The Anatomist: A True Story of Gray's Anatomy

by Bill Hayes

  We all take a turn, rotating the arm as well as flexing it in a modified biceps curl. Just making the movement occur, though, is not enough. Each of us is compelled to place a gloved finger directly in the elbow joint as the bones twirl and glide, to feel what can only be felt from the inside: movement at its source.

  Dr. Topp, overhearing our excitement, comes to take a look. “Even after all these years,” she leans in to me and says, “I still find that really cool, too.”

  I look around and see jaws dropping at every table. Celeste and her group have exposed the shoulder joint, a ball-and-socket that has pulled them into its rotation. One table down, it is circumduction of the wrist. Two over, it is pronation of the opposite forearm, the elbow dance in reverse. Students stroll around the room, table to table, watching, making, and feeling the movements. Everyone here, the living and the dead alike, has become a demonstrator of anatomy.

  IF NOT IN the classroom demonstrating, he might be found in the lab dissecting. And if not in the lab, then at the hospital, whether in surgery or in the morgue or in the Dead House, or maybe in a meeting, being by now a member of the board of governors of St. George’s, not to mention the London Pathological Society and the Royal Medical Society and the Hunterian Society. And with the few spare minutes left in a day, in early October 1852, Henry Gray could most likely be found in his office at home. But do not disturb him. He is trying to complete his treatise on the spleen, a project he has been working on for more than two years now, and it is due in less than two weeks.

  This would be Gray’s submission for the Astley Cooper Prize, a prestigious award based on a dead man’s unusual posthumous request. As mandated in the will of Sir Astley Cooper (1768—1841), every third year a judging panel would accept manuscripts of original research on a predetermined anatomical part, pulled from a list he had drafted. The spleen was the current topic of inquiry. The not insignificant cash award to this triennial prize, paid from a sizable endowment, was £300. The winner would be announced the following July.

  Cooper, a highly regarded English anatomist, surgeon, and professor, had died when Henry Gray and Henry Vandyke Carter were just boys. But he was responsible, in a sense, for bringing them together. Had it not been for Sir Astley’s prize, after all, Gray might not have found himself in need of an artist, back in June 1850; Carter might not have found himself offering his services; and, ultimately, the two Henrys might never have become friends.

  There is no better gauge of a friendship, I believe, than the ability to do nothing together, and, as Carter’s diary testifies, the two had little trouble in that department. They would often while away quiet afternoons together, and one day Gray even coaxed Carter into doing something completely out of character: the two men stepped out of the hospital doors and just kept walking. Once they got to Chelsea, they took a leisurely boat ride on the Thames, eating up a whole half day. Carter, in other words, had played hooky! He normally fought against “idleness” and berated himself for each misspent minute, yet he never portrayed being idle with Gray as wasted time. Gray felt likewise, no doubt; in H. V. Carter, he had met a kindred spirit.

  Despite the differences in age, religion, and family background, these two shared a keen interest in medicine and science, of course, but also a passion, verging on the macabre, for dissecting. For instance, even after Gray completed his one-year stint as postmortem examiner (1848—49), he continued on in an unofficial capacity. Quite often, Carter attended these autopsies as an observer, and at least once that I can verify, he assisted Gray in a PM exam. For both men, a postmortem was a dissection with a puzzle built in: What went wrong here? Sometimes, in addition, the examination yielded an unexpected anatomical treasure, such as a heart with four rather than three cusps to the aortic valve, an astonishing anomaly.

  As for Carter, his dissecting proclivity was never more pronounced than during summer vacation back home. On top of fishing with his brother or walking and people-watching with his sister—seaside Scarborough swelled with vacationers (“trippers”) this time of year—he would spend many an hour performing dissections. Not on cadavers, mind you, but on local creatures, frogs and fish and such. In one nigh-maniacal marathon, he first dissected a single snail, then five more, then collected an additional half dozen for future disassembly. Oh, and p.s., “Snails not easily killed!” he noted boyishly in his diary. Though his relentless dissecting seems almost comical (and I can only imagine what his parents thought of this pastime), it also shows Carter’s seriousness of purpose, as he was, in effect, teaching himself comparative anatomy, the study of the similarities and differences in the structure of living things.

  Following the 1850 summer break, he returned to London and performed what would become a ritual over the next few years: he immediately checked in with Henry Gray. I get the sense that seeing his friend after time away was a welcome, and perhaps even necessary, way to transition back into frenetic London life. Gray, like an affable older brother, clearly had a steadying effect on the anxious, temperamental Carter, and he was always encouraging and respectful of his talents.

  Carter’s involvement with the spleen project came in two bursts. He created twenty-three paintings and drawings initially, but it wasn’t until April 1852 that the senior Henry again needed his artistic skills. This time, the focus was the spleen in animals. These drawings were done primarily at the Royal College of Surgeons, a two-mile (three-and-a-quarter-kilometer) walk from St. George’s, where Carter worked from the school’s extensive collection of preserved animals. And, no doubt, his knowledge of comparative anatomy proved useful, especially since Gray, by his own admission, had little experience in this branch of anatomy. But what made these drawings unlike any he had ever produced was that, once the batch was completed near the end of June, he got paid. Better than finding a fourth cusp on an aortic valve, this was H. V. Carter’s “first professional engagement” as a medical artist, and Henry Gray had made it possible.

  Actually, make that “Henry Gray, F.R.S.”

  Gray had been bestowed those three little letters just a few weeks earlier. On June 3, 1852, he was elected a Fellow of the Royal Society, a singular honor for a man of just twenty-five. His candidacy had been supported by a long list of Fellows, yet it was really Gray’s own work that had provided his highest recommendation. On earlier occasions, two of his scientific papers—one detailing original research on the development of the human eye, another on the spleen—had been read before the assembled Fellows, then discussed by the group, an experience that must have been as heady the second time as the first. Both papers were accepted for publication in the society’s prestigious journal, Philosophical Transactions. And shortly after being named a Fellow, Gray received a £100 grant from the Royal Society, to be used toward completing his investigations into the spleen, including, presumably, paying for his artist’s efforts.

  Carter had recently acquired an impressive set of initials as well. On May 21, the day before his twenty-first birthday, he became a Member of the Royal College of Surgeons, having passed the extensive entrance exams. Now certified to practice surgery, Henry Vandyke Carter, M.R.C.S., still had to obtain an apothecary license in order to become a full-fledged physician. The apothecary exams would be coming up in October.

  Carter, who had completed his required apprenticeship with Dr. Sawyer earlier in the year, had also moved out of the Sawyer home and acquired a new address. Joined by Joe Carter, who had come to London to study art and, if H.V.’s rantings are to be believed, to torment his older brother, had moved into an apartment on Upper Ebury Street. Though he now lived much closer to Henry Gray’s home, gone were the idle days of old. The demands on their time had become too numerous, Carter with his studies and exam prep, Gray with his many professional obligations and the looming deadline for the Astley Cooper Prize.

  When that day finally came, it received a quiet mention in Carter’s diary. “See Gray,” he notes on October 13, 1852. “He has just finished his subject.” If Carter sounds w
eary, it is for just cause. Six days earlier, he’d “passed the Hall,” meaning he had earned his apothecary license; all his formal schooling was done. And six days hence, he would be setting his London life aside and leaving the country.

  OCT. 1852. “19 Tu. Last day in town. Today got passport & ticket. Back just in time to get things together in 2 carpet bags—one Mrs. Loy’s—leaving many important things, amongst others, my Bible, which much regret—”

  Mrs. Loy? That’s his landlady.

  Why the hasty departure? And where did he go? Well, again, Carter himself does not explain. As is the diarist’s prerogative, he doesn’t have to. The same rule does not apply to the letter writer, thankfully. Letters demand a narrative and very often provide an explanation. I therefore returned to the Carter archive, placing an order for 3 of the 116 surviving letters from H.V. to his sister Lily, who was nineteen months his junior. These three bear the postmark “Paris.” I requested scans this time, this time being impatient, and within days, via online delivery, I, like Lily Carter almost 153 years ago to the day, found myself opening mail from H.V.

  October 23, 1852

  Hotel de Seine

  Rue de Seine

  Paris

  My dear Sister,

  This is the first quiet evening I’ve had since I left town and I take occasion of it (as the French might say, if they spoke English) to quiet your apprehensions at home, to satisfy, in a measure, your curiosity.

  But before he continues further, a caveat:

  Do not anticipate, dear Lily, a detailed account of all I’ve seen and heard, nor yet, a chapter of horrors and oddities: what I write is meant for a succinct narration of facts and observations—so now to begin.

  Fortunately, Carter does not stick to this game plan and proceeds with lively detail about his voyage by steamer and rail to Paris. On his first night there, two fellows he had met on the journey took him out on the town—and oh, Lily, what a time! “We supped at a grand café, a la Française, everything in great style such as you have never seen.” Then, in a sentence that does not come up for breath, he tells how the three strolled in the Palais Royal, “a most extensive pile of splendid buildings with a square and fountain and gardens in the middle, and gorgeous shops around, colonnades, and arcades all lit up in the most brilliant manner and crowded with chattering gay French folk—the whole is a tout ensemble, certainly not equaled in London, or the world.” Breath. “We were charmed.”

  He seems almost drunk on the details, and it is somewhere between his descriptions of the tree-lined boulevards with their magnificent houses and his sharing his plans to go to the Louvre the next day that I recall why I went to Paris for the first time at his same age: to see Paris. That is reason enough, if not reason alone, to pack one’s bags. But Carter, it turns out, had also come to Paris with letters of introduction and a larger purpose: the man who had just finished his studies was actually continuing them.

  As becomes clear in his second letter, he arrived in Paris just in time to get settled and make the opening ceremony for the winter session at the renowned La Charité Hospital medical school. Already, Carter had resumed a familiar routine. “In the morning I go very regularly to one of the great hospitals where the physicians and surgeons usually begin to visit at 8:00 or soon after. Then comes a lecture—a ‘clinique,’ we call it—then a walk to the ‘Laiterie’ (breakfast), where we arrive with a good appetite. In the middle of the day, I’m engaged at the lecture and dissecting rooms.” In addition, he regularly goes on rounds and attends lectures at Paris’s famed Hôpital des Enfants.

  Part of me wants to say that making this trip was a very smart move on Carter’s part, a way to gild his résumé (not to mention, improve his French). But I know better. I have glanced ahead. And his daily entries soon leave no doubt that something else is going on here, something he would never share with his sister.

  He had forgotten his Bible but brought all his demons with him. Like a storm that’s suddenly changed direction, Carter’s crisis of the soul has shifted from doubts about faith—the impetus for Reflections, a volume that is tellingly silent during this Paris period—to overwhelming anxiety about his professional prospects. Now that he has obtained his diplomas, he must make the transition from student to practitioner, yet Carter sees nothing but difficulties ahead. Rather than face them, he is in Paris, a fugitive from his own future. As he writes on New Year’s Day 1853, “The tolerable success and éclat of student’s progress at St. George’s is over. Then, knowledge was my sole aim; now, I must think of a livelihood.”

  His is not an uncommon dilemma for a new graduate, but I suspect he is operating under the misconception that learning must end with earning a living. Though his “love of science and the higher branches of the profession” remains steadfast, Carter confides that he has “no interest whatever in the Profession.” He does not want to be a John Sawyer, a G.P. with an apothecary and an apprentice and so on. At the same time, Carter feels he still lacks the self-confidence, the inner oomph, “to strike high and risk the consequences,” meaning, to be an innovator such as Henry Gray, for instance.

  “Perhaps [I] ought then to be content with a lower station,” he tells himself, “yet, and here seems the rub, my ambition is but just enough raised to cause inquiet…. This is the poison.” And the poison paralyzes.

  He has, however, set into play a possible escape plan. Just prior to leaving for Paris, he had made a number of discreet inquiries about becoming a surgeon aboard a “packet,” or small cargo ship, traveling back and forth between England and India. The colony had become a major market for English goods, and hundreds of companies were operating vessels with fully staffed crews. In fact, one of the surgeons at St. George’s had promised Carter help in getting a “surgency” with an outfit called the General Screw Steamship Company. Such a job must have sounded far more exciting to him than hanging out his shingle back in London or Scarborough.

  That the idea of leading a more adventurous life would have appealed to the twenty-one-year-old is reinforced by a rather large clue he left behind. It comes on the very first page of his new daily diary, bought and begun in Paris. On an otherwise blank page, Carter affixed an elegant calling card bearing only a name:

  J. BELLOT, LIEUTENANT DE VAISSEAU

  It meant nothing to me until I returned to his first letter to Lily. Of course! Bellot was the name of one of the fellows who had taken Carter out on his first night in Paris, “a Naval English-looking young officer,” he’d told his sister. In point of fact, Bellot was not English, as Carter soon discovered. But that was the least of it. After dinner and a good many glasses of wine, the men began discussing the latest news on Arctic exploration, and, as H.V. explained to Lily, “I burst into admiration of a French officer who accompanied the last expedition.” This man’s story had been in all the papers back home; he had become a hero to the people of England by volunteering in the search for Sir John Franklin, a celebrated English explorer and sea captain who had disappeared in the polar regions.

  As Carter told his sister, he’d gushed and gushed about this brave French officer till, finally, “my friend stopped me and said he could not hear himself so praised—he was the very man,” Joseph René Bellot! (the “Bellot of the Papers,” as Carter would call him)—but so modest that no one would ever have guessed. “And we found him out by chance.”

  Next morning, Carter and Bellot breakfasted together, then spent the day walking around Paris—the Tuileries, Place de la Concorde, and other sights—till, finally, the two parted ways, Bellot having his own journey to complete. The young adventurer left behind an indelible memory and a calling card that Carter would later put to use when starting his new diary on New Year’s Day. The name on the card would serve, in effect, as the epigraph for the next phase of his story—The Life of Henry Vandyke Carter, Volume 2—setting a bold tone for what was to come.

  PART TWO THE ARTIST

  Man is only man at the surface.

  Remove the skin, disse
ct,

  and immediately you come to “machinery.”

  —Paul Valéry (1871-1945)

  Eight

  SOMEDAY I MAY WONDER WHERE I FOUND THE NERVE TO DO this. It is just one hour after morning coffee, and I am helping to perform what is awfully close to a decapitation. We have turned our cadaver onto its stomach and have propped the chest on a block so that the head nods down, leaving the neck a clean downward slope. This is whiplash terrain, the thick, powerful muscles that help support the head, and I slice right through the three main ones: the longissimus capitis, the semispinalis capitis, and the splenius capitis (capitis meaning “head”). Kelly, the gang, and I take a few minutes to examine each fleshy cross section, then plunge ahead. Our ultimate goal is to dissect C1, the very top vertebra of the spinal column, a site of catastrophic neck injuries. Commonly called the Atlas, for the man of myth who held the world on his shoulders, this deeply embedded vertebra serves as the base for the globe that is the head. To reach it, we need to tunnel through several more layers of muscle.

  I can see C4, like a subway token at the bottom of a meaty purse, but rather than stopping to finger it, I slice northward about six inches (fifteen centimeters). Now, Kristen, facing me on the opposite side of the cadaver, makes a horizontal cut across the base of the skull, connecting the backs of each ear. Where her line meets mine, we each begin peeling back the triangular flaps of scalp. Just like on my head, our truck driver’s hair is buzz-cut (as are all the cadavers’), to make tasks such as this easier. The skin feels as tough and bristly as animal hide.