The Anatomist: A True Story of Gray's Anatomy (15 page)

Illustration from Henry Gray’s
On the Structure and Use of the Spleen

At a loss to understand what happened, I find that I want to blame the publisher; it is possible a paragraph was cut from the preface, perhaps to save space, certainly without Gray’s knowledge. To me, that is the only satisfying answer. Carter, I believe, had a very different explanation, one that reflected a significant change in his perception of the world. He thought he deserved it. The omission wasn’t a sign from Gray. No, it was a sign from God.

Coloring his thinking was
Providence,
a Christian concept that colored my own upbringing. But Catholics do not spell the word with a capital
P,
as strict Evangelicals such as Carter did, and in that single letter lies a world of difference in how one views God’s workings. I always understood providence in its broadest sense, as the belief that, while God has a master plan for all of creation, certain actions and events are beyond our comprehension. Though inexplicable, they are “providential,” or, as God intended.

By contrast, Carter saw God as a hands-on manager of human affairs who, if pleased or displeased with an individual, intervenes through acts of Providence, sent from heaven like a personal bolt of lightning. This was a bedrock belief of Victorian-era Evangelicalism, as Cambridge historian Boyd Hilton has observed. God operated through a “system of rewards and punishments appropriate to good and bad behaviour,” Hilton writes. “Almost always in the case of individuals, and sometimes in the case of communities [for example, an epidemic of cholera], suffering was the logical consequence of specifically bad behaviour. It could therefore incite as well as guide men to virtuous conduct in the future, but they must of course take the opportunity to examine their own actions in the light of their suffering.”

Providence was clearly not a notion Carter invoked lightly. The word itself did not make a major appearance in his diary until he had flunked the M.B.’s in November 1853, his first unmitigated personal disaster. A week later, having picked himself up off the floor, he found himself “willing to view the matter as somewhat
Providential
in its occurrence,” a diagnosis he had come to by a process of elimination. His “mind” was not at fault for the failing—he was certainly smart enough to have passed the exam, in other words—so his behavior must be to blame. Lax in his study habits, envious of others, neglectful of his religion, Carter had given God a host of reasons to intercede. Through the exam, He was sending H.V. a clear message. But in a perverse way, this slap from the hand of God ended up doing the young man some good. It made him
feel
God’s presence. In failure, H. V. Carter found faith.

Like a scientist not wishing to publish a finding too early, he remained circumspect about his breakthrough. “Would not presume, but trust Christian principles [are] beginning to have some influence on [my] Character—specially that of Faith,” he confides to
Reflections
in mid-May 1854. “Truly the very simplicity [of Faith] is almost a stumbling block,” he adds, a line that comes across as a stunner for the reversal it shows in his thinking. What he had pursued so doggedly in the past had perhaps never really been so far out of reach. But then, as if the skeptic in him cannot refrain from questioning, he wonders: “Are we all together, body and soul, so much under God’s direct influence and knowledge, that it may be said, the very hairs of our heads are numbered?”

The spleen book omission would be God’s second warning to Carter. In his growing awareness that a Providence is never “any excuse for inexcusable deficiencies” but rather an impetus for soul-searching, he sets aside his disappointment and commits himself to succeeding on his second try at the M.B. exams.

And he earns his reward. “Success, under Providence,” he writes on November 14, 1854, “M.B.—first division.”

Hooray!
he might have added, but he saves his effusiveness for a letter to Lily. “The only thing after all that can be said about the examination is that it is the
best
in the country. To have passed it implies a certain amount of knowledge.” But more important, Carter must have felt he’d passed the greater test put to him by God. With a note of pomp, he then explains to Lily that degrees such as the M.B. are merely “
weapons
with which to fight the
battle
of
life
, and some men will fight as well with few as many. The contest will shortly begin downright, though, for many reasons, I do not greatly fear.”

That Carter believed he had achieved a milestone in his spiritual growth is underscored just days later in
Reflections,
though it’s what he
doesn’t
say that is so telling. He stops writing here. His four-year-long running debate on whether to lead a Christian Life has quietly ended in God’s favor. From now on, he folds his religious ruminations into his daily diary. However, none of this is meant to suggest that faith had come with inner peace. On the contrary, Carter remains as tortured as ever, albeit with an important difference. Whereas in the past he had agonized over the absence of God, now he agonizes over His presence. Sadly, though, he has little skill at recognizing God’s signals. When your life is a lightning storm, as Carter’s so often was, how do you know which bolt is a Providence?

At the start of December, Carter receives a request from John Sawyer, a figure who has been absent of late. Sawyer asks his former apprentice to fill in for him for a couple of days. For the younger doctor, this comes as a welcome chance to practice medicine and is also an unexpected compliment. Carter had covered for Dr. Sawyer for a full week back in September, a trial by fire as a G.P. that, frankly, had left him somewhat singed at the edges. All started well enough, he had written. Carter felt honored just for being asked (plus, he relished the chance to take time off from the college), but he ran into trouble almost as soon as Dr. Sawyer was out the door. The trouble being with himself. “Rather young appearance somewhat against me,” he found, and I expect this was a fair assessment. The patients were used to the avuncular John Sawyer, after all, and here was this, this—

And who might
you
be?
I can imagine being the first question to Carter from Sir Gordon Drummond, a regular of Dr. Sawyer’s and a man whose name alone spells dyspepsia.

But it wasn’t just his boyish looks that gave Carter away as green. “Try too much to make self agreeable, which people who are ill don’t so much relish as a more suppressed and sober manner,” he writes one evening, diagnosing his own performance. Carter, who often lacked a certain social polish even in casual settings, found himself flustered and forgetful at those very moments when he could least afford to be—while seeing patients. “Omit many questions, etc., absolutely necessary to a careful enquiry into nature of ‘case,’” he pointed out. But what made the young doctor most anxious was writing prescriptions. To his dismay, he didn’t “find knowledge so ready at one’s finger’s ends” (or
fingertips,
as one would say today) and sometimes remembered the very best drug or dosage only after the patient had gone.

His week did end on a successful note, Carter happily reported, when he earned a fee of £1 for setting a broken leg. The patient had been a referral and wasn’t a person but a bird—one Lady M.’s “favorite bullfinch!” Adept at taking animals apart, Carter was no doubt also gifted at fitting them back together. At least this is the impression one gets from his diary, which sometimes reads as if he were being trained as a veterinarian. At the college, an entire menagerie comes under his capable scalpel, from a walrus to a dog to a horse to a cuttlefish. Sometimes, too, he would also draw the creatures. In the summer of 1854, he had spent days dissecting and making drawings of a South American giant anteater, a magnificent creature he had actually gone to see when it was a popular (albeit short-lived) attraction at the zoo in Regent’s Park. Given the task of anatomizing the anteater, Carter put up with fumes so foul he suffered from diarrhea and headache and ultimately earned high regard from superiors for his “artistic skill and praiseworthy industry.” In spite of this, one might reasonably question the real-world relevance of the entire exercise, given that the only example of this peculiar animal in all of Great Britain was now dead.

Carter himself recognized the often esoteric nature of his work. “I don’t dislike the occupation,” he tells Lily. “In fact it suits me very well, though how it will further my practical experience, or enable me to cure more patients, I cannot tell.”

“Rough sketch” of an anteater, H. V. Carter, 1854

His restlessness with the studentship comes through most strongly with the start of the new year, 1855. At this point, with less than six months left at the college, he has little of significance to occupy him. Mr. Queckett is frequently ill and often not at work. Also, the junior student (to Carter’s senior) had recently resigned and taken a “better appointment,” a surgency with—as irony would have it—the General Screw Steamship Company, “a berth I once sought.” But if hearing the younger man’s news had hurt, Carter does not let on. He has both larger and smaller concerns. As he writes in early February, “The point is still,
what
to work at?” While he still entertains “dreams of [having a] delightful country practice,” he is leaning more toward a career in medical research. His recent purchase of a high-powered microscope has opened new possibilities. “Have now sufficient confidence to trust [my] own powers in any branch of investigation concerning
human
anatomy”—note the distinction—“and now seem to wait for [the] opportunity.”

The day after he turns twenty-four, opportunity knocks: “Professor Hewett made an offer that [I] should attend to [St. George’s] Anatomy Museum and be a Demonstrator for £50 per annum—a kind and pleasing thing.” If he were to take the job, Carter would primarily assist Henry Gray, in both the museum and the classroom.

“The offer is very tempting and in most respects very advantageous in its consequences.” Still, there is some fine print to consider. Hewett had let him know that, as a member of the staff, Carter would be expected “to ‘do something’ to advance the reputation of the school,” such as publishing a major scientific paper.

“And here’s the rub:
Gray
has done very much, [he represents] a difficult precedent.” Carter fears he will never measure up. What’s more, he already imagines that people are insinuating, “‘
Carter, look at him
,’” meaning,
Look at what Gray has accomplished,
and by this point, it was quite a list. The twenty-eight-year-old multiple prizewinning published author, distinguished anatomy lecturer, and museum curator had most recently been appointed surgeon to the St. George’s and St. James’s dispensary.

Of course, Carter’s concerns have less to do with Henry Gray, per se, than with how he sees himself. As he confides to his diary during a low moment, “Feel that [I] am
not
fit to ascend the ladder of distinction—must hold it for others.”

But Professor Hewett sees none of this.
For heaven’s sake, take the job!
he had urged him, even pointing out that the job offer might itself be a Providence. “
He
reminded me of this,” Carter writes. “I felt quite abashed and do now. Is this prospect from God?”

Henry Gray is equally encouraging. “A conversation with Gray has relieved some anxiety,” he reports on his third day of wavering. Yet it takes another reassuring visit to Gray before he makes a final decision. “In short, the offer will be accepted, though with anxious feelings.”

After all the hand-wringing, he makes a seamless transition from student to staff member, though the job does get off to a quiet start. He is a demonstrator without students to demonstrate to until winter session begins. When Henry Gray commissions him to do a series of drawings, Carter doesn’t hesitate. The subject: microscopic views of bone tissue.

As always, drawing remains perhaps the only aspect of his life over which Carter does not agonize. He purchases a lamp so that he can work in the evenings with his microscope, and he completes all forty illustrations for Gray in about as many days. “Gray called,” he writes on October 7, “and liked very much [my] microscopic drawings.” So much so, apparently, that several weeks later he approaches Carter with a far bigger project, though its scope doesn’t seem to faze him in the least. “Little to record,” Carter reports nonchalantly on November 25, 1855. “Gray made proposal to assist [him] by drawings and in bringing out a Manual of Anatomy for students: a good idea.” (This “Manual” is the book that would come to be known as
Gray’s Anatomy.
But that’s jumping far ahead. At this point, Carter hasn’t the foggiest idea of what fate has in store.) “Did not come to any plan,” he adds, noting only that, for this project, he would not simply be the artist. He and Gray would be collaborating on the dissections.