The Anatomy of Deception - Lawrence Goldstone [144]
The larger question, of course, is whether science must inevitably be willing to compromise ethics in order to achieve great and beneficial change. Medicine in 1889 was a science teetering on the edge of immense advances in curing disease and alleviating suffering. I believe we as a society are in a similar position today. Dr. Osler’s dilemma could easily be our own.
From a narrative standpoint, I strove to portray the personalities of both men as they were. Osler was affable and well liked, while Halsted, after his addiction, became sarcastic and aloof. (Despite the rumors, Halsted’s face in the Sargent portrait did not fade over time.)
I thought it crucial to get the science right, and thus all of the medical tradecraft depicted in The Anatomy of Deception is as historically accurate as I could make it, from the instruments used to the order of procedures. The autopsies conducted by Osler in the first chapter come from his own notes; the manner in which he examined patients in the ward and the discussion of a physician’s four compass points also come from life.
For dramatic flow, I did take minor liberties with chronology. Rubber gloves, for example, while first fabricated in 1889, were evidently not used by a surgeon until 1890. William Osler often had tea at the home of Samuel W. Gross before Dr. Gross’ illness, and thus was introduced to Grace Linzee Gross before she became a widow.
The art side of The Anatomy of Deception is also, I hope, substantially correct. Thomas Eakins did teach in Philadelphia, where he had a nervous breakdown, and was sent out West to recover by Weir Mitchell, who was at the time considered the preeminent authority on nervous diseases. Eakins remains one of the great controversial figures in American art, and he did pose frontally nude for his own photographs. His reputation plummeted with the rise of abstract art, but he was eventually rediscovered and is now considered one of the great painters in our history. His medical paintings and their impact are as described.
Once again, for smoothness, I made some changes. Eakins, for instance, did not convert the top floor of the house on Mount Vernon Street to a studio until after his father’s death in 1899. From 1884 until that year, he worked out of a rented studio on Chestnut Street.
While Reverend Squires and the Philadelphia League Against Human Vivisection are fictional, there was great resistance to autopsy in 1889, and all the machinations necessary to secure cadavers are as they were. The Blockley Dead House was as described, and the attendant was an Alsatian whom Osler nicknamed “Cadaverous Charlie,” who had indeed been caught on more than one occasion drinking from the specimen jars. There was an exhumation in which a corpse was discovered to have three livers. Although Wilberforce Burleigh is fictional, his surgical techniques are not. More surgical patients died of shock and blood loss than of illness in 1889. Cesarean section had a mortality rate of 80 percent.
The notes from Wright’s experiment and the animal tests afterward are taken from the journals, and all the details of the development of heroin are accurate. While there is no specific evidence of experiments at Bayer to acetylize morphine as early as 1889, the competition between the German chemical companies to develop drugs from industrial products was as described.
ACKNOWLEDGMENTS
I HAD A GREAT DEAL of help in completing this book, both in the research and the writing. For the former, I wish to thank Dr. H. Wayne Carver, III, chief medical examiner for the State of Connecticut, who took great pains to educate me on the intricacies of autopsy and the history of opiates and cocaine. Carol Fletterick, also of the medical examiner’s office, was consistently helpful and gracious in answering what must have been some pretty dumb questions.
Drs. Dennis Wasson and Greg Soloway both read the manuscript to ensure that I didn’t make any egregious errors in the medical sections, and Dennis imparted some wonderful anecdotes about nineteenth-century surgery. Any errors