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.
The young man gave no sign he had heard, even when the professor clapped his hands sharply, and McGowan knew suddenly whom he was dealing with. He started to rise, but then sank back, curious to see where this might lead.
The young man moved the hook selectively among the items in the brine. Most of them were old, and many had been cut upon by other classes of students. Their general condition of mutilation and decomposition was the key element in the shock of a first anatomy class. McGowan saw the youth bring a wrist and hand to the surface, a tattered leg. Then he brought up a lower arm and hand that evidently was in better shape than most of the anatomical pieces. McGowan watched as he used the hook to bring the desired specimen into the top-right corner of the tank and then covered it with several disreputable objects. Hiding it!
At once the youth placed the hooked stick where he had found it and moved to the table, where he proceeded to inspect the scalpels for sharpness. When he found one he liked, he moved it slightly above the others on the table and returned to the amphitheater to take his seat.
Dr. McGowan chose to disregard him, and for the next ten minutes continued to work with the records. Eventually students began to drift into the laboratory. They took seats at once. Many were already pale, for there were odors in the room that gave flight to their fantasies and fears.
Precisely on the hour, Dr. McGowan put down his pen and moved in front of the desk. “Gentlemen,” he said.
When they had fallen silent, he introduced himself. “In this course we study the dead in order that we may learn about, and help, the living. The first records of such studies were made by early Egyptians, who dissected the bodies of poor wretches they killed as human sacrifices. The ancient Greeks are the true fathers of physiological investigation. There was a great medical school in Alexandria, where Herophilus of Chalcedon studied the human organs and viscera. He named the calamus scriptorius and the duodenum.”
Dr. McGowan was aware that the eyes of the young man in the center seat of the first row never left the professor’s mouth. They literally hung on to his every word.
Gracefully he traced the disappearance of anatomical study into the superstitious void of the Dark Ages, and its renaissance after A.D. 1300.
The final portion of his lecture concerned the fact that after the living spirit has left, researchers must treat the body without fear but with deference. “In my student days in Scotland, my professor likened the body after death to a house whose owner had moved. He said the corpus must be treated with careful dignity, out of respect for the soul who had lived there,” Dr. McGowan said, and was annoyed to see that the youth in the front row was smiling.
He told them each to take a specimen from the brine tank and a knife, and to dissect their anatomical object and make a drawing of what they saw, to be turned in before they left the class. Always at the first class there was a moment’s hesitation, a reluctance to begin. During this hanging-back, the youth who had arrived early was first again, for he’d risen at once and gone to the tank to collect the specimen he’d stashed, and then the sharp scalpel. While the others began to mill about the tank, he was already setting up shop at the dissection table with the most favorable light.
Dr. McGowan was acutely aware of the pressures of the first anatomy class. He was accustomed to the sweetish stink that rose from the brine tank, but he knew of its effect on the uninitiated. He’d given some of the students an unfair task, because many of the specimens were in such poor condition it would be impossible to dissect them well and draw them accurately, and he took that into account. The exercise was a discipline, the first blooding of green troops. It was a challenge to their ability to face unpleasantness and adversity, and a harsh but necessary message that the practice of medicine consisted of more than collecting fees and enjoying a respected place in the community.
Within minutes several people had left the room, one of them a young man who departed in a great hurry. To Dr. McGowan’s satisfaction, at length each of them returned. For almost an hour he strolled among the dissection tables, checking on their progress. The class contained several mature men who had practiced medicine after apprenticeships. They were spared the nausea of some of the other students. Dr. McGowan knew from experience that some would be excellent doctors; but he watched one of them, a man named Ruel Torrington, slashing away at a shoulder, and he sighed, thinking of the terrible surgery this man must have left behind him.
He paused a fraction longer at the last table, where a fat youth with a sweating face struggled to work on a head that was mostly skull.
Across from the fat youth, the deaf boy worked. He was experienced and had used the scalpel well to open the arm in layers. The fact that he’d known to do this revealed a prior knowledge of anatomy that both pleased and surprised McGowan, who noted that joints, muscles, nerves, and blood vessels were neatly depicted in the drawing, and labeled. As he watched, the young man printed his name on the drawing and handed it to him. Cole, Robert J.
“Yes. Ah. Cole, in the future, you must make your printed letters a bit larger.”
“Yes, sir,” Cole said quite distinctly. “Will there be anything else?”
“No. You may return your specimen to the tank and clean up after yourself. Then you may go.”
The dismissal brought half a dozen other drawings to Dr. McGowan, but each of the students was turned back with a suggestion for revision of the drawing or several ways to improve the dissection.
While he conferred with the students, he watched Cole return the specimen to the tank. He saw him wash and wipe the scalpel before replacing it on the table. He observed that Cole carried water to the dissection table and scrubbed the side of it he’d used, and then took brown soap and clean water and washed his own hands and arms carefully before rolling down his sleeves.
Cole paused by the chubby youth on the way out and examined his drawing. Dr. McGowan saw him lean over and whisper. Some of the desperation left the other boy’s face, and he nodded as Cole patted his shoulder. Then the fat one went back to work, and the deaf one left the classroom.