For Doctors Only
Barber Shops and Disease--Chance for a Trust and a Public
Benefaction--Tropical Hotel Clerk from Canada--A Visit to the
Hospital at Ancón--Beautiful Location--Housekeeping under
Difficulties--Genial and Gentlemanly Doctors--The Buildings Left by
the French--Details--Prevalence of Malaria--Drinking Water--Why the
People of Panama Ought to be Dead--The Spoiled Child--Why the Eleven
O’clock Breakfast is Enjoyable at Ancón--A Specimen Hotel Breakfast.
Doctor Echeverría did not appear for a half hour after I had finished
my coffee and rolls. While waiting for him I had my hair trimmed,
and experienced the pleasure of sitting in the chair next to a
dirty-looking man with a skin disease which had caused his hair to fall
out in patches, and which caused mine to stand up all over, as the
barber’s assistant began using comb and shears on him and making the
hair and dust fly in my direction. If this man had come an hour earlier
he might, without my knowledge, have been shorn on the same chair that
I occupied, and with the same comb, scissors and unwashed hands that
were used on my head. I felt like resolving never to go into a barber
shop again, but knew that I could not live up to the resolution. I
would have to step up and take my share of dirt and microbes and have
them rubbed in at least once a month or two, for I could not trim my
own hair. I could not help repeating that good old saying, “God made
Barbarians and seeing that they were no good, called them Barbers.”
The proprietor of the shop was a gentle old German, too good natured
and old to learn the technic or meaning of cleanliness. He had cut
hair and beards in Germany, the United States and Cuba, and knew all
about his business except cleanliness. Cleanliness in barbers is like
biblical honesty in business. While having my hair trimmed and my scalp
infected by the old fellow, I asked him if he did a better business in
Panama than he had done in the United States. He said:
“Ogh, yes. In the Unidet States I did a goot pisness, yet not such a
pig pisness ass here. Dere I wass only a boor barbeer, but here I make
much money and am a pig man.”--He was.
The want of cleanliness of the barbers, and the custom of using public
combs and brushes at hotels, clubs and entertainments accounts for nine
tenths of the baldness in the world. Barbers’ brushes bear the germs of
baldness and badness from scalp to scalp, and their infected fingers
rub it in. One should always go home and wash his head with soap and
water, or with alcohol, as soon as possible after a barber has had his
comb and black-bristled brush on it. One should also furnish his own
comb and brush, razor and mug, and insist that the barber wash his
hands thoroughly before touching them. Under no circumstances should he
be allowed to give the head a “dry rub.”
There is a chance to make millions of dollars and benefit millions of
people in the barber business. A trust that would teach its employees
an appropriate antiseptic technic; would provide combs, brushes and
all kinds of barbers’ instruments adapted to sterilization by _strong_
antiseptics or by heat each time they were used; and would provide
aseptic shaving, hair cutting, epillation, electric vibration, facial
massage, baths and hairdressing, as well as clean furniture, floors,
hands and men, would drive the old dirt-men out of the business in a
short time. It would at least force them to wash their hands between
customers. Such a trust would, of course, raise, or try to raise,
prices, and thus “scalp” the community, and be censured for it. But it
is better to be scalped than bald-headed, to be expensively clean than
economically dirty. It would constitute a great reform, which should be
an aim of all trusts.
How a cleanly man can go and await his turn in a barber shop to be
shaved two or three times weekly by dirty hands, and be combed by dirty
combs and brushes, and have his head dry-rubbed by hands that have been
dry-rubbing other heads without being washed, when he can do the same
himself at home with clean hands and implements and without waste of
time, is almost incomprehensible. To gaze into a barber shop is bad
enough. Flashy mirrors and massive furniture cannot compensate for
dirty methods. Barbers dare not use brushes with white bristles, for
they would look frightful before night. They would have to be washed.
The hotel clerk was a polyglot French Canadian who, like the barber,
the barber’s assistant and a large proportion of the other trained
employees about town, had traveled considerably before coming to
Panama, and would probably travel again in search of more congenial
climes and more remunerative work as soon as rivals should come and
conditions improve. He spoke French well and Spanish and English
indifferently, and was willing to talk to any one until some one else
claimed his attention. He fitted in his place very nicely, for he
possessed that complicated lack of system that forms an essential part
of tropical hotel management. He was unfailingly obliging and affably
irritable, as forgetful and unreliable men are apt to be. In giving him
orders, it was always well to wait and see them carried out. If one
wanted anything sent to one’s room, or brought down, it was well to
wait until the gong sounded, the boy called down, the clerk called up,
and the message was correctly delivered and intelligently understood;
otherwise it was liable to be given wrong, be misunderstood or be
forgotten. When time hung heavily on one’s hands this supervision of
the clerk and bell boy served to help the hot half hours move on.
Doctor Echeverría appeared at last, full of half a roll and an orange
and ready for the morning’s work. He had sent his daily cablegram
to his wife before taking coffee, but had not yet heard from her.
As he was the official head of medical affairs at Limón, he wished
to be prompt in paying his respects to the chief sanitary officer
of the Canal Zone, Dr. Wm. G. Gorgas, and the chief of the Marine
Hospital service, Dr. H. R. M. Carter, and the chief of the Quarantine
department, Maj. L. A. LaGarde. He could not rest until he had done
his duty as a public health officer, a brother physician and a
courteous gentleman. He did not realize that the social and ceremonial
conscience of the Anglo-American race was not as sensitive as that of
the Latin-American. While these chiefs would have been glad to see him,
they were bound up in their work and would not have taken notice of a
little delay on his part. So we drove to Ancón Hill, which was a short
distance beyond the railroad station, and arrived there about nine
o’clock. Leaving the cab we slowly walked up the beautiful avenue that
led along the hillside through the grounds.
The location of the hospital on the slope of Ancón Hill was certainly
well chosen, for the ground was high and the view unobstructed. The
driveway was shaded by palm trees and bordered with well-kept, sloping
lawns upon which neat-looking frame houses were scattered. It seemed to
me almost preferable to be sick up there than well in the dingy, dusty,
sun-baked city below. The medical officers certainly had the choice
place of residence on the isthmus, for here were fresh breezes, clean,
well-drained grounds, quiet surroundings and a charming outlook upon
semi-mountainous, tropical scenery. The Tivoli has since been built
here and its construction must certainly have given the “black eye” to
Gran Hotel Centrál. But to those who wish to know what Panama really
is Gran Centrál is the place. Those who go to Tivoli read guide books
and forget; those who go to Gran Centrál need no guide books, and never
forget.
We did not find any of the chiefs at their homes on the hillside; they
were down town at their offices in the government building in Plaza
Centrál, from which we had started. We had gone from them instead
of to them. These men get up at daybreak, take a cup of coffee, and
presumably half a roll, and go down to their offices and transact a
good day’s office work by eleven o’clock. Then they drive back home,
eat a hearty breakfast and remain in their garden of paradise with
their families until the midday heat begins to be tempered by the
regular afternoon breeze, when they go to work again.
But we had a pleasant chat with Mrs. LaGarde, the wife of Doctor
LaGarde. She gave us all sorts of information from a woman’s
standpoint, and proved to us that although the exteriors were beautiful
and perhaps enjoyable at Ancón, and the hospital a charming place to
get sick and get well in, the comforts of housekeeping and living
constituted, according to United States habits and standards, a sort
of seamy side of life for these hard-working semi-exiles. The houses
had not the places to put things in, nor the conveniences for cooking
and other details of housekeeping that are considered essential in the
North. Closet room is a Yankee luxury. Clothes would not dry except
in the sun and wind, and if put away would get wet again. Insects
were annoying and screens had not yet been provided. Alterations
about the house had to be made, and makeshifts adopted. There was
neither running water nor drainage. But Mrs. LaGarde was cheerful and
even breezy in her talk, just as if she not only enjoyed giving the
information but also overcoming the difficulties. With the assistance
of the United States she has, I believe, overcome some of them since.
Doctor Carter’s son hunted up the young resident doctors. They were
engaged peeping into microscopes, but they cheerfully gave up the
private matinee they were having over their germs and, after having
given us a peep at malarial high life, showed us through the hospital
buildings. We found Mr. Carter and the young doctors exceedingly
painstaking and courteous, and we afterward also found Doctor Gorgas,
Doctor Carter and Doctor LaGarde even more so. A more genial and
gentlemanly set of men in a quiet American way I have scarcely met.
They seemed to have become imbued with the spirit of Spanish courtesy
without having lost their American frankness and sincerity, and bore
their great and unusual responsibilities with cheerfulness and modesty.
There were about twenty hospital wards, in separated one-story frame
buildings, arranged in three curved tiers on the beautifully terraced
slope of the hill. In fact, the ornamental grounds were so large and
elaborate that the expense of keeping them up was quite an item.
But the French had plenty of money, while they had it, and spent it
artistically and generously, while they spent it. And there is no doubt
but they built well, since the majority of the houses were found in a
good state of preservation, and have been repaired at small expense.
Ancón Hospital had at the time less than a hundred patients, two thirds
of whom were negroes, and over half of whom were employees of the canal
commission. To be laid up in those clean, well-kept wards and be waited
upon by those tidy, cheerful nurses must have been a great luxury to
the poor black devils. To die there would be enjoying themselves to
death, no matter where they finally went to.
Superficial swamps all along the Zone were being drained or filled,
in hopes of exterminating the malaria breeding mosquitoes. About the
Ancón hospital, malaria had already practically disappeared. The extent
of malaria in the Canal Zone had been demonstrated by blood analyses.
At Bohio the blood of forty-four school children had been examined
and the malarial organism found in twenty-nine cases. After they had
taken twelve grains of quinine daily for ten days the organism was only
found in five. It was also found that seventy per cent. of the 12,000
inhabitants of twelve villages along the Zone had the malarial organism
in the blood. This is largely the cause of the prevalent anemia.
Colonel Gorgas had been appointed health officer of the city of Panama
and of Colón by the Panama government, and health departments were
being organized in both cities. A systematic cleaning of dirty places
(a Herculean task) and a rigid enforcement of modern sanitary laws and
regulations had already been begun. The Zone commission was at work
constructing the new reservoir, about twelve miles from the canal,
out of which Panama and the whole Zone have since been supplied with
healthy water. The people of Panama were using rain-water collected
in cisterns for drinking and washing. In the rainy season the streets
flowed with it and the cisterns overflowed; but in the dry season many
of the reservoirs were empty, and there was practically a water famine
up to the time of my visit. Those who could afford it, drank imported
waters, such as White Rock, Apollinaris, Vichy, etc.
Why the people of Panama are not all dead long ago is past finding out.
The animal kingdom from the mosquito up has preyed upon them, and the
elements have conspired against them, drenching them for six months of
the year and burning them and devitalizing them during the other six.
They have also conspired against themselves, having had a civil war
on an average of almost once a year. The country has been ravaged by
adventurers and pirates in past centuries and beggared by Colombia in
the present one. They have scarcely any developed resources. But now
they have run under the wing of the United States, who will kill the
mosquitoes for them, provide hospitals to take them in out of the sun
and rain, make fresh ice-water to keep them cool, arbitrate for them to
keep their peace, build a canal for them to increase their business,
and will keep out the foreign foe when they are threatened. If such a
sudden change from prostration to prosperity does not spoil the child
then it deserves all it gets, and is fit to survive. The French spoiled
the Panamanians somewhat, and made them dependent and parasitic,
but it is to be hoped that our influence will be to encourage the
development and financial independence of the country.
We were cordially invited to remain at Ancón and breakfast with the
officers and their families at eleven o’clock. The breakfast seemed to
be looked forward to with great pleasure and was made quite a social
event by them. And I do not wonder that they enjoyed it after doing a
good day’s work while fasting. Their aim was never to put off until
after breakfast what could be done before. They must have been ravenous
by eleven o’clock. But as our blood was heated and our collars wilting,
we thought it better to get back to the hotel before the day became
hotter.
After our customary appetizer, to keep away Doctor Echeverría’s
melancholy and fulfill my vow to do as the Panamanians did, we went to
our rooms and refreshed ourselves with cold water and fresh linen (both
externally), and were prepared to appreciate a substantial breakfast.
They brought us first a large dish of tiny clams (_coquillos_) cooked
in their shells. These varied from the size of a small split pea to
that of a lima bean, and were as finely flavored and delicious as their
delicate physique indicated. We then had some very hot shirred eggs and
made them hotter with a little Worcestershire sauce, which gave them a
fine, tropical flavor. Then came Italian spaghetti daintily served, a
medium-tough nicely cooked beefsteak, some juicy pineapple, too sweet
to bear any sugar, and a small cup of deliciously bitter coffee which I
subdued by the addition of a little evaporated cream.
I was glad that I had not spoiled my breakfast by eating eggs at eight
o’clock, for I was very hungry when we sat down to it, and enjoyed it
so much that I think it really must have been good.