Moral dilemmas abound in this nineteenth century medical whodunnit, culminating in Star Trek's favourite metaphysical teaser, when push comes to shove, should the one be sacrificed for the many? Mr Spock never answered that question to my satisfaction, but at least with the fate of the Universe hanging in the balance the question was of more significance than debating how many angels dance on the head of a pin.
In this story a surgeon who cannot operate without morphine to stiffen his nerve and steady his hand is deprived of his drug of need and a girl who he is performing an abortion on dies on the operating table. The wrong man is accused of murder of the purported abortionist with arsenic intended to cover up the girl's murder. In the meantime the actual offender goes free and two of his doctor colleagues ponder whether the lives the killer will save as a gifted surgeon justify him leaving the wrongly accused in jail and not admitting to his guilt and errors.
The main advocate of the latter course of action argues that all will be well because money and influence will eventually free the wrongly accused, and the girl is dead anyway so why should her killer stand forth?
Before the rescue can be effected someone else enters the jail cell of the wrongly accused, stabs and murders him. Then we find the actual offender has made a confession he would have given the police, and one of the doctors goes to tell the police but refuses to exonerate the slain innocent once he learns of his death because he thinks it is all the fault of the police and has nothing to do with him for withholding evidence -- acquired earlier as an amateur sleuth.
So providing by the end of the book that everyone is telling the truth the denouement is that the innocent wrongly accused dies unvindicated, his parents never learn the truth, the actual offender goes on to greater glory and the doctor who withheld evidence blames the police. Move over, Shakespeare, there is a new kid on the block.
And the dead woman? Well she was a fallen woman so perhaps her agonising death from a botched abortion did not matter anyway.In these pre Roe v Wade days abortion was viewed as an abominable crime, social stigma was merciless and 80% of caesarian sections resulted in death. The last fact is actually incidental to the story. One of the plethora of factoids plucked from history to spice up the story, making it into a slice through medical life and social mores in 1889.
Here is writer in flight from non-fiction to fiction and he is two thirds of the way there. This book is faction, making play with the medically mighty Johns Hopkins University and weaving a story around its luminaries. Real lives embroidered by a fictitious story line, and, as an aspiring professional historian I find that disturbing. It might actually be too soon, less than a century after the death of the protagonists to imply that an esteemed surgeon might have committed murder. He has no defence, being dead. Ought one ever to weave such fantasia, even a millennium later? The rigorous historian in me says, no, one should never do so. The journalist in me, conscious of current and future litigators, rebels.
Surely the historian's task is narrative that is as accurate as possible given the sources available and the question to be addressed? Spice the whole with analytic evaluation of the narratives interaction with societal and political tides and perhaps clothe the whole in a framework in which the dominant shaping force of the time is, say, emergence from civil war, as in this story, and the ethics of post mortems and dissecting a human corpse. Then one has history not faction.
This is faction.
Yet the author holds a Ph.D in American history so must have pondered the ethics of his work as he turned these lives into a source of essay questions for aspiring medics, ethicists and metaphysicians. So is this a gripping read? In part. This is not a John Grisham page turner, not Ian Rankin at his best. Nor, despite the sprinkling of nineteenth century medical history is it Roy Porter performing one of his scintillating tour de force in the world of medical history. Written by a fictitious narrator, interspersed with with first person accounts, with a reflective epilogue written supposedly 40 years after the critical narrative events, the book is good and is written by a writer reaching for a fiction writer's voice. But when all is said and done what this really is is a book for a morally inquisitive teenager with medical, ethical, moral or metaphysical academic leanings. And the biggest question to my mind is whether a responsible historian ought to have written such recent faction at all.