The Heart Specialist (14 page)

The jars and cavernous room pulled me back to another place and time. I stood still, inhaling formaldehyde. The smell of things preserved. I was remembering the barn at St. Andrews East and my own early attempt at curatorship, but these memories went even further back. I had seen these jars and shelves before. The room at the back of our house in Montreal.

Eventually the dean left, promising to send the janitor with a pail and any other cleaning materials that I might need. He was apologetic about this too, as if cleaning the place was somehow beneath a person of my station.

For the following half hour I did nothing but sit on a stool by the work table, watching the dust motes swirl. The sun was at its highest point in the sky and its light made its way through the grime of the window, which faced south over McGill’s campus. I would get light all day.

Dr. Clarke had not described my duties but the first tasks were obvious. The museum was like an attic, things placed haphazardly and tumbled on their sides. Something white caught my eye. Bent awkwardly around a metal pole was a skeleton. It was undersized, too small for a grown woman. As I straightened it out the right arm detached at the shoulder, coming away in my hands.

I cradled this arm. My father’s possessions had been preserved. William Howlett must have brought them here for safe keeping, and now I would be their custodian. Did Dr. Clarke have an idea of the gift he had just offered me? My eyes filled with tears.

Like the skeleton almost every item in the museum needed repair. But it would be a pleasure. I put down the bones of the arm I still held, which were grainy and surprisingly light. I began to inspect the jars. Some were from animals. One jar contained slices of pig’s lung, culled for the parasites blocking the bronchi. “Strongylus,” I read in handwriting I’d been deprived of knowing intimately. My own script is somewhat squat, especially if I hurry. His was tall and thin, spiking upwards as if it yearned to fly away.

One shelf held nothing but pickled human hearts. The first jar on it was labelled “Fatty Heart with Rupture,” in my father’s hand. These specimens were very old, with mossy surfaces you would not want to touch. Another specimen was labelled “Acute Purulent Pericarditis.” It had belonged to a woman who, according to my father’s notes, had produced a pint of “laudable pus.” These things had belonged to him. He had excised them himself and then preserved them. It was overwhelming.

“The Room of Horrors,” I said aloud, smiling at the memory. I looked about at the extent of the disorder. It would take time and effort to sort through it all, but I had days and months and Dr. Clarke was going to pay me.

When the dean returned after lunch he found me sweeping, my charcoal skirt knotted to keep the hem out of the dust, a bright kerchief wound around my head. A good number of the jars were already lined up on the work table for a preliminary sorting. He sneezed prodigiously.

“I’m afraid I’ve stirred things up,” I said, waving my hand through the soupy air.

Dr. Clarke laughed. “Is that not your specialty, Dr. White?”

I was about to object when a second man appeared in the doorway and stopped me short. I recognized him immediately.

“I thought you two should meet,” Clarke ventured affably.

Dr. Mastro did not step forward. He remained at the threshold, his powerful shoulders rounding slightly, hands thrust in his pockets.

“We have already had the pleasure,” I said, bowing my head in greeting. I ensured my voice was cordial.

“I have just learned of your appointment,” he said. “Forgive my surprise.”

Dr. Clarke produced a small, embarrassed laugh. It was clear he’d overstepped the chair of physiology. It was equally clear that Dr. Mastro was not pleased. “Dr. White is eminently qualified …”

“I’m sure she is,” said Mastro, shifting his weight as if he might take a boxer’s two-fisted jab at us. His gaze took in my presentation, which was closer to that of a charwoman than a member of the faculty of medicine, then stepped past me into the clutter. “Well,” he said after a pause. “Someone had to do it.”

“And you’re away, Ed,” Dr. Clarke pleaded. “You couldn’t do it by yourself. I thought you would be relieved.”

Dr. Mastro smiled. “Of course.” He clicked his heels as if he were a soldier and made a dismissive gesture with one of his hands. “If you two will excuse me now, I have a lecture to prepare.”

His shoes clacked on the tiles as he retreated. Dr. Clarke laughed again, but I could not bring myself to share his mirth. I had stirred up more than dust that morning. The museum was full of ghosts who were all awakening.

III
THE HOWLETT HEART

The heart may be prolonged into a hollow process.

— MAUDE ABBOTT, “CONGENITAL CARDIAC DISEASE”

10

APRIL 1899

I made it through that first winter at McGill, but with the exception of Dr. Clarke I had no friends on faculty. No one stopped me in the halls to chat, and the one time I ventured into the common room at coffee hour my colleagues stared with such intensity that I didn’t dare repeat the experience. They were perturbed by my presence at McGill. I had not been hired to teach or do research and yet I was collecting pay. The hostility was never spoken. They were too respectful of the dean to show open defiance, but it was there all the same. No one besides Dean Clarke addressed me formally as “Doctor.” There was no plaque on my door announcing my title or name. I was a class apart.

I pulled my scarf tighter around my neck. There was a crack down one side of the window, which skewed my view across campus and let in frost and drafts. I had complained to Mastro about it in November but nothing had been done. It was the least of his worries. He was away in Saranac Lake often; I was left to run the museum without him. And now it was April. It would probably not snow again but still the air was chilly.

The window shuddered. I was sure it would give way one day. I took a moment to survey my little kingdom. Today the exhibits seemed drearier than usual because it was overcast, but on sunny days the glass jars gleamed and their contents glowed. I had done a great deal of work since first setting foot in the building last September. I’d had to sort through each item, dusting and grouping it by organ or functional system. At first I’d had to undertake the basic housekeeping jobs of cleaning and painting the shelves. There was a prodigious amount remaining to do. Many of the seals on the jars were broken and decay had set in. In others the glass tubes supporting the specimens had slipped loose or snapped.

In my darkest moments I couldn’t help thinking it was a mistake to have accepted this position. When Dr. Clarke had first proposed it I’d thought it was a dream come true; but I should have asked questions I now realized. A more experienced person would have made sure that the salary was satisfactory before flinging himself headlong at Dean Clarke’s feet. I now understood why nobody else had jumped at the position.

On the table before me was a collection of hearts — three dozen in various sizes and shapes, collected at any time between the previous week and seventy years before. Cut from thick slabs of glass, the jars shone like crystal. In some the formaldehyde had yellowed, in others there were hints of blue. Some of the organs were whole, others sectioned. Whatever their state, each was strikingly beautiful, yet also defective. The irregularities were there — small tears in the septum, scar tissue on the valves hampering opening or closing, coarctation of the aorta, transposition of the aorta and the pulmonary artery. During the patients’ lives the clues would have been subtle: breathlessness, recurrent pain, pallor and a cyanotic cast to the skin. To the initiated there would also have been sound. A stethoscope on their chests would have related an unearthly symphony.

The newer specimens weren’t labelled. Precious little in this forsaken place had been labelled when I’d first arrived. I had cleared two shelves in a corner for these broken hearts — a heart corner like the one Father had had in the Room of Horrors. For now, however, the heart specimens sat in a mess on the work table, surrounded by chemical puddles and the stained pages of my notes.

I picked up the nearest jar. Inside was the largest heart of the collection, grey as a pigeon’s breast, with feathers of disintegrating flesh blurring the contours. This one was labelled “Ulcerative Endocarditis.” The handwriting was my father’s.

There was a knock on the door and Dr. Clarke’s head appeared. I checked my watch. It was eleven o’clock, the hour I’d said I would expect him. I had forgotten. My lab coat needed a wash, I thought suddenly. I smelled as if I’d been pickled in preservatives myself. I blushed, trying to disentangle myself from the coat as Dr. Clarke walked toward me across the room.

“How’s the system?” he asked, taking my hand.

The “system” was something I had dreamed up when I realized the extent of the pathology collection with which I had been entrusted. The oldest items dated back to 1823, the year the McGill medical school had been founded. In the intervening years hundreds of specimens had been collected. With some regularity specimens arrived by the pail-full from the Montreal General or the Royal Victoria Hospital, compounding the chaos. There was enough room for everything, but the challenge was to organize the collection so that items could be retrieved with speed and efficiency.

In Zurich a physician had adapted the Dewey Decimal Classification system — devised in 1876 and used primarily to sort books in libraries — to anatomical specimens. My innovation, which had impressed Dr. Mastro and several other faculty men, was to add a pathological number after the decimal point. It had taken four months to devise this system and apply it. As of this week each of the identified specimens in the museum, save the hearts, had been tagged.

Incoming specimens were less problematic. They arrived with autopsy reports, and if these reports were unclear all I had to do was check with Mastro or the doctor who had supplied them. It was the older specimens that caused me anguish. Much of the time I felt like Sisyphus, pushing that boulder up the hill only to have it roll down and squash me. The anatomy was the easy part of my task. More challenging was to identify the pathological anomaly. I had to date these specimens, which led me to search through ancient hospital records to see what had been written about them. It was slow, painstaking work.

“Done!” I said dramatically.

Dr. Clarke laughed and shook my hand. “You’re quite a girl.”

The skin on my hand was rough from daily handling of specimens; I pulled it back quickly.

Dr. Clarke pretended not to notice. “So what have you unearthed, Agnes?”

The previous night I had left a note on his desk. As a rule I tried to avoid placing demands on him. He had too much work. On top of his administrative functions he published scholarly papers and ran a private medical office. He was also a mentor to students and younger colleagues.

I pointed to the jar with the large heart at which I’d been peering all morning. It was an adult organ, but such a strange, misshapen thing, it was a mystery how its owner could have survived infancy.

Clarke pulled the jar toward him and squinted at the heart in the uneven light. “Ulcerative Endocarditis?”

“The label’s wrong.”

“I’ll say,” Clarke agreed. “It’s some sort of anomaly, but not one I’ve ever seen. Look at how dilated the auricles are.”

My spirits began to sink. Working here was like trying to piece together an enormous jigsaw puzzle with parts missing and others that refused to fit. “You’re not familiar with it?”

He rotated the jar slowly. “It has only one ventricle,” he said, shaking his head in wonder. “Like a reptile!”

I nodded. When I first came across it I had thought it could not be human. The museum held a number of veterinary specimens and I’d suspected it might be one of those. I suggested this to Dr. Clarke.

“Too big,” he said, scratching his chin. “All but the ventricle is clearly human.”

“Not quite,” I said, pointing to the heart’s right corner, just off the pulmonary artery. “There’s a cavity. Can you see it? I suppose it’s to make up for the missing chamber.”

Clarke rotated the jar a final time, lips pursed, deep in thought. “Do you know who could help you with this?”

My breath slowed. I didn’t dare turn my head. The heart was old, perhaps even predating my father, although he had been the resident expert in morbidity when it had been acquired. He had, perhaps, autopsied it. I did not look at the dean, did not know what I would do if the name I both dreaded and hoped for rolled off his tongue.

“William Howlett,” the dean said, bringing the tips of his fingers together.

I was surprised and turned to face him.

“He knew this collection better than anyone,” Clarke explained. “When he was teaching here he used these specimens in the classroom. They were demonstrations for his students.”

I tried to nod and smile.
William Howlett
. His name hadn’t even crossed my mind.

“Yes,” said Dr. Clarke. “Howlett’s the man you want. You’ve heard of him, of course?” He put the mysterious specimen down on the table. “He’s made quite a reputation for himself since he left Montreal.”