Author Affiliations: Department of Ophthalmology, University of South Florida College of Medicine, James Haley Veterans Hospital, Tampa (Drs Margo and Harman); and Department of Neurology, University of Colorado Health Science Center, Denver (Dr Smith).
Generations of disabled persons were inspired by the miraculous recovery Charles Fletcher Lummis made following a series of devastating strokes that began at the age of 28. The famed author, editor, and social activist was struck by misfortune again at 51 when he went bilaterally blind. At the height of his career, Lummis never let the loss of vision interfere with his many professional responsibilities or his personal life. The cause of Lummis's stroke and blindness has been the subject of speculation for nearly a century and involves one of the most sensitive and perplexing diagnoses in medicine.
On August 1, 1911, the Los Angeles Tribune reported that Charles Fletcher Lummis, the celebrated editor of Land of Sunshine, poet, photographer, amateur archeologist, and Indian rights advocate, had gone blind.1 Lummis, a friend and confidant of President Theodore Roosevelt, had written in his personal journal just 7 days earlier of having to shave for the first time in utter darkness.2 The first hint of any visual problem surfaced in May of that year, several weeks after Lummis returned from an expedition to Guatemala.3,4
An obsessive diarist, Lummis wrote from 50 000 to 55 000 words each year in a personal journal from 1888 to 1928, documenting the most trivial aspects of his daily routine. During the months that preceded blindness, Lummis made only casual reference to his vision. In June 1911, he purchased new glasses at the department store and found them somewhat helpful.5
From the earliest onset of visual symptoms, Lummis attributed his eye condition to “jungle fever,” contracted while on a 6-week expedition to the Mayan ruins of Quirigua. During the excursion, every member of the expeditionary party developed the “breakbone” fever characteristic of the disease except for Lummis and his youngest son Quimu, who accompanied him on the trip.6(pp142-144) No one other than Lummis, however, ever manifested the latent complication of vision loss.
For approximately 15 months he remained completely blind, unable to recognize faces or to tell night from day.7(pp188-290) Despite the enormity of the disability, Lummis never sought the input of an eye specialist, although a friend, Otto Benz, recommended that he consult Professor Otto Haab of the Zurich Eye Hospital for an opinion.8
Usually introspective and prolific, he wrote next to nothing of substance about the tribulations of going blind or the ways he physically coped with darkness. Between July 1911 and late 1912, he was seldom seen in public without a bandanna covering his eyes, suggesting—perhaps—some element of photophobia. When he was outdoors, Quimu acted as his guide.
Lummis adjusted immediately to blindness. Outwardly, the disability had no substantial effect on his work or social life (Figure 1). He continued to supervise the construction of the Southwest Museum, his major preoccupation at the time. Tracing his fingers over the floor plans, Lummis could imagine the 3-dimensional relief of the building well enough to engage in heated arguments with the architect about changes in design. He continued to hike, cook, practice the guitar, trim hedges, and perform sundry manual labor (Figure 2). Unwilling to abandon photography, Lummis taught young Quimu how to use the camera and directed him on what scenes to capture.6
Lummis wearing bandanna and posing under parasol with family members of Adolph Bandelier, mentor archeologist and friend, circa 1912, New Mexico. Gray scale of original cyanotype. Courtesy of the Braun Research Library, Autry National Center of the American West, Los Angeles, California; P.33783.
Lummis hiking in New Mexico approximately 1 month after he lost vision. Frank Springer, noted authority in Paleozoic archeology, is guiding him uphill while Quimu is leading the procession.6(p143) Gray scale of original cyanotype. Courtesy of the Braun Research Library, Autry National Center of the American West, Los Angeles, California; P.58132.
Details about Lummis's visual recovery are sketchy. On the last day of August 1912, he wrote: “lifted the big black bandage [bandanna] and pried the bad eye open and got dim but recognizable glimpse of my Bertha [daughter], my Quimu . . . first human faces I had looked on in 14 months.”6(p151) Nothing following that journal entry indicates visual recovery was imminent.
In November, Lummis received a letter from attorney George Crothers expressing delight over having heard (secondhand) that he could see again.9 That same month, rumor of his recovery reached another friend, George Frey, who wrote Lummis asking what might have led to his cure.10 His question was personal, for Frey had also gone mysteriously blind himself. As in the case with Lummis, the process was painless and left no visible signs of inflammation.10
As 1912 came to an end, he continued to appear blindfolded in public, although amber goggles periodically replaced the bandanna (Figure 3). Lummis downplayed his miraculous recovery, waiting until March 1913 to announce at a dinner reception his good fortune; the news was greeted with a round of applause.7(p290)
Lummis at the groundbreaking of the Southwest Museum, November 16, 1912. After hoisting the American flag, he addressed about 300 citizens while wearing a white bandanna.6(p147) Courtesy of the Braun Research Library, Autry National Center of the American West, Los Angeles, California; S1.6.
After 1913, there were no new revelations about vision until Lummis began having difficulty focusing on photographs in the 1920s. This time he sought the opinion of an eye specialist who diagnosed cataracts in 1927.4 Lummis, now 68, was dissuaded from surgery because extraction of the worse cataract would “prejudice and bungle the sight in the left eye.”4 Lummis complained periodically about his vision, but more pressing medical problems kept him from having the cataract removed. On November 25, 1928, he died from presumed intracranial spread of cancer of the maxillary sinus.
The curious blindness of Lummis has remained the subject of speculation for nearly a century. The subject has avoided medical scrutiny, possibly because it deals with one of the profession's most unsettling diagnoses—factitious disease.
At the age of 2 years, Lummis lost his mother to tuberculosis and was cared for by maternal grandparents until he was old enough for school. His father, Henry, a Methodist clergyman and disciplinarian, brought him back to Lynn, Massachusetts, where he taught at a girls' academy. Henry actively participated in his son's religious and secular education, providing the majority of instruction at home. Despite the cloistered atmosphere, the personal attention he received gave Lummis a decided advantage in Latin, Greek, and French by the time he entered Harvard in 1877.
A capable college student, he made extra money tutoring classmates in language and philosophy. Now free of paternal oversight, Lummis lacked direction and rejected authority. Known for his brazen pranks, he was lucky to not have been expelled during his first years at Harvard.7(pp10-12) At Cambridge, Lummis developed an interest in physical conditioning and participated in a variety of sports. Although slender, he took pride in his muscular build and athletic ability. A self-confessed cutup, he also displayed a serious side, publishing a book of verse in 1879 titled Birch Bark Poems,11 which received encouraging reviews from the literary community.
Living without parental guidance had other perils. Lummis was secretly married to medical student Dorothea Rhodes his junior year, at about the same time he fathered a child out of wedlock with another woman. And although his academic performance up until this time never seemed to suffer, Lummis dropped out of Harvard 3 days before commencement, attributing the incapacitation to “brain fever.”12(p6) Details surrounding the sudden illness remain murky. Brain fever loosely translates to encephalitis or meningitis, but there is no evidence he suffered from any neurologic disorder at the end of his senior year. Later investigation into the incident showed Lummis had failed examinations in trigonometry and analytical geometry.6(p14)
After dropping out of Harvard, he moved to Chillicothe, Ohio, to work on his father-in-law's farm, while Dorothea remained in Boston to complete her studies. In Ohio, he boxed, wrestled, played baseball, and developed an interest in archeology. Never seriously intent on becoming a farmer, Lummis tried his hand at editing a small newspaper in the Scioto Valley and enjoyed it.
At some point in 1884, he decided to explore the West. He contacted Harrison Gray Otis, the publisher of the Los Angeles Times, and persuaded the newspaper owner to underwrite a promotional stunt to subsidize his move to California. Lummis promised to walk across the country writing weekly dispatches about the journey in exchange for $5 per epistle and a chance to work at the newspaper once he arrived in Los Angeles.7(pp17-21)
At the age of 26 and in top physical condition, Lummis began the 112-day journey in Cincinnati on September 12. His trek across the Southwest was vividly recorded in weekly stories he wired to the Los Angeles Times. By the time he reached southern California, Lummis was already a minor celebrity. The long hike was later embellished in a book, in which Lummis recounts the origins of his infatuation with the Southwest and his love of Indian culture.13
Despite differences in personality, Lummis got along with Otis, who appreciated his spunk and initiative. Lummis let his new job consume him, often working 7 days a week and seldom getting more than 4 hours' sleep a night. After working for nearly 3 years to the point of exhaustion, he began to experience numbness of his left index finger. The symptoms lasted a week and were associated with nonlateralizing sensations in his legs, head, and trunk.14(pp25-29) One afternoon a “creeping numbness close to the heart” preceded his collapse. Awakening on a couch, Lummis discovered he could not get up. After 20 minutes he was able to stand, but “couldn't move a muscle” in his left arm.14(pp25-29)
Rather than seek medical attention, he decided to treat himself by immersion in the New Mexico wilderness, even though he was “barely able to waddle.”14(pp25-29) Although commenting that his speech was “more or less affected,” there was no documented problem with language or verbal communication. Once in New Mexico, Lummis bathed in ice water, learned to roll cigarettes with one hand, shot a rifle like a revolver, and drove a wagon. He learned photography, recorded more than 800 songs on an Edison device, and broke more than 20 wild broncos. Although his left arm remained useless, he became a “contented hermit,” living independently off the land.14
To further recuperate, Lummis moved to the Indian pueblo of Isleta, where he enjoyed traditional hacienda life. The prolonged separation from Dorothea, however, strained their already tenuous marriage. Still without improvement in motor function of his left arm, Lummis sustained 2 more paralytic attacks, one following a letter from Dorothea presumably asking for a divorce.12(p12)
Hospitalized in Santa Fe, he lay helpless and mute but was able to use the time to prepare humorous vignettes for Life and Time magazines.12(p12) Once discharged, his ability to speak reappeared unexpectedly one afternoon, when he caught himself humming a Spanish tune aloud.7(p140) Function of the left arm appeared to catch Lummis off guard in much the same manner as his voice. Not long after divorcing Dorothea and marrying Eva Douglas, whom he met during convalescence in New Mexico, Lummis found himself stroking the hair of his new wife with his left hand.7(p140) It was the first documented use of the limb in 3 years 7 months, and a special unexpected gift for the newlyweds. Strength and dexterity returned rapidly to its preapoplectic baseline.
Lummis described his experience overcoming paralysis in the 1891 book My Friend Will.14 Written in the third person, the book had the express purpose of giving hope to persons with a disability and of demonstrating the power of the human spirit to overcome adversity.
From a purely neurologic standpoint, it is difficult to identify a clinical disorder that adequately explains migratory, bilateral paresthesias, absolute paralysis of the left arm, weakness in the left leg and then in both legs, well-preserved strength in the right arm, and mutism without aphasia. This presumably multifocal process followed an unusual temporal course, with profound motor impairment localized to the left arm and then total, rapid recovery after 3½ years. The clinical features and courses of cerebrovascular and demyelinating disease do not fit this picture.
Remarried and physically whole again, Lummis behaved as if he had a new lease on life. In 1893, he returned to Los Angeles, where for the next 17 years he threw himself into a host of ambitious projects, including archeological excavations, restoration of the California missions, and editing the widely popular Western literary magazine Land of Sunshine.
Lummis seemed to enjoy defying convention. The offbeat names of his children and the eccentric clothing he wore begged for attention. A gray Stetson sombrero, green wrinkled corduroy suit, and red Navajo sash were his trademark attire. He spent more than 10 years building a house of boulders, rocks, and adobe—a stone castle along the Arroyo Seco to showcase the legacy of Spanish colonial America, a culture he thought Californians were foolishly rejecting. The atmosphere of dinner parties at his house resembled a European salon; his home became a regular gathering place for members of California's art and literary circles.15
As Lummis got older, he engaged in salacious affairs with dozens of younger women. These affairs destroyed his second marriage and family.7(pp278-286)
The year Lummis went blind was as stressful as any time in his life. He lost his only source of regular income after resigning as chief librarian of the Los Angeles Public Library, a job he had held since June 1905. Although his resignation was not forced, Lummis received considerable criticism about the way he ran the library. He rationalized his departure as giving him more time to pursue his dream of building a museum. Having worked tirelessly since 1904 to get the Southwest Museum off the ground, Lummis was ready to supervise construction of the main building atop Mount Washington, several miles north of downtown Los Angeles, when he lost his sight. All this occurred as Lummis was engaged in a very public and very bitter divorce with Eva, who could no longer tolerate his extramarital affairs.
Although Eva seemed to have limited interest in her husband's tangible assets, she rejected completely his right to raise their children. By many accounts, Lummis was a devoted father; he was particularly fond of 10-year-old Quimu, who he insisted live with him in Los Angeles to serve as his second eyes.16 Eva moved in with Phoebe Hearst, the mother of William Randolph Hearst, and then decided she must forsake her pride to win custody of her children by exposing every detail of her husband's infidelities.
Eva learned to turn Lummis's obsession as a diarist against him. With some patience, she was able to decipher the cryptic entries that for years cataloged his sexual exploits.7(pp278-286) Once the scandalous stories got out, they made great fodder for newspapers, but it was questionable whether they would shame Lummis into giving up the children. As the domestic battle raged into its second year, Lummis turned the tables on Eva—accusing her of extramarital liaisons.
When the divorce was eventually finalized in June 1912, Quimu was 12 years old and tired of leading his father about and running errands. By the fall, Lummis's sight had improved enough so he could walk unaided with goggles.
Lummis was always content with his self-diagnosis of jungle fever, while later in life almost relishing its exotic appeal.4 Having traveled for months as a young man in South and Central America, Lummis had firsthand experience with diseases that fell under the 19th century rubric of jungle fever (malaria and yellow fever being the most obvious examples). He was also likely familiar with river blindness, when few physicians in the United States would have had any knowledge of the condition now known as onchocerciasis. The type of jungle fever he brought home with him in 1911, however, was highly unusual for any infectious disorder. It was not associated with any febrile illness, and visual symptoms developed weeks after returning from the jungles of Guatemala.
Much of our current understanding of river blindness originally came from a Guatemalan physician named Rodolfo Robles, who, 6 years after Lummis went blind, discovered the pathogenic role of the filarial parasite Onchocherca volvulos and its transmission to humans by insects of the genus Simulium.17 River blindness has an incubation period and can be carried into nonendemic areas asymptomatically, but it is a notoriously itchy, chronic inflammatory skin disease. Lummis never had any documented feature of onchocerchiasis. Although exotic disorders like malaria or yellow fever were implied causes of vision loss, no tropical disease can adequately explain his clinical course of isolated blindness.
The simultaneous and bilateral loss of vision points to conditions that affect the occipital lobes or visual cortex. However, diseases known to injure this part of the visual pathway to the extent that they extinguish all light perception, whether they be vascular, demyelinating, neoplastic, or neurodegenerative, do not spontaneously remit after 15 months. The clinical course also is atypical for the posterior reversible encephalopathy syndrome.
Several persons, including 2 of his children, have debated whether Lummis's paralysis at age 28 and blindness at age 51 were related and whether they were organic or functional in origin. In compiling a biographical memoir of their father years after he died, Turbesé Lummis Fisk and Keith Lummis questioned whether the Lummis family strain of migraine could produce neurologic symptoms suggesting paralysis or blindness.6(p151) Concluding it unlikely, they mused whether the contemporary term psychosomatic illness might be a more appropriate diagnosis for their father's affliction.6(p151)
Edwin Bingham, an historian and student of Land of Sunshine and its famous editor, confessed that there is no way of knowing where organic disease ends and psychosomatic illness begins, yet he acknowledged that there was suspicion that Lummis's paralysis and blindness were “largely delusory.”12(p33) Others privately doubted Lummis ever went blind. Among them was John Muir, who politely told him so in a letter and then encouraged him to get more rest.18
Lummis seemed to have savored the challenge that darkness presented him to the point of denying an authentic human response to the challenges blindness inflicts. Apparently nostalgic for the adversity of blindness, he continued to shave for years with his eyes shut.19
The phenomenology of nonorganic visual loss is incompletely understood, encompassing aberrant behaviors both involuntary and deliberate. Usually subdivided into psychogenic or the result of malingering, functional vision loss is a diagnosis of exclusion. Strategies to test the validity of alleged vision loss are now part of every ophthalmologist's training, but they are difficult, if not impossible, to apply historically.20,21
Evidence suggesting Lummis may have been faking his blindness comes from his handwritten journals, the corpus his wife used to disgrace him during their divorce proceeding. In general, the quality of one's penmanship is relatively unaffected by severe vision loss, although a common gaffe of the unsophisticated imposter is intentionally exaggerated careless handwriting. Lummis's cursive script appears entirely unaltered by blindness; however, there are other features of his writing that are difficult, if not impossible, to reconcile with the notion that a blind man could have written such text.
Late at night, from July 1911 through 1913, Lummis crammed his journal with notes recounting the activities of the day, just as he had done for decades. He wrote in a bound ledger on narrowly spaced, preprinted lines, squeezing hundreds of words onto the single page allotted for the day (Figure 4). He wrote neatly, never dropping below a line or veering upward. Ink is seldom dripped or smeared. He began each line at the designated margin. He blanketed the sheet with tiny script yet avoided the preprinted header atop the page. Selected words and phrases were underlined for emphasis, parentheses were wrapped around words—never through them or over them— and afterthoughts were occasionally inserted between lines in different color ink. He also maintained a financial ledger during the period of total blindness. Written in his hand, each entry is neat and perfectly fitted to row and column (Figure 5).
Lummis's handwritten diary the day he went totally blind (July 25, 1911) and the first time he performed a “blind shave.” Roughly 37 lines of written text respect the preprinted lines on the page. Words avoid headers, and the left margin is exact. Personal diary, 1911. Courtesy of the Charles F. Lummis Manuscript Collection, Braun Research Library, Autry National Center of the American West, Los Angeles, California; MS.1.
Financial ledger showing cash expenditures from January through August 1912. Unassisted, Lummis placed entries within rows and columns. Twice on this page, he inserted entries between lines. Personal diary, 1912. Courtesy of the Charles F. Lummis Manuscript Collection, Braun Research Library, Autry National Center of the American West, Los Angeles, California; MS.1.
Although we will never know for sure whether Lummis's blindness was real or feigned, his description of the ordeal in November 1912 offers another potential clue: “I intend to get all my eyes back in time. . . . The dark is another world and I had fun exploring it.”6(p151) This degree of self-confidence contradicts the humility that people typically face at the hands of a cruel and capricious disease. One wonders whether it also reflects the psychological improvisation of a complex man.
Correspondence: Curtis E. Margo, MD, MPH, University of South Florida, 12901 Bruce B. Downs Blvd, MDC Box 21, Tampa, FL 33612 (firstname.lastname@example.org).
Submitted for Publication: August 20, 2010; final revision received August 22, 2010; accepted August 31, 2010.
Financial Disclosure: None reported.
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