Open Wound: The Tragic Obsession of Dr. William Beaumont

by Jason Karlawish

  Beaumont took his drink modestly and passed his solitary evenings crouched over his worktable beside the fire. He read the histories of Mavor, Rollins and Antequil, Mackenzie's travels, recited Shakespeare and Burns, copied favorite passages into his notebook. He penned letters to fellow physicians and the leaders of Plattsburgh, filled his diary with passionate fantasies of Deborah. They soared upon the pinions of love. He wrote her long letters describing his life on the island and his plans for their family.

  There was a calculated logic to his serving on the frontier. His solitary practice was like the company's monopoly on the fur trade. Suffer the island's isolation in return for a steady income and favorable prospects of advancement in the surgeon's corps.

  AT TWENTY-ONE, he'd left his father's farm in Connecticut and traveled north to Champlain, New York. Cousins there had written of a brisk trade in goods to and from Canada. He worked as a shopkeeper, he speculated in hay and silk, and entered into politics, but his unyielding support of Jefferson's embargo act ruined both his business and his political careers. He taught school. In time, he grew determined to secure a steady income. He tried to learn Latin. He read a tattered copy of Thornton's Philosophy of Medicine.

  Three years later, he collected what fees he could gather from the parents of his students, quit the school and crossed into Vermont and took up as apprentice to Dr. Benjamin Chandler. His debts were multiplying. In 1810, the War Hawks swept Congress, and by 1812 the United States was at war with Great Britain. President Jefferson's promise that taking all of Canada would be a mere matter of marching north became Beaumont's opportunity to pay off his debts, lay claim to land in Canada and make his name in the world. Three years later the fighting ended in a stalemate. Though he had gained neither land nor fortune, his surgeon's skills were now expert.

  At war's end, he posted an announcement in the Plattsburgh Republican that Dr. William Beaumont, licensed to practice both physic and surgery by the Third Medical Society of Vermont, assistant surgeon in the Sixth Infantry Regiment of the Army of the North and veteran of the Battle of Plattsburgh, would commence seeing patients.

  The ebb and flow of the suffocating fiscal anxiety of private practice reduced him to living in a slant-roofed room on the third floor at the back of Israel Green's United States Hotel. He had to duck a beam in order to step into the corner, where he had a small table and chair set before the shingle-sized window that overlooked the outer buildings. He swapped bottles of tonic for his meals at a regular table at the public house. For several months, he tried to walk to patients or negotiate a carriage ride, but the delay cost him fees, for patients soon found that either doctors Brown or Martin arrived quicker by horse, so he set down half the price in cash for a mare he kept in Green's barn and a promissory note good for the balance.

  Nature itself seemed to conspire against him. The winter of 1817 kept snow on the fields and chunks of ice in Cumberland Bay until June. Then came a drought so severe that by autumn, acres of forests and fields burned. The air stank of smoke, and the evening sun hung red and pulsing, threatening like some great fireball overseeing the world's end. The few farmers who managed to plant crops lost much of them, revenues plunged, debts accumulated and commerce stalled. The merchants' wives ceased buying tonic, and the tally of fees owed to him multiplied. The preachers thundered that God was preparing the nation for the end times. He wished those without means would exercise discretion and limit their calls, but still they called, and often theirs were the most complex cases.

  He kept a good pair of boots in high polish and a black dress coat and pants and stiff-collared shirt he wore exclusively for the Masonic meetings, the debating society and the meeting of the veterans of the Second War of Independence. He devised a rhyming game to learn the names of all the town's leaders and merchants. The monthly columns recording his debts and fees not collected grew together like two twisting serpents chasing his revenues collected. Some months, revenue led the chase; others, debt led revenue.

  Finally, one summer Sunday morning in 1819, as the church bells rang, Beaumont sat shirtless and sweating at the tiny table in his cramped room, the flies humming, the pungent smell of horses carried in from the barn. He ceased tallying his ever-fluid accounts, set down his nib and decided he must return to the military service. The army had given a certain security to his life that the routines of private practice could not.

  He composed a letter to Dr. Lovell, his commander during the war and now the surgeon general in Washington City. From merchants and leaders, friends and veterans of the war whose names and addresses he kept in careful alphabetical order, he solicited near sixty signatures on a petition to Secretary of War Calhoun and President Monroe. He gathered testimonial letters from the prominent and educated among these men that he was a man of first standing and respectability as both a gentleman and a physician. By autumn of 1819, on the eve of his thirty-fourth birthday, he set down one dollar and ten cents postage to submit his case to Washington City in support of his appointment as surgeon in the Surgeon's Corps of the United States Army. Then he waited.

  Four months later, as Beaumont was patiently courting Deborah, Surgeon General Lovell wrote with the offer of a commission at Fort Hill on Mackinac Island in the Northern territories, not as a surgeon but as an assistant surgeon. Beaumont would have rejected it outright, for he was adamant that the commission he deserved was as a surgeon, but in his circumstances, he had no position against which to negotiate.

  He explained his plans to Deborah one evening as they sat in the parlor of her father's inn.

  “It's an opportunity for both of us. An opportunity to leave here and start again, together, as man and wife. The economic conditions are simply too harsh here, but I truly do believe in the future. At a garrison such as Mackinac I shall be the only physician, and that means we will have the income from not only my military work but also my work as physician to the residents and the American Fur Company. And the Indian office will surely want the Indians vaccinated against the pox. It will be remote, but it will be lucrative. And in time, as I accrue money and seniority and a reputation, we'll leave there, perhaps to return here. Return promoted to surgeon. Surgeon William Beaumont.”

  UPON HIS ARRIVAL IN MACKINAC, he set out to make himself a better man. At the end of each day, he whittled the tip of his carbon pencil fine and took up his virtue diary and recorded that day's tally of transgressions against the week's selected virtue and the preceding week's virtues as well. He had laid out the pages just as Dr. Benjamin Franklin prescribed in his Autobiography's project for attaining moral perfection. A page for each of the thirteen virtues ruled with seven columns in red ink, one for each day of the week, and thirteen red-lined rows, one row a week. As Dr. Franklin instructed, Beaumont gave one week of strict attention to each of the virtues, beginning with Temperance and concluding with Humility. Thirteen weeks for thirteen virtues described precisely four cycles per year. Beaumont had timed his cycles to fit with the seasons, for he well knew how certain seasons tempted particular transgressions.

  Franklin ordered these virtues with the logic that the prior acquisition of some might facilitate the subsequent acquisition of others. Temperance was first, as it procured a coolness and clarity of head so necessary when, as a physician, constant vigilance was to be kept up. This acquired, Silence would be easier. And so on through Order, then Resolution, followed by Frugality and Industry, making Sincerity, Justice and Moderation easier, and concluding with Cleanliness, Tranquility, Chastity and finally, though Beaumont thought somewhat oddly, Humility.

  Beaumont deemed the Autobiography required reading for all American men, especially one such as him, a Connecticut farmer's son, who, like Franklin, was born into modest station and set out into the world with little or no fortune save his ambition. The Autobiography contained essential guidance for a man who intended to rise to even a moderate summit of his expectations.

  But by the winter of his first long and solitary year on the island, as he c
harted his way through his third cycle of the thirteen virtues, he found Franklin's ordering of the virtues not as evident as they once had seemed. Chastity and Cleanliness were facile, but between them Tranquility continued to score blotches, and imitating Jesus or Socrates in Humility seemed difficult when faced with the likes of Ramsay Crooks and Captain Pearce. And how was Socrates different from Plato? And how to be both Resolute and Silent? The great Dr. Franklin offered little guidance on how best to balance the claims of one virtue against another.

  IN THE SPRING OF HIS SECOND YEAR on Mackinac Island, after the thaw opened the harbor, he departed for Plattsburgh. Six weeks later, he returned with Deborah as his bride. She brought with her a few pieces of furniture and several crates of books and household goods. She ordered Rex out of the house and set up a semblance of a parlor in the one room that was neither bedroom nor kitchen. They had chairs and two tables, no couch, and just a single cabinet to display her books and the set and a half of blue-and-white china. Beside her husband's medical, history and travel books, his volumes of Shakespeare, she set out her favorite novels.

  “There simply isn't space for the rest,” she announced and directed him to store in the narrow attic space the balance of her books and her sheets of music, as there was no piano on the island.

  Beaumont kept at his virtue diary. He was keen to eliminate the continued blotches against Tranquility and Silence, but in time, Dr. Franklin's exercises were neglected. This was not from transgressions upon Industry. His work caring for the soldiers and the employees and families of the American Fur Company and vaccinating the Indians steadily increased.

  By winter, just after the New Year, Deborah showed signs of quickening. In June, just one week before the morning of the fur trapper's shooting at the company store, she labored four hours under Mrs. Farnham's care and gave birth to their first child, a girl they named Sarah.

  FOUR

  IT WASN'T UNTIL LATE IN THE AFTERNOON of the day of the shooting that Beaumont rested. He was famished. He desired nothing more than to return home to his wife and newborn daughter. The thought of them made him smile, but he felt an urgency to record his notes on the case of the young man they now called Alexis Samata.

  He made a quick lunch of sausage and black bread as he sat at his desk sketching the shape of the wound, taking care to indicate the dimensions of the aperture into the stomach. He blew away the bread crumbs and stared at that sketch. This would be the kind of case he would never forget, the kind of case to share with his colleagues. There was a knock at the door; chewing fast, he looked up.

  Elias Farnham stood at the doorway.

  “I think you should come see something, Doctor.”

  “What's the matter?”

  Elias grimaced. “I think it's best you see it with your own eyes, sir.”

  Beaumont followed Elias into the room where Alexis lay. “The lad was sleepin' like a babe until a few minutes past, and when he awoke, I took to feeding him wine mixed with vinegar and spring water. He takes it well enough, considering, but it's not staying in.”

  “Staying in? The wound's well dressed.”

  “Please, follow me, sir.”

  Beaumont sat upon a milking stool beside Elias. The enormity of the dilemma became evident. The little that Alexis drank did not remain in his stomach, but soaked out into the dressings and dribbled onto the bed.

  “You see there, sir, how it all comes out that end.”

  Beaumont recalled the mess of food at the site of the shooting.

  “What's wrong? Have I done something wrong?”

  Beaumont touched the damp dressing. “No. You haven't done anything wrong. Perhaps I have.” He began to explain the wound to Elias.

  When he finished, Elias stammered, “You mean, his stomach's tapped open like a barrel with a bunghole?”

  Beaumont nodded. “Yes. Give him some more please, Elias.”

  Beaumont gazed at the young man as he took another spoonful. A simple compress dressing was insufficient. To prevent this leakage, Beaumont knew he would have to plug the hole into the stomach with a carefully wrapped tight wad of lint, but while this treatment solved one problem, it would create another. When kept plugged, the hole could not heal closed. The stomach was one great fermenting vat. Even if Alexis survived the shooting, he would die of this hole and the leakage of its putrefaction onto the wounded tissues of his chest and lung.

  “Try your best to give him what he can take. Smaller spoonfuls and pace them out a bit.”

  He sat and watched the older man patiently feed the younger one. It would be a horrible death. Unlike a limb where Nature afforded a joint to separate the morbid part from the whole, this kind of wound was to the very core of a man. He could not definitively amputate the gangrenous part. He could only cut away more and still more dead tissue and hope the wound would heal before there was no more tissue to cut away.

  Perhaps, he thought, it would have been better to have left him at the storeroom, because when this man died, Pearce and Crooks would surely question whether the garrison needed a brash and disobedient assistant surgeon who made a show of trying to rescue a dying man. The precedent, William. The precedent. He thought of his sketch of the wound. Showing that to other surgeons would be perverse, an embarrassment even.

  A WIND TOOK UP, swooshing through the high pines, rattling the windows, and within minutes, a yellow flash of lightning was chased quickly by thunder.

  “Oh my, now here it comes,” muttered Elias. “I smelled it comin'.” He stepped out of the infirmary room. When he returned, he carried a set of pails and began to place them on the floor over his precisely set chalk marks.

  Within minutes, the hospital's roof rattled as if stones were being poured upon it, and drops began to fall into the buckets, at first singly like the slow beat of a drum but soon quickening to a regular flow. Farnham stood with his arms crossed upon his chest and admired the precision of his work.

  “Say then, Doctor, what would it take to get us a proper new roof? That patchwork the soldiers did the other week did nothing.” He motioned to a bucket, which was receiving a steady dribble of water. “You'd think with all the trading happening here they'd see to the funds for it.”

  “They?”

  “The company, sir. Ramsay Crooks and his people.”

  “The hospital belongs to the army, Elias. It's Captain Pearce's decision whether we have a new roof.”

  Farnham turned and busied himself with his buckets.

  “Their decision,” he spat. “With all due respect, I think that lad's better here than layin' upon some rickety cot in that rat trap Ramsay fancies a storeroom.”

  “I do too.” Beaumont used his fingers to comb back the hair that covered Alexis's eyes.

  “Crooks's not just cheap but damn ornery. Just look at how he bullied you in that store, going on even about the garden. And Captain Pearce, why he's no more than some boot licker.”

  Beaumont rose from his stool. “I won't disagree with you, but I'm sorry I snapped at you when I called you to my office to say we were to go back and get the lad. The way I see it, in this world, men like you and me are the underdogs in the bottom of the saw pit, always halfway to what we deserve.” He was looking over at Alexis. “Like this young fella.”

  “You did fine work today. You've got pluck. I've always admired that in ye, I have.”

  “I could use a bit of luck too. For him.” He surveyed the room. The water stains upon the ceiling and walls had obtained new dimensions.

  “I can keep that hole plugged, but with this dampness and the heat, I'd expect putrefaction will set into that wound by the morrow. We'll need to double our diligence with his dressing changes. Let me tend to some paperwork, but summon me promptly if he starts to turn for the worse.”

  The creak of hinges followed by the sound of wood slapping upon wood caused both men to turn as one. The door to the hospital opened, and a soldier in a rain-soaked oilskin slicker stepped into the room. He kicked the door shut with the
heel of his boot, and then he looked at Beaumont. His face was rain slicked, and the brim of his hat was floppy and dripping. The man made a quick two-fingered salute.

  “Doc Beaumont, sir, Captain Pearce sends me. Wants you up at his headquarters soon as you can muster ye'self.”

  BEAUMONT PAUSED AS he stepped out of the hospital. Drops of water gathered along the roofline, shimmered momentarily and then fell under their weight. He looked down at his boots and then at the rain-splattered mud. In just a few steps these boots would be mud coated to the ankles.

  In the middle distance along the beach at the base of the hill, the rain-soaked sand had turned a darker shade of sepia. The storm had stirred up knee-high waves. He watched men hurrying to secure two errant canoes. Several naked children, their wet bodies shiny like seals, played along the shoreline. Since the spring thaw, in the field before the beach, the Indians and voyageurs had set up a crowded village of dirty tents and lean-tos, some displaying the fluttering symbols of their brigades on poles. A black feather. A roram hat. A fleur de lis. From somewhere there came the sound of a flute.