had predicted in the first American paper dealing with cocaine, there is a
shadow side to the remedy.
In New York, by the fall of 1885, signs of trouble were emerging. The
students and surgical apprentices who had started to use cocaine snuff and
even inject the concoction in social settings were now mired in tribulation.
“The students began to drop from sight. The doctors’ behavior grew
increasingly erratic. They slept less, talked endlessly and excitedly, and
eventually performed less surgery and ignored their duties.”^16 What
started as good-intentioned, quasi-scientific experimentation had led to
chemical dependency.
They had become cocaine addicts.
Within a year of the first experimental injections, Halsted, his
colleagues, and his students had ceded control of their lives to cocaine.
Halsted himself was beginning to miss morning sessions at his Roosevelt
Hospital clinic, his erratic behavior resembling that of the junkies that
were starting to materialize around the city. His coworkers witnessed his
spasmodic gesticulations, nervous tics, impatience, and perspiration-filled
encounters. A pharmacologically stimulated comrade is a wild, fiendish
alternate of himself, frightening and unnerving.
Halsted made a triumphant return trip to Vienna in the fall of 1885,
continuing his cocaine binge while abroad. He demonstrated his regional
anesthesia technique to surgeons and dentists, and connected with old
friends. There is no record of him meeting with Freud in Vienna, but one
can imagine what that interaction might have entailed. Gerald Imber, in
Genius on the Edge, writes that Halsted had lost command of his life, and
those closest to him feared that he would be lost forever.
William Stewart Halsted was back in New York by January 1886,
further spiraling out of control, lying, and obfuscating. Welch, his
erstwhile friend, now in Baltimore to start the work of establishing
Hopkins as an elite institution, was alerted by a mutual colleague about
Halsted’s deterioration. “Once modest and self-effacing, he was now
abrupt, spoke incessantly, and cared little for the response of those he was
speaking with.”^17 Welch formulated an intervention with two other
physician friends, the four professionals meeting in an office to save the
young surgeon from cocaine damnation.
The one physician, probably the sole human being, who could confront
Halsted was the collegial and brilliant Welch, the scion of Connecticut