El Monstruo.
Article Type: Resena de libro
Author: Rigau-Perez, Jose G.
Pub Date: 12/01/2009
Publication: Name: Puerto Rico Health Sciences Journal Publisher: Universidad de Puerto Rico, Recinto de Ciencias Medicas Language: Spanish Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2009 Universidad de Puerto Rico, Recinto de Ciencias Medicas ISSN: 0738-0658
Issue: Date: Dec, 2009 Source Volume: 28 Source Issue: 4
Topic: NamedWork: El Monstruo (Libro)
Persons: Reviewee: Zeno Gandia, Manuel
Accession Number: 212102678
Full Text: El Monstruo

MANUEL ZENO GANDIA, Edition and introduction by Miguel Angel Nater, San Juan: Editorial Tiempo Nuevo, 2008; 79 pages; $13.00; ISBN: 0975545337

Editorial Nuevo Tiempo has rescued El Monstruo, a short novel, from the archives of the Manuel Zeno Gandia legacy. Its title refers to a child disfigured by congenital malformations, who is loved by his mother and his physician, but not by his father. Curiously, that is the history of the text itself, rejected as inadequate for publication by its author, Zeno Gandia. Nevertheless, in imitation of one of the principal characters in the novel, a physician, there is reason to celebrate the appearance of this Monster. It enriches not only literature, but also the sources of our medical history and the means to educate health professionals in the twenty-first century.

Manuel Zeno Gandia was born in Arecibo, Puerto Rico, in 1855, and died in San Juan in 1930. In 1866, his family moved to Barcelona, where he studied "bachillerato" (high school). He graduated from medical school in Madrid in 1875. Therefore, he became an adult in Spain at the time of the revolution against Queen Isabel II and lived in the capital during the First Republic and the Alfonsine restoration. While still a student, he published a monograph in 1873 entitled "The Infuence of Climate on Human Diseases. " He later furthered his training with an internship at Hopital St. Andre in Bordeaux, France (1). The institution dated back to 1390, but the establishment of a medical faculty in 1874 had resulted in the renovation and expansion of its facilities and, above all, a completely modern educational environment (2). Months later, Zeno visited Paris (the world capital for medical advances at that time) and other cities in France. He returned to Madrid and then immediately to Puerto Rico in 1876. He settled first in Arecibo, where he wrote El Monstruo in 1878, then moved to Ponce in 1880, where he established his medical practice. For several years, until 1898, he also occupied the position of port physician or quarantine officer (3). After the American invasion, his medical work was replaced by political, journalistic and literary activities. He advocated independence for Puerto Rico as a leader of the Union Party, until it changed its platform and relegated sovereignty to a distant goal.

In spite of Zeno Gandia's abundant poetic production, he is best known for his four "Chronicles of a Sick World", published between 1894 and 1925: the novels Garduna, La charca [The stagnant pond], El negocio [The business] and Redentores [Redeemers]. He is considered a naturalist writer in the school of Emile Zola mainly by the style of the first two novels, in which he describes human behavior, without hiding its baseness or cruelties, with the supposedly impartial eye of a scientific observer. Zola reached popularity around 1867 and Zeno undoubtedly became familiar with his work in Madrid or France. El monstruo demonstrates, 10 or 15 years before the writing of Zeno's greatest novels, his interest in the analysis of human weakness. The text shows the additional influence of Victor Hugo by citing the novel L'homme qui rit (1869), about a disfigured child who grows up in a circus. Zeno's main character in El monstruo is also reminiscent of the hunchback Quasimodo in Hugo's Notre Dame de Paris, published in 1831.

In the second chapter of Zeno's book, Juan, an expectant father, is anguished by the indications that some tragedy has occurred during his wife's delivery. He is about to enter the bedchamber when the physician, another important character in the plot, appears on the threshold. The doctor only increases Juan's apprehension with words like: "Science has intricate mysteries ... You are a man and one more pain is of no importance when added to the many we suffer in life". For a long while he raises enigmas, names of illustrious physicians, and medical terms in Spanish and Latin, until Juan, completely confused, storms into the bedroom, stares at his son and leaves horrified. The author leaves no doubt that he shares the reader's dismay at the physician's inappropriate and "inopportune speech".

The child, whom the narrator considers "a frightfully ugly being", had "an enormously voluminous head and the face pushed and folded into a corner"; only one eye, wide and long earlobes, harelip, short neck, irregular chest, crooked back, and, ironically, six "perfectly developed" fingers on the right hand. As if this were not enough, he is later scarred by smallpox at the age of two. In real life, the problems that the author accumulates on the newborn would produce death in early infancy.

When Zeno wrote, physicians could not "explain" the development of a congenital malformation (4). Even today, of course, it is not possible to explain why an individual case occurs, but embryology, genetics and biochemistry have deciphered many of the different mechanisms. Our knowledge of the high incidence of two causes (endogamy and deficient nutrition) in nineteenth century Puerto Rico suggests that malformations occurred frequently. The painter Jose Campeche and the physician naturalist Agustin Stahl provide evidence through their work (5).

In the third chapter of the novel, Zeno presents a meditation on the physician's character. His name is Gedeon Haro, clearly a symbolic name. Gideon, a powerful biblical warrior, destroyed the altars of the false gods (Judges, 6-8) and Juan de Haro successfully defended San Juan against the Dutch in 1625. The doctor's name therefore suggests an advocate of truth and Puerto Rico. He shows affection for the malformed child, whom he accepts as godson and names Claudio, probably a reference to the Roman emperor who appeared simpleminded but ruled wisely, or maybe in honor of the great French physiologist of the era, Claude Bernard. Doctor Haro tries to persuade Claudio's father that the child, who learned to read perfectly at the age of five and has demonstrated an aptitude for wood carving, is capable of great intellectual achievement and profound emotion. Haro bases his arguments on the postulates of phrenology, a theory that related cranial superficial anatomy with the abilities and talents of the subject (6). The clinical reasoning only serves to distress the father.

After these brief indications of the novel's plot, it is possible to remark on its Prologue. Zeno warns that the book is exclusively for men, who should read it in hiding, "when everyone in the house is asleep". The novel criticizes males for their typical rejection of a malformed son, in contrast to the unconditional love offered by mothers. The author recommends that the book not be shown to wives because it might fill their hearts with "painful fears and annoying restlessness ... They would fear, each time Nature makes them a promise, for the loving fruit of its blessing, and you [reader] know how delicate and brittle this state [of pregnancy] is in woman".

At the end of the book we must ask: who is the monster? Claudio, the child; Gedeon the physician; Juan the father; one of the characters I have not mentioned; Puerto Rico, or even the text itself? Zeno resembles the authors of our own era in this ambiguity.

El Monstruo demonstrates Zeno Gandia's first steps in the transition from physician to novelist. The book also presents the medical ideas of a recent graduate in 1878, including gender-based opinions regarding susceptibilities and aptitudes of fathers and mothers. In addition to its usefulness as a historical source, the novel provides an instrument for training health professionals in the twenty-first century. Its brevity makes it useful as assigned reading, to analyze the requirements for good communication between health care professional and patient. It facilitates learning through different methods, such as literary criticism or role-playing. How should parents be notified of birth defects? How do mothers, fathers, physicians, neighbors react? How do these attitudes change as the child grows? This brief novel presents all of those situations.

Abbreviated translated version of remarks at the book presentation at the Center for Advanced Studies on Puerto Rico and the Caribbean, San Juan, Puerto Rico, April 1st, 2009. The author has no affiliation or financial involvement with the publisher

La Editorial Tiempo Nuevo ha rescatado de los archivos la novela corta El Monstruo, de Manuel Zeno Gandia. Su titulo alude a un nino desfigurado por malformaciones congenitas, a quien aman su madre y su medico (pero no el padre). Esa es, curiosamente, la misma historia del texto, a quien su autor, Zeno Gandia, rechazo como inadecuado para lapublicacion. Tal como el personaje medico de la novela, celebro la aparicion de este Monstruo, que viene a enriquecer no solo la literatura, sino tambien las fuentes de nuestra historia medica y los recursos para educar a los profesionales de la salud del siglo XXI.

Manuel Zeno Gandia nacio en Arecibo en 1855 y fallecio en San Juan en 1930. La familia se mudo a Barcelona en 1866. El estudio alli bachillerato (nuestra escuela superior) pero se graduo de medicina en Madrid en 1875. Es decir, se hizo adulto durante la epoca de la revolucion isabelina y vivio en la capital durante la Primera Republica y la restauracion alfonsina. Todavia estudiante, publico en 1873 una monografia titulada La influencia del clima en las enfermedades del hombre. Prosiguio su entrenamiento en un internado en el Hopital St. Andre, en Burdeos, Francia (1). La institucion data de 1390, pero la fundacion de una facultad de medicina en la ciudad en 1874 habia impulsado la renovacion y ampliacion de las facilidades y, sobre todo, un ambiente educativo completamente actualizado (2). Meses mas tarde, Zeno visito Paris (la capital mundial de los adelantos medicos en aquella epoca) y otras ciudades de Francia. Regreso a Madrid y enseguida a Puerto Rico, donde llego en 1876. Se establecio primero en Arecibo (donde escribio El Monstruo en 1878) y luego traslado su practica a Ponce en 1880. Tambien ocupo alli, hasta 1898, el puesto de medico del puerto u oficial de Sanidad Maritima (3). Despues de la invasion americana, sus actividades politicas, periodisticas y literarias desplazaron la labor medica. Abogo por la independencia de Puerto Rico y figuro entre los lideres del partido Union hasta que este relego ese ideal a segundo plano.

A pesar de la abundante produccion poetica de Zeno Gandia, lo conocemos principalmente por sus cuatro "Cronicas de un mundo enfermo", publicadas de 1894 a 1925: las novelas Garduna, La charca, El negocio y Redentores. Se le considera un escritor naturalista, en la escuela de Emile Zola, sobre todo por el estilo de las primeras dos novelas, en las que describe el comportamiento humano sin ocultar sus bajezas y crueldades, con el ojo supuestamente imparcial de un observador cientifico. Zola alcanzo la popularidad desde 1867 e indudablemente Zeno se familiarizo con su obra, si no en Madrid, durante la estadia en Francia. El monstruo evidencia, 10 o 15 anos antes de la escritura de las primeras grandes novelas de Zeno, ese afan por presentar y analizar las debilidades del ser humano. El texto mismo senala la influencia adicional de Victor Hugo, al citar la novela L'homme qui rit, publicada en 1869 y que trata de un nino desfigurado que crece con un circo. El personaje principal de El Monstruo tambien recuerda al jorobado Quasimodo de Notre Dame de Paris, publicada en 1831.

Las escenas del libro de Zeno en que participa el personaje medico son de especial interes. En el segundo capitulo aparece Juan, el padre de la criatura, desesperado por los signos de que alguna tragedia ha ocurrido durante el alumbramiento. Va a entrar al dormitorio cuando el medico aparece en su dintel. Sin embargo, el doctor solo aumenta la zozobra de Juan, con palabras como estas: "La ciencia tiene misterios inextricables ... Usted es hombre y nada importa un dolor mas unido a los muchos que sufrimos en la vida". Por largo rato le plantea enigmas, nombres de medicos ilustres y terminos tecnicos en espanol y latin hasta que Juan, totalmente confundido, irrumpe en lahabitacion, contempla a su hijo y sale horrorizado. El autor hace claro que comparte el asombro del lector ante la reaccion inapropiada del medico y su "inoportuno discurso".

El nino, a quien el narrador considera "un ser espantosamente feo", tenia "la cabeza enormemente voluminosa y la cara empujada, replegada a un rincon"; un solo of o, anchos y largos pabellones de las orej as, labio superior dividido en dos (leporino), cuello corto, pecho irregular, columna vertebral j orobada e, ironicamente, seis dedos "perfectamente desarrollados" en la mano derecha. Como si fuera poco, a la edad de dos anos la viruela lo dej a marcado de cicatrices. En la realidad, los problemas que el autor acumula en el recien nacido producirian una muerte temprana.

Al momento en que Zeno escribe, el medico no podia "explicar" por que ocurria una malformacion congenita (4). Aun hoy no es posible, por supuesto, explicar por que ocurre un caso individual, pero la embriologia, la genetica ylabioquimicahan descifrado muchos de los mecanismos causales. Nuestro conocimiento de la alta incidencia de dos de ellos (la endogamia y la nutricion deficiente) en el Puerto Rico del siglo XIX sugiere que las malformaciones congenitas habran surgido con frecuencia. El pintor Jose Campeche y el medico y naturalistaAgustin Stahl dejaron evidencia de ello (5).

En el tercer capitulo, Zeno presenta una reflexion sobre el personaje medico. Se llama Gedeon Haro, un nombre claramente simbolico. Gedeon, poderoso guerrero biblico, destruyo los altares a los dioses falsos (Jueces, 6-8). Don Juan de Haro defendio exitosamente a San Juan contra los holandeses en 1625. El nombre del medico sugiere entonces un paladin de la verdad y de Puerto Rico. Este muestra carino por el nino malformado. Acepta apadrinarlo y le pone por nombre Claudio, probablemente en alusion al emperador romano que parecia retardado pero resulto sabio, aunque quizas tambien recuerde al gran fisiologo frances de la epoca, Claude Bernard. El doctor Haro intenta persuadir al padre que Claudio, quien a los cinco anos aprendio a leer perfectamente y ha demostrado aptitud parala talla en madera, posee una gran capacidad intelectual y emocional. El medico fundamenta sus argumentos en los postulados de la frenologia, una teoria que relacionaba las protuberancias del craneo con las habilidades ypasiones del sujeto (6). El razonamiento clinico solo consigue angustiar a Juan.

Sin revelar mas de la trama, es posible comentar una peculiaridad del Prologo. Zeno advierte que este es un libro exclusivamente para hombres, que deben leerlo a escondidas, "cuando todos duermen en la casa". La novela atribuye y critica a los varones la reaccion de rechazo ante el hijo malformado, en contraposicion al amor incondicional que ofrecen las madres. El autor propone que "no ensenemos este libro a nuestras esposas" pues pudiera llevar a sus corazones "penosos temores y enojosas inquietudes ... Temerian, cada vez que la naturaleza les hiciera una promesa, por el amoroso fruto de su bendicion, y ya sabes [lector] cuan delicado y vidrioso es este estado [del embarazo] en la mujer".

Al final del libro hay que preguntarse ?quien es el monstruo? ?Claudio el nino, Gedeon el medico, Juan el padre, alguno de los personajes que no he comentado, Puerto Rico o hasta el mismo texto? En esta ambiguedad, Zeno se acerca a los autores de nuestra propia epoca.

El Monstruo evidencia los primeros pasos de Zeno Gandia en su transito de galeno a novelista. Tambien el libro expone las ideas medicas de un recien graduado en 1878, incluyendo una vision de genero de las susceptibilidades y aptitudes de padres y madres. Aparte de su utilidad como fuente historica, la novela provee un instrumento para entrenar a nuestros profesionales del siglo XXI. Su brevedad le recomienda como texto base para explorar las condiciones de unabuena comunicacion entre el personal sanitario y los pacientes y sus familiares. Facilita ademas el aprendizaje mediante herramientas accesorias como la critica literaria y el juego de roles. ?Como se da a los padres la noticia de una criatura malformada? ?Como reaccionan la madre, el padre, el medico, los vecinos? ?Como cambian sus reacciones segun crece la criatura? Esta breve obra presenta todas esas situaciones.

Version abreviada de la presentacion de la novela El Monstruo, Centro de Estudios Avanzados de Puerto Rico y el Caribe, San Juan, Puerto Rico, 1 de abril de 2009.


(1.) Biographical data on Zeno compiled from information in Marxuach CI, "Introduccion", in Zeno Gandia M. La charca. San Juan: Centro de Estudios Avanzados de Puerto Rico y el Caribe, 1987: 7-61; Arana Soto S. Diccionario de medicos puertorriquenos (que se han distinguido fuera de la medicina). San Juan, n. e., 1963: 345-350 and Catalogo de medicos de P. R. de siglos pasados (con muchos de este). San Juan, n. e., 1966: p. 467-468.

(2.) Available at: URL: http://www.chu-bordeaux.fr/chub/le-chu/ histoire-des-hopitaux/1-histoire-des-hopitaux-de-bordeaux/ \hopital-saint-andre/; http://www.chu-bordeaux.fr/chub/le-chu/ histoiredes-hopitaux/1-histoire-des-hopitaux-de-bordeaux/hopital-saint-andre/ saint-andre-de-la-revolution-au-xixeme-siecle/.

(3.) Arana, Catalogo, p. 467-468.

(4.) Guerra F. Historia de la medicina. 3a ed., Madrid: Norma-Capitel, 2007: p. 335-339.

(5.) Rigau-Perez JG. Monstruos, martires o ejemplos: teratologia en Puerto Rico, de 1798 a 1808. Bol Asoc Med P Rico 1985;77:326-333; Stahl A. Demostracion de dos casos de neuropatias y dos de teratologia. Bol Asoc Med P Rico 1908;6:5-66.

(6.) Guerra 262.

Jose G. Rigau-Perez, MD, MPH

Academia Puertorriquena de la Historia

Assistant Professor ad honorem

Departments of Pediatrics and Epidemiology

Schools of Medicine and Public Health

Medical Sciences Campus, University of Puerto Rico

Email: jgrigau@prdigital.com
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