Showing posts with label Pepagomenos. Show all posts
Showing posts with label Pepagomenos. Show all posts

10 April 2015

The doctor and his patient




Demetrios Pepagomenos was the second of the four speakers at Cleofe's memorial. I have written about these monodies at other times, in detail about those by Bessarion, the last speaker, and George Gemistos Plethon, the first. (The order of the speakers has to be deduced: Plethon was the oldest and certainly of the highest status of the four, Bessarion the youngest and, being a monk, of the lowest status. Cheilas probably has to follow Pepagomenos as he makes a comment about him.)

Pepagomenos was a doctor specializing in gout. We do not have an absolute statement that he was Cleofe's doctor, but there is enough evidence to allow us to deduce it. For example, in his monody he said, “There is need for all of us, and for myself especially, to let our voices loose in the intensity of our suffering.” I read that as a comment on his sense of involvement in, if not responsibility for her death. Later he spoke of “the body of our holy queen, so well-formed, so harmonious as to bring future happiness to the race.” As the daughter of an obstetrician, I read that as saying her body was suited for child-bearing, and so something he would be the only man, other than her husband, in a position to know.

But when Cleofe died at noon on Good Friday, she had been fasting for nearly forty days, and there is strong evidence to suggest that she would have followed the most severe fast. She spent nights standing in prayer. She had, unintentionally, prepared her body for a massive hemorrhage. Pepagomenos called it a cataclysm, a deluge over the whole race – ἄλλον τινὰ καταχλυσμὸν τοῦ γένους παντὸς, and said it had come on suddenly. Bessarion also refers to blood, saying that her husband (like Zeus) had wept tears of blood (and, like Zeus, at the loss of a son in addition to his wife).

I think the dead child was a son, because Pepagomenos said this birth was to have been such an even that “all good and decent things might come to settle not only among us present here but among all the entire race . . . that there might be skipping and dancing . . . the singing of festival chants, the display of general happiness.”

“All the best for us came,” he said to her – sometimes he spoke to the assembled mourners, and sometimes to Cleofe – “with your settling among us. . . . But now everything goes the other way.” He mentions first her husband, “our holy ruler,” and then “her dear daughter . . . all her blood relations, her servants and cities.” Pepagomenos speaks of her daughter three different times, and then again of the loss to her subjects.

He becomes more specific about her subjects: “But the bellies of the poor mourn especially the hands of our queen, which worked as it were to one purpose throughout her life, to nourish those in want, not merely through instruction, and through those of others', as might have been expected of such a queen, but themselves performing the service of cookery, collecting wood from wherever they had to, and lighting the fire, even roasting the food of the poor over it and serving it to them, nourishing them daily, taking no account of the heat of the fire, the intense burden of the smoke, and the inescapable duration of this service. This is an exceptional description. It was conventional for Renaissance and Byzantine ladies of good families to feed the poor, but nowhere, I think, do we learn that they carried firewood and cooked in the smoke.  Though I do wonder where she had learned to cook.  All the speakers spoke of Cleofe's character: Pepagomenos spoke more than the others of what she actually did in her life.

He specified other groups whom she nurtured: “The orphaned children of her household mourn her, who acted as a mother to all, sharing out to each of them what was right, and neglecting nothing of their care; she made it possible for the women to live together with husbands and men with wives, to act openly and to practice another way of life, something that had in many periods over the years been neglected. but was rightly and properly fostered during the reign of our most holy queen, with all attention and concern, as one might say. Widows, too mourn their protector, and strangers the source of consolation from which they often benefited--- all, in short, for whom she offered a respite from loss.”

It is possible that Pepagomenos himself knew the pain of losing a wife. The cleaving of the one flesh that is a marriage was an easy topos for the Byzantines, but he went further: “The cleaving apart of a bodily union brings the unbearable pain of an amputation when a mother dies in childbirth. This, more than anything else makes the pain of the cut intense and presents the suffering as ever new in the eyes of the husband, and becomes an inexhaustible fuel for the fire, always displaying the newness of the loss, and never ceasing. But the severing of spiritual attachment has an intense bite and makes the pain even more unbearable, inasmuch as it is carried on in the the present life, while the former pain, although it is, so to speak, undying, continues to be associated with that material, though now lost, companionship.

He went on to raise topics that might have been considered better unmentioned and, as with Plethon and Bessarion, the frankness of subjects towards their ruler is striking. There were aspects of the earlier relationship between Cleofe and Theodoros that nearly led to his rejection of her, and we might wonder if Theodoros had been repenting to Pepagomenos of his stubborness. “When the time was right, even before your marriage, you lighted the brand of self-mastery with a little spark and disregarding paternal pride, canceling maternal agreements, the petitioning of your sisters, and the native innovations in religion of your homeland, you were pliant in everything to your husband and lord, putting this before all else, to follow his beliefs throughout your life and to practice them as fully as you were able. (Had she confided to Pepagomenos the real facts of her "conversion"?) All of this scorches him the more intensely and causes greater agony as he thinks of what consolation, aid and assistance against this greater and more final loss he has lost.”

Theodoros had apparently insisted that she change her style of dress as well as convert, things directly opposed to the agreements he had made for the marriage. “The wearing of clothes outside our habits of dress, beyond our temperament and sense of what, so to speak, is naturally required, was a matter of her unmaterial and spiritual nature, one unassociated with worldly passion or any kind of bodily necessity, because she aimed, in her unconcern with such matters, at what seemed to her always to be a more perfect order and self-governance. Not that there might ever be perfection more perfect than perfection, or that clothing will change character, but nonetheless, there was some length of time before the end, when, unless she was constrained by official ceremonies, she wore the fashion of those who live monastically, so that what was earlier unappreciated by outsiders, was now obvious to all.”

Toward the end of his monody, Pepagomenos embarked on a series of thirteen “O”s: "O dwelling-place of virtues . . . O all those dreams . . . O charms of that holiest body . . . O lady, death loved you . . . O terrible and lightless day.”  These Os formed a transition from the main body of his monody to his conclusion, addressed directly to her, speaking to her as the representative of all of them there listening: 

“You, most divine, pious and holy queen, who have made this translation only under the instructions of God. . . you have flown from us through the approval of the almighty . . . Do not withdraw into this new world but, even before us, watch over our most holy despot of the Romans, your co-worker utterly cast down by so great strife, and by the onslaught of disasters, brought on him by your death. For you were the best co-worker -- συνεργόν --urging him toward the good, and consoling him for what was incurable, a good counselor, a guide for action, and a harbor for all that is good, and all of this is gone, flown away with you. (Here it is clear that Pepagomenos had read the poem Theodoros had written for her in which he had called her his ξυνεργὸς, his co-worker, though in the poem I have preferred “fellow poet.”)

“This was not a good thing, and not how it should have been. Οὐ καλῶς μὲν οὐδ’ ὡς ἐχρῆν γέγονε δ’ οὖν.

“It would be in your power, either with your prayers to the divine, as you stand immediately beside God, to alleviate the distress of our ruler, and through this the misfortune of the entire Roman people---you can do this, I know, with a mere nod of assent-- δύνασαι γὰρ τοϋτ’, εὖ οἶδα, εἰ κατανεύσειας μόνον -- or to leave us to mourn and lament throughout life, as long as the sun sends its rays over the earth.”

This is astounding: he has put Cleofe in the position of the Panagia, and has given her the nod – and so the authority – of Zeus.




Pierre MacKay made the translation. Greek text available at http://nauplion.net/CL-Pepagomenos (3).pdf












29 August 2009

The Doctor

Theodora Palaiologina died at Stameron in November 1429, in the throes of labor. "She left behind," wrote Sphrantzes, her husband's close aide, "much grief for her husband and for all of us, because she was really lovely."

Kleope Palaiologina died in April 1433 at Mistra from the results of childbirth. "She was outstanding," wrote Chalcocondyles who knew her,"for her beauty and all other seemliness." In an eloquent eulogy, Kleope's doctor, Demetrios Pepagomenos, said that her residence among them had made them better, and mentioned an infant born too soon, a daughter, her companionship with her husband.

When their father-in-law, Manuel II, whom neither woman had ever met, visited the Morea in 1415, Pepagomenos was with his suite. He was a specialist in gout. He was left in Mistra to serve Theodoros II as court physician.

The author of Mazaris, a book of upper-class male humor written for Theodoros, was also traveling with Manuel. He said Pepagomenos was a skilled poisoner, and had even poisoned himself and someone's secretary by mistake. There are a lot of doctors in Mazaris, and the author gives them all a rough time. Byzantine humor when not scatological involved satire at the expense of others who were usually present.
Humans have always and ever joked about doctors killing their patients: we need not take any of this as courtroom evidence. This was written as humor and the Mistra intellectuals were probably rolling on the floor, howling with laughter.

We are told Pepagomenos had two sons. The younger, Theodosios, nicknamed "Little S**t," was driven by ambition to rise at court, while the older, nicknamed "Lizard Eyes," had also entered the ranks of licensed killers. This, too, was found hilarious.

Pepagomenos means "frozen." Mazaris missed a chance to joke about it. That is irrelevant here. And the eulogy makes it difficult to connect the man with any idea of frozen.

What is relevant is that he was Kleope's doctor. Given the intense conservatism of the last Palaiologoi in regard to the aides they employed, it is very likely that he was also Theodora's doctor. And most medical knowledge and practice was based on sources 1500 years old.

In Florence in those years, one could expect one maternal death for sixty-nine childbirths. Ultimately, one woman out of five would die as the result of childbirth, But here in the imperial family, we have two maternal deaths for three childbirths.

Kleope had successfully given birth to a daughter in the winter of 1428-1429. One of her letters indicates that she was worried about the birth, but there is no way to know whether she knew of a problem, or whether it was normal concern. Her mother had died in childbirth, after at least five successful pregnancies. Still, Kleope had that intimate loss behind her concern. That first birth went well: she had a daughter Helena who in turn had daughters, Charlotte and Cleope.

There is evidence over many centuries that a radicalization of death rates happened whenever men moved into midwives' territory, and got hands-on where midwives knew better than to interfere. A fine book, A Midwife's Tale, based on a diary written in the early 1800s, before penicillin and before the germ theory of disease, records a single maternal death for Martha Ballard out of 1000 deliveries. It also relates what happened when a doctor settled in the area and the status effect drew patients she had successfully delivered to him, a decision. often taken by the husband.

All this may be traducing a good man. Kleope and Theodora might well have died without him. We cannot blame Pepagomenos for a premature birth, but it was not a good thing to be an imperial lady in the medieval Morea.