The Cole Trilogy: The Physician, Shaman, and Matters of Choice (147 page)

“Mister, we had seventy-two craft off-load or take on cargo at this pier yesterday, and that’s in slow season, and we’re just one Mississippi freight company of many. And most of those boats hire young men who walked away from a family somewheres, so I don’t hardly take notice of any of em,” he said, not unkindly.

Shaman thought the Southern states seceded like corn popping in a hot skillet. His red-eyed mother spent her time praying, and his father went on his home visits without smiling. In Rock Island one of the feed stores moved as much stock as possible into the back room and rented half its space to an army recruiter. Shaman drifted into the place once himself, thinking that perhaps if all else failed in his life, he could be a stretcher-bearer, because
he was big and strong. But the corporal who was signing up men raised his eyebrows comically as soon as he learned Shaman was deaf, and told him to go home.

He felt that with so much of the world going to hell, he didn’t have much right to be troubled about the confusion in his own life. The second Tuesday in January his father brought home a letter, and then another one that Friday. His father surprised him, because Rob J. knew he’d recommended nine schools, and he had kept track of the nine answering letters. “That’s the last of them, isn’t it?” he said to Shaman after supper that night.

“Yes. From Missouri Medical College. A rejection,” Shaman said, and his father nodded without surprise.

“But this is the letter that came on Tuesday,” Shaman said, and he took it from his pocket and unfolded it. It was from Dean Lester Nash Berwyn, M.D., of the Cincinnati Polyclinic Medical School. It accepted him as a student on the condition that he successfully complete the initial term of study as a trial period. The school, affiliated with the Southwestern Ohio Hospital of Cincinnati, offered a two-year program of study leading to the degree of Doctor of Medicine, four terms in each year. The next term was to begin on January 24.

Shaman should have felt the joy of victory, but he knew his father was seeing the words “on condition” and “trial period,” and he prepared himself for an argument. With Alex gone, he was needed on the farm, but he was determined to escape, to grasp his chance. For many reasons, some of them selfish, he was angry that his father had allowed Alex to run away. While he was about it, he was angry at his father for being so damned certain there wasn’t a God, and for not realizing that most people just weren’t strong enough to be pacifists.

But when Rob J. looked up from the letter, Shaman saw his eyes and his mouth. The knowledge that Dr. Rob J. Cole wasn’t invulnerable entered him like an arrow.

“Alex won’t be hurt. He’s going to be all right!” Shaman cried, but he knew it wasn’t the honest assessment of a responsible person, of a man. Despite the existence of the room with the ivory-assed dummy, and the arrival of the letter from Cincinnati, he understood it was only the worthless promise of a desperate boy.

P
ART
F
IVE
A FAMILY QUARREL

January 24, 1861

45

AT THE POLYCLINIC

Cincinnati sprawled larger than Shaman had expected, the streets teeming with traffic, the Ohio River ice-free and busy with boats. The intimidating smoke of factories rose from tall chimneys. Everywhere, there were people; he could imagine their noise.

A horse-car trolley took him from the riverside railroad depot straight to the promised land on Ninth Street. The Southwestern Ohio Hospital was composed of a pair of red-brick buildings, each three stories high, and a two-story wood-frame pesthouse. Across the street, in another brick building surmounted by a cupola with glass sides, was the Cincinnati Polyclinic Medical School.

Inside the school building Shaman saw shabby classrooms and lecture halls. He asked a student for the dean’s office and was directed up an oak staircase to the second floor. Dr. Berwyn was a hearty middle-aged man with white mustaches and a hairless head that gleamed in the soft light of the high and grimy windows.

“Ah, so you are Cole.”

He motioned Shaman into a seat. There followed a short talk on the history of the medical school, the responsibilities of good doctors, and the necessity of rigorous study habits. Shaman knew instinctively that the greeting was a set piece, recited for every new student, but this time there was a finish just for him. “You must not allow yourself to be intimidated by your conditional status,” Dr. Berwyn said carefully. “In a sense, every student here is on trial and must prove himself a worthy candidate.”

In a sense
. Shaman would have wagered that not every student had been informed of his conditional status by letter. Still, he thanked the dean politely. Dr. Berwyn directed him to the dormitory, which proved to be a three-story wood-frame tenement building hiding behind the medical school. A dormitory roster tacked to the hallway wall informed him that Cole, Robert J., was billeted in room Two-B, along with Cooke, Paul P.; Torrington, Ruel; and Henried, William.

Two-B was a small room entirely filled by two double bunks, two bureaus, and a table with four chairs, one of which was occupied by a plump youth who stopped writing in a notebook when Shaman came in. “Halloo! I’m P.P. Cooke, from Xenia. Billy Henried’s gone to get his books. So you must be either Torrington from Kentucky, or the deaf fellow.”

Shaman laughed, suddenly very relaxed. “I’m the deaf fellow,” he said. “Do you mind if I call you Paul?”

That evening they watched one another, drawing conclusions. Cooke was the son of a feed merchant, and prosperous, judging from his clothing and belongings. Shaman could see he was accustomed to playing the fool, perhaps because of his portliness, but there was shrewd intelligence in his brown eyes, which missed little. Billy Henried was slight and quiet. He told them he’d grown up on a farm outside of Columbus and had attended a seminary for two years before deciding he wasn’t cut out for the priesthood. Ruel Torrington, who didn’t arrive until after supper, was a surprise. He was twice as old as his roommates, and already a veteran medical practitioner. Apprenticed to a physician at a young age, he had decided to attend medical school to legitimize his title of “Doctor.”

The other three students in Two-B were cheered by his background, at first believing it would be an advantage to study alongside an experienced physician, but Torrington arrived in a bad mood that never changed as long as they knew him. The only bed that was unclaimed when he arrived was the top bunk against the wall, which he didn’t fancy. He made it obvious that he scorned Cooke because he was fat, Shaman because he was deaf, and Henried because he was a Catholic. His animosity welded the other three into an early alliance, and they didn’t waste much time on him.

Cooke had been there several days and had gathered intelligence which he shared with the others. The school had a faculty of generally high repute, but two of its stars shone more brightly than any others. One was the professor of surgery, Dr. Berwyn, who also served as dean. The other was Dr. Barnett A. McGowan, a pathologist who taught the dreaded course known as “A&P”—anatomy and physiology. “They call him Barney behind his back,” Cooke confided. “They say he’s responsible for failing more medical students than the rest of the faculty put together.”

The next morning Shaman went to a savings bank and deposited most of the money he’d brought with him. He and his father had planned his financial needs carefully. Tuition was sixty dollars per year, fifty dollars if paid in advance. They had added money for room and meals, books, transportation, and other expenses. Rob J. had been happy to pay whatever was necessary, but Shaman stubbornly had held the idea that since his medical education was his own plan, he should pay for it. In the end they agreed that he would
sign a note to his father, promising to repay every dollar following his graduation.

After leaving the bank, his next errand was to find the school’s bursar and pay his tuition. It didn’t help his spirits when that official explained that if Shaman should be dismissed for academic or health reasons, his tuition money could be only partially refunded.

The first class he attended as a medical student was a one-hour lecture on the diseases of women. Shaman had learned in college that it was essential to reach every class as early as possible, in order to sit close enough to lip-read with a high degree of accuracy. He showed up early enough to gain a place in the front row, which was fortunate, because Professor Harold Meigs lectured rapidly. Shaman had learned to take notes while watching the lecturer’s mouth instead of the paper. He wrote carefully, aware Rob J. would ask to read his notes to learn what was happening in medical education.

His next class, chemistry, revealed that he had sufficient laboratory background for medical school; this cheered him and stimulated his appetite for food as well as for work. He went to the hospital dining room for a hasty lunch of crackers and meat soup, less than wonderful. Then he hurried to Cruikshank’s Bookstore, which serviced the medical school, where he rented a microscope and bought his books from the required list: Dunglison’s
General Therapeutics and Materia Medica
, McGowan’s
Human Physiology
, Quain’s
Anatomical Plates
, Berwyn’s
Operative Surgery
, Fowne’s
Chemistry
, and two books by Meigs,
Woman, Her Diseases and Their Remedies
and
Diseases of Children
.

As the elderly clerk was totting up his bill, Shaman glanced away to see Dr. Berwyn in conversation with a short glowering man whose neat beard was sprinkled with gray, like his mane of hair. He was as hirsute as Berwyn was bald. They were obviously deeply engaged in argument, although evidently they kept their voices low, because none of the people nearby paid them attention. Dr. Berwyn was half-turned from Shaman’s sight, but the other man faced him squarely, and Shaman read his lips more by reflex than out of any desire to eavesdrop.

… know that this country is going to war. I am well aware, sir, that this incoming class is forty-two students instead of the usual sixty, and I know well that some of these will run off to battle when the study of medicine gets too tough. Especially at such a time we must guard against lowering our standards. Harold Meigs says you have accepted some students whom last year you’d have rejected. I am told that among them there is even a deaf mute …

Mercifully, at that point the clerk touched Shaman’s arm and showed him the amount due.

“Who is the gentleman talking with Dr. Berwyn?” Shaman asked, the mute finding his voice.

“That is Dr. McGowan, sir,” the clerk said, and Shaman nodded, gathered up his books, and fled.

Several hours later, Professor Barnett Alan McGowan sat at his desk in the dissection laboratory of the medical school and transcribed notes into permanent records. All the records dealt with death, since Dr. McGowan seldom had anything to do with a living patient. Because some people looked upon death as a less-than-happy environment, he’d grown accustomed to being assigned working places that were out of the public’s eye. In the hospital, where Dr. McGowan was chief pathologist, the dissection room was in the basement of the main building. Although it was convenient to the brick-lined tunnel that ran under the street between the hospital and the medical school, it was a drab place notable for the pipes that crisscrossed its low ceilings.

The medical-school anatomy laboratory was in the rear of its building, on the second floor. It was reached from both the corridor and a separate stairway of its own. One tall window, curtainless, let leaden winter light into the long narrow room. At one end of the splintery floor, facing the professor’s desk, was a small amphitheater, its rising tiers of seats placed too close for comfort but not for concentration. At the other end stood a triple row of students’ dissecting tables. In the center of the room was a large brine tank full of human parts and a table bearing rows of dissecting instruments. The body of a young woman, completely covered by a clean white sheet, lay on a board placed out of the way on sawhorses. It was the facts concerning this body that the professor was entering into the records.

At twenty minutes before the hour, a lone student came into the laboratory. Professor McGowan didn’t look up or greet the large young man; he dipped his steel pen into the ink and continued to write as the student went directly to the middle seat in the front row and claimed it with his notebook. He didn’t take the seat, but instead strolled through the laboratory on an inspection tour.

Stopping before the brine tank, to Dr. McGowan’s amazement he picked up the wooden staff with the iron hook at the end of it, and began fishing
among the body parts in the saline solution, like a small boy playing in a pond. In the nineteen years Dr. McGowan had taught first lessons in anatomy, no one ever had behaved in such a fashion. New students came to anatomy class for the first time with portentous dignity. Usually they walked slowly, often with dread.

“Here, now! Stop that at once. Put the hook down,” McGowan commanded.