Northern Liberties

By Glenn Vanstrum

NORTHERN LIBERTIES

A painter can imitate life through his art, but he can also imitate death.

In 1876, Thomas Eakins talks his way into the operating theatre of the famous surgeon, Samuel Gross. As Eakins sketches, the patient’s mother, Abigail Doverlund, has a near seizure at the brutality of the operation. An anesthesiologist keeps her boy in a coma, true, but the filth and lack of sterility at the scene fill her with dread.

A homicide detective, George Callahan, investigating a series of mysterious disappearances, watches the surgery, too. Soon he finds evidence leading him to an anatomy lab tucked in the basement of Jefferson Medical College.

Abigail, widowed owner of a failing newspaper, struggles to keep her son alive. Her paper’s circulation grows, however, with both its coverage of the disappearances and her science editor’s muckraking articles on infections and the use--or lack of use--of new antiseptic techniques. Meanwhile Eakins, when not working feverishly to create his masterpiece, utilizes his med school connections to supply his art classes with anatomic sketching materials. Gross himself has a never-ending need for cadavers for his medical students.

Abigail and George meet but have trouble acknowledging their mutual attraction, for each retains psychic wounds from the Great War. As their love grows, as Abigail’s reportage leads her from hospital to hospital and teaches her about microbial theory, the dark side of Eakins and Gross’s genius becomes clear. George, searching Northern Liberties, a downtrodden quarter of Philadelphia, unearths a macabre crime, but not until he comes close to losing his beloved Abigail.

When scientific and artistic experts converge for the 1876 Centennial Exposition, multiple threads of love, art, medicine, and murder weave a cloth of beauty, passion, death, and redemption, a tapestry evoked by that horribly wonderful painting itself, The Gross Clinic.

• Language: English
• Publisher: Glenn Vanstrum
• Release date: Nov 5, 2011
• ISBN: 9781465760869

Glenn Vanstrum

Glenn Vanstrum’s fiction has been published in LITnIMAGE, the Bellevue Literary Review, and THEMA. His book of nature writing, The Saltwater Wilderness (Oxford), won a San Diego Book Award. Essays of his have appeared in Sierra, California Wild, and the Los Angeles Times.Vanstrum has written five novels and two story collections. Setting plays a major role in his character-driven fiction, work that often uses nature, music, or medical themes. His novels range from drama (Let Fall Thy Blade; Certain Stars Shot Madly) to historical fiction (Northern Liberties) to satire (S.I.C. Memorial). His latest work, Humboldt, a story set among the Northern California redwoods, is part roman noir, part satire, and part thriller.A Minnesotan by birth, Vanstrum majored in music at Grinnell College in Iowa and attended U.C.S.D. medical school. He has spent most of his life in California, where he practices anesthesiology.A professional nature photographer, he publishes images in numerous venues worldwide. Magazine credits include Audubon, Sierra, Terre Sauvage, National Geographic Traveler, National Wildlife, and Discover. The photographic stock agencies Animals Animals/Earth Scenes and Custom Medical Stock Photography represent his photographs.Vanstrum, a pianist from age five, still practices daily and performs works from the classical, romantic, and modern repertoire on a regular basis. A student of Cecil Lytle and the late Nathan Schwartz, he plays both solo and chamber pieces.The author, a lifelong surfer, has ridden waves in Hawaii, Mexico, Costa Rica, and Bali. Still riding a shortboard, he wipes out with great regularity.Further information on Vanstrum’s writing, including book reviews; music, including concert schedules; and surfing, including a surf blog; appears at http://www.gvanstrum.com"Glenn Vanstrum is a force of nature. In addition to being a published author (The Saltwater Wilderness, Oxford University Press, 2003), he is a concert pianist (and regularly performs complex pieces by Beethoven and Mozart in public venues near his home in San Diego), a highly regarded medical doctor, an accomplished surfer, an underwater photographer who has worked around the world, and a dedicated husband and father. Somehow, in this incredibly busy life, he continually produces exemplary works of fiction and non-fiction."I've known Glenn for fifteen years. In that time, I have read every single one of his books, and they are uniformly excellent. His fiction is distinguished by fast-paced plots, fascinating characters, amazingly realistic dialogue, and passages of great strength and beauty. His innovative treatment (in Northern Liberties) of Thomas Eakins' painting 'The Gross Clinic' was absolutely brilliant, and his collection of animal stories is par excellence--certainly in the league with such notables as Roger Caras and Ernest Thompson Seton."His non-fiction, best exemplified in the essays of The Saltwater Wilderness, reflects his love for the sea and dedication to the conservation of oceanic resources. In summary, any book by Glenn Vanstrum is worth reading and owning, and I enthusiastically encourage all those who value contemporary literature to explore the corpus--now available as e-books or print-on-demand--of this gifted American author. "--John A. Murray, senior editor, The Bloomsbury Review (1987-present); founding editor, the Sierra Club American Nature Writing annual (1994-2005); former director, graduate program in professional writing, University of Alaska; author of 42 books; recipient of Southwest Book Award and Colorado Book Award.

Book preview

Northern Liberties

A Novel

by

Glenn Vanstrum

A painter can imitate life through art, but he can also imitate death.

Northern Liberties

A Novel

Copyright 2011 by Glenn Vanstrum

All rights reserved.

This is a work of historical fiction. Any resemblance to living persons is entirely coincidental.

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Northern Liberties

Selected reviews of Thomas Eakins’s painting, The Gross Clinic:

The ugly, naked, unreal thigh, the pincers and lancet, the spurting blood, and the blood on the hands of the Professor and his assistants are bad enough, but Mr. Eakins has introduced, quite unnecessarily, an additional element of horror in the shape of a woman…who covers her face and by the motion of her hands expresses a scream...

New York Times, 1876

Here we have a horrible story--horrible to the layman, at least--told in all its details for the mere sake of telling it and telling it to those who have no need of hearing it.

New York Tribune, 1876

Hands down, the finest 19th century American painting.

New York Times, 2002

Northern Liberties

Table of Contents

Part I: The Surgery

Part II The Funeral

Part III The Canvas

Part IV The Newspaper

Part V The Unveiling

Part VI The Detective

Part VII The Exposition

Further Reviews of The Gross Clinic

Acknowledgments

About the Author

Works by Glenn Vanstrum

Sample Chapters of Other Fiction

Humboldt

Let Fall Thy Blade

Of Lion Paw and Tiger Jaw

Yellowstone, 1876

Certain Stars Shot Madly

S.I.C. Memorial

Picture This!

Disease Beyond My Practice

Northern Liberties

Philadelphia, April, 1875

Part I: The Surgery

-1-

A hard rain fell that night before the surgery. It scrubbed the cobblestones, scoured horse manure into the Delaware, and sluiced raw spring earth down the Schuylkill. The deluge cleansed the wrack of winter from the city, but it failed to touch the demon that ate through the leg of Abigail Doverlund’s boy.

The torrent cascaded in a roar onto the asphalt roof of Jefferson Medical College. In the corner near her son’s bed, only a yard from her stool, a steady leak plopped into a tin bucket, the sound driving Abigail to near madness. With the downpour came wind, too, blasts of northeast air that crept through the rafters and laid cold hands upon her throat.

Four beds stood in the ward, each holding someone’s child. A ten-year-old girl, two days out from the excision of a bladder stone, screaming every four hours for her dose of laudanum. A five-year-old with the croup, barking in a honking metronome as regular as the drops plunking into the bucket. A toddler who drank a bottle of household lye, too ill to cry, struggling for air.

And Phillip, her beloved Phillip, the last remnant of her once vibrant family. Phillip, the survivor of three operations, now destined for a fourth. Phillip, the seventeen-year-old, too old for pediatrics. She’d slipped a dollar bill to the head nurse to have him housed here, since the twenty-bed ward of the adults offered no privacy at all. Listening to the dripping, the gusts of wind, and the cacophony of sick children, she wondered if she might have made an error.

Dawn brought the rest of the room into slow focus. The parents of the toddler, awake most of the night, at last dozed. The veil of slumber gave them brief respite from their nightmare. That their firstborn would drown in his own saliva seemed a forgone conclusion, yet the two-year-old’s mother and father never abandoned their crib-side vigil. Abigail shuddered, knowing their lot to be worse than hers. Phillip had a chance, after all.

Dr. Gross insisted today’s surgery would be the last. Her reckless teenager survived the first three. Surely he could handle a fourth.

It poured just as hard that November day eleven years ago when she got the letter from Andrew’s captain. The postman, sensing something odd about the battered envelope with its smeared ink and Virginia postmark, knocked on the door and handed it to her, a strange look of compassion on his face. Phillip, a sturdy six-year-old at the time, pulled at her skirts. Is it Daddy? Is Daddy coming home?

Now she pulled the red wool afghan tight across her knees, shivering. Rain, snow, sunshine, hail. Whatever the Lord saw fit to grant, she would accept. She searched her soul for the iron faith that supported her so well in the past, but she failed to find the buttress of belief that sustained her through the dreadful recovery of her husband’s body. A tattered Bible fell between her knees, the same Bible she’d studied a decade ago to make sense of Andrew’s fate. It was still too dark to read.

Her son tossed and turned, pushing his down comforter aside. She stood, stretching limbs cramped from crouching on the oak stool. Catching the Holy Book and setting it on the wood, clutching her blanket, she reached over to feel his forehead. Sweaty and hot. Too hot.

For the thousandth time, she wondered if she should take the lad home. Everyone told her Dr. Gross was a genius. Something, though, made her unsure about the surgeon. His smarmy manner, his exaggerated sweetness. The way he treated his entourage of students, like gnats he could swat away with his hand.

Phillip opened his eyes. His father’s green eyes. Mother.

You’re not chilled?

My head’s cooking. My feet feel like icicles.

She pulled from her bag a clean pair of stockings, the faded blue wool knitted years ago by her own mother. Trying not to move his left leg, the one with the infected bone, she slipped on the first sock.

He inhaled quickly, the whimper of a man-child in pain.

Sorry.

The skin of his foot felt cold. She pulled on the twin.

Better?

I’m hungry.

The anesthetist made clear she must not let him eat before for the operation. I’ll buy you something from the canteen. That turkey broth you like. At lunchtime.

I’m not having surgery.

If we don’t trust Dr. Gross, whom can we trust?

He hauled the comforter back over his body, this time covering his head. She couldn’t tell if he was burning up or freezing. From under the goose down his voice sounded muffled.

No surgery. Never again.

When your leg gets better, let’s go to the country. Any place you’d like.

He shoved down the covers, a smile breaking the pale mask of his face. Delaware Bay. The Atlantic.

We can go crabbing.

Clam chowder. The kind you make, with scallions and cream.

We’ll stay in Wilmington. I know a hotel. We can hike that waterfall--
No surgery. Not today. Not ever.

She sighed, shaking her head. He yanked the comforter back over his face.

-2-

In a more northerly section of that same city on that same night, a woman entertained a circle of men. Eyes sparkling sapphire blue, golden arms glowing, beads of sweat glistening like diamonds upon her half-exposed bosom, her riches stoked their lust. Her laughter, a tintinnabulation ringing through the saloon, blended with her beauty to draw the admirers closer.

The scar searing across her left cheek marred her perfection. Lightning bolt jagged, it ran from the corner of her eye to her lip, rendering her both accessible and piteous.

Cigar smoke hung in a haze over oil lamps lighting the hall. A drunk in a bowler hat, his mustache wide as a wheelbarrow, pounded the ivories of an out-of-tune piano. Through a window iron-shod hooves clattered, the sound mingling with the splash of April rainstorm.

A well-dressed man observed the flirtations of the woman from the far end of the bar until he could bear it no longer. Waving to catch her gaze, he rose and pulled out his pocket watch.

Midnight. He mouthed the word, jerking his head toward the balustrade. She winked.

It would not be easy, this thing he must do. Still, the anticipation made him tremble.

She took his hand and led him up the stairs past the balcony, out of sight from the ogling crowd.

I wondered when you’d arrive. She ran a hand through her hair as she spoke, hair that fell upon her chest in an ebony waterfall.

I watched you for an hour. Such a joy to see you entertain the masses.

Just killing time.

You could have any man you desire, like that. He snapped his fingers.

That laugh again, a silver bell pealing through the hallway. Right now, I want you.

In the room on the third floor, a pair of candles flickered shadows on the walls. He bolted the door, grasped her waist, and pulled her tight, sliding his tongue deep into her mouth.

She pushed him away. Wait.

I can’t. In a brusque motion he slid down the velvet of her gown. The burgundy cloth felt warm against his hands, her nipples cool.

Her voice took on a chill. The money.

He pulled out the twenties, five of them, and pressed them into her hand. An enormous sum. She folded the bills lengthwise as he continued undressing her, holding them between whitened knuckles.

She scrambled between the sheets, still holding the cash. Did you work today?

He followed her into bed, wrapped himself around her, the touch of skin on skin making him feel slightly delirious. I did.

I admire you for helping people in need.

I get paid. Same as you.

Did anyone die?

Never. Not on my watch. The musky scent of her perfume excited him. With his fingertip, he drew his name upon her hip. "Did you work today?"

A subdued version of the laugh this time. No. I read a book.

You’re lying.

"That you’re the first today, or that I read something?’

Both.

"I read Oliver Twist. Five chapters."

While you worked?

"Some of my...my clients like a woman who reads."

Now you’re really lying.

I admire Oliver. His heart stays pure, even when he’s in Fagan’s gang. She pulled away from him. My parents abandoned me, too.

Dickens is fine, if you like treacle. Try a little Poe sometime.

She rose to her elbows, lifted her head above the covers, and stuck out her tongue. In the chiaroscuro of candlelight, her hair blazed with an odd glow. His story about that heart, that vile, throbbing heart. Made me sick.

Trying his best to get her to shut up, he began to massage her shoulders. He decided, this last time, to pleasure her every way he could. Kneading the tension from the muscles in her back, he felt her body soften into a languid jelly. She sighed and spoke no more.

Footsteps thumped in the hallway outside. He ignored them until a battering ram of a knock smashed into the door. Twice.

A drunken voice boomed through the walls. Mary. Lemme in. Now.

Twisting her head, she stirred beneath him. Later, Slam. I’m with someone.

Lemme in, goddamn it.

After a few minutes, Slam--whoever that was--thumped away, leaving them in peace. He sighed. The bull crap he had to put up with. She lay next to him, her eyes screwed shut. It took a long time for her to relax again. With infinite patience he held her, his grasp tender. At last she melted into his arms.

When he finished, she lay exhausted against him, eyes closed, a faint smile breaking across her face. A smile held in check only by that scar.

An hour later, sure she slumbered, he slipped off the bed to his coat, found the gauze and the bottle three-quarters filled with clear fluid. He took a deep breath, steeled his nerves, and dampened the cloth. A chemical odor filled the room.

-3-

Damn you, Eakins, you’ll need to be quick about it. The surgeon and the artist squared off in the center of a deserted amphitheatre. No sound but their voices could be heard echoing off the stone floor. That, and the rain pelting down upon the glass dome above them, leaded glass through which the morning light beamed upon a mahogany table. This will be a real patient, under real anesthesia. We shall have no time for artistic shenanigans.

Not to worry, my dear Dr. Gross. All lies in perfect preparation.

Why Samuel D. Gross, M.D., agreed to this painting now seemed beyond him. He had a dozen surgeries on his list and a speech to write before he steamed to Europe. Dyspepsia complicated his wife’s neuralgia, the paper on osteomyelitic bone lay unfinished on his desk, and damnable Eakins wanted him to stand for hours to fix in pigment a certain look of the eyebrows.

The doctor tried to keep control of the situation. Hearn will induce with the chloroform, I shall make my incision, and when I turn like so, he twisted from the table as if to give a pearl of wisdom to the ghosts in the empty seats above him, you may have your image. After that, I cannot be bothered by the whims of some artist, even one burnished by sin pots abutting the River Seine.

Could you keep your left hand on the table?

Gross shook his head. What the devil did his left hand matter? Really.

I insist. You should maintain connection to the patient when you turn away.

Eakins, I wish you were dead.

The surgeon, impatient, drummed his fingertips on the smooth hardwood of the table. The painter laid out oils and brushes on the shelf of his easel, adjusted his bulky camera, tapped magnesium into his pans. Students slipped in through the hallway and filed into the seats above them. Gross’s chief of clinic, James Barton, mustache and sideburns dripping from the downpour, carried in a wooden case filled with scalpels and retractors.

The anesthetist, Joseph Hearn, paused in the doorway to assess the scene before he stalked into the amphitheatre holding a worn leather case. It held, Gross knew, twin sixteen-ounce canisters of chloroform and a roll of silk gauze. The kit also contained resuscitative remedies: turpentine injections, a galvanic stimulator, and smelling salts.

All set, doctor? Hearn said, slipping off a wet oilcloth raincoat. He nodded at Eakins and raised an eyebrow, his only acknowledgement at the oddity of being photographed and sketched during a surgery. Gross never knew what to make of him. A tall man with a razor-sharp part to his hair, the Virginian, a cocky aristocrat, seldom made small talk. Also a learned physician--the surgeon himself attended a few of the anesthetist’s lectures--rarely, if ever, did Hearn kill anyone with his chloroform.

Only one thing missing, Hearn. Our patient. Something about the man disturbed Gross, something he could not readily identify. Perhaps it was the fact the anesthetist had fought for the South in the war, maybe even shot a Pennsylvanian or two. Or perhaps it was the rumored knowledge that Hearn, a handsome fellow, consorted with women who bore less than desirable reputations. He wondered if constant inhalation of poisonous gas hadn’t addled the man’s brain, or at least his moral fiber.

The operation worried Gross as well. In his fourth surgery on this seventeen-year-old, one Phillip Doverlund, the surgeon hoped to remove the last trace of infection from the left femur and leave behind only healthy periosteal membrane to foster bony re-growth. This would prevent an above-knee amputation. Three times he’d entered the limb, and three times he’d escaped the perils of sepsis and gangrene. Three times Hearn had given anesthesia, and each time the lad took the ether.

But the infection still smoldered, here came yet another round, and the boy’s mother had run out of patience. The day before she accosted him in the whitewashed hallway outside the ward. Gripping his jacket, she wailed, wiping her tears onto the velvet lapel.

Doctor, when will he be cured? When?

Soon, my dear, just one more resection, he answered in his most confident tone.

Oh, Doctor, I cannot lose him. His father left us, you know… After she made this oft-told revelation, freshened streams of sorrow tracked down her face.

Gross did his best to feign solicitude, yet it was not his fault Mrs. Doverlund’s husband died from a Minié ball to the neck years ago during the Battle of the Wilderness. Nor was it his responsibility running the family business (a small newspaper, the Philadelphia Courier) had descended upon this frail lady’s shoulders. He did not force her son to dive off a rock into the chill waters of the Schuylkill with four friends--including Thomas Eakins!--and gouge his leg on a submerged willow branch.

Charles Briggs, the second assistant, arrived with a medical student in tow, a scowling nineteen-year-old with an unkempt mass of red hair, a juvenile beard, and acne dotting his face. The two of them each carried a stack of fresh linens. With Daniel Appel, the third assistant, they unfolded them to pad the operating table.

Noting that the hundred seats in the auditorium had filled, Gross cleared his throat.

Gentlemen, today we shall perform what is, we hope, the final surgery upon our young man. You recall that, while undertaking a frolic in our city’s finest river, the lad impaled his leg upon an obstacle. Cruel infection of the bone took hold, yet we have stemmed the tide of that calamity by three resections of the femur.

Gross paused to gaze around the gallery. To his surprise, the street-wise mug of George Callahan, detective for the Philadelphia Police Department, appeared among the pudgy faces of the medical students. A sharp-eyed wolf amidst a herd of sheep. Gross worked before with the man during a homicide autopsy and wondered why he came today to witness this surgery. A glance at Eakins answered the question: Callahan also fancied himself an artist. The detective, a fellow pupil with the surgeon at several of Eakins’s drawing classes, came to see the master at work.

We plan, assuming our patient agrees to subject himself to Dr. Hearn’s chloroform (polite laughter), to incise the leg in a longitudinal fashion. In dividing the lateral, distal--

A commotion from the entrance hallway interrupted the surgeon’s lecture.

You must.

I shall not.

Dr. Gross says you must.

I’ve had enough of doctors.

He says you may lose the limb.

He can kiss my arse.

The mother and two nurses propelled the son, sitting upright on a wheeled bed, his left leg wrapped in a bandage, into the center of the auditorium. The boy glared at Gross. His skin pale, his hair unwashed, his face glistened with a cold sweat. A cotton smock sheltered his thin body. A pair of aged wool socks covered his feet. His wild eyes left the surgeon to glance around the theatre and take in the hundred faces, the rain splattering overhead, the empty operating table. He fixed his gaze once again upon Gross.

Go to hell, you…you bastard.

-4-

While mother and son argued, the painter stood impassive before his easel. The beam of cloud-filtered light from the dome seemed more intense, though the spring showers still poured down. Thomas Eakins stepped to the camera he’d borrowed from the Academy, slipped the black silk over his head, and focused the lens, placing the table to the right. He took care not to have too much foreground, yet he wanted to show Phillip’s body foreshortened by perspective, just as Rembrandt van Rijn compressed his corpse in The Anatomy Lesson of Dr. Deyman. He would decrease the exposure time to make up for the increased light. The image would make the painting. Without its help, it might take forever to nail down the proper relationship of the tiered seats to the operative scene.

Eakins paid scant heed to the cussing of the boy or the near-hysterical urgings of the mother. The surgeon put a calming hand upon the lad. The boy wilted and acquiesced, as if God himself had touched him. Gross, with his graying shock of hair and domed forehead, possessed the charisma of a deity. People prostrated themselves before him, gave in to his every whim, jumped at each imperious order. But Eakins had seen the doctor’s attempts at drawing and knew him to be human.

Technical diagrams, anatomic sketches of arteries or nerves, these the man could handle. Yet in class the brilliant Gross could barely scratch out a likeness of the model Eakins hired: The surgeon’s finished work looked more giraffe than male nude. By encouraging him, though, by praising an ego already overblown, Eakins succeeded in getting himself where he stood today, in the heart of a real operation.

A strange smell struck the painter’s nostrils, an agreeable smell, fragrant and fruit-like. He pulled out from under the camera’s mantle and raced to his easel, for the anesthetist lowered a chloroform-soaked gauze over the boy’s face. Earlier, Eakins had prepped the canvas with sheets of vermilion underpainting. He seized a horse-hair brush, dipped it in a smear of black oil paint on his palette, and began to shape in the table, the anesthetist, the hallway, and the amphitheatre. He worked at near-frantic speed. After the black, he dabbed in plain leaded white to capture the highlights. If the camera failed him, he would still have the oil sketch.

Pigment flowed from his brush like a cascading arpeggio from a violin. He’d struggled so to master color years ago in his studio at 64 rue de l’Ouest. Gérôme, forever patient, showed him again and again how to mix and create hues that reproduced nature--but his first works shamed him, the oils smearing into a muck-ridden mess. Armed with but a few years of instruction from the master, though, his skills progressed. With each completed work his command of the medium grew. Today, only a decade after he huddled seasick in his stateroom on the Péreire en route to Europe, he felt himself at the peak of his artistic powers.

From this preliminary sketch would come his masterpiece. His timing was perfect. In one year, Philadelphia planned to host the gala centennial celebration for the United States. Millions of people from all over the globe would view his painting--this painting--and it might just make his career. The jury would accept entries in May of ‘76. Surely he could get the work done in twelve months. Already he had close to completion an oil study of Gross, the leonine figurehead at the center of the work. But to get everything else in proportion, he needed today.

The members of the operative team kneeled around the rapidly-fainting Phillip. For a moment Eakins recalled the young boy at the river with his chums, Stewart, Jason, and Alexander. Unseasonably warm early April air bathed them in waves of false August. Tendrils of snow still lay melting in the shadows of the willows, yet, in some meteorological conundrum, a southerly wind blew the swelter of summer up from Floridian climes.

The delirium that springs north after a cold winter turned them half insane. Emboldened by the wine he’d bought, the five of them stripped to proffer flesh in worship to the long absent sun. When they could take the heat no more, jumping off the rock into the icy water at his urging, naked, seemed eminently logical. A very male sort of thing to do. Mad high jinks, without a doubt.

He could still recall the jolt as he plunged into the frigid Schuylkill. At the time he worried the cold might stop his heart. The shock made his skin tingle in delicious pain.

A damnable shame, the drowned branch spiking the boy. An abrupt end to a jolly good afternoon. Cursed bad luck. As the Italians would say, maledetta sfortuna.

Eakins tore himself from the easel and returned to the camera. He checked to see if he could capture Gross’s head at a point defined by the golden ratio of the Greeks, 1:1.6. The young surgeons clustering about the patient formed the base of a pyramid. He trisected the image with horizontal and vertical lines in his head, placing the surgeon’s bushy-haired cranium in the left upper center. Ducking out from under the silk, flint wheel ready, he held above his head the flash pan with its 2.1 grams of magnesium powder. When Gross turned, he would expose the plate, spark the flash, and close the shutter.

He hoped no one would get injured.

-5-

Everything’s going well, my lad. Relax. Relax and let the cares of the world fall from your shoulders.

Joseph Hearn tapped another 25 drops of chloroform onto his gauze and watched the boy inspire. Keep them breathing, that was the key. The lad swallowed, and Hearn, attentive to this sign, turned the head at once to capture the vomitus on a towel held ready for such a mishap. His stomach emptied, the young man settled into a series of deep respiratory cycles. Three or four inhalations of the saccharine-tasting compound and even the strongest bare-knuckled boxer would fall, incapacitated.

The boy on the table arched his back in a twisted spasm. His limbs writhed, his torso shook. It took every last bit of strength for the assistants to hold him down. A tortured cry escaped his lips. A moment later he collapsed, insensate under the power of the drug.

Hearn nodded to Briggs, Barton, and Appel, who turned the patient right side down, lifting the cotton smock to expose the left femur and buttock. He flicked the boy’s eyelash and found no response.

You may proceed, Doctor, he said to Gross. Hearn felt himself relax. Another case, another thirty dollars added to his account. Soon he would have his stake ready for the Preakness. A wealthy patient of his, the owner of a sleek three-year-old entered in the May event, let him visit his stables last week. If he could put together five hundred dollars, he would take the ten-to-one odds on the unknown bay and buy his way out of the financial dilemma that threatened to evict him from 314 Catherine Street.

The sound of a woman keening to his right brought him back to the moment. The mother, Mrs. Doverlund. She insisted on watching, as if this were a charity case.

Let her moan, just so she pays the bill.

A shapely woman in her late thirties, a woman widowed by that scum Ulysses Grant and his brutally successful battles of attrition, the lady might well be attractive could she but smile and not worry so much about her son. Unlikely. Flicking Phillip’s eyelash again, he got no response but sensed a quickening of the lad’s respirations. The surgeon stropped a blade on the leather upper of his left boot and, after nodding to the anesthetist, made an incision. Hearn counted out another 25 drops of chloroform.

Gross widened his cut and set the medical student to retract the anterior margin. Fitting a second curved metal retractor in the wound, he passed the handle to young Appel, who pulled back upon the posterior edge. Briggs gripped the lad’s bare legs, azure socks covering his feet, and Barton probed the soft tissue within the wound, looking for pus pockets. The surgeon turned from the patient and, holding the scalpel like a pen in his now-bloodied hand, addressed the onlookers, his voice a soothing drone to Hearn.

We have incised the fascia lata, taking due care to avoid the two branches of the sciatic nerve. We now expose the distal femur…

The anesthetist had seen and heard it all a hundred times before. He felt himself nodding off. The stuffy auditorium air, damp from the rain, did not help him stay alert.

A bit of bleeding has ensued, but as the great Galen wrote, hemorrhage eases both fever and plethora. This poor lad has an abundance of both. We have only to separate--

An explosion of noise and brilliant light startled Hearn. Acrid smoke filled the room. His left hand jerked uncontrollably and knocked over the chloroform container, although he uprighted it after spilling but an ounce. The sweet smell of the anesthetic mixed with the pall of oxidized magnesium and spread through the auditorium.

What the--

A howl of despair emanated from the floor to his right. The mother, Mrs. Doverlund, shocked by Eakins’s flash, terrified by the blood and helplessness of her son, had descended into an apoplectic fit.

Hearn spotted the surgeon’s eldest son observing from the doorway, the boy’s high-domed forehead and bushy hair so like his father’s. Quick, young Gross, put a compress on her head, use these smelling salts. And get her out of here.

From the corner of his eye, Hearn noted Eakins sketching at his easel with furious haste. Gross himself, unperturbed, carried on with the surgery.

He flicked the eyelid of his patient, detected a subtle reaction, and counted twenty respirations per minute. The temporal artery pulsated robustly under his left little finger.

With care he measured 15 drops of chloroform onto the gauze.

-6-

I’m quite all right. I wish to stay.

I insist, Madam. This case is too much for the fair sex.

"I insist, young man. It’s my right to watch my son’s surgery."

The law states only in charity cases must the family be present.

Damn the law.

You mustn’t make disturbing noises.

The blast. It caught me off guard.

Here. Sniff this.

The salts of ammonia kicked Abigail in the head. She jerked back, pushing away the obnoxious hands holding them. The only woman in a room filled with men, medical students and doctors so confident and assured in their jackets and ties, she, the poor mum in her kerchief, felt tears welling up again. With all the power her thin form could muster, she willed herself to keep them at bay. No more would she cry, no more would she collapse. She must pay attention to Dr. Gross, Phillip’s only hope.

She stood and tried to see, but the broad back of the surgeon obstructed most of the wound. A medical student kneeled to his left. An anesthetist sat on a chair and held her son’s jaw. The sugary smell of chloroform seemed stronger now. They’d exposed her son’s bottom to scores of people.

Why did she insist upon witnessing this surgery? It would be Phillip’s last, of that she was sure. She felt the burden of a stone-heavy guilt for forcing her son into this last resection of bone. For the thousandth time, she wondered how stupid he could have been to go swimming in the Schuylkill. Unclothed, no less, in the presence of his new cronies and that abhorrent Thomas Eakins, the man who now so cheerily painted this morbid tableau.

Rumors swirled through the city, rumors of Eakins and his debaucheries as an art student in the city of Paris. People said he smoked opium there. People said he went to parties where dozens of artists, men and women alike, undressed, guzzled wine, and performed orgies. People said he fancied young boys. Abigail shuddered, trying not to let her imagination get too explicit.

Now the man had corrupted her only son, her dear Phillip. Whatever made the boy turn from his studies at Central High, his baseball team, his helping out at the newspaper, to run off with those hellion art friends and the company of that, that Eakins, whatever made him do it might kill him. The tears threatened again, but she closed her eyes and forced them back.

Dr. Gross lectured on. To Abigail, he seemed more interested in teaching than in working on her poor son. She did not understand much of what he said, only that he despised Lister and loved blood-letting. She’d checked with everyone she knew, even with the editors at the city’s biggest daily, The Public Ledger. Everybody agreed if you needed a surgeon, you went to Samuel D. Gross.

The scent of the chloroform made her ill. She could also smell--she tried to shut her mind to it--blood itself. Her son’s blood. A metallic sort of odor. The reeking auditorium reminded her of an abattoir she’d visited as a reporter, something about a bovine epidemic, hoof and mouth disease. But that was years ago, back when her father ran the paper before he died, only a few years after Andrew passed...

That damnable crying welled up once more. Concealing her sorrow and fear, trying to block out the horrid events going on but a few feet away, she hid her face with her arms.

She must be strong. She had to be strong. She had a son to nurse and a newspaper to run.

-7-

Midway up the gallery behind the painter, a tall man observed the surgery, a man considerably older than the medical students seated around him. George Callahan’s eyes held a world-weary look, as if he had seen many dark things, yet, in spite of his angular nose and chin, a softness pervaded his spirit, a gentleness. A student of human nature by inclination and a detective by trade, he fit each of the characters in the surgical tableau before him into a series of traits, a skill his job on the force engrained in him over the years.

The surgeon he knew to be an indomitable force, a man to be reckoned with. Power oozed from his fingertips. The artist--Callahan’s teacher, Thomas Eakins--held every bit as much self-assurance as the doctor, a characteristic at odds with his shabby trousers and coat. Some people made up for their lack of means with swagger. Perhaps it was the other way around: Their inability to doubt themselves guaranteed their penury. Or maybe Eakins had money but could care less about the opinions of a mediocre detective, or anyone else.

Callahan’s attention shifted to the others gathered around the table. The patient, now asleep: a teenager, barely grown into his angular body, his personality plastic, his anger at authority plain. The young surgeons, all but cowering before the master. The anesthetist: proud, competent, peculiar in his mannerisms. The man moved his lips in silence, as if talking himself through his task. Several times he would rapidly raise an index finger, then, slowly, tap the tip of his nose. An odd duck. Of the doctors, he alone seemed unfazed by Gross’s charisma.

A thin but comely woman, the sole female in the amphitheatre, sat on a low stool just behind the surgeon. Rich brown hair billowed from under a silk headscarf. A member of the family, the mother, perhaps. Every few moments