The Gutsmut Game

I never thought I'd see the day when my lover's quarrel with American culture would lead me to quote Shirley Temple. Bugs Bunny, maybe, Marshall McLuhan or Mary Poppins, perhaps. But not Shirley Temple, whom McCall's magazine hailed last year as the "uniquely winsome little girl who dimpled and danced her way across the Depression-weary scene" of the Thirties.

Probably because of some serious lack on my part, little Shirley's dimpling and dancing never brightened my Depression-weary scene for a minute. In fact, there are some of us who feel that the Depression didn't begin until little Shirley gave out with On the Good Ship Lollipop. Before that, we were poor but happy.

But enough of nostalgia. Our concern is with the present. And when the grown-up Shirley Temple Black "speaks up about some of today's 'adult' movies" in a big, two-page article, and a great national magazine like McCall's puts it up front in the lead-off slot--well, America had better pay attention. We may be headed for another crash.

The article was laid out under an illustration of a sinister-looking strip of film draped over a couple of stacks of quarters labeled "Sex at the box office" and was a kind of formal position paper in which the former child star once again explained her world-shaking resignation from the chairmanship of the Venice (California) Film Festival in protest against the proposed showing of a Swedish entry called Night Games. "In dissenting from my fellow members of the Film Selection Committee, I expressed my opinion that the film had little to recommend it and much to disqualify it for a civic-sponsored festival such as ours," the grown-up Shirley explained. "I noted the technical inadequacies of the film, but chiefly I criticized the preponderance of and unnecessary emphasis upon erotic detail. I called it 'pornography for profit.' Advocates of the movie protested. It was, they insisted, 'a serious attempt to ennoble one man's search for the roots of his sexual impotency.' Perhaps. But if so, it was rather like shooting for the moon and hitting the outhouse door."

Unfortunately, the latter lively comparison was rendered somewhat less than felicitous by the fact that Shirley's high-minded think-out on "pornography for profit" was bordered by a McCall's ad for a Toilaflex All-Angle Toilet Plunger and her own declared preference for another naughty Svenska flicker called--of all things--Dear John.

But it was just such little ambiguities and happenstances that made for much of the article's charm. "What I am fed up with are those medicine men of movies who create and sell hard-core pornography for profit," the authoress continued to insist--leaving the reader to wonder where she might stand on the issue of hard-core pornography without profit. Was it the commercialization she objected to? Was she, perhaps, in favor of turning the production of hard-core pornography over to some nonprofit-making National Foundation for the Propagation of Filthy Films? Or would she have preferred to see it subsidized by taxes, through some sort of Federal grant?

Though it hardly seems likely that Shirley Temple would ever lend her name to a Government-sponsored program of socialized smut, her support of the foundation principle was suggested in a biographical squib in which the editors noted that "Shirley Temple Black not only crusades against pornography for profit in films but works tirelessly for the international pooling of talent and resources to fight multiple sclerosis"--a good and worthy cause, whose non-profitable status is evidenced by the fact that of an estimated $4,300,000 income enjoyed by the National Multiple Sclerosis Society in 1965, a mere 21 percent was spent for the purpose of actual research.

But, as I was to learn from a copy of Time that appeared during the same month, Shirley Temple Black's interest in things medical did not end with multiple sclerosis. "There are bird watchers and bee watchers, satellite watchers and girl watchers," Time observed in its weekly miscellany on "People," "in fact, watchers for just about everything. But Mrs. Charles Black, 38, once known as Shirley Temple, belongs in a category all her own. 'I'm an operation watcher,' she explained to The New York Times. It started when Shirley was 14, visiting (continued on page 78) Gutsmut Game (continued from page 71) an Army hospital in Oregon. 'A boy asked me to be with him while his leg was amputated. I held his hand the entire time, and since then have watched many operations. Gall bladders are the best--the colors are gorgeous.'"

While I found it somewhat surprising that a person of Mrs. Black's lofty and humane sensibilities could be quite so ardent in her enthusiasm for the visual kicks to be had from seeing people cut open and divested of their gall bladders, I was even more taken aback by Time's saying that her fascination with displays of the human gizzard put her "in a category all her own." Time, of all publications, should have known better. Its own weekly coverage of the medical-surgical scene is so notably thoroughgoing, deep and inside, as to suggest that its audience must include a considerable number of visceral voyeurs--bladder enthusiasts, kidney fans, liver lovers, brain-surgery buffs and transplant aficionados.

During the Great Heart-Transplant Festival that began in late 1967 and early 1968, for example, Time's reportage was so vivid and detailed that the operation watchers in its audience were privy to more clinical minutiae than were the readers of Medical World News, Science News or The Journal of the American Medical Association. JAMA's report to the medical profession was, indeed, sparse and telegrammic in comparison with Time's big cover story on "The Transplanted Heart." Jam-packed with dramatic facts and peppered with real-life photos, the Time report wore its big red heart on the front cover and offered a three-step diagram of surgical procedure that was so easy to follow, it was a wonder it didn't start a vogue for weekend heart swapping among the surgical swingers of suburbia.

Because of the fast-breaking developments--"In an unprecedented flurry of daring surgery, four human hearts were transplanted last week"--Time's heart-transplant coverage lacked much of the colorful, well-planned gore of its never-to-be-forgotten "Surgery" issue. One of the spirited newsmagazine's fabulous, in-depth specials, on the order of "Is God Dead?" and "Sex in the U. S.," the Time takeout on surgery appeared back in May of 1963, but it is only recently that I have been able to force myself to even look at it.

The cover is OK, as such things go--a portrait of this famous surgeon in his surgical cap and gown. His surgical mask dangles casually from his neck and his craggy, unsmiling face is framed in a shower of surgical hardware: an assortment of scalpels, a large clamp and a couple of pairs of forceps with steely crocodile teeth. Slashing across one corner, there runs a five-inch scarlet legend: "If they can operate, you're lucky."

To find out how lucky, the reader has only to trundle his eyes over 17 gorgeous inside pages. But no flinching, remember. This stuff is educational. You can put off looking at the full 12-page color folio of "Seven Major Operations," if you wish, but there's no avoiding the first photo page. An overhead shot, looking down at a group of ghostly, gray-gowned figures huddled around a large, blood-red excavation in a human chest: "Heart Operation, involving clusters of men and machines, is supreme effort of surgery...."

By average laymen's standards, this is truly a surgical feast for the eyes. But in Time's lavish smorgasbord, it is but an ocular aperitif--a visual hors d'oeuvre to pique the operation watcher's appetite for the entree of innards and brains to come. No use trying to duck it by retreating into the text, either. From the very first line, you are there. In surgery:

"The gray-gowned figure in charge looks like a visitor from another planet. Between skullcap and mask, his head sprouts a startling pair of binocular spectacles. His hands move with confident precision and his even voice snaps with authority, but his very words seem part of an alien language--a communication designed solely for his colleagues:

"Fours on Frenchies, please. Twos on threes....

"Let's get those little bleeders up there. Give 'em a little current!

"Suction! Suction!

"Swift yet unhurried, the tense drama of the operating room plays itself out as Dr. Francis D. Moore, surgeon in chief of Boston's Peter Bent Brigham Hospital, removes a breast afflicted with cancer...."

Removes a breast! Boy, oh, boy! Imagine that, all you lucky little bleeders out there in Bladdersburg, Sicksville and Kidney Heights! Would any of you fellas and gals like to see how it's actually done? You wanna see what a real, human-female breast removal looks like?

Well, just flip a few pages. There you are, gang--a two-page spread! Two full-color diagrams and seven full-color photographs, detailing every important step in a radical mastectomy! One of the biggest, goriest hunks of major surgery ever presented in a mass-circulation magazine!

Just take a gander at those diagrams, Shirley--and you, too, Sam. Look at that first one. A female torso, showing the two female breasts, with the two female nipples and all. Take a good look at the left one. It looks healthy enough, but that's the one that's coming off! This is just the first step: "Opening the breast." There are the "outer mammary lymph nodes" and there's the "inner window incision through the chest wall...." Over here, the "window flap is opened" and you can get a look at her left lung through the "scissored ribs." And here we have the "pectoral muscles" and the "internal lymph nodes and mammary blood vessels" that are exposed when the "window flap is removed along with entire breast."

Gorgeous! Bet you never saw a female breast like that before! From the inside! And those are just the diagrams. Here are your seven exciting color photos: "1. Dr. Urban pulls back skin and outer tissue of chest, exposing surface of breastbone as clamplike hemostats stem blood flow from large vessels. 2. Mallet strikes on chisel as surgeon cuts through breastbone.... 3. Placing finger in opening (right), Dr. Urban feels for location where he will cut chest wall, make window complete...."

Man, that guy's really in that chick, ain't he? Her breast is off and her whole left side is laid wide open. Gorgeous! Looks like a bombed-out meat market. And the beauty of it is, it's all so educational. Like it's the miracle of the human body, only it's not pornographic or objectionable, because it's inside! Dig? Once you cut through the epidermis, and jazz the body up with malfunctions and disease, anything goes! Nothing is "too raw for public showing," as are some of those sexually explicit "adult" movies, where people go raunching around in their whole skins.

When it comes to sex, Charlie, sickness saves. You show a naked female breast in a family magazine, without you got a doctor on the scene, and you're apt to run into trouble. People will write indignant letters and cancel their subscriptions. But if you show a naked female breast, and right away quick you get a surgeon to cut it off--then you've got a real crowd pleaser. They'll shower you with bouquets!

"It's worth a year's subscription price," a lady in Catawba, South Carolina, wrote in praise of Time's big "Surgery" number. "I admired your guts," punned a gentleman in Boston. The medical profession was equally fervent in its praise. "Congratulations and a bushel of orchids," wrote John L. Bach, assistant director of the American Medical Association's Department of Scientific Assembly. "The text, the pictures and diagrams were marvelous. Time can really be proud."

It would be inaccurate to imply, however, that Time's operation watchers were all hung up on breast surgery. There were, after all, six other "Major Operations" in that one issue alone. There was "Surgery by Microscope," wherein the armchair intern was treated to all the nitty-gritties of a tricky middle-ear job, and a colorful seven-picture spread on "Repairing a hand deformed by arthritis." (continued on page 98) Gutsmut Game (continued from page 78) There was a chilling two-page report on deepfreeze cryosurgery performed on a human brain: "Dr. Cooper then makes an incision and bores a hole in the patient's skull. He places a bow-shaped instrument of his own design around the patient's head ... carefully threads a long cannula (tube) toward the thalamus at the center of the brain." There were the vividly photographed details of "unclogging a blood vessel" and the gutty, bloody-gloved business of "replacing a faulty kidney": "Diseased kidney is removed through incision after being cut from abdominal wall. Healthy kidney from donor in next room is placed in proper position for entry into prepared 'bed' in host's lower abdomen. Surgeon prepares to suture kidney vein to iliac vein of patient."

Before your very eyes--in brilliant, true-to-life color.

As one who has personally clocked up more than three hours of major surgery and has seen his share of open wounds, compound fractures and burned flesh, I can only say that it was a hell of a lot for the reader to take without so much as a whiff of ether. Yet, curiously enough, only one mild note of objection was sounded amid the chorus of postoperative hosannas in Time's "Letters" column. "One of the happiest miracles of modern surgery is that it is not carried out in my living room," wrote Philip H. Hartman of Cambridge, Massachusetts. "You, alas, have changed all that."

As the sole published dissenter, Mr. Hartman was evidently one of the few among Time's huge audience who were psychologically incapable of digging the sadomasochistic delights of spectator surgery. In all likelihood, he had been as successful as I in ignoring Time's "Medicine" department, until it had been so forced upon his attention that a quick flipping of pages would no longer suffice to get past its weekly peep show of medical exotica. "Transplant Progress: More Bold Advances," the anonymous impresarios of Time's visceral varieties announced in a typical week. "In the dawning age of surgical transplant, there seems to be no end to the variety of daring and delicate feats that surgeons are willing to try in the hope of saving patients who would otherwise be doomed by the failure of a vital organ.

"A young Colorado mother was getting along well last week, although her liver had been replaced by one taken from a dead man. A boy of 12 was living a normal life in his Pueblo, Colorado, home with his mother's spleen inside him, while his mother went about her chores with no spleen at all.... Today at least twoscore Americans are going about their business kept alive and active by kidneys transplanted from other people.... Denver patient Jerry Will Ruth, 24, got a kidney from Brother Billy, 22.... But in New Orleans, a woman for whom no donor could be found in time had a pair of monkey kidneys implanted in her groin...."

The brain boggles. Imagination runs amuck. A brother's kidney! A mother's spleen! Surely, there can be no greater love than this. One can almost see that spleenless mother going "about her chores," scrubbing floors in Pueblo, Colorado, while her 12-year-old son sits at home "living a normal life." "Better I should go without than him," she selflessly sighs in the mind's ear. "What is a mother for, otherwise? All I ask is that now and then he should show a little consideration."

The woman with the monkey kidneys "implanted in her groin" is, of course, understandably silent. One senses a reluctance to brag about her operation. Meeting a neighbor on the bus, how could she even begin to explain it? With the monkey out of the way, the secret is between her and the doctor--until Time has to go and blabber it to the entire nation: "This was the first significant 'heterotransplant' (between different species), important even though it finally failed and the patient went back on the artificial kidney.

"No less ingenious are 'autotransplants' of a patient's organs to a different part of his own body.... Parts of the adrenal glands that bestride the kidneys have been moved to the thigh to facilitate continued treatment.... The latest liver surgery in Denver involved the deathwatch and precise timing that are a common feature of homotransplants."

Homotransplants, Time explained in its customary anatomy chart, are "from donor or cadaver to patient." And many a dramatic tale has been told of the doctors' deathwatch over accident victims who possessed the needed spare parts and the exquisite sense of timing involved in transferring the wanted organ from the body of a fresh corpse to that of a waiting patient. As the deathwatch ticks on from one paragraph to the next, the reader finds himself rooting only for the patient. Sentence by sentence, he is unwittingly dehumanized to the point of desiring--willing--the "accident victim's" death. "Die ... die," the nerve ends cry. "You are not the hero of this story. You are an 'accident victim'--lacking voice, face, laughter, hope and all endearing traits. You are an aggregate of transferable parts, a collection of useful, salvageable guts. Die and have done with it! A Denver housewife needs your liver! A kid in Palo Alto, California, is waiting for your kidney! Your one undamaged cornea can bring the blessing of sight to a nun in Philadelphia!"

Long before the great heart-switch derby of 1967-1968, Time was very big on transplants. Operation watchers must love them. The idea of implanting one person's organ in the body of another--for keeps--seems endlessly fascinating.

But gorgeous, loverly as it all is, the rate of failure is high, because of the body's defensive rejection of foreign substances. Most likely to succeed are homotransplants between identical twins and close blood relatives. And if it's a choice between procuring a catered kidney from a living donor outside the family or one from an unrelated corpse, one's chances are somewhat better with a kidney from a corpse.

"Cadavers Are Best," Time's transplant handicappers declared, after attending a 1967 get-together of specialists at Duke University. But, as deathwatchers in Time's audience knew, cadavers are always in short supply. So grievous is the body shortage that, in May of 1966, Time's "Medicine" department was to be found pondering the ethical niceties of "thanatology," the science of death. "What Is Life? When Is Death?" the mediwriters inquired, like a chorus of clinical Hamlets: "The question of when to 'pull the plug' and let death occur has acquired new urgency with the practice of transplanting kidneys and other vital organs. Transplant surgeons want organs as fresh as possible; the chance that a cadaver kidney will work well in the recipient patient is vastly increased if it can be removed immediately after circulation has stopped. But in the U. S., as in most countries, it would be illegal to remove a kidney from a patient who has not yet been pronounced dead."

And a jolly good thing, too, one might add. What with all the "bold advances" in this "dawning age of surgical transplant," a chap would be fair game for kidney snatchers, heart thieves, bladder burglars and lung looters whenever he lay down to take a nap.

As was indicated in another item in the same issue of Time, many corporal odds and ends are stashed away in "banks." In this case, it was "a bank of human heart valves removed from accident victims...." Other Time reports have dealt generously with the founding and funding of such surgical trusts: eye banks, tooth banks, bone banks, and the like. This piling up of cadaverish capital appeals to the deathwatcher's sense of thrift. "Waste not, want not" is an old adage, and interest in new ways to scrimp and save occasionally leads Time to take an admiring peek behind the Iron Curtain--as, for example, in the case of "Fingers from the Dead."

"Faced with a person who has lost a finger in an accident, most surgeons do little more than sew up the stump," Time observed, in what sounded almost like a grumble of complaint, "though (continued on page 157) Gutsmut Game (continued from page 98) in some cases they may transplant one of the patient's own fingers, especially to replace a thumb. Russia's Dr. Viktor Kalnberz goes much further: He sews on a finger taken from a cadaver.... Kalnberz has collected a bank of dead men's fingers, trimmed the skin and soft tissues, refrigerated the remaining bone, ligaments and tendons.... To use one of those severed fingers, the inventive surgeon first pares a strip of skin loose from a patient's abdomen, leaving both ends of the strip still attached, to provide a blood supply. The loose part of the strip is rolled around the cadaver bone and sutured in place."

Small matter that Dr. Kalnberz claimed but limited success in only five such cases or that the transplanted dead man's digit had "little or no sensation" and had to be "moved as a unit from the knuckle." Finger watchers aren't fussy about such little details. When morbidity beckons with a freshly sutured joint, Time and its readers can rise above such trivial considerations.

Great moments in medicine! Wonders and prodigies the whole family can enjoy! Here is the little Thalidomide baby, "who has only tiny arm stumps and whose feet are attached to his buttocks." And here is a photo of the "Six-Digit Hands" of a rare breed of Amish dwarfs. Here, middle-aged and smiling, are the Siamese-twin sisters who refused to be surgically separated and died of cancer in January 1967: "United Unto Death.... Joined by bone and flesh just above the buttocks, they had separate organs except for the rectum." Here's a picture of Bachelor Bob Brewis, "Britain's first human case of foot-and-mouth disease." And here, finally, is "Snail's Plague," or schistosomiasis, a disease that is "almost unknown in the U.S.": "Cause of all the trouble is a wiggly tailed, microscopic larva that lives out its life as an unwelcome hitchhiker in both snails and men. Hatched in fresh water ... the larvae move on and burrow into a human body, where they mature and mate in the blood stream. Then they settle down to years devoted to depositing eggs in vital organs. The adult parasites live in an almost constant state of copulation and the female can produce up to 3000 eggs a day for as long as 30 years."

Gutsmut. The pornography of sickness, deformity and disease.

Explicit far beyond the needs of the average layman, it trades on human misery and serves only to titillate the morbid imagination. Concerned mainly with luridly described acts of promiscuous surgery and bizarre deviations from the clinical norm, it induces dejection in healthy males and incites healthy females to perturbation. To the thoughtful person, applying humane standards, the dominant theme of the material taken as a whole appeals almost solely to the sadomasochistic interests of visceral voyeurs. It is the one privileged and permissible pornography of this ailing age and the only form of obscenity acceptable to those who--by reason of anxiety, guilt, learned habit or lack of true wholesomeness--fear and, perhaps, subconsciously despise the human body.

But, it will be argued, this material is educational and scientific. We are living in an era of great medical advances. Is not the public to be kept informed? Isn't it helpful and heartening to know of the many miracles that modern medicine can now perform?

Helpful and heartening to whom, one wonders. To you? Me? A woman with kidney disease? Another set of Siamese twins who coincidentally share the same rectum? A man with a worrisome cardiac condition, leafing through Time in a doctor's office? A surgeon in the transplant game? A foot-and-mouth specialist? The head teller in a Russian finger bank?

Whom?

"Your circulation places these scenes before many who neither desire nor ought to see them," a reverend gentleman chides in a letter to Time. "You misuse your wide circulation when you step out of character in this way."

To what scenes was the reverend gentleman objecting? Time's full-color freakout on the removal of a female breast? The sight of a severed hand or foot? No, for these were not in the least "out of character" in America's leading newsmagazine. The answer lay in the single sentence that preceded those in the letter quoted above: "I am distressed at your printing pictures of nudes."

Now, as all we regular Time readers realize, the magazine has trouble enough finding ways and means to include pictures of the nude or near-nude female form, without having to resort to radical surgery. Indeed, a good part of the fun in reading Time is in watching the various shifts and dodges the editors employ in getting such pictures into the magazine. Movies, fashion, art, beaches, floorshows, Happenings, topless restaurants, carnivals in Rio and Time's continuing coverage of moral breakdown at home and abroad all provide opportunities for photos of female exposure that even the most prudish can ogle without feelings of guilt--providing they remember to shake their heads and say "Tsk."

The search for pictures that readers can tsk at is, apparently, never ending--on the part not only of Time but of most other mass-circulation magazines that aim their product at the front door of the American home. Tskable pix that can be made to serve as objects for righteous condemnation are not nearly as easy to come by as readers might imagine. The moral breakdown at home and abroad has been neither rapid enough nor sensational enough to meet editorial needs and the demand for more sin and more skin grows with each passing year.

The tsks, after all, are merely one symptom of epidemic dermaphobia--a psychological disorder that may be characterized as an "irrational and persistent fear" of the human skin. The cause of this highly contagious malady is tiny maggots of misguided morality that burrow into the human brain to attack and destroy whole areas of the reason, including those that are required for the thinking and speaking of common sense. Illusions of self-righteousness are soon manifested and, in a very short time, the victim's vision becomes so distorted that the mere sight of healthy, unbroken skin becomes objectionable and obscene. All manner of evil and depravity are attributed to its exposure and delusions of imminent national doom spring from the sight of its unblemished surface. Sin, in short, is centered in the skin, which serves as a kind of morality barrier, through which--by means of incision, abrasion or laceration--the dermaphobe must mentally pass in order to experience the sadomasochistic satisfactions he finds in brooding upon raw entrails.

In this vicarious penetration of the outer integument of flesh, the dermaphobe is psychologically transported beyond the reach of good and evil and enters into a relationship with the human body that is free of all guilt and distress. Once he is mentally inside the gut, he is able to relax and fantasize in a manner that would be considered prurient if applied to the outer skin. Best of all, his morbid indulgences are not only condoned but culturally encouraged. In the guise of medical information, the pornography of his perversion is available everywhere and may be had by flipping open a family magazine, picking up a daily paper or switching on the TV. At times, indeed, the entire informational might of all our mass media are focused upon one single, ailing gut, for what amounts to a civic-sponsored festival of visceral voyeurism. Witness, for example--as millions did--"The Presidential Cholecystectomy."

I am referring, of course, to the national orgy of ogling that was touched off in the fall of 1965 by the removal of President Johnson's gall bladder--a surgical spectacle that, in the opinion of no less an authority than Shirley Temple Black, is the best and most gorgeous of all.

Ever alert to their informational responsibilities, our mass media provided coverage from the moment it became known that a "sharp and colicky pain" had attacked the Presidential stomach and the need for an operation was just a gleam in the surgeon's eye. Rare was the front page or TV newscast that didn't feature a detailed diagram of the President's "abdominal cavity," showing the stomach, kidneys, gall bladder, liver, ureters, urinary bladder and intestines. Millions who had never been invited to tea at the White House were welcome to feast their eyes on the Executive sweetbreads. Multitudes who had never shaken the President's hand were placed on the most intimate terms with his entrails.

By the time operation day rolled around, Americans were so briefed and filled in that they knew more about the President's health than they did about their own. "The President's blood pressure is 118 to 136 over 70 to 80; his pulse averages 70 to 80 and his respiration rate is 16 to 18," one New York daily reported to thousands of readers who had not the vaguest idea of what their own pressures and rates might be. In the press, on radio and TV, the names and professional track records of members of the surgical "team" were given, as though in preparation for an all-star bowl game to be held in the President's bowels.

As might be expected, Time's postoperative wrap-up was both vivid and detailed--and there was plenty of detail. "'From skin to skin,' as surgeons speak of the time from the first incision to the placing of the last suture to close the wound, the operation took two and a quarter hours...." But, for once, Newsweek almost stole the show by making "The President's Operation" its cover story. "L. B. J.'s surgical spectacular" was what Newsweek called the resulting free show. And while it still isn't clear to me just how many--if any--journalists were present in the operating room, the immediacy of the reportage was such that it seemed an absolute miracle that someone besides L. B. J. didn't get badly cut.

"With the single order, 'Scalpel,' Dr. George A. Hallenbeck began the President's operation," the Newsweek mediteam reported. "He made a 'right subcostal diagonal,' the customary incision for gall-bladder removal.... The heavy, brown lobes of liver were pushed aside and held out of the way with gauze packs to expose the gall bladder. Then the surgeon probed for the cystic duct, the passage leading from the gall bladder into the larger common bile duct connecting the liver to the intestine (diagram). Two clamps were then placed side by side on the cystic duct as a preliminary to snipping the tube and...."

On and on like that, until you could damned near feel it.

Suffice it to say that the President's subcostal wound was--in paraphrase of Mercutio's--not so deep as a well, nor so wide as a credibility gap. But 'twas enough, 'twould serve to allow for the removal of his gall bladder and the first stone.

"Hallenbeck also routinely searched for stones in the common bile duct--and found none," the Newsweek scribes went on to reveal. "But a search in the President's abdominal cavity produced a kidney stone.... This time Mayo Clinic urologist Dr. Ormond Culp, probing with his rubber-gloved finger tips, found a ragged, quarter-inch stone partially blocking the ureter leading from the right kidney to the urinary bladder and removed it.... Another small stone in the left kidney, present for at least a decade, was left untouched, since it did not interfere with kidney function."

"One Stone Unturned," Newsweek joshed, while stitching together the loose ends after the two-and-a-quarter-hour show. There were statements from Press Secretary Bill D. Moyers and Mr. Johnson's clergyman, following which, the surgical team held an all-media press conference, complete with color slides.

At the time, Mr. Johnson's various stones were easily the most widely publicized concretions of historic mineral matter since Plymouth Rock. But by November 1966, the nation's operation watchers had something new to divert them--or, rather, two somethings new. First, there was an incisional hernia, an inch to the right of L. B. J.'s gall-bladder scar. And second, but no less exciting, a Presidential polyp! "The polyp (from the Greek polypodos, many-footed) near the President's vocal cord is a soft growth that looks something like a miniature octopus," Time explained, with every appearance of trying to be helpful. The hernia was "a piece of intestine (it may be either the large or small bowel)" that had pushed through where "plastic drain tubes were left in place" following the President's cholecystectomy. "Fingertip size in April, it is now as big as a golf ball," Time confided.

Get the picture? Millions of Americans did--whether they wanted to or not. Through the miracle of mass communications, the nation was treated to a second L. B. J. "spectacular" that was, in many ways, more suspenseful than the first. That many-footed, octopuslike growth near the Johnson vocal cord--was it ... malignant?

It was a grimly provocative question and the President had apparently been as thoroughly "educated" to the expectation of becoming a cancer victim as had the rest of the electorate. Smokers and nonsmokers, males and females alike, Americans have been so frequently and insistently "alerted" to its symptoms that there is no longer a question in most minds as to whether one will get it, but only where and when. "You worry about those things until you know," the President was quoted as saying.

Only a biopsy could determine for sure. "Plopped into a stainless-steel bowl, the polyp was rushed to the pathological laboratory," Time was to report. "L. B. J.--NO MALIGNANCY," afternoon headlines announced. "He's OK After 53-Minute Surgery. Hernia Is Corrected and Polyp Removed."

Dr. Hallenbeck later remarked that the hernia repair and polyp removal were "much less of an insult physiologically to the President than the experience he had a year ago." And, since the experience of being the nation's number-one medical exhibit was likely to be a bit easier the second time around, it was probably less of a psychological insult, as well. But despite repetition and the fact that the President has never been reputed to be an overly sensitive or shy man, it is inconceivable that any human being would not be somewhat traumatized by having his innards put on display and mentally mauled by every gut nut in the country.

But surely I must be letting humanitarianism run away with my sense of perspective. The President is, after all, our Chief of State and his health is of the utmost importance to the entire nation. Certainly it must be granted that in the event of a President's illness, the public and press have a right to know all the details--no matter how clinical and unpleasant.

By all means. Yes, indeed. Though I personally happen to feel that color slides of his diseased gall bladder are not exactly essential to good government and that interest in the President's polyp ceased to be purely political when it was "plopped" into a stainless-steel bowl and submitted to a journalistic biopsy, I would gladly concede the argument. Providing, of course, that something of the same freedom we allow the mass media be permitted the Chief Patient, as well.

Normally a loquacious man, the President, you will recall, was really almost reticent about discussing his first operation--and so might any of us be, if our bladders, bowels and shabby little stones had been shown on TV. But when he finally did speak of it, while sunning himself on the hospital grounds, it was with a folksy and nonclinical kind of understatement that somehow described what he had been through better than all the surgical minutiae supplied by the newsologists.

"What we had here," the President said, "was two operations for the price of one. Dr. Hallenbeck went in there and messed around a couple of hours, then he stood aside and let the other fellow in. There are footprints everywhere that hand went and I can still feel them."

Lacking gore and vivid gristle, the President's description was not one that would cause operation watchers to dimple and dance to the tune of The Good Ship Polyp Lop. After all that had been said and seen in the mass media, it was, in fact, scarcely newsworthy and might have passed quite unnoticed--had not the President chosen that precise moment to raise the tail of his sport shirt and show the reporters his scar.

Cameras clicked, pencils scribbled--and plastered all over front pages and blown up on TV that night was a most shocking photograph of the President of the United States showing his "right subcostal diagonal" scar, completely surrounded by skin!

Ugh!

Ripples of revulsion washed across the land. Epidemic dermaphobia broke out in muttering patches, from the hidebound coast of Maine to the shores of funny-peculiar California. Small matter that the President's organs and jagged stones had been seen in living rooms and at breakfast tables in each of the several sovereign states. This was somehow ... different! Tasteless, objectionable! Just about the ugliest thing America ever saw! Regardless of political beliefs and party affiliations, citizens from all walks of life winced and tsked and shook their heads in dermaphobic disgust.

Time wisely--or, perhaps, instinctively--refrained from printing so revolting a photograph. Would that its sister publication, Life, had displayed as much discretion!

"Sirs," wrote Life reader Ken B. Dalby of Levittown, Pennsylvania, "In my opinion, you missed a rare opportunity recently to perform a great service to your readers by refusing to run the gigantic (suitable for framing?) photo of the nation's Number One Citizen exposing his scar to the world...."

"Sirs," wrote J. M. Griffin, Jr., of Hackensack, New Jersey, "I tried hard to imagine the other leaders of the world debasing themselves in a like manner: Wilson of England, De Gaulle of France."

"Sirs," wrote Walter F. Martin III of Stockbridge, Massachusetts, "Would Thomas Jefferson or James K. Polk have done something like this?"

"Sirs," wrote Stephen W. Scull of Bellefonte, Pennsylvania, "I'm sure Calvin Coolidge would turn over in his grave."

Were it even remotely possible that Calvin Coolidge actually would, Mr. Scull could have rested assured that Life photographers would have been dispatched to record the ex-President's posthumous capers--for Life has always had a flair for capturing candid likenesses of cadavers, skeletons and mummified remains.

Dream photo spreads aside, however, Life readers condemned the L. B. J. scar portrait five to one.

In measuring the many splendid opportunities that Life offers for operation watching and general, all-round gut gawking, one has only to take all the more sensational medicina morbida found in Time and blow it up to large-page size:

"Boston doctors perform a delicate eye operation.... Upside-down Surgery. It's a topsy-turvy way to perform any operation, but this heels-over-head technique is now being used for some of the most delicate eye surgery doctors know how to do. It may save the eyesight of this patient strung up in the air."

"Views never seen before.... The Corridors of the Heart. Camera lens set in chest cavity photographs a heart laid bare by doctors for corrective surgery.... The main artery, choking to death. Aorta in ruins. This Dantesque scene shows what can happen to a human aorta when it is overrun by atherosclerosis.... Twisted masses of fatty tissue loom like red stalagmites in a cave and thrombi--blood clots--cling to the floor.... The Clot That Kills...."

"Spare Parts for the Human Body. Recipient of a lung transplant dies but surgery takes a leap forward.... On the 11th floor, Yates opened Sismour's chest. Then Magovern raced upstairs and removed Sismour's left lung.... When it was out, he phoned the donor's room, where a resident cut away the remaining connections of the dead man's lung and plopped it into a sterile bucket...."

"Rare study of Siamese twins in the soviet. Masha and Dasha. Balancing themselves on shared legs, these sisters are bound to each other physically--and permanently.... Between them they have four arms but only three legs--two perfectly good ones plus a third vestigial leg, partly visible behind Dasha's left arm.... They have two stomachs (visible in drawing) and separate upper intestines which join into a single lower intestine and rectum. They have four kidneys--but only one bladder, and they don't always agree on when to urinate; sometimes one twin wants to and the other doesn't. Soviet doctors say there is no physiological reason why Masha and Dasha could not become a mother: They have a common reproductive system."

Assuming that Masha and Dasha could synchronize their sexual desires and agree to say da to the same romantically offbeat Comrade Right, the birth would be one that Life's dauntless lensmen would bore a secret tunnel under half of Europe to cover. As veteran Life staffers remember and neophytes soon learn, much of their magazine's early success stemmed from its history-making spread on the birth of a two-legged baby whose mother had only one head--with the result that fast-lens photo midwifery has been a specialty of the house ever since.

"When picture journalism was relatively new, we published a story called 'The Birth of a Baby' (Life, April 11, 1938) and caused a commotion," the editors fondly recalled in May of 1965. "The story consisted of three dozen small black-and-white pictures from a movie that was produced by The American Committee on Maternal Welfare, Inc., sponsored by a group of medical organizations and endorsed in advance by everybody from the Surgeon General of the United States to the mayor of Minneapolis....

"Even so, the story made nationwide headlines. It was banned in Canada, Pennsylvania, in Boston and 32 other cities.... Roy Larsen, then our publisher ... had himself arrested to test the ban.... We got thousands of letters, most of them angry....

"Two weeks ago, almost exactly 27 years after 'The Birth of a Baby,' we published a cover and color essay on the development of the living human fetus, 'The Drama of Life Before Birth.' ... One reader, Mary Sistrunk of San Antonio, wrote in, saying, 'I'll bet my new Easter hat you get more "pan" letters on your cover than any you ever received. Right?'"

"Wrong," managing editor George P. Hunt retorted in a one-word paragraph that gave each of ye Life eds a winner's share in Mary Sistrunk's new chapeau.

"Our cover of Yvette Mimieux in a bikini (Life, October 25, 1963) drew far more fire. The response to 'The Drama of Life' ('Letters' column, page 27) was as emotional as it was in 1938, but it was different in character--more broad-minded and philosophical, more interested in being informed, less bothered by taboos. The majority of those who wrote in admired the pictures....

"Many of the admirers found a new awareness of God's handiwork and expressed a feeling of awe--the word appears again and again, and so does 'miracle.' Expectant mothers were especially thrilled by the pictures, and so, we are told, were children."

In thus commending the beauty of their fetal photos, the editors managed not only to claim vindication as champions of broad-mindedness and truth but to appoint themselves the defenders of God's handiwork and miracles. One got the impression that Life's obstetrical paparazzi had been granted a God-given patent on human pregnancy.

Among the few dissenters, whose letters appeared amid the kudos and congrats on page 27, was a mother in Sacramento, California, who wrote--apparently out of the very extremity of desperation and household din--"Why such a picture on the cover? My eight-year-old picked it up on the doorstep as it was delivered and screamed.

"What next? The mating process on the cover?"

Life made no answer to the latter question. Nor, in fact, was any answer needed. When she calmed down and thought about it, the mother would undoubtedly realize that Life's patent on the process of reproduction is subject to certain self-imposed restrictions that limit the awesome miracle to its purely internal, postejaculatory phenomena; i.e., the socially acceptable gut issues. But, even so, Life was making no promises that it would not depict the mating process on its cover, if the right set of clinical circumstances permitted--such as, in the unlikely event that Soviet doctors were to invite the magazine's cameramen to attend the inpatient copulation of its three-legged Siamese twins and a four-fingered Russian dwarf with monkey glands under each arm. Unlike "Yvette Mimieux in a bikini," a cover like that would be "educational," and Life would certainly feel obliged to run it, no matter how many narrow-minded eight-year-olds it frightened into hysterics.

As a normally courageous adult, my own reaction to Life's prenatal cover was somewhat more restrained. Upon opening my mailbox that morning--upon reaching my hand inside and pulling forth that full-color, Life-size fetus--I uttered no more than a stifled groan. "Unprecedented photographic feat in color. Drama of life before birth," the cover cried out in my hands. "Living 18-week-old fetus shown inside its amniotic sac--placenta is seen at right."

It was quite a sight. Even the most jaded of Life subscribers must have been a teensy bit surprised to find little Freddie Fetus curled up in their mailbox that morning. Afloat in a splotchy black void, encased in a ghostly sac of sheer membrane, umbilically attached to its looming, purplish-pink placenta--with scarlet blood vessels lacing the thin skin of its large, bald head and tight-shut eyes clamping a corpselike appearance over its half-formed face--Life's fetal cover kid resembled nothing so much as a dead Martian, adrift in some weird kind of plastic coffin on the margins of outer space.

The appearance of death was not entirely misleading. Though billed as "living," the cover fetus--like all but one of the dozen or more depicted on the inside pages--"had been surgically removed for a variety of medical reasons." Technically still alive, perhaps, it verged on the brink of death, as did the "Millions of Sperm" in the puddle of human semen, which Life had "magnified about 2000 times" in a two-page color blowup that served as the postejaculatory preface to a perfectly darling shot of an armless, legless, faceless embryo at three and a half weeks: "This embryo is an imperfect one (the blue tissue at right is torn and ragged). At top is the incipient head."

Needless to say, little Johnny Embryo was in no shape to smile or say "Cheese"--no more than were the other little abortions that followed. "During this period it is almost impossible to distinguish a human embryo from any other mammalian embryo," Life explained in a caption beneath a full-page study of a five-week-old prenataler who looked like a dying prawn. "It is a critical time.... From 28 to 42 days, the arms and legs can be deformed by Thalidomide. (Some of the famous 'Thalidomide babies,' in fact, were born with flipperlike arms much like those shown here.) The brain, too, is susceptible to damage, and the embryo will shortly be at its most vulnerable to the ravages of the German measles virus...."

Expectant mothers who could read as well as look at the pretty pictures must have been "especially thrilled" to muse upon such possibilities. The pictures were the work of a Swedish photographer, Lennart Nilsson--and, according to the editors, the greatest single shot was the opening photo: "The first portrait ever made of a living embryo inside its mother's womb."

The italics in this case are mine, but the ingenuity required to perform such a feat--even in Sweden--was all Nilsson's: "Using a specially built super-wide-angle lens and a tiny flash beam at the end of a surgical scope, Nilsson was able to shoot this picture of a living 15-week-old embryo, its eyes still sealed shut, from only an inch away."

When a leading Swedish gynecologist saw Nilsson's super-close-up of little Sven, "He exclaimed, 'This is like the first look at the back side of the moon.' Another doctor, on seeing Nilsson's pictures, said. 'As far as I know, in utero pictures such as Nilsson's have never been taken before.... Being able to view the fetus inside the uterus, and being able to note its circulatory details, is rather sensational from our point of view.'"

And from mine, too.

Only "an inch away" is as close to a living embryo as even the most ardent fetus fancier could possibly wish to get.

• • •

"Some magazines and shows go in rather heavily for models," Life mused aloud, in a full-page newspaper ad for one of its best-beloved issues of recent years. "We use models, too. But what a difference this week. This week, Life's models are made of sterner stuff ... they take you inside a little-known world of medicine. In a 13-page color essay, 'The Virus Enemy,' you'll see the model above of the human antibody, the body's miraculous defender. And you'll study the models of the enemy, below, as you read this revealing article on medicine's new frontiers. These models are no pinups, admittedly, but chances are they'll make it up in classrooms throughout the country. That's why Life is Life ... a conversation piece for thoughtful Americans week after week."

The ad itself was a model of corporate self-righteousness--just as the vaunted 14-page color essay was a kind of virulent visual organism. The mind, the eye, the imagination had no defenses against "The Flu Germ ... magnified 2,500,000 times" on Life's colorful cover. As large as a honeydew melon, bristling with purple spikes the size of swizzle sticks, the flu germ spread its pictorial infection over all the nation, saturating the U.S.A. like the spray from a supercolossal sneeze.

Blown up to the size of a volleyball on the inside pages, the Flu Germ again "unfolds in all its spiny splendor.... An outer shell of protein and fatty material, shown in yellow, encloses and protects the core and anchors an array of purplish spines which apparently enable the flu virus to get a foothold on the slimy surface of the body's respiratory tract."

See? See the Flu Germ? This is the Flu Germ coming to get YOU!

Look! Look! See the ugly cowpox virus?

See the two big ugly things that may give you leukemia!

See the glowing red adenovirus! This is an adenovirus, "enlarged 2,500,000 times." Study the adenovirus. The adenovirus "produces feverish respiratory ailments, sore throats and eye infections. In children it is sometimes responsible for fatal pneumonia."

Just think, you may have millions of adenoviruses attaching themselves to your slimy respiratory tract, this very minute!

Pathological pinups. Morbidly suggestive pictures of loathsome microorganisms, suitable for hanging in schoolrooms throughout the country. "Given the vastness of this swarming horde, it seems astonishing that we survive at all," Life thoughtfully pointed out. "We actually live in a kind of gray world in which we are never totally well but are seldom seriously ill."

A gray world.

Yes, that says it, I think. That pretty much describes the media-made mental America where the majority of our medically overinformed citizens live, work, love, worry and daily die a thousand imaginary deaths.

It's an always slightly sickish, never totally well world, where Life is worth 35 cents and "The Workings of the Incomparable human body" are always carefully accompanied by a grim bill of particulars on "What Can Go Wrong." A world where "Man-made and transplanted organs usher in an era of rebuilt people" and one is given to wonder, "When is a dead man really dead?" A world where "A Lifesaving kidney machine forces a cruel choice" and an "Experiment right out of monster movies" is performed on a disembodied "Living Brain." It's the wondrous, gut-oriented world of a "Womb with windows," where fetal surgery heralds the day when "the patient-within-a-patient will have come into its own" and "Plant experiments stir speculation that man might reproduce while Bypassing Sex."

Oh, sing the sickly tidings! Let the leaden bells toll out the dreary news to each draining ear! That's what makes Life Life ... a conversation piece for visceral voyeurs and galloping hypochondriacs. And that's what helps make the Reader's Digest the "World's Best Seller," with a circulation more than double that of Life's. Without any photographs, either.

As even the most casual newsstand browser must know by now, the Reader's Digest doesn't need photographs. The organs stand right up and talk to you.

"Me? I am Joe's heart," a gabby little ticker confided, in April 1967. "I hang by ligaments in the center of his chest. I am about six inches long and, at my widest point, four inches across--more pear-shaped than Valentine. Whatever you may have heard about me from poets, I am really not a very romantic character. I am just a hard-working four-chambered pump...."

If you think you detect a faint flutter of self-pity creeping in there, you're absolutely right. Lord only knows what Joe had been drinking, but his heart was obviously on one of those real low-down, moody jags where it didn't know whether to cry or fight. "When Joe thinks of me at all, he thinks of me as fragile and delicate," it mumbled, with a cardiovascular scowl. "Delicate! When so far in his life I have pumped more than 300,000 tons of blood? I work twice as hard as the leg muscles of a dash runner, or the arm muscles of a heavyweight boxing champ. Let them try to go at my pace and they would turn to jelly in minutes. No muscles in the body are as strong as I am--except those of a woman's uterus as she expels a baby. But uterine muscles don't keep at it day and night for 70 years, as I am expected to do."

Listening to all this, over the alarming lub-dub-scoobie-do of his own neglected pump, the reader got the impression that if Joe's heart had it to do over again, it would rather be a uterus. Wilma's womb, Lulu's ovary, Fanny's Fallopian tubes--anything but Joe's poor overworked heart.

If, however, it had spent a little less time feeling sorry for itself and had used its between-beat "rest periods" to peruse a few issues of the Reader's Digest, Joe's pear-shaped bosom buddy would have realized that every organ gets to feeling frazzled now and then and that none is safe from the ravages of disease, abuse or fatal accidents. Liver, kidneys, lungs, intestines, hair, bones, eyes, feet, fingers, glands and aging gums, all have turned up for speedy and sometimes scary treatment in the Digest's monthly dispensary, where jungle medicine and shipboard surgery lend spice to the most humdrum symptoms and the rate of miraculous cures is higher than it has been at any time since Saint Bridget used the blessings of beer to cure the thirst of Irish lepers.

A brief checkup on one sample issue of this hypochondriac's handbook--known to some as the "Bleeder's Digest"--is sufficient to indicate the symptomology of its chronic success. Take a batch of nonmedical brain joggers, with titles such as "Meet the 'Monster' That Checks Your Taxes," "Decision at Sea," "Let's Make Government Work Better!" and "How Colleges Have Changed!" Gather a bunch of secondhand jokes, quotable quotes, picturesque speech and patter--and get cracking on "News from the World of Medicine": "Mothers' Backs," "How Germs Learn to Live" and "Cleveland Fights a Killer." Pick your Patients of the Month--your main medistars--and get 'em in at the top of each article, so the reader can suffer along with 'em, right from the first line:

"For a week a 14-year-old Los Angeles schoolgirl had dabbed ointment on a red eruption on her face. But the acne remedy didn't help. Then her class at school took up a new subject. By the second session, the girl suspected the truth. 'I think,' she told her mother fearfully, 'I have to see a doctor.'

"As she had guessed, her 'acne' proved to be a symptom of syphilis."

Great! Good stuff. Frighten the pants off any parent whose kid comes home with a pimple. Nice sex angle, too. Kind of gooses 'em with the old idea that all the teeny-boppers in the country are screwin' themselves blind. What else have we got for 'em this month? Ah, yes. "Our Fastest-Growing Health Menace." Sing it to me. Leroy. I can't find my specs.

"In Boston, a wasted man who looks 20 years older than his actual age of 57 sits staring out a window, watching the postman deliver the mail. He rises slowly and shuffles to the door 20 feet away. Three steps and he stops, gasping for breath. Another two steps and a severe fit of coughing forces him to rest against the wall. It takes him five minutes to get to the door and back, and he sits down too weak to open his letters."

OK, that's enough. I remember now--the menace of respiratory disease. Should worry the living daylights out of anyone who has ever had a tickle in the throat. That little prose trip through the lungs is a gasser!

With the brain-tumor bit, the cervical cancer, the pulmonary embolism, the pituitary tumor and the mammography for "finding tiny cancers in fatty breasts," we've just about covered all bases. If you run short, stick in a few jokes. Like the one about the Medicare patient who "woke up to find a placard on his incision: 'This is a Federal project showing your tax dollars at work.'" It's not too funny, maybe, but it keeps our finger in the anti--socialized medicine dike.

But what about a shot of hope? Like, maybe, an inspiring story of how someone overcame some god-awful handicap. What have we got like that?

"'A Man Can't Afford to Get Soft!' by Paul Friggens.... 'I wanted to earn my living, not just collect it,' says this wheelchair farmer who refused to quit.... Permanently disabled and in constant pain from a broken back, [Lawrence] Mans today successfully operates 480 acres in central Minnesota, where he raises a fine herd of about 100 Hereford beef cattle and 20,000 broad-breasted white turkeys. He is also a leader in his...."

Community. Beautiful! We're all set. Start the presses. Let's put it to bed.

And they do put it to bed. And along with it go some 50,000,000 American readers, who are never totally well but seldom seriously ill. Citizens of a gray world, where Reader's Digest reprints the lurid mediarticles its loyal subscribers may have missed in Life, Time, Farm Journal, Family Safety, Today's Health and The Modern Hospital.

Readers who can't wait for the Digest to select the best of the worst, or who want more complete coverage, can stay spooked every day of the month by going right to sources. Virtually every family-type magazine is a potential source of worrisome symptoms and far-out cures, from Look and The Saturday Evening Post to Better Homes and Gardens and the Insider's Newsletter--whose Christmas 1967 issue caroled the glad news that a noted American transplant surgeon "may decide to store the heart--perhaps for several days--in the groin of an intermediary host who would probably be a relative of the person who was to receive the heart." Thus solving the age-old problem of what to give Aunt Ida.

For those who like their medicine served with feminine chic, Vogue will cover-plug its "Special Medical Feature" along with "First news from Norell," while upper-income medisophisticates of the suburban pill set are able to sample occasional servings of clinical caviar in The New Yorker's "Annals of Medicine" series: labyrinthitis, salmonellosis, anthrax or "woolsorter's disease," schistosomiasis or "snail's plague"--rabies in humans, from the bite of an "ordinary insectivorous bat!"

Differences in tone and treatment are small but significant, and media students may find it interesting to compare The New Yorker's description of the breeding habits of the parasitic wrigglers that cause snail's plague with that which was found in Time. In Time, the parasites burrow into the human blood stream, where they luridly "live in an almost constant state of copulation." But in The New Yorker, the burrowing and breeding are described in terms that make the parasitic invasion sound more like a move by affluent young marrieds to one of the better communities in Westchester: "There they grow to maturity (about an inch in length for the females and less than half that for the males), and mate. They then retire to the comfort of a tiny backwater vein, where the female, still enclosed in the male's embrace, deposits--for incubation and eventual excretion with the body's wastes--the first of an almost infinite number of eggs."

Both the male and the female seem to find this pretty groovy. And since hubby worm never has to interrupt romantic relations in order to earn a living, wifey worm never has any occasion to complain of a lack of interest or affection, and the question of "Can This Marriage Be Saved?" never arises. In having her hubby at home, furthermore, wifey worm is kept so busy making her little marriage work that she never has the leisure to brood upon the innumerable female disorders that are regularly trotted out for treatment in our human-type women's magazines--moniliasis, trichomoniasis, premenstrual tension, post partum depression, placenta previa, inverted nipples and acute uterine anteflexion, otherwise known as "U-shaped womb."

"You always thought life was a chancy thing? You don't know how right you are," an erstwhile one-gender journal recently exclaimed, while sicking its readers onto a mediarticle that had been put together from scary notions set forth by "medical authorities" in the daily press. "Fifty new ways to die."

Apart from its numerical overkill of worrisome suggestions, the novelty of this particular medispooker stems solely from the fact that it appeared not in a women's magazine but in Esquire and represents an incursion of hypochondriac thought into a field that has traditionally been one of the most physically fit and happily germfree in America--namely, the men's magazines. "There comes in every man's life (usually in the late 30s) that enchanted moment when he realizes his body is no longer his accomplice, but his enemy," the male author suggestively philosophized in the opening paragraph. "He is getting fatter, slower, dumber. More and more time is spent trying to describe, to incredulous doctors, his indescribable symptoms. ('I have this strange pain in my fingernails.' 'I got this sort of whirring sound in my stomach all the time.') Doctors being no good at whirring sounds, the aging man begins his endless process of self-diagnosis, suspecting his environment of harboring all sorts of hidden dangers....

"But--and this is our revelation--he may be right!" the author revealed, in a manner that struck me as distressingly reminiscent of the exclamatory medistyle of the old "Tell Me, Doctor" divertissements of the Ladies' Home Journal. "There are more dangers in heaven and earth than he dreamt of during his worst night. To help him along in his worrying, we here present a list of 50 certified things to worry about...."

Appropriately titled "Look Out!" the Esquire suggestion sheet listed such well-known respiratory chestnuts as, "Anything to do with smoking (tobacco, matches, fluid lighters, relighting cigarettes) possibly promotes cancer" and "Smog can lead to respiratory diseases and complications." Among the more bizarre bugaboos provided as fear fodder for 30ish males were, "Touching figs in the blazing sunshine causes blisters in persons predisposed to phytophotodermatitis," "Pet turtles often cause Salmonella, typhoid fever and blood poisoning, particularly when they are kissed" and "Playing on lawns near flowers, barefooted, bareheaded, dressed in gaily colored but rough fabric and wearing sweet-scented hair oil increases one's chances of being stung by bees."

Needless to say, it would also increase one's chances of being chosen queen of the May. Indeed, the triple-threat combination--kissing turtles, touching figs and romping around in gay attire with sweet-scented hair--may understandably cause one to wonder, "What sort of man reads Esquire?"

In the past several years, Esky has made every effort to obliterate the memory of its racy youth. The once-popular Petty girls are long since gone, together with all the healthily ribald, masculine jokes and cartoons for which Esquire was famous. But it's hard for a men's magazine to get accepted in all the best places, and if the path to propriety has led to whirring sounds in the stomach and strange pains in the fingernails--well, that's the approved American way.

Including its ads, Esquire today publishes fewer pictures of scantily clad females than do many of the women's magazines. But this is not to suggest that women readers are any less dermaphobic in their reactions to the sight of a clear skin and a full bosom. The acquired response to ample breasts is so negative in some quarters that it creates a reaction of distaste and disgust toward the total physical appearance of any woman who happens to possess a bosom of any prominence. When, for example, McCall's put a portrait of Sophia Loren on a recent January cover, its March letters column indicated that its lady readers objected, two to one--though Miss Loren's neckline was clear up to her throat and her bosom was cut off at the bottom of the page. "Ugh, ugh, ugh," one reader wrote from Canton, Ohio, "that ugly woman with her uncombed hair, looking badly in need of a shampoo. How could you bring yourselves to put her on your cover ... ? You must be losing your aesthetic grip."

Having studied the offending portrait quite carefully, I can only say that Miss Loren's hair looked clean to me. Though her coiffure might not have met the high standards of combing and styling set by the well-groomed matrons of Canton, Ohio, only a few wispy hairs were out of place--no more, certainly, than in another highly approved portrait of Miss Loren that appeared that same month in magazines and newspapers all over the country. In this case--an ad--Miss Loren looked nine times as sexy and seductive as she did on the McCall's cover. Her long hair was swept up behind her head in the sensuous clutch of her shapely arms and the cleavage of her bounteous bosom rose roundly and proudly out of the deep V neck of her form-fitting gown. But few, if any, Americans took offense, because the aesthetics and morality of it all were clearly and properly established in the copy printed beneath:

"A woman's body. Architecturally, quite interesting. To a man. But not to the woman who owns one. Most women tend to ignore their own bodies.

"Do you? Do you check your body, particularly your breasts, every month, for any lump or thickening? You should. A lump or thickening in the breast or elsewhere could be a warning signal of cancer. And cancer is easier to cure when it's detected early.

"Sophia Loren knows the seven warning signals of cancer. So should you:

"1. Unusual bleeding or discharge. 2. A lump or thickening in the breast or elsewhere. 3. A sore that does not heal. 4. Change in bowel or bladder habits. 5. Hoarseness or cough. 6. Indigestion or difficulty in swallowing. 7. Change in a wart or mole.

"If a signal lasts longer than two weeks, see your doctor without delay.

"It makes sense to know the seven warning signals of cancer. It makes sense to give to the American Cancer Society."

Bravissimo! Sex, Italian style? No, no, signori. Fund raising, American style! Sure, itsa show Sophia witha bigga buzoom. But Americans no gonna get mad from that, because itsa tell 'em to feela for lumps! Itsa tell 'em to checka your bowels, watcha your warts and moles like acrazy! Any time you gotta cough or mebbe a little hoarse inna throat, you coulda have cancer! Or mebbe not. But you ain't gonna know for at leasta two weeks. So, inna meantime ... suffer! Worry, worry, night anda day! Americans, they gonna love it!

Cancer is no joke. Nowhere in the world do people laugh at it. But in America, cancer is almost sacred. In an era of lost beliefs and changing values, it is one of the few things that all Americans still respect--and fear. Millions more fear it than will ever get it. Each night of the year, untold multitudes of Americans with warts, indigestion, coughs, lumps or acute diarrhea secretly the a thousand imaginary deaths as a result of years of "education." It hasn't been easy to imbue Americans with the idea that an ordinary "bump" or "frog in the throat" may be a harbinger of death. As the leading volunteer organization for the promulgation of information about America's ninth-ranking illness and number-two killer, the American Cancer Society has had to try harder, annually competing with some 20 other major organizations for attention and contributions--the American Heart Association, the National Tuberculosis Association, the March of Dimes, the Arthritis Foundation, the National Cystic Fibrosis Research Foundation, the United Cerebral Palsy Association, the National Multiple Sclerosis Society, the Muscular Dystrophy Associations, the National Kidney Disease Foundation, and others.

It is not overdrawing the case to say that the output of "information" by such zealously single-minded groups results in a rather large input of morbid imaginings for millions of Americans who will, perhaps, die in their sleep at the age of 80 or step in front of a truck and be killed. Nor is it overdrawing the case to say that in no other nation on earth does health take so many planned holidays. In recent years, our national festival of fear and information has been extended to cover virtually every week and month of the year. We have not only foundation-sponsored Shrovetides and observances, such as Cancer Control Month and American Heart Month, but a whole string of commercially created mini-Lents--the most inclusive of which is the six-week-long "National Indigestion Week."

But no matter what disease or affliction Americans are pressured into brooding upon during any given month or week, the beneficial effectiveness of such informational "crusades" is never questioned--despite the fact that years of the most alarming reports on the possible relationship of smoking to cancer and heart disease have coincided with an increase in cigarette consumption among a fully informed and thoroughly frightened public.

Only occasionally, moreover, does the medical profession dare cast doubt upon the ultimate value of foundation-sponsored efforts to warn and inform--as happened in 1963, when Dr. Edward F. Lewison, of Baltimore, made a speech "contending that despite improvements in detection and treatment, the death rate of women from breast cancer has stayed about the same for half a century."

Excerpts from Dr. Lewison's address, which had appeared in the American Medical Association's Journal, were published in almost 100 newspapers. And, according to my own favorite medical journal, Time, hospitals and doctors were besieged by "agonized inquiries from women who had had operations for breast cancer or were about to have them. "This led to a "blunt rejoinder" to the Lewison findings, by medical director Henry T. Randall of Manhattan's Memorial Sloan-Kettering Cancer Center. "It should be re-emphasized," he re-emphasized, "that breast cancer detected at an early stage and promptly and adequately treated is one of the most curable of human cancers." To which Time added, "No matter how advanced the cancer, provided it can be operated on at all, there is a 65-percent five-year survival rate. This is almost exactly twice as good as the survival rate 50 years ago."

Though no one was supposed to notice, a "65-percent, five year survival rate" does not necessarily contradict or nullify Dr. Levison's statement that the death rate of women from breast cancer has stayed about the same for half a century. Would to God that it did. And would that an adequate contradiction were possible to a later charge made from within the medical profession that, "Many American doctors are failing to spot early cancer cases because they're 'too shy and bashful' to examine their patients closely from head to toe."

"Only the most exceptional doctors have ever seen their patients in the nude," Dr. Irwin Rothman, director of psychiatric research at the Philadelphia Mental Health Clinic, has declared. "And even when these bashful physicians give a complete physical, it includes only a hurried glance at a woman's breasts or the male and female genital areas."

While it is beyond the scope of this report to conduct a complete top-to-toe on the sexual hang-ups of American doctors, it is interesting to note that Dr. Rothman has found the medical profession prone to the same sort of dermaphobic reactions that we have previously observed as prevalent among the operation-watching laity. For both, it would seem, embarrassment and confusion stem from a deeply rooted belief that the unbroken surfaces of the human body are "too raw for public showing," while the guts, glands, tissues and bones that lie beneath the skin are evidences of the Almighty's handiwork and are absolutely "gorgeous."

Given our high national level of hypochondria and psychogenic illness, the medical profession would not require the investigative abilities of the FBI to track down the effects of this oddly perverted attitude or to demonstrate how Americans of all ages are daily and hourly encouraged to have morbid preoccupations with sickness and disease. But the alarming fact is that the gutsmut game is one in which a considerable segment of the medical profession is itself involved. Many are the verbally gifted medicos who moonlight in the profitable field of periodical mediwriting, and syndicated doctors' columns freely dispense daily doses of easily adopted symptoms to a vast and highly suggestible audience of newspaper readers. "What is sprue?" the anxious inquire. "Is endometriosis serious?" "What causes a kidney to disappear and what effect will it have on the other kidney?" "My legs from thighs to knees feel hot, but from knees to feet they are cold. What can do this?" "I am a single woman, 54. Would it be possible for a doctor to make a pelvic examination while I am under anesthesia?" "Will you explain the meaning of erosive cervicitis and metrorrhagia?" "Why do some doctors refuse to give people more than one flu shot a year? Where can I go to get two shots annually?" "Can athlete's foot spread to the ear?"

The impression that America is not feeling totally well is inescapable. It is an ever-present condition of our daily life and one that apparently cannot be changed either by additional "education" or by a massive campaign against medical columns in the daily papers. Our national preoccupation with illness and disease is so far-reaching and deep that even the most dedicated gutsmut hunter would scarcely know where to begin to stamp it out.

Increasingly, illness, medicine and surgery have become a major form of mass-media entertainment. There's the all-night, all-star telethon, for example, where moving pleas for contributions are interspersed with songs and comedy and brave little stand-up tragedians, who are among the dread crippler's most appealing victims, come hobbling on with cheery smiles.

The pornography of mercy.

Man, that's show business! Like Ben Casey, Dr. Kildare, The Doctors, The Nurses and General Hospital.

"Transplant Patient Fine; Dispute Flares Over Sale of TV Rights to NBC," one reads. "Networks row over Heart Man.... Doc Mulls U.S. Offer."

There are coast-to-coast guest shots for surgeons who have knifed and sutured their way to stardom. There are film dickers, quickie book offers and LP record albums featuring a "team discussion" of an ill-fated heart switch. There are all those really great, great TV "specials" that duplicate and often outdo the "educational" efforts of Time and Life:

"This man is desperately ill.... Unless he receives a healthy, functioning kidney, he will die.... His sister Evelyn has offered to donate one of her kidneys.... Doctors hope to transplant Evelyn's kidney into her brother's body.... It all begins in a pair of adjoining operating rooms.... Here in OR-1 the donor kidney is being taken from Evelyn's body.... Now the donor kidney is being carried into the adjoining operating room...."

And you are there! You can see it, hear it and absorb it. You can almost touch it and smell it!

And if you are not there, you may be tuned to your favorite situation comedy, drama, variety show or sporting event--and if you stay with it for a while, you can see and absorb all sorts of other ailments in 60-second doses. Hour after hour. Hundreds of tiny little time pills of pure commercial misery:

"This is how it starts.... Something happens to upset you. Something happens to make you tense up ... cause nerves to snap.... And with each mounting pressure, excess acid may start to flow in your stomach.... First a drop.... Then another.... And another.... And another.... Result: acid indigestion, heartburn, that burning sensation...."

"A headache starts to grow ... and grow ... and pound ... and pound.... It's hard to be happy when you hurt...."

"Nasal congestion here! Congestion deep in the sinuses here! This scientific breathing bag shows breathing almost blocked...."

"Uh-oh, here it comes.... Pain.... Its tension tightens your nerves.... Feel it? ..."

Of course you do! It's like magic--black magic, audio-video voodoo, drumming away at you, every time you turn on the tube.

But the siren voice of sickness can be soft and sexy, too:

"Ooh ... got a cold? ... Poor baby! ... You need some sympathetic understanding.... Relax.... Loosen your tie.... Put your feet up.... How'dcha catch that cold, anyway? ... A great big strong man like you.... Listen ... I've got something for you...."

If you'll take what she's got, "You'll start feeling better in minutes, and you'll keep on feeling better...." Like, wow. And for the girls, there are virile men's voices talking about "deep, penetrating heat" and "fast-acting, longer-lasting relief." Sometimes you wonder what they're selling. Sometimes it sounds almost like ... something salacious!

As yet, no one claims to have found an antidote or a panacea for the Schmerz that can afflict a whole nation when its leading means of communication address themselves so assiduously to merchandising misery and exploiting the gut issues. But new advances are being made all the time. "Alka-Seltzer invents a new disease," the video voice says, half kiddingly, on the commercial level, "the blahs.... The blahs is kinda like the blues, only physical.... It's when you're not feeling right, but you don't know what's wrong.... It might be a headache on its way ... a stomach-ache on its way.... Ooh ... the blahs! ... Who needs 'em? ... You know, we wouldn't have invented a disease unless we had something to take for it.... Alka-Seltzer.... If Alka-Seltzer can take care of the real big upsets ... think of what it can do for a simple case of the blahs...."

I have been thinking. And so, undoubtedly, have you. About how speedy old Alka-Seltzer has finally hung a name on the number-one American illness--the queasy little crippler of a gray society, in which people are "never totally well but seldom seriously ill."

For me, the blahs is when you've finally had a bellyful of seeing sickness, morbidity and fear being peddled for profit. And there's no adult-formula cure for that, other than a large daily dose of raspberry-flavored perspective.

It's hard to be happy when you hurt. But it really doesn't hurt at all, once you've caught on to the gutsmut game--once you're aware of how it works and who wins. But don't look for TV specials or fearless, follow-up photo essays, telling how the game is played.

The sickening of an entire nation is not quite in the same safe class with the death of a President--or auto safety or sexy Swedish movies. You can cock a snook at the Pentagon or rip the lid off the CIA. You can blow the whistle on the Mafia, heckle the undertaker or spill the beans on a few crooked doctors--and still win good marks from the media. But you can't make unpleasant noises about the whole gutsmut game and expect the well-heeled winners to present you with an achievement award.

Silence is golden, and that's what to expect. A beautiful 14-kt. hush.