The Cole Trilogy: The Physician, Shaman, and Matters of Choice

by Noah Gordon

  “I sensed it,” Shaman said in a low voice.

  “What? Speak up, Mr. Cole, so the class may hear.”

  “I sensed it, sir.”

  “You do not have enough experience to know about body fluids, but you are able to sense impending death,” the professor said cuttingly. He looked at his class. “The lesson here is clear, gentlemen. While there is life in a patient, we never—you shall never!—consign them to death. We struggle to give them renewed life until they are gone. Do you understand that, Mr. Cole?”

  “Yes, sir,” Shaman said miserably.

  “Then you may sit down.”

  He took Jim Halleck to supper at a riverside saloon with sawdust on the floor, where they ate boiled beef and cabbage and each had three schooners of bitter dark beer. It wasn’t a victory meal. Neither of them felt good about what had occurred. Besides agreeing that Meigs was a real misery, they had little to say to one another, and when they had eaten, Shaman thanked Halleck and paid him for his help, allowing him to go home to his wife and four children several dollars less poor than he had left them that morning.

  Shaman stayed there and drank more beer. He didn’t allow himself to worry about the effect of the alcohol on the Gift. He didn’t imagine that he would be in a position very much longer in which the Gift could be important to his life.

  He walked back to the dormitory carefully, not allowing himself to think of very much except the necessity of placing each foot just so as he progressed, and climbed up into his bunk fully dressed as soon as he had arrived.

  In the morning he knew another good reason to avoid strong drink, because his head and his facial bones ached, fitting punishment. He took a long time to wash and to change his clothing, and he was slowly heading to a late breakfast when another first-year student named Rogers hurried into the hospital dining room. “Dr. McGowan says you are to come at once to his hospital lab.”

  When he reached the low-ceilinged dissection room in the basement, Dr. Berwyn was there with Dr. McGowan. The body of Arthur Herrenshaw lay on the table.

  “We’ve been waiting for you,” Dr. McGowan said irritably, as though Shaman were late for a preordained appointment.

  “Yes, sir,” he managed, not knowing what else he could say.

  “Would you care to open?” Dr. McGowan said.

  Shaman had never. But he had seen his father do it often enough, and Dr. McGowan handed him a scalpel when he nodded. He was aware of the two physicians watching closely as he incised the chest. Dr. McGowan used the rib cutters himself, and when he had removed the sternum the pathologist bent over the heart and then reached in and lifted it slightly so Dr. Berwyn and Shaman could see the roundish burned-looking damage that had been done to the wall of Mr. Herrenshaw’s heart muscle.

  “Something you should know,” Dr. Berwyn told Shaman. “Sometimes the failure occurs inside the heart, so that it can’t be seen in the heart wall.”

  Shaman nodded, to show he understood.

  McGowan turned to Dr. Berwyn and said something, and Dr. Berwyn laughed. Dr. McGowan looked at Shaman. His face was like seamed leather, and this was the first time Shaman had seen it lit by a smile.

  “I told him, ‘Go out and get me more of them that are deaf,’ ” Dr. McGowan said.

  47

  CINCINNATI DAYS

  Every day during that slate-gray spring of national torment, anxious crowds gathered outside the offices of the Cincinnati Commercial to read news bulletins of the war, written in chalk on a blackboard. President Lincoln had ordered a blockade of all Confederate ports by the federal Department of the Navy, and asked men in all the Northern states to answer the call to the colors. Everywhere there was talk of the war, speculation aplenty. General Winfield Scott, general in chief of the Union Army, was a Southerner who supported the United States, but he was a tired old man; a patient on the medical ward shared with Shaman the rumor that Lincoln had approached Colonel Robert E. Lee and asked him to take command of the Union Army. But a few days later there were newspaper reports that Lee had resigned his federal commission, preferring to fight on the side of the South.

  Before that semester was over at the Polyclinic Medical School, more than a dozen students, most of them in academic trouble, had quit to join one army or the other. Among them was Ruel Torrington, who left two empty bureau drawers that retained the smell of unwashed clothing. Other students spoke of finishing the semester and then joining up. In May Dr. Berwyn called a meeting of the student body and explained that the faculty had considered closing the medical school during the military emergency, but after much soul-searching they had decided to continue to teach. He urged each student to stay in school. “Very soon doctors will be needed as never before, both in the army and to care for civilians.”

  But Dr. Berwyn had bad news. Because the faculty was paid from tuition receipts, and because enrollment had decreased, tuition fees had to be raised sharply. For Shaman, this meant he would have to come up with funds he hadn’t planned for. But if he wouldn’t allow deafness to stand in his way, he was determined that a little thing like money wouldn’t stop him from becoming a doctor.

  He and Paul Cooke became friends. In matters of school and medicine, Shaman was the adviser and the guide, while in other matters Cooke did the leading. Paul introduced him to restaurant dining and the theater. In awe, they went to Pike’s Opera House to see Edwin Thomas Booth as Richard III. The opera house had three tiers of balconies, three thousand seats, and standing room for another thousand. Even the eighth-row seats Cooke had wangled from the box office wouldn’t have allowed Shaman full comprehension of the play, but he had read all of Shakespeare at college, and he reread this play before the performance. Being familiar with the story and the speeches made all the difference, and he enjoyed the experience tremendously.

  On another Saturday evening Cooke took him to a whorehouse, where Shaman followed a taciturn woman to her room and received a fast servicing. The woman never lost her fixed smile and said almost nothing. Shaman didn’t ever feel impelled to go there again, but at times, because he was normal and healthy, sexual desire presented a problem. On a day when it was his duty to drive a hospital ambulance, he went to the P. L. Trent Candle Company, which employed women and children, and treated a thirteen-year-old boy for leg burns suffered from a splash of boiling wax. They took the boy back to the ward, accompanied by a peach-skinned young woman with black hair who gave up her own hourly wages to go to the hospital with the patient, her cousin. Shaman saw her again that Thursday evening during the weekly visiting hour in the charity wards. Other relatives waited to see the burned boy, so her visit was short, and he had a chance to talk with her. Her name was Hazel Melville. Although he couldn’t afford it, he asked her to have supper with him on the following Sunday; she tried to appear shocked, but instead she smiled in satisfaction and nodded.

  She lived within walking distance of the hospital, on the third floor of a tenement building very similar to the medical-school dormitory. Her mother was dead. Shaman was very conscious of his guttural speech as her red-faced father, a bailiff at the Cincinnati Municipal Courthouse, regarded him with cool suspicion, not certain what was different about Hazel’s caller.

  If the day had been warmer, he might have taken her boating on the river. There was a wind from the water, but they wore coats and it was comfortable to walk. They looked in the windows of shops by the waning light. She was very pretty, he decided, except for her lips, which were thin and severe, etching tiny lines of habitual discontent into the corners of her mouth. She was shocked to learn of his deafness. While he explained about lip-reading, she wore an uncertain smile.

  Still, it was pleasant to talk to a female who wasn’t ill or hurt. She said she’d been dipping candles for a year; she hated it, but there were few jobs for females. She told him resentfully that she had two older male cousins who had gone to work for good money at Wells & Company. “Wells & Company has received an order from the Indiana State Militia to cast ten thou
sand barrels of minié musket balls. I do so wish they would employ women!”

  They had supper in a small restaurant Cooke had helped him choose, selected because it was both inexpensive and well-lighted, so he could see what she was saying. She appeared to enjoy it, though she sent the rolls back because they weren’t hot, speaking sharply to the waiter. When they returned to her flat her father wasn’t at home. She made it easy for Shaman to kiss her, responding so completely that it was a natural progression for him to touch her through her clothing and eventually to make love to her on the discomfort of the fringed settee. Lest her father return, she kept the lamp on and wouldn’t remove her clothing, pulling her skirts and shift back above her waist. Her womanly odor was overlaid with the smell of bayberry from the paraffin into which she dipped her wicks six days a week. Shaman took her hard and fast and without any semblance of enjoyment, conscious of possible enraged interruption by the bailiff, sharing no more human contact with her than he had experienced with the woman in the bordello.

  He didn’t even think of her for seven weeks.

  But one afternoon, impelled by a familiar longing, he walked to the Trent Candle factory and sought her out. The air in the interior of the candle works was hot with grease and heavy with the concentrated scent of bayberry. Hazel Melville was annoyed when she saw him. “Mustn’t have visitors, want me discharged?” But before he left, she said hurriedly that it wouldn’t be possible to see him again, because during the weeks of his neglect she had become promised to another man, someone she’d known a long time. He was a professional person, a company bookkeeper, she told Shaman, making no attempt to disguise her satisfaction.

  The truth was, Shaman had less physical distraction than he would have expected. He turned everything—all yearning and desire, every hope and expectation of pleasure, his energies and his imagination—into the study of medicine. Cooke said with frank envy that Robert J. Cole had been designed to become a medical student, and Shaman felt it was so; all his life he’d been waiting for something that he had found in Cincinnati.

  Midway in the term he began dropping into the dissection laboratory whenever he had a free hour, sometimes alone but more often with Cooke or Billy Henried, to help them develop their techniques with the instruments or to drive home a fine point made by their textbook or in a lecture. Early in the A&P course, Dr. McGowan had begun asking him to help students who were having difficulty. Shaman knew his grades in his other courses were excellent, and even Dr. Meigs had been known to nod pleasantly at him when encountered in the corridor. People had become accustomed to his differentness. Sometimes, concentrating hard during a lecture or a laboratory class, he fell into his old bad habit of making humming sounds without realizing it. Once Dr. Berwyn had paused during a lecture and said, “Stop humming, Mr. Cole.” In the beginning, other students would titter, but they soon learned to touch him on the arm and give him a look that told him to be quiet. It didn’t bother him. He was confident.

  He enjoyed wandering alone through the wards. One day a patient complained that he had walked past her bed unheeding although she had called his name repeatedly. After that, to prove to himself that his deafness need not hurt his patients, he developed the habit of stopping briefly at every bed, holding the patients’ hands in his own, and speaking briefly and quietly to each person.

  The specter of conditional status was well behind him one day when Dr. McGowan offered him a job in the hospital during July and August, when the medical school would be on holiday. McGowan told him frankly that both he and Dr. Berwyn had considered competing for Shaman’s services, but had decided to share him. “You’d spend the summer working for us both, doing dirty work for Berwyn in the operating theater every morning, and helping me autopsy his mistakes every afternoon.”

  It was a wonderful opportunity, Shaman realized, and the small salary would allow him to meet the rise in tuition. “I would like it,” he told Dr. McGowan. “But my father is expecting me home to help work the farm this summer. I’ll have to write and ask his permission to stay on here.”

  Barney McGowan smiled. “Ah, the farm,” he said, dismissing it. “I predict that you are done with farming, young man. Your father is a country physician in Illinois, I believe? I have been meaning to inquire. There was a man several years ahead of me at University College Hospital in Edinburgh. Same name as yourself.”

  “Yes. That was my father. He tells the identical anecdote you told our anatomy class, about Sir William Fergusson’s description of a corpse as a home from which the owner has moved.”

  “I recall that you smiled when I told that story. And now I understand why.” McGowan gazed contemplatively, through narrowed eyes. “Do you know why … ah … your father left Scotland?”

  Shaman saw that McGowan was trying to be discreet. “Yes. He’s told me. He got into political trouble. He was almost transported to Australia.”

  “I remember.” McGowan shook his head. “He was held up to us as a warning. Everyone at University College Hospital knew of him. He was Sir William Fergusson’s protégé, with an unlimited future. And now he’s a country doctor. What a pity!”

  “There is no need for pity.” Shaman wrestled with anger and ended up smiling. “My father is a great man,” he said, and with surprise he recognized that it was true. He began telling Barney McGowan about Rob J., about how he’d worked with Oliver Wendell Holmes in Boston, about his trek across the country in lumber camps and as a railroad doctor. He described a day when his father had had to swim his horse across two rivers and a stream to reach the sod house where he delivered a woman of twins. He described the prairie kitchens in which his father had operated, and told of times when Rob J. Cole had performed surgery on a table moved from a dirty house into the clean sunshine. He told of his father being kidnapped by outlaws who had held a gun on him and ordered him to remove a bullet from a man who had been shot. He told of his father riding home on a night when the temperature on the plains was thirty degrees below zero, and saving his own life by slipping from his horse and, clutching the horse’s tail, running behind Boss in order to force his blood back into circulation.

  Barney McGowan smiled. “You’re right,” he said. “Your father is a great man. And he is a fortunate father.”

  “Thank you, sir.” Shaman started to move away, but then he stopped. “Dr. McGowan. In one of my father’s autopsies, a woman had been killed by eleven stab wounds to the chest, approximately .95 centimeters in width. Made by a pointed instrument, triangular in shape, all three edges ground to sharpness. Do you have any idea what instrument would make that sort of wound?”

  The pathologist considered, interested. “It could have been a medical instrument. There is Beer’s knife, a three-sided scalpel used to operate for cataracts and to cut out defects of the cornea. But the wounds you describe were too large to have been made by Beer’s knife. Perhaps they were made by some kind of bistoury. Were the cutting edges of uniform breadth?”

  “No. The instrument, whatever it was, was tapered.”

  “I know of no such bistoury. Probably the wounds were not made by a medical instrument.”

  Shaman hesitated. “Could they have been made by an object commonly used by a woman?”

  “Knitting needle or some such? It’s possible, of course, but neither can I think of a housewife’s object that would make such a wound.” McGowan smiled. “Let me consider the problem for a time, and we’ll discuss it again.

  “When you write to your father,” he said, “you must give him the best regards of one who came to William Fergusson a few years after he did.”

  Shaman promised he would do so.

  His father’s reply didn’t arrive in Cincinnati until eight days before the end of the semester, but it came in time to allow Shaman to accept the summer hospital job.

  His father didn’t remember Dr. McGowan at all but expressed pleasure that Shaman was studying pathology under another Scot who had learned the art and science of dissection from William Fergusson
. He asked his son to extend his respects to the professor, as well as his permission for Shaman to work in the hospital.

  The letter was warm but brief, and from its lack of chattiness Shaman knew that his father’s mood was melancholy. There had been no word of the whereabouts or safety of Alex, and his father revealed that with each new round of fighting, Shaman’s mother became more fearful.

  48

  THE BOAT RIDE

  It wasn’t lost on Rob J. that both Jefferson Davis and Abraham Lincoln had emerged into leadership by helping to destroy the Sauk nation in Black Hawk’s War. As a young army lieutenant Davis personally had taken Black Hawk and the medicine man White Cloud down the Mississippi from Fort Crawford to Jefferson Barracks, where they were imprisoned in balls and chains. Lincoln had fought the Sauks with the militia, both as a private and as a captain. Now each of these men answered when addressed as “Mr. President,” and each was leading one half of the American nation against the other half.

  Rob J. wanted to be left alone by the gibbering world, but it was too much to expect. The war was six weeks old when Stephen Hume rode to Holden’s Crossing to see him. The former congressman was frank to say he had used influence to gain a commission as colonel in the U.S. Army. He had taken leave as the railroad’s legal counsel in Rock Island in order to organize the Illinois 102nd Volunteer Regiment, and he’d come to offer Dr. Cole a job as regimental surgeon.

  “It’s not for me, Stephen.”

  “Doc, it’s all right to object to the idea of war in the abstract. But now we’re down to cases, there are good reasons why this war should be fought.”

  “… I don’t think killing a lot of people is going to change anybody’s mind about slavery or free trade. Besides, you want someone younger and meaner. I’m a forty-four-year-old man with a thick waist.” He had put on weight. Back when escaped slaves came to the secret room, Rob J. had become accustomed to putting food in his pocket as he walked through the kitchen—a baked yam, a piece of fried chicken, a couple of sweet rolls—to help feed the fugitives. Now he continued to take the food, but he ate it himself in the saddle, for comfort.