It’s a unique sight and usually coated in rare and precious stones
Tibetan Buddhist right-turning conch shell (Shankha)
The Shankha looks like an ornate snail shell. The outside is usually decorated with patterns regarding the Buddhist faith, and is usually painted in light, white colors. The shell is one of the eight auspicious symbols of Buddhism (the Ashtamangala), and represents water and Buddhism’s pervasiveness.
If you want to see one of the conches in person, it tends to be used to bring together and call on followers to meet. During rituals, it is sometimes used as a musical instrument, but can also be used to carry holy water from one place to another.
Tibetan prayer beads (malas)
The Malas is probably one of the most well know Tibetan ritual items. These Tibetan prayer beads are composed of 108 beads, each of which signifies the mortal sins of humanity. The beads themselves tend to be made from the wood of a special tree, known as the Ficus religiosa. Sometimes, bodhi seeds are also used, or rattan seeds. The different materials generally signify different uses, with the wooden beads being seen as generally ‘all-purpose’.
A visit to any Buddhist temple will usually allow you to see the Tibetan prayer beads both on sale, and being used by the monks themselves. Monks will usually count the beads whilst praying.
The Gawu box is an amulet usually made from silver, which is used to hold an image of the Buddha made from metal or clay. The outside is usually decorated with expensive and rare stone, with ornate designs and patterns you’ll find on other Tibetan ritual items as well. Usually, the Gawu is used during prayer to ward off evil spirits and bring about the Buddha’s blessing.
Whilst travelling to Tibetan temples, keep an eye out for the differences you’ll see. One of the most striking is that males tend to wear a square shaped amulet, whilst women will adorn a more rounded one.
Tibetan prayer wheel
The Tibetan prayer wheel is a cylindrical wheel which comes in many different shapes, sizes, and materials. Whilst small, personal ones can be found, there are also those which are much larger and must be held up by (usually) wooden structures. One thing they tend to have in common, though, is that they usually come in gold. The Prayer wheels also tend to be decorated with the 8 auspicious symbols of Ashtamangala.
Larger, stationary prayer wheels tend to be located in most monasteries. Visitors can usually move the wheels themselves by running their hands over them as they walk past.
Tibetan butter lamp
The Tibetan Butter Lamp is found in almost all Tibetan temples and sanctuaries. The (usually) golden cup tends to burn Yak Butter, which represents the illumination of Wisdom. If you head to the temples early in the morning, you’ll find monks taking part in their morning ritual, which consists of an offering of the Tibetan butter lamp, along with seven other bowls containing other symbolic offerings. Pilgrims, whilst travelling between temples, tend to supply oil for these lamps to gain favor.
First published in the Sydney Morning Herald on September 5, 1979
Compound painkillers which were banned from sale from July 1 are still freely sold across the counter in Sydney.
Chemists as well as other retailers were found breaking the law yesterday.
The banned compounds have a mixture of two or more of the substances aspirin, paracetamol, salicylamide and caffeine.
In place of the compound analgesics, drug manufacturers are distributing for open sale single analgesics in similar packets.
But yesterday I bought compound analgesics at four of 14 city shops without difficulty.
At a cafe in George Street, Vincent’s powders made of aspirin, caffeine, citrate and salicylamide were in a plastic cup behind the counter. I was told I could buy only one sachet.
Another George Street cafe kept compound Vincent’s powders on view. Two assistants asked how many I would like.
Two of 10 pharmacies sold me compound analgesics.
A pharmacy in Liverpool Street displayed the new, single-analgesic Bex, but a white-coated man needed no prompting to offer for sale a box of compound-formula Bex. He said it was his last.
He collected the Bex from a back room and said he had been trying to “sell all the old stock” because of the new restrictions.
When I asked for a packet of Bex powders at a George Street pharmacy the sales assistant said only the new formula Bex was in stock, but would I like some of the old kind of Vincent’s?
When I answered yes, the assistant spoke to a whitecoated man. This man asked how many powders I wanted, collected a box of 24 from a back room, handed them over surreptitiously and whispered the price.
Peter Kennedy, State Political Correspondent, was able to buy a four-sachet-pack of Vincent’s compound powders in Macquarie Street yesterday. He writes:
The regulations on compound analgesics were tightened because substantial evidence of a direct link between overuse of the analgesics and kidney failure.
Retailers who illegally sell them face a maximum penalty of an $800 fine or six months jail.
The executive Officer of the NSW Drug and Alcohol Authority, Mr Brian Stewart, said that retailers of the compound analgesics were clearly breaking the law.
“Ample warning has been given,” he said. “It means the retailers are liable to the stiff penalties and are acting contrary to the interests of public health.”
Bitter pills: a quick fix, and a long road to recovery
The silent generation – those who came before the baby boomers – were a stoic bunch who resisted taking drugs to treat even the worst ailments. Migraines, muscle pain and insomnia were treated through a cup of tea, a warm bath, a lie down or fresh air.
But with the 1960s, a new, medical element was added to that mix when a marketing phrase entered the vernacular: ”Have a cup of tea, a Bex and a good lie down.”
Bex, the analgesic made up of aspirin, phenacetin and caffeine, became an Australian icon. It was recommended to treat headaches, colds, flu, fevers, rheumatism, nerve pain and for ”calming down”.
Dissolving some Bex powder in a cup of tea became particularly common among housewives, widely available and sometimes taken up to three times a day.
It wasn’t until the 1970s that clinicians realised Bex and other similar formulations were responsible for kidney disease and addiction, and was carcinogenic. Phenacetin was pulled from the market by 1983.
But the damage had been done, says the director of the National Centre for Education and Training on Addiction at Adelaide’s Flinders University.
Professor Ann Roche says taking drugs for even mild illness or stress became a ”common Australian tradition” and has remained so.
Aggressive marketing from drug companies meant it was even common to pop an analgesic in children’s lunch boxes. ”Generally we don’t think twice about taking certain medications,” Professor Roche says.
‘We see it as fairly common and benign and something that has been used for decades and there is now this tradition of using drugs for pain relief, sleeping issues or anxiety.”
But this attitude has now extended to stronger, prescription drugs being commonly requested from doctors as a first line of treatment.
The 2013 Global Drug Survey found almost half of all respondents had used prescription drugs in the past year, with up to 10 per cent experiencing signs of dependency. Of 2700 prescription drug users, 12 per cent said they had shared them, while 12 per cent mixed them with alcohol to enhance the effects. People also reported using the drugs, particularly opiates, to induce positive emotional and behavioural states.
Opiates, such as oxycodone, continue to be prescribed for chronic pain, even though scientists have shown in recent years they may not be very effective for long-term use. While they are effective for cancer pain and short-term pain, many doctors and patients have failed to realise there are better first-line treatments.
Benzodiazepines, such as Xanax, Serepax and Valium, are being used for short-term stress and anxiety.
”But the big shift we’ve seen in the last few years is towards oxycodone and the other one is fentanyl, mistakenly seen as innocuous as it enters the blood through a skin patch,” Professor Roche says.
Not only are people using them but they are sharing drugs including sleeping pills and pain relievers with family and friends.
There is no ”typical” drug abuser, Professor Roche says, with varying groups trying to get hold of the drugs. Professionals are using them to cope with the stresses of life, while illicit drug users are turning to prescription drugs as cheaper, easier-to-obtain and perceived ”safer” options.
More people are surviving severe trauma, Professor Roche says, such as car accidents or disabilities, often requiring long-term medication and opening the potential for addiction. People are getting older and fatter and suffering from joint pain, she says, overwhelming doctors who sometimes prescribe drugs as a first-line treatment. ”Another contributing factor to growing use is shortened hospital stays thanks to keyhole surgery and other medical advances,” she says.
”This facilitates a faster discharge, where patients are often given quite a lot of pain medication with repeat scripts that people just keep filling even if they no longer really need them.”
A former prescription drug abuser, Charlotte*, would use anxiety drugs every day, taking up to 35 Valium mixed with 10 to 12 Xanax. They were sometimes mixed with heroin.
That kind of intake saw her overdose and come close to death three times. Because of her schizophrenia, she could tolerate higher doses of the drugs, combined with the fact she had built up a tolerance to prescriptions from the age of 14.
About 20 of her friends have died, either through prescription overdose or from illicit drugs combined with prescription medication. She is 23.
”I started on prescription drugs at about 13 and I guess they were my gateway drug into illicit substances,” she says. ”Xanax was my main problem, followed with Valium and Serapax and then I went on to heroin and ice.
”I used to get it from friends and then I started doctor shopping.”
At 17, she was diagnosed with schizophrenia. And while her psychiatrist refused to prescribe benzodiazepines, Charlotte says it was much easier to use her diagnosis to get the drugs from general practitioners.
She went back to the same doctors again and again.
”My friends and I had a list and all the drug users would see the same people,” she says. ”And they knew we were abusing them. Unless they were really stupid, they knew.”
She has been clean for 14 months, but says weaning off the prescription drugs was harder than stopping heroin.
She went to a rehabilitation clinic in Thailand, taking three months to get off the pills.
”I have seen heaps of bad things from prescription drugs; I think they’re worse than heroin,” she says. ”You’d think meth and heroin would be the worst but the thing is every time my friends or I overdosed on heroin, its always because [it was] mixed with drugs like Xanax and Valium.”
While she acknowledges she was an extreme user, Charlotte says people in general are too often turning to prescription drugs for minor ailments. She would like to see Valium banned.
Alex Wodak was the director of the alcohol and drug service at Sydney’s St Vincent’s Hospital until last July, a position he held for more than 30 years. He has seen first-hand the shift towards people seeking fast comfort.
”People work seven days a week and are always available because of computers and phones, working around the clock,” he says.
”Family life is sacrificed and I think we’re paying the price.
”We have to look at what kind of community we want and we need politicians to implement family-oriented policies.
”We are living in an era where a lot of people are seeking comfort and solace from chemicals; it is a trend that is very supported in our culture.”
Dr Wodak is now working in the area of drug reform. He believes tackling prescription drug abuse is achievable.
”If we stay calm and base policy on evidence I believe we can come out of this,” he says. ”What’s so difficult is the power of the pharmaceutical industry.
”But what we have seen in the cases of tobacco and increasingly with alcohol is that community resentment about a lack of action to fix the problem builds and sooner or later, they will vote for a politician willing to take a stand.”
*Not her real name.
Bex Powders were a compound analgesic that comprised aspirin (420mg), phenacetin (420 mg) and caffeine (160mg), also known as APC. It was the first APC product marketed in Australia and the most popular. Bex Powders were produced from the 1920s in South Australia by Beckers Pty Ltd. Beckers moved to Sydney in the 1960s and in 1964 was based at the corner of Campbell and Crown Streets, Sydney.  Bex Powders were commonly taken by dissolving the powder in water or a cup of tea. The packaging claimed a Bex would relieve ‘Headache, Neuralgia, Rheumatism, Sciatica, Lumbago…Influenza and Cold in early stages’. 
Bex were promoted particularly to women with the advertising slogan ‘Stressful day? What you need is a cup of tea, a Bex and a good lie down’.  The line has become part of the Australian vernacular and can be used to suggest that someone should relax and ease up. The Bex slogan was immortalised in 1965 when the Phillip Street Theatrestaged a long-running satirical review A Cup of Tea, a Bex and a Good Lie Down, written by John McKellar and starring Reg Livermore and Ruth Cracknell. Over forty years later, in September 2011, Kevin Rudd, addressing suggestions he might challenge the incumbent Prime Minister Julia Gillard, told journalists ‘I just think it would be a good thing if everyone seriously had a cup of tea and a Bex and a long lie down, OK?’ 
The problem with Bex
The recommended daily dose of caffeine is 250mg per day and yet Bex packaging advised taking at least two powders, containing 320mg of caffeine. It has been recorded that many women took up to 30-40 doses a day, sometimes washed down with Coca-Cola, adding to the caffeine intake and strengthening the addiction. A further complication was that many of these women were also prescribed Valium, another addictive substance.
In the 1960s Dr. Priscilla Kincaid-Smith discovered that Bex Powders were addictive and that the large doses of phenacetin consumed by habitual users caused kidney disease.
One woman, Norma O’Hara took Bex Powders sometimes twice a day every day for up to eight years from when she was 20. She used to work at Rosebery Wrigley’s factory and said ‘most of the girls took Bex… it was to keep you going. Working the machines, you thought you needed them.’  O’Hara was subsequently diagnosed with kidney failure which was linked to compound analgesic abuse. It was common practice for factory managers to provide Bex Powders free of charge to their workers.
APC compounds were banned in 1977 and painkillers containing them were removed from the Australian market. Over time, this led to a dramatic decline in kidney disease. 
The virgin cleansing myth (also referred to as the virgin cure myth, virgin rape myth, or simply virgin myth) is the belief that having sex with a virgin girl cures a man of HIV/AIDS or other sexually transmitted diseases.
Anthropologist Suzanne Leclerc-Madlala says the myth is a potential factor in infant rape by HIV-positive men in South Africa. In addition to young girls, who are presumed to be virgins because of their age, people who are “blind, deaf, physically impaired, intellectually disabled, or who have mental-health disabilities” are sometimes raped under the erroneous presumption that individuals with disabilities are sexually inactive and therefore virgins.
The myth was first reported in 16th-century Europe and gained prominence in 19th-century Victorian England as a cure for syphilis and gonorrhea among other sexually transmitted diseases. The origin is unknown, but historian Hanne Blank writes that the idea may have evolved from Christian legends of virgin–martyrs, whose purity served as a form of protection in battling demons.
People all over the world have heard this myth, including in sub-Saharan Africa, Asia, Europe and the Americas.
A survey by the University of South Africa (UNISA) in South Africa found that 18 percent of laborers thought that having sex with a virgin cures HIV/AIDS. An earlier study in 1999 by sexual health educators in Gauteng reported that 32 percent of the survey participants believed the myth.
According to Betty Makoni of the Girl Child Network in Zimbabwe, the myth is perpetuated by traditional healers advising HIV-positive men to cure their disease by having sex with virgin girls. In Zimbabwe, some people also believe that the blood produced by raping a virgin will cleanse the infected person’s blood of the disease.
In 2002, psychologist Mike Earl-Taylor wrote that the virgin cure myth may explain the staggering rise in child or infant rapes in South Africa, which is facing an HIV/AIDS epidemic. UNICEF has attributed the rape of hundreds of girls to the virgin cleansing myth.
However, it is unknown exactly how common the myth is and to what degree rapes happen because of the belief in it. The claim that the myth drives either HIV infection or child sexual abuse in Africa is disputed by researchers Rachel Jewkes and Helen Epstein, as well as by research on convicted sex offenders in Malawi, where no evidence was found to support the idea that the virgin cleansing myth prompted any rapes.
Importance of education
Ignorance with regards to HIV and AIDS infection serves as a barrier to prevention in numerous African nations.
Education has helped women such as Betty Makoni speak out against the myth and attempt to dissuade people from believing the virgin cleansing myth.
According to UNICEF, culture-based gender roles that prize innocence and ignorance in girls and that accept sexual licentiousness in men promote this myth. Girls may be forced to marry older men, which can increase the likelihood of HIV transmission to girls. The stigma attached to AIDS also stops many people from seeking information or health services to shield their status, contributing to further transmission.
In popular culture
The virgin cleansing myth is referenced in the Broadway musical The Book of Mormon. The minor character Mattumbo is stopped from raping a baby based on the belief that sex with a virgin will cure his AIDS. During the song “Making Things Up Again”, Elder Cunningham tells Mattumbo that raping babies is against God’s will, and invents a passage in the Book of Mormon in which God tells Joseph Smith to instead have sex with a frog to cure his AIDS.
Why people living and aging with HIV will lead the way
Tuesday, 9/18 is National HIV/AIDS and Aging Awareness Day. Long-term survivors of HIV face unique challenges; they are the “hidden” survivors of the epidemic. When I was diagnosed with HIV in 1989 I wasn’t sure I’d be here in 2018 to talk about it. At the time there was no effective treatment for people living with HIV, it
was basically a death sentence. For those of us who did have access to health care and treatment, we were given what we now know is suboptimal therapy that not only rendered us resistant to more effective medications that were being developed, but also had life-altering side effects that remain with some of us to this day. These side effects from those earlier, more toxic treatments have added to the stigma of aging with HIV and have disfigured us, made us frailer, and caused our hearts to literally skip a beat.
Don’t get me wrong, I am grateful to be here. As a white, gay, cis man living with HIV who turns 60 this year, I also recognize and acknowledge my privilege. I have access today to a one pill, once-a-day therapy that keeps my virus fully suppressed, so that I’m unable to pass on HIV to others, and I experience virtually no side effects to my current regimen. But I also know that when I walk into a room, I have “the look”—the sunken cheeks, the veiny arms and legs, the extended belly. “You should be grateful to be here,” we’ve been told, “thankful to be alive!” But to what end? Grateful to be here to suddenly be rolled off of disability after being out of work for 20–30 years, expected to join the ranks of the work force without any specialized training or support? Grateful to be here only to fall into addiction or isolation because our support networks, friends and former lovers no longer exist? Grateful to be here while there is scant culturally competent care for aging LGBTQ+ seniors who are living with HIV? We as a society in general do not value our elders—how does the LGBTQ+ community regard those of us aging, let alone aging with HIV?
There is much work to be done, but if anyone can lead the way, it’s people living with HIV and our allies. We were the ones who took care of each other back at the start of the epidemic, and we will come to the forefront of the battle once again. The lesbian community was there for many gay men back in the 1980s when we were dropping like flies and when no one else would touch us; thank heavens for these unsung heroes. Community-based organizations like TPANwere founded by people living with HIV so that we could survive and thrive. Informational resources like Positively Aware delivered the information we needed to live healthy, happy lives.
Earlier this year The Reunion Project convened a community-led, diverse coalition of survivor advocates to discuss the needs and priorities of survivors, and issued a report in June. Go to tpan.com/reunion-project for more info. As someone living with HIV for 29 years, I am excited to be part of a national network of survivors that is giving voice to those who don’t have one and who have in many respects been left behind.
Currently 50% of people living with HIV are over the age of 50, and by 2030 it will be 70 percent. But we knew this was coming. Where is the sense of urgency? Where is the crisis task force taking up our agenda? Do we matter?
I believe we do. As the saying goes, with age comes wisdom. Long-term survivors have an opportunity to come together and join forces, mentor those coming up behind us on how to age and live with HIV gracefully, and to advocate for those who have no voice. An entire generation was lost, so who now is going to step up and advocate for us?
Dee Dee Blancharde was a model parent: a tireless single mom taking care of her gravely ill child. But after Dee Dee was killed, it turned out things weren’t as they appeared — and her daughter Gypsy had never been sick at all
For seven years before the murder, Dee Dee and Gypsy Rose Blancharde lived in a small pink bungalow on West Volunteer Way in Springfield, Missouri. Their neighbors liked them. “’Sweet’ is the word I’d use,” a former friend of Dee Dee’s told me not too long ago. Once you met them, people said, they were impossible to forget.
Dee Dee was 48 years old, originally from Louisiana. She was a large, affable-looking person, which she reinforced by dressing in bright, cheerful colors. She had curly brown hair she liked to hold back with ribbons. People who knew her remember her as generous with her time and, when she could be, generous with money. She could make friends quickly and inspire deep devotion. She did not have a job, but instead served as a full-time caretaker for Gypsy Rose, her teenage daughter.
Gypsy was a tiny thing, perhaps 5 feet tall as far as anyone could guess. She was confined to a wheelchair. Her round face was overwhelmed by a pair of owlish glasses. She was pale and skinny, and her teeth were crumbling and painful. She had a feeding tube. Sometimes Dee Dee had to drag an oxygen tank around with them, nasal cannula looped around Gypsy’s small ears. Ask about her daughter’s diagnoses, and Dee Dee would reel off a list as long as her arm: chromosomal defects, muscular dystrophy, epilepsy, severe asthma, sleep apnea, eye problems. It had always been this way, Dee Dee said, ever since Gypsy was a baby. She had spent time in neonatal intensive care. She had leukemia as a toddler.
The endless health crises had taken a toll. Gypsy was friendly, talkative even, but her voice was high and childlike. Dee Dee would often remind people that her daughter had brain damage. She had to be homeschooled, because she’d never be able to keep up with other kids. Gypsy had the mind of a child of 7, Dee Dee said. It was important to remember that in dealing with her. She loved princess outfits and dressing up. She wore wigs and hats
to cover her small head. A curly, blonde Cinderella number seems to have been her favorite. She’s wearing it in so many photographs of herself with her mother. She was always with her mother.
“We are a pair of shoes,” Gypsy once said. “Never good without the other.”
Their house, like everyone else’s around them, had been built by Habitat for Humanity. It had amenities specially built for Gypsy: a ramp up to the front door, a Jacuzzi tub to help with “my muscles,” Gypsy told a local television stationin 2008. Sometimes, on summer nights, Dee Dee would set up a projector to play a movie on the side of her house and the children of the neighborhood, whose parents usually couldn’t afford to send them to a movie theater, came over for a treat. Dee Dee charged for concessions, but it was still cheaper than the local multiplex. The money was to go to Gypsy’s treatments.
Dee Dee became particularly close with some people across the way, a single mother named Amy Pinegar and her four children. Over years of tea and coffee, Dee Dee would tell Pinegar her life story. She was originally from a small town in Louisiana, she said, but she’d had to flee her abusive family with Gypsy. It was her own father, Gypsy’s grandfather, who’d been the last straw; he’d burned Gypsy with cigarettes. So she’d lit out from her hometown for good.
She told Pinegar that Gypsy’s father was a deadbeat, an alcoholic drug abuser who had mocked his daughter’s disabilities, called the Special Olympics a “freak show.” As Pinegar understood it, he’d never sent them a dime, not even when Dee Dee and Gypsy had lost everything in Hurricane Katrina. It was a blessing that a doctor at a rescue shelter had helped them get to the Ozarks.
Sometimes, listening, Amy Pinegar found herself overwhelmed. “I wondered,” Pinegar told me over the phone last fall, “keeping this child alive… Is she that happy?” All she could do was be a good neighbor and pitch in when she could. She’d drive Dee Dee and Gypsy to the airport for their medical trips to Kansas City, bring them things from Sam’s Club. Ultimately, they did seem happy. They went on charity trips to Disney World, met Miranda Lambert through the Make-a-Wish Foundation. Looking back on it, Pinegar was sometimes even jealous of them.
It was a perfect story for a human interest segment on the evening news: a family living through tragedy and disaster, managing to build a life for themselves in spite of so many obstacles. But the story wasn’t over. One day last June, Dee Dee’s Facebook account posted an update.
“That bitch is dead,” it read.
It was June 14, a hot Sunday afternoon that had driven a lot of people indoors to the blessings of air-conditioning. The first few comments on the status are from friends expressing wild disbelief. Maybe the page had been hacked. Maybe someone should call. Does anyone know where they live? Should someone call the police, give them the address?
As they debated it, a new comment from Dee Dee’s account appeared on the status: “I fucken SLASHED THAT FAT PIG AND RAPED HER SWEET INNOCENT DAUGHTER…HER SCREAM WAS SOOOO FUCKEN LOUD LOL.”
Kim Blanchard, who lived nearby, was among the first to react. Though Kim had a similar last name to the Blanchardes, she wasn’t a relative. She had met Dee Dee and Gypsy in 2009 at a science fiction and fantasy convention held in the Ozarks, where Gypsy could wear costumes and not be particularly out of place. “They were just perfect,” Kim said. “Here was this poor, sick child who was being taken care of by a wonderful, patient mother who only wanted to help everybody.”
Kim called Dee Dee’s number, but there was no answer. Kim’s husband, David, suggested that they drive on over to the house just to make sure everything was all right. When they arrived, a crowd of worried neighbors was already gathering. Dee Dee and Gypsy had sometimes been unreachable before, off on a medical trip without telling anyone. The windows had a protective film on them; it was hard to see in. Knocking on the doors brought no response. But everyone found it suspicious that Dee Dee’s new cube van, which could easily transport Gypsy around in her wheelchair, was parked in the driveway.
Kim called 911. The police couldn’t enter the house without a warrant, but didn’t stop David from climbing through a window. Inside, he saw nothing amiss. All the lights had been turned off, and the air-conditioning was on high. There were no signs of a robbery, or any struggle. All of Gypsy’s wheelchairs were still in the house. It was frightening to think about how helpless she might be without them.
The police began taking statements while they waited for a search warrant. Kim relayed information
back to Facebook. Yes, they’d been to the house; yes, the police had been called. Dee Dee’s online friends and acquaintances began bombarding Kim with questions. She answered as best she could, but the status was beginning to get shared around Missouri. “Here’s the thing guys…I know everyone is very concerned,” Kim wrote on Facebook. “We need to realize that whoever posted this can read all of this.”
The search warrant didn’t come through until 10:45 that night. The police found Dee Dee’s body in the bedroom. She’d been stabbed, and had been dead for several days. But there was no sign of Gypsy.
The next day, Kim organized a vigil and a GoFundMe account to take care of Dee Dee’s funeral expenses — and possibly Gypsy’s. Everyone feared the worst. All her life, Gypsy had evoked protective responses in people. She was so small and looked so helpless. Many people couldn’t understand why this had happened to her. Who could prey on someone who had no defenses?
Meanwhile, the police were starting to sort things out. A young woman named Aleah Woodmansee had approached them. There were some things she knew, things that might be helpful. For example, she told them, Gypsy had a secret online boyfriend.
Aleah was Amy Pinegar’s daughter, a 23-year-old who’d worked as a medical claims investigator. She felt like a big sister to Gypsy, and evidently Gypsy felt the same. But they were rarely alone together, as Gypsy’s mother was constantly by her side. So when Gypsy confided in Aleah, it was through a secret Facebook account, under the name Emma Rose.
“This is my personal account my mom is still overprotective so she don’t, know about this account,” Gypsy wrote in October 2014. Then she confessed she’d met a man on a Christian singles site. She was in love with him, she told Aleah. Gypsy hadn’t yet told her mother. She wrote that she knew Dee Dee wouldn’t approve, that she wasn’t allowed to date, though she longed to grow up and have a boyfriend like other girls her age.
“In the past I told my mom something mean I says I wished ur mom was my mom instead of my mom cus mrs Amy let Aleah date anyone she wanted so that hurt my mom,” Gypsy wrote.
The new boyfriend’s name, Gypsy revealed, was Nicholas Godejohn. They’d been communicating for over two years. He didn’t care that she was in a wheelchair. And Gypsy planned to marry him. They were both Catholic. They had agreed on names for their children. She was cooking up an elaborate plan for Dee Dee to casually meet Nick at the local movie theater, after which Gypsy was hoping they could be open about their relationship.
This wasn’t the first time Aleah had gotten clandestine messages from Gypsy about boys. She knew that Gypsy had tried to meet men online before, that in spite of what Dee Dee said about Gypsy’s 7-year-old mind, thoughts about romance and sex were taking root anyway. But she was concerned. Gypsy had always seemed naive to her. In October 2014, she wrote “I’m 18. Nick…is 24,” which made Godejohn six years older.
Plus, the way she talked about the relationship was odd. “It was like some kind of magnificent fairy tale was unfolding,” Aleah said over coffee in Springfield last fall.
She was worried, too, about Dee Dee, who’d confronted her in 2011 about her chats with Gypsy, telling her she was corrupting a child. “I’m not going to tell your mom about the things you said,” she told Aleah. “But I don’t want you talking to Gypsy like that.” Dee Dee took away Gypsy’s phone and computer for a time. Gypsy had always managed, nonetheless, to slip through some crack in her mother’s attention, find some other way of getting to Aleah. But the two saw each other less and less, and after the messages about Nick Godejohn in the fall of 2014, Aleah didn’t hear from Gypsy again.
Standing in front of the house half a year later with the crowd that had gathered, it occurred to Aleah that the police should know about all this. She showed them the Facebook messages, and they wrote the name down. The police also put a trace on the Facebook posts to Dee Dee’s account. The IP address was registered to a Nicholas Godejohn in Big Bend, Wisconsin.
On June 15, a team of officers in Waukesha County, Wisconsin, were dispatched to Godejohn’s house. The standoff was brief. Nick quickly surrendered. Luckily enough, Gypsy was with him, unharmed, in excellent health. Relief flooded everyone, at least for a moment.
“Things are not always as they appear,” the Springfield sheriff said at a press conference the next morning.
It turned out that, in fact, Gypsy hadn’t used a wheelchair from the moment she left her house a few days earlier. She didn’t need one. She could walk just fine, there was nothing wrong with her muscles, and she had no medication or oxygen tank with her either. Her hair was short and spiky, but she wasn’t bald — her head had simply been shaved, all her life, to make her appear ill. She was well-spoken, if shaken by recent events. The disabled child she’d long been in the eyes of others was nowhere to be found. It was all a fraud, she told the police. All of it. Every last bit. Her mother had made her do it.
“I just cried,” Aleah said, her sheer disbelief about everything that had happened overwhelming her.
Kim Blanchard cried, too. “At that point it really became: ‘I don’t know anything about this person. What have I been believing? How could I have been so stupid?’”
“No one asked for any more documentation. No one raised an eyebrow,” Amy Pinegar told me later. “Were they behind closed doors laughing at us” — she paused for a second — “suckers?”
Dee Dee’s legal name was Clauddine Blanchard. She’d used various aliases and misspellings over the years: DeDe, Claudine, Deno. By the time she reached Missouri, she went by Clauddinnea and always added an “e” to her last name. Not all of her stories turned out to be false. She was, indeed, from Lafourche Parish, in the ball of Louisiana’s foot. She had grown up in a town called Golden Meadow alongside five brothers and sisters, most still living. Her mother died in 1997, but her father is still alive.
So is Rod Blanchard, Gypsy’s father. He still lives in the area, in Cut Off, not far from Golden Meadow. Gypsy has his nose. He has a laconic manner, sometimes stoic, sometimes funny. He met Dee Dee when he was still in high school, and they dated for four to six months. He was 17 to her 24 when she became pregnant, and at the time the only logical thing he thought he could do was marry her. “I woke up on my birthday, on my 18th birthday, and realized I wasn’t where I was supposed to be,” he told me recently. “I wasn’t in love with her, really. I knew I got married for the wrong reasons.” He left Dee Dee, and though she tried on more than one occasion to get him back, the marriage would not stick.
Gypsy Rose was born shortly after the couple separated, on July 27, 1991. Rod said Dee Dee liked the name Gypsy, and he was a Guns N’ Roses fan. As far as he knows, neither of them knew about Gypsy Rose Lee, the 1920s vaudeville child star turned stripper whose early life was the basis for the Broadway musical Gypsy. That Gypsy had a controlling stage mother too, one who lied about her daughter’s age to make her seem younger, one who kept forcing her daughter to perform even though she didn’t want to.
Gypsy was healthy at birth, Rod said. But when she was 3 months old, Dee Dee became convinced that her baby had sleep apnea, that Gypsy would stop breathing in the night. It was then when Dee Dee began taking her to the hospital. As Rod remembers it, the doctors couldn’t find anything, in spite of three rounds of tests and a sleep monitor. The conviction that Gypsy was a sickly child took hold. She explained the increasingly bewildering array of problems to Rod by saying that Gypsy had a chromosomal defect. Many of Gypsy’s health issues, she claimed, stemmed from that one thing.
It all spiraled so quickly. Dee Dee always had a new idea about what was wrong with Gypsy, a new doctor, a new drug. She had once worked as a nurse’s aide; she had a knack for remembering medical terminology and spitting it back. The information overload acted as a kind of wall around mother and daughter. It always seemed that Dee Dee had things under control. She knew so much, and she was never troubled by questions — she always had an answer.
Rod eventually remarried and had two other children. He and his new wife, Kristy, saw Gypsy often over the first 10 years of her life, and can share pictures from various happy family outings right up until 2004. They remember going to the Special Olympics, too, but have good memories of it. “All smiles,” Kristy said. They have a picture of Gypsy grinning widely with her father and brother there. In all those years, Gypsy never said a word against her mother or anything else.
Meanwhile, Dee Dee’s relationship with her own family, never great to begin with, got worse. The cause isn’t clear. (In spite of repeated attempts to contact her father, Claude Pitre, I was never able to speak to her family directly.) She’d begun to get in trouble with the law, usually for small misdemeanors, like writing bad checks. Eventually, Dee Dee simply moved away, to Slidell, two hours north and kitty-corner to New Orleans across Lake Pontchartrain.
Dee Dee and Gypsy spent their years in Slidell living in public housing and visiting doctors at the Tulane University Hospital & Clinic and the Children’s Hospital. Dee Dee told doctors there that Gypsy had seizures every couple of months, so they put her on anti-seizure medications. Dee Dee insisted to one doctor after another that her daughter had muscular dystrophy even after a muscle biopsy proved she didn’t. There were problems with her eyes and ears, too, Dee Dee insisted, poor vision and frequent ear infections. Doctors dutifully operated on her. If Gypsy had a cold or cough, she was taken to the emergency room.
In 2005, Hurricane Katrina hit Slidell. The power was off for weeks. The pair turned up in a special-needs shelter in Covington, Louisiana, with pictures of their old apartment in rubble. She told the shelter staff she didn’t have Gypsy’s medical records with her because they’d been destroyed in the flood.
One of the doctors at the shelter, Janet Jordan, was from the Ozarks. (She declined to be interviewed for this article.) She was charmed by Gypsy in the shelter: “When I first met her, I had to cry a little bit, and she goes, ‘It’s okay, you’re only human.’” Jordan told a local news station in 2005. It was, apparently, she who suggested the Blanchards move to Missouri.
The story of a mother and disabled daughter left without anything proved irresistible to local press. It worked on charities, too. Dee Dee and Gypsy were airlifted to Missouri in September 2005, where they rented a house in Aurora. They lived there until the Habitat for Humanity house on West Volunteer Way in March 2008.
While Gypsy had been involved with charities for children with disabilities from the time she was quite small — Dee Dee often stayed at Ronald McDonald houses — this was obviously the largest benefit Dee Dee had managed to arrange. It seemed to give her an appetite for more. While in Springfield, they’d benefit from free flights from a volunteer pilots organization, stays at a lodge for cancer patients, free trips to Disney World through various charity organizations. (None of the organizations with which the Blanchards had confirmed links returned requests for comment.)
Dee Dee kept Rod updated on his daughter’s whereabouts and medical circumstances. She did this even as she told doctors and new friends in Missouri that he was a drug addict who had abandoned his daughter. Meanwhile, Rod and Kristy spoke to Gypsy pretty often. They always planned to visit, but “for one reason or another, it would never work out,” Rod said.
Rod continued to send, as he always had, $1,200 a month in child support to a New Orleans bank account. He also sent the occasional gifts Dee Dee asked for, television sets, and a Nintendo Wii. He continued to send these things even after Gypsy turned 18, because Dee Dee said Gypsy still required full-time care. “There was never a question whether or not I was going to stop paying,” he said.
There were, occasionally, small signs of deception. When Rod called Gypsy to talk on her 18th birthday, he said, he was excited to make all the jokes dads make to their daughters about becoming an adult. But Dee Dee intercepted the call, he said, to remind him that Gypsy didn’t know her true age. “She thinks she’s 14,” Dee Dee said. She asked that he not upset Gypsy by claiming otherwise. Rod heeded the instruction.
“I think Dee Dee’s problem was she started a web of lies, and there was no escaping after,” Rod said. “She got so wound up in it, it was like a tornado got started, and then once she was in so deep that there was no escaping. One lie had to cover another lie, had to cover another lie, and that was her way of life.” They never saw all the local news stories about Dee Dee and Gypsy that had been written and filmed up in Missouri. They knew nothing of any charity drives and trips except what Dee Dee told them, which was very little.
That all changed last June when Rod called Kristy, sobbing in the middle of a workday. Dee Dee’s sister had called him; Dee Dee was dead and Gypsy was missing. “I was in hysterics thinking she got brought somewhere and was left to die,” Kristy said. And if Gypsy was found, she continued, “how could I take care of her when Dee Dee knew everything on how to take care of her?”
The first time Rod saw his daughter walk was in a news report on Gypsy’s arraignment hearing in Wisconsin. No one had prepared them; Kristy had spotted the video on Facebook. Rod was so confused when he saw it that he said his first reaction was, “I was really happy that she was walking.”
When Gypsy’s attorney showed them Dee Dee’s autopsy report, Kristy said she stared for a while at the portion about Dee Dee’s brain. The lawyer asked her why.
“I want to know what the hell was going through her mind,” Kristy said. “What is in that brain of hers that triggered all of this shit?”
Dee Dee won’t ever be able to answer anyone’s questions. All there will be is Gypsy’s story. And Gypsy doesn’t know all of it herself. From the time she was arrested to my more recent talks with her in prison in Missouri, she is confused about details large and small. For example: When she was arrested, Gypsy told the police that she was 19. Rod and Kristy were able to straighten that out by giving authorities Gypsy’s birth certificate. She was actually 23.
Parents make your world, and Dee Dee made Gypsy’s into one where she did, indeed, have cancer. Gypsy told me her mother said some of the medications were related to it. Even as she grew older, she wasn’t sure how to question it. There are lingering questions, in fact, about exactly what medications Gypsy was given over the years. Some of them may never have been prescribed to Gypsy at all; her attorney, for example, suspects Dee Dee gave Gypsy some kind of tranquilizer.
The pile of bogus diagnoses, the confusing lists of drugs: It all points to a syndrome called Munchausen by proxy. Munchausen syndrome was first identified by a British psychiatrist named Richard Asher in 1951. A successor, Roy Meadow, identified Munchausen by proxy in 1977. It has been in the DSM, the diagnostic manual used by psychiatrists, since 1980. (In the latest version, the DSM-V, it goes by the name “factitious disorder,” but for clarity’s sake I’ll stick to the Munchausen nomenclature.) In short, a person with the syndrome either feigns or induces physical and psychological symptoms for no obvious benefit other than attention and sympathy. If the person does this to themselves, it’s plain Munchausen syndrome; when the symptoms are feigned or induced in others, it’s called Munchausen by proxy. The DSM-V recommends distinguishing Munchausen syndrome from what is called “malingering,” that is, faking or inducing symptoms of illness where there is some hope of material benefit. Malingering isn’t considered to be a mental illness. It’s just plain fraud.
While most with the syndrome are mothers, there are also documented cases of fathers doing this to their children, husbands doing this to their wives, nieces doing this to their aunts. And doctors often don’t detect it for months or years. In fact, it’s difficult to say just how prevalent Munchausen is in the general population. By its very nature, it hides in plain sight.
That doctors often miss Munchausen seems counterintuitive, but the doctor-patient relationship is a bond of trust that goes both ways. “As health care providers,” said Caroline Burton, a doctor at the Mayo Clinic in Florida who’s treated cases of Munchausen where the proxy is an adult, “we rely on what a patient tells us.” Even if a doctor suspects his or her patient is lying, there isn’t much incentive to refuse treatment based on the doubt. What if the doctor is wrong and the patient suffers for it? “You have to be careful not to overlook organic disease,” Burton said. “You’ve really gotta go through quite a lot of diagnostic hurdles.”
A diagnosis of Munchausen syndrome by proxy is attached to the perpetrator, not to the victim. Because Dee Dee is dead, it’s impossible to diagnose her. She didn’t leave behind a diary or some other documentation of her intentions. She did keep a binder of medical information in which she seemed to be sorting through the different information she’d given to various doctors. And she did fit certain parameters that doctors often cite as red flags for Munchausen syndrome: For example, she had some medical training. The number of doctors she took Gypsy to see over the years, and her propensity for changing locations so there was no clear medical trail, is also common. So are the concerns over sleep apnea, which is one way Munchausen often seems to begin in the various documented cases.
It is also not unusual, as Burton told me, for extended family members — and even sometimes immediate ones — to be totally unaware of the feigning of illness. “The perpetrators are very intelligent people,” she said. “They know how to manipulate other people.”
They manipulate their victims, too, and the longer it goes on, the higher the chances are that the actual patient might collude with the perpetrator. The desire to please a parent can be enough to enlist a child in the deception. But even in adult cases, there can be some kind of emotional attachment keeping the patient in on the lie. “The relationship that develops between the two is so unhealthy,” Burton told me, of the adult cases she had treated. And no source I consulted had ever heard of a case where the abuse went on for this long, into their adulthood. One thing seems certain: For the patient in a Munchausen by proxy case, the truth becomes corroded.
Gypsy’s medical records are sobering. All the way back in 2001, doctors at Tulane University Hospital tested Gypsy for muscular dystrophy. Her tests came back negative. In fact, all scans of her brain and spine were relatively clear. The records of all those tests survived Katrina. Nonetheless, Dee Dee continued to insist to doctor after doctor in Louisiana and Missouri that Gypsy had muscular dystrophy. Most doctors appear from these records to have taken her assertion at face value and didn’t probe. Instead they proceeded to treat Gypsy for various vision, hearing, sleep, and salivation problems that were presumed to flow from the muscular dystrophy. (The records I reviewed for this article appeared to cover only some of Gypsy’s care. It’s impossible to say how many other relevant records might exist.)
Some interventions were surgical. Gypsy’s eye muscles were repeatedly operated on for alleged weakness. Tubes were put in her ears for alleged ear infections. She was given a feeding tube and ate very little by mouth, surviving on cans of the meal replacement PediaSure well into her twenties. Her salivary glands were first injected with Botox, then removed because her mother complained that she drooled too much. Gypsy’s teeth rotted out and had to be extracted, though whether that was because of poor dental hygiene or a mixture of medications and severe malnutrition, it’s hard to say.
The repeated invasions of Gypsy’s body in the name of these illnesses she turned out not to have were, in short, serious and prolonged. It is difficult to say now whether any of it was medically needed at all. What is not difficult to say is that all of it began when Gypsy was impossibly young and could hardly have been expected to challenge authority figures — her mother or her doctors — about how she was feeling.
For their part, doctors did not pick up on innumerable hints that Dee Dee’s stories did not add up — not even the sleep doctor, Robert Beckerman, who saw Gypsy both in New Orleans and in Kansas City. Instead he featured his treatment of Gypsy in the hospital newsletter and mentioned repeatedly in the medical files that she and Dee Dee were his “favorite mother, daughter patient.” (Beckerman did not reply to requests for comment for this story.)
There was one exception. In 2007, a pediatric neurologist named Bernardo Flasterstein, consulting on the case in Springfield, became suspicious. In a recent phone conversation, Flasterstein told me he had his doubts from the first time he saw Dee Dee and Gypsy. Dee Dee’s stories about Gypsy’s myriad illnesses didn’t fly with him. In his notes to Gypsy’s primary care doctor after the first visit, he wrote, in bold, underlined type, “The mother is not a good historian.”
There was an “unusual distribution” to Gypsy’s weakness for a muscular dystrophy patient, he wrote in his notes. Still, Flasterstein says, he gave the case the “benefit of the doubt” and sent Gypsy for all the usual tests, the MRIs and the blood work. It all came back normal. “I remember having her stand up,” he told me, “and she could hold her own weight!” He said he told Dee Dee, “I don’t see any reason why she doesn’t walk.”
In between his visits with Gypsy, Flasterstein tracked down a doctor who had seen Gypsy in New Orleans. That doctor told him that the muscle biopsy in New Orleans had been negative for muscular dystrophy, and that Gypsy’s previous neurologist had explained that to Dee Dee. When confronted with the problem, Dee Dee simply stopped seeing those New Orleans doctors.
“Analyzing all the facts, and after talking to her previous pediatrician,” Flasterstein wrote in the file, “there is a strong possibility of Munchausen by proxy, with maybe some underlying unknown etiology to explain for her symptoms.” Dee Dee stopped seeing him after that visit. “I assume she got my notes,” Flasterstein says. He said nurses told him later that on the way out of his office on that last visit, Dee Dee was complaining that he didn’t know what he was talking about.
Flasterstein never followed up. He told me that in the network of Springfield doctors Dee Dee saw, “everyone bought their story.” He remembers being told to treat the pair with “golden gloves.” He says he thought that if he reported it to social services, they wouldn’t believe him either.
Thinking about it now, Flasterstein regrets not doing more. He says this was only the second case of Munchausen he’d seen in his decades-long career. He heard about the murder when a former nurse in his office wrote him about it last year. “Poor Gypsy,” he told me. “She suffered all those years, and for no reason.” He wishes he “could have been more aggressive.”
It was not the only missed opportunity for authorities to intervene. In the fall of 2009, someone made an anonymous call to the Springfield Police Department, asking for a wellness check. The person said that they had doubts that Gypsy was suffering from all the ailments her mother described. (Flasterstein says it was not he who made that call.) The police drove over to the house, but Dee Dee put their fears to rest. She told them that the reason she sometimes used inconsistent birth dates and spellings of her name was to hide from an abusive husband. No one called Rod Blanchard, or checked on these claims. The police accepted the explanation. Gypsy “does suffer from some type of mental handicap,” they wrote in their report. The file was closed.
Gypsy also tried, once, to escape her mother. She met a man at the science fiction convention that Kim Blanchard and her husband also attended. Gypsy and this man began communicating online. At the time, in February 2011, Gypsy and Dee Dee were leaving everyone with the impression that she was 15. (She was actually 19.) According to Kim, the man in question was 35. He took Gypsy back to his hotel room. Through conventioneer intelligence — “We were all overprotective of her,” Kim Blanchard said — Dee Dee found them. She apparently knocked on the hotel room door with papers that showed Gypsy was a minor, and the man let Gypsy leave. (He could not be reached for comment.)
After that incident, Dee Dee was furious to the point of public spectacle. She smashed the family computer with a hammer, cursed the internet to her friends. When she eventually replaced it, Gypsy was allowed to use the internet only with Dee Dee’s supervision. And for months afterward, Kim Blanchard said, Gypsy was subdued, though “she wasn’t acting any differently than a normal child who was in trouble at that point.”
The whole situation has left bystanders in Springfield with feelings of guilt. “I just wish she would have come to me,” Aleah Woodmansee told me. A lot of people feel that way. If Gypsy had, just once, stood up and walked across the room, the spell would have been broken. But plainly it wasn’t that easy for her. In a way, that makes sense. She slipped, as people are fond of saying, through just about everyone’s cracks. She had no reason to believe that her life would change. Until, apparently, she met Nick Godejohn.
Under other circumstances, a tale of child abuse as long and as involved as what Gypsy experienced might have inspired public sympathy. But something about the fraud element deeply offended people, particularly those who hadn’t known Gypsy or Dee Dee at all. Evidently there are a lot of people who are worried that others who are sick and disabled don’t deserve their generosity. So Facebook groups began to spring up. They splintered on whether Gypsy could be said to be blamed, whether Rod and Kristy were in some way in on the fraud. Some groups ballooned to over 10,000 members, some of them posting every day about the crime, voicing unfounded theories about what had happened.
If their speculation had been confined to private forums, it might have been one thing. But more than a few of these amateur detectives were not satisfied with online discussion. They wanted to affect the case in real time. A St. Louis–based Thought Catalog writer named Meagan Pack was keeping track of “tips” she’d gotten from Facebook about Gypsy and Dee Dee’s crimes and posting them to a much-referenced post. Pack told me she called the police detective to inform him of all she’d learned. Random observers on Facebook also called the police with their various speculations. Then, when the court hearings began, they came to those, too. One even showed up to Dee Dee’s house when the initial “That bitch is dead” Facebook post went viral in Springfield. She hadn’t known Gypsy or Dee Dee at all. She was shooed away from the crime scene by the neighbors and the police.
The result was informational chaos. Kim Blanchard’s GoFundMe became a flashpoint for online sleuths. When Dee Dee’s financial fraud was revealed by the sheriff, Kim shut it down, but not before the groups had taken it upon themselves to investigate Kim herself. Several thought Kim and David Blanchard were lying about their involvement with Gypsy and Dee Dee, and assumed they were relatives because of their last name.
Kristy Blanchard, meanwhile, was still gathering a lot of the news about her stepdaughter from Facebook. That’s when she discovered that many thought she and Rod were in on Dee Dee’s plans. Others thought Rod must have been a neglectful father who didn’t financially support his own child. “They don’t understand that I’ve always been supportive,” he said. “In every way,” Kristy chimed in. In fact, if anything, Dee Dee may have had so much money — Gypsy and Nick had escaped with about $4,000 from Dee Dee’s safe — because they were receiving his support checks. (Dee Dee died intestate, without a will, and apparently without meaningful assets other than that cash.)
Kristy tried, at first, to defend herself and Rod to these groups, but it turned out they were hard to convince. “It was hell,” she said. She withdrew from all the groups and asked friends and family to stop accepting new friend requests, which were pouring in.
The neighbors in Springfield also had this problem. “It was like, ‘Forget you!’” Amy Pinegar said of the few attempts she made to correct the online sleuths on their factual errors. The obsessives ended up piling confusion onto the already confusing situation Dee Dee had created. And they proved quite resilient. At the hearing I attended in September 2015, two people from the largest Facebook group were there. After the hearing, they made a beeline for the local television crew and started talking to them. Gypsy’s attorney, Michael Stanfield, saw them too, and tried to hurry out of the courtroom to confront them.
“Who were those people?” he asked the television crew. “What did they say?”
For a while, it seemed like Gypsy’s case would, eventually, go to trial. The prosecutor declined to go for the death penalty, but both Gypsy and Nick were charged with first-degree murder. As the investigation into the crime continued, it turned up text messages between the two that appeared to discuss and plan Dee Dee’s death. “Honey, you forget I am ruthless, and my hatred of her will force her to die,” Godejohn texted Gypsy. “It’s my evil side doing it. He won’t mess up, because he enjoys killing.” Prosecutors also said they found social media evidence of Gypsy directly asking Godejohn to kill her mother, though these have never been made public. Documents from pretrial discovery show him telling a friend about Gypsy’s desire to murder her mother as early as May 2014.
Godejohn referred to his “evil side” because he and Gypsy had constructed an elaborate online fantasy life, mostly through a jigsaw puzzle of Facebook accounts. They were into BDSM imagery. They had specific names and roles for each other. They took pictures of themselves in costumes, Gypsy dressing up at one point as the comic book character Harley Quinn, posing with a knife. Reality and fantasy blended quite a lot, for both of them. Even now, it’s not clear why Godejohn participated in this scheme. He had no history of violence. (Reached by telephone, Godejohn’s attorney Andrew Mead declined to comment on the case.) His only prior arrest was for lewd conduct in 2013 at a McDonald’s, where he had been watching pornography on a tablet. But both he and Gypsy told police he was the one to wield the knife. She said that while her mother was being stabbed, she was in the other room, listening. One of the taxi drivers who’d carted the pair around Springfield after the murder told interviewers they thought Gypsy was the ringleader.
Gypsy’s attorney, Michael Stanfield, is a public defender. In an average year, he told me, he handles over 270 individual cases. He drew Gypsy’s case at random and had no idea what he was in for. “I think this is probably the most complicated case I’ll ever get,” he said. The Greene County public defender’s office was somewhat lucky, in that they were also able to pull a former leading public defender, Clate Baker, out of retirement for the case. Stanfield also had an investigator and a paralegal working on it. Kristy and Rod had no money to hire a private attorney, though they told me repeatedly as I reported this story that they would never have told Gypsy to switch attorneys because they found Stanfield so capable and reassuring.
The process of figuring out what had happened was, in a word, complex. Stanfield went down to Louisiana and dredged up some elements of Dee Dee’s past. It took him months to get Gypsy’s own medical records, because Dee Dee had set up a power of attorney over Gypsy’s medical decisions after Gypsy turned 18. The hospitals refused to help, even though the power of attorney did not surrender Gypsy’s rights to look at her own medical documents.
When the records finally arrived, though, they were so damning, Stanfield called the prosecutor without needing to investigate further. A plea deal was worked out. On July 5, Gypsy pleaded guilty to second-degree murder. The judge gave her the minimum sentence: 10 years. With the year she’s served, she’ll be eligible for parole in about seven and a half years, at the end of 2023. By then she will be 32 years old.
For his part, Godejohn is still scheduled for trial in November. It was not, Stanfield told me, a listed condition of Gypsy’s plea bargain that she testify against him. At a recent hearing in mid-July, he looked bewildered and lost, a beard concealing most of his face. His family never seems to come to hearings.
Gypsy is now an inmate being processed at the Women’s Eastern Reception, Diagnostic and Correctional Center in Vandalia, Missouri. Her hair is long, her skin clear and healthy, and she wears proper adult glasses. She’s off all her medications, and there have been no health problems in the year she’s been out of her mother’s control. “Most of my clients lose weight in prison,” Stanfield pointed out, because the food is so bad. Gypsy gained 14 pounds in the 12 months she spent in Greene County Jail before her plea.
Kim Blanchard, who visited Gypsy once in jail, told me, “She looked much more like the person that she was, which was the complete opposite of the person that I knew, and it was like she had a costume on that whole time and then took it off.”
But obviously, there are lingering effects. When I last checked her inmate record, it still had her last name misspelled, bearing the extra “e” that her mother somehow thought was a good disguise. In the Greene County Jail, Gypsy had a therapist she saw once a week. It remains to be seen if she’ll have one in her new home, or if that therapist will be trained to attend to the specifics of her unique situation.
Rod and Kristy saw Gypsy not too long after the plea bargain. It has been a relief to know what’s going to happen to her. They don’t know if they’re going to sue the hospitals or doctors that Gypsy saw all her life. They’ll decide that after everything has settled down, after they can properly talk to Gypsy. While the case was pending, they never discussed the crime with her; the prosecutor forbade it. Now there will be more to talk about. They’re hoping to get up to her new facility two or three times a year. It’s a long drive, and there’s still the matter of money.
Months ago, Rod and Kristy told me they still catch Gypsy in small lies about her life, things she’s clearly afraid to be frank with them about. It worries them. “Of course we want her to get better about that,” Kristy said.
When I spoke to them more recently, Rod’s voice was sagging a little. He sounded older. He said he’d started to wonder what exactly Dee Dee had told Gypsy about him all those years. He had only begun to pose those questions. He was wondering lately, he said, how Dee Dee had managed to be so friendly on the phone all those years if she hated him so much. He asked Gypsy about it.
“She said, ‘Keep your enemies close,’” Gypsy told him.
For most of the year I spent reporting this article, the case was pending and I wasn’t able to speak to Gypsy herself. After the plea deal, that changed. I sent her a note. She called me from prison in Missouri to talk in short conversations broken up over a few days.
Her voice is still high-pitched, though now that we know what we know, it no longer seems unusually high at all. People heard what they wanted to. Gypsy speaks in long, beautiful sentences. She is sometimes so eloquent in conversation that it is hard to believe anyone could have ever spoken with her and thought her “slow,” as some put it. It reminded me of all the doctors who wrote in her files that in spite of Gypsy’s alleged cognitive defect, she had a “rich vocabulary.”
She was eager to talk, barely able to contain herself once she started. She wants people to know, she said, that this wasn’t a situation where a girl killed her mom to be with her boyfriend. This was a situation, she said, of a girl trying to escape abuse. In prison she’s hoping to join all sorts of programs, to help people. She wants to write a book to help others in her situation.
I asked her what I’d long been waiting to ask her: When did she realize her life was different, that there was something wrong? “Whenever I was 19,” she said. She meant the time when she ran away with the man at the convention in 2011. When her mother came to take her back, she began to wonder why she wasn’t allowed to be alone, to have friends.
About her mother, her opinion seems to waver. “The doctors thought that she was so devoted and caring,” Gypsy said. “I think she would have been the perfect mom for someone that actually was sick. But I’m not sick. There’s that big, big difference.”
Gypsy still doesn’t feel she actively deceived anyone. “I feel like I was just as used as everybody else,” she said. “She used me as a pawn. I was in the dark about it. The only thing I knew was that I could walk, and that I could eat. As for everything else… Well, she’d shave my hair off. And she’d say, ‘It’s gonna fall out anyway, so let’s keep it nice and neat!’” Gypsy said her mother told her she had cancer, too, and would tell her that her medication was cancer medication. She just accepted it.
As for a childlike demeanor, Gypsy grew defensive when I asked her about it. “It’s not my fault. I can’t help it. This is my voice.”
Often, it didn’t occur to her to question any of it, and when it did, she worried about hurting her mother’s feelings. It often seems to Gypsy, even now, that Dee Dee really thought she was sick. “I was afraid that we were gonna get in trouble,” Gypsy said. “The line between right and wrong…was kinda blurred, ’cause that’s the way I was taught. I just grew up that way.”
“When I think about it now,” she added, “I wish I would have reached out to somebody and told somebody before I told Nick.”
She mostly used the internet late at night, when her mother was asleep. Nick, she said, was the first person who had offered her real protection. She believed him. Ultimately, after everything that happened, she said she thinks he has “anger issues.” She repeatedly takes responsibility for the murder: “What I did was wrong. I’ll have to live with it.” But she said Nick is the one who took “a plot between us both” and “made it into action.” Gypsy was the one who had the idea to post about the murder on Facebook, so that the police would come check on her mom. She recalled asking Nick, “Can we please just post something on Facebook, something alarming, that would make people call the police?” But she said he told her what to write.
I asked, repeatedly: Are you angry? With your mom? With the doctors? She will admit only to frustration. “It makes me frustrated that none of the other doctors could see that I was perfectly healthy. That my legs were not skinny, like someone who was [really] paralyzed. That I can’t… I don’t need a feeding tube. Stuff like that.” In jail, Gypsy had access to tablet computers. She looked up the definition of Munchausen, after hearing the word so often used to describe her situation. Her mother matched every symptom, she told me.
Every once in a while, I’d get Gypsy explaining some element of her abuse in such detail that something in me would break. Once, feeling speechless but aware that the clock was ticking on her phone time, I blurted out, “I’m so sorry this happened to you.” Gypsy immediately switched into the girl she was back in those feel-good local news interviews. “It’s okay. I mean, honestly, it’s made me a stronger person, because I truly believe that everything happens for a reason.”
Even on the subject of her prison sentence, Gypsy is a model of radical acceptance. She’s told people she feels freer in prison than she did when living with her mom. “This time is good for me,” she said to me. “I’ve been raised to do what my mother taught me to do. And those things aren’t very good.”
“She taught me to lie, and I don’t wanna lie. I want to be a good, honest person.” ●
For starters, medicine balls are noted to be one of the most diverse pieces of exercise equipment one can own, useful for toning almost every part of the body, and are also extensively used in various forms of physical therapy.
While details are sparse on the history of medicine balls, we can reliably track their usage back around 3000 years, where they were used by Persian wrestlers looking to become stronger. In Ancient Greece, Hippocrates considered them to be an essential tool for helping injured people regain mobility and he advised people to use them as a general, all purpose way of remaining healthy.
This all brings us back to the origin of the name. The word “medicine” was long synonymous with the word “health”. For example, it’s noted that Renaissance physician Hieronymus Mercurialis advised that people of all fitness levels should use what we would recognise as medicine balls in his book De Arte Gymnastica, as part of what he called “medicinal gymnastics“. The use of the word “medicinal” in this case was to highlight how the exercises could be used as both a way of healing injuries and preventing them in the first place through general fitness.
Although devices we would recognise as being medicine balls have been commonplace for millennia, the word itself is only a few hundred years old, being attributed to one, Professor Roberts way back in 1889. According to a Scientific American article from the time, Roberts coined the term “medicine ball” in reference to the fact that using the ball “invigorates the body, promotes digestion, and restores and preserves one’s health“. As “health” and “medicine” were considered to be synonymous terms at the time, calling it a “medicine ball” was natural enough.
Today, we still refer to medicine balls as such, even though the terms “health” and “medicine” aren’t as synonymous as they once were. “Health ball” also doesn’t quite have the same ring to it.
In the ancient world, medicine balls often took the form of animal bladders filled with sand.
President Hoover was supposedly a big fan of exercising with a medicine ball and would reportedly spend a great deal of time throwing one over a net to a willing catcher who would then throw it back. This game is sometimes known as “Hoover-ball” in his honor.
Have you ever wondered what sex during the Black Plague was like? It sounds sick and twisted, but life goes on, as they say, even during an epidemic. People are still people, even when a ton of people are swept away (atleast75 million died during the epidemic). Engaging in physical relationships during the Black Plague (another common name for it) was in many ways a lot like how it was during the rest of the Middle Ages, but the extreme conditions led to some extreme expressions of sexuality.
“Bedroom activity” during the Black Plague was in some ways pretty wild, with some “revelers” deciding to hump the rest of their seemingly short lives away. But doctors at the time also told people to avoid overexerting themselves in the bedroom because they thought the “bad air” would reach them easier if they did. Read on to learn more about what making love during the Black Plague was really like.
There Were “Gatherings” In Graveyards
The Black Plague was a stressful time to be alive, for obvious reasons. One way to cope, according to historian David Herlihy inThe Black Plague and the Transformation of the West, was by celebrating life in cemeteries. “Group activities” were one of the ways people celebrated life. At Avignon’s Champfleur cemetery, for example, things got so bad that a papal official had to threaten the “fornicators and adulterers” with excommunication for committing “unseemly acts” on the graves.
Street walkers even took advantage of this desire by hanging out at cemeteries. It wasn’t all fornication: revelers also dared to dance, fight, throw dice, and play other games among the graves as well.
Medical Experts Advised Limited “Physical Activity”
Medical logic at the time said that too much “physical activity” “overheated the body,” according to Joseph Patrick Byrne’sThe Black Plague, and this allowed “bad air” to enter the body through one’s pores, increasing the chances of catching the plague. Heavy breathing during the act might also lead to inhaling too much of that same “bad air.” A German physician even advised that “all physical exertions and emotions of the mind,” including running, jumping, jealousy, and promiscuity, should be totally avoided or risk catching the dreaded Black Plague. Whatcouldpeople do? They could spend their downtime “relating tales and stories and with good music to delight their hearts.”
“Selling Yourself” Was Institutionalized
As the casualty toll of the plague increased, working girls benefited more and more, according toJeffrey Richards.They began to enjoy a “seller’s market” due to a general lack of labor in the era, leading to “a general improvement of their conditions.”
Leah Lydia Otiswrote that as the Black Plague waned, there was a “quantum leap in the institutionalization of [working girls.]” Municipally-owned “parlors” were built, complete with “royal safeguards.” Otis did note, however, that the demand for girls began to wane at that time, as well.
Some Thought Immorality Helped Cause The Plague
Joseph Patrick Byrnewrote that many lawmakers at the time adopted the “Christian belief that sin angered God, who expressed his divine wrath through plague,” and they turned those beliefs into legislation. Many older “moral laws” essentially became just plain laws. This meant sexual immorality was heavily legislated. This “sanitary” legislation targeted sodomy and selling one’s body in particular. In Florence, for example, working girls were “kicked out” of the city in the waning years of the Black Plague. When the industry reemerged in the decades that followed, they were still forbidden to work on the streets. Certain establishments, however, were still allowed to legally operate.
There Was Still An Active Gay Subculture
According to theEncyclopedia of Homosexuality, Volume 2, a “vital urban subculture” of homosexuals existed during the Black Plague. It wasn’t until the Renaissance that “more detailed records of the life and attitudes of homosexual men and women” emerged, but this vital subculture was alive, despite “only fleeting glimpses of it in the literature” of the period.
A few decades before the Black Plague,King Edward IIof England was murdered, and centuries-old rumors say he was executed for homosexual activity. (Mel Gibson’sBraveheartreceived a lot of criticism for its negative portrayal of Edward.) The belief that “sexual immorality” such as “sodomy” helped cause the Black Plague surely was another factor in keeping the subculture hidden during the period.
‘Pseudo-Flagellants’ Performed Acts In Public
So-called “flagellants” during the Black Plague were, according to Professor Mark Damen ofUtah State University, “professional self-torturers” who went around whipping themselves for a fee in order to “bring God’s favor upon a community hoping to avert the bubonic plague.” They were literal whipping boys that people employed to buy “remission from sin.” The Church, of course, outlawed this behavior, but that didn’t have do much to stop the practice. There was also anothergroup of lesser-known “pseudo-flagellants”that went from town-to-town performing “physical acts” in public for a fee. The Church outlawed them, as well.
Incidents Of Incest Increased
InDomestic Violence in Medieval Texts, Eve Salisbury, Georgiana Donavin, and Merrall Llewelyn Price wrote that incest in England actually increased during the Black Plague. Why? Simple arithmetic. The plague “destroyed between one-third and one-half” of the population, making exogamy (marrying only outside their clan or community) “improbable.” The problem, Donavin wrote, wasn’tkeepingcousins from marrying, but instead “finding living cousins with whom one might preserve the patrimony.” A lot of noble families died off during the plague years, meaning “intrafamilial marriages greatly increased.”
Fines For Fornication Increased
Richard M. Smith wrote in Land, Kinship and Life-Cyclethat the severity of fines for fornication in England increased as the severity of other legal fines generally decreased in the middle of the Black Plague period (1349). Smith interpreted the high fines during this period as a punishment for acts that were seen as morally improper. The courts, essentially, decided to ramp up the punishment for immorality in response to the Black Plague. Blame the fornicators, basically. Smith did note, however, that attitudes about unseemly acts such as fornication, and thus the inclination to increase the fines for such acts, may have been changing even before the plague struck.
The Most Intense Symptoms Suffered By Victims Of 14th-Century Black Plague
Responsible for eliminating anywhere between 30 to 60% of Europe’s population between 1346 and 1353, the bubonic plague was a cause of terror. Gruesome symptoms led to mass panic and widespread fear. What happened to people with the black plague? From oozing boils to decaying skin, gross symptoms of the black plague were a common sight in Europe during the 1300s.
The disease occasionally crops up again today. While not always fatal, bubonic plague symptoms can have lasting consequences for sufferers. Early black plague signs include odd lumps and bumps, but also very common ailments. Many plague sufferers initially experience normal symptoms of a cold or flu, like a fever and chills, only to have their health start deteriorating rapidly. Learning about the black plague will leave you second-guessing waiting to see a doctor the next time you come down with a seemingly mild sickness.
Gangrene Is An Unpleasant Side Effect
Sufferers often end up with gangrene as a result of the virus, which is sometimes treated via drastic measures like amputation. Gangrene causes the skin to turn shades of blue, purple, green, red, or black. Swelling and blisters may also occur, and these emit a foul-smelling pus. Skin may also become cold and tender.
One reason amputation is often necessary is that gangrene can lead to septic shock, an often fatal complication.
Bumps And Boils Eventually Start To Ooze
After their initial appearance, the egg-sized lumps found on plague sufferers get worse. The bumps and boils spread throughout the body. Over time, they begin to rupture and emit blood and pus.
One Complication Will Promptly Shut Down Bodily Functions
Disseminated intravascular coagulation is a medical condition sometimes caused by the plague. This is a serious and potentially fatal complication in which blood clots throughout the body and – as a result – internals organs begin to shut down. This was a death sentence in the early days of the plague, and is often still fatal today.
However, the condition is sometimes successfully treated via a medically induced coma.
Bumps The Size Of An Egg Present As The First Symptom
If you’ve contracted the plague, the first symptom is a little hard to miss. You develop what are called “buboes,” which generally develop a week after you’re exposed to the virus. These are large bumps, about the size of a chicken egg, that are found around the groin, armpit, or neck. In addition to being massive, they’re sensitive.
The bumps are also warm to the touch and tender.
Sufferers Engaged In Self-Flagellating Religious Rituals
When you’re suffering intensely for unknown reasons, it’s not uncommon to look to the skies for an answer. In the 1300s, some sufferers concluded the Black Death was a punishment brought on by an angry God for the impurities in their own souls. Their solution? Intense acts of self flagellation.
Sufferers, especially those in the upper class, would march from town to town. In front of a public audience, they would beat one another and themselves with heavy straps of leather covered in shards of metal. This ritual was repeated three times a day for a 33-and-a-half-day period.
As more and more people began participating, the pope caught wind. Concerned the self flagellants could usurp his power, he condemned the practice. It fizzled out shortly thereafter.
Mutant Bacteria Was Especially Harmful
Plague bacteria spreads rapidly throughout the body, shutting down nearly every vital function. While complications like gangrene and dehydration often led to the end for sufferers, many people were more or lesspoisoned.
This is due to yersinia pestis, a mutant bacteria that causes the plague. This bacteria is particularly violent as it is unable to survive outside a host, and it can penetrate and hide in a host’s cells. In order to survive, the bacteria multiplies quickly and disables a sufferer’s immune system. Yersinia pestis bacteria then clot underneath the skin, in hopes of being picked up by a passing flea.
Even Survivors Have Lasting Side Effects From The Vomiting
Vomiting is par for the course for a wide variety of common illnesses, but this is no minor ailment when it’s related to the black plague. Depending on the duration of the infection, the consequences of months of acid reflux and vomiting can last for years.
Take the case of Katie Simon, a woman who caught the plague on a backpacking trip she took shortly after college in the early 2000s. Her stomach was afflicted that she had to stick to a strict diet comprised of mostly bland foods free of gluten, dairy, alcohol, caffeine, and processed sweeteners. Her upper digestive system was completely inflamed, and she had ulcers covering her stomach and esophagus. Recovery took two and a half years.
Sufferers Bleed Pretty Much Everywhere
In the disease’s later stages,bleeding is common. Septicemic plague occurs when plague bacteria begin multiplying in a sufferer’s body. They may bleed from the nose, mouth, rectum, or even under the skin.
Extremities Blacken As Bacteria Multiply
After an initial infection, bacteria begins to multiply in a sufferer’s bloodstream. This can cause a number of side effects associated with more common illnesses, such as fever, chills, and diarrhea. However, one symptom distinct to the black plague is a change in body color.
Sufferers often experienced the blackening of their fingers, toes, and nose.
Overall Skin Color Sometimes Changes
Blackening of the extremities is a common side effect, but some sufferers experience complete changes in skin color.
Take the case ofPaul Gaylord, an Oregon man who contracted the plague from his cat in 2012. After the initial fever, his skin began to turn grey throughout his body. This caused his wife to rush him to the hospital, where he luckily received life-saving treatment.
The Initial Symptoms Mimic Those Of Normal Colds And Flus
One of the scariest things about the black plague is that initial symptoms aren’t really that different from the run-of-the-mill flu or cold. You may experience fever, shaking, general weakness, and increased sweating.
Next time you experience these symptoms, especially if you’ve been near rats or fleas recently, you might want to see a doctor just in case.
How Humanity’s Response To Epidemic Disease Has Stayed The Same Throughout History
For millennia, societies have faced destructive epidemics that caused a major loss of life. Although the germs that cause epidemics change over time, and people may pretend humanity has too, responses to epidemics show startling similarities across centuries. During Justinian’s Plague, 40% of Constantinople’s population perished. When the plague of Athens struck, it took out up to 30% of the city. And when the Black Death swept Europe in the 14th century, it ended the lives of millions, with population losses of over 50% in some areas. Even epidemics with lower mortality rates cause major disruptions, like the Spanish flu of 1918. But regardless of era or disease, people have shown many of the same responses: flee from the source of the danger, look for a scapegoat, propagate pseudoscientific cures, and question scientific authority.
In a time of crisis all bets are off; we fall into the most primal fears and patterns. And though people will do what they can to save themselves, not all behaviors are bad. Some may even better prepare humanity for future epidemics and crises.
People Try To Find A Scapegoat, Leading To Instances Of Extreme Prejudice And Racism
When epidemics spread, communities often look for a scapegoat. During the Black Death, Europeans blamed Jewish communities for spreading the disease. One chronicle reported, “Death went from one end of the earth to the other, on that side and this side of the sea . . . In some lands everyone died so that no one was left.”
In Strasbourg, the plague took out thousands, and Christians blamed the city’s Jewish population. “On Saturday – that was St. Valentine’s Day – they burnt the Jews on a wooden platform,” the chronicle recorded. “There were about 2,000 people.” The same happened in other cities. “In some towns they burnt the Jews after a trial, in others, without a trial.”
Just as the Jews became scapegoats during the plague, racism against Chinese people increased during the 2003 SARS epidemic and the 2020 coronavirus epidemic because they both originated in China. In New York City, during the 2020 epidemic, tourists have even avoided Chinese restaurants for fear of catching the virus despite there being no evidence to suggest people of East Asian origin are more likely to spread the disease.
These are not the only cases in modern history, however, and people of East Asian origin are not the only targets of prejudice. During the Ebola outbreak of 2015, people from West Africa were targets of xenophobia; while the LGBTQ+ community was stigamatized during the AIDS crisis of the 1980s.
People Peddle Pseudoscientific Cures And Spread Disinformation
In 1900, the bubonic plague reached the shores of America. An outbreak in San Francisco threatened to spread the disease. Doctors warned that bacteria spread the plague, but government officials undermined their efforts by questioning the science.
In California, Governor Henry Gage was skeptical about germ theory. He couldn’t personally see the bacteria that caused plague, and thus denied its existence. As the plague swept through Chinatown, white San Franciscans claimed they were immune from the disease, blaming its spread on poor hygiene. But they, too, soon faced a plague epidemic, regardless of their scientific skepticism and denial.
Similarly, during Justinian’s Plague in the sixth century, people turned to cures with no basis in science. Some claimed taking cold baths protected people from plague, while others sold magic amulets.
Similar pseudoscientific claims continue into the 21st. During the 2015 Zika virus epidemic a rash of conspiracy theories made their way through social media platforms. One such claim blamed one of the viruses symptoms, microcephaly, a condition which causes babies’ heads and brains to develop abnormally, on MMR and DTAP vaccines in an effort for pharmaceutical companies to profit off of Zika vaccines.
Psedoscientific claims can cause adverse effects to individual and societal health. In the case of the Zika virus, doctors and scholars looking to limit the disease’s reach claimed the disinformation threatened the legitimacy of healthcare institutions, potentially exposing more people to the disease as people refused to trust healthcare professionals. In other cases, the pseudoscientific claims and cures, like drinking bleach, have caused more direct health issues.
Due To Extreme Population Loss, Affected States Experience A Loss In Military And Political Strength
In the sixth century, the Byzantine Empire experienced a horrific plague that caused a massive drop in population. Under the Emperor Justinian, the Byzantines had expanded their borders and fought to regain parts of the western Roman Empire. But Justinian’s Plague threatened to destroy the empire.
Thanks to population loss, the Byzantines could no longer defend their overseas territories. In addition to the military losses, the Byzantines also endured economic and administrative problems that decreased the empire’s political power. Though the empire survived the plague, it never again achieved the reach it had under Justinian.
Justinian’s Plague was not the only Ancient historical case. In the fifth century BCE, the Greek city-states of Athens and Sparta faced each other through a nearly 30-year war. During the second year of the war, however, while Sparta had laid siege on the Athens, the defending city was swept by an unknown epidemic disease, which ended a third of its entire population including the states leader, Pericles.
Some historians and scholars have attributed this unexpected loss of life to Athens’s ultimate defeat and the eventual decline of Ancient Greece’s cultural output. Others would not go that far, citing Athens’s eventual regrowth and victories throughout the battles, but they do agree the city state did lose prestige and power due to the political aftermath of the disease.
Similarly, historians have attributed Germany’s loss at the end of WWI to the emergence of the Spanish Flu epidemic in the summer of 1918. Beginning the year with a military advantage against the Triple Entente and looking to end the war before American soldiers could be deployed, the Germans launched an offensive in hopes of breaking through enemy lines and reaching Paris. They, however, lost about half a million men due to the virus, making it impossible for the army to make that final charge.
Because They Feel A Personal Responsibility To Help, Healthcare Personnel Experience The Worst Of The Disease
Doctors, nurses, and other healthcare workers often experience high mortality rates during epidemics. The famous plague doctor costume, developed in the 17th century as the bubonic plague continued to ravage Europe, attempted to protect doctors from miasmas, or disease-transmitting clouds. In modern epidemics, doctors wear personal protective equipment, including masks and gloves.
Due to the close proximity and extended time healthcare personnel spend among epidemic diseases, the high mortality rate among healthcare workers is still the norm despite technological advances.
In the fifth century BCE, Athens experienced a horrific plague that took out one in three Athenians in a single summer. As the Peloponnesian War raged, Athenians battled against an unknown enemy riskier than combat. Doctors experienced an even higher mortality rate during the plague of Athens. That year, according to Thucydides, “Neither were the physicians at first of any service, ignorant as they were of the proper way to treat it, but they died themselves the most thickly, as they visited the sick most often.”
But during the 2015 Ebola epidemic in West Africa, doctors and nurses also perished at a much greater percentage the rest of the population. The World Health Organization attributed the high mortality to fairly regular problems within epidemics, including shortages of both medical supplies and staff, improper use of equipment, and longer than recommended exposure to the disease most often due to a sense of duty to help.
Societies Affected By Major Epidemics Have Resorted To Mass Burial
When the Black Death swept across Europe, millions perished in its wake. And the disease’s mortality rate left societies with a troubling logistical problem: How should they dispose of the bodies piling up in the streets?
In Lincolnshire, England, Black Death victims were buried in a mass grave. Discovered in 2013, the grave contains the bodies of nearly 50 people. The community apparently left the grave open and filled it as people perished. According to a journal article in Antiquity, the grave was “filled over the course of several days or weeks.”
Large cities experienced an even more critical problem. According to a 14th century Florentine chronicle, bodies were thrown into deep trenches every night. “The next morning, if there were many [bodies] in the trench, they covered them over with dirt. And then more bodies were put on top of them, with a little more dirt over those; they put layer on layer just like one puts layers of cheese in a lasagna.”
Similar action was taken during the 1918 Spanish Flu epidemic. In 2015, a Pennsylvania Department of Transportation contractor looking to widen the 61 Freeway dug into a 2.25 acre field in Schuylkill County, 100 miles northwest of Philadelphia. Many of the regions residents who perished from the Spanish Flu were found to be buried without caskets. Historians and archaeologists believe there was such a high mortality rate the grave diggers and casket makers could not keep up with the demand, forcing them to unsystematically bury the victims in a large pit.
A Certain Contingent Of People Resort To Hedonism When Death Seems Inevitable
In an era before people understood bacteria and viruses, epidemics brought even more confusion. And when succumbing to the disease seemed inevitable, some people cast off social restrictions and turned to hedonism.
Boccaccio described the response to the Black Death in Florence. Some shunned the sick and avoided any contact with them. “There were those who thought that to live temperately and avoid all excess would count for much,” Boccaccio related. These people secluded themselves from society while “eating and drinking moderately.”
Others took the opposite tactic. They believed “that to drink freely, frequent places of public resort, and take their pleasure with song and revel, sparing to satisfy no appetite, and to laugh and mock at no event, was the sovereign remedy for so great an evil.”
These hedonists traveled from tavern to tavern, “drinking with an entire disregard of rule or measure.”
Boccaccio reported that many of the hedonists perished – but so did those who chose to live moderately.
Similar behavior transpired during the Plague of Athens in the 430 BCE. According to Thucydides:
Men now coolly ventured on what they had formerly done in a corner, and not just as they pleased, seeing the rapid transitions produced by persons in prosperity suddenly dying and those who before had nothing succeeding to their property.
So they resolved to spend quickly and enjoy themselves, regarding their lives and riches as alike things of a day. Perseverance in what men called honor was popular with none, it was so uncertain whether they would be spared to attain the object; but it was settled that present enjoyment, and all that contributed to it, was both honorable and useful. Fear of gods or law of man there was none to restrain them.
In The Wake Of Epidemics, Artists Focus On Macabre Themes
Throughout history, epidemics shape culture as well as society. After living through an epidemic, artists in many eras turn to macabre themes.
During the Black Death, artists emphasized the end of life itself. Historian Frank M. Snowden says that the plague “had a transformative effect on the iconography of European art.”
Artists drew the “dance of death,” showing skeletons reveling, and also emphasized perishing through including hourglasses in their art. Art reminded viewers that there was no escape from the inevitable.
People Change Their Personal Religious Beliefs And Practices
A dangerous epidemic can either shake people’s faith or reinforce it. During the Black Death, Europeans worried the disease had been sent by God as a punishment for their sins. Although many flocked to church for protection, faith didn’t protect Europeans from the plague.
In the 14th century, the plague swept through religious communities, wiping out entire monasteries and convents. The pope himself withdrew from society instead of stepping up as a religious leader. Zealots like the flagellants swept across the continent, atoning for sin by publicly whipping themselves.
During modern epidemics, backed by knowledge of germ theory, religious communities modify traditions to stop the spread of disease. Others simply stop attending church to avoid exposure to large crowds.
Societies Isolate And Quarantine Those Infected
For centuries, people separated the sick from the healthy. The Old Testament even lists rules for isolating lepers.
But quarantines in the modern sense began in the 14th century during the bubonic plague. Venice, a trade hub in the Mediterranean, established the first quarantine by banning ships from the city for 40 days after arriving. Our word for “quarantine” comes from the Italian word “quaranta” which means 40.
The idea quickly spread. In the second major plague outbreak in 1374, Milan adopted a quasi-quarantine by sending plague victims to a field outside the city, where they remained until they recovered or perished. The coastal town of Ragusa on the Dalmatian coast created its own quarantine station, an idea that quickly caught on. Several islands in the Venetian lagoon were used as quarantine stations for centuries.
Quarantines continued into the 20th century. During the Spanish flu, one city protected itself from influenza by shutting down the roads and quarantining anyone who arrived by trains. In that city, Gunnison, Colorado, no one perished from influenza.
People Practice Healthier Behaviors
Educating the public about the spread of disease has been an important tool in fighting epidemics. In the early 20th century, public health campaigns warned people not to carelessly spit, cough, or sneeze, since these helped spread infectious diseases like influenza.
In the 1980s, public education was an important tool in fighting the AIDs epidemic. To slow the spread of the disease, these campaigns focused on changing at-risk behavior. These efforts warned against sharing needles or having unprotected sex. After peaking in the early 1990s, the number of HIV cases in the US dropped in large part thanks to public education.
People Migrate En Masse To Escape The Disease
During epidemics, large groups of people often migrate to avoid disease. Boccaccio’s Decameron tells the story of Italians who fled Florence during the plague.
In 14th century Egypt, the bubonic plague destroyed villages and forced many from rural areas to migrate into Cairo. In one district in Upper Egypt, a survey counted 6,000 workers in the fields before the plague. Thanks to those perishing and migrating, only 116 laborers remained after the plague.
Similarly, in January 2020, about 5 million people left the city of Wuhan, China, before the lockdown. According to Mayor Zhou Xianwang, millions fled days before the quarantine went into place. However, migrants fleeing an epidemic potentially spread the disease, undoing the impact of quarantines.
While Bad For The Economy In The Short Term, Epidemics Tend To Bring Positive Long-Term Economic Changes
In the short term, epidemics bring massive economic disruptions. During Justinian’s Plague, trade nearly came to a halt and agricultural prices soared thanks to fewer farmers. In Constantinople, where up to 40% of the population perished, the Byzantine Empire faced an economic crisis when tax revenues collapsed.
During the Black Death, the high mortality rate meant fewer laborers in the fields. In the short term, that meant higher prices. The bubonic plague, however, brought some unexpected long-term improvements to Europe’s economy. Thanks to a labor shortage, wages rose in the decades after the plague. In England, wages roughly doubled. In Suffolk, laborers made 67% more for reaping after the Black Death.
Increased wages for the laboring classes meant higher spending and a greater standard of living. Agricultural workers could suddenly afford “luxury” items like butter. In cities, people benefited from more disposable income. In effect, the Black Death redistributed wealth from the aristocrats to the peasants and urban workers, helping drive Europe’s economic engine for centuries.
The Bubonic Plague Ravaged San Francisco In The 1900s—And The Government Tried A Massive Cover Up
The San Francisco bubonic plague outbreak was one of the biggest health crises — and controversies — of the 20th-century United States. The plague was a disease most thought had disappeared with the medieval period, but when it resurfaced, it became one of the worst epidemics in US history. The state of California was forced to contend with an illness not yet entirely understood, as government officials and the press actively covered it up. Not only did they have to pioneer treatments for the bubonic plague, but the entire problem was also wrapped up in anti-immigrant and specifically anti-Chinese racism. Some people even referred to it as the San Francisco Chinatown plague, implying a problem specific to the Chinese residents of the city.
But that wasn’t the case. Blaming a select group of people meant that the cause itself — flea-infested rats carrying the same strain of plague causing deaths in China — went unaddressed. The San Francisco plague death toll rose, taking the lives of many of the city’s underprivileged residents. It wasn’t until a second plague swept the city, this time primarily affecting San Francisco’s white population and spreading to further areas of the US, that the root cause was identified and put to rest. While modern-day humanity still deals with tragedy incurred by the flu, the plague of the early 1900s incited racist tension and social horror simply because of the ignorance of its causes and the inexplicable death it left in its wake.
The San Francisco Plague Was The First Major Plague Outbreak In The Continental US
Though the San Francisco plague was hardly the first major illness that residents of the continental US had to address, it was the first major outbreak of the plague. The illness — named the Black Plague or the Black Death when it ravaged Europe in the 1300s and caused some 50 million deaths — made a comeback in the 1800s, seriously affecting China and much of east Asia.
Because of global trade and increasing numbers of people emigrating and immigrating worldwide, it was only a matter of time before epidemics began to spread. However, people did not yet understand exactly how the disease was transmitted — many believed it spread through open wounds, food, or the “miasma” theory, which claimed that diseases like the plague spread through “bad air.” Because of these conflicting, erroneous theories, the world wasn’t prepared to respond to a wide-scale epidemic.
The First San Francisco Plague Victim Was A Chinese Immigrant
The first person to die in the San Francisco plague was Wong Chut King, a lumber salesman and Chinese immigrant who was found unconscious in the flophouse where he lived after suffering an intense fever. In a morbidly preemptive move, he was brought to a nearby coffin shop where he died.
Examination of his body revealed swollen lymph nodes — called buboes, hence the disease’s name — consistent with a plague infection, as well as an insect bite. Flea transmission was not yet a popular theory to explain plague infection, so while it was noted, the report did nothing to quell the subsequently rampant xenophobic explanations for the disease. When microscopic investigation revealed plague bacteria in Wong Chut King’s blood, Chinatown was quarantined to stop the spread, though the fleas and rats that carried the disease were not hindered by arbitrary barriers.
The Outbreak Centered On San Francisco’s Chinatown District
San Francisco’s plague outbreak was concentrated in the Chinatown district, just a few blocks from what is now the Port of San Francisco. Because Chinatown was particularly overpopulated, had poor sanitation, and had many people living in poor conditions, those features were blamed for the outbreak rather than the actual cause: flea-ridden rats brought from plague-stricken China on the ships that came to the harbor. Instead of treating the cause, the city quarantined its Chinese residents.
But quarantines don’t stop rats, and the disease continued to spread outside of the quarantined zones. Because conditions were poor, and racism was rampant, the quarantined residents didn’t get proper medical treatment. Thus, the concentration of infected people, fleas, and rats could grow, leading to even more infections.
Rats From China Probably Carried The Plague To America On Ships
In the late 1800s and early 1900s, scientists and medical professionals weren’t yet sure what caused the plague. The miasma theory, which suggested the disease was spread through “bad air,” was popular, as were suggestions that the plague might travel through contaminated food or open wounds. The bubonic plague is actually transmitted via flea bite, with the carrier fleas often living on rats.
China was dealing with a plague outbreak of its own in the mid-late 1850s, which soon made its way to Hong Kong. Since Chinese immigrants and imports commonly made the journey to San Francisco, it was only a matter of time before the plague reached American soil.
Racism Was Undoubtedly A Factor In The Plague’s Outbreak
The plague itself was a problem, but anti-immigrant sentiment and racism against Chinese people exacerbated the issue. Around this same time, the Chinese Exclusion Act, which prevented Chinese people who were not merchants from immigrating to the US, was extended. Rampant, unfounded anti-Chinese sentiment promoted racist policy, which in turn validated racist viewpoints because of state-sanctioned rules.
In the initial quarantine, white people in Chinatown were told to leave while Chinese residents were forced to stay. Miasma theory, which posited the disease was spread via contact with contaminated air, was blamed for the plague in Chinatown.
Rather than the poor sanitation being a symptom of the area’s poverty, it was instead said to be evidence that the Chinese people themselves were the problem. Some went so far as to claim that a rice-based diet made them susceptible to the plague.
San Francisco’s Governor Denied The Outbreak Out Of Fear It Would Hurt The City’s Reputation
One of the biggest stumbling blocks to stopping the plague’s initial four-year hold on San Francisco was the city government. The governor, Henry Gage, actively denied the city had a problem, fearing it would hurt tourism and trade. Worse, he didn’t just deny the problem — he actively thwarted efforts to stop it. Gage claimed funds were being diverted to stop a plague that didn’t exist. He also suggested Dr. Joseph J. Kinyoun, who led the quarantine effort, had fabricated or caused the plague himself by injecting Chinese residents with the disease.
Though there was little help available for victims, Gage’s denial — as well as his active attempts to stoke tension between Kinyoun’s efforts and the Chinese people whose civil rights were being violated — ensured the plague continued to ravage the city’s ostracized citizens.
The City Ran A Defamation Campaign Against The Officer Who Discovered The Outbreak
Dr. Joseph James Kinyoun was the leader of the plague eradication movement, but, due to both concentrated misinformation efforts and lack of scientific information, his plans to stop the plague were thwarted. Kinyoun was unsure how to curtail the plague’s spread, and he ineffectively quarantined Chinatown in the hopes that it would keep the infection isolated. When animals were infected with the disease and didn’t immediately die, the quarantine was lifted, and the city government, particularly Governor Henry Gage, seized on it as proof that Kinyoun had no idea what he was doing. He warned that shipments of goods could spread the illness out of San Francisco and around the country, leading to other states refusing to accept goods from California.
Gage responded to the lost profits by claiming Kinyoun himself had created the plague by injecting Chinese corpses. Furthermore, he stoked the flames of the poor treatment Chinese people were receiving by encouraging them to fight back. Combined with Kinyoun’s reportedly uptight demeanor, which did not mesh well with the Chinese population he was meant to be helping, his efforts were undercut, and he was eventually transferred. The plague raged on until Dr. Rupert Blue replaced Kinyoun and shifted the treatment from quarantine to pest eradication.
Governor Gage’s Denial Helped Seal His Loss In The Elections
Governor Gage’s actions were not without consequences. Anti-Chinese sentiment, along with the tensions that arose from the quarantine and Gage’s efforts to create a divide between health officials and Chinese residents most threatened by the outbreak, meant that people hid the deceased bodies of plague victims, furthering the infectious spread. People continued to get sick and die, and not just in Chinatown.
Though the disease was concentrated in the slums, it wasn’t thwarted by barbed-wire quarantines. As it became increasingly clear that the illness was real, the citizens of San Francisco realized Gage’s denial and shifting of the blame to Dr. Joseph Kinyoun were actively hurting people. The state’s conservative party refused his nomination, and Gage left office in 1903. He continued to blame Kinyoun for the barring of California goods in other states and the subsequent economic hardship.
The next governor, George Pardee, shared Gage’s concerns regarding public address of the situation but immediately took ownership of the situation. He removed health officials from the case and worked privately to provide medical attention, research, and eradication of the plague.
Some Of The City’s Treatments Actually Spread The Disease Further
Because the plague was not well understood, many of the treatments San Francisco health officials initially used to combat the illness actually made things worse. The quarantine, the first line of defense when the plague’s initial victim was found, concentrated the Chinese-American population in an area with poor sanitation and did nothing for the actual cause of the plague — the rats that were drawn there precisely because of the poor sanitation. The city also used carbolic acid in an attempt to rid the air of the alleged miasma, which drove rats out of sewers and into the streets carrying their plague-riddle fleas with them.
In addition, because relations between the Chinese people of San Francisco and the health officials were so poor, people in Chinatown started hiding the bodies of the deceased. Without proper disposal, the health crisis worsened. Nobody knew that the disease was mostly transmitted through flea bites, thus, nobody was doing anything to stop the spread. All of these factors combined to make the plague even worse.
Another Outbreak Occurred After The 1906 Earthquake
The first plague outbreak occurred from 1900 to 1904, but it wasn’t the last to affect San Francisco in the early 1900s. A second outbreak occurred in 1906 following the enormous San Francisco earthquake, which killed some 3,000 people and displaced 250,000 more. But people weren’t the only ones displaced.
As humans fled their damaged homes, so did infected rats. As they spread, the chaos of the post-earthquake city and the concentration of people in refugee camps meant that the illness was allowed to spread once again. This outbreak was even stronger than the first, but it was more quickly contained thanks to scientific advancements between 1904 and 1906.
The Second Outbreak Was Dealt With Far More Efficiently
While the second outbreak of plague hit San Francisco just two short years after the first one, it was handled much more quickly. Scientific advancements meant people better understood the plague’s transmission, and instead of quarantining infected people, Dr. Joseph Kinyoun’s replacement, Dr. Rupert Blue, targeted the rats. They were rounded up in great rat-catching efforts thanks to financial bounties, which ultimately prevented some of the spread and allowed scientists to test and kill infected rats.
Not only was the threat identified before the plague’s second time around, but the city government also could no longer scapegoat the Chinese residents of the city: all the victims of the second plague were white. Though anti-Chinese sentiment was still prominent, the blame couldn’t be shifted — it wasn’t miasma, diet, or any xenophobic cause, which meant it had to be dealt with scientifically and medically.
119 People Died In The First Outbreak
119 people died during the San Francisco plague outbreak, many of them in the concentrated, quarantined region of Chinatown. Without access to health professionals and pest control, infected victims spread the plague inadvertently but rapidly. Although it’s certainly a deadly disease, the city’s failure to isolate the actual cause and treat infected people ensured its spread and ability to affect more people.
Though it’s not the absolute deadliest outbreak in US history — the introduction of smallpox by European settlers killed almost all indigenous people in what is now North America, for example — the San Francisco plague is one that could have been prevented or had its harm minimized if those in authority had taken action.
Instead, it was allowed to fester in the city’s most impoverished communities, sowing further anti-Chinese sentiment.
Honolulu’s Chinatown Burned To The Ground When Authorities Attempted To Eradicate The Plague
The plague resurfaced in China on the backs of rats in the 1850s and wound up in Hong Kong. Chinese immigrants and imports often passed this way en route to San Franciso via port stopovers in Hawaii. Following one ship’s stop in Hawaii in 1899, a case of the plague broke out in the Honolulu Chinatown, spreading quickly to four more people. In an attempt to contain the plague and eradicate the conditions fostering its rapid spread, The Hawaii Board of Health isolated the victims and quarantined 14 blocks of the area complete with military guards. According to historical record, “To clear contaminated areas, the Board set 41 controlled fires, cleaned and disinfected buildings, burned garbage, filled old cesspools and dug new ones.”
However, when this failed to quell the problem and new cases of the plague arose, the Board set another fire which quickly spun out of control and resulted in all of Honolulu’s Chinatown burning to the ground. The problematic ships nonetheless continued to San Francisco where, because people on the ships did not show plague symptoms, they were allowed to dock. Along with humans also disembarked infected rats, carrying the disease straight into the port city.
The Mysterious ‘Sleeping Sickness’ That Plagued New York In The 1920s
Medical science has come a long way in the last hundred years, but that doesn’t mean every medical mystery has been solved. The cause of the mysterious sleeping sickness that struck New York in the 1920s, Encephalitis lethargica, remains unsolved to this day.
Originally called “the sleeping sickness” because the first few cases involved active people spontaneously falling asleep, it had a wide variety of symptoms and presentations. Some neurologists and pathologists believed it was an unusual manifestation of a concurrent flu epidemic, while others believed it was completely unrelated. It was also theorized that the mysterious illness was related to the polio virus, but nothing conclusive has been proven. This is despite the fact that the disease still pops up in isolated cases around the world.
From its first reported cases in 1915 to its abatement in the 1930s, Encephalitis lethargica is estimated to have infected half a million people in Europe alone. Those who survived often had crippling side effects, with some remaining borderline catatonic for the rest of their lives.
The sleeping sickness of the 1920s was never solved, but it has drawn the attention of scientists for years, including Oliver Sacks, whose work on the disease was adapted into the film Awakenings starring Robert De Niro and Robin Williams.
During The 1920s And ’30s, The ‘Sleeping Sickness’ Perplexed Doctors Around The World
In 1917, as WWI brought mass destruction like the world had never seen, two epidemics began tearing through the shell-shocked world. The first, which would become known as the Spanish Flu of 1918, remains one of the worst pandemics in human history, wiping out an estimated 50 million people and affecting up to half a billion. While this crisis understandably took precedence, it was accompanied by a lesser-known but far more perplexing virus: the sleeping sickness.
The sleeping sickness is believed to have originated in Romania in 1915, but WWI disguised its true impact in Europe. It became more noticeable in New York, and doctors across Europe scrambled to identify the disease. There was plenty of confusion, but no clear answers.
It Was First Described By The Prolific Austrian Neurologist Constantin von Economo
Due to the varied presentations of the disease, the overwhelming demands of WWI, and the appearance of other epidemics around the same time, many doctors treated individual cases of Encephalitis lethargica without realizing they were dealing with a wholly new illness. It took the work of Austrian neurologist Constantin von Economo to fully isolate and categorize the disease.
Economo was a wealthy aristocrat and a Renaissance man. He was the first Austrian man to hold the equivalent of a pilot’s license, and he was trained as an engineer before he moved on to psychiatry.
Economo gave the disease its name, based on what he determined to be its principal manifestation: lethargy and catatonia. In a series of monographs that are studied to this day, he argued his case on the nature of the disease from its categorization as encephalitis (an illness resulting from inflammation of the brain) to its varied pathologies.
Some Of The Afflicted Reported Feeling No Discomfort In Their Sleep
The sleeping sickness prompted, among other things, an examination of the nature of sleep and the difference between sleep and catatonia. However, there was a wide array of experiences reported, some of which were quite pleasant. Take this account, written by Eleanore Carey, who suffered from the illness in 1923:
After two months of illness I was in little pain, in fact… It was so heavenly just to be allowed to sleep, but these people around me seemed determined to prevent my being comfortable! When the idea finally crept through my sleeping brain that I must waken, it seemed to be a physical impossibility. I wanted to be obliging, but I just could not.
Other victims reported dreams and vivid hallucinations. Often, it was possible to wake the patient, but only for a few moments before they succumbed to sleep again.
Some Victims Perished Within Days, While Others Slowly Recovered
During the course of the epidemic, most doctors kept and compared rigorous notes. This allows us to examine a wide variety of case histories, although it is difficult to derive clarity from them because of the wide range of symptoms. However, one thing that does emerge is the unpredictable nature of the sleeping sickness.
One case study details a woman who suffered the sleeping sickness in 1917. She came to the clinic exhausted, and then slid further into somnolence. These symptoms were accompanied by a fever and the paralysis of her right arm. This woman seemed lucky, as her condition slowly improved, and two months later, she was discharged from the hospital with no signs of fever or paralysis. Unfortunately, she passed a month afterward due to pneumonia.
However, not everyone was lucky enough to stage a partial recovery. One young boy was brought to a clinic on April 20 already in a comatose state. He passed on April 28. Both of these cases were common, and there was no known indicator of who might survive and who might not.
Many Who ‘Recovered’ Developed Disabilities Later In Life
During its acute phase, the disease caused somnolence, lethargy, paralysis, fever, and sometimes ended the patient altogether. Some patients, however, made a full recovery, often without any treatment. While this must have come as a relief, the disease was not quite finished with them.
After recovery, many of these patients developed some form of Parkinson’s disease, a progressive nervous disorder that often causes the loss of various forms of muscular control. Parkinson’s can include wide variety of symptoms, and one of the most extreme forms was often seen in survivors of the sleeping sickness: akinesia.
Essentially, this means total body paralysis. Some of these patients remained in a paralytic coma for many years. Robert De Niro’s character in Awakenings, Leonard Lowe, is exactly this sort of patient.
Some Survivors Remained In A Sleep-Like State For Years
At various points during a case of Encephalitis lethargica, it is possible for the patient to fall into a deep, akinetic coma. Chiefly, this was experienced by people who thought they had completely survived the disease, only to develop a worsening case of Parkinson’s years later that culminated in the coma.
Because the cause of the disease was unknown, these comas were thought to be irreversible, and those who suffered them were largely forgotten, as long-term coma patients often are. However, when Oliver Sacks began treating them with L-DOPA, some of them were able to interact with the world for the first time in 40 or more years.
Awakenings’ Showed What Happened To Those Who Temporarily Recovered
Overshadowed as it was by the Spanish Flu and WWI, the sleeping sickness didn’t really come to the public eye until the renowned British neurologist Oliver Sacks wrote his groundbreaking Awakenings, a book that movingly detailed his interactions with patients who suffered from the disease. Sacks was responsible for the proliferation of L-Dopa, the medication that awakened many of these patients. In the book, he describes the challenges of bringing people from the 1920s into the 1960s.
The book was a massive success, and is still considered one of the best pieces of medical nonfiction ever written. It should come as little surprise, then, that it was adapted into a major Hollywood motion picture, starring Robin Williams as a fictionalized version of Sacks, and Robert De Niro as the man who wakes up in a new decade. After it was released, Roger Ebert wrote:
What both the movie and the book convey is the immense courage of the patients and the profound experience of their doctors, as in a small way they reexperienced what it means to be born, to open your eyes and discover to your astonishment that “you” are alive.
Nobody Knows What Caused It
Despite Oliver Sacks’s groundbreaking work with the treatment L-DOPA, there remains no complete cure for Encephalitis lethargica, as the medication often only provides temporary relief. It is perhaps unsurprising that there is no cure, because scientists don’t really understand what causes the sleeping sickness in the first place.
During the outbreak, there were many different theories as to the cause. When the disease first appeared in England, doctors believed that it was a form of botulism. However, botulism is the result of detectable bacteria, and the bacteria simply was not present. Many other theories were proposed regarding the mystifying disease.
At the end of the day, the truth is simply unknown. Papers are still written advancing various theories, but none have been proven or widely accepted.
Cases Continue To Pop Up Today
Because of the mysteries surrounding the illness, it is difficult to truly define when it began and ended. It is also difficult to identify whether there have been any new cases, although conventional wisdom says that at least a few more cases have popped up.
In 2015, a paper was published about a young boy who had contracted HIV. However, when he came to the hospital, he quickly developed symptoms similar to Encephalitis lethargica: lethargy, mutism, and muscular weakness of the optical nerves. There are numerous examples of similar cases, but cautious doctors are reluctant to label them as sleeping sickness.
Some Believe Adolf Hitler’s Parkinson’s Disease Was An Aftereffect Of The Sleeping Sickness
Adolf Hitler may be one of the most over-diagnosed individuals in human history. Due to his morphine addiction, his illness-plagued youth, and his high profile, modern doctors love to retroactively diagnose him with everything from borderline personality disorder to irritable bowel syndrome. While many of these assumptions are sensationalist and based on wild assumptions, there has emerged something of a consensus that the German dictator could well have suffered from Parkinson’s disease.
If that’s true, it is likely that he also suffered from the sleeping sickness in his youth. Due to the relatively late onset of his Parkinson’s disease and his age at the time of the epidemic, the sleeping sickness makes a great deal of sense as the source of his Parkinson’s. A medical paper also makes the case based on his symptoms:
Hitler had oculogyric crises [deviation of the eyes], phenomena only associated with post-encephalitic parkinsonism. In addition, he had dystonic facial spasms, palilalia and a sleep disorder, phenomena more likely to be associated with post-encephalitic than idiopathic parkinsonism.
President Wilson May Have Contracted It In 1919
It is always dicey to retroactively diagnose historical figures, due to both the lack of contemporaneous material and our own modern biases. This is made doubly difficult in the case of someone like Woodrow Wilson, who had a battalion of health issues independent of whatever we may diagnose him with today.
However, that hasn’t stopped a number of modern doctors and pathologists from using historical sources and medical records to diagnose Wilson as a sufferer of Encephalitis lethargica. Edwin Weinstein, one of Wilson’s most prominent biographers, believes that a complicated series of medical disasters accounted for Wilson’s famously altered behavior during the peace negotiations at the end of WWI.
Weinstein believes that after a number of strokes throughout his life, Wilson contracted the flu, which left him vulnerable to the sleeping sickness. Regardless, Wilson didn’t have long to live after the 1919 Peace Conference; he passed five years later in 1924.