The Heart Specialist

by Claire Holden Rothman

  “Well,” I said, breaking the silence. There was an irony to this situation, I had to admit. For months I had been pestering Clarke for an assistant but I had imagined someone entirely different from this morose, peculiar boy. I also remembered my own hiring and the way it had been announced to Dr. Mastro. The dean seemed to take pleasure in throwing together people who were clearly incompatible.

  “He comes highly recommended,” Clarke told me. “He’s medically trained.”

  A muffled snort came from the trio at the table. In my shock I had forgotten them. Falconbridge was pretending unconvincingly to blow his nose into a hanky.

  “Well,” said the dean, echoing the only word I had been able to utter. It was a word of so many possible meanings that in the end it meant nothing. It was noise, that was all, in this case intended to cover feeling. Wells were for drawing water. Wells were for wishing. I smiled bitterly. Dr. Clarke had granted my wish.

  He cleared his throat. “I’ll leave you to your work, Agnes. Mr. Hertzlich has papers to sign in my office.”

  I sat down rather heavily in my chair when they left. Dr. Clarke tended to present matters this way. It had the virtue of avoiding arguments so common among academics but it also made people angry. I thought again of Mastro. Our relationship had improved recently, much to my surprise. After Grandmother died he had come to my office to offer condolences. More astonishingly he had commended my work with his students. Apparently the class average in physiology had risen that year, which he attributed in large part to my tea-party tutorials. He had spoken with the dean and insisted the tutorials be included officially in the curriculum for the following year. Thanks to him I had climbed to the ranks of a sessional lecturer.

  My interactions with Dr. Mastro might be improved but I doubted there was hope for this lad in an ill-fitting suit.

  “He’s a Jew, Miss,” Hornby whispered.

  “Don’t be small-minded, Horn,” said Falconbridge, suddenly alert. “What you really ought to know, Miss, is that he’s loony.”

  The other two burst out laughing.

  “You know him?”

  “Never laid eyes on him,” Falconbridge said. “But I’ve heard of him. He’s a legend.”

  Jakob Hertzlich had apparently been a prodigy in the class from several years earlier. He won every prize in his year. Then, in the middle of his training, without word or warning he disappeared. Rumour had it he was institutionalized. The faculty had driven him stark raving mad. Boyish laughter followed the telling of this tale.

  “Sorry to be the bearer of bad news,” said Falconbridge, puffed up with pleasure, gathering his books.

  I shrugged, unable to hide my impatience with these students, not one of them capable of writing their final exam, let alone winning a prize.

  “Good luck with the loony,” Falconbridge said before slipping out the door. His laughter resonated in the hallway.

  Luck, I thought. Yes. I had been rather short of it lately. I rose from my chair and walked to the window. The air smelled fresh and full of promise. I could not believe what Dr. Clarke had done, what thought process had led him to deliver young Hertzlich to me. I had told the dean about Laure. Had it been anyone other than Dr. Clarke I would have called this act sadistic. He’d felt sorry. That must be the explanation. Jakob Hertzlich was a misfit, a Jew, and a cut above most people in intelligence, just the sort of individual Dr. Clarke was in the habit of collecting. I had been a beneficiary of the dean’s compassion. Why not this singular boy?

  Because it affected me! Because I had quite enough lunacy on my hands at the moment without having to endure it in my place of work. The museum was my refuge. At home I was managing, but just barely. I had thought Samuel Clarke astute enough to understand my situation.

  I had installed Laure at the Priory where she felt safe and where Huntley wouldn’t interfere. Not that he was showing much desire in that regard. He seemed relieved to have Laure out of his hair. Miss Skerry had dropped a perfectly good job in the city to come back to St. Andrews East and care for her. Yet Laure was a trial; some days she was herself, others a complete stranger. Just last week she’d thrown a boiling kettle at Miss Skerry, who had had to call in neighbouring farm hands to subdue her.

  Here Dr. Clarke expected me to accept this boy with no facial expression and a total lack of grace into my life. What was I to do? A light rattling sound startled me and I whirled around to find the very boy of whom I had been thinking standing less than three feet away.

  “What are you doing?”

  He didn’t answer and stood with his head bowed. He fidgeted with his hands, working at his mysterious oval tin. At last he opened it and popped something in his mouth. He did not seem nervous. He sucked whatever it was he’d put in his mouth and gazed about in an odd, disconnected way. He might have been contented to stand there forever if I hadn’t interrupted.

  “What is that?”

  “What?” His voice was lower than I’d imagined, definitely not a boy’s.

  “The thing you just put in your mouth.”

  “Oh,” he said, extending the box to me. “Licorice bits. From Holland. Would you like one?”

  I took the tin and shook one into my palm. It was tiny and hard, tar black.

  “I’m trying to quit cigarettes. My mouth misses them.”

  “When do you start?” I asked neutrally as if we were talking about a job at the market and not a position in my museum.

  “Now.” He popped another licorice bit in his mouth.

  There was no way out of it. The licorice bit made me realize I was thirsty so I offered Jakob tea, which he accepted and then lingered over as if it were a special treat to be savoured.

  When I had recovered my spirits I assigned him a task. Nothing difficult: sorting work to start with. I’d test him over the next few days, I decided, build up the challenge in increments. If he slipped up even a little, even once, the dean would hear about it. Looney was one thing. Incompetence I would not tolerate.

  After an hour or so he walked over to where I was sitting. He’d been so quiet in his corner I’d actually begun to get work done myself. “Finished already?” I asked, knowing this couldn’t be the case.

  He shook his head. “I’ve noticed something.”

  His bluntness was sweet but unnerving. He was looking at the wall. “Over there.”

  I looked too. His gaze was directed at a labelled drawing of a heart I had tacked up to hide a crack in the plaster. I’d never been fond of it. The aorta, pulmonary artery, atria and ventricles were painted a garish petunia pink.

  “It’s wrong,” he said simply.

  “Excuse me?”

  With hands plunged into his pockets he now looked like a professor about to expound. “I was a student here once,” he told me. “I know that poster and it’s always bothered me. In my day it used to hang in the library.”

  “The colours are dreadful,” I agreed in an effort to sympathize.

  “It’s not the colours, even though it is a crime to put that pink next to the green veins.”

  I laughed. Jakob Hertzlich had a sense of humour.

  “It’s worse than that. Look at the pulmonary artery.”

  I squinted.

  “Not only was the artist colour-blind, he was standing on his head.”

  Sure enough. The thoracic aorta was where the pulmonary artery should have been. I looked back at him in wonder. How many months had I worked in the museum beneath this poster and failed to notice the glaring error? The illustrator wasn’t the only one with eye problems.

  16

  SEPTEMBER 1900

  That autumn, just as the new term was starting at McGill, I bumped into Dr. Rivers outside the professors’ lounge in the medical faculty. He’d won a fellowship in pathology, which allowed him to teach at McGill and work at the Montreal General Hospital. His bearing was even more military than the last time we’d met. His hair was shorn right to the scalp and his shoulders, surprisingly narrow in a man so tall, were ram
rod straight. He had just come from a year fighting the Boers with the D Battery of the Canadian Field Artillery, he told me in his funny, high-pitched voice.

  I had read about the Boer War in the newspapers and about protests among French students across Montreal. I had to confess that my sympathies were with the protesters. What did Britain think it was doing, sticking its nose into the affairs of a country as far away as South Africa? Why was it recruiting Canadians such as Dugald Rivers to risk their lives on such distant soil? Rivers saw no problem with it. When he announced his rank it was a boast, although I hadn’t the foggiest notion of what it meant. “Battery” sounded violent and “field” made me think of the farms around St. Andrews East. I cut short the soldier talk and invited him to tea. He was welcome at the museum any day of the week, I said, any hour. “Please send what specimens you can from the Dead House. Keep an eye out for me.”

  Dr. Rivers’s first visit came at the end of September, a particularly warm day, which made everyone forget winter was about to descend. I opened the upper half of the big window in the museum and sunshine poured in, turning the interior a dusky gold. Pigeons cooed from their perches beneath the eaves. Rivers showed up with a pastry box in one hand and a pail in the other. He stepped over my threshold and then took a step back when Jakob and I turned, realizing he hadn’t yet been invited inside. I rose immediately to welcome him.

  He stood in my doorway, illuminated by golden light. With his cropped hair and eager smile he didn’t look at all like a distinguished pathology fellow. When he’d first arrived he’d caused quite a stir with the nurses. His looks were undeniable — the chestnut hair and skin so wonderfully unblemished and pale. He held himself with authority, which women tend to like. But there was something lacking, I couldn’t help thinking. Looks weren’t what made me sit up and take notice when a man entered the room. It was something else, a kind of energy that even a short, ugly body might possess. Whatever this energy was Rivers didn’t seem to have it. I found I could be completely at ease with him. This may have been why, of all the women who flocked about him that first autumn in Montreal, I was the person he chose as a friend.

  “I brought you something,” he said, swinging his pail up on my desk.

  Jakob Hertzlich and I peered inside. A freshly excised heart was sloshing in its juices.

  “I’ve come from the Dead House,” Rivers said. “I figured the fastest way to get it here was by foot.”

  Jakob usually ignored strangers, continuing with his work when someone dropped by for a visit. Today, however, he made an exception. “You mean you walked like that from the hospital?” he said, much impressed. The Dead House was annexed to the Montreal General Hospital on Dorchester and St. Dominique Street, a good twenty minutes by foot.

  I began to laugh.

  “With one stop along the way,” said Rivers, lifting his pastry box.

  “You stopped to shop?” I asked. “And no one noticed the pail?”

  Rivers flashed a boyish grin. “One lady did. She mistook it for a beef heart though and gave me a recipe for entrail pie.”

  I laughed so hard my ribs ached. Jakob smiled. I poked a finger at the gift, which was very large and red. A grown man’s, given the size, neatly chiselled to show the lesion.

  “Atrial septal defect,” I observed. “A fine example.”

  Rivers accepted the compliment with grace. “I have the autopsy report and a patient history for you,” he said. “I thought it was an especially clean one. It’s a wonder he lived into his forties. I had no idea until a few days back when his pressure suddenly shot up.”

  “The atrial ones can be sneaky,” I said, nodding. “It’s the pressure that usually gives them away. The ventricular ones you can tell right off because of the murmur.”

  “How right you are.”

  It was my turn to show grace. “Enough to predict that this one will soon smell if we don’t get to work. You’ll excuse Jakob if he tends to it before tea? Thank you, Dugald.”

  The new fellow was surprised and visibly gratified when I pronounced his name. First names were my custom in the museum. I was Agnes, Jakob was Jakob, and now Rivers would be Dugald. Poor man. Patronymics were the only thing allowed in the Army and as a general rule hospitals were not less formal than military barracks.

  I handed the pail to Jakob. Over the months I had come to trust him and was now convinced that he could do any job in the museum as competently as I. He was intelligent, hard-working, and had proven to be a brilliant choice on Dr. Clarke’s part.

  When I returned to Dugald’s side he was examining the wall. “Nice likeness,” he said, pointing at a poster Jakob had brought in not long after he’d started working for me. It was a pen-and-ink drawing on bristol board, lightly coloured with water wash, depicting three hearts from various angles. The component parts were meticulously labelled.

  “My assistant’s work,” I told him.

  Dugald Rivers’s head bobbed in surprise. “Him?” he whispered, turning to the corner of the room where my unimposing helper was rinsing our newest specimen. “That person?”

  I nodded.

  “He’s talented.”

  It was one of the many surprising facts I’d learned about Jakob Hertzlich over the months of our association. He was an artist. A real one. He liked nothing better than to sketch the day away on his notepad. His spare time was devoted to drawing and his results were sometimes breathtaking.

  I invited Rivers to take a seat. I liked a proper tea, and in order to make the occasion festive I spread a white cloth embroidered by Laure and Miss Skerry over one end of the dissection table. Rivers laid down his pastry box. While we waited for the kettle to boil we chatted about the faculty and his duties and I asked how McGill compared to his experience in Baltimore.

  “Apropos,” he said suddenly. “Did you end up learning about that heart of yours? You remember the one — that mysterious reptilian thing you brought all the way down on the train with you? I’ve thought of it many times.”

  I lifted it from where it now sat on a permanent, privileged corner of my desk. “This one you mean?”

  Dugald Rivers nodded, sucking in his breath. “It really is a wonder.”

  “Wondrous or not,” I said with a laugh, “it very nearly got me thrown out of Number One West Franklin.” I proceeded to tell the story of little Revere and his pilfering.

  Dugald laughed. He could picture it, he said, the old heart ticking like a bomb beneath Kitty Howlett’s meticulous table.

  “I managed to get the history, though,” I said. “Dr. Howlett has such precise recall. The autopsy was performed twenty-seven years ago. October of eighteen seventy-three. The patient was in his thirties when he died.” I paused to let him take this in. “That makes it nearly sixty years old.”

  Dugald whistled. “Well it’s a damned nice job. Howlett’s got more than recall, I can tell you. Look at the way he opened up the ventricle. What a light touch.”

  “The work isn’t Howlett’s.”

  He looked at me in confusion.

  “It’s misleading because for years everyone called it the Howlett Heart.” I took down from the wall a framed copy of the article I’d published with Dr. Howlett’s help in the Montreal Medical Journal.

  “Burritt,” he read, mispronouncing my father’s name.

  “Dr. Honoré Bourret,” I corrected with French Rs and a silent T. The name rolled off my tongue with intoxicating ease. I even managed to meet Dugald’s gaze. It was French, I explained, although like so many ambitious French Montrealers he had spent his adult years speaking mostly English.

  Dugald’s curiosity was piqued. “But where does William Howlett come in? Why the Howlett Heart?”

  “Bourret was his mentor,” I explained. “He was a professor here. They worked together a lot of the time. The patient was Bourret’s and Howlett was invited to the autopsy.”

  “So it was this fellow Bourret’s work?”

  I nodded. “There was a scandal, though. Bourre
t was forced to leave McGill.” I kept my voice neutral and avoided Dugald’s eyes.

  “Is that when Howlett was hired? When this Bourret fellow left?”

  I did not trust my voice. I nodded.

  “Lucky man,” Rivers sighed. “I wondered how he was appointed to faculty at such a young age. He was a full professor and the sole pathologist at the Montreal General practically upon graduation.”

  My throat clamped. I needed tea.

  “He’s fortune’s child,” said Dugald.

  I watched him withdraw from me, his eyes becoming slightly unfocused. Was I as transparent as this? Since returning from Baltimore I’d been floating. Dr. Clarke and Miss Skerry had remarked on it: how strong and full of spirit I was despite my grandmother’s death and Laure’s collapse.

  Howlett was the reason. My work in the pathology museum, which I was now undertaking with his blessings and on his penny, and my correspondence with him were my lifeline. When his name was spoken my cheeks became hot. I was aware of my affliction but it was only now, watching Dugald Rivers, that I wondered if it might show. At the slightest reference to Howlett Dugald’s face turned wistful. It was at once pitiful and funny. I glanced over at Jakob, who watched us from his corner. I could only pray that I was more opaque than the adoring Dugald Rivers.

  I felt an urge to snap him awake. “It was not fortune alone.” Howlett had worked with discipline and energy to attain his present stature. His list of publications was impressive. The number of autopsies he’d performed — 787 in fewer than ten years — seemed unimaginable.

  I explained a little of this to Dugald. “I’m not even through my classifications yet but I’d say a good two thirds of the specimens are his. The quantity of his work is remarkable, Dugald. And everything was written up either in notes or for publication.”

  Dugald Rivers was completely still while I enumerated Howlett’s accomplishments. He looked slowly around. “So you’re saying that almost all of this is William Howlett’s.”