Authors: Kim van Alkemade
“What are they?”
“These are the pictures we make with the X-ray machine.” The chair moved—Rachel realized it was on wheels—and together they rolled closer to the images. “The X-rays pass right through you, through your skin and your muscles, to reach the bones and organs. The X-ray makes the radiograph. Then, when the light shines through the radiograph, it shows all of the shapes and shadows. Because I know how to read them and I understand the anatomy, the radiograph lets me see what’s inside you.”
The doctor’s words sparked a memory in Rachel’s brain. She was in the tub in Mrs. Giovanni’s kitchen, warm water up to her chin, being scrubbed with a rough, red cloth. “It’s all my fault,” Rachel whimpered, thinking of the broken teapot, of Papa’s left-behind lunch, of the operator from the factory, of her mother’s black eyes. “You listen to me now,” Mrs. Giovanni said, taking the little face in her soapy hands so she could look into the girl’s eyes. “Nothing is your fault. Never think that again. God can see inside you, right into your soul, and He knows you did nothing wrong. Remember that, Rachel, if you ever feel alone or afraid.” Looking at the X-ray images, Rachel imagined this was what God saw when he looked at her. Where on the radiograph, she wondered, did it show right from wrong?
“See this bright squiggle?” Dr. Solomon’s gloved hand pointed. “That’s why you drink the milk shake, so I can see what’s inside your intestines. And look here, these are your ribs.” Dr. Solomon
slipped off one rubber glove and reached under the cape. As she pointed to the white shapes on the radiograph with her gloved hand, the other touched Rachel’s ribs. “And there is your spine.” Rachel felt a finger slide up the middle of her back. “See your shoulders there, and your hip bones, here? These big clouds are your lungs. And on this one, with your head turned to the side, see your jaws, and all your baby teeth, with the grown-up teeth behind them, ready to take their place? And see that little swirl, there? That’s your tonsils.”
Mildred Solomon leaned forward, lost in thought as she contemplated the radiographs. She remembered learning about Béclère’s experimental X-ray treatment of a tumor on a young woman’s pituitary gland. The tumor had shrunk after exposure to the rays, but how had Béclère solved the problem of burning the skin? Oh yes, he varied the angle of the rays, focusing on the tumor from different points of entry. If he could use X-rays to shrink a tumor, Mildred Solomon wondered if the tonsils, too, could be eliminated through X-rays. It was the most common procedure in pediatric medicine, performed on thousands and thousands of children a year. Those surgeons, so superior, regarded radiology as little more than a mapping service to guide them in the real work of cutting people open. With X-rays, though, surgical tonsillectomy might become a thing of the past. At the Infant Home, it was standard practice to excise the tonsils and adenoids of every five-year-old. If she could develop a technique using X-rays, it might replace the tonsillectomy, sparing countless children the risks of surgery.
Mildred Solomon quivered with excitement. This would be her experiment: the X-ray tonsillectomy. After a series of X-rays, testing varying lengths of exposure, the results could be confirmed
through surgical excision. She would need a number of subjects as her material. She thought it through in her mind. Eight orphans should do.
In the glow of the light table, Rachel tilted her head to look up at Dr. Solomon’s face. On the warm lap with the heavy cape around them both, Rachel had a surge of affection for this woman whom she wanted so desperately to please. She twisted to wrap her arms around Dr. Solomon’s neck.
Mildred Solomon would have normally been irritated by the child clinging to her like that, but she was flush with the thrill of her brilliant idea. In an unusual show of feeling, she stroked the girl’s head. Her hand came away covered with strands of brown hair. It was a predictable side effect of the X-rays; really, she should have expected it. Taken by surprise like this, though, she couldn’t help but shudder.
“What’s the matter?” Rachel asked, then followed Dr. Solomon’s gaze to the hair in her hand. For a horrible moment, Rachel thought it had grown there.
“That’s enough for today,” Dr. Solomon pronounced, removing the cape and setting Rachel on her feet. She brushed her hand against the side of her skirt to wipe away the girl’s hair. “Let’s get you back to the ward. I have an idea for a new experiment you can help me with.”
I
EXPECTED TO BE EARLY TO THE
M
EDICAL
A
CADEMY, BUT
there was a delay transferring to the Lexington line, so by the time I got there it had just opened. I’d always thought of it as an exclusive club for physicians and had forgotten about the library until Gloria reminded me. Wandering around, I was impressed by its gilt chandeliers and carved ceiling beams, the stunning views of Central Park through Palladian windows. I lost count of the marble busts and portraits in oil. I thought of my share of the rent for that old walk-up in the Village—that entire place could have fit three times over in this one reception hall. I knew there were magnificent spaces like this all over New York, but I forgot, sometimes, that a brick facade was as likely to encompass unused ballrooms as cramped apartments.
I found the library on the third floor. The card catalog stretched the length of an entire wall. Dozens of drawers high, its little brass card holders were multiplied as in a kaleidoscope. It was amazingly easy to find what I was looking for—the librarians had cataloged not only authors but also coauthors and citations. I walked my fingers over the cards, their edges softened by years of inquiry, until I came to Solomon, M., M.D. I felt a little thrill on discovering
this tangible proof of the old woman’s claims. I thought of how pleased she would be to hear I had actually looked her up until I realized that, at her prescribed dose of morphine, she was unlikely to be lucid enough to understand me. I’d have to be content with finally learning what I had suffered from that necessitated all those X-rays.
Mildred Solomon was sole author of an article published in 1921, “Radiography of the Tonsils: Efficacy of a Nonsurgical Approach.” She was coauthor, along with Hess, A., M.D., of a study on childhood digestion, and she was cited in Hess’s book
Scurvy: Past and Present
. There was also a citation in a recent article about breast cancer by a Dr. Feldman, but that one, I imagined, must be a different M. Solomon. I copied down call numbers from all of these cards, then walked down the catalog and pulled the drawer for Hess as well. Besides his work on scurvy, there were a number of articles on rickets—a quaint affliction one never heard of in Manhattan anymore and of no interest to me. I did notice the Hebrew Infant Home listed as a subject heading for an article on pertussis; I decided to jot down that call number, too, even though it didn’t cite Dr. Solomon.
I went to hand in my numbers, but the librarian was nowhere to be seen. I rang the bell on the counter and soon she appeared, a tall woman with a pixie haircut wearing trousers that reminded me of Katharine Hepburn. She looked over my list of call numbers as I peered at the name tag pinned to her tight knit top:
DEBORAH
. “It may take me a while to pull these. There’s a coffee shop on the ground floor that should be open by now, if you’d rather wait there?”
“No, I’m fine, but could you tell me where’s the restroom?”
“The only public ladies’ room is on the first floor, off the reception hall. Here, why don’t you follow me?” She lifted a section of the counter and tilted her head. Together, we went through to the stacks, metal shelves from floor to ceiling as far as I could see. “The staff use this one over here.” She showed me to a simple bathroom with a frosted window high in the wall. “The lock’s a bit tricky if you’re not used to it, but you won’t be disturbed. The other librarian doesn’t come in until noon.”
After I freshened up, I found my way to the reading room and settled down to wait. I had the quiet space to myself. Not quite as grand as the rest of the Academy, the reading room was stuffy and hushed, the shelves lining its walls packed with dusty leather-bound books, the huge oak table gouged and scratched by decades of note-taking doctors. I went over to the window and sat in the deep sill, looking across Fifth Avenue to the park. I would have lifted the sash for some fresh air but wasn’t sure if it was allowed, so I contented myself with the view as I searched my mind for more memories from the Infant Home. It was frustrating. I knew they were in my brain somewhere, but I couldn’t make them materialize.
My sources must have been deep in the stacks; it was twenty minutes before Deborah returned, balancing the volumes in her arms. As she bent to put them on the table, I couldn’t help but notice how her breasts fell forward, straining her top.
“Let me know if you need anything else,” she said. I blushed, hoping she hadn’t caught me looking. Thanking her, I turned to the task at hand, excited at the prospect of pulling the past into the present. I wanted to save Dr. Solomon’s article for last, so I started with Hess’s pertussis study. I took the heavy volume of bound journals from the pile and cracked its spine.
If I expected to find some Dickensian description of the Hebrew Infant Home in those pages, I quickly saw I’d be disappointed. The sentences read like dry kindling—clinical descriptions of experimental designs, dispassionate recommendations based on results. Dr. Alfred Hess used the word
material
for the children in his study, as if we were guinea pigs or rats. The article pointed out that orphans made particularly good material for medical research, and not just because there were no parents from whom to wrangle consent.
It is probably also an advantage, from the standpoint of comparison, that these institutional children belong to the same stratum of society, that they have for the most part been reared for a considerable period within the same walls, having the same daily routine, including similar food and an equal amount of outdoor life. These are some of the conditions which are insisted on in considering the course of experimental infection among laboratory animals, but which can rarely be controlled in a study of man.
I remembered how upset I was at being kept in a crib; it seemed now I should have been grateful they didn’t keep us in cages. Still, as I continued reading, I saw his pertussis study consisted of little more than extended observation. One hundred days of it, to be exact. The charts in his appendix struck me as cold, the way children were numbered and plotted instead of named, but wasn’t that how medical articles were always written? Other than enduring months of boredom, I couldn’t see how the children he’d
studied were any worse off. Yet his choice of words rankled: “these institutional children,” as if we were a different breed or race. I doubted he’d compare his own children to laboratory animals. It made me glad to think that Mildred Solomon had been there to mitigate Dr. Hess’s dispassion with a woman’s touch.
I was eager now to dispense with Dr. Hess. I flipped hastily through
Scurvy: Past and Present
on my way to the index, planning to turn to the pages where Dr. Solomon was mentioned. Halfway through, my hands froze, the book opened to a black-and-white photograph. It was cropped to show a child’s mouth. Just that, not his or her face, only the mouth stretched wide, the camera’s lens focused on a bloody sore. Transfixed, I stared at the photograph. It was as if that picture had been pulled from a shoe box of memories that now fell from a high shelf in my mind and spilled open on the table before me.
My fingers trembled. I forgot to breathe. I remembered.
I wasn’t one of them, the children in the scurvy study, but from my own crib I watched as they wasted away, joints swelling, sores migrating from lips to arms to legs. One of the nurses charged with supervising their meals began crying one day, spooning some kind of mush into the mouth of a bruised boy too weak to stand, while in the next crib a child was being urged to finish her orange juice.
“It’s almost over,” another nurse encouraged her. “They’ll all be back on orange juice in a few days, you’ll see how fast the sores disappear.”
“Why make them suffer? Dr. Hess can see already what happens when the children don’t get any citrus. Why is it still going on?”
“That’s what they’re trying to learn from all this—how much is
necessary, how much is too much. It’s for the good of all children.”
“Not this one,” the nurse said, stroking the sunken cheek of the boy she was feeding.
I blinked hard to dissolve the scene from my mind’s eye. For pertussis, he’d simply confined the children and observed how the disease progressed—it wasn’t as if there was a cure being withheld. But with scurvy? Could it be true that he actually brought on the condition just to test different treatments? I leafed through the book again, catching some passages describing experimental treatments he’d tried: feeding infants dried thyroid glands; infusing blood somehow with citrus and injecting it back into the child. When I was placed in the Infant Home, did anyone know what was going on there? Of course they did. They must have. Here was the book to prove it.
Realizing I would be there all day if I settled in to read, I turned to the index, anxious to discover the extent to which Dr. Solomon had been involved in this. I was relieved to see she was credited with the X-rays, nothing more. I looked at some of the radiographs reproduced in the book, eerie images of children’s bodies cut off at the neck and waist, the captions noting the “characteristic beading of the ribs,” a characteristic I failed to see, that I began to doubt even existed. Dr. Solomon had said all the children were x-rayed, that it was routine. It wasn’t as if it was her experiment. I thought of what Gloria had said, that it must have been hard for her to be a doctor in those days; even today virtually all of the doctors were men. I supposed Mildred Solomon had to do as she was asked. She was only a resident anyway, wasn’t that what she’d said? She couldn’t have interfered with Dr. Hess’s experiments no matter how much she might have wanted to.