The Heart Specialist

by Claire Holden Rothman

  The next thing I knew he had disappeared and I was staring up at another face. A dark face, brown as coffee with hardly a drop of cream, with a moustache drooping from its upper lip. I lay perfectly still trying to make sense of this. A smell was in the air too, familiar, yet so distant I couldn’t immediately place it. Spice and chocolate together but with an underlayer of bitterness. I tried to lever myself up and immediately collapsed.

  Howlett helped me lower myself flat. “She’s come around,” he said and it was as sobering a stimulant as smelling salts. The room stopped spinning. I stared into his eyes and felt the full weight of my mortification.

  I had swooned like a girl in a fairy tale, gone down right at Dr. Howlett’s fashionably shod feet. What would he think? I had so wanted to impress him, to show him my hard-won toughness and strength. My awareness gradually expanded to include whisperings in the air around me and a number of blurry faces.

  “Hand me her glasses.” This was Howlett again. The frames were placed on my nose and hooked gently behind each of my ears.

  I was startled. Nurses, doctors, students, even patients in their nightshirts had formed a ring around me and were peering anxiously down. I tried to protest, waving my left hand for emphasis, but it didn’t seem to belong to me anymore. The sight was awful. My ring finger was a pulpy mess. Blood was dripping on the floor, on my coat and on the fabric of my dress. And yet I felt nothing. I was looking at someone else’s wound.

  Howlett took the hand and placed it gently on my stomach. “Turn your head or we’ll lose you again,” he said gently. “It appears a lot worse than it is, just needs a bit of antiseptic. You’ll be on your feet in no time.” He motioned to someone behind me and the young man who had cried out prior to the accident stepped forward.

  “I tried to warn her,” he said in his squeaky voice. His eyes darted everywhere, avoiding my face.

  “Couldn’t be helped, Rivers. You did your best.” Howlett hadn’t flinched at the voice so perhaps it was always like this. He turned from the young man and addressed me. “Dr. Rivers is an expert in first aid. He’ll tend to you. If you’re up for it he’ll also give you the royal tour. What do you say?”

  My finger was throbbing. I couldn’t tell by looking at it whether or not I’d lost the tip.

  The accident gained me admission into the pathology department. I glanced gratefully at the young man named Rivers. He seemed not at all pleased, however, and it went beyond guilt over the door slamming. The corners of his mouth were pulled down in a pout.

  Howlett spoke again, offering me an invitation to dine with him that evening at his home. It was the least he could do, he said, to compensate for my pain and suffering. He wouldn’t want me to leave Baltimore with only negative memories of my visit. I was dazed, I barely managed to stutter a thank you.

  Howlett dusted off his pants and retrieved his walking stick. “Ladies and gentlemen,” he said, addressing the crowd still milling about the hall, “the show is over. This young woman has had the intelligence to injure herself in one of the best medical facilities in the world. She will be well-attended, of that you can rest assured. Now go back to your stations and your studies.” He made a shooing motion and disappeared into his office.

  Only the man with the squeaky voice and I were left in an otherwise empty corridor. He dispatched a nurse to fetch disinfectant and gauze, and while waiting for these materials chatted with me, trying to put me at my ease. He turned out to be nicer than he had initially appeared. He became almost garrulous, and the way he held my damaged hand was confident and gentle. It turned out he was a Canadian born in Ontario. His medical degree was from Toronto, where he’d been a gold medalist but where the education, he confessed, had been second-rate, nothing like what he was now experiencing at Hopkins. He’d been down here for a year, working with Howlett as a resident in pathology.

  When he talked about Howlett his eyes changed. One moment they were the dull brown of tree bark, the next they ignited and blazed. He didn’t look at me when he spoke but fixed his gaze somewhere over my left shoulder. I kept turning, expecting to find someone behind me, but all I saw were hospital walls. His voice changed too. In his excitement he spoke more breathlessly. Every two or three words he wheezed, as if his mouth couldn’t keep up with his multitude of thoughts. At one point, after a particularly eloquent bit of praise, he doubled over, gasping.

  He had been holding my hand when it happened. We were still in the hospital corridor. I was lying on the floor, knees up in case of a faint and he had just bound me with gauze and tape provided by the nurse when suddenly he lurched away, struggling for air. Once I had seen an infant die of this — the inability to draw sufficient oxygen into the lungs — but it was rare in a grown man. Then, as suddenly as it had flared, the attack ended and Dugald Rivers collapsed into a chair. “Sorry about that,” he said. “It’s probably the tree pollen. I guess we’re both hard on our health today.”

  Minutes later he was back at my side, tying one last knot at the base of my finger so the bandage wouldn’t slip. “All done,” he said, his voice cracking on the second word. “You look like a soldier with that thing. It’ll make a marvellous conversation piece tonight.”

  I laughed. I had managed to sit up and my head had stopped spinning. I was getting used to Rivers’s voice, but it was embarrassing to have seen him in such weakness. To break the tension I raised my finger, which was longer than usual because of the splint and bandages, and aimed at him. He smiled, lifting his hands like a prisoner.

  Clearly Dugald Rivers was in Howlett’s thrall. Equally clearly he was not alone. We were members of a large club. To have been singled out by the great man and invited home for dinner was an honour many coveted. But how would I manage? Almost every item of clothing I had brought with me was stained or dirty. I wouldn’t be able to wash things in time, especially with only one hand free for scrubbing. I had a clean dress in my closet at the hotel, but what about shoes? And my satchel was ruined. “I must look shocking,” I said gazing down. I was covered in drying blood.

  Rivers smiled. “I have seen far worse. You are speaking to a doctor, don’t forget.”

  His words were hardly a comfort.

  “The chief won’t mind,” he assured me. On a couple of occasions during the tour people had addressed Howlett as Chief. “He’s a medical man too. And you can count on Mrs. Chief to act proper.”

  I peered at him. “Mrs. Chief?”

  Rivers nodded. “Kitty Revere Howlett. The wife.”

  So there was a wife. I should have expected it with a man as successful as Howlett, but for some reason I hadn’t considered this possibility.

  “She’s not bad,” Rivers said amicably, “If you ignore her obsession with dolls.”

  “Dolls?” I repeated, thinking I’d heard wrong.

  “Their house is crammed with them. On the plus side she doesn’t stick around long. As soon as the meal is done she’s off. Can’t abide medical talk.”

  I nodded and glanced surreptitiously at my bag. I would bring it along tonight but make sure to keep it out of Mrs. Chief’s sight.

  “The kid is sweet. Spitting image of his old man.” Rivers paused and took a breath. “I don’t know why I’m telling you this,” he said, “except perhaps that you are lucky. This,” he said, pointing at my finger, “is a hidden blessing. You can thank as well as curse me for swinging that door on you. The Chief hasn’t had a dinner in weeks and we’re all a little hungry.”

  So dinners with Howlett were a regular thing. It turned out he was in the habit of inviting the entire crew of clerks in on Saturday nights. “He’s like a father to us,” Rivers said, his breath shortening again and his voice breaking awkwardly.

  It was time to change the subject, to divert poor old Rivers for his own good. I began questioning him about Johns Hopkins and his research work, but no matter how I tried to push the conversation in other directions it kept returning to the great man, Howlett.

  “You’ll see the house tonig
ht,” Rivers said breathlessly. “It means the world to us, you know, shut up in our dorms for months on end. He’s the only one on faculty who does it. The rest dig under their rocks for the weekend, but not Dr. Howlett. He gives of himself …” The following words were lost as Rivers doubled over in a fit of coughing.

  12

  MAY 1899

  Number One West Franklin had a wide lawn and a cobbled, curled driveway. It was not far from my hotel so I had come by foot in shoes wet from scrubbing. I had changed my dress but was still carrying the blood-stained satchel.

  The royal tour with Dugald Rivers had lasted longer than anticipated. He took me to his laboratory and showed me the project on which he was working. In turn I revealed the heart.

  “Phenomenal!” he cried after staring at it dumbstruck for a full minute. “An aberration of nature.” He’d done nearly a hundred autopsies so far but never had he laid eyes on anything so singular. “Why are you carting it around with you if you don’t mind my asking?”

  I had been asking myself the same question. But when it popped so impetuously out of his mouth I laughed and sat down on one of his lab stools. “I thought I would show it to Dr. Howlett.” He nodded as if this were perfectly logical.

  Before moving to the States Howlett had taught at McGill, I explained. He was from Canada originally. While at McGill he had been in the habit of using specimens from the pathology museum as teaching aids during his lectures. I was hoping he might know the origins of this aberrant heart. He might have autopsied it himself. It had come to me without a correct label or record and I was anxious to learn its history.

  Rivers was nearly as intrigued as I and urged me to bring it to the house that night. “You must present it to him, Dr. White. Absolutely. It’s the type of thing he loves. A young lady touting a heart in her bag all the way from Canada. It’s rich, Dr. White. Truly rich.”

  As wonderful as Rivers’s company had been, I now wished I’d cut the visit short. I was late getting back to my hotel, late arranging for my clothes and shoes to be cleaned, late attempting to scrub my satchel in the tiny hotel wash bowl, late obtaining directions to the Howlett house, and late leaving for dinner. I’d had to hurry a good part of the way and was now flushed and sweating.

  I gazed up at the facade of the house. I had exactly five minutes in which to cool off and have a look around. The street was quiet. The sun was still high, although a hint of evening’s dampness had crept into the air. The neighbourhood children must all be inside now, taking their baths or eating supper with their nannies. This part of Baltimore had a solid look to it. Men with respectable jobs lived here along with their respectable wives and children. They hired people to care for the lawns and hedges and regular painting of their porches.

  Howlett’s house was number one and the street bore the name of one of America’s most illustrious historical figures. Everything about it was of a piece. It was an impressive structure of red brick with white trim around the windows and doors. The veranda was green with white verticals between each step. A picket fence surrounded a substantial, well-tended lawn. Beside the gate was a mailbox emblazoned with the name Dr. William E. Howlett.

  I looked at my shoes, which squeaked damply with each step. My reticule had a dark, ugly stain down the middle. I did not belong here. A house such as this would not tolerate a marginal soul like me, living alone without husband or child, working to support myself, and proving dangerously prone to accidents.

  Before my hand touched the knocker the door opened and a man pronounced my name. He was dark skinned as every servant in Baltimore seemed to be and did not lift his eyes to look at me. He took my coat and tried to take the satchel, ignoring the stain with great tact. I shook my head and pulled the bag close.

  As I peered into the vestibule mirror to check my hair I had the strongest sensation of being watched. It wasn’t the manservant. It had to be someone else. The mirror was positioned in such a way that I could see most of the hallway and a bit of red caught my eye. A child with a red shirt and a holster slung around his waist peered around a doorway. He held a toy rifle in a tight grip, aiming it right at me. Our eyes met for a second, he grimaced and slipped back into hiding.

  Without pausing I raised my bandage to my nose and took aim. “Bang,” I said loudly, alarming the poor servant if not the boy. “Bang, bang, bang.” I could see him now. He poked his head out again and was fixing me with gleaming eyes. I focused on my finger, blowing the tip as if it were smoking. The boy gazed in wonder. So did the servant, whose eyes had risen to meet mine. In Baltimore, evidently, women did not pack pistols when invited to dine.

  I was led up a curving staircase to the study where Dr. Howlett was waiting. No one seemed to be about. I could smell dinner cooking, which suggested there must be human life somewhere not too far off but I saw no one.

  Halfway up the stairs was a landing with a window cross-hatched in lead. On the sill stood three large dolls, leaning together as if gossiping: Kitty’s collection. It was just as Dugald Rivers had warned. These were made of beeswax as Laure’s dolls had been. Kitty had taken pains with the costumes, which were both intricate and colourful. White gloves hid their hands and one of them had a fan covering her mouth.

  In an alcove on the second floor were two more whey-faced dolls and a vase of freshly cut daffodils. A woman’s touch. The pale pink runner and flowery wallpaper also must have originated from a woman’s design. My hand closed a little more tightly around the handle of my satchel. What had I been thinking, a pickled heart in this place?

  The servant made a noise in his throat to get my attention. He obviously did not appreciate the way I was looking with such curiosity at all the details of the Howlett home. He wanted to deliver me to the master and be done with it.

  As I started walking again I smelled smoke. The end of the second-floor hall was pungent with it. I didn’t really need to be shown the way after all. All I needed was to follow my nose to the closed door, which was the source of the smell. I stood on the threshold breathing in the pepper-sweet scent of pipe tobacco.

  There was a rustling inside the room after the servant knocked. I could hear someone rising. “Enter, my dear. Enter,” said Dr. Howlett, opening it wide. His scalp shone through thinning hair in the bright light from overhead. He looked more his age without the hat he had worn that morning. Was it vanity that had kept it on his head in public? His moustache was practically white in places, a detail I had failed to notice before. His eyes, however, were unchanged. They still danced playfully, giving him a youthful air. He dismissed the servant and turned to me, smiling warmly. “Was I hard to find?”

  I shook my head. My hotel was only five blocks away, I told him. A succession of platitudes then jumped from my mouth like dry little toads. The house was lovely. The neighbourhood grand. What a perfect day it had been for a walk! I snapped my mouth shut in dismay.

  He seemed to take in everything, starting with the nun-like charcoal habit I had put on at the hotel, thinking it looked dignified, going next to the now-grimy bandage swaddling my hand and settling finally on my sweaty face. With my good hand I clutched the satchel closer.

  “Honoré’s,” he said quietly.

  I stared into his eyes and to my complete mortification burst into tears. It was horrible. I had wanted so much to be strong, to show him the mettle of which I was made, and instead I’d burst out crying. Howlett had every right to dismiss me. Instead he came around the desk and offered me a handkerchief. He didn’t touch me, probably because we were alone and the situation awkward, but I could feel the heat of him as he bent over me. He sat me down then fetched another chair and joined me. “Your father used to carry that to our lectures,” he said, his voice reverent and sombre.

  A fresh wave of tears rose in me. All the resentment I’d felt toward him for his role in barring me from McGill evaporated, insubstantial mist in the morning sun of his attention. It was too strange to hear someone speak of my father without rancour or shame. I bit the inside
s of my cheeks but this only served to increase my anguish. What must he be thinking? I must have seemed horribly weak.

  When he next addressed me, however, his voice was kind. “You loved him, didn’t you? It was easy to love Honoré.”

  He talked for a while about how my father had been his mentor and how he’d respected him almost to the point of worship. “It’s because of him I started smoking, you know,” he said, holding out his pipe. “We used to go at it like chimneys in the Dead House to mask the smell.” That gave me a start and I wondered about his moustache. Perhaps it too had been inspired by my father. It took some doing to imagine William Howlett, the object of admiration to so many of his own students, holding my own fallen father in awe.

  He inhaled deeply. “Enough about him, Agnès,” he said, pronouncing my name as my father had. “You must tell me about yourself.”

  It was too much. My head felt like a pumpkin, the brain scooped out and tossed away. If I could have fled I would have, but I was stuck there, mesmerized by his gaze. I looked down at his ink blotter and its wormy blue patterns. I studied the shelves behind him sagging with books: Virchow’s Cellular Pathology, Bigelow’s Discourse on Self-Limited Diseases. I spotted the textbook he had authored, his name shining in gold print on the spine.

  His hands were folded in his lap. After a few more seconds he said something to fill me with gratitude. “You are stronger than you look. You persisted.” He paused and puffed on his pipe, watching the smoke dissipate with such concentration he seemed to forget all about me.

  I began to speak. It was easier now he wasn’t looking. I opened my mouth and out my story poured; it had been there through the difficult years of my young womanhood, waiting for me to remove the cork. I told about my disappointment over McGill. How that had been the absolute lowest point of my entire life. I did not enter into details, my breakdown and months in bed. I was ashamed of this and didn’t wish to seem bitter or rancorous. He was unembarrassed about McGill, accepting the account of my hardships quite neutrally. At times he hardly seemed to be listening, which helped me get through my narrative. I recounted how I had ended up at Bishop’s Medical School through the intervention of a kind friend with connections. The friend was, of course, my former governess, but this fact I did not disclose. I told him about my work as an intern at the Montreal General Hospital and then my travels to Zurich and Vienna, where I’d laboured in some of the best university laboratories in the world. I larded my account with the names of prominent physicians. I had studied with the pathologists Kolisko and Albrecht and with Ortner in internal medicine.