Disease Detective

"I am a literary gumshoe," Hayden says. "I did not do primary research. If it was a biography about one person's infection, it would have to be primary sources. But this is a book about a pattern; the pattern of the experience of having syphilis. It gives biographers leads to work with.

"I often asked myself how my delightful little investigation of Lou [Salomé] got so far afield. Finding so much on syphilis that no one had written about kept me following details farther and farther afield. I had to stop digressing if I was ever to finish the book!

"Working on 15 characters at once, focusing on their horrible deaths, it was very depressing, like living in a hospice. There were high moments, the spy-thriller aspect of the story; beneath that lay the horror of working on Hitler so intensely."

But there was exhilaration in working so intensely. Over her computer she hung a sign, "Art is a vampire." She is intrigued by vampire symbolism -- "the poisoned blood passed from person to person, sexualized," she says. In a very real way, her immersion in the tainted blood of the dead was giving her creative life.

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Little is known about the evolution of the syphilis spirochete. Researchers speculate that 100 million years ago, the whiplike, double corkscrew-shaped organism symbiotically colonized the guts of cockroaches. A few thousand years ago, it started to attach itself to human beings, slipping into the bloodstream through cuts in the skin. When our species began bathing, the spirochete found it expedient to move into our moist sexual orifices, following warm pathways of saliva and ejaculate into the mucus membranes of new hosts. The little viral beastie reproduces by repeatedly splitting in two, massively infecting the penis, vagina, or anus with hideous but painless lesions that soon vanish, in an apparent cure, as the bacterium wiggles its way deeper into the lymphatic system. Syphilis is only transmittable during the first few years of infection through open sores in the mouth and on the genitalia; nonsexual infection is rare, although the disease can be transferred by a wet towel.

As the pus-filled abscesses of primary-stage syphilis dry up, the spirochetes chew away at the heart, liver, brain, bones, muscles, and eyeballs. During its second and third stages, the disease evades diagnosis by mimicking the symptoms of rheumatism, arthritis, gout, eczema, epilepsy, headache, stomachache, jaundice, mania, depression, dementia, paralysis, schizophrenia, deafness, and "nerves." The tertiary and final stage gradually brings about the disintegration of mind and body; the longer the unfortunate sod hangs onto life, the worse his end is likely to be.

With spirochetes lodged permanently in his brain, a carrier may experience moments of preternatural clarity, emotional ecstasy, and even creative genius. "I do not want to romanticize syphilis, but there is a Faustian bargain to the experience," says Hayden. "The sufferers are often rewarded with a creative, disinhibiting burst. Euphoria and exhilaration are not so horrible -- that's all I can say." In the end, though, a stroke, an aneurysm, a heart attack, or systemic organ failure sends the syphilitic to his grave.

Hayden points out that shortly after Columbus returned from raping and pillaging Hispaniola, a nasty strain of syphilis invaded the bodies of millions of Europeans, vectored thither by the vaginas of prostitutes. Five hundred years of raging debate has yet to solve the question of geographic origin. New World or Old World, the cold fact remains that the fearful syphilis pandemic (rivaled only by AIDS for insidiousness) ravaged Europe and the Americas at the dawn of the 16th century, killing millions.

The tempo of mass infection slowed in the intervening years; by the 19th century, syphilis was considerably less virulent, although it was thought to infect as much as 15 percent of the population of the industrialized nations. It was known to be an unpleasant consequence of promiscuity and considered by many doctors to be hereditary. It was treated with mercury, arsenic, spider webs, and burnt deer horn. (One company manufactured mercury-laced chocolates for husbands to give to unsuspecting wives.) And since the visible signs of the disease — the chancres, pustules, and skin lesions — faded away after these treatments, it was often presumed cured. When the paralyzed syphilitic expired in coronary agony decades later, blame was often laid to other causes. The only sure way not to catch it in those pre-penicillin days was virginity (no kissing either!).