CHAPTER 15
I HAD BUILT MY LIFE on discipline, on gathering data and making decisions only after reflection and analysis. Even after circumstance had thrown me into a maelstrom of intrigue, I had tried to maintain the scientific principles that had brought me success in the past. But love is a glorious compulsion to behave against one’s own best interests, and, if the risks were greater, so were the rewards. To be sure, without fulfillment of the heart, all other success is hollow.
The irony that my only chance at such fulfillment had been created by the murder of George Turk and the enigma of Rebecca Lachtmann did not escape me. What if, after the skullduggery had ended and the mysteries were resolved, I was left with the love of a woman to whom mere access would have been unthinkable before? What a strange and welcome turn of fate.
Thus, in my sorry state of hope and rapture, I met the Professor at the Broad Street Station at ten the next morning for our journey to Baltimore. Daniel Coit Gilman, president of the Johns Hopkins University and director of the hospital, had reserved a first-class compartment so that we would be allowed to pass the two hours in peace and comfort. How different this would be from my third-class journey from Marietta to Chicago a decade before.
We settled in opposite each other, and were soon under way. The locomotive gained speed and we headed west, crossing the Schuylkill in view of the hospital, the immense Blockley complex standing like a leviathan just beyond. As Philadelphia slipped by, the Professor gazed out the window, as if it were a segment of his life receding rather than a spot on a map.
“It will be a great adventure, Carroll,” he said softly, but did not turn from the window.
“Yes,” I agreed. “To be a part of the finest medical facility in the nation …”
“And what will be the finest medical school. Think of it. We’ll be able to help prepare the next generation of doctors … perhaps even to set the standards of medical education. Even if we each treated ten thousand patients in the course of our careers, it pales before the numbers that those whom we train will treat. We can bring knowledge and humanity into the wards everywhere.
“To be in the position to make a genuine difference, Carroll,” he mused. “How few get that chance, no matter how brilliant or talented. What a stroke of luck, to be here, at this time.”
“Whatever luck may be involved,” I said, “it is no more than you have earned.”
“Thank you for saying so,” he said, and then heaved a sigh. “Still, it is an enormous privilege … and an enormous responsibility.”
Two people who spend as much time together as the Professor and I can sense when conversation is no longer desired and, seconds later, seemingly at the same instant, we each reached into our respective valises and withdrew a book.
I had brought a second volume of Turk’s Plato, this one containing Republic. I knew of the essay, of course, but had never delved into it. It seemed appropriate now to read of the philosopher-king while traveling with a man who might actually fit the role. I placed the volume in my lap, crossed my leg in order to rest it on my thigh, and then lifted the cover open with my thumb.
I felt myself start. Cut into the inside of the front board was a latchkey. It was shiny and black and I knew instantly that its home was a door on Wharf Lane that led to the lair from which Turk had conducted his nefarious activities.
I quickly shut the book and saw the Professor eyeing me.
“Is everything all right?” he asked.
“Oh, yes, Dr. Osler,” I said. “Quite all right. I was just thinking of the enormity of my good fortune.”
“All of it deserved,” replied the Professor, accepting the explanation. “What are you reading?”
When I told him, he smiled and nodded. “Good man. Plato is indispensable.”
“And you?” I asked, anxious to deflect focus from the volume in my hands.
“It’s called Servetus and Calvin. Written by Robert Willis, a Scottish physician, about ten years ago.” I was certain now that he did not think anything amiss. He closed the book gently and ran his fingertips lightly across the front. It had a black cloth cover, with imitation gold letters on the spine; an inexpensive volume but one, from the manner with which he handled it, that had substantial meaning for him. “Do you know of Servetus?”
I confessed that I did not.
“He was a remarkable man and a brilliant physician, responsible for one of the great discoveries in anatomy, one which altered the course of medicine for all time.”
I was no medical historian to be sure, but nor was I a novice, and I could not imagine any great discovery in anatomy of whose attribution I was unaware. I had read, I was certain, of all the great anatomists—Galen, Vesalius, Harvey, even the Arabs, Avicenna and Averroës. The Professor sat across from me, amused at my perplexity, and eventually raised a cautionary finger.
“Ah, Carroll, I did not say Servetus received credit for his discovery.”
“Who did?”
“You mean that Servetus discovered blood circulation before Harvey?”
“Precisely. Seventy-five years before, to be exact. In 1553.” The Professor tapped the cover of the book. “Servetus confined his theory largely to pulmonary circulation, but hypothesized about greater circulation and even the presence of capillaries. Until then, everyone had missed the role of the heart, even Vesalius.”
“Why didn’t Servetus receive credit if his discovery preceded Harvey’s?”
“Servetus’ discovery was contained in a theological text he called Christianismi Restitutio—the ‘Restoration of Christianity’—which was judged heretical by both Catholics and Protestants. One thousand copies were printed and all were thought to have been destroyed, most on the order of John Calvin, who presided at the trial at which poor Servetus was condemned. He was burned at the stake in Geneva … a grisly death … they used green wood that burned slowly and Servetus was roasted for thirty minutes before he finally died. It was not until over a century later that the first surviving copy of Christianismi Restitutio surfaced, well after Harvey had published his great work in 1628. Three copies have been unearthed in all, the last of which, in fact, was not found until ten years ago, when it was discovered quite by chance on the shelves of the library at the University of Edinburgh. It turned out to be Calvin’s own.”
“Calvin ordered all the copies destroyed, but kept his own?”
“Apparently. Evidence that the Edinburgh copy was Calvin’s is indisputable.”
“How did it get to Edinburgh?”
The Professor shrugged. “No one is quite sure, although it seems to have come through the Marquess of Queensbury.”
“As in the rules for pugilism?”
“The same family, although I am uncertain as to who specifically acquired the volume or under what circumstances.”
“Quite a tale,” I said.
“More than that, Carroll. I’m drawn to Servetus. He was a Spaniard by birth. Brilliant … a prodigy. He was a theologian, a geographer, and a linguist, in addition to his medical skills. He spent his life searching for truth and was guided strictly by the dictates of his own conscience. He cared nothing for the judgment of others. His great heresy, according to Calvin, was the belief that God exists in all men. No one in European or American history more epitomizes the struggle for freedom of thought.”
“You feel kindred to Servetus?” I asked. “I have never thought of you as heterodox.”
“We all fight ignorance with truth, Carroll,” he replied, “and conscience is our only guide.”
“Do you not believe in Scripture, then?”
“Of course I do. God’s word must always be paramount. But all too often, I’m afraid, theologians interpret God’s word based on their own prejudices … and sometimes with more sinister motives. Can there be any more telling example than the resistance to our work? Think of that dolt, Reverend Squires, trying to prohibit autopsy. And think of the reaction to the writings of Darwin. Evolution is evidence of God’s wonder, not blasphemy … and where does it say in the Bible that Man should not attempt to learn about the workings of the body? No, Carroll, it is individual conscience that provides our most reliable guidepost.”
“My pastor, Reverend Powers, agrees with you.”
“An enlightened man.”
“He is that. But why is Servetus not better known?”
“He is something of an underground figure in Europe,” the Professor went on. “I came across some articles when I was in Germany and have been pursuing his story ever since. Servetus was terribly flawed, but deserved much better from society. Flaws of personality must be overlooked in those who could bring such benefit to the world.”
With the Professor in such an expansive mood, I decided to explore his views of another rebel. “Dr. Osler,” I asked, “what do you think of Thomas Eakins?”
“‘The Portrait of Professor Gross’? Very realistic rendition, as far as it goes. He is doing a similar depiction of Agnew, I believe.”
“Do you know anything of the man?”
“Something of a rake, is he not?” replied the Professor. “I confess that I do not understand the art world, Carroll. It is all well to produce renderings of the world in which we live, but too many of these people seem to revel in immorality. Even in ‘The Portrait of Professor Gross,’ Eakins chose to sensationalize, to emphasize the horrors of surgery rather than its benefits. Old Gross is depicted more as a Jehovah figure passing judgment on the wretch on the table than as a man who was doing everything he could to save his patient’s life.”
“But there is value, is there not, in making us see the world through fresh eyes, even if the view disturbs us?”
“There is value in truth, Carroll, and truth is not found in sensationalism.”
I decided not to press the point but the Professor had not finished. “I suggest you reconsider the time you spend with those people. You have a brilliant career ahead of you. It would be a great tragedy if, after all your efforts, you let it dissipate. Abigail Benedict would turn any man’s head. But if you are not careful, Ephraim, she will move on and you will be ruined. You should put an end to your late-night meetings.”
“How did you know?”
“Hiram Benedict told me. He asked if I thought you a suitable match for his daughter.”
“What did you say?” I wondered how the Benedicts had communicated details of a visit that had taken place just the night before.
The Professor smiled. “I told him that you would make a superb addition to his family.”
I was confused. “But I thought … you just said—”
“Just because I hope you will make a decision on your own does not mean that I will make it for you.”
With that, we returned to our reading. I was careful to open my book in the center, keeping the inside front cover concealed. While the Professor seemed to become instantly immersed in his Servetus, I was unable to concentrate at all on Plato.
Destiny, I realized, is a combination of desire and timing, or luck as the Professor put it. A man can put any degree of effort into shaping his fortune—as I had—yet it will all be for naught if the opportunity to manifest that effort does not avail itself. I had purged my speech of the twang that marked me as a western rustic; worked tirelessly to become knowledgeable and proficient in my field; read philosophy, history, and literature in addition to anatomy and biology, so as not to be judged as narrow; learned to dress and carry myself like a gentleman; and, most of all, sought out the most exalted stage on which my profession was being played. The result had been an appointment to a high position at a prestigious institution, when I might have droned out my days only one step up the ladder from Jorgie, a respected but nondescript physician at a well-regarded but hardly noteworthy hospital.
But luck only reveals itself in retrospect. George Turk, Rebecca Lachtmann, and, most of all, Abigail Benedict had now entered the mix, and whether my encounter with her would seal my good fortune, as I hoped, or my doom, as the Professor feared, could only at this point be guessed at.
My musings were interrupted as the train slowed at the outskirts of Baltimore. The Professor glanced up, closed his book, replaced it in his valise, and stretched.
“Well,” he said, “it begins.”
When we alit from the train ten minutes later, two men waited to greet us on the platform. One, whom I took to be Daniel Coit Gilman, was about sixty, white-haired but for dark eyebrows, with muttonchops that met at a full mustache over a shaved chin. He wore a frock coat, and was tall with a slightly shambling look. The other man was about the same age as the Professor, bald and of medium height with a carefully trimmed mustache and Vandyke. He stood extremely straight, almost military, but broke into a smile when he saw the Professor.
“Willie,” he exulted, grabbing the Professor’s hand and clapping him on the shoulder. “It’s glorious to see you.” I had never heard anyone except poor Annie call the Professor “Willie” before.
“Good to see you too, Willie,” the Professor rejoined, pumping the other Willie’s hand so hard that it seemed as if he were trying to draw water. The Professor gestured toward me. “And this is the man I told you about.” He positioned himself between us. “Ephraim Carroll … William Welch.”
So this was Welch, who was to head the entire faculty and be the Professor’s superior. The Johns Hopkins staff, then, would not only be brilliant: It would have the energy of youth.
The older man, Gilman, had waited patiently—and happily—while the two Willies greeted each other, which I considered a remarkable show of diffidence and self-assurance. A man like Hiram Benedict would surely have taken umbrage at not being the first introduced. Now, however, Gilman stepped forward and extended his hand, not just to the Professor, but to me as well.
“Doctors,” he said, “it is an honor to have you at Johns Hopkins.”
The ride to the hospital was brief but memorable. As we crossed the downtown and emerged on the east side of the city, a remarkable sight came into view. On the top of a rise was a massive redbrick structure, topped by an enormous cupola and two towers. It seemed to stretch to the horizon. To the east of the main structure were a plethora of other buildings, constructed of the same material, all of which were clearly part of the hospital complex.
As we drew closer, I realized that the main building was not a single structure, but rather a number of separate facilities placed in proximity to one another. I asked why the hospital had been constructed in compartments.
“We did that intentionally,” said Gilman. His voice was high-pitched and had a break that was incongruous in such a legendary scholar. He’d been enticed ten years before to leave his post as president of the University of California, and had personally overseen the hospital’s design and construction.
“Since, as we know, most contamination and contagion are airborne, John Shaw Billings, who was our guiding spirit, designed the hospital not only to separate the administrative areas from the wards, but also to segregate other functional sections … laundry, dispensary, commissary … to minimize transmission. All the buildings, or ‘pavilions’ as we call them, are extremely well ventilated so that noxious air does not settle. It was a good deal more costly to design the hospital in this fashion, but the trustees were quite serious in their intention to create the finest medical facility in the world.”
The first item on the agenda was a luncheon to welcome us to the hospital and introduce us to our fellow doctors and the professors at the university. The interior of the new building glistened. Double doors opened onto a long, well-appointed, wood-paneled room, with large windows facing west. There were at least fifty others already present and, as we walked through the doorway, they began to applaud. The Professor stopped short and I thought he might actually blush.
Welch, who had been scrupulous in treating me with the same respect as he showed the Professor, led us both into the hall, and he and Gilman began to make introductions. We moved from one small knot to another, and the names were soon swimming in my head. Although the professors at the university tended to be in their fifties and sixties, most of the medical staff was young, the oldest being in their early forties.
As we reached the far end of the dining hall, we came upon a man standing alone. He was not tall, but had a thick chest and gave the impression of great strength. He was serious-looking, like a stern schoolmaster, but impeccably dressed in a dark suit with a brilliantly white collar and dark blue silk tie. He appeared to be older than the Professor or Welch, and was light-haired and balding, with a carefully trimmed, turned-up mustache and a beard cut close to his cheeks. Behind his pince-nez, his eyes were an odd blue-green and arresting, as if they had been lit from the rear.
Even had his demeanor not been so haunting, there was little danger that my memory of this man would be lost among the others. I had seen him before—not at a medical facility, but at The Fatted Calf, where he had been taken away by a short, mustached man in a bowler hat.
The Professor extended his hand, smiling. “Doctor,” he said, “I am so pleased to see you again.”
The other nodded and accepted the Professor’s hand, but there was little warmth in his demeanor. “And I you, Doctor,” he replied evenly.
“Ephraim Carroll,” the Professor said, “I would like you to meet the finest surgeon in America, Dr. William Stewart Halsted.”
I took Halsted’s hand. His fingers were short but his grip was firm and confident, his stub of a thumb pressing into the flesh of my hand. His eyes unflinchingly held mine. I could read nothing from his gaze and hoped that he read nothing from mine.
“It is an honor, Dr. Halsted,” I said, after it was clear that he would not speak first. “Dr. Osler speaks of you in exalted terms.”
Halsted nodded perfunctorily, but otherwise did not change expression. The effect was unnerving. I could not imagine that he recognized me from The Fatted Calf—I had been across the room. Might he have seen me somewhere else, perhaps with Turk earlier that evening, or outside Mrs. Fasanti’s when I had come upon my dying colleague? I fervently hoped he had not. I was violating strict scientific method to think so, but the man before me was so startling … so chill and controlled … that at that moment I had not one scintilla of doubt that he was capable of visiting Turk at his home and, by either force or subterfuge, inducing the younger man to take poison.
At luncheon, conversation centered on the hospital, and through the first courses Billings explained the theory behind the planning and construction. The Johns Hopkins University was the first institution of higher learning in the United States constructed specifically to promote research. The hospital, although physically removed from the university campus, was to be an extension of that mission, as would be the medical school, which Billings said would be complete within three years.
Billings, a surgeon by training, but a man who had emerged as the nation’s most forward-looking thinker in public health and hospital design, had been persuaded by Gilman to join Johns Hopkins after a brilliant career in the army. He had been the man who had convinced the trustees to make research and medical education integral to the hospital’s mission.
Although the discourse was fascinating, for me the event was dominated by the man diagonally across from me. Dr. Halsted spoke very little, even when he was asked about the many improvements in both surgical technique and equipment upon which he was currently engaged. But laconic or not, Halsted’s brilliance was inescapable. In ten words, he could express an insight that seemed a century ahead of its time. I understood very quickly why the Professor considered this man a treasure to be protected, as one would encase a rare gem in a museum. Belying his deportment, Halsted seemed to have a human side as well. During his discussion of surgical gloves, he mentioned that Caroline Hampton, the nurse whose sensitivity to carbolic soap had spurred the innovation, was now his fiancée. As soon as the discussion moved to other topics, however, Halsted once again retreated into silence. But, to me, his presence dominated the table.
After luncheon was done, we toured the hospital and the facilities, which, as I had come to expect, were nothing short of miraculous. Every possible innovation had been incorporated into the design of the wards and the operating theaters, and the laboratories were more extensive than anything I had ever seen. Even the Professor seemed awed. When we had completed our tour, it was near dusk, so we repaired to Gilman’s home, where we would be staying, to relax until dinner. Gilman and his wife left us to ourselves, placing a bottle of sherry and two glasses on a tray on the sideboard.
“Well, what do you think, Ephraim?” demanded the Professor after each of us had poured a glass and settled into an extremely commodious side chair. “Quite an establishment, eh?”
“Indeed,” I agreed enthusiastically. “With a staff to match. I will feel like an interloper on Olympus.”
“Ha! This may surprise you, Ephraim, but I find the atmosphere a bit intimidating myself.”
“Intimidating indeed. And no one more than Halsted. Has he always been such a presence?”
The Professor pulled at one end of his mustache. “In fact, the frost in his demeanor is a recent phenomenon. He used to be an extremely affable and outgoing chap. Did you know that he was also a superb athlete? He rowed, played baseball, performed gymnastics … do you know what football is?”
“It’s a sport that some colleges play, isn’t it? Sort of tug-of-war in reverse. A lot of fellows lined up in opposition, each side trying to a push a ball over a line by shoving the other fellows backward?”
“That’s pretty much it,” agreed the Professor. “It takes strength and a certain ferocity. The university has a team, although I’ve never seen the game. It has become quite popular, I hear, at Yale. Halsted was one of the originators of the sport and named captain of his team at Yale.”
“I was not aware that he was such a violent man,” I said.
“I didn’t say he was violent, only that he played a violent sport in college. He fancies dachshunds as well.”
“Of course,” I said quickly. “But you also said that he used to be affable. What changed him?”
The Professor sighed. “It was the cocaine.”
“And you are sure he is no longer under its influence?” Both Monique and Haggens had indicated that Turk was in the drug trade. What other reason could there be for a man like Halsted to seek Turk out?
“Why would you think otherwise?”
“No reason at all,” I ventured hastily. “But cocaine craving has proven to be so terribly difficult to overcome….”
“You cannot imagine,” sighed the Professor. “It’s been torture for the poor fellow. And to think it was his own fearlessness that caused the problem in the first place.”
“How do you mean?” I asked.
“He always proceeded according to what he thought best, regardless of personal consequences. Some years ago, when his sister suffered a postpartum hemorrhage, Halsted performed an emergency transfusion, using his own blood, and saved her life. When his mother became ill one year later, he diagnosed the ailment as gallstones. Her physicians insisted he was wrong and refused to operate, so Halsted performed the surgery himself, although he had never operated on a gallbladder before. He saved her life as well.
“When the opportunity came to experiment with cocaine as an agent to block sensation in individual nerves, he chose to use himself as the first subject. After he became addicted, he was shunned by those very colleagues who had lauded him. Only Welch, who had been the chief pathologist at New York Hospital, stood by him. Eventually, Welch brought him here to stay in his home. Is it any wonder that a man who has been through such an experience would undergo a change of personality?”
I agreed that it was understandable.
“Understandable?” exclaimed the Professor. “Inevitable, more likely.” Then he paused, as he often did when a revelation overtook him. “But why all this interest in Halsted?”
“It is just that he is so riveting,” I replied, attempting to keep my response casual. “A man of such ability who has been forced to overcome an immense obstacle cannot help but be an object of fascination.”
“It’s true. Excuse my shrill tone, Ephraim. It’s simply that those of us who have witnessed his ordeal have become extremely protective of him.”
“Yes,” I agreed. “I understand.”