The 26th Historical Clinicopathological Conference

The Wages of Apostolic Poverty

By the time this patient reached the end of his life at age 44, absolute poverty and disease had reduced him to the condition of a living corpse. He was not, however, born destitute. In fact, the patient’s family was wealthy enough to enable him as a youth to live a hedonist’s life of revelry, song, and nightly escapades about his native city with a multitude of friends. Much later he would refer to that time as his “years in sin,” though an early (approved) biographer insisted that “he never yielded to seductions of the flesh.”

When the patient was 19 his life changed radically. Captured during a battle with a neighboring city, he was imprisoned for a year in a damp and polluted subterranean cell. He languished there in near perpetual darkness on a diet of rancid food and tainted water, while exposed to brutal cold in the winter and sweltering heat in summer. When finally freed, he was so frail he could barely walk or speak. His face was drawn and sallow, and his digestion permanently impaired. He was also wracked repeatedly by protracted episodes of chills and fever. For an entire year, he was bed-ridden. Under his parents’ care, he eventually recovered much of his former strength but for the rest of his life continued to suffer with chronic gastritis and intermittent violent episodes of chills and fever.

In the aftermath of the patient’s imprisonment and partial recovery, he rejected both his family and former life as a popular and endlessly inventive wastrel. From then on, he committed himself to an existence of possessing nothing—not just less than the poorest of the poor, but, literally, nothing. He became homeless and shoeless, dirty, pale, and emaciated. His only possessions were a burlap tunic and walking staff. When he ate, which he did irregularly due to frequent fasting, his meals typically consisted of wild fruits and a few turnips. Rarely did he consume meat or cooked foods, and even when burning with thirst, allowed himself only minimal amounts of water.

In this new life, the patient became a contemplative hermit, itinerant preacher, and restorer of derelict churches. He also ministered regularly to the poor and infirm with simple acts of charity. He had a special affinity for lepers, who he not only embraced but “washed all the filth from them, and even cleaned out the pus of their sores.”

The patient’s health was generally poor though stable until age 31, when he suffered a bout of depression that lasted six weeks. When finally recovered, a barefoot journey from Italy to Spain in inclement weather precipitated additional attacks of chills and fever and episodes of gastritis, manifested as right upper quadrant abdominal pain, dyspepsia, and nausea. For a brief period, he also seems to have been delirious, in that he was unable to speak or to understand what was said to him. He made a gradual but complete recovery from the dysphasia, but was so exhausted by the illness that, for the next four years, he was forced to restrict his activities.

When the patient was 37, he accompanied a military expedition to Egypt. Sanitation was poor and tropical diseases so prevalent that and estimated 1/5 of the expeditionary force perished from disease. The patient survived, but on returning to Italy a year later, a new disorder was added to his attacks of fever and gastritis. His eye lids had become irritated and thickened; his eyes burned and teared constantly; and both bright daylight and nighttime firelight caused intense eye pain. Sometimes he was unable to see at all, and even when his vision cleared, images were frequently blurred.

Thereafter, the patient’s condition spiraled progressively downward. He was now confined to bed, blind with pus oozing constantly from his eyes, while shivering with fever in a state of perpetual physical agony. His color was waxen, his upper limbs rail-thin and his legs and abdomen swollen. Severe abdominal pain and dyspepsia made eating difficult.  Moreover, his skin was now covered with sores and ulcers, which he tried in vain to hide from visitors.

Doctors were summoned and applied red-hot irons to both sides of the patient’s head, from his cheeks to his eyebrows. They also cut open the veins of his temples in a futile effort to cure his eye disorder. Then they inserted red-hot irons into his ears. Throughout the length of his illnesses and desperate treatments, the patient offered no complaint. His suffering finally ended on October 3, 1226.

Event Info:
May 3, 2019
Davidge Hall

Reza Manesh, M.D.

Eliot L. Siegel, M.D.

Joanne Schatzlein, OSF