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Franz Kafka and Tuberculosis

Franz Kafka was one of the most influential writers of the twentieth century, even though little of his work was published before his death at the young age of 40. He had tuberculosis in his esophagus, which prevented food from reaching his stomach, so he starved to death. He finished none of his full-length novels and burned most of what he wrote. He requested that his remaining writings be destroyed after his death, but his friend Max Brod ignored his wishes, edited his manuscripts and had them published. His novels were so influential that they are still taught at most high schools and colleges.

Many of Kafka’s characters suffered unjust and cruel treatments from powerful people or totalitarian governments. He seemed to foresee the consequences of the rise of Nazi Germany. W. H. Auden called Kafka the Dante of the twentieth century and Vladimir Nabokov said he was the greatest writer of the century. Other famous writers who came after him, such as Jorge Luis Borges, Albert Camus, Gabriel García Márquez and Jean-Paul Sartre, used many of Kafka's writing techniques.

Education and Influences
Kafka was born Jewish in Prague in the Austro-Hungarian Empire, and he spoke three languages: Yiddish, Czech and German. He came from a well-to-do family, but saw his parents only at night because they both worked all the time in the family retail clothing business. Two younger brothers, Georg and Heinrich, died in infancy by the time he was six.

He was a very good student and at age 19, he was admitted to the Deutsche Karl-Ferdinands-Universität of Prague. His friends there included Max Brod, who was responsible for making him famous after his death; and Franz Werfel, who became Anna Mahler's third husband (after Gustav Mahler and Walter Gropius).

Although he was technically studying to be a lawyer, he obtained a broad education in classic literature. He read Plato in the original Greek, Flaubert in French, Dostoyevsky in Russian, and Goethe in German. At age 23 he received his Doctor of Law degree. He went to work for an insurance company, but spent most of his time pursuing his two main loves: writing and sex. He wrote short stories, novels, and thousands of letters to his lovers, friends and family.

His father was a tyrant who wanted his son to make money rather than waste his time writing stories. His father was so overbearing that Kafka could never please him. He suffered from depression, sometimes so severe that he thought of suicide. He also suffered from migraines, insomnia, constipation, and boils. In his writings, Kafka characters often suffered from the same problems and had to overcome oppression. He wrote about struggles between fathers and sons, or about helpless people trying to defend themselves against those in power. In a "Letter to His Father" (1919) he wrote, "My writing was all about you; all I did there, after all, was to bemoan what I could not bemoan upon your breast. It was an intentionally long-drawn-out leave-taking from you."

https://www.youtube.com/watch?v=BQGUhknUOKU

He Never Married
Kafka was a womanizer, frequented brothels and was interested in pornography. At age 25, he met Max Brod’s cousin, Felice Bauer. Over the next five years they exchanged countless letters, met sporadically, and became engaged twice. His letters to her were published after his death. During his engagement, he had an affair with Felice's friend, Grete Bloch, who was rumored to have given birth to his son.

At age 33, he became engaged a third time, this time to Julie Wohryzek, who was an uneducated hotel chambermaid. However, while engaged to Julie, he left her for another woman.

He had been diagnosed with tuberculosis at age 30 and as a result, in August 1917 at age 34, he moved to the small Bohemian village of Zürau to live with his sister on a farm. There he was able to write extensively without being bothered by having to work at a job.

At age 37, he began a passionate relationship with Milena Jesenská, a Czech journalist and writer who was 13 years younger than him. Milena’s diaries describe torrid lovemaking with Kafka. However, Milena was already married to Ernst Pollak, a well-known intellectual. It appears that Ernst and Milena had a relationship in which both had many other lovers. Kafka was already suffering from tuberculosis, while Milena was still very young and social. His letters to her were eventually published as “Letters to Milena”. In his last letter to her, he wrote, "Sex is the punishment for the happiness of being together”. However, Kafka made a note in his diaries that they were to be given to Milena upon his death.

Declining Health, Death and Posthumous Fame
At age 39, Kafka was losing weight and had difficulty eating because the tuberculosis had spread to his esophagus and caused pain whenever he tried to swallow. At age 40, he met Dora Diamant, a 25-year-old kindergarten teacher from an orthodox Jewish family, and moved to Berlin to live with her. She encouraged him to become interested in the Talmud, the Hebrew bible, and he was able to write extensively during this relationship. He wrote to Dora's father and requested marriage, but her father refused him. However, she introduced herself to their friends as Franz Kafka’s wife. They were so happy that he and Dora decided to burn some of his previous work that had been written when he was miserable.

On April 10, 1924, Dora took Kafka to Wienerwald Sanatorium in Vienna to treat his severe pain, weakness and exhaustion. The tuberculosis now involved his entire throat so that he could communicate only by written messages. He fought with his doctors and wanted to be on morphine all the time. His throat made it too painful for him to eat and he died of starvation on June 3, 1924, in Dora's arms. He was buried in the New Jewish Cemetery in Prague-Žižkov.

Kafka published very little during his lifetime, and requested that all of his manuscripts and letters be burned after his death. The world owes Max Brod a great deal of gratitude as it was he who saved much of Kafka's remaining work from destruction. Brod edited manuscripts and letters, finished some of the incomplete works and took them for publication.

Many of Kafka’s characters suffered cruel and unjust treatments that seemed to predict what was going to happen in Germany. In their effort to destroy the work of dissidents, particularly Jewish writers, Nazi soldiers raided the Berlin apartment of Dora Diamant and burned the diaries, letters and manuscripts that Kafka had entrusted to her. However, they were not able to suppress Kafka's views on the evils of totalitarianism and oppressive governments.

What is Tuberculosis?
Tuberculosis (TB) is a disease caused by bacteria that infect primarily people with decreased immunity from conditions such as AIDS, diabetes, hidden cancers, malnutrition, lack of vitamin D, or taking drugs that suppress immunity such as cortisones and almost all of the drugs used to treat auto-immune diseases. It usually starts in the lungs, but can go anywhere in the body. Most people have no symptoms at all and only one in ten progresses to active disease.

The most common symptoms of a progressive TB infection are a chronic cough with blood-tinged sputum, fever, night sweats and weight loss.

TB Risk Factors
One in three people in the world have been infected with tuberculosis, 13.7 million people today have chronic infection with TB that could kill them.

Tuberculosis is associated with poverty, overcrowding and malnutrition. Other major risk factors are use of illicit drugs, being homeless or in prison, having any chronic lung disease, smoking cigarettes, or being an alcoholic.

TB Treatment
Treatment today involves taking multiple drugs over many months and years, and correction of risk factors such as stopping drugs that suppress a person’s immunity. Often the drugs do not work, so current recommendations are to take a combination of the antibiotics rifampicin, isoniazid, pyrazinamide, and ethambutol for two months, and rifampicin and isoniazid for at least four more months. Vitamin D is often an important part of treatment as it has been shown to make drugs more effective in controlling TB (Proceedings of the National Academy of Sciences. September 18, 2012;109(38)).

Until the 1940s, the only treatment was to put people with tuberculosis into a sanatorium where they would not infect healthy people, and make them sit in the sunlight for many hours every day. Sunlight provides vitamin D, and lack of vitamin D suppresses a person’s immunity and causes diabetes (Emerg Infect Dis. 2010 May; 16(5): 853–855).

https://www.youtube.com/watch?v=EMbKA8Jur7c

Postscript
In 1942 all three of Kafka’s sisters were killed by the Nazis. Ottla divorced her non-Jewish husband to remain with the Kafka family and died in Auschwitz, and his other two sisters died in other concentration camps.
In 1944 two of Kafka’s lovers, Grete Bloch and Milena Jesenská-Pollak, were killed in Nazi concentration camps.

Dora Diamant, Kafka’s last lover, died in London in 1952. In the 1930s Dora married Lutz Łask, editor of Die Rote Fahne, the Communist party newspaper. They had a daughter, Franziska Marianne Łask, in 1934. Being Jewish, they had to sneak out of Germany in 1936 and went to Russia. In 1937, the ever-paranoid Stalin put Lusk in prison because he came to Russia from Germany. Dora left Russia with her daughter, traveled across Europe, and reached England in 1939, one week before the Nazis invaded Poland. From 1940 to 1941, she and her daughter were interned as enemy aliens of the British on the Isle of Man. She died of kidney failure in London in 1952. In 1973, after 40 years of separation, 70-year-old Lutz Lask was allowed to leave East Germany to visit their daughter in London. He was forced to return to East Germany and died in Berlin in 1973. Their daughter died in London in 1982.

Felice Bauer died in New York in 1960. In 1919, she married Moritz Marasse, a partner in a private bank in Berlin. To avoid the Nazis in 1930, they left all their money and moved to Switzerland and in 1936 came to America. They were very poor and supported themselves by selling her knitting. Her husband died in 1950 and in 1955, she sold her letters from Kafka to the publisher Salman Schocken.

Franz Kafka
July 3, 1883 - June 3, 1924 (aged 40)

https://www.youtube.com/watch?v=gQafXHKPWu0

March 15th, 2015
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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