Volume 1, Issue 4 - August 2009
By Philip Liebson, MD
In the September 16, 1940 issue of TIME Magazine an intriguing obituary was found:
After a patient wait, death came last week to Hans Zinsser, bacteriologist, physician, philosopher, poet, ironist, historian, raconteur. At 61, he died of chronic leukemia, a slow-moving, mysterious disease of the blood for which there is no known cure.
By many, Dr. Zinsser was regarded as the world's leading authority on typhus, the ancient plague which is now known to be virus-borne by human lice and rat fleas. Five years ago, in " Rats, Lice and History," he traced with surprising charm the red-brown spots of typhus across world history. This year he announced a method for mass production of a typhus vaccine.
Hans Zinsser was born in New York City of German parents from the Rhineland. His father was a prospering chemist. The young man went to Columbia, decided to be a writer, switched to biology, then to medicine. When he saw that most of his patients were scared by his fanatical thoroughness, he turned to research and teaching.
During World War I he went to Serbia to fight the typhus which ravaged that country after the Austrian invasion, later served with the US Army in France in the Medical Corps.
For the past 17 years he was professor of bacteriology at Harvard, periodically traipsed over the world in pursuit of his typhus research. He once caught the disease himself, was restrained from jumping out of a fourth-story window, he said, by a devoted nurse.
An affectionate, voluble, energetic, terrierlike man, Hans Zinsser had a strong fondness for wine, women, horses, books. Two years ago, returning from a junket to China, he noticed that the sun on ship board turned him not healthy brown but lemon yellow. He knew then that there was something serious with his blood. Back in Boston, he consulted a colleague and friend, who told him, with "affectionate abstinence from any expression of sympathy," that he had leukemia.
Looking out at the white sails on the Charles River, Zinsser realized that he was going to die. A great lover of life, he began soon to fall in love with death.
This summer Dr. Zinsser published a transparently disguised autobiography called "As I Remember Him—The Biography of R. S." (TIME, July 1). The initials R. S. stood for "Romantic Self." In that book Zinsser revealed that he was an agnostic, that he did not know what lay beyond the last door. But he said that the imminence of death had made his perceptions keener and lovelier.
"When he awoke in the mornings," he wrote of himself, "the early sun striking across the bed, the light on the branches of the trees outside his window, the noise of his sparrows, and all the sounds of the awakening street aroused in him all kinds of gentle and pleasing memories of days long past. . . ."
Only a month ago Dr. Zinsser still went to his laboratory every day, jaunty and gay. But he knew the end was near.
He was taking X-ray treatments [at New York’s Memorial Hospital] which did no good. In mid-August, he [again] entered Memorial Hospital under the care of his friend Dr. Cornelius Packard Rhoads.
Thirty-six hours before he died, Hans Zinsser lost consciousness.
In his last sonnet he had written: "How good that 'ere the winter comes, I die!”1
But what did the initials RS really stand for? This was a mystery which was unresolved - Romantic Self? Romantic Scientist? Real Self? Or the initials of someone he admired? A character of fiction? Or a childhood memento?
Here is someone who could easily be a role model for Strauss’s Ein Heldensleben. He lived during a pivotal time in medicine – the year he was born was the year of Karl Rokitansky’s death, William Welch was studying pathology in Germany, the classification of bacterial organisms was 6 years old, Edison had just invented the phonograph and the Congress of Berlin was attempting to separate the Ottoman Empire from the Balkans.
Of Welch he said, “the greatest of these [leaders of the transitional period]. Without him, American medicine might have taken much longer to develop. The thought of him warms my heart with affectionate reverence for that fusion of wisdom and courtesy which is as rare as genius.”2
Getting back to Ein Heldensleben, here was a man who could write poetry for the Atlantic Monthly under the initials R.S., write textbooks of bacteriology through many editions, write a popular history of epidemic disease to rival Paul de Kruif’s Microbe Hunters, and tramp through some of the most desolate and plague infectious parts of the world for epidemiologic discoveries. His work included investigations into the etiology, pathogenesis and possible vaccine against typhus but also into antigen-antibody reactions, characterizations of viruses, and investigations into typhoid, leprosy, tuberculosis, syphilis and influenza.
The year he died, Florey and Chain developed the first usable form of penicillin, the first vaccine for typhus was 3 years old, just enough time to be available for use in World War II, the first synthetic anti-malarial, chloroquin, was used, and on the day of his death, the Luftwaffe was bombing London.
In the span of his lifetime medicine had developed a scientific backbone, Medical Institutes had been initiated to develop and undertake research techniques, the curricula of US medical schools had been revolutionized after the Flexner report in 1910, and from Zinsser — “Oh, Abraham Flexner! We hail you as the father – or better, the uncle - of modern medical education in America. You did, on occasion, hit below the belt, yet in the spirit in which the Christian knights slashed off the infidels’ heads while shouting 'Kyrie Eleison!'—”3
The concept of the medical center was just 12 years old at the time of Zinsser’s death. The Columbia-Presbyterian Medical Center (It was called The Medical Center) had opened in 1928 and the New York Hospital-Cornell Medical Center in 1931.
Like many men of science and medicine of his day, he had a comfortable upbringing. His father was of the liberal German background from the Rhineland for which the revolution of 1848 was a disincentive to remain. His father in fact was an industrial chemist. Zinsser grew up in Westchester, NY, among private tutors, governesses, maids, riding lessons, and trips to the Continent when it was THE continent.
The family also had a town house near Central Park, in which he did much sledding. He spent one winter with an uncle in Lake Maggiore with the appropriate tutors and another at a school in Germany preparing German students for Oxford and Cambridge, where, in fact, he really began to learn elegant English, since he spoke predominantly German until he was 10. His prep school was in Manhattan, one that his father thought would represent the best tradition, at a brownstone on 59th street, run by Julius Sachs, a German-Jewish democrat. Both Jewish and non-Jewish students were there because of their admiration for German culture. It was under Sachs' tutelage that Zinsser’s English further became fluent and elegant.
Although initially, at Columbia, the group he was drawn to was “bawdy and idle,” specializing in drinking and pool playing. However, after sending some verses to The Spectator, the college newspaper, he was drawn to a more artistic crowd.
He was introduced to poetry and essay writing at Columbia by George Woodberry, whom James Russell Lowell had dubbed “the American Shelley.”4 Although his initial interest was comparative literature and letters, he was introduced to science by Edmund B. Wilson, not the man of letters but one of the founders of developmental genetics, in Schermerhorn Hall, the biology building. It would have been interesting to have seen how Zinsser would have interacted with the other Edmund Wilson. Through Wilson, Zinsser became interested in experimental biology and cytology.
While Zinsser was still in college, the Spanish-American War, catalyzed by Citizen Hearst, stimulated Citizen Zinsser to join a cavalry squadron, which, unfortunately never got to Cuba, but allowed him to escort Theodore Roosevelt to his New York governorship inaugural.
When he became a student at Columbia’s College of Physicians and Surgeons in 1899, two of his classmates were Oswald Avery, later a pivotal research geneticist at the Rockefeller Institute, and Joseph Thomas, the father of Lewis Thomas. The College of Physicians and Surgeons at the time was located on West 59 St. in Manhattan and was associated with the adjoining Roosevelt Hospital. There was no Medical Center, and Presbyterian Hospital was somewhere northeast on Park Avenue. It is interesting that while in Medical school, Zinsser worked with radium on bacterial survival for an MA degree. Could this exposure have had some effect on his developing leukemia?
In 1903, when Zinsser graduated from Medical School, a “fresh breeze was blowing across the horizons of scientific thought” in American Medicine. Medical research was beginning to "blossom forth” and “the spirit of investigation was carried into hospitals and clinics.”5 In 1901, the Rockefeller Institute was organized, and a few years later the Flexner Report established a framework for analysis of the quality of medical education based on the transformation of medicine into a more scientific discipline. However, as Zinsser noted, “if the stubborn insistence of a few die-hards upon the superiority of eyes, ears, and hands over the test tube and the retort was occasionally irritating and obstructive it had - on the other hand - the beneficial effects of saving from complete neglect the traditions of the personal art and skill of mind and hand without which the scientific medical training must remain impatiently applied to the problems of the bedside.”6
Zinsser interned at Roosevelt Hospital, which in New York in those days was equivalent to an internship at Johns Hopkins or the Brigham. It was the hospital in which Dr. Charles McBurney, of appendectomy fame, operated. Zinsser was not the only poet who interned in Roosevelt Hospital, so did William Carlos Williams.7
While on the ambulance service at Roosevelt Hospital as an intern, he was involved in managing many suicide attempts in the Hell’s Kitchen district on the West Side of Manhattan:
"Another carbolic candidate ignorant…Of the fact that alcohol is an antidote, walked into a saloon near the hospital one night, asked the barkeeper for a double whiskey, then pulled out a little bottle from his pocket and, saying to the bartender, ‘Well, Bill, this is the last drink I will ever take.’ Swallowed the contents of the bottle and followed it with a large dose of bad whiskey. He then sank to the floor-purely because that seemed the proper thing to do. When I got there a few minutes later and washed out his stomach, he was considerably annoyed because I made so little fuss about him."8
He had entered medicine only with the eventual hope of becoming an investigator of infectious disease. While obtaining a part time job as a bacteriologist in a hospital laboratory at St. Luke’s Hospital, he went into a practice with “a born doctor."
“He had the not unimportant asset of a blond moustache that looked as though it belonged to his face naturally…” Unfortunately, “my great fault, aside from my youthful appearance, was my excessive thoroughness.” Once observing Zinsser at his examination of a patient, one of his mentors said to him, after rounds: “My boy, you seem to know your stuff; but you will never make a great doctor until you pay a little more attention to the psychology of your patients…All patients, especially women, expect the doctor to act as though they were really sick...Pat the hand and say ‘Brave little woman’…say nothing deliberately and slowly, with the air of withholding great deal. Then give them…a lot of laboratory examinations.”9
Zinsser was certainly thorough. A patient seeing him with a sore foot might be subjected to questions about whether there was tuberculosis in the family, venereal disease and questions about appetite, a thorough physical examination including ophthalmoscope examination and percussion of the liver, and every case must have a Wassermann - he had just learned to do a Wasserman reaction. “No one tells the truth about such things.” Most of his patients walked out at one stage or the other, because “we didn’t get down to the sore foot.” However, thoroughness in his practice was a trait necessary for his future research career. A friend of his leaned toward “snap diagnoses.” One day, a middle aged coachman came to see Zinsser’s friend complaining of stiffness and a sore throat. Zinsser’s friend prescribed a gargle. The next day the man was back with his throat more stiff. Again he painted the throat with iodine in glycerin, and a reassuring pat on the back. Two days later the coachman came back again with difficulty in opening his mouth, “You know, doctor, if you didn’t say I was all right, I’d think that I might have lockjaw.” "Good god man," cried the friend in consternation, “why didn’t you tell me that in the first place?”10
While finishing his residency, Zinsser met and married Ruby Handforth Kunz, whose parents also came from Germany. She was a painter and sculptor, excelled in foreign languages, was an insatiable reader of poetry, and rode horses easily but not passionately as did Hans.
In 1910, Zinsser was interviewed by David Starr Jordan, President of Stanford, for an academic position. He interviewed him in Jordan’s hotel room in New York while Jordan was dressing. “David Starr Jordan was a big man in more than his feet. The old man was making heavy weather of dressing while we talked…it may well be that I owed my first professorship to the holding up of the President’s pants more than to my scientific achievements…the rear of him looked pathetically like an elephant’s hind legs, and stirred a warmth of filial friendliness in my heart.”11 Jordan, a biologist himself, was famous - not to say infamous - for his preoccupation with his field of specialization, ichthyology - the study of fishes. When Zinsser took up an appointment at Stanford as Associate Professor of Bacteriology, he was given advice by Jacques Loeb on how to get along with President Jordan: “If you wish to be a success at Stanford, work on fish. Jordan himself, when he works at all, works on fish....[T]he physiologist... works on fish....The geologists, the paleontologists, the botanists, the English department, the Romance Languages, even the philosophers - they all work on fish. Go there, my boy, be happy, and work on fish.”12
Although Jordan was a teetotaler, Zinsser had the assignment of preparing his acidophilus brew, which he did with an alcohol-producing yeast, thus making the teetotaler a beer drinker.
Of Stanford, Zinsser remarked: “(It) has left many memories which have little academic bearing. To me, it was a paradise of cheap horses in which the toughness of the bronco has been preserved in mixtures with the noble breeds…”13
Although his office was 14 x 16 feet with lab and kitchen included, it took 2 years before provision was made for experimental animals. Zinsser was a high profile academic - his lectures were witty, stylish and popular. He became an accomplished pursuer of experimental lambs, both animal and man frequently leaping out of the lab windows. He went from home to lab stylishly as well with horse and buggy. He fenced with his students and raced them with horse or bicycle.14
After several years at Stanford, he was offered the position of Full Professor and Head of the Bacteriology Department at Columbia, an offer he could not refuse, although wanderlust led him to join several commissions while at Columbia to combat epidemics in Serbia and Russia.
In March 1915, during the first year of World War I, with Serbia fighting Austria-Hungary, there were about 150,000 cases of typhus in Serbia, with a death rate close to 70%. The epidemic started in early 1915 among the troops on the Belgrade front. Infection traveled southward. There was a shortage of shelter, clothing food and fuel, and large numbers of Austrian prisoners aggravated the situation, with 35,000 of these dying of the disease.
Zinsser felt that he ought to get into the war in some capacity and participated in the Red Cross Typhus Commission in Serbia in 1915. Of that experience he remarked:
"I find…that my reminiscences of the Serbian typhus epidemic of 1915 [was] as terrifying and tragic an episode as has occurred since the Middle Ages, are on the whole rather prosaic and completely…unconvincing of that heroism which the Arrowsmith type has made us so familiar in prose and cinema, and which, despite Paul de Kruif and other, I have never - thank God! - observed in any of my numerous professional colleagues in action."15
Efforts were made by the commission to delouse entire villages. “But to delouse the Serbs, at that time, was as hopeless as exterminating the ticks on Cape Cod - which incidentally may become a real problem in itself before long.”16 (He was thinking of Rocky Mountain Spotted fever, not Lyme disease).
He was assigned to a typhus hospital run by a British unit. “Life in the [unit] was at first difficult. We Americans were accepted as members of the staff…but the word 'welcome' as we understand it did not apply. I took great pains to be polite…these overtures were met with cold stares…I was fed up, became silent…and sat down to meals without a word. A few days of nasty manners proved that I belonged to the better classes.” He was asked once by his neighbor, a British major, who was sitting next to him at a luncheon given at the British Army Medical College, “Major, how much German are you by blood?” It was a dreadful question to ask at that time, and at a military mess. Zinsser responded, “I believe, sir, that I am just as German as the King of England.”17
During the First World War he volunteered as a major, then a colonel in the Medical Corps. However, after the War, he was glad to be back to his laboratory.
In 1923, the Health Section of the League of Nations invited Zinsser to go to Russia as a Sanitary Commissioner. Russia at that time was passing through a sanitary period not unlike that prevailing in Europe during and after the Thirty Years’ War, with 30,000,000 cases of typhus and 3 million deaths, and the most devastating famine since the Middle Ages. “Basically, the Revolution had not changed the Russian character. Procrastination and inefficiency remained. Only now it was devoid of any of the formality and good-natured courtesy which prevailed in other days. Also, the disorder and sloppiness which were everywhere obvious were being inexpertly disguised by a pretense of bustle and much talk.”18
Zinsser moved to Harvard in 1923 to become Head of the Bacteriology and Immunology Department. As head of the department , he fostered a collegial and productive faculty.
Much of his time over the next decade was spent in finding approaches to a vaccine for typhus and field trips to such places as Serbia, Mexico and China, where he researched its epidemiology.
His researches lead to the discovery of a variant of typhus in European immigrants to America — Brill-Zinsser disease, a mild recrudescent form of typhus produced by the same rickettsial organism.
When Zinsser arrived at Harvard he was seated at a dinner next to the ex-president of Harvard, Charles William Eliot, who was then in his late 80’s. According to Zinsser, “His inquisitiveness was flattering. ‘How old are you? Where were you educated? How long have your ancestors been in America? Where were you born? Are you married? How long were you at Columbia? Why did you leave? What was your salary at that time? What is it now? Did you take a smaller salary here because you have money of your own? Why did you leave medical practice to become a bacteriologist?’”19
Zinsser had some astute comments about Boston: “Boston is a much maligned town. I’ve lived here some 18 years…and being a rank outsider, have been let into the secrets that hereditary members of the various clans take the greatest pains to hide from each other. No Mr. O’Neill, though I hate to contradict a man to whose genius I do homage, I’ve not run into a single case of incest in all that time.”20 Of John Marquand’s Bostonian characters, whom Zinsser admired: “his characters might have been from the Chicago lakefront, or the banks the Monongahela, had it been Mr. Marquand’s misfortune to be born in Pittsburgh.”21
“Harvard and the New England states in general possess some subtle quality which gets under the skins of the rest of the country. However, let me challenge Mr. Marquand to try to catch a louse in Boston (Zinsser was trying to collect lice for his studies). There are unimaginable difficulties. One cannot accost likely groups of people, even in clinics, and say ‘Do you mind if I examine your head to see whether you are lousy?’”22
Zinsser spent the summer of 1928 in pursuit of his typhus studies in Tunisia in the company of Charles Nicolle, himself an eminent bacteriologist. It was Nicolle who was awarded the Nobel Prize for Medicine for demonstrating that lice transmitted typhus.
In the summer evenings with a cold breeze coming from the Gulf of Bizerte, they discussed among other things relapsing fever, trachoma, dysentery, brucellosis, Carthaginian archeology, Roman mosaics, medieval legends and French encyclopedists. It was Nicolle who was one of the first to assert that influenza was caused by a virus while other noted experts were pursuing various bacteria. Nicolle, a wide-ranging intellect like Zinsser, had written a novel, and works in history and philosophy. Nicolle had some comments about Moslem culture which he considered arrested after the 12th century: “How can a man with four wives do any constructive thinking?”23
In order to evaluate the role of the rat in spreading typhus, Zinsser brought some typhus infected rats aboard a ship to Mexico to compare the strains with sporadic typhus in the Mexico City area. Typhus cases had been occurring in Mexico and the Southwestern United States sporadically and the young American epidemiologist Kenneth Maxcy, upon investigating these cases, questioned whether rats could transmit these cases of typhus rather than lice. These cases were similar to the characterization of cases seen in the highlands around Mexico City investigated by his colleague Mooser. This condition spread by rat fleas instead of lice with the organism named Ricklettsia Mooseri was termed Murine typhus, which is less virulent than classical typhus.
On board the vessel from New York, Zinsser struck up an acquaintance with the poet Hart Crane, who, when off the Brooklyn Bridge, was usually intoxicated but charmingly gregarious. Zinsser let him in on his cache of rats, which of course was hidden from the ship’s crew. Hart Crane was fascinated by the rats and watched as Zinsser surreptitiously dumped some dying rats into Havana harbor when the ship docked there. The next morning, Crane, in one of his gregarious moods began to recite poetically to the Ship’s first officer
The Doctor has thrown rats into the harbor of Havana
The doctor has thrown typhus rats into the water,
There will be typhus in Havana
The doctor has thrown rats into the harbor.24
Crane was in one of his post-alcoholic states and was known to see animals when they weren’t there. It was obvious to the First Officer that Crane was confabulating. Perhaps it was also Crane’s declaration to the officer that he was a poet. It was on the return voyage from Mexico that Crane committed suicide by leaping into the sea off the coast of Yucatan.
In the search for an immunization against typhus, Zinsser and Maximiliano Ruiz Castañeda, his collaborator in Mexico, in 1932 discovered antibodies in the blood serum of typhus patients. The scientists knew they needed large quantities of microorganisms to produce a vaccine, so they infected chick embryo yolk sac tissue with Rickettsia. This tissue was used to inoculate normal chick tissue which was then grown on the surface of agar in flasks. Zinsser's work led to new tissue culture methods still used today as standard laboratory procedures. The typhus vaccine developed by Zinsser and his coworkers contains dead Rickettsia, which carry markers called antigens. These antigens spark an immune system reaction whether they are alive, weakened, or dead. Since the vaccine contains weakened or dead organisms, the person experiences a mild reaction, but does not develop typhus.
Zinsser had comments on various topics and I would like to present them in various categories. These came from Rats, Lice and History and his autobiography.
|Charles Nicolle (left), to whom Hans Zinsser (right) dedicated Rats, Lice and History|
From Rats, Lice and History: “We have chosen to write the biography of our disease because we love it platonically — as Amy Lowell loved Keats — and have sought its acquaintance wherever we could find it. And in this growing intimacy we have become increasingly impressed with the influence that this and other infectious diseases, which span — in their protoplasmic continuities — the entire history of mankind, have had upon the fates of men.”25
Consider the louse: “To the louse, we are the dreaded emissaries of death. He leads a relatively harmless life;...then, out of the blue, an epidemic occurs; his host sickens, and the only world he has ever known becomes pestilential and deadly…he is transferred to another host whom he, in turn, infects. He does so without guile…with death already in his own entrails. If only for his fellowship with us in suffering, he should command a degree of sympathetic consideration.”26
As for rats: “[T]he natural history of the rat is tragically similar to that of man...some of the more obvious qualities in which rats resemble men — ferocity, omnivorousness, and adaptability to all climates...the irresponsible fecundity with which both species breed at all seasons of the year with a heedlessness of consequences, which subjects them to wholesale disaster on the inevitable, occasional failure of the food supply... [G]radually, these two have spread across the earth, keeping pace with each other and unable to destroy each other, though continually hostile.”27
“In America, the professor never held the respected position occupied by his European colleague. The title was too often shared in our country by cornet players, boxing instructors, and dog trainers...in many smaller colleges the teacher was a sort of underpaid employee of a president…and board of trustees who regarded him as something more than a janitor and a little less than a football coach.”28
“Th(e) resolution of the medical division of general biology from a meagerly scientific art into a true applied science had begun slowly, like a chemical reaction at low temperature…It gathered velocity progressively, until, at the time when I was ready to enter my hospital service, its forces and reactions were beginning to pervade all phases of medical activity from the premedical laboratories to the wards of hospitals…”29
In regard to research however, and institutional pressures, Zinsser had some observations that remain currently relevant: “There has been…a good deal of personal and institutional rivalry, growing as public interest increases…Positions are gained by volume of output, as much as by quality. And vanity plays a part rather more important than financial or worldly gain. To be just to scientists themselves…the most serious delinquencies of this kind committed in our country in the last decade or so must be laid at the doors of administrators and directors impelled by desire for institutional advertising.”30
No, this was not written in 2009 but in 1939. He continued, “…the pressure of premature publication has ruined a considerable number of good men.”
“The investigator tests…the trellis of theory…built up beyond the solid stakes of fact. [He is] perched on scaffoldings of experiment which break down again and again...Eventually, as soon as he has tied down an elusive shoot, he loses interest and is lured by the ones a little higher up. There is never an end, and never a complete satisfaction.”31
“The destinies of men are guided by the most extraordinary accidents. In my sophomore year, while in Woodberry poetic exaltation, and feeling much of the time like a young Shelley, I threw a snowball across the campus at a professor emerging from the Natural Science building…He happened to be both an anthropologist of note and a philosopher (probably Franz Boas), and it was he who awakened in me the realization of the philosophical implication of scientific fact.”32
The conflict of science and humanism has been a major concern of humanists in the twentieth centuries and continues to be so. CP Snow in his book The Two Cultures (1959) felt that the “intellectual life of Western Society is split into two polar groups” - science and humanism. This reflects the opinion of Zinsser in which he supports the liberal education of a future scientist. “The revelation of the orderliness both in physical and organic nature “is a sort of religious experience…which…must profoundly influence the philosophy, theology, and even the art of the future”…Science is not without effect upon the classicist and historian...Thus the study of science would seem to have earned the right to be included in (what he called) the New Humanism.”33 He felt that it was just as important for the Humanist to have a working knowledge of the law of thermodynamics as the scientist the background of a liberal arts education. Or to quote the late Adlai Stevenson, “MIT humanizes the scientist and Harvard simonizes the humanist.”
One of his concerns was the roles of religion and science in balancing perspective. Zinsser was an agnostic as were his parents, although his mother was raised as a Catholic. His comments on applying his experiences in learning science with his concepts of the spiritual:
“A particularly strong impression was made upon me by my first…course in physical chemistry…The laws of conservation of matter and of energy in the inorganic world, and the carrying out of these laws into the regulating mechanisms of life processes, followed…Subsequent experiences have often made me wonder why theological schools do not include a rigid discipline in the fundamental sciences…On the unalterable harmony of the natural laws…the revelation of the marvelous orderliness [offers] the final refutation of chance and purposeless.”34
“The questions of immortality of the soul and freedom of the will, though they have called forth libraries of controversial literature, continue to appear not only beyond any possibility of satisfactory proof but…trivial in being so definitely personal, once the principle of an all-pervading and ordering force is accepted”...One cannot imagine such a God occupied through millions of years, up to the Pleistocene, with personal supervision, reward and punishment, of amoebae, clams, fish, dinosaurs, and saber-toothed tigers; then suddenly adjusting His own systems and capacities of the man-ape He had allowed to develop.”35
In regard to morality and disease: “If syphilis had been a disease acquired by inhalation or with a can of spoiled beans, instead of being what it is, we should have made infinitely more progress and might be rid of it by now”...but, “the sentiment is changing. The American Social Hygiene Association, cautiously steering its narrow channel between the Scylla of moral turpitude and the Charybdis of women’s clubs and the clergy, has done much to prepare the way.”36
Dr. Zinsser was fascinating in ways far beyond his work with typhus. A poet in the tradition of his Harvard Medical School predecessor, Oliver Wendell Holmes, his nature deeply influenced his students. For example, Dr. John Enders, then a graduate English student at Harvard, casually sat in on one of Dr. Zinsser's lectures. Enders was so taken by one of Zinsser's lectures that he changed his major, studied in Zinsser's labs and ultimately won the Nobel Prize for his work on the polio virus.
“Infectious disease is one of the few genuine adventures left in the world. The dragons are all dead and the lance grows rusty in the chimney corner...About the only sporting proposition that remains unimpaired by the relentless domestication of a once free-living human species is the war against those ferocious little fellow creatures, which lurk in dark corners and stalk us in the bodies of rats, mice and all kinds of domestic animals; which fly and crawl with the insects, and waylay us in our food and drink and even in our love.”37
I have not commented about why his feet began to hurt when he saw an Italian primitive painting, or why one of his college professors poured a bucket of sea urchins down his neck, or why he was not allowed to be the troop bugler for the Admiral Dewey parade down Fifth Avenue but became Theodore Roosevelt’s body guard instead when he was inducted into the governorship of New York, and almost killed the governor with a cannon shot during a subsequent guard review. Nor have I mentioned his search for a Protohippus tooth, and mastodon heads in the Southwest during a college summer break. Certainly nothing about why Zinsser was permanently wary of psychiatrists and of anything that might involve the risk of revealing his sexual reactions. Nothing at all about how to assist in a birth with the mother squatting above a cold dirty floor, or why he felt that American medicine in his later days would have been impossible without a certain amount of rich malefaction in the 1880s or 1890s. No information on why Zinsser was convinced that the inventor of the condom was a Bishop Condom. Nothing at all about how he absentmindedly left a dead syphilitic baby he needed for his Treponema research studies in a hotel room eventually occupied by newlyweds. Not one word about why he wanted to name his son Kerensky but was dissuaded by his wife. We have certainly not covered the extensive medical literature or his honorary degrees from Harvard, Yale and Columbia, or the extensive lists of the students he mentored who became outstanding academicians in the field of infectious diseases. Finally, nothing about the explanation as to why poetry was to him much like horses. However, we will conclude with his comment on the importance of the poet that he himself was:
"The poet arrests emotions at their points of greatest supportable heat, just short of the melting point as it were, and can hold in that perfect state, permanent in his words and metres, those feelings and comprehensions which pass too quickly to be held through the minds of ordinary men. The poet imprisons them in words or color or marble, so that we lesser men can contemplate them and recognize in them their own hearts and minds."38
Here are two of Zinsser sonnets, one early and one late in life to show the contrast of development:
Zinsser’s sonnet in 1901, at age 22.
The cold little wrens on a wintry tree
Sadly sing of the never-to-be
And the dead leaves, driven by,
Rustle and whisper “Thou and I”39
His last sonnet in Atlantic Monthly shortly before his death:
How sweet the summer!
And the autumn shown
Late warmth within our hearts as in the sky
Ripening each harvest that our love has sown.
How good that ere the winter comes, I die!
Then, ageless, in your heart I’ll come to rest
Serene and proud as when you loved me best.40
When Zinsser was dying of leukemia, he kept his illness secret from his colleagues, but when he became weak, he would go to New York for radiation treatments at Memorial Hospital telling his colleagues that he was going on a little vacation. He remained quite busy until the end, working on a mass immunization vaccine for typhus.
It was during this period that he wrote his autobiography under the initials R.S., the same initials under which his poetry was published in the Atlantic Monthly. The autobiography first appeared as a series in the Atlantic Monthly before being published in book form, which suggests why R.S. was used, but didn’t reveal what the initials stood for. The book was published two months before Zinsser died.
He was buried in Sleepy Hollow Cemetery in Westchester, NY and lies there along with such notables as Andrew Carnegie, Walter Chrysler, Elizabeth Arden, William Rockefeller, Samuel Gompers, Mark Hellinger, "Major" Bowes, Whitelaw Reid, and Oswald Garrison Villard, among others.
But who was R.S.?
Near death he told John Enders that R.S. was Rudolph Schmidt, a German scientist whose book, Pain: Its Causation and Diagnostic Significance in Internal Disease, was first translated into English by Zinsser in 1908. However, there is still some skepticism about the validity of this and some are convinced it represents a character in some much-loved literary work. John Enders, who was responsible for the attribution of R.S. to Schmidt, however, in his own papers and recollections only acknowledges the enigma. Perhaps really a childhood recollection?
Philip Liebson graduated from Columbia University and the State University of New York Downstate Medical Center. He received his cardiology training at Bellevue Hospital NY and the New-York Hospital Cornell Medical Center where he was on the faculty for several years. He has been on the faculty of Rush Medical College and Rush University Medical Center since 1972 and is a Professor of Medicine and Preventive Medicine.