Providentia

The Castrato

There are different traditions concerning why Giovanni Velluti was castrated as a young boy. Born in Montolmo, Italy in 1780, his father had planned a military career for him but this plan changed abruptly when Giovanni developed a high fever. According to the most common legend, his parents had taken him to a local surgeon for treatment and the surgeon, mistaking the parents` intentions, castrated Giovanni instead. That marked the end of any military career for the boy and he was sent to be trained as a singer.

Castration in boys between the ages of seven and twelve prevents the larynx from undergoing the normal physiological changes associated with puberty and enables boy sopranos to keep their large vocal range throughout their lives. While some testosterone continues to be produced by the adrenal glands, the reduced sex hormone levels in their bodies results in other physical changes including lack of facial hair, physical tallness, smooth skin, rounding of the hips and a high speaking voice. The very term "castrato" or "eunuch" was often considered offensive and words such as "musico" or "virtuoso" were preferred (political correctness has a long history).

While castrati have been around since ancient times, the use of castrated boys as Church singers was first introduced in 16th century Spain. Women were not allowed to sing in choirs (due to one of St. Paul's teachings requiring women to be silent in church) and castrati seemed ideal for falsetto roles. The angelic quality of their voices caused this innovation to spread across many European countries but it was in Italy where the tradition of the castrato singer took root. By all accounts, the purity of their voices combined the awesome vocal quality of boy sopranos with the lung capacity of adult men. The spread of opera across the continent made castrati widely sought after as singers and they often became the superstars of their day.

Despite the fact that castrations for non-medical purposes had become illegal by Giovanni`s time, there were still doctors (and even barbers) across Italy who practiced the operation discreetly. The castrations would then be explained away as being due to congenital problems or "accidents". While the primitive nature of the surgery meant that many boys died of blood loss or infection, most survived to continue their musical careers. It may never be known many boys were castrated over the years but some estimates suggest that there were thousands.

The competition among castrati was fierce and only the greatest singers were allowed to become opera stars. For the rest, there were the church choirs and the modest living that these positions provided. Many poor Italian families found that having one son castrated meant an opportunity for the entire family to have a better life as a result. Church doctrine banned castrati from marrying or taking holy orders and their lives tended to be focused exclusively on their music and providing for their families.

Giovanni Velluti is widely considered to be the last great castrato opera singer. While the popularity of castrati as singers and the sponsorship of the Catholic church ensured a steady market for centuries, this era came to an end during Velluti's lifetime. He mesmerized audiences across Europe and many operatic roles were written just for him. Although he was a prima donna by nature with singers and music directors often finding it impossible to work with him, Velluti was in a position to demand (and get) special treatment. He made his London debut in 1825 despite growing English opposition to castrato singers. As the first castrato to sing opera in England in twenty-five years, he certainly had his share of fans and critics. Velluti even became music director for a season but financial problems and poor reviews caused him to leave England. By 1830, he had retired from stage and became a gentleman farmer until his death in 1861.

Aside from his musical career, Velluti became legendary for his flamboyant clothes. feminine good looks, and romantic escapades with numerous women in high society. Contrary to popular belief, castrati are not sexless. If anything, many castrati are said to be able to hold an erection longer than an uncastrated male due to lack of ejaculatory tension. Women often saw Velluti as an ideal lover since there was no pregnancy risk (plus husbands seemed incapable of believing that a castrato could be romancing their wives).

After Velluti's retirement, there were no more roles for castrati in opera and, with a Papal declaration condemning the practice in 1878, few choir roles were available either. Despite official church doctrine, it was only in 1913 when Alessandro Moreschi, the last Vatican castrato, was removed from the Sistine choir. He made two gramophone recordings in 1902 and 1904 which are the only ones of its kind in existence. Even given the poor sound quality, Moreschi's voice evokes an earlier era although he was well past his prime by the time the recordings were made. It was his very public funeral in 1922 that truly marked the end of the castrato age.

While countertenors and falsettos are often used in opera to simulate the castrato effect and androgynous singers continue to have musical careers today, we can only imagine how it must have been during the long period when castrati reigned supreme as singers. It is hard to believe that sexual mutilation of young boys could have been allowed for so long but, like many other examples of similar practices, maybe it just seemed like a good idea at the time.

Casualties of War

The Winter issue of Perspectives in Biology and Medicine presents a thoughtful overview on war and its casualties. Throughout America's first 145 years of war, far more of the country's military personnel died from infectious diseases than from combat injuries. This only began to change in World War II due to better methods of disease prevention and treatment. The authors suggested that soldier deaths throughout U.S. history can be divided into a Disease Era (1775-1918), during which infectious diseases were the major killer of America's armed forces, and a Trauma Era (1941-present), in which combat-related injuries were the major cause of fatalities. Using the 3,400 U.S. military fatalities in Iraq as a comparison, suicide deaths have become more prevalent than deaths from infectious disease.  Given the rising rate of suicides in U.S. soldiers posted overseas, this trend is not expected to change.

Click here for the abstract.

"My Mom Stabbed Me"

Police in Largo, Florida reported that a mother stabbed and critically wounded her 15-year old son at a local psychiatrist's office on March 22. Celeste Grace Minardi, 51, had been attending supervised visits with her son for the past three years and there was no previous indication of potential danger. The attack occurred at 10:00 am in the office of Ronald Knauss and Associates while the mother was sitting with her son under a nurse's supervision. Without warning, Minardi pulled two long knives from her purse and began stabbing her son. After receiving gashes in his lower abdomen, neck and face, the boy (his name has not been released) managed to get away before collapsing in the lobby. Police reported that the boy was able to say "My mom stabbed me. I don't ever want to see her again" before being taken to hospital. He received emergency surgery at Bayfront Medical Center and is described as being in critical condition.

Celeste Minardi is the ex-wife of attorney, Timothy Driscoll, who had custody of their son since divorcing in 2004.  She has been seeing her son in twice-monthly visits and there is no history of criminal or violent behaviour.  She would not say why she attacked her son and there is little additional information on her mental state. Police have charged her with first-degree attempted murder and carrying a concealed weapon.

Click here for the link.

Starved For Science

While the conscientious objectors (COs) who were part of the Civilian Public Service (CPS) carried out a variety of unpleasant duties, one of the most far-reaching involved their participation as research subjects in medical experiments. Under the authority of the Office of Scientific Research and the U.S. Surgeon-General, medical schools and hospitals across the United States conducted a series of medical experiments studying infectious disease and human endurance. Many COs volunteered for research despite the very real dangers that such research faced. Although no deception was used and there was full informed consent, it seems hard to believe that these research studies were carried out given the potential risks. Some of the studies involved deliberate exposure to live viruses including hepatitis, typhus, malaria and pneumonia to determine likelihood of infection and to test new treatments. Other subjects were placed in decompression chambers and subjected to temperature extremes to measure human responses to severe environmental changes.

The Minnesota Hunger Experiment was carried out under the direction of Dr. Ancel Keys of the University of Minnesota Laboratory of Physical Hygiene. It began with a pamphlet titled "Will You Starve That They Be Better Fed?" sent out to the various camps describing a study into the effects of starvation. As the war was drawing to a close, it was becoming clear that famine would be a major  challenge facing post-war reconstruction. The experiment was intended to learn more about malnutrition in human beings and how it could be treated. Of the 100 COs who volunteered, only 36 met the rigorous screening requirements. Another 18 were hired as support staff. The participants were given full information about what would be required and they were also warned about potential long-term risks. The study began with a three month standardization phase in which the subjects received a daily 3200- calorie diet followed by a six-month semi-starvation phase (a daily diet of 1800 calories each). The goal was to reflect the poor diet that was common across much of war-torn Europe. The final three months would be the recovery phase in which the researchers would test different high-protein diets to help the participants return to normal. Over the course of the experiment, the participants lived on the University of Minnesota campus and took their meals together in Shevlin Hall. During the semi-starvation phase which began in February, 1945, each participant was obliged to walk 22 miles (35.4 kilometers) a week either around the campus or on indoor treadmills.

Despite the high idealism of the COs who participated, their enthusiasm quickly diminished as they realized how rigorous their lives became. They reportedly grew more irritable as the effects of their limited diet affected their physical health. Tolerance for cold weather quickly decreased (this was a big problem considering the cold Minnesota winter) and they began experiencing dizziness, fatigue, muscle soreness, hair loss, and tinnitus. Concentration and coordination were also affected and some of the participants who were attending classes were forced to withdraw from their studies. Many of the participants became increasingly obsessed with food and collected recipes. Their libido was also adversely affected. The sight of the emaciated participants around the campus became increasingly common as they began wasting away. Their sunken faces and bellies, protruding ribs, and edema-swollen legs and ankles made them extremely noticeable and they became the subjects of newspaper and magazine articles across the country. When asked if they wanted to withdraw, the participants flatly refused. One participant, Harold Blickenstaff later recalled that "I had just decided that this was what I was going to do and so I was going to do it . . . and so I would say walking by a bakery was like walking by a bank. It might be nice to have what's in there, but it's out of the question. I never debated whether or not I should break diet or do anything else"

One respondent in particular had an extremely difficult time and broke down in the eighth week of the semi-starvation phase. Going into town, he went on an ice-cream binge and tearfully confessed following his return to the laboratory. On that basis, the participants were placed on a "buddy system" and no participant was allowed out alone. Despite this system, the respondent who had broken the fast began stealing food and was later released from the program due to severe emotional distress. He was placed in the psychiatric ward of the university hospital and diagnosed with a borderline psychotic episode which subsided after several days. Three other participants were also dropped from the study due to concerns about the pattern of weight loss noted.

Ironically, it was the three month re-feeding period that was the hardest part for many participants. Some were surprised to find that they were still losing weight despite the increased rations (due to loss of edema). As not all subjects received the same number of calories in their re-feeding diet, the effects of starvation continued longer for some than others. One participant would cut off three fingers with an axe while chopping wood although he was vague afterward over whether this was deliberate. He remained to complete the study however. Although the worst symptoms of starvation had passed by the end of the re-feeding period, full recovery would take considerably longer for most of the participants.

The results of the Minnesota Hunger Experiment were written up in a 1,300 page two-volume report titled The Biology of Human Starvation that was released in 1950. In addition to their own findings, the authors included information about the Siege of Leningrad, the Warsaw Ghetto, Japanese and German concentration camps, and field data from various post-war countries. World War II provided all too many opportunities to learn about the effects of starvation on human beings and most of the published studies remain classics in the field.

It is highly unlikely that medical experiments done with COs during World War II would ever be approved by a modern ethical review board and their value to science remains controversial. Still, medical professionals working with famine-stricken populations continue to use the Minnesota results for guidance in dealing with the effects of malnutrition. A number of the study participants went on to distinguished careers as academics and peace activists but when 18 of the survivors were interviewed in 2004, they emphatically stated that their involvement in the Minnesota Hunger Experiment was one of their most important achievements. It is a fitting legacy for these people of conscience that tends to be largely forgotten today.

Click here for more information on the Minnesota Hunger Experiment (pdf)

Psychotic Symptoms In The Elderly

A study in the December 2007 issue of the American Journal of Geriatric Psychiatry examines the prevalence of psychotic symptoms and schizophrenia in nondemented 95-year-olds over a one-year period. A sample of 338 95-year-olds living in Göteborg, Sweden (individuals with dementia were excluded leaving 163 subjects for this study) received psychiatric and physical examinations as well as cognitive tests and interviews with close informants. The results indicated that the one-year prevalence of any psychotic symptom was 7.4% overall (hallucinations 6.7% and delusions 0.6% ). Four of the study participants met DSM-III-R criteria for schizophrenia (2.4%). No differences in cognitive functioning were found between individuals with psychotic symptoms and individuals without these symptoms. Individuals with hallucinations and paranoid ideation also had an increased frequency of paranoid personality traits. The authors concluded that there was evidence of a higher than expected prevalence of psychotic symptoms, paranoid ideation, and schizophrenia in the very old.

Click here for the abstract.

Lawyer Seeks Insanity Plea in Microwave Baby Case

Lawyers are seeking an insanity plea for an Arkansas man on trial for placing his 2-month old daughter in a microwave oven last May 10. Joshua Joyce Mauldin, 20, of Warren Arkansas has been charged with causing injury to a child and faces a potential life sentence.

According to his attorney, Sam Cammack III, Mauldin has a longstanding history of psychiatric problems including auditory hallucinations and mood swings and has been on medication since the age of 10. Despite concerns about his mental state, his family had accompanied him to Galveston, Texas when he reported hearing a call from God to become a preacher. After they checked into a motel, he was left alone with his daughter, Anna, as the rest of the family went to get food. He reportedly became agitated while feeding her and locked the motel room door. Mauldin then placed the infant in the microwave after first placing her in the motel room safe and refrigerator. Although he removed her immediately afterwards, Anna sustained second and third-degree burns and would later require skin grafts to her face and hands.

Mauldin told conflicting stories to police, hospital staff and Child Protective Services but eventually admitted to placing her in the microwave four days later. While the district attorney is resisting the call for an insanity defence, Mauldin's attorneys are seeking to have him committed to a psychiatric facility. Anna has been placed with relatives.

Click here for the link.

In Good Conscience

Being a person of conscience is never easy, especially during wartime when governments begin mass conscription to bolster their armed forces. Whenever drafting begins, the problems involved in dealing with conscientious objectors who, by virtue of their religious or political beliefs, refuse to serve in the military inevitably arise. Conscientious objectors (also known as COs or "conchies") in many countries were often allowed to serve in non-combatant roles (although there were frequent cases of COs being placed in military prisons where they experienced ill-treatment and abuse). When the United States entered World War II in 1941, there remained the problem of what to do with the estimated 72,000 COs who filed for exemption from conscription (approximately 0.15% of all draftees). Many of these COs belonged to pacifist religions (including Mennonites, Quakers and Seventh-Day Adventists) and it was these churches that spearheaded a new solution. The Civilian Public Service (CPS) was established in 1941 to allow COs to serve their country in various non-combat support roles. For the years that the CPS was in operation, 12,000 COs were interned in camps across the United States and Puerto Rico. During their internment, the COs worked in tasks that included soil conservation, forest fighting, medical research (as test subjects), and social services. Beyond a small allowance (the churches provided most of the funding for the CPS), COs received no compensation for their work, no medical insurance and no  death or disability benefits despite their often hazardous duties. Life in the CPS camps was harsh as the COs lived in barracks and worked long hours with little recreation. Their families often faced severe hardships, due to the lack of financial support as well as the frequent harassment that they faced from their communities (COs were widely reviled for not "doing their part" for the war effort). While the churches were nominally in charge of the CPS program, they had little actual control over the day-to-day operations or conditions under which COs were expected to live. The American Civil Liberties Association actively denounced the conditions in the CPS camps (they viewed the COS as being more poorly treated than German prisoners) but the program continued until 1947 (well after the end of the war).

One area where COs were widely used was in working with psychiatric patients. The war effort had led to a critical shortage of hospital workers (through lack of psychiatrists as well as orderlies who had left for better paying jobs) and, by the end of 1945, 2000 CPS workers were working in psychiatric institutions across twenty U.S. states. Many of these workers reported being appalled by the poor conditions under which mental patients were expected to live. The use of physical restraints and punishments (including beatings) to control patients was common and CPS workers were instrumental in developing non-violent alternatives. The CPS also helped publicize the widespread abuses that they found in psychiatric hospitals across the United States (this was long before psychiatric medications were introduced) and paved the way for crucial reforms. With the assistance of Eleanor Roosevelt, COs helped launch what would later become the National Mental Health Foundation which, in turn, merged with other agencies in 1950 to become the National Association of Mental Health (now Mental Health America).

Long after their term of service with the CPS ended, former COs would continue their activist work for mental health reform as well as post-war relief efforts across Europe. It was because of this relief work that the 1947 Nobel Peace Prize was presented to Quaker organizations in the U.S. and U.K.(largely staffed by COs). Despite later wars, the CPS was never reformed in the U.S. and conscientious objectors continue to be imprisoned in countries around the world.

COs served in other areas as well, including as subjects in dangerous medical experiments. More on that next week....

Blinded By The Light

Following reports about a miraculous appearance of the Virgin Mary in the sky at a hotel owner's home near Kottayam (located in southeast India), approximately fifty people have permanently damaged their eyesight by eagerly staring at the sun. Since the visions were first reported, a local hospital has examined at least forty-eight cases of patients with damage to their retinas as a result of overexposure to the sun. Dr Annamma James Isaac, ophthalmologist at St. Joseph's ENT and Eye Hospital has reported that the patients have developed " photochemical, not thermal, burns after continuously gazing at the sun,"

While churches have warned their congregations about the purported miracle and the dangers in staring at the sun, hopeful pilgrims are reportedly still flocking to the area and further cases of eye damage are expected. The hotel owner who had started the craze had reportedly made previous claims of statues of the Virgin Mary in his home that cried tears of honey, perfume and oils. He has since moved away from the area.

Click here for the link.

Seeking Refuge

The International Organization for Migration (IOM) has released a report indicating that Iraqi refugees in Lebanon are experiencing high levels of emotional distress and post-traumatic symptoms. The report outlines the results of a study carried out between November 2007 and January 2008 on 800 Iraqi refugees in Lebanon and Jordan. More than half of the refugees studied reported post-traumatic symptoms such as panic attacks, anger, fatigue, anxiety and sleep disorders. For the 34 per cent of study participants who reported experiencing direct violence, including attacks on themselves or family members, the emotional distress was particularly acute. In addition to the effects of recent trauma, factors relating to their uncertain existence as refugees are sources of added distress. Economic difficulties relating to lack of employment, poor living conditions and limited access to health and social resources and educational opportunities has led to physical expressions of anger and frustration. Domestic violence, behavioural and learning problems in children, and isolation are common experiences in refugee families.

"The level of instability is very high among the refugees. We see humanitarian agencies and governments responding to the basic needs of displaced Iraqis at home and abroad, and we need to see a similar response in dealing with their equally important psychological well-being," said Guglielmo Schinina, head of IOM's psychosocial office in the Middle East.

The study was carried out in partnership with international and non-governmental organizations such as the Iraqi Youth League and the Jordanian Women's Union, as well as UNICEF, which provided financial assistance.

Click here for more information.

The Unforgettable Shereshevsky

It all began with a daily meeting at a newspaper in Moscow, sometime in the 1920s.

The editor was handing out assignments to the various reporters and was annoyed to note that one of the newer reporters had neglected to bring along a notebook. Solomon Shereshevsky (sometimes spelled Sherashevsky), then 29 years old, was quietly listening to the editor speak while all of his fellow reporters were busy writing down their assignments. The editor had noticed this before and decided to give his employee a scolding for not paying proper attention. When meeting him afterwards, the editor was astonished to find that Shereshevsky was able to remember every detail of the meeting with perfect accuracy. The journalist was just as astonished at his editor's reaction since he thought his perfect memory was normal. Always on the lookout for an interesting story, the editor decided to send his reporter to the local university for testing. It was there that Solomon Shereshevsky met Alexander Romanovitch Luria and an amazing collaboration began.

Over the course of the next 30 years, Luria would carry out an extensive series of experiments examining the journalist who would become his most famous case. Solomon Veniaminovitch Shereshevsky (identified only as "S" in Luria's writings) was born in Latvia and was part of an accomplished family (his father was a bookstore owner who could recall the location of every book in the store while his mother knew much of the Torah by heart). Although he had originally trained as a violinist, Shereshevsky became a journalist after an ear infection ended his musical career. Given his perfect recall, conventional memory testing was impossible but Luria was able to detail the processes underlying how Shereshevsky was able to memorize details so accurately. During the research trials, Shereshevsky was able to recall extensive lists of words, numbers and even nonsense syllables without mistakes and with only occasional hesitation. He could also report the numbers or letters in reverse order and could retain the information, seemingly indefinitely. Even events from early childhood could be recalled (including things that happened when he was still in his crib). There also appeared to be no limit to his digit span (as opposed to the seven to nine items that most humans can manage).

Based on his research, Luria concluded that Shereshevsky possessed an extreme form of synaesthesia which he used to convert various stimuli into visual images. It was this visual imagery that was one of the key factors in his astonishing recall. Whatever he was asked to remember, he would first mentally convert into visual images but often needed extra time to make the conversion. The perfect recall only failed when this process was disrupted in any way. He was even able to convert music and numbers into visual imagery by imagining the tones or numbers visually.

There were some intriguing limits to what Shereshevsky could remember however. He had a surprisingly poor memory for faces or voices heard over a telephone. He also had difficulty with abstract logical concepts and metaphors and often appeared slow and forgetful to others meeting him. His synaesthesia made him acutely sensitive to changes in his environment (for him to enjoy food in a restaurant, there had to be the right kind of background music playing).

Alexander Luria published his research results in 1968 as The Mind of a Mnemonist: A Little Book about a Vast Memory which has since become one of the great classics of psychology. He died in 1977 after an accomplished career as a neuropsychologist.

As for Solomon Shereshevshy? His amazing memory was also a serious handicap since his visual imaging meant that he frequently spent his life in a nonstop daydream. He gave up his journalism career and became a professional mnemonist giving regular shows to paying audiences. Despite his success, he never had great satisfaction as a performer and gave it up after a while. The last reference that I could find on him was that he became a taxi driver in Moscow but his life faded into obscurity afterward. Aside from a possible death date in 1958, there seems to be little else available.

By his own reckoning, Shereshevsky viewed himself as a failure in life since he was unable to use his vast memory in a way that he found personally fulfilling. He had wanted to be remembered for accomplishing something "great" in his life and, given his place in the history of psychology, may have succeeded. In 1998, Peter Brook released a theatre production based on Shereshevsky titled Je Suis Un Phenomene (I am a Phenomenon). Solomon Shereshevsky will be remembered.