Medical Desperation
Why did the Dances With Wolves major blow his brains out?
By: Dr. Jim Kornberg 01/01/2009
Who knows the number of times that pioneers, cowboys, military men and others in the Old West suffered from afflictions of one sort or another that were untreatable for various reasons?
A tragedy, not uncommon in the Old West, occurred when both the availability and the advancements in medical or surgical care were absent. With intolerable suffering, an afflicted person probably searched in vain for treatment, hung on until the bitter end or even took his own life.
The most interesting cinematic depiction of this problem occurred in the Kevin Costner epic Dances With Wolves (1990). Recall that Costner (as the character Lt. John J. Dunbar) had been deemed a hero after his unsuccessful, battlefield suicide attempt during the Civil War. He was posted, by his own request, to remote Fort Hayes on the Kansas/Colorado frontier. After a journey by horseback and before leaving for his abandoned military post, he presented his orders to his commanding officer, Maj. Fambrough (Maury Chaykin). Acting in a quixotic, bizarre manner, while dismissing Dunbar, Fambrough stood up and uttered the desperate lines, “Sir Knight, I’ve just pissed my pants, and nobody can do anything about it!” Within minutes, while Dunbar was leaving the fort, Fambrough walked to the window of his office and blew his brains out.
The reason for this behavior requires the establishment of a differential diagnosis, the pillar of any good medical investigation. I have very little information about this man, but I will assume that Fambrough had been struggling with this problem for some time. I will also assume that Fambrough was afflicted with an uncontrollable loss of urine that is known medically as urinary incontinence.
There are four general classifications of urinary incontinence. Their causes are numerous but can be generally related to neurological and/or mechanical lesions, tumors or even psychological factors, including dementia.