by Paul Collins
I present to you a case of recovery from a passage of an iron bar through the head—Mr. Phineas P. Gage.
Gage peered out at them from his partly shattered face, perfectly conscious and voluble. “The iron entered there and passed through my head,” he liked to say while pointing, and Bigelow hefted the brutal iron spike that had done the deed. It was three feet long, over an inch thick, and sharpened to a point on one end.
“The leading feature of this case is its improbability,” Bigelow later explained. He handed the bar around for inspection. “This is the sort of accident that happens in the pantomime at the theatre, but not elsewhere.”
The physicians of Boston ran their fingers along Gage’s skull, gently examining the depression in the top of his head, where the pulsations of the brain could still be felt through the scar tissue. The top of his skull, Dr. Holmes marveled, had been pierced “as if it had been a pie-crust.”
Bigelow had already secured a loan of the crowbar to the society from a hesitant Gage. The real prize was still in the patient’s head, though, for the society had a sizable collection of fractured skulls in its anatomical display cabinets. Some had been split by sabers, others cracked by the kick of a horse, and one battered cranium was from a sailor killed by six years of epileptic attacks after he “fell through the decks of a man of war.” But only one much resembled Gage’s: the old skull of a coachman who’d lost a chunk of the parietal bone through a bad fracture, with the resulting opening sealed up by scarring on the brain’s dura mater membrane, “very dense and as firm as parchment.” That one had been donated by Dr. George Parkman, a founding member of the society. Dr. Parkman was still active, having just contributed an essay on the disordered mind of Jonathan Swift—and even though Parkman was busier these days as a wealthy landlord than as a physician, the society’s “Monstrosities” cabinet still included an impressive mummified pair of conjoined twins from his doctoring days. But with all his years and his wealth, even Dr. Parkman couldn’t top the curiosities Bigelow had brought to tonight’s meeting.
For now, the bar alone would have to suffice. The society’s collection remained an incomplete set; though the drilled-out demonstration skull was a fair enough facsimile, a proper display really required the actual matching skull—which, by some gentle negotiations later, Phineas might be induced to part with, after it was no longer in use. Harvard’s medical men certainly couldn’t be seen coveting the skulls of the still living, or outright stealing the bodies of the newly dead.
After all, they were in quite enough trouble about that already.
3
THE SKELETON BOX
FOUR DAYS A WEEK THE FOOTSTEPS CREAKED, SHUFFLED, AND thudded across the ceiling of Professor Webster’s laboratory—the sound of students trudging up the grand front stairs of the building and gathering in the lecture hall above. Underneath their dozens of feet, Webster had his sanctuary: a snug laboratory with one furnace to keep him warm, and another for high-temperature chemical assaying. A few steps away, across a wooden floor dotted with the inevitable alkali burns and acid splashes, a long table had been shoved up against a corner window. It looked out across a muddy lot to the neighboring Massachusetts General Hospital, a reminder of Webster’s early days, some thirty years ago now, as a hospital dresser and a Harvard Med student. That was back before his attentions gravitated away from the corporeal body and over to the smooth glass beaker, when he ascended beyond bloodletting and alighted upon the chemical constituent parts of blood itself.
He finished his lecture notes under the sharp, cold light from the window. So much had changed since Webster’s own student days; there was always more to keep up with. When he graduated with his MD in 1815, the medical school had just three professors and a six-week term; now it was seven professors and a seventeen-week term. Back then, the AMA hadn’t been founded, and the stethoscope hadn’t even been invented yet. And now? In just the last three years alone, ether had revolutionized surgery, doctors were beginning to wonder whether they should wash their hands before treating patients, and a woman—a woman—had graduated from a medical school in New York.
In the opposite corner from his desk, a tightly wound private staircase ascended to the back room of the lecture hall. Within easy reach for that moment was the dark coat he always wore for his lectures, and which he hadn’t quite managed to destroy yet through chemical mishap. He would not need to don it today, nor ascend those back stairs to the lecture stage; it was a Monday, the one weekday when he did not have to lecture. As noon approached, the silence remained thankfully unbroken by students’ footfalls; only the ministrations of the building’s live-in janitor, Ephraim Littlefield, ever interrupted the Monday morning quiet, as he swept the floors and tumbled scoops of coal into the little stove. It was as well that Littlefield was working today; Professor Webster had cut his hand while trimming grapevines—raw material for yet another one of his experiments—so he’d need the janitor’s help even more than usual. But before he could get under way on the day’s work, Webster couldn’t help but notice a puzzling absence in his lab: it didn’t smell the way it used to.
That vault, he absently asked Littlefield. Did it get fixed?
It most certainly had been, the janitor proudly informed him. The medical building was only three years old, and Ephraim knew it as intimately as his own home, which indeed it was. He knew exactly where the retaining and load-bearing walls ran under which part of each room, and he knew what ailed the building, too. The coal pen off Webster’s lab, heaped high with eight solid tons the previous winter, had cracked a wall in the medical school’s subbasement, releasing foul air from a dissecting room disposal vault. And so during the summer, with the med school professors off collecting specimens and visiting family, Ephraim had overseen the descent of two hired men into the vault to repair it. This procedure struck Webster as impossible: Wasn’t the only way into the vault through the small chute used for dumping body parts?
“We took up the brick floor in the dissecting room entry, and then cut a hole through the board floor,” the janitor shrugged.
And that’s the only way to get under the building? Webster asked.
“The only way.”
It seemed a shame, because the vault itself could prove useful for research into the gases generated by decomposition. Couldn’t, Webster suggested hopefully, a light still be lowered into the vault—say, a candle or a lantern?
“No,” the janitor replied.
It was impossible: why, just a few days back he’d had trouble when Professor Ainsworth hung a severed head down there on a rope, letting it macerate so that he might eventually procure a clean demonstration skull. The problem was, the old rope they used rotted away, just like everything else in the vault, and the head tumbled into the charnel pile. Ephraim’s unfortunate task from Ainsworth was to try to spot the head and fish it back up. Decomposition not only rendered the air unbreathable, it snuffed out the janitor’s candles and made it impossible for him to see inside.
Still, there were good grounds for Webster to seek out that bad air: Boston and Cambridge were both struggling with overcrowded graveyards, which had become a festering public hazard and a hotly debated topic at city council meetings—a matter so pressing that, on that very day, Boston’s mayor and city council were going on an outing to scout a new cemetery location. “It is not alone when the stench becomes intolerable, that burial grounds become injurious,” the Cambridge Chronicle had warned that fall. “The subtle exhalations and gases impregnate the atmosphere, and, though it may not be perceived, bear their deadly influence in the community around.” The wonders of Webster’s chemistry lab might, perhaps, offer an answer to what to do about these gases; and the school’s vault was an ideal place, in its own fetid way, to collect them. Even its geographic location helped: the dissecting room was a graceless extension on wooden piles over the muddy flats by the Charles River, and when the river rose with the estuary tides, the dissecting vaults easily flooded, sometimes to the heig
ht of a man.
“It is a good time now,” Littlefield said, sizing up the river. “The tide is in, and will press the gas up.”
Yes, yes, the professor agreed absently. Perhaps he’d assemble an apparatus for gathering it. But he didn’t get around to it that day, or the next. There were many other cares for a professor to attend to, and the gas could wait, as it wouldn’t leak away from the repaired vault. In fact, there would only be more lurking beneath the building: it was early in the semester, and soon the bodies would start piling up.
WEBSTER’S LAB was tucked into the middle of the Medical College’s ground floor; flanking his lab was the dissecting room and Littlefield’s family quarters. With Mrs. Littlefield’s niece up from Connecticut that day to visit, the dissecting room and its vault might have been the preferable location of the two for Littlefield. It was, in any case, more truly the man’s castle; for Littlefield not only saw to its maintenance, he was quietly in charge of keeping it well stocked with bodies.
The problem of obtaining cadavers had dogged Harvard for decades. Painstakingly crafted wax anatomical mannequins, imported from France, might suffice for public demonstrations, but training students in the fine points of surgical and anatomical instruction allowed no substitute. While in other cities, corpses could be had from graveyards for the price of a bottle of whiskey and a midnight bribe to the sexton, Boston’s precincts of the dead were better guarded, not least because of the particular umbrage local Irish Catholics took at “resurrectionists.” And that was too bad, as port cities had the best specimens; sailors were especially prized for the fine musculature they displayed under the scalpel. Harvard had some legal right to unclaimed indigent bodies but for years had quietly supplemented its supply of cadavers by buying them in bulk on the Manhattan black market. The problem was so acute that Harvard medical students paid a special five-dollar fee for access to the dissecting room, and while this collection was not labeled a grave-robbing fund, it might as well have been.
The new Medical College building opened in 1846 and was greeted in print not with acclaim but with a dime-novel shocker: Marietta, or The Two Students: A Tale of the Dissecting Room and “Body Snatchers.” In case there was any question about whose dissecting room was meant, the story clarified it by including a Boston street address, as well as other details whose veracity came from its author being a recent dropout from the college.
The opening scene’s taunt by one medical student to another, as they faced a beautiful young woman dead on the table, carried the hard and cold ring of experience:
“What possible harm can it do to that body—fair and delicate it is I allow—to dissect it?” the classmate asks. “Will it feel the keen edge of the knife? Will the tender limbs shrink from it, and give intimations of torture? Do you fear that those closed eyes there, will start open, and that clod-like hand will raise itself, and that still tongue will throw off the spell of death, at the first incision, and entreat you to desist? Fie! Where is your manhood?”
Marietta could be awkwardly laughed off as a fiction, right down to its unnerving scenes of bodies being electrically shocked into twitching and spasms, but events two summers later made the portrayal come uncomfortably close to the truth. In May 1848, in the New Hampshire mill town of Manchester, one Sarah Furber left her boardinghouse for the afternoon, saying she was “visiting relatives in the city.” She never came back. Her fate might have joined that of many others who simply seemed to vanish from newly burgeoning cities, save for a shocking revelation weeks later in New Hampshire newspapers: “Her body was carried to Boston, where it has been found in a dissecting room, cut to pieces!”
Nobody needed to ask whose dissecting room it was. The resulting inquest, published in cheap pamphlets and hawked to the public as readily as Marietta, hauled Harvard before a jury to reveal the whole unsavory truth. Sarah, a young woman in whom the pamphlet found “nature was not sparing in its ornaments,” had been carrying on an affair with a married forty-eight-year-old man in Manchester. Soon her housemates noticed her fashionable green-and-white dotted dress being let out slightly; in her brasher moments, she confided that “she was going to throw off her quilted coats and join the aristocracy.” Sarah’s beau had other ideas. After a failed attempt at abortion through a laudanum overdose, she was sent to her “relative in the city”: James McNab, a doctor willing to perform procedures for the right price.
It did not go well.
Dr. McNab, hoping still to turn his afternoon to some profit, had coolly packed Sarah’s body into a crate of straw and charcoal and taken it with him to Boston as baggage marked GLASS. A visit to Oliver Wendell Holmes, the medical school’s dean, was quickly arranged, and a student recalled McNab’s sales pitch for “a young girl, 20 years old, perfectly fresh. . . . He spoke of her freshness two or three times.” What was more, McNab’s price was reasonable—“he said he would sell it cheap, as it had cost him but a trifle.”
Holmes needing little convincing. He sent Littlefield over to pick up the goods from McNab’s hotel, telling the doctor that if the body was all he said it was, he had a sale.
“If I send a man with ten dollars,” Holmes assured him, “there will be no trouble about it.”
But there was trouble. The body, examined on the dissecting table, was distressingly fresh—too much so to have come from a graveyard. Joined by Professor Ainsworth in examining the specimen with a few incisions, Holmes found that the cause of death became readily apparent: a very clumsily pierced uterus.
“Never in my practice have I seen anything like this puncture,” Professor Holmes shook his head. “I hope I never shall again.”
Littlefield was sent back to McNab with a curt response: No sale. The doctor swallowed his rising panic and asked the janitor for a small favor.
“Bury it,” he asked. “Or cut it up or put it down the vault.”
Littlefield, sizing up the situation, demanded five dollars. Instead of earning ten dollars, McNab was now taking a loss on Sarah—and, desperate, he handed over the money, reminding the janitor to “put it where it would not be found.”
But it was already too late: Holmes had sent for the police, as McNab was clearly a menace to the medical profession. So the Medical College had indeed done the right thing—eventually. Nevertheless, the scandal dragged both Holmes and Ainsworth before a jury, as well as Littlefield, and left the school firmly established in the public mind as a den of body snatchers. In that fall’s newly printed Harvard catalog, the school now sheepishly promised, “No exertions are spared to obtain a supply of subjects according to the existing laws.”
Just about the only person to come out ahead was the janitor. He’d kept the doctor’s five dollars.
WEBSTER’S LECTURES weren’t all dry recitations; he always affected some theatricality. In his undergraduate chemistry class, he was known for pyrotechnic displays that on at least one occasion had nearly set the building afire. On another, a gas explosion shot a copper vessel across the lecture hall and demolished a seat in the back row—a seat whose usual inhabitant, fortunately, was absent that day. After being upbraided by the college president, Webster reluctantly admitted, “He said I should feel very badly indeed if I had killed one of the students. And I should.” But demonstrations in animal chemistry to graduate students were a different matter; a medical school lecture required a more subtle flair. That Thursday, November 22, he retreated back down the stairs into his laboratory, doffed his lecture coat, and decided that he needed another important tool for his lectures: blood.
Blood was a splendid thing to have in the lecture hall. You could show the absorption of gases by agitating the stuff in a vial of oxygen and watching the fluid turn bright red; with some low heat you could separate out the serum, so strangely like egg whites; and if the blood came from a gout sufferer, you could cook down that serum into pink crystals that resembled cayenne pepper—uric acid, the fiery cause of all the patient’s agonizing woes. Later on, when the students were more advanced, the
y could be shown the delicate process of the Marsh test. Webster, as a hired expert in a murder cases, often had occasion to use the test on blood. And Massachusetts General, just across the field from the laboratory, was a veritable spigot of the stuff.
“I want,” he instructed Littlefield, “as much as a pint.”
The shelf by the stairs to the lecture hall held a number of glass receptacles, and the janitor grabbed a larger one, about quart-sized; the extra capacity was good to have, as you never knew how much blood they’d actually drain out of a fellow.
How’s this? he asked Webster.
“Yes,” the professor said with a glance. “Get it full, if you can, over at the hospital.”
The janitor took the jar upstairs, but he paused before continuing up to the second floor; the person he needed would be coming out of another professor’s class, and the lecture was still in progress. Littlefield gently set the jar down atop a display case and waited for the inevitable swelling of noise at two p.m.: the scraping of chairs, shuffling of papers, a professor’s final instructions—Gentlemen! Remember!—called out over the din.
Inside the anatomy lecture hall, students were emptying out as Professor Holmes gathered up his presentation aids. To most of the public, Oliver Wendell Holmes was a poet—the man Poe had praised for “Old Ironsides,” written when he was just twenty-one. To Bostonians, he was a physician from one of the area’s oldest families, a man whose impeccable breeding made his newfangled insistence that doctors wash their hands all the more remarkable: opponents might protest that “a gentleman’s hands are clean,” and what was Holmes but a gentleman? To his colleagues, he was the respectable public face of the institution, a dean still fairly new to his job, but an old friend of Emerson’s and a Med Fac prankster of the Class of ’29. He could be seen strolling the leafy campus, a tape measure in his pocket to measure tree trunks—he had a peculiar love of anything arboreal—and pointing out the wonders of nature to his eight-year-old boy, Oliver Jr.