Authors: Andrea Barrett
Now she offered him a biscuit and said, “Of course your own practice keeps you so busyâhow is your practice?”
“The same,” he said bitterly. “As you know.” Why was she being so hard on him? His practice was the least part of his professional life, and the part in which he'd most obviously failed. “Hypochondriacs, asthmatics, rheumatics. And few enough of those. If Dr. Perrault had ever told me that a man with my training would have such a hard time finding patients⦔
“Perhaps you ought to pay attention to that,” she said. “Perhaps you ought to think about other ways to employ your talents.”
Why were they arguing? All the warmth of their moment over the jewel-box had dissolved into this disagreement, which had surfaced several times since Arthur Adam's departure. Where Lauchlin had always believed that his dedication to science would serve the world in large ways, Susannah believed in more immediate good works, embracing the recent flood of immigrants as if by doing so she might bring her parents back. During their honeymoon, she and Arthur Adam had investigated the slums of Paris and Edinburgh, and Arthur Adam claimed she'd contributed to his articles. Since he'd left for Ireland, she'd been helping her aunt and uncle gather food and bedding for the sick. But it was not as if Lauchlin had been idle.
“You've made your point,” Lauchlin said. “I notice you don't seem to mind living in this fine house, though. Even if you're too good to wear a necklace.”
Immediately he was ashamed of himself; she had lost both parents, where he had lost only one. And the oil portraits in their gilt frames, the piano, and the table with the claw-feet grasping marble spheres were not her choice. Once, when the three of them had been playing whist with another of Arthur Adam's friends, the friend had complimented Susannah on the new Turkey carpet and she had said, “Arthur Adam picks out
everythingâcongratulate
him.
” A silence had fallen across the card-table, but later she and Arthur Adam had stood arm in arm at the front door, waving good-bye to the two single men.
“I'm sorry,” Lauchlin said. “I know you wish I was more like your admirable husband.”
He'd meant to be sarcastic, but to his horror she didn't disagree. “So
do
something,” she said. Her handsome hand, flicking the air in a furious gesture, knocked her cup to the floor.
And at that, so discouraged and disheartened was he by both her attitude and Arthur Adam's letterâArthur Adam, brave and noble, off doing all that he ought to be doing himselfâthat he set down his own cup and left, his jacket tossed over his arm and the afternoon completely spoiled.
Annie Taggert watched Lauchlin leave. She had overheard most of this conversation; she had also, as Susannah suspected, listened to him read Arthur Adam's letter. But the letter didn't keep her from wishing the emigrants arriving here would all stay home. They were like Sissy, she thought. She bustled back into the sitting room and swept up the fragments of broken china while her mistress stared out the window. Too pathetic to help themselves, more and more of them flooding this country: like Sissy, whom Mrs. Heagerty had hired last fall in a moment of weakness. Filthy and stupid and good for nothing. Making a mockery of the people already here.
Down the stairs she went to the kitchen, balancing the heavy tray and already anticipating all that Sissy would have done wrong in her absence. Annie had left Ireland almost twenty years ago; she remembered her fellow passengers as poor but respectable. Men who found work immediately, on the docks or in the forest, cutting timber. Women like her, who went into service with a knowledge of what it meant to do their part in keeping up a household. Nothing like the new arrivals. She noted
a small puff of slut's wool on the stairs; Sissy, again. And in the kitchen she found Sissy crying as she peeled parsnips.
“What's with her?” Annie asked Mrs. Heagerty, the cook. “What's the girl sniffing about now?”
Mrs. Heagerty was filling and trimming the lamps, which marched across the table in tidy rows. The room was fragrant with the pies cooling on the range. “I went across to see Mrs. Mullaney,” Mrs. Heagerty said. “Just for a minute, you understand. And what do I find when I come back? Our lazy girl here, sleeping under the table like a dog.”
“What can you expect?” Annie said. She and Mrs. Heagerty had an old and firm bond; they had both worked for Arthur Adam's parents for years, in one of the finest houses in the city, before coming here to set up this new household. They knew how things should be done. “The stairs are a horror, you know. You saw the filth she left in the corners?”
“No,” Mrs. Heagerty said. “Really?” They turned to weeping Sissy and shook their heads. Annie piled the crockery near the sink. “Don't you be smashing these when you wash them,” she warned Sissy. “Mrs. Rowley's already done enough damage for one afternoonâand the good china, too.” She turned to Mrs. Heagerty. “Swept a cup right to the floor, she did. She was that angry at the doctor.”
“What was he wanting?” Mrs. Heagerty asked.
“He had a letter,” Annie said. “From Mr. Rowley. I heard him read part of it. Terrible goings-on over there. If you could hear the things he writesâa stone would cry.”
“
He'll
cry,” Mrs. Heagerty said darkly. “When he gets home. If someone doesn't have a word with that wife of his.”
“They had a fight,” Annie said. “I think that'll be the end of our doctorâyou should have heard the tone in her voice.”
“He's a useless creature, isn't he? I heard from Mrs. Mullaney that whole days go by when he isn't called to a decent house.”
Annie agreed, although she was not sure what it was she wanted the doctor to do. No one could emulate Arthur Adam Rowley, and the idea of the doctor joining in Mrs. Rowley's dogooding was hardly better. Annie disapproved of her mistress's actions almost entirely. Exposing herself to filth like that, walking through low parts of town with only a Quaker woman for a chaperoneâno, it was not appropriate. Although it was just what you might expect from a woman brought up so irregularly. Mr. Rowley's mother would never have done such a thing.
Sissy sniffed. “I heard,” she said, in a quavery voice just audible to Annie.
“You heard what?” Annie said sharply. “Speak up.”
“I heard,” Sissy repeated, “from Margaretâyou know, at the Richardsons'âthat a patient of his died because of something he did. Mrs. Sewell, it was. She had the dropsy. And Dr. Grant wouldn't bleed her, Margaret says. She says Mrs. Sewell swolled up like a great pig and died, because Dr. Grant wouldn't bleed her.”
“You
heard,
” Annie said angrily. “You heard. You know better than to repeat that sort of gossip.” But to Mrs. Heagerty she said, “What can you expect of a man like that? Learning here isn't good enough for him, he has to go to Paris, France. Then he's surprised when he comes back here with his fancy theories and finds no one to welcome him but our generous Mr. Rowley.”
Mrs. Heagerty made a sour face and picked up the first pair of lamps. “And his generous wife.”
On an evening two weeks later, the only lamps lit at Lauchlin's house were in the kitchen, where he had no place, and in his crowded office. He shared this house with his father in theory, but in fact his father was not around for more than a few weeks a year. In his absence, Lauchlin had let go all the servants
but one housemaid and the housekeeper and the housekeeper's nephew, who slept in the stables and did part-time duty as gardener and groom. Lauchlin could hear them laughing downstairs, by the warm range.
His room was cold. He sat on the floor, in front of the fire, with a glass of Bordeaux beside him and a plate of food congealing on the arm of his chair. Slowly, meticulously, he pried the top from a large crate and began to unpack the shipment of books he'd been awaiting all winter. Henle's
General Anatomy,
which he handled reverently and then set on the shelf beside his earlier work,
On Miasmata and Contagion.
Chadwick's
Sanitary Report,
which he placed next to Southwood Smith's
Treatise on Fever.
Thick books bound in smooth calfskin, containing knowledge he'd begun to think he would never use.
In Paris, where he'd studied with the famous Dr. Pierre Louis, he had learned to be suspicious of excessive blood-letting and over-zealous purgation and to seek scientific explanations for disease. He had learned percussion and auscultation and how to use a watch with a second hand for the counting of the pulse. In Paris human dissection was legal; he had not had to rely on demonstrations but had explored scores of bodies himself. Here, thoughâhere the doctors were old-fashioned, even ignorant. Although they'd admitted him to the Quebec Medical Society, no one agreed with his methods and no one sent patients his way. His research had yielded nothing so far and his practice was dead. He might be better employed doing almost anything.
Susannah's right, he thought. I'm useless. Still stinging from her sharp tongue, he'd called a few days after their argument on his father's old friend, Dr. Perrault, and mentioned his desire to find some way of combining his interests in research and preventive medicine with patient care. To his surprise Dr. Perrault had responded enthusiastically, although he hadn't had an immediate solution.
“Public health,” Dr. Perrault had said. “It's the emerging
fieldâthink about Mathew Carey's study of yellow fever in Philadelphia. Or Dr. Panum's handling of the measles epidemic last year in the Faroe Islands. In his report he proved beyond doubt the efficacy of quarantine and the fact that measles is not miasmatic but purely contagious in character. The most rigorous, mathematical epidemiology and investigation of underlying cause, combined with patient care and social policyâgood science combined with good medicine. Or so it seems to me. You might keep your eyes open to opportunities here for similar work. It's a shame to waste your kind of training.”
The conversation had sent him back to his books and, even more than Susannah's apparent scorn, had made him think perhaps he should reconsider his direction. He had not gone to see Susannah these past two weeks; no more evenings playing cribbage, no long talks over tea. Since their argument he had felt himself to be a scuttling little creature: a rodent, say. Or a louse. His desk was piled with unpaid bills and he'd have to draw on his father's account again. The house needed repairs, after this long harsh winter. Gutters needed patching, stonework repointing, the shrubberies were a mess; workmen had to be organized and plans drawn up. He had more than enough time to attend to all this, but the idea filled him with an overwhelming boredom. Surely, surely, this was not how he was meant to spend his life.
He finished shelving his new books and then methodically broke the crate into kindling and stacked the pieces beside the fire. Nothing to do now but face the mail. Bills, a heap of medical journals, some of them from the States; a letter from Bill Gerhard in Philadelphia and one from a Dr. Douglas.
He opened the letter from Gerhard first: the usual list of triumphs and enthusiasms. In Paris, Gerhard had already been established as Dr. Louis's prize student when Lauchlin arrived, and they'd overlapped just long enough to establish a friendship. Since his return to the States, Gerhard seemed to have done everything that Lauchlin wished he'd done himself. An appointment
at the prestigious Pennsylvania Hospital; an enormous practice; an investigation into epidemic fevers that resulted in a series of brilliant papers in which he differentiated typhus and typhoid in terms of their distinctive lesions.
Increasingly I lean toward the theories of Henle,
Gerhard wrote, after giving the news of his family.
These fevers must be due to some sort of pathogenic microbes; and not, as the miasmatists contend, to noxious exhalations given off by filth. But I have to admit I have had no success in finding these microorganisms.
Lauchlin skimmed the rest of the letter and then put it down, feeling very tired. His twenty-eighth birthday had passed without anyone noticing it but him; perhaps, as Gerhard had once suggested, he should have settled in New York or Philadelphia upon his return from Paris, instead of coming here. He almost burned the other letter unread. A request for money from one of the newly founded medical schools, or an invitation to a dinner honoring a colleague he did not respect; he could not bear one more reminder of his failure to make his mark in this city.
But it was just possible that the letter was a referral, and so he slit the envelope.
May 2, 1847
Grosse Isle Quarantine Station
Dear Dr. Grant:
Dr. Perrault has been in touch with me, about your recent inquiry into the possibility of entering the field of public health. I am writing to ask if you might consider assisting me here at the Quarantine Station for the summer months. Every evidence suggests that the coming migration from Ireland will be extraordinarily large this year. We have news that vast numbers of emigrants began leaving Ireland in February, and I believe we may expect them here within
a few weeks, now that the ice has finally cleared from the St. Lawrence.No doubt you have read in the newspapers the various expressions of alarm by the citizens of Quebec and Montreal. Their alarm is justified, I believe. And likely you are also aware of the recent harsh legislation in the United States, which will almost surely have the effect of turning the bulk of the emigration toward us. However, I have not so far succeeded in convincing Buchanan of the probable seriousness of the situation. I have been granted hardly a tenth of the money I requested for preparations. Nonetheless, I have been empowered to hire several physicians to assist me.
Dr. Perrault has recommended you most warmly, and I pray, if your own business is not too pressing, that you consider joining this important effort. If you can see your way to doing this, I could use you at your earliest convenience. Our small steamer, the St. George, arrives at the King's wharf on Fridays for supplies, departing Saturday, and is available to convey you. Please let me know your decision as soon as possible.
Yours sincerely,
Dr. George Douglas