Open Wound: The Tragic Obsession of Dr. William Beaumont

by Jason Karlawish

  Alexis stood, all the while gazing at the wound. His long greasy black hair hung about his face. He cupped his hands before it in anticipation of an efflux of gastric contents. Nothing came. He looked at his hands, looked at Beaumont, who gazed at the orifice that was no longer a simple orifice.

  “Oh, mon dieu.” Alexis crossed himself. “I'm cured. Dr. Beaumont, I am cured. You are my savior.” He began to weep.

  NINETEEN

  FOR WEEKS FOLLOWING HER DELIVERY, Deborah kept to bed. When she tried to walk, the throbbing pains in her swollen legs were so great that she moaned and shuffled back to bed. Beaumont wished to bleed her, but she demurred and only allowed him to wrap her calves with elastic dressings. She took her meals in bed, cradled the infant William and nursed him. Sarah lay beside her, gazing at her nursing infant brother.

  In the evenings, Beaumont listened to her stories of her childhood when she lived at her father's hotel and she and her sisters helped to care for their infant siblings. He listened as her voice thickened and slowed until sleep overcame her. He lay awake or sat in the chair as he rocked the infant, stroking his tiny back as he analyzed the development of the orifice's valvular flap.

  The event reminded him of patients who presented to his surgery with an ulcer the size of a half eagle dollar, an appendage swollen to twice its natural dimensions, or skin the color of a new race of men. When he asked these patients as plain and matter-of-fact as he could, when did this start, they hesitated, shrugged, they couldn't honestly say how long; just the other day they had noticed it.

  So it had been with the flap of gastric lining over the hole in Alexis's wound. When did it start? Perhaps it had slowly developed over the past weeks. The tissues of the wound were like the pattern of sand, stones and jetsam along the lakeshore, ever changing and, after the storm of an infection or a debridement, entirely rearranged. Now, there it was. A lid over the hole.

  That chance, rather than his careful observation, had revealed the flap's significance bothered Beaumont. This wound was not only Alexis's wound, but his as well. His side had the same puckered orifice, the same cicatricle swirl of scar tissue that he had come to accept as simply a natural part of him. This fold of tissue the size of his thumbnail changed everything. The tissues still needed to be observed, the flap could change, but the need to dress the wound daily with a tight compress was gone. Alexis was, in a manner of speaking, cured.

  BY THE END OF JANUARY, the thin skin of Deborah's eyelids had wrinkled and darkened to the color of buff kid leather, the hair about her temples had thinned, and dry gray strands were visible amid her auburn hair. The bones of her feet were once again visible, and she could wear her shoes without pain.

  At Fort Hill, weeks living in close quarters and days so cold the piss in the tin pots outside the laundry froze solid began to affect the soldiers' health. The count of men on the sick roll grew. Men came on, came off it, and some returned sicker than when the fever had first struck them. Some of the men developed a high fever with soaking sweats and rattling in the chest, with phlegm the color of rust. These Beaumont treated with the lancet and blistering clysters over the congested region.

  One evening, Beaumont returned early from the hospital. Deborah was cooking a joint of beef over a low kitchen fire, the fat dripping and flaming. Sarah was stacking wooden blocks on the hearth. Alexis was out. Beaumont sat with his legs stretched out so that his stocking feet warmed, his boots upright beside them.

  Deborah sat beside her husband. “You look tired.”

  He gazed into the fire. “Well as common. Where's Alexis?”

  “I let him go after his afternoon chores. Did you see him at the fort?”

  “Saw him about the company warehouses earlier today, tossing snow-balls with some of the clerks. How's he here with you?”

  She shrugged. “Fine. He does his chores, and then he's off and back more or less when he promises. Red nosed sometimes, but he's back. I suppose he prepares us for life with a son.”

  Beaumont shook his head slowly. “Not that lad. You don't read to him anymore, do you?”

  She shook her head. “Not since the time of my confinement. With Sarah wanting attention and walking it was hard.”

  “I remember when Sally Thompson and you read to him in the hospital from the children's primer. Does he read? That Bible he keeps? Crooks's gift, if you can fathom that.”

  She shook her head. “He's not literate. I think he just keeps it, like a kind of treasure. Our experiment in moral improvement seems a failure.”

  “That's what Ramsay says.”

  The two of them gazed at the cooking beef.

  “How is he?” she asked. “You're not so intent on checking the wound twice a day.”

  Beaumont took up one of his boots, inspected an imperfection in its stitching and then began to slip it on. “He's doing well. The wound's formed a sort of flap over the hole. It's a tiny bit of tissue, and that works well to seal the thing closed. Well enough that he no longer needs the compress dressing.”

  She set down her fork. “You mean he's healed?”

  “In a manner of speaking, I suppose, yes.”

  “William, that's wonderful. You must be so proud.”

  “Proud?”

  “You healed him. It's been what, nearly two years, and now he's as he was before the injury.”

  “Not at all as he was. That hole still remains.”

  “That explains so why he's so changed in his countenance and manner. He's like a boy again. Sometimes, I hear him singing hymns.”

  Beaumont took a pewter cup from a peg, stepped over to a short barrel of cider and poured out a cup to warm beside the fire. “It's simply a clever fold of gastric tissue that Nature managed upon its own.”

  Deborah stepped closer to her husband. “But you did it. Nature takes nurture, and you provided that. What will happen to him now?”

  “What will happen?”

  “He's healed, has he not?”

  “It's only a valve, not a seal. Though I don't need to bind the wound closed with that complicated dressing, with minimal effort I can still gain access into the cavity. He can get up and walk about and do his chores.”

  Deborah was confused. “But why would he?”

  “Why would he get up?”

  “Why would he stay here? He's a fur trapper. I'd expect he'd want to be rid of this place the moment the ice clears.”

  “Has he spoken of this to you?”

  “The wound?”

  “No. Leaving in the spring.”

  “Of course not, William. William, what's the matter? What's wrong?”

  “He may no longer need the compress and in a sense is healed, but let's not go calling a man with a persistent fistula into his stomach cured simply because he does not need a compress dressing to close it.”

  “William, you needn't raise your voice.”

  “I'm not raising my voice.”

  “You are.”

  He closed his eyes. How to be Resolute and yet Tranquil? When he spoke it was near a whisper. “His fistula remains, and I can't predict what shape it may take in the coming months. As long as I can gain access into his stomach, I have every intention of continuing my study. He may wish to leave, but he mustn't. I need him. We need him. By Heaven, I was the one who nursed him from the brink of death, who changed his dressing twice a day, who took him in and assumed all costs of his care when the leaders of this town saw fit to cast him away in a boat. I know precisely the fate of such men. I saw it in the war.”

  Deborah regarded her husband, and he her. He reached for his mug but then drew back. His hand was trembling. “Forgive me for raising my voice.”

  She swallowed hard. “Of course. Of course I do.”

  “You must know that Alexis is more than a singular case. Much more. The entire process of human digestion is here before me to be observed, studied and experimented upon. This is a once-in-a-lifetime opportunity. Sometimes I think to myself that it's like the land out west. If I don't c
laim it, someone else surely will. Should I just let him go, the first doctor who has a bit of common sense will see what opportunity lies in the study of him.

  “Here on this island is the greatest opportunity to study the process of human digestion. I can't just let him leave and end up with another physician. I've told you before, most surely I'll hear that physician's laughter clear across the country at the folly of the man who sent this prize off in a bateau.”

  “William, what is it that you propose?”

  “I don't know, Deborah. I do know there is an opportunity here that I cannot ignore. I need time to think about what to do. How to do it. When he lies on his side I can look directly into the cavity and almost see the process of digestion. I've suspended flesh into it, raw meat, and seen it dissolve. It takes near thirty minutes for raw beef. Deborah, I've seen things no other physician has seen. I've seen wonderful things. Don't you see?”

  “You're a physician, William.”

  “I know what I am.”

  “You're physician to the garrison and borough of Mackinac. You're continually pressed with work. How then can you propose to study this man and his stomach?”

  “There will be time, there will be time. I beg you, Deborah, just to give me time. I've sent a letter to Dr. Lovell presenting the case and the proposal to perform experiments.”

  “What did you propose?”

  “Deborah, when it is done . . . ”

  “When what is done? What?”

  “When my study of digestion is done, I shall have knowledge that will change the field of medicine. You see how the men eat and drink with intemperate dissipation unto dissolution, farced with crude food, coming about with moans and groans and all kinds of pains and lamentations. I will have the knowledge about how we digest what we eat. Not only the army will value such knowledge, but all people will. Everyone eats.

  “The results will be splendid. A book to sell thousands of copies. Here and in Europe. Akin to Franklin's Experiments and Observations on Electricity, but grander. Far grander. With that kind of recognition, the Griswold affair will be forgotten. I'd have my pick of posts. We could well be in St. Louis, or even Plattsburgh, well settled, and comfortable in our means. All I ask, Deborah, is your patience to keep the man here. I know it's a burden on you. On us. He's odd, to be sure, but it's a burden we share as we share its reward.

  “But what if he won't agree to this plan?”

  “I can't imagine Lovell would disagree.”

  “No, I meant Alexis. What if he won't agree?”

  “Why would he not? I've cared for him for more than a year and a half now. He owes his life to me. All I'm asking of him is a small measure of gratitude. He trusts me, and he needs me.”

  He hesitated.

  “Alexis is my hope. Our hope. Especially now, after the president's rebuke. I tell you, in time, his case shall be known the world over. What's happening now reminds me of my years as an apprentice to Chandler. And my years in the war. Some days were like years. At the end of a week, I'd look at my notebook and wonder who I was at the beginning of the week. That's how much I had learned. Do you believe me, do you trust me, Deborah?”

  She studied her husband. This manner of conversation, her honest plea and his answer, it had occurred only once before, and that man had betrayed her. Now, sitting in the kitchen of her small house, she realized that the moment to change things had already passed. She told her husband she trusted him. She had no choice. She was bound to his choice.

  They embraced.

  “Trust me, Debbie. My father left me only debts. I intend to leave my family wealth. Someday we shall have a grand house of our own. Someday we shall have all the things we desire. Like the Crookses.”

  TWENTY

  WINTER EXHAUSTED HIM. Both its labors and its loneliness. Some days he dreamed of the book about digestion; others, he dreaded the project. He kept to his notebooks, jotting notes and ideas, rereading past entries. “Tended to a young voyageur at the company's store. Shot into his left lower chest. Accident. Wound engages both lung & stomach, likely mortal.” He understood why some men drank to forget.

  By April, the ice began to melt enough that it was no longer safe to ice fish and, after a week so warm that men were in shirtsleeves by noon, boats began to appear in the harbor, at first singly, but soon in groups of travelers. The first of the camps was set up along the beachfront. Daily, Beaumont watched this thaw; daily he saw Alexis strengthened. His time was running out.

  One evening when Beaumont was walking back from the hospital, he spied two men standing atop the hillside. They waved him over.

  It was Ramsay Crooks and Theodore Mathews.

  “We've been star gazing, William,” Mathews said.

  “There it is.” Crooks pointed. “Look, look there, gentlemen.”

  The three men stood in a line and watched the path of one and then another falling star.

  “That's the seventh one this evening,” Crooks explained. “It's been going on all week. Last night I saw three at one time. Has it never occurred to you gentlemen that we ought to be astronomers? That science came from wanderers and traders in the open spaces such as these?”

  Mathews and Beaumont were equally entranced by the celestial show. They nodded in agreement.

  “You fancy yourself an astronomer now, Ramsay?” Beaumont said.

  “I tell you, William, I slept beneath these heavens for many nights when I was a younger man running furs for Mr. Astor. Hundreds. Perhaps a thousand. And only in these last few months have I thought of them anew. Look at what's about us. There are facts everywhere to be had. It was just the other day a question came to me. Although the Book of Genesis maintains that the stars are all set in the firmament to give light upon the earth, is it credible that the scheme of creation, with all its wondrous economy, should include globes far vaster than our own earth but destitute of life?”

  Mathews spoke. “Those immense spheres are necessary conditions for the essential motions of the earth. Besides, their creation cost but the word of the omnipotent. Small price, I'd reckon.”

  “That's some strange currency you posit, Teddy. How, with the innumerable other suns and systems disposed irregularly at a distance, how is it that those stars give us no light and yet can still be the Creator's handiwork? Is the Creator wasteful with his handiwork? There must be others like us. How say you, Doctor?”

  Beaumont chuckled. “A very great obstacle to science is an impatient proliferation of theory, leading to a hasty acceptance of dubious facts. Medicine's full of it, Ramsay.”

  “You think I play with theory?”

  “Not at all, Ramsay. You're an empiricist if ever there was one.”

  Mathews spoke. “Mr. Crooks, you think there exist other planets with Christian men and the company?”

  Crooks turned to face Mathews. “God made the Indian, did he not? He who smears himself with mud, cuts himself for penance and sees a deity in every plant, tree and stone. Those little brown ones your wife tries to teach to read. Give our Lord full faith and credit as a creator, Teddy. It took us how many centuries to be here as we are, and how many shall it take the savage to become as we are? How long will it take for one of those little ones to become president?” Crooks pointed to the smear of stars. “Is there not room for another planet of savages?”

  Mathews smiled. “Tell that to the good reverend.”

  “Ah, science,” Crooks mused. “Other works of genius are scarcely recognized now. Poetry is as dead as astrology, as religion. It's all for the women.” He waved his right hand at the sky. “Names for each of these stars, their distances and positions, their intensities. The mind is over-powered in the attempt to amass such a vast storeroom of facts. A map for future travel to the next frontier. In these times, the deep searcher of the wonderful, of religion, the novelist, does not fear persecution, but rather neglect. He cannot interest the public. I tell this to my boys. This is the mechanical age. America is the country of the future, of beginnings, of pr
ojects, of vast designs and great expectations. The greatest triumphs of science are the most practical. This, gentlemen, is the age of steam.”

  They stood together, the three of them, for several minutes. Stars fell. The sound of a dog barking rose from the harbor, then ceased as abruptly as it had begun. Mathews shivered and tightened his coat collar.

  “Doctor, you know my Abigail is among those who disapprove of Alexis and your charity for him, but I've long meant to tell you I admire what you've done for him. Your patience and your industriousness to heal the young man and make him a better man are exemplary. I admire you for that.”

  Beaumont had lowered his head as he listened to Mathews. “Thank you, Theodore,” he said. “Such a sentiment fortifies my soul. I confess, it has been a rough winter.”