by Tony Pollard
‘That was the third of your lectures I have attended, doctor. I have found them fascinating, most fascinating. But one thing has been puzzling me. I have been addressing you as doctor, just as I have heard others call you, but is it not usually the case that you surgeons refer to yourselves as mister?’
‘Well spotted, sir. There has long been a fashion for surgeons to be misters rather than doctors; it goes back to our medieval origins as barbers, when razors were used to cut more than beards. But in addition to my training to be a surgeon I also earned a doctorate in philosophy for my research, so people tend to use my academic title. Anyway, my patients seem happier believing they are being treated by a doctor rather than a plain old mister.’
Brunel smiled. ‘Research, eh? Well, doctor, that brings me to my next enquiry. I was hoping that you and I could talk further on aspects of an anatomical nature.’
The prospect was an intriguing one, but this was not a good time. ‘Sir, it would be a pleasure to talk further with you and share whatever knowledge I have, but I am afraid I have commitments in the hospital for the rest of the day.’
Brunel walked back to the bench on which he had been seated and picked up a tall stove-pipe hat. Pressing it on to his head, and in so doing adding at least a foot to his height, he turned back to me. ‘No matter. I have an appointment with a pack of scoundrels at the yard anyway. Perhaps I could call on you at a time more convenient to both of us?’
‘Very well,’ I replied, pushing my hand free of the coat-sleeve just in time to shake his once again.
With that he was gone, leaving behind him a cloud of cigar smoke which had still to disperse by the time I made my own departure several minutes later.
*
There is always something special about making the first incision in a fresh cadaver, breaking the skin which, until my intervention, has served to hold inside the wonderful mechanism which is man. But today William seemed set on taking the shine off the occasion.
‘That may be the last for a while, sir,’ he said, mournfully surveying the corpse he had just delivered to the table.
‘What do you mean, the last? You sound like a poulterer running short of birds at Christmas.’
‘There may be one or two, but it’s the typhus – the city fathers ’ave suspended all supplies until it passes. They’re burnin’ the stiffs – I mean corpses – that would normally be comin’ our way.’
Of course I was aware of the outbreak, but I had not yet considered it a threat to our supply of cadavers. Under normal conditions the hospital created not far off enough corpses to feed its own teaching needs and, as I had explained to Brunel, any shortfall was made up by sources such as the workhouses and jails, but an outbreak of typhus or cholera anywhere in the city meant that all fresh corpses were buried in quicklime or burned on communal pyres.
‘Then we will have to hope for a swift end to the outbreak, won’t we?’
William seemed doubtful. ‘My sister says she’s thinkin’ of movin’ back to the country.’
‘I can’t blame her, William. What do we expect when the Thames itself is nothing but an open sewer? From what I hear, though, the source is Newgate Prison, and not for the first time.’ It was well known that the inmates were kept in such dreadfully cramped conditions that any contagion spread like wildfire and inevitably escaped into the wider population.
‘Give me an escaped murderer over pestilence any day of the week,’ commented William.
‘We must be extra vigilant. Break out the brushes and keep scrubbing. Just how bad is the situation?’
‘Pretty grim, I think. Twenty or so dead. But no sign yet on our own doorstep.’
‘No, William, not the typhus, the cadavers. How many do we have left?’
‘Oh, can’t tell you that just now. I need to do a stocktake.’
I looked at my watch. ‘Well, there’s no time like the present. We still have half an hour before the students arrive. Let’s go down to the cellar.’
William was apt to preside over the cellar like some goblin prince of the underworld, and he was initially a little put out by my insisting that I accompany him into its depths.
‘You need to be careful,’ he warned. ‘It can get a little close down ’ere, what with the fumes an’ all.’
In the low, vaulted chamber, the walls of which were slicked with moisture, the light was poor, what illumination there was provided by a series of vents which opened out at street level. The footsteps of pedestrians could be heard as they passed by on the pavement – they would surely quicken their pace if they had any inkling of the use to which the space beneath their feet was being put.
In one corner of the brick-floored room was a large iron cauldron perched upon an inert hearth with a flue above it. It was here that William boiled down the remains of cadavers once I had no further use for them in the theatre, removing all trace of flesh and leaving nothing but the bones. In the centre of the room was a huge wooden vat, its barrel-like staves bound tightly by iron hoops and surrounded on the outside by a timber walkway at the top of a short flight of steps. William took a long pole with a hook on the end from a rack on the wall and, once on the walkway, began to stir the dark fluid within.
‘Here, give me that,’ I said, eager to assess the situation for myself, but before I could take a hold of the thing the vinegar-like bite of the preserving spirit threatened to knock me off my feet and I let out a choking sound.
‘You may want to tie your ’ankerchief round yer mouth, doc. Like I said, it’s pretty strong stuff at this volume, and you don’t want to be fallin’ in there.’
I did as he suggested. ‘Doesn’t it get to you?’
‘Not any more, sir. Guess I’ve been pickling myself from the inside for long enough not to be fussed.’
I laughed, only to start coughing again.
‘Steady, sir. Sure you don’t want me to do that?’
I shook my head and swept the pole through the fluid. It continued unhindered from one side of the vat to the other. Drawing out the hook, I changed position on the walkway before trying again. This time its passage was obstructed, and with a firmer hold on the shaft I pulled the hook towards me. First an outstretched arm and then the head and torso of a cadaver broke the surface. It was a male of indeterminate age and, like a friend of William’s, his mouth was set open as though to drink in the liquid in which he floated. Pulling the corpse to the side of the vat before allowing it to sink again, I moved once more and made another sweep. Nothing.
‘You were right, William. This soup is thin, far too thin.’
Our faces shrank and then expanded in the surfaces of the large glass jars lining the shelves. Suspended in the clear preserving fluid were the various members of the anatomy collection; body parts now become artefacts in this museum of life made possible only through death. There were organs, limbs, almost-entire bodies, some normal, some displaying disease, others deformed. Flesh was discoloured in preservation, everything appeared strangely unreal in this freak-show cum hall of mirrors I knew as a workplace.
Brunel peered into the jars. Moving from one to the next, he stared, fascinated. I pulled one down and placed it on the table. A heart bobbed in the unsettled fluid. We had talked for most of the afternoon, and it was by now very clear that his interest in human anatomy centred around this organ in particular. He rested a finger against the glass as the liquid stilled. The heart turned gently before coming to rest. I pointed to the various parts, rotating the jar on the table as I spoke their names and explained their various functions.
I had not proceeded far when William returned from the preparation room to inform me that my instructions had been carried out. I told him to bring the subject to us and returned to my tutorial, explaining to Brunel the role of the severed vessels protruding from the organ. My guest stifled a query as William appeared again, this time carrying a wooden board with a freshly removed heart perched upon it. He put the board on the table next to the jar and returned to his duties.
<
br /> I pushed the heart, which just happened to be our last fresh specimen, around the board with the blade of a scalpel. This allowed me to clarify points of detail which may have been less than clear due to the incarceration of the previous example. After pointing out the pulmonary veins, the aorta and vena cava, I turned the heart and moved on to the ventricle and the heart bulb. Brunel asked one question after another, his incisive comments and queries forcing me to dust off an expertise which had lain almost dormant since completing a programme of detailed research some years before. It felt good to be stretched, so much so that I determined to spice up the perhaps rather stale heart and lungs lecture I regularly gave to my own students. But before then, of course, I would need to acquire fresh specimens and in the midst of the current typhus epidemic that was not going to be easy.
Once the discussion of the heart’s outer appearance had been concluded to Brunel’s apparent satisfaction, I began to dissect, bringing the blade down on the surface at a point just to the front of the vena cava superior. For an instant the muscle refused to give, the resilient tissue springing under the blade. Then it went, and with a snap the scalpel began its work, dividing the sinews and cleaving its way through the outer wall of the heart. I cut down and back, opening a deep incision across the ventricular and auricular margins. Rotating the heart, I continued round with a sawing motion, parting the edges with my fingers. Then it was done, and the organ fell apart, separated into two slightly unequal parts.
With the internal parts exposed we studied the chambers, the walls and the entrances and exits through which the blood passed. In order to assist my demonstration I poked a brush bristle through one opening and indicated to my student where it would reappear in another. I explained that the right side, with auricle to the top and ventricle below, was the venous side, where dark blood drained of its life-giving properties arrives first, from the upper part of the body via the vena cava superior and from the lower via the minor, into the auricle and then the ventricle, after circulating around the body. From there, I went on, it is fed through the pulmonary artery into the lungs. After being arterialized the refreshed blood then returns to the left side of the heart via the pulmonary veins, pumping into the left auricle before being drawn into the attendant left ventricle. Leaving the heart through the aorta, the blood is then recirculated into the body through the arteries.
Brunel seemed intent on fully understanding the theory of the pumping action. He was fascinated by the tricuspid and coronary valves, the position of muscle walls at various points in the process being of special interest to him. All the while he made sketches in a notebook, furiously scribbling with the stub of a well-worn pencil.
Aware of time drawing on, I took an ostentatious look at my watch. But Brunel was not a man to take a hint. Question followed question until finally I had to be rather abrupt and insist that we brought the session to an end as I was by now late for my rounds. He at last demurred but asked if he could stay behind for a while and take some measurements. I left him working under the blind gaze of a pair of eyes as they floated, one above the other, in a jar beside the door. In life they had been a startling blue but now they were a dull grey.
Now, rushing from bed to bed, I tried to concentrate on the task at hand but my thoughts constantly returned to the engineer and the ease with which he had grasped details I had always considered the domain of my own profession.
Upon returning to the collection room in the late evening, the heart was still on the table and it was obvious that Brunel had made several further incisions. Next to it lay an unsmoked cigar and a note scribbled on a page torn from his notebook:
Dr Phillips,
The day has proven most informative. My thanks to you for your kind indulgence of an engineer’s whims. Another engineer, by the name of Leonardo da Vinci, once wrote: ‘How could you describe the heart in words without filling a book?’ Such is your eloquence on the matter that I believe you could. I look forward to renewing our association in the near future.
I. K. Brunel
2
Examining a patient’s stool is not the most edifying way to start the day, especially when the task is interrupted by the unmistakable voice of the hospital superintendent, Sir Benjamin Brodie, assailing one from the rear. ‘Ah, Dr Phillips,’ he announced, with all the satisfaction of a hunter having run his prey to ground, ‘I thought we might have a word in my office at some point today.’
I turned around, only just keeping control of the contents of the bedpan, and addressed the gaunt, grey-haired man now standing before me. ‘Yes, Sir Benjamin. When would suit?’ I should have left it there but foolishly let my tongue run on. ‘I have a relatively easy afternoon ahead of me.’
‘Well, we’ll see about that,’ replied Sir Benjamin ominously; the old goat never missed a trick. ‘Four o’clock then.’ And with that he was off, stalking down the ward with Mumrill, his odious assistant, in tow.
‘Shit,’ I muttered under my breath, passing the pan to the nurse. She looked inside and nodded, no doubt in appreciation of my powers of observation. The stool was free of blood but discontinuous, its edges jagged and rusticated as though it had suffered violence inside its host, which was to be expected of a turd produced in a bowel so recently the subject of an operation. I smiled reassuringly at the patient, who seemed a little bemused at my interest. ‘Very good,’ I said. ‘Nothing to worry about there.’
Having finished on the ward, I made for the sanctuary of my office, still regretting my ill-conceived comment about an easy afternoon. If there was one thing that made Sir Benjamin happy it was to see his staff kept busy. Lord knows what extra duties were about to come my way.
‘What are you doing here?’ I asked, somewhat irritated to find Brunel sitting behind my desk and flicking through my case notes – famous engineer or no, those records were confidential.
‘Good, you’re here at last,’ he chimed, casually casting aside the sheet of paper in his hand. ‘You have some very sick people on your hands.’
I tidied up the papers and dropped them into the drawer of a cabinet next to the desk. ‘You did see the word “hospital” written over the front door as you came in?’
My ill-tempered sarcasm fell flat on his thick skin. ‘Grab your hat and coat. We’re leaving,’ he sparked, jumping to his feet.
Surely, I thought, this was not the same morose fellow who had introduced himself in the operating theatre a couple of weeks or so before. But, despite his enthusiasm, the proposal was out of the question. ‘Impossible!’ I insisted. ‘I’m on duty. Sir Benjamin will have my guts for garters if I leave the premises.’
The engineer cocked his head and looked at me as though I were an idiot. ‘Do you or do you not want to see history being made?’
I closed the cabinet drawer. ‘You’re going to launch the ship?’
‘Yes. Now get a move on.’
Against all better judgement I followed him out into the hall, pulling on my coat as I went but returning briefly to pick up my medical bag.
The prospect of witnessing the monumental feat of pushing the ship into the water quickly overwhelmed all sense of responsibility. I had memorized its weight of 22,000 tons from the newspapers. That made it the heaviest object ever to be moved by man – if he managed to move it, of course. According to the papers, very few people, including fellow engineers, believed that such an incredible feat was possible.
Irresistible as the attraction was, I took my Hippocratic oath seriously enough not to leave my patients at risk. I had no rounds to make and had planned to spend the rest of the day, until my evening duties, on tiresome paperwork. Nonetheless, just to make sure my absence was known to someone I reported to the senior physician and told him I had been called to attend an unexpected emergency, little realizing how prophetic this fabricated excuse would later prove.
Less anxious now, I departed with Brunel, satisfied that as long as I returned in time for our meeting there was very little chance of my absence coming to t
he attention of Sir Benjamin.
As we drove towards the docks I sat in the grip of an excitement that had lain dormant since the last time I played truant from school.
Brunel’s carriage was like no other I had seen before and contained a folding table and bed. ‘It was my office and accommodation while I worked on the Great Western Railway,’ he explained as we trundled along.
‘But an office built for speed,’ I said, having taken note of the graceful lines and sleek four-horse team.
My comment serving as a spur, the engineer checked his watch. ‘The navvies called her the flying hearse, and we might as well be on our way to a funeral for all the progress we are making. Samuel, pick up the pace,’ he yelled, ‘at this rate I’ll miss my own ship’s launch.’
The driver replied through a small hatch in the roof. ‘Sorry, sir, the traffic’s dreadful.’
Putting my head out of the window, I looked ahead to see an abnormal number of cabs, wagons and omnibuses – a logjam of humanity threatening to choke the road before us. The closer we got to the river, the worse the congestion became, the carriage by now moving in stomach-churning stops and starts.
Brunel’s patience had run out. ‘Samuel, we’re going ahead on foot. Follow us when this madness clears.’
We trotted along the pavement, but by now it was almost as choked with pedestrians as the road was with vehicles. All of them were walking in the same direction, towards the river. Then the truth of the situation dawned on Brunel. ‘Look at this, Phillips! I don’t believe it. Those dolts from the company have broken the news about the launch. The fools have turned today into a circus!’
By now we were barging our way through the dockyard gates, and Brunel almost exploded when a man wearing a steward’s armband asked him for his ticket. ‘Ticket, ticket! I have a ship to launch! Now let us through and for God’s sake close those gates.’