The Anatomist: A True Story of Gray's Anatomy

by Bill Hayes

  Fifteen

  IN A WORKING-CLASS NEIGHBORHOOD IN SOUTHWEST LONDON, forty minutes by tube from the site of the original building, stands the current St. George’s Hospital. There is no grand façade. No columns, no marble, no tourists. The modernist architecture of today’s St. George’s is straight out of the 1970s, uninspired and un-memorable. On the other hand, just as in the days of Gray and Carter, the building doubles as a general hospital and a teaching hospital and, fortunately for my purposes, contains a small archive of historical material as part of its medical library. Even better, St. George’s has Nallini Thevakarrunai, the “library cataloger,” as she describes herself (archivist, I would call her), who has been the soul of patience in answering my many questions via e-mail about the hospital’s history.

  Upon receiving her responses back home, I often thought, What a beautiful name: Nuh-lee-nee Thu-vak-ar-roo-na; it sounds like a musical phrase spelled phonetically. And upon meeting her in person in the St. George’s library, I find she exudes a similar quality, pleasant and serene. Nallini is originally from Sri Lanka and has worked for the hospital for almost thirty years, she tells Steve and me, which presents a mystery as she does not look a day over forty. She shows us a few historic items displayed in the library (including the hide of “Blossom,” the cowpox-infected cow that was the source for the first human smallpox vaccination in 1796), then leads us down a back stairwell to the archive, a small bunker of a room in the hospital basement.

  Nallini mentions that she wants to let Dr. Gibson know we have arrived. Moments after she makes a call, a red-haired thunderbolt enters the room: Sandra Gibson, heir to the title once held by Henry Gray, curator of the Anatomy Museum, and a professor of biology at the medical school. After a quick volley of hellos, Dr. Gibson says, “Did Nallini tell you yet?!” Too excited to wait for an answer, she continues in her Irish lilt, “Nallini said you were coming today, so I did some looking, and I found two specimens that I can link to Henry Gray.” The museum has only a few specimens dating from the 1850s, she adds, but by digging into old records and checking against Gray’s actual postmortem reports, she had confirmed their authenticity.

  It’s fair to say, I am pretty shocked, knowing that the original St. George’s Anatomy Museum had been destroyed during the Blitz. I didn’t think any specimens had survived.

  Eager to share her discovery, Sandra leads us across the hallway to “the museum,” although, as she is quick to concede, museum is too fancy a word for the place. It is a large room filled with sturdy shelves holding hundreds of containers—bottles and vitrines—containing anatomical specimens. This is a teaching collection, Sandra explains, a resource for the med school staff, brought into classrooms when visuals are needed. We come to a stop at a low shelf in the back corner. She removes a bottle the size of a Mason jar and hands it to me. “How’s your anatomy?” she asks in a friendly way.

  “Pretty good,” I reply, although I honestly have no idea what’s inside the bottle; it looks like a dog’s chew toy, microwaved.

  “This is the heart of a twenty-five-year-old woman,” Sandra says. “You can see the aorta here”—she points to an eye-shaped opening—“but what’s unusual is, she had four rather than three aortic valve cusps.”

  Pickled in preservatives, the heart has shrunken over time, but I can clearly see the abnormality she described.

  “Would that be what killed her?” Steve asks.

  “No, in fact, Gray says in his postmortem that this had never caused her any problems or even been detected. She died of typhoid or tuberculosis or something. But it was an unusual condition, which is why he preserved it.” Steve hands the heart back to Sandra, and she returns it to the shelf.

  She next shows us a preserved portion of spine with two completely separated cervical vertebrae—that is, a broken neck. This is another Gray original but, unlike the heart, is still in its original container. Rather than suspended in liquid, it rests on a bed of cotton in a thick-walled glass vitrine sealed at the top with bitumen, which looks like dried black tar.

  This is the closest I have ever gotten to Henry Gray himself, it strikes me as I hold the container. You could probably dust the inside of the lid for his fingerprints or open it up and hunt for one of his hairs, maybe an eyelash, and test it for his DNA. But, really, finding proof through fragments of Gray’s anatomy is not necessary. As Sandra explains, both specimens can be matched to postmortem reports written in Gray’s hand.

  She heads out the door, and we follow her follow mes. Back in the archive, Nallini rejoins us, and the four of us stand before a wall lined with large leather-bound books. The topmost shelf holds what looks like a set of encyclopedias for giant children but is in fact a series of nineteenth-century postmortem reports, bound and arranged by year. Sandra had previously pulled the hefty 1858 volume, which now rests on a library cart. Nallini moves it to a nearby table, Sandra turns to a report about twenty pages in, then each takes a small step back. The two women—one pale and freckled, the other olive-skinned—wear matching expressions: Well, go ahead, take a look.

  The first thing we notice is his signature, Henry Gray, underlined twice at the bottom of the page. I instantly compare it in my mind to H. V. Carter’s, whose signature is both less legible and fussier-looking; Gray’s penmanship, by contrast, is easy to read. The patient had been “under the care of Dr. Page” (a familiar name from Carter’s diary), and in describing the condition of her heart, Gray had written, “The aortic valve was composed of four flaps.” In the margin, he had noted in a smaller hand, “Specimen showing the Aortic valve is preserved in the Museum.”

  Sandra allows us a moment to marvel, then tells us to flip to case number 199. Here we find a report for one “William Parry,” who, as Gray reported, had “fallen, head first, a height of about 14 feet—”

  “Ouch,” I think aloud, “that would’ve hurt.”

  “Not for long, though,” Steve adds. As Gray noted, Mr. Parry “had lost all power of motion or sensation in all the extremities and in the trunk of the body.” He was paralyzed and died two days after being admitted to the hospital.

  Sandra has to dash off to teach a class, but Nallini invites us to pull whatever volumes we want from the wall. There are hundreds of reports by Henry Gray within these books, she tells us, and points out the two worktables on the opposite side of the room.

  My first impulse is one I almost feel I should suppress: to see the postmortem report on Henry Gray himself. Without knowing why exactly, this seems ghoulish; it’s one thing to read reports on total strangers, but on someone you’ve come to know? In any event, I am spared any further moral ambivalence. Steve is already up the step stool retrieving the 1861 volume. We find no report for Henry Gray, which, upon reflection, makes sense. Merely by looking at the thirty-four-year-old man’s ravaged body, his death by smallpox would have been unmistakable, and, given the risk of contagion, an autopsy probably would not have been allowed.

  Suddenly, the horror of what Gray went through hits me. He must have known, from the moment he saw a patch of pustules on his body becoming confluent—meaning, running together, a continuous blistering—he would not survive. Once the pustules spread into his mouth and throat, slowly suffocating him, the end would be terrifying. Whereas his death had once seemed incredibly fast to me, coming just a week after falling ill, now it did not seem fast enough.

  WE KNOW THAT he was buried in a private grave, dug to an extra-deep depth of eight feet (not due to smallpox, interestingly, but to allow for additional interments on top); that the exact time of burial was half past one o’clock on Saturday, June 15, 1861; and that the total burial cost was £7.3s. Keith Nicol has all the documentation from the London Cemetery Company. We also know that a woman named Ellen Connor—a private nurse, in all likelihood—was present at the time of death. This fact is listed on Henry Gray’s death certificate, a copy of which was easy enough for Keith to track down at the General Register Office. We know, too, that Gray had apparently contracted
smallpox from the nephew he had been treating. Still, Steve, Keith, and I find ourselves puzzled by the most basic question about Gray’s death. As the death certificate clearly states, he had been “vaccinated in childhood” against smallpox, so why did he become ill?

  “I think the reason Henry fell prey to it,” Keith suggests, “is that he’d been nursing Charles for so long and he was literally exhausted.” Gray’s work ethic may have also played a role. “Because he was such a hard worker as well, perhaps his general strength wasn’t a hundred percent.” Plus, “We just don’t know how good or effective the smallpox vaccine was back then.” Perhaps he should have been vaccinated again, as an adult?

  Another possibility, I offer, is that the strain was especially virulent. “But if so, how did his little nephew survive?”

  “Maybe he didn’t get it from the nephew,” Steve counters.

  Keith shrugs and smiles a sympathetic smile that says, I know, I know. I’ve been dealing with questions like this for fifteen years.

  As we speak, we are surrounded by the product of Keith’s labors: dozens of binders containing the research he had gathered for his Henry Gray chronology. Some are still lined up on bookshelves here in his home office, but most lie in piles around us. Our visit to Keith’s South London home was meant to be purely social, a chance to get acquainted over a cup of tea. But other than learning that he is an uncommonly gracious man, that he has two grown daughters, and that he is tall, bearded, and “of 1956 vintage,” I do not know a lot more about Keith personally than I did before we arrived. Instead, we have spent the last three hours going through the binders and hashing out the two Henrys. This no doubt reveals a lot about the two of us. Keith was first drawn to the history of Gray, and I, to the mystery. Our research paths have taken us in different directions, mine straight to Carter, his circling lesser known figures at St. George’s. But in the end, it is the story of Gray that brings us together. Here we are, in the dying light of a humid October afternoon, trying to re-create the anatomist’s final days.

  I tell Keith that Steve and I had spent the morning at St. George’s and mention the likelihood that an autopsy had not been performed—

  It wasn’t just Henry Gray that was potentially infectious, Keith points out. “With smallpox, the blisters would have a very watery discharge inside them, and the skin would be stretched to such an extent that the slightest touch would break it. It would then burst as an aerosol into the air. Eventually, once the smallpox was confluent, he was horrible. So was the room that Gray was in; it was full of these fomites, which was the aerosol infection. So the bedding, the wallpaper, the curtains, everything that was in the room, was potentially infectious. Imagine that this was Henry’s bedroom, the room we’re sitting in—”

  Steve and I look around the packed, closed room.

  “The Victorians had one solution for that level of contamination: fire.”

  “Fire,” I repeat to myself. The word crackles.

  “In Victorian London, there was an official called the inspector of nuisances—”

  “Nuisance must have had a different meaning then,” Steve interjects.

  “Oh yes, it wasn’t the guy that pesters you, saying ‘Do you want to buy any naughty postcards?’” He laughs. “No, nuisances as in epidemics, infectious epidemics. Smallpox, chicken pox, all that sort of thing. This group was responsible for disinfecting or cleaning out the infection from a house or an area. They would probably have gone in and just said, ‘Right, strip this room down to the bare plaster and just burn everything.’”

  Keith hesitates for a moment. “This is just a theory, but I reckon that’s what carried away the evidence that you and I so desperately want—”

  “His papers.” I can see them going into the flames. “His letters, diaries—”

  “Possibly, yeah,” Keith says, hedging a bit. “I don’t know for sure.”

  “No, I’m sure you’re right,” I respond. “That’s what happened to his new book, the one on tumors—”

  “And his revisions for the next edition of Gray’s,” says Steve, tossing more fuel on the fire, “his original manuscript.”

  His clothes, the rugs, his Bible—we heap everything on the pile.

  “Yes,” Keith nods. “A bonfire of everything he had touched.”

  Sixteen

  THE WELLCOME LIBRARY DOESN’T HAVE A SINGLE MS. WHEAT. NO, it has four Ms. Wheats, one of whom is a silver-haired man. The staff person presiding over the Special Collections Room has changed throughout the day: the petite brown-haired young woman who greeted us at 9:30 and gave us the first folder of letters from the Carter archive morphed into a middle-aged man, who, next time I glanced over, had turned into a fortyish matronly type—a cousin to Valerie Wheat—and then, wordlessly, back into another young woman, this one with ruddy skin and a nose piercing. But—who knows?—maybe there was yet another librarian sitting there in between those last two. Since arriving, Steve and I have hardly looked up from the piles of letters.

  Every page of every letter—every scrap of paper in the Carter Papers, including actual scraps of paper—bears a tiny penciled number identifying its proper place in each of eighteen separate folders. Despite the impeccable organization, however, there’s no math that makes it easy to calculate how long it will take to get through a single folder. It depends as much on the number of pieces as on their readability, length, and relevance. There are more than three hundred items in the Carter archive, and over the next few days, we have many loose ends to tie off. Our unexpected discovery at the British Library, for instance—that Carter had not, in fact, put Gray’s Anatomy behind him in coming to India—has made me rethink another assumption: that he’d put his old friend Henry Gray behind him as well. Now I have a new thought. Gray must come up in Carter’s correspondence, but where and when?

  Near the bottom of a box of letters to Lily is the answer: The eighty-eighth of 116 letters, dated October 10, 1861, to be precise: “You will know (‘young’) Mr. Gray is dead,” he tells his sister, adding on a sorrowful note, just as he was “on the threshold of a high career.” As his phrasing indicates, he is not breaking the news to Lily; she would have heard or read about it long before word reached him in Bombay. Rather, H.V. is tacitly sharing his grief, which I find all the more moving. Lily had visited her brother in London twice during his years there and perhaps had met “Mr. Gray” in person. Better than anyone, she would know how keenly he felt the loss of this extraordinary man.

  As an object, the letter itself captures the delicate emotions conveyed. The opaque onionskin stationery is as thin as tissue paper, and the ink, once brown perhaps, has faded to a gold so faint as to be nearly invisible. Read it quick and write it down fast, I tell myself, before it disappears.

  Gray’s passing is not the only sad news he shares. He tells Lily that Mr. Queckett at the College of Surgeons has also died. Carter then carefully, very carefully, drops a bombshell. “Misfortunes,” he writes, “have at length broken up my little household. She who was my wife has left India, in a sailing vessel, for England, and I am now quite alone.”

  He doesn’t give Harriet’s name, as if it were too distasteful to include in so gentle a letter. As portrayed by Carter, she is continually the villain in the tale—a liar, a loose woman, a corrupter—someone I had pictured as being irresistibly sensual and impossible to please. Which is why “hearing” her voice elsewhere in the Carter Papers, starting with two letters from Harriet to H.V., comes as a surprise. On paper, she seems lady-like and agreeable, the very words Carter had used when he first met Harriet back in Khandalla.

  “My dear Henry,” she writes in a short note sent the day before setting sail for London:

  I am much obliged to you for giving me the Certificate of our Marriage, and I promise never to show it to any one, or to name such a document as being in my possession unless I am actually obliged to do so for self protection.

  Yours,

  Love,

  H. Carter, Late: Bushell />
  Harriet writes again two days later, September 21, 1861. Now on board the boat with her two children, she bares her soul. “I have given you much pain and trouble, forgive me, I pray you…. I am sincerely sorry that I have managed so badly.”

  Later in this letter, she unwittingly reveals an unexpected side to H.V. and to their relationship. “Your last words that you would ‘be with me in spirit’ are indeed a consolation. Never for a moment have [sic] any thing taken my thoughts from you, my preserver.” Harriet then speaks of what a comfort their daughter is to her. “I can feel that you are actually present with me in her.”

  So what was the real story here? Someone wasn’t being entirely honest, whether H.V. or Harriet Carter, or perhaps both. How to uncover the truth?

  Steve and I start where all the trouble began, with one word: widow. Sure enough, there it is on the couple’s marriage certificate, which we found tucked in a small file of Carter’s miscellaneous papers. Why had Harriet lied? What had been going through her mind?

  Her lawyer, in a letter from May 1862, offers an explanation: Harriet had had “doubts” as to whether her divorce had been finalized, so, in order to “avoid debate,” she had sworn widowhood instead—simple as that. But why remarry if you are the least bit unsure you’re actually divorced? Something fishy was going on, and Steve and I followed the trail back to the tip of Africa, the Cape of Good Hope, five thousand miles from Bombay. Here is where Harriet’s first husband divorced her on grounds of adultery, it turns out, presumably with the aforementioned Captain Robinson. Now, whether she had actually been unfaithful is unknown. But shame, not doubt, must have led her to lie on the marriage certificate. Far better to be known at the time as a widow than as an adulterous divorcée.

  Just as this was beginning to sound like musty Victorian melodrama, out of the blue came a voice of reason: “I have already informed you that the first marriage was completely annulled and that the second marriage was valid—”