Page 26 - Delaware Medical Journal - November 2016
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MOVIE REVIEW
Florence Foster Jenkins
Wesley W. Emmons, III, MD FACP
Within the past few months, my wife and I had the pleasure of seeing the movie Florence Foster Jenkins (PG-13). Although no longer in theaters, it is available by rental and is well worth your time. Based on the true story of a wealthy for her money, maintaining a torrid love affair on the side?). The comedy is never forced and erupts spontaneously from excellent acting from Meryl Streep, Hugh Grant, and Simon Helberg. Facial expressions and spoken lines clip along quickly enough to keep the
But what intrigued me was the reference to her medical condition, syphilis, and I could not help but wonder if the disease (or its treatment at the time) fueled her desire to sing publicly (or affected her ability to realize her utter lack of talent).
Married in 1885, Florence Foster Jenkins left (but did not divorce) her husband in 1886 because she apparently contracted syphilis from him. The favored treatment at the time was mercury, and
it remained so until 1910, when Ehrlich discovered the rapid spirocheticidal effect of arsenic. Mercury’s side effects include emotional lability, memory impairment, insomnia, peripheral neuropathies, pink skin, desquamation, tachycardia, salivation, sweating, Fanconi’s syndrome, and tooth loss. Thousands died each year from the treatment, not the disease. By the early 18th century, syphilis was no longer the virulent epidemic disease that it was
in the past. Arsenic also had toxic side effects (nausea, vomiting, fatigue, fever, tachycardia, abdominal pain, and diarrhea). By 1921 arsenic, combined with either bismuth or mercury, was the mainstay of syphilis treatment until penicillin was found to be highly effective in 1943.
Florence Foster Jenkins began performing in 1912, ultimately performing at Carnegie Hall in 1944 at the age of 76. If she was infected in 1886, she no doubt suffered from late symptomatic neurosyphilis by 1906, probably the parenchymatous form (although there is frequent overlap with the meningovascular form). Parenchymatous neurosyphilis includes general paresis (cortical involvement) and tabes dorsalis (spinal cord involvement). The
Florence Foster Jenkins
incidence of symptomatic late neurosyphilis is not clear, as the signs and symptoms are (aside from Argyll Robertson pupils or the lancinating pain of tabes dorsalis). General paresis occurs 15-20 years after the onset of disease; it
is a constellation of neuro-
paranoia, illusions, delusions, megalomania, decreased judgment and insight.1 In accounts of her life, she
watching the movie, and in reading
appeared to have some of these characteristics.
It is unlikely the left arm palsy she had was secondary to neurosyphilis, although she implied this in the movie; this is not implied in biographies of her life. She did not apparently have Argyll Robertson pupils, Romberg’s sign, cranial nerve palsies (especially
In sum, it is a wonderful movie about a unique character. Whether her desire to sing (and not realize how bad she was) was in part critics), or from general paresis, or from her ongoing treatments with mercury will never be known, but is worth thinking about.
■ WESLEY W. EMMONS, III, MD FACP is a board-certified Infectious Diseases Physician in private practice in Newark, Del. He also holds a Certificate of Knowledge in Clinical Tropical Medicine from the American Society of Tropical Medicine and Hygiene.
REFERENCE
1. Tramont EC. Treponema pallidum (Syphilis). In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Disease, Vol. 2. 5th ed. Philadelphia: Churchill Livingstone; 2000:2474-2490.
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Del Med J | November 2016 | Vol. 88 | No. 11
