Tuesday, September 24, 2013

Dr. José Rizal and Dr .Máximo Viola meet in Berlin, December, 1886.

Dr. Máximo Viola’s braided narrative* of his Meeting with Dr. José Rizal in Berlin

Berlin, December 3, 1886. 

I remember leaving the Paris rail station.  The Eiffel tower's foundation-scaffolding built by Engineer Gustave Eiffel dominated the skyline. Ever so slowly, it receded behind me leaving tumbles of steel and spire.

All day long in my train compartment, I passed through a range of picturesque hills—steep, wooded, conic-shaped. Here and there dwellings and rugged crags with ruinous castles perched away and up toward the drifting clouds.    

Berlin was driving cold. Strong gusty winds blew snowdrifts along the tracks. Snow on the ground produced grey misty hues that traced the trees’ bare branches against the whitish-purplish fog that muffled the city sounds.

It was almost midnight when I arrived at José Rizal’s boarding house on 71 Jägerstrasse, corner of Friedrichstrasse., Berlin.  In the center of the city and a short walk from the train station, I reached a modest looking brick house with a grey façade adorned with a couple of dormer windows on the upper level attic floor.

I stepped out elegantly from my chaise dressed in a sartorially fit winter outfit.[1]  I proudly carried with me a brand new medical satchel--the standard handbag size--containing basic medical instruments and necessary vials and prescription pills.  I had it tooled of Cordoba leather and engraved with my name, Dr.[2] Máximo Viola, Médico-Cirujano.

I went up four flights of stairs to his 3rd floor flat and I met an unshaven person in dishabille who could hardly stand. I couldn’t have come at a most inappropriate time. José Rizal was nursing a fever. I noted his sallow skin, sunken cheeks; droopy lips, and bloodshot eyes. He told me he felt “awful.”  I insisted that he stay in bed. I promised to come back and visit him early the next morning.  I left immediately and checked in at Central Hotel on Unter den Linden Boulevard, a few blocks away.
The following morning there was a loud knock on my door. Rizal was at my doorstep.  He did not wait for me to come, but instead had come to my hotel to fetch me.  I dressed quickly and we went to his apartment to analyze his ailment that he had outlined to me the previous night.

The room had green shuttered window frames where light filtered in. Books cluttered his bed. Crumpled papers were strewn about like breadcrumbs on a baker’s counter. The wastebasket was a waterfall of sheet papers. I planted my medical satchel bag on the table nearby and fished out a stethoscope and a thermometer. I faced my patient squarely.

“Now,” I told him sternly and with pompous authority,  If you don’t mind,  I am your newly minted medico and you, Sir, are my first personal (not practice case) patient.” [3]

“I don’t mind,” said my first private patient feebly. It didn’t matter that Rizal himself was also a newly minted medico.  However in this case I lorded it over him and Rizal was too sick to object to being the object of my professional medical examination.

“Peping,[4] open your mouth.  That’s good! Healthy tonsils. But your throat is slightly irritated, indicating signs of coughing! Let’s have your temperature. 106 degrees F.  You’re running a fever although your pulse rate at 78 is borderline normal.”

“Weight 119.6 lbs.”  I shake my head in disbelief. He had lost weight considerably since I last saw him.

“Blood pressure:  156/69.” 

“No lymph nodes felt around the carotid artery. The parotid gland in the angle of the jaw and neck seem normal. Lungs seem fine, but there’s a brand new way of examining the lungs by getting transparent images called Roentgen.  We’ll see about that later. Suffering any pains?”  

My bedside manner is standard textbook material.

“Yes,” he replied and continued talking:  “I have a slight chest pain because of strain from intermittent coughing.  I run a fever every afternoon, for almost two weeks now, accompanied by heavy sweating.  I believe that’s a sure symptom of Tuberculosis. I tell you, when I was a child I was diagnosed as having the likelihood of incipient TB.” [5] 

“Leave the medical evaluation to me, and please don’t self-diagnose. That’s insane,” I said in a gentle reproach.   

“Likelihood” I emphasized, “is not the same as-- suffering from.  Have you observed any spot of blood in your sputum when you cough lately?”

“Not really.”

“Has any of your ancestors or near relatives ever died of tuberculosis?”

“None that I know of.”

“Pues, I see that your lungs are healthy. It may be TB but I’m certain it is not. I categorically dismiss your self- diagnosis. But I’ll see to it that you are referred to a German doctor who can give you a second opinion.” [6]

“A ver, you have lost weight since I last saw you, and did you say you feel tired most of the time?”

“That’s because I go to the exercise gym daily for routine weightlifting, on a dare, of course.” [7]

“Mind that you’re not mis-using your exercise routine.  Do you have a trainer to supervise your daily exercise? You may be over-exerting yourself.”

“No, that’s unnecessary. I know what I'm doing. Going to the gymnasium has been a favorite pastime of mine ever since Madrid and Paris days.”

 “But your workout alone does not explain your drastic weight loss. By the way, what did you have for breakfast today?”

“Oh, breakfast! I forgot all about breakfast.”

“Well, what did you have for dinner last night?”

“The usual water and bread, no butter. You know, that’s a healthy meal.”

“Peping, yes, healthy, only if done occasionally.”

“Indeed, friend Imô, I do, occasionally.”

 Now, what’s the immediate cause of these sunken red eyes and dark circles?”

“Oh that.  I’m busy staying up to the wee hours of the morning.  You see, I’ve just completed writing this manuscript [8] that I earlier told you about, and I’m in the process of the final edit.” [9]

“Then, you need to seriously alter your work habits that should include a good night’s sleep for at least five hours daily, until your general fatigue and afternoon fever dissipate.”

Well anyway, what do you think of my coughing, fever, afternoon sweating and general fatigue and drastic weight loss?  It looks clinically symptomatic of Phthisis to me, Señor Doctor Médico Máximo Viola.”

You, my esteemed friend, are suffering from a psycho-socio-economical and structural aberration of the body-environs, complicated by an over-extension of physical, unguided, and benighted kind of bravado.” [10]

Rizal couldn’t suppress a loud laugh. “Your words are well couched in diplomatic language, amigo, old chap.  Any medical prescription, Don Máximo?”

I need to ask you first what kind of medication you had prescribed for yourself.”

The usual Fowler’s prescription.” [11] Rizal answered.

Fine.” I replied,  “Keep the dosage light on the arsenic and continue taking it, but meanwhile my prescription is simple. Let us to go inmediatamente to a nearby restaurant.  I’ll make sure you join me everyday for a week to take a restorative menu at a restaurant [12] of my choice.   I need to monitor your actual meal measurement intake of lean body mass or nitrogen balance for at least two weeks. That’s doctor’s orders.”

 “And the next week, it will be your turn to take me to the restaurant of your choice.  Now, take your hat and cuerpo frock coat and let’s go out for a stroll.  The air is freshly crisp outside.”

I ordered extra coals from the concierge to make sure the apartment is toasty and warm upon our return. It had been freezing cold in Rizal’s room.

We entered a restaurant nearby and sat down for a meal.  I said,  As of today, let’s go easy on the rich food.”

I ordered the following for Rizal: 
Soup, [13] Bratwurst, Rotkohl, (red cabbage) Kartoffel (boiled potatoes) mit Sosse (sauce) und Weizenbier (light beer).

For myself, I ordered; 
Kraeuterhackbraten, Gemischtes Gemüse, (varied vegetables) Kartoffelpuree (mashed potatoes) mit Sosse (Sauce) und Wein (wine). [14]

What a perfect medical prescription for a malnourished and starved José Rizal, and it sure is delicious!
Es Schmeckt sehr Gut! 
Returning back to his room, I dipped into my breast pocket and handed him the diamond solitaire ring  (Saturnina’s) that he requested me to pick up from Juan Luna, the Filipino painter, from his art studio in Paris. 

*  Don Brennock, of Dublin suggested I should change the wording "braided narrative" to "have interwoven Viola's memoirs with Rizal's journals and letters..." email 14 Oct. 2013.  I replied that I like his suggestions.

[1] In a letter to Rizal, dated 21 October 1886, Viola asked if his Madrid winter outfit would be serviceable in Berlin. “Tell me… if the suits I wear in Spain can be worn there in winter, or if, by wearing them, I would be looked upon in Germany as a Spaniard, that is, backward…” p. 65.  We do not have a record of Rizal’s reply, but Viola arrived Berlin with a new set of winter clothes.
 [2] Ibid.  Viola mentioned in this letter that he had matriculated for the doctorate.
[3] I thank my brother, Dr. José Villarica, Jr. (Dr. Máximo Viola’s grand nephew), for suggesting this mock-up physical examination of Rizal based on historical records.
[4] Among friends in Madrid, Rizal was called Pepe.  Only among close friends is the familiar Peping used.
[5] See Rizal’s letter to Blumentritt dated 9 December 1886. “When I was still a small boy, the physician at Ateneo Municipal said I had incipient tuberculosis.”  José Rizal’s Correspondence with Blumentritt, NHCP, 2011, 30. Vol.1. 
[6] Viola referred him to a German doctor who confirmed his medical opinion. See Mis Viajes, 
[7] He had challenged his friends at the gym that he could lift the heaviest load during their practice.
[8] Rizal was working on the final chapters and editing the novel Noli me Tángere.
[9] See Máximo’s letter of 21, October 1886 in answer to Rizal’s request for canvassing cheap printers in Barcelona, NHI, 2011. José Rizal’s Correspondence with Fellow Reformists, pp 64-65.
[10] Viola soft-pedals his diagnosis to mean, “Malnutrition compounded by an overdose of weight lifting daily regimen” hidden in obscurant words. This reflected Rizal’s financial difficulties at the time. This is not the first time Viola shows his friendly loyal and diplomatic language when he refers to his friend, José Rizal.  (See his Mis Viajes con el Doctor Jose Rizal, 1913.)
[11] A mild form of arsenic.
[12] The etymology of the word restaurant came from the French language meaning a restful restorative health repast.
[13]Potato soup with dumplings,  
[14] Roasted Pig knuckles, prepared a little like the Tagalog national dish of “Crispy Páta” This was what I ate when I first arrived in Berlin on Oct 1st, 2012 with my Knights of Rizal hosts, Sir Gerhard Müller, and Lady Lulu.

No comments: