The Professor and the Prostitute (17 page)

“They couldn't tolerate having any experiences that weren't mutual,” said a female physician who had also been a resident with them. She'd become pregnant with her first child during her residency and given birth on a night when the Marcus brothers were the gynecological residents on duty. “Having them in attendance was horrible,” she told me. “One checked with his fingers to see how far I was dilated. Then he called over his brother, and had him check too. Then they did it again. It was painful enough to have one person checking the dilation, excruciating to have two people doing it. It was also, I should add, totally unnecessary. But they did it anyway. It was as if one couldn't bear to do something without sharing what he was doing with his brother.”

It was during their residency that the first signs began to appear that the twins' mental disturbance was potentially dangerous. “They were arrogant, resentful of criticism, disobedient of orders,” said a doctor who had been their chief resident.

The chairman of the gynecology department became concerned. He was the famous Dr. Alan Guttmacher, world-renowned specialist on family planning and himself a twin. His brother, Manfred, was a psychiatrist. Alan Guttmacher believed, and once wrote in an essay, that twins were, in a way, “monsters”—the traditional medical term for Siamese twins. They “have successfully escaped the various stages of [actual] monstrosity,” he wrote, but he cautioned that unless twins worked hard at establishing separate identities, they were always in danger of turning into psychic monsters.

He must have seen that propensity for psychic monstrosity in the Marcus twins, for one day he decided that even if they themselves would not or could not make the sanity-preserving move of separating, he would see to it that they did. He insisted they leave Mount Sinai, where they had antagonized so many people, and recommended that wherever they trained subsequently, they do so at separate institutions.

They tried to follow his advice. Stewart transferred to University Hospital at Stanford, Cyril to Joint Diseases Hospital in New York. But, after a year away, Stewart returned to New York and joined his brother at Joint Diseases.

After that year of reunion, there was a fourth year of residency still to accomplish, and Stewart went back to California. But he came back to New York as soon as the year was over, and subsequently both brothers went into private practice—a shared practice.

Still, if they were clearly intensely attached to one another, they did try to form other attachments, at least at the stage of life when their fellows were doing so. At around the time they were finishing their residencies, they each made an effort to fall in love, hoping to be married.

Stewart was the first. He began dating the journalist, who came from a well-to-do Manhattan family. After six months, they became engaged, but she began to feel that there was something mechanical about him and that he didn't truly like, let alone love, her. “He was terribly impersonal and distant,” she told me. “He hardly ever introduced me to any friends. I don't think he had any. And except for an occasional kiss, he never touched me. It was the late 1950s. Sex wasn't yet what it became in the sixties, something you did without much thought. So when he didn't show any sexual drive toward me, at first I thought he was just being respectful. But when, after we got engaged, he still didn't seem to have any physical interest in me, it began to trouble me a whole lot.”

Two weeks before the wedding, which was going to be held at New York's fashionable Plaza Hotel, she called off the ceremony. “I finally realized there was something terribly wrong with Stewart and that I shouldn't just go ahead and marry him. The night I decided this, I tried to tell him, but he was so into his own mind, he didn't even seem to hear me at first. I had to pull the engagement ring he'd given me off my finger and stuff it into his pocket to get his attention, and once I had his attention, he turned furious. How could I do this when people had already bought wedding gifts? he kept saying, as if that were more important than my feelings, our futures.”

Stewart's onetime fiancée remembered further that both the twins frequently made inappropriate remarks, recalling, “Cyril once asked my mother outright just how much money and property Stewart could expect if he married me. My mother was horrified. And Stewart, who had a very high opinion of himself and his brother, but of almost no one else, was always correcting and criticizing other people. Once he got violently mad at me because I said something about the airline, Pan Am. What was wrong? I asked him. He said I was being ungrammatical, and shouted, ‘There's no such airline as Pan Am. It's Pan
American!
'”

She was relieved when she finally ended the engagement. “I never felt at all sentimental or nostalgic afterward,” she said. “You know the way music, say, or flowers can make you remember something from the past? I felt none of that. Stewart had been so impersonal that in a way it was as if I had never known him.”

Why had she wanted to marry him? I asked at one point.

“Those were the days when a girl was
supposed
to grow up and try to catch herself a doctor,” she said bluntly.

Stewart was never to marry. But shortly after his aborted engagement, Cyril did.

It was a relatively short-lived event. In 1969, after nine years of marriage and two daughters, his wife asked for a divorce. He was too perfectionistic, she complained to friends. He was explosive and irrational. And he had no respect for anyone but his brother.

The two of them were together all the time after that. Cyril took the apartment on York Avenue, in the same building in which Stewart lived. Then he and Stewart took to traveling together on vacations, sharing a summer house in the Hamptons, dining
à
deux
in chic Manhattan restaurants. And they never again attempted to include a third person in their tight, mutually circling orbit.

Perhaps, had they not been so close, they might have conquered the aloofness that coursed through their bodies like a numbing anesthetic through bodily tissues. Some schizoid individuals who have no one with whom to share their hours occasionally do. But because the brothers had one another, they turned only to one another. They viewed their bond as sustaining and nourishing. But it was, in fact, a disease that would eventually kill them.

Their medical practice was flourishing in the sixties, for the Marcuses were among the few surgeons then to have perfected the “purse string,” an operation that enabled women whose wombs were unable to bear the weight of a developing fetus to carry their babies to full term. They did research into infertility and published numerous scientific papers suggesting new treatments for the barren. They co-authored a textbook,
Advances in Obstetrics and Gynecology
, that was considered a classic in the field. They received hospital privileges at both Lenox Hill and New York hospitals, and the latter made them faculty members of its medical school. Successful and well connected, they inspired the confidence of colleagues, who gave them numerous referrals.

But they were, almost invariably, irascible and prone to irrational outbursts. A patient who was pregnant for the first time late in life, when the risk of having a retarded child is greatest, told me that she asked Cyril to arrange to give her infant a PKU test, a test for mental retardation now required by law and automatically received by all infants born in New York State. The test was not, however, standard procedure at that time, and Cyril flew off the handle at her request. She was being demanding, he told her. She was being pathologically anxious. Why, he hadn't even had the test done for his own children. Then, shortly before her child was born, the test became law. The patient felt that Cyril would now see that she had been right to request it, but if anything he became even more angry with her. “He hated to be wrong about anything,” she said.

Another woman had a similar experience with Stewart. She inquired whether a certain medication he had prescribed for her was safe to use during pregnancy, and he—no doubt feeling that his judgment had been called into question—became defensive, shouted at her, and threatened to throw her out of his office.

These were not isolated incidents. Over time, I heard accounts like this from dozens of women who had used the Marcus brothers as their obstetrician-gynecologists.

But if the brothers were always explosive and paranoid, they became even more so once Cyril separated from his wife and he and his twin began relying solely on one another for companionship. A nurse who quit their employ after working for them throughout the late 1960s said of Cyril, “He would sit down and you would see an expression on his face change, and all of a sudden he would become a totally different person—arrogant, nasty, biting, cutting.”

So extreme were his tantrums that one day he threw a sterilizer full of instruments at her. She quit, never to return.

No one knows whether all along, from the days of their medical school training, the twins were taking drugs. No one knows whether their tendency to be quarrelsome and to explode into tantrums was natural, an artifact of their personalities, or a chemically induced phenomenon. But certainly by the early 1970s both of the Marcus brothers—still delivering babies, still performing operations—were addicted to several substances, among them amphetamines and barbiturates. Druggists' records indicate that they repeatedly ordered these drugs for themselves, making out their prescription forms to nonexistent patients.

In 1972, Cyril seems to have taken an overdose of some drug or another. That summer, the handyman in his building, an expansive fellow named Bill Terrell, was passing Cyril's apartment on his way from a repair job on the floor when he heard a buzzing noise within. It sounded like a telephone off the hook. Terrell thought nothing of it until, several hours later, he was again on Cyril's floor and again heard the buzzing. This time he rang Cyril's doorbell and, when he got no answer, began to pound on the door.

No one responded. Terrell went downstairs and telephoned Stewart immediately. “There's something not quite kosher at your brother's place,” he told him. “I think he needs your help.”

What happened next amazed and intrigued Terrell. There was a long silence. Then Stewart put the phone down. The handyman hung on, but Stewart didn't get back on the phone for a long while. Terrell had the feeling that he was somehow consulting the air waves, communing with his brother. Other people have speculated that Stewart was considering letting his brother die so that he might at long last escape from the monstrosity of being a double. But most likely he was simply trying to pull himself together, to mobilize himself out of some drugged condition of his own. Whatever the reason, it was a good minute and a half before he got back on the phone and at last said, “You're right. He needs help. I'll be right over.”

Still, once he arrived on Cyril's floor, Stewart seemed oddly lethargic and slow to grasp what needed to be done. The door was locked from the inside, and Terrell had to insist that they break into the apartment. When they did, they saw Cyril lying fully dressed and unconscious in the foyer of the apartment. Stewart turned pale and said, “He's dead,” then stood there passively. Terrell was the one to put his ear to Cyril's chest and say “He's not dead. He's still breathing.”

“Give him artificial respiration,” Stewart then directed.

“You're the doctor,” Terrell said. “You do it.”

“I can't,” Stewart replied. And he stood stock still, unable to move.

In the end, Terrell yelled for help, and some other doctors who lived in the building arrived and gave Cyril mouth-to-mouth resuscitation and called an ambulance for him.

He was hospitalized briefly. But soon he was back in the office, seeing patients.

In the next few years, the physical condition of both brothers deteriorated and their emotional control evaporated. Stubborn to the point of self-destructiveness, they were now refusing to fill out medical insurance forms for their patients, saying the activity wasted their time, and they would engage in screaming arguments with patients who badgered them about the forms. Cyril, angry at a hospitalized patient who complained that an intravenous needle was badly inserted and was hurting her, grabbed the bottle of intravenous liquid and hurled it onto the floor. Stewart, under contract to edit a second volume about advances in obstetrics and gynecology, lost the manuscripts of fellow doctors whose research articles were to have been in the book and spoke so antagonistically to his publisher that he decided to drop the project. The twins' office grew dirty, disarrayed. The rent went unpaid. The air conditioner broke down and was never repaired. And their nurses would frequently receive calls from them in which, in slurred voices, they would direct the nurses to cancel their day's appointments.

It will forever be a stain on the history of medicine in America that the Marcus twins, whose psychological condition was known to their colleagues—if not fully recognized as a drug problem—were allowed to continue to practice and to remain on the staff of a major New York hospital. But they were. And although the hospital did eventually drop them, the decision was not made in time to prevent the brothers from jeopardizing the safety of several patients.

In March 1974, Cyril, sweating profusely and unsteady on his feet, undertook to circumcise a newborn infant. A technician who was in the room with him looked up to see that his hands were shaking and that he was trying to cut the baby's foreskin by sawing it with the dull handle of his surgical instrument. Terrified, she ran for help. But when the help she had summoned—several other doctors, including the head of the department—arrived, Cyril was allowed, under their supervision, to complete the procedure.

A year later, in March of 1975, a similar incident occurred, but this time it was Stewart who, pale, weak, and with unsteady hands, undertook a circumcision. This time it was a nurse who intervened, and this time Stewart was enjoined from continuing the procedure and sent home.