Moral dilemmas abound in this nineteenth-century medical whodunnit, culminating in Star Trek's favourite metaphysical teaser,
'when push comes to shove, should the one be sacrificed for the many?'. Mr Spock never answered that question to my satisfaction, but at least
with the fate of the Universe hanging in the balance,
the question was of more significance than debating how many angels dance on the head of a pin.
In this story a surgeon, who cannot operate without morphine to stiffen his nerve and steady his hand, is deprived of his drug of need, and
a girl whom he is performing an abortion on dies on the
operating table. The wrong man is accused of murder of the girl. In the meantime, the actual offender goes free, and two of his doctor
colleagues ponder whether the lives the killer will save as a gifted
surgeon justify leaving the wrongly accused in jail.
The main advocate of the latter course of action argues that all will be well, because money and influence will eventually free the wrongly accused,
and the girl is dead anyway, so why should her
killer stand forth?
Before a rescue can be effected of the innocent man someone else enters the jail cell of the wrongly accused, and stabs and murders him. Then
we find the actual offender has made a confession
he would have given the police. One of the doctors goes to tell the police, but refuses to exonerate the slain innocent once he learns of
the innocent man's death, because he thinks it is all the fault of the police, and has nothing to do with him for withholding evidence --
which he had acquired earlier as an amateur sleuth.
So, providing by the end of the book that everyone is telling the truth, the denouement is that the innocent wrongly accused dies unvindicated,
his parents never learn the truth, the actual offender goes on to greater glory, and the doctor who withheld evidence blames
the police. Move over, Shakespeare, there is a new kid on the block.
And the dead woman? Well- she was a fallen woman, so perhaps her agonising death from a botched abortion did not matter anyway - within
the thinking of the time. In those pre Roe v Wade days abortion was viewed
as an abominable crime, social stigma was merciless, and 80% of caesarian sections resulted in death. The last fact is actually incidental
to the story. One of the plethora of factoids plucked from history
to spice up the story, making it into a slice through medical life and social mores in 1889.
Here is a writer in flight from non-fiction to fiction, and he is two thirds of the way there. This book is faction, making play with the
medically mighty Johns Hopkins University, and weaving a story around its
luminaries. Real lives embroidered by a fictitious story line, and, as an aspiring professional
historian, I find that disturbing. It might actually be too soon, less than a century after the death of
the protagonists, to imply that an esteemed surgeon might have committed murder. He has no defence, being dead. Ought one ever to weave such
fantasia, even a millennium later? The rigorous historian in me says,
no, one should never do so. The journalist in me, conscious of current and future litigators, rebels.
Surely the historian's task is narrative that is as accurate as possible, given the sources available and the question to be addressed? Spice the whole with analytic evaluation of
the narrative's interaction
with societal and political tides, and perhaps clothe the whole in a framework in which the dominant shaping force of the time is, say, emergence
from civil war, as in this story, and mix in the ethics
of post mortems and dissecting a human corpse. Then one has history, not faction.
This is faction.
Yet the author holds a Ph.D in American history, so must have pondered the ethics of his work as he turned these lives into a source of essay questions for aspiring medics, ethicists and
Is this a gripping read? In part. This is not a John Grisham page turner, nor Ian Rankin at his best. Nor, despite the sprinkling of nineteenth-century medical history, is it Roy Porter,
of his scintillating tour-de-force in the world of medical history. Written by a fictitious narrator, interspersed with first person accounts, with a reflective
epilogue written supposedly 40 years
after the critical narrative events, the book is good, and it is written by a writer reaching for a fiction writer's voice. But when all is said and done, what this really is - is
a book for a morally inquisitive
teenager with medical, ethical, moral or metaphysical academic leanings. And the biggest question to my mind is whether a responsible historian ought to have written such
recent faction at all.
Republished on 14.08.2020, and edited to tidy up and clarify the text. I am an iterative writer, and I should
have put the item above through an additional iteration before publishing. I have now done so. The changes are minor, and none are subtsantive. 21.08.20. HG.