.what disturbs our blood
Is but its longing for the tomb.
William Butler Yeats, “The Wheel”
The public legacy of the FitzGerald family is impressive. Journalist and award-winning biographer James FitzGerald, born into the privileged upper crust of Upper Canada, in the centre of the Canadian medical universe that was Toronto circa 1950, comes from a stock of pioneering physicians. His father, Jack FitzGerald, was a leading allergist during the 1950s and President of the Canadian Academy of Allergy. Just before the outbreak of World War I, his grandfather, John Gerald “Gerry” FitzGerald, the titan of the family, founded Connaught Laboratories, which became famous for the production of diphtheria antitoxin and later insulin at low cost for widespread distribution. Gerry FitzGerald was a pioneer in the field of preventive medicine and is a laureate of the Canadian Medical Hall of Fame.1
On the surface, it would be hard to imagine a better pedigree. But the FitzGerald family tree was blighted by unhappiness—marred by fathers consumed by work, fathers eventually annihilated by depression, dysfunction, addiction, and suicide. For years, the reality of their private lives was carefully tucked out of view.
In his darkly elegant book of 2010, What Disturbs Our Blood: A Son’s Quest to Redeem the Past,2 James FitzGerald confronted the truths about his family’s many successes and troubled past in a cathartic, thoroughly researched, and captivating effort. Wrestling with the weight of his own Y chromosome, he embarked on a journey down the family tree and through the not-so-distant history of medicine and psychiatry, interweaving these threads into an intriguing and often disturbing story.
Ghosts and secrets
Even when one is surrounded by the ghosts of past glories and discoveries, such as on the campus of the Faculty of Medicine at the University of Toronto, one often has little idea of the significance of the names attached to buildings and lecture halls. Medical students at the University of Toronto are divided into undergraduate “academies” at the different hospitals in the city. The FitzGerald Academy is located at St Michael’s Hospital on Queen Street, and is named after Gerry, as is the FitzGerald Building on campus. During my 4 years at the university during medical school, I was never aware of Gerry’s first name, nor did I know about his many achievements—which included, besides those listed above, being the university’s former Dean of Medicine and the globetrotting Scientific Director of the International Health Division of the Rockefeller Foundation in the 1930s. Nor did I know that Gerry, on a hot summer day in 1940, while an inpatient at the Toronto General Hospital, thrust a dinner knife into his femoral artery, thereby ending his life in a pool of blood.
The truth was hushed up; the death certificate listed the cause of Gerry FitzGerald’s death as a duodenal ulcer. Growing up, James learned little from his parents about his accomplished grandfather. When, as an adult, James started digging into his father’s and grandfather’s past, the veil was lifted for the first time. James’s long journey and relentless research to find out about his family culminated in What Disturbs Our Blood, a riveting account in which the skeletons tumble out of the closet and onto the page.
Precocious talent, paralyzing depression
Gerry FitzGerald’s family had come to Canada along with flocks of other Irish immigrants in the early 1820s.3 Gerry was the first of the family to shed the mantle of obscure toil and join the new bourgeoisie, to leave the small town and travel to the big city. In 1899, when he was 16, he left Drayton, Ont, to study medicine at the University of Toronto, where he was accepted as the youngest student in the school’s history.2 His motivation to enter medicine stemmed at least in part from his parents’ dichotomous experiences with the healing art. On the one hand, Gerry’s father, Will FitzGerald, embraced the promise of the medicines he prepared himself in his pharmacy; on the other hand, his mother, Alice, struggled with chronically poor health.3
After graduating from medical school, Gerry first pursued a career in psychiatry, then changed course to the disciplines of public health and preventive medicine, where he would make his lasting mark. After completing an internship in neurology and psychiatry at Johns Hopkins Hospital, he became the first pathologist and clinical director of the Toronto Asylum for the Insane.3 The irony of his early career path is biting, given how his life ended.
When Gerry entered the nascent field of psychiatry, it was in an age when asylums served as wretched holding facilities. It was still a time when depression was called melancholia, and when mild neuroses were feared to be harbingers of a coming florid lunacy, all of these illnesses more often than not attributed to weak moral character and squalid living conditions. At the same time, Sigmund Freud’s emerging theories about the unconscious mind and psychoanalysis offered a radical new approach to understanding mental illness. Although Freud embraced scientific empiricism, he was shunned by many physicians as being too speculative.4 This was the case in Toronto in the early 1900s, where Freud’s theories were seen as too radical and did not gain acceptance.3 Instead, hard science was the name of the game. Treatment of mental illness was the new holy grail, and physical treatments came into vogue.
Gerry’s path, as a physician, and later as a patient, was marked by these once “promising” therapies: hydrotherapy (where a patient was wrapped with a sheet soaked in freezing water—eerily reminiscent of contemporary water-boarding), electroshock therapy (initially in the absence of muscle relaxants—so that seizures could be so violent as to break bones), and insulin shock therapy (in which a hypoglycemic coma was purposefully induced).
Following his departure from the field of psychiatry for bacteriology and public health, Gerry’s next 30 years overflowed with evidence of his ambition. He followed a fellowship at Harvard with work at the Pasteur Institute in Paris, France, the Lister Institute in London, England, and the University of California at Berkeley. He eventually returned to the University of Toronto as the head of 2 visionary institutions: Connaught Laboratories and the School of Hygiene. His pace was relentless, which surely contributed to his mental breakdown in 1938, from which he never recovered.
At this point Gerry re-entered the world of psychiatry, transformed from all-powerful physician to patient. The results of James FitzGerald’s research about this period are truly fascinating. Among the most intriguing findings are the letters written by Gerry from the Hartford Retreat in Connecticut (originally named the Connecticut Retreat for the Insane) in 1939, where he was a patient for a full year. Full of despair and rumination, they offer a rare and visceral insight into the consuming and paralyzing nature of depression, as well as the horrors of insulin shock treatment (which Gerry received 57 times):
The insulin treatment has been on now for eight days. Two days ago I refused and was dragged upstairs .... I am absolutely in hell all the time now .... I have had eight insulin treatments, up to 70 units daily. I sweat and go through the rest of it but it cannot get me out of the doghouse or benefit fear, shame, and remorse.2
After his death in 1940, Gerry’s funeral was held at Convocation Hall at the University of Toronto. His pallbearers included Sir Frederick Banting and Charles Best.3 In the crowd was his family, including his son Jack, then 23 years of age.
Elusive answers
In What Disturbs Our Blood, Jack, James’s father, is a figure even more enigmatic than Gerry. Readers struggle alongside the author to gain some meaningful insight into Jack’s personal thoughts and struggles with depression, as they were able to do through Gerry’s letters. Jack’s lifelong repression of Gerry’s suicide must have been a tremendous personal burden, but this was apparently never heard from Jack. Even during the decades when Jack was functioning and well, his temperament seems to have been brooding and distant.
Like his father, Jack graduated with a medical degree from the University of Toronto; he then embarked on a successful career at the Toronto Western Hospital as a researcher and a clinician.2 Then, again like Gerry, when he was well into his fifties, things began to unravel. A suicide attempt was followed by failed treatments and institutionalizations, then marital strife and addiction, and finally years of reclusion.
The exploration of Gerry’s and Jack’s downfalls is a brave excavation by James FitzGerald—a herculean effort to confront the past and find comfort and sanity in his own skin.5 By the end of the book, and in subsequent interviews, it seems he has found a large measure of peace. But, for readers, a clear understanding of the exact combination of genetics and environmental factors that irrecoverably toppled Gerry and Jack from their successful careers is elusive. In this, depression maintains some of the mystery and menace it always has.
Footnotes
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Competing interests
None declared
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