Medical advances

On November 3, 1934, the Saturday Evening Post published “Her Last Case”, a short story by F. Scott Fitzgerald. His relationship with the magazine was coming to an end. The Great Depression and Fitzgerald’s personal difficulties were to blame. From late 1934 to the end of 1935, he published just a few more stories: his wife, Zelda Sayre Fitzgerald, remained hospitalized for mental illness at the Sheppard-Pratt Hospital in Baltimore, and Fitzgerald himself was either hospitalized or needing care at home as his drinking intensified. Many of the stories from the early to mid-1930s have, as a consequence, medical settings, or feature doctors and nurses as characters. The nurses minister to damaged, distressed, sick but still attractive men. Such wish fulfillment is most apparent in the series Fitzgerald began about a student nurse nicknamed Trouble; in “Nightmare (Fantasy in Black)”, much revised, and unpublished until 2017; and in “Her Last Case”.

“Her Last Case” is a quasi-romance – a pastiche of the past and present of the sort Fitzgerald managed so well in The Great Gatsby. A beautiful young nurse named Bette Weaver, “born and bred in a desolate little streak of wind and rain on the Pennsylvania border of Maryland”, arrives at the Virginian plantation home of a sick man, Ben Dragonet. It will be her last case, for she is engaged to an earnest young doctor and about to give up her profession. Dragonet is a wounded veteran of the First World War, but the ghosts of the distant past and the Civil War have done the real damage. His ex-wife (also his cousin), an irresponsible woman who feeds on Ben’s goodness “like a vampire feeding on his blood”, abandons their young daughter, Amalie, to his care. Bette wants out of this turbulent situation, but her fiancé insists she see it through – an error, for by now she has fallen in love with Dragonet. “Her Last Case” is available online only behind a paywall, via the Saturday Evening Post website, and is hard to find in print: it last appeared in the Cambridge Fitzgerald volume A Change of Class (2016), in hardback, and can currently be obtained for about £100.

The setting – the town of “Warrenburg” – was inspired by several trips Fitzgerald made to Middleburg, Virginia, in the summer of 1934. Zelda was in hospital and their daughter, Scottie, was staying with Fitzgerald’s cousin Cecilia and her family in Norfolk, Virginia. After a drunken week in New York in early July, Fitzgerald was gathered up by his friend and editor Maxwell Perkins and taken south. Perkins’s adoring cousin Elizabeth Lemmon owned a 1770s plantation in Middleburg called Welbourne. She took Fitzgerald and Perkins on a tour of Civil War monuments and battlefields, driving as far as Appomattox, where the war ended in April 1865. Fitzgerald returned in August and September, and sent Lemmon a draft of “Her Last Case” in early September : “This is the story that I got out of ‘Welbourne,’ with my novelist instinct to make copy out of social experience. I don’t think for a moment that this does any justice to ‘Welbourne’ but it might amuse you as conveying the sharp impressions that the place made on me”. Lemmon lived on the grounds until shortly before her death at 100. In Fitzgerald’s Ledger – the detailed chronicle of his earnings and life events – he confirms that he wrote “Her Last Case” in August 1934, in between visits to Welbourne. In the same chronicle he makes a number of allusions to people and events that have long puzzled scholars.

He mentions a “collapse at home” in Baltimore after the trip to New York in July. Then comes a reference to the “first Welbourne trip”, annotated thus: “Wolfe + Perkins” and “Gallant Pelham”. Thomas Wolfe had been invited to Middleburg, but stayed in New York. John Pelham was a young Confederate officer who died in the Battle of Kelly’s Ford, forty miles south of Welbourne. Pelham, given his posthumous nickname by his commanding general, figures prominently in “Her Last Case.” In August Fitzgerald mentions “Another Welbourne trip” and “Hospital again. The nurse who was the doctor’s wife … ‘Her Last Case.’ Two days only in hospital (three?)”.

Scholars have assumed “the nurse who was the doctor’s wife” to be a mistake on Fitzgerald’s part, since Bette Weaver, in “Her Last Case”, is engaged to a doctor, but not yet married. It’s no mistake. There was indeed a nurse who was a doctor’s wife, and she was Fitzgerald’s nurse at the time. Her name was Carma Kaufman Freeman, and the inscriptions in the books Fitzgerald gave her, still in her family’s possession, shed fascinating light on “Her Last Case.”

Carma Kaufman was born in Baltimore in 1904. Her family owned the Kaufman Beef Company, a specialist butchers that stayed in business until the 1980s. She graduated from Johns Hopkins Hospital Training School for Nurses on May 26, 1927, and shortly thereafter married George Freeman, a young doctor from Spokane, Washington, who was a medical student at Hopkins. George did his residency in New York City at St. Luke’s Hospital, and the couple moved to Seattle. But the Freemans, and particularly Carma, returned to Baltimore often during the early 1930s. There she tended to her younger brother Gordon, who had tuberculosis. While visiting her family, Carma worked part-time as a private nurse at Hopkins. Graduation photographs show a serious young professional woman; The family portraits of her from the same period give better indications of her warmth and charm.

Fitzgerald was her patient in Baltimore in the summer of 1934. Her copy of Tender Is the Night reads “For Carma Freeman with the gratitude + best wishes of the author F. Scott Fitzgerald, Marburg 1934.” (The Marburg Building was the impressive domed brick centerpiece of the Johns Hopkins Hospital, built in 1889.) In the copy of This Side of Paradise he also gave her, Fitzgerald let his sense of humour show. He liked wordplay and was an impressive physical comic. The inscription to Carma in his first novel reads: “Best wishes (‘Now you just go right to sleep’) from Old Insomniac Fitzgerald to his old childhood nurse, Mrs. Freeman”. Ill or well, Fitzgerald was indeed a chronic insomniac, as we learn in “The Crack-Up” (1936), his essay for Esquire.

Carma received letters from Fitzgerald, but didn’t keep them. She did, however, save an untitled poem that he wrote out for her. It is undated, on letterhead paper from “Cedar Top”, in Ruxton, Maryland, the summer place of DK Esté Fisher, Sr., a Baltimore lawyer, and his wife, Sally. Fisher, Jr. was an architect who coincided with Fitzgerald at Princeton. The author was possibly a guest at Cedar Top for a late-summer party, or maybe an overnight house guest, availing himself of the stationery. The poem is “The Other Side of the Moon,” by the American novelist and poet Edgar Fawcett (1847-1904). Published in Songs of Doubt and Dream (1891), “The Other Side of the Moon” was much anthologized in the early 1900s. It is a conversation between an adult and an eight-year-old girl about the far side of the moon, from which heaven may be seen.

Why this emotional poem? Perhaps because Fitzgerald and Carma had discussed Scottie and his worries for her; the little girl with golden hair in “The Other Side of the Moon” seems to recall his daughter, as does Amalie in “Her Last Case.” Perhaps, too, because he and Carma had spoken of the first child she and her husband were expecting. Carma never spoke in depth about her conversations with Fitzgerald; she took patient confidentiality seriously. But when Carma showed her grandson the inscription in This Side of Paradise, she confirmed that “Now you just go right to sleep” was what she usually said to Fitzgerald after he’d taken his medicine. In “Her Last Case” Bette Weaver similarly orders her patient: “You must go to bed.”

Did Fitzgerald send Carma a copy of “Her Last Case”? Impossible to say. We know that he identified with his characters, and particularly the leading men. As he wrote in his Notebooks, “I am an only child. Gatsby my imaginary eldest brother, Amory my younger, Anthony my worry. Dick my comparatively good brother but all of them far from home.” Surely the elegant shoes and well-tailored clothes of Virginia gentleman Ben Dragonet appealed to him. Surely, too, Fitzgerald turned his appreciation for the nurse who cared for him at Hopkins – but who, as a happy young wife, wasn’t at all interested in her alcoholic patient – into fiction.

Thanks to Carma Freeman’s grandson George for sharing Carma’s story, and for the images used here

Anne Margaret Daniel is a lecturer in literature at the New School University in New York. She is the editor of F. Scott Fitzgerald’s I’d Die for You and Other Lost Stories2017, and is currently working on a book of essays about Bob Dylan

The post Medical advances appeared first on TLS.

Leave a Comment