The Anatomy of Deception - Lawrence Goldstone [6]
The Professor instructed Simpson to measure each chamber and the connecting valves, with the measurements then recorded in the journal. He noted where muscles were fibroid or pale in color or valves thickened at the edges. When the examination of the heart was complete, it was left on the table and the Professor removed each lung, one hand at the top, the other at the bottom, and repeated the dissection process. He observed that in both were large spots of apoplexy—hemorrhaging—and the anterior borders were emphysematous. Tissue sections presented coarse appearance of brown atrophy. After the lungs, he examined the bowels, kidneys—on which there were several cysts—liver, and spleen.
The next step was to remove the brain, a delicate operation that only the most skilled anatomist could perform without mishap. Unfixed brain tissue has the consistency of gelatin and is notoriously difficult to handle. It had taken me months, but I finally mastered the technique and was now the only member of the staff to whom the Professor would delegate the task. After my first success, Turk had proclaimed me “Lord of the Runny Eggs.”
I made a transverse incision at the back of the head from ear to ear across the brain stem, then separated the scalp from the underlying skull and pulled it forward. After utilizing a bone saw to score the calvaria—the cap of bone at the top of the skull—I employed a skull chisel, known as a “Virchow skull-breaker,” to remove it. I then moved with great care to gently lift the brain out of the cranial vault. My hands were soaked with perspiration and my clothes clung to me in the still air, making delicate movement laborious. I managed to remove the brain, which, as Turk had so aptly noted, felt like a mass of undercooked eggs, and placed it in a large jar of formalin fixative. After soaking for a moment, the brain tissue coagulated and was removed to a table and sliced for examination.
“The brain, as we would have expected,” said the Professor after taking some cross sections, “presents nothing abnormal. The arteries at the base are opaque, but not rigid.”
The remainder of the autopsy went quickly. The intestines were opened with an enterotome, a large specialized pair of shears. The major blood vessels were examined, but nothing further of interest was discovered.
When the examination was completed, ninety minutes after we began, the Professor washed his hands in the sink and then returned to the table. “Well, not too much question of what did this fellow in, eh?”
Those of us familiar with the Professor’s teaching methods knew not to answer too hastily, but Farnshaw, four months removed from Harvard, rashly offered, “No, sir. Hypertrophy.” Farnshaw was tall, like Turk, with a smooth, clean-shaven face, and the innocence that is the inevitable result of an upbringing in which wealth is utilized to insulate life’s many pitfalls. So ingenuous was Farnshaw, however, that it was impossible not to feel affection for him. That he constantly stumbled in his barefaced attempts to prove himself worthy of our professional respect endeared him to us all the more. He was not, it must be said, a bad doctor, simply unseasoned, like newly hewn poplar.
“Indeed,” replied the Professor. “An enlarged heart. Now, Farnshaw, this chap entered the hospital in relatively decent shape. Some coughing, but no evidence of advanced disease. What might have been done for him to prevent this unfortunate result?”
“Digitalis,” replied Farnshaw triumphantly. My gaze met Simpson’s for a moment and her eyes rolled upward. Digitalis, derived from the otherwise poisonous purple foxglove, was known to strengthen contraction of the heart muscle, slow the heart rate, and help eliminate fluid from body tissues. It had been popular for a century and was prescribed by almost every physician in the nation for almost every heart problem. Every physician except the Professor,