Flannery_ A Life of Flannery O'Connor - Brad Gooch [88]
A disorder in which the immune system forms antibodies that attack its own connective tissue, causing chronic inflammation and often affecting multiple organs, systemic lupus erythematosus (SLE), with no certain viral or genetic trigger, remained nearly as elusive to her doctors as it had in her father’s day, due to a confusing array of possible symptoms. While syphilis, treatable with penicillin, had earned the title “the great imitator” in the nineteenth century, lupus, frequently misdiagnosed as rheumatoid arthritis on first examination, inherited this same distinction by the early fifties, because no two patients exhibited exactly the same symptoms. Like a more virulent undulant fever (“It’ll keep coming back,” Dr. Block warns in “The Enduring Chill”), the disease complicated matters by oscillating between “flares” and “remissions.” As Flannery later wrote to Robert Lowell, “It comes and goes, when it comes I retire and when it goes, I venture forth.”
Since the disease could compromise joints, blood vessels, lungs, kidneys, heart, or brain, its diagnosis involved identifying at least two to four items on a checklist of nearly a dozen symptoms, including rashes, high fevers, photosensitivity, oral ulcers, hema-tologic disorders, and arthritis. Suffering from a severe case, Flannery manifested a number of these markers during her great “flare” of 1951. Of the disease that often announced itself with a wolfish rash across the bridge of the nose, she reported, in 1957, to a friend, “I have not had the rash in several years.” And she wrote to Maryat Lee, “When I was nearly dead with lupus I had these sweats. They are a sign of serious chemical imbalance.” Indicating a low white blood cell count, she recalled, “In ’51 I had about 10 transfusions.” Most obvious, in her case, were the painful, inflamed joints of arthritis.
The lifesaving treatment Dr. Merrill prescribed was a high dosage of ACTH, or adrenocorticotropic hormone, derived from the pituitary glands of pigs. She would eventually sing the praises of this natural hormone, discovered by the same group of scientists who had developed cortisone for treatment: “I owe my existence and cheerful countenance to the pituitary glands of thousands of pigs butchered daily in Chicago Illinois at the Armour packing plant. If pigs wore garments I wouldn’t be worthy to kiss the hems of them.”
As a corticosteroid — one of the hormone groups generally produced by the outer part, or cortex, of the adrenal glands on top of the kidneys — ACTH stimulated the body’s secretion of cortisone. Yet all such new cortisone-related treatments, especially at high doses, had potent side effects. “I was an intern at Columbia Presbyterian Medical School, in the fifties, when cortisone came into widespread use in hospitals,” says the psychiatrist and O’Connor scholar Robert Coles. “One gets stirred by cortisone. I don’t want to turn this into a federal case, or an interpretation of her writing. But the drug that was saving her life was also, to some extent, stirring her body and mind.”
Flannery certainly felt this stirring, lying ravaged in an Atlanta hospital bed, her hair having fallen out during high fevers, her face bloated and “moon-like” from the cortisone. As she later described the mental over-stimulation to Betty Hester, “I was five years writing that book and up to the last I was sure it was a failure and didn’t work. When it was almost finished I came down with my energy-depriving ailment and began to take cortesone in large doses and cortesone makes you think night and day until I suppose the mind dies of exhaustion if you are not rescued.”
She imagined a connection between the disease and the novel that she had worked on so strenuously. By a sort of magical thinking, propelled by the treatment — “the large doses of ACTH send you off in a rocket and are scarcely less disagreeable than the disease” — she wondered if she