"If it's chafed, put some lotion on it."
--Some practical advice, offered by the character portraying Andrew Jackson, speaking toward the audience in the last scene of Bloody Bloody Andrew Jackson, a play written and directed by Alex Timbers
Recently I had occasion to see the outrageous politico-emo-rock musical, Bloody Bloody Andrew Jackson, which recently moved to Broadway's Bernard B. Jacobs Theatre. The production focuses on the life and times of the seventh President of the United States.
Now, Old Hickory comes on like a rock star. The story is narrated, in part, by an excitable, graying Jackson groupie who bumps around the stage in a motorized wheelchair. A wild and rattling cast sets the thing's tone in a startling first number, "Populism, Yea, Yea!" An early review of this musical, toward the end of its early 2008 Los Angeles run, cites these lyrics:
Sometimes you have to take the initiative.
Sometimes your whole family dies of cholera.
Sometimes you have to make your own story.
Sometimes you have to shoot the storyteller in the neck.
Sometimes you have to take back the country ... (These words antedate the Tea Party, to which the play vigorously alludes in its current form.)
You get the idea: It's lively, a bit disjointed and politically relevant. And fun. It messes with the facts, and is tangentially rife with medical topics.
In the play, Jackson's father, upon witnessing the whoosh and arrow-in-her-back slaying of Jackson's mother in a backwoods cabin somewhere in South Carolina or Tennessee, immediately and without hesitation attributes her death to cholera. A moment later, he and a cheery cobbler are felled by similar instruments. The future President Andrew Junior, who's playing with toy cowboys and Indians while both of his parents are shot dead in this life-motivating scene of pseudo-history, refers later to his parents' deaths from cholera.
Most historical sources and Jackson's Tennessee home's current website attribute the mother's death to cholera. According to a scholarly review of cholera epidemics in the 19th Century, the disease didn't appear in North America until after 1831 or so. A fascinating, original New York Times story details the ravaging effects of this illness in Tennessee in 1873, but that would be long after Jackson's death in 1837.
An unexpected medical writer's gem of a song, "Illness As Metaphor," cuts to the heart with a message about blood, symbolism, love and Susan Sontag's classic essays on the meaning of tuberculosis and cancer in literature and in life. The lyrics of the song from Bloody, Bloody Andrew Jackson are hard to find online, but you can get it through iTunes, by which I found these words:
A wise woman once wrote that illness is not metaphor.
So why do I feel sick when I look at you?
There is this illness in me and I need to get it out, so when I bleed
It's not blood, it's a metaphor for love.
These aren't veins just the beating of my heart.
This fever isn't real it represents how I feel ...
I'm not sure how Susan Sontag would feel about emo-rock in general and about this song in particular. A few other medical digs include mention of Jackson's hepatitis, acquired on "the battlefield," as he explains to his admirers, syphilis, a killer of Indians and, consistent with the play's hemi-modern approach, Valtrex, which some of the prostitute-turned government advisees run to get when it's given for free.
All in all, it's a terrific play about Americans, Manifest Destiny, populism, anti-elitism, economic frustration, anger toward foreigners, fears of terrorism and the founding of the Democratic Party, with a spoonful of medicine to go.
This post originally appeared at Medical Lessons, written by Elaine Schattner, ACP Member, a nonpracticing hematologist and oncologist who teaches at Weill Cornell Medical College, where she is a Clinical Associate Professor of Medicine. She shares her ideas on education, ethics in medicine, health care news and culture. Her views on medicine are informed by her past experiences in caring for patients, as a researcher in cancer immunology and as a patient who's had breast cancer.