Open Wound: The Tragic Obsession of Dr. William Beaumont
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OPEN WOUND
THE TRAGIC OBSESSION OF DR. WILLIAM BEAUMONT
Jason Karlawish
THE UNIVERSITY OF MICHIGAN PRESS
Ann Arbor
Copyright © by the University of Michigan 2011
All rights reserved
This book may not be reproduced, in whole or in part, including illustrations, in any form (beyond that copying permitted by Sections 107 and 108 of the U.S. Copyright Law and except by reviewers for the public press), without written permission from the publisher.
Published in the United States of America by
The University of Michigan Press
Manufactured in the United States of America
Printed on acid-free paper
2014 2013 2012 2011 4 3 2 1
A CIP catalog record for this book is available from the British Library.
Library of Congress Cataloging-in-Publication Data
Karlawish, Jason.
Open wound : the tragic obsession of Dr. William Beaumont / Jason Karlawish.
p. cm.
ISBN 978-0-472-11801-4 (cloth : acid-free paper) — ISBN 978-0-472-02804-7 (e-book)
1. Beaumont, William, 1785-1853-Fiction. I. Title.
PS3611.A7836O64 2011
813'.6–dc22 2011020861
for my parents,
Anne Wright and John Karlawish
In that land the great experiment was to be made, by civilized man, of the attempt to construct society upon a new basis; and it was there, for the first time, that theories hitherto unknown, or deemed impracticable, were to exhibit a spectacle for which the world had not been prepared by the history of the past.
ALEXIS DE TOCQUEVILLE,
Democracy in America
These subjects deserve better: a protocol that is not tainted with conflict of interest and is not tainted by our own professional agenda.
JAMES WILSON, MD, Philadelphia,
Pennsylvania, December 9, 2008
CONTENTS
Prologue
PART 1
The Taker Made Mad
CHAPTER ONE
CHAPTER TWO
CHAPTER THREE
CHAPTER FOUR
CHAPTER FIVE
CHAPTER SIX
CHAPTER SEVEN
CHAPTER EIGHT
CHAPTER NINE
CHAPTER TEN
CHAPTER ELEVEN
CHAPTER TWELVE
CHAPTER THIRTEEN
CHAPTER FOURTEEN
CHAPTER FIFTEEN
CHAPTER SIXTEEN
CHAPTER SEVENTEEN
CHAPTER EIGHTEEN
CHAPTER NINETEEN
CHAPTER TWENTY
CHAPTER TWENTY-ONE
CHAPTER TWENTY-TWO
CHAPTER TWENTY-THREE
CHAPTER TWENTY-FOUR
PART 2
The Only Men Entitled to Happiness
CHAPTER TWENTY-FIVE
CHAPTER TWENTY-SIX
CHAPTER TWENTY-SEVEN
CHAPTER TWENTY-EIGHT
CHAPTER TWENTY-NINE
CHAPTER THIRTY
CHAPTER THIRTY-ONE
CHAPTER THIRTY-TWO
CHAPTER THIRTY-THREE
CHAPTER THIRTY-FOUR
CHAPTER THIRTY-FIVE
CHAPTER THIRTY-SIX
CHAPTER THIRTY-SEVEN
CHAPTER THIRTY-EIGHT
CHAPTER THIRTY-NINE
CHAPTER FORTY
CHAPTER FORTY-ONE
PART 3
The Immortal Part Cracked
CHAPTER FORTY-TWO
CHAPTER FORTY-THREE
CHAPTER FORTY-FOUR
CHAPTER FORTY-FIVE
CHAPTER FORTY-SIX
Epilogue
Author's Note
Acknowledgments
About the Author
PROLOGUE
August 1850
St. Louis, Missouri
Dear Alexis,
Without reference to my past efforts and disappointments, without reference to expectation of ever obtaining your services again for the purpose of experiments, upon the proposals and conditions heretofore made and suggested, I now offer to you in faith and sincerity, new, and I hope satisfactory, terms and conditions to ensure your prompt and faithful compliance with my most fervent desire to have you again with me. With me not only for my own individual gratification, and the benefits of medical science, but also for your own and your family's present good and future welfare.
I propose the following—$500 to come to me without your family, for one year—$300 of this for your salary, and $200 for the support and contentment of your family to remain in Canada in the meantime—with the privilege of bringing them on here another year. I submit this, my final offer, out of the principles of Justice and Fairness.
I can say no more, Alexis. This is my final letter—you know what I have done for you over many years—what I have been trying, and am still anxious and wishing to do with and for you. You know what efforts, anxieties, anticipations and disappointments I have suffered from your nonfulfillment of my expectations. Don't disappoint me more, nor forfeit the bounties and blessings reserved for you.
Sincerely,
William Beaumont, MD
PART 1
The Taker Made Mad
ONE
June 6, 1822
Mackinac Island in Lake Huron, Michigan Territory
DR. WILLIAM BEAUMONT WAS AT HIS DESK in the army hospital when he heard the gunshot. It came from the bottom of the hill, in the direction of the American Fur Company's warehouses along the Mackinac Island harbor. He rose from his chair and stood before the small office window. The gate of the fort at the top of the hill was open, and several soldiers at arms ran down the hill. Within the minute, Elias Farnham, Beaumont's steward, flung open the door.
“Doc Beaumont, there's been a shooting in the company store. A young fur trapper's shot bad.”
Elias held out Beaumont's surgical kit. Beaumont took it in hand, hefted the thing before he tucked it into his coat pocket, then together they ran down the dirt road to the American Fur Company store. The sweating crowd of fur trappers, Indians and soldiers stood in a golden halo of road dust as they tugged at their ringing ears. Dogs were barking. A child was crying.
“Doctor's here, let him in! Let him in!”
A soldier held open the door.
A ring of men, some standing, others squatting, surrounded a man lying on the floor and moaning. The smells of gunpowder and burnt flannel and flesh hung in the thick air. A young man, his clerk's apron blood-spattered, ran up to Beaumont. It was Theodore Mathews, the manager of the store.
“It's horrible, Doctor! Horrible! A shotgun discharged right here inside the store, and this fella took the blast close on.”
Beaumont nodded. He knelt before the wounded man and reached out to lay his hand on the young man's shoulder.
“Easy there, lad. Easy. I'm Dr. Beaumont. I'll take care of you.”
He took his surgical kit from his coat pocket.
“Elias, unroll my kit on the floor just to my left.” He gestured to two men. “You there, ease out this lad's legs, one man on each leg. I need you to keep him from writhing about. Elias, you take his arms. And if you don't need to be here, please leave. I don't need an audience.”
As he gave these orders, he was carefully stripping off the young man's red flannel shirt, using his jackknife to slice it away at the sleeves. The blast had torn a hole in the shirt. The edges of the hole were burnt, and the cloth was wet with the distinct smell of coffee and bits of what looked like breakfast meat and bread.
“J
esus,” he murmured.
It was a horrible wound, the size of a man's palm, riddled with bits of fractured rib and cartridge wadding. Someone handed Beaumont a rag. He wiped away the blood and started to pick away the debris. The fur trapper moaned and coughed, and a protrusion of flesh heaved up, and the source of the coffee and food was revealed. The blast had torn a hole into the man's stomach. Beaumont sucked in his breath. Just above the injured stomach, a lobe of lung was caught on the ragged edge of a fractured rib. The man's breath bubbled through the blood that soaked the lobe. Beaumont used his penknife to snip the tip of that rib, then eased the lobe back into place.
“William, can I talk to you as you work?”
It was a voice as steady as Beaumont's.
“Yes of course, Captain.”
Captain Pearce, the commander of Fort Hill and the Mackinac Island garrison, stood beside the doctor, watching him.
“I've got the assailant outside under guard. Teddy Mathews says he saw the fella set his gun down—set it down like it was a walking stick—and the lad here was right in the way of the blast. The balance of the witnesses' testimony is that this was an accident.” He eyed the fur trapper. “A tragic accident,” he said. “Look like that to you?”
“Hard to tell, but the shot's not direct. There's a bit of an angle to it, sort of upward and outward.” He looked up and whispered to the captain. “If it was dead on, I wouldn't be needed here.”
The captain's eyes narrowed as he peered at the wound.
“What on earth is that thing that looks like a turkey's egg?”
“Lobe of lung.”
The captain grimaced. “Ah, Christ.” He shook his head slowly.
It took the doctor twenty minutes to superficially clean the wound and apply a compress dressing. When he finished, he turned to Elias Farnham and ordered him to fetch a stretcher so they could carry the lad up to the hospital.
“William?”
Beaumont turned. It was Ramsay Crooks, the American Fur Company's principal agent on Mackinac Island. He was a large, red-headed man with a raw strength gained from some twenty years leading fur trapping expeditions as far west as the Oregon territory. Crooks gestured with his chin for Beaumont to step closer, and when Beaumont did he placed the length of his thick right arm upon Beaumont's shoulders and eased the doctor to a quiet corner of the store.
“You've done fine work with that Frenchie, William. Fine work. I always tell my sweet Emilie how lucky we are to have you on this island.” He bit his lower lip, and looked in the direction of the young man. “You think that boy'll live?”
Beaumont considered the question. “He's not sinking.”
Crooks grimaced. He tightened his grip.
“But do you think he'll survive the day?”
“In the war I managed wounds far worse than this. A few lived.”
Crooks lowered his voice. “Let's just have him stay here.”
“Here?”
“Here, yes. In the storeroom.” Crooks released Beaumont and gestured to the door to the storeroom. “There's plenty of room, and there's always someone there. It's clean, dry and temperate. I've slept there myself some nights.”
Beaumont frowned.
“Ramsay, I think perhaps . . .”
Crooks interrupted him. “Captain Pearce,” he called.
The captain stepped over.
“I was just saying to William here that we can set the wounded trapper up on a cot in the storeroom. I'll be there at my desk to watch over him, and if I'm not, Teddy or one of the other clerks can see to his care, and William can check on him as he requires. Remember that fellow with the broken leg last year? And he was certain to live, and that's simply not the case with this one.”
Pearce listened and nodded. Beaumont looked back and forth from the captain to Crooks. Speechless.
“What is it, William?” Captain Pearce snapped.
“Captain, the wound engages both lung and stomach, and I simply gave it a superficial cleaning. If he survives the morning, there's likely more to debride, and I'd rather manage that in the hospital.”
Crooks smiled, and placed a hand on Beaumont's shoulder.
“It's a short walk down the hill, and you can come whenever you require. I'll even lend you a key to the storeroom.” He spoke in a high tone, practically singing.
“But Ramsay.”
Crooks tugged Beaumont closer to him. “William, you know as well as I do that I don't pay for these Frenchies to stay in the army's hospital. You start moving them in there, and then I've got some thousand men, women and children—white and Indian—living on that beach who can lay claim to a company-sponsored stay in the hospital. People with injuries far simpler than this man's. Think of the precedent, William. Think.”
“I've plenty of empty beds.”
“But you won't if you start fillin' them with the company's voyageurs and their families,” Captain Pearce interjected.
Beaumont was incredulous. He looked around seeking an ally, but Elias was staring at his boots.
“Captain, this is an accident, not the war, and the lad's not dying. He's my patient now.”
“Keep your voice down, Assistant Surgeon. I don't need a scene.” The captain stared coldly at the doctor. “It's up to Ramsay, really. If he wants to pay room and board, I won't stop you from moving the lad to the hospital. A day costs little, and he ain't eatin'.”
“I should say it's up to you, Captain.” Crooks gestured to the wounded fur trapper. “That boy there is one of my indentured servants, and if he's anything like the lot of them, he owes me dollars against his indenture. But with a wound like that, even if by some miracle he survives the day, I'm never going to see that money. And now add to that a bill to house a dying man, not to mention the others who will come to expect the same. I can't run a charity hospital for the village of trappers along the beachfront. This doctor's your charge,” he insisted. “He wears your uniform. And I might add that he seems quite busy stirring things up. Penning circulars about the expansion of the company warehouses and now standing here and telling me I've got to foot the bill for a lost cause.”
He was speaking of a circular Dr. Beaumont had issued the other day to protest the company's plan to expand a warehouse onto the land where the garrison maintained a vegetable garden.
Beaumont stared at Crooks.
Captain Pearce exhaled heavily. The store was beginning to fill once more. They were being watched with increasing interest. Men were whispering.
“William, if Ramsay wants to pay for this Gumbo's room and board at the army's hospital, you can take care of him there. Otherwise, you care for him where he lays. That's what the army's agreement with the company stipulates. Be reasonable. I was in the war too. That lad's gonna die. You know that as well as I do.”
Crooks nodded smartly. “I've heard enough,” he murmured, and then stepped over to the wounded man. His eyes were closed and his breathing shallow. Crooks reached into his pocket and produced a handkerchief. He wiped his eyes and his brow, and then he slowly lowered himself to his knees and wiped the wounded man's brow. He looked at the men around him.
“Friends, this here is a terrible tragedy. It's sad to see one of the company's brave trappers wounded in the line of duty. He's like a fallen soldier.”
Crooks shook his head mournfully.
“Teddy, you and the boys ease this young fellow onto a cot there in the storeroom. We'll set him right by my desk so I can watch over him and pray for him like he was my son.”
TWO
THE VILLAGE OF MACKINAC ISLAND and the beachfront camps along the shore of Lake Michigan were astir with the labors of the day. The white walls of Fort Hill gleamed like a hilltop temple.
Beaumont was seated at his desk in his cluttered office at the hospital. His inkpot and leather notebook lay open as he had left them when Farnham came with the news of the shooting. His habit was to begin his day writing. The notebook served as both his personal diary and his professional record of cases
. It contained notes on his travels and letters written and received. There were copied passages from the poet Burns, as well as his own observations upon the nature of man. Numbers and computations interspersed the written words, accounting his credits and debts, the former finally ahead of the latter. The notebook had become a collected record of his wealth, the chronicle of his ambition.