Asylum Doctor: James Woods Babcock and the Red Plague of Pellagra

Preface

xvii P r e f a c e This book traces back to 1944−1946 when I was a toddler living with relatives in Anderson, South Carolina, where my uncle ran a textile mill. A silver bowl of tan-colored tablets sat on the mahogany dining table. I snitched them by the handful. I loved the taste—brewer’s yeast. When my father came back from the war we returned to Columbia, where he resumed his dermatology practice at 1515 Bull Street. The older boys in the neighborhood teased us incessantly:“Bull Street . . .Bull Street!” When I went off to grammar school I kept it a secret that Dad’s office was on Bull Street. During the summer of 1961 my best friend was Arthur Simons.I never went to his house without admiring a pair of crossed racing oars.The inscriptions marked races won and Arthur said they’d been his grandfather’s. Unwittingly, I followed a path blazed by the oarsman. I went north, rowed on the Charles River as an undergraduate (albeit in a wherry, not a racing shell), studied medicine, and, after missing out on my era’s racial excitement (the dismantling of Jim Crow), returned home to spend my career within a three-mile radius of where the oarsman spent his— the old asylum on Bull Street and, later, the Waverley Sanitarium. I learned more about the oarsman through articles by my late friends William S.Hall (“Psychiatrist, Humanitarian, and Scholar: James Woods Babcock, M.D.”) and S. Hope Sandifer (“Pellagra in South Carolina”). Like the oarsman I found myself,because of my chosen medical specialty,in the vanguard against a mysterious, highly-lethal, new disease (HIV/AIDS) that affected nearly every organ system and caused among the general public great concern, P r e f a c e xviii Preface sometimes bordering on hysteria.Like him I started a task force,taught my colleagues and the public, arranged for care of the disadvantaged in central South Carolina (through a federal grant), and became concerned especially for African American women,who suffered disproportionately.Also like him I rose to a senior administrative position for which I was unprepared, knew the frustrations of titular authority without real power over other doctors, proved more adept at tracing the history of institutional problems than at solving them, and sublimated by turning to history and biography. In 1998 Shane Mull,then a first-year medical student and now Doctor Mull, approached me about a summer project on Babcock, the oarsman. Could Babcock claim priority for recognizing epidemic pellagra in the United States? Babcock said no. Whenever someone gave him such credit, as the governor of South Carolina once did before a large audience, he immediately deferred to others.And he would tell us that recognizing a fullblown case of pellagra does not count for much—it’s an easy call if you’ve read a description of the disease. We next examined whether Babcock understood the dietary-deficiency hypothesis before 1914, when the U.S. Public Health Service turned its pellagra effort over to Joseph Goldberger,the story’s eventual hero.Babcock reminded us that for nearly two centuries, beginning with the Spaniard Gaspar Casál, nearly all students of pellagra advocated better diet. And Babcock never speculated about causation except for a general sympathy with the “Zeists”(those who thought corn had a lot to do with it).He had little if any training in research and was a busy asylum superintendent. I eventually learned, however, that he was among the first to see the analogy between pellagra and two other vitamin-deficiency diseases, beriberi and scurvy. Shane Mull did an outstanding job during the summer of 1999 and a subsequent elective rotation but graduated from medical school, finished a residency,started a family,and now practices emergency medicine and serves as a lieutenant colonel in the National Guard.Dr.Charles N.Still,the third member of our band,dropped out for other pursuits.I was left staring at the prospect of a full-length biography involving extensive primary and secondary sources. Was the project worthwhile? I ultimately said yes for several reasons. First, three distinguished historians—Edward Beardsley of the University of South Carolina, Peter McCandless of the College of Charleston, and Todd Savitt of East Carolina University—all felt Babcock deserved a biography. He was South Carolina’s first trained psychiatrist or “alienist,” an asylum superintendent during a difficult time in the history of asylums, [3...