Disease Detective

"Somewhere around 1990, I made an appointment to talk to a therapist because I was working absurdly long hours on the [direct-mail] business and I was feeling burned out -- there was something missing. In the first session, he asked what I would most like to do and, without thinking, I said I'd like to read everything I could find about Lou Andreas Salomé." Salomé, an early 20th-century female psychologist, was close to both Sigmund Freud, an originator of modern psychology, and nihilist philosopher Friedrich Nietzsche.

Hayden had become intrigued by Salomé in the mid-'60s as a student at Bucknell University in Pennsylvania. She had taken a class about Salomé's tempestuous friendship with Nietzsche before the influential philosopher slipped into madness. After college, Hayden moved to Paris, studying at the Sorbonne and working part time at the famed Shakespeare & Co. bookstore, a mecca for English-speaking literati. Returning to San Francisco, she managed a bookstore for the Esalen Institute, a New Age outfit that mixed spiritual self-discovery with pop psychology, futurism, and deep body massage. After working on direct mail for Esalen, Hayden started Pacific Lists, which matches nonprofit groups like Doctors Without Borders, the San Francisco Food Bank, and Harvard Medical School with potential donors.

In 1992, after two decades of immersion in direct mail, Hayden cut back on her office hours to renew her study of Lou Salomé. Over the next year, as she amassed 1,000 pages of research notes, she wondered why Nietzsche broke off his relationship with Salomé. The question took on significance as it became increasingly clear to Hayden that the author of Ecce Homo and Beyond Good and Evil, who suffered from horrible headaches, chronic nausea, failing eyesight, muscle cramps, and, in the end, hallucinations, paralysis, and a fatal stroke, was, in all likelihood, afflicted with syphilis. The disease is often called "The Great Imitator" because its symptoms closely resemble many other maladies.

Hayden's success in finding diagnostic evidence of syphilis in Nietzsche put the Salomé project on indefinite hold. One discovery led to another as she followed the syphilis trail from Nietzsche to famous writers such as Charles Baudelaire, Oscar Wilde, and Karen Blixen (Isak Dinesen), and music composers including Franz Schubert and Robert Schumann. Although historians had speculated that many of Hayden's subjects had suffered from the ravages of syphilis, Hayden began uncovering new evidence in each case, and assembling a pattern of how the disease manifested in all of them. When she discovered important new evidence that pointed to Hitler as a syphilis carrier, she became so consumed by her intellectual investigation that she organized her entire life around it.

"There are escapes from the body," says Hayden, "but we always return to the body, and that's probably why I am so interested in syphilis. There are hundreds of biographies written about people who are sick as if their illness does not matter. I say that syphilis is more relevant than any other disease because it profoundly affected all aspects of a life -- social, marriage, job, mental change, philosophy."

Paraphrasing Nietzsche, she says, "A man's work is an unconscious memoir of his life." It is of obvious historical import when leading cultural and political figures are found to have been afflicted by a terrible, debilitating, socially unacceptable disease.

Hayden set herself two tasks. The first was to marshal and present evidence that selected historical characters suffered from syphilis. The second was to correlate the behaviors of each doomed individual into an overall pattern indicating the presence of syphilis. Along the way, Hayden tried to get inside the heads -- and aches, pains, and ecstasies -- of her subjects. She wrote a stream-of-consciousness introduction to Pox, which reads in part:

"no one must know i'm rotting inside. rotting in the bones, melting like an old camembert. oozing sores now on my shins, i bandage them, hide them. when will i find an end?

"today i felt a breeze from the wing of madness.

"is that how it will end? but, oh, such visions. i fall to the earth and weep for such ecstasies. a mystical light. could there be a god? electricity lights my brain ... someday, the world will explode, because of me ... i chase thoughts like colored butterflies, my urine is full of jewels. i scream, i rage. then i play the piano, gently, and all is well. i remember everything ... and then, one day, i ask: who is that face in the mirror?"

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What started out as a diversion turned into an obsession. By 1999, Hayden was known as an expert syphilologist from the Bay Area to South Africa.

William Schaberg, author of The Nietzsche Canon: A Publication History and Bibliography (University of Chicago Press, 1995), reviewed the Nietzsche sections of Hayden's book prior to publication. "It's a testimony to [Hayden's] intellectual curiosity," he says, "that she traveled so far down the syphilis road. It is still an indelicate subject; she looked at it square in the face."