The Bone Garden: A Novel

Twenty-four

The present

JULIA LOOKED UP from Wendell Holmes's letter. — Was Wendell Holmes right, Tom? Did that case of childbed fever have anything to do with Charles's blood poisoning? —

Tom stood at the window, staring out at the sea. The fog had started to lift that morning, and although the sky was still gray, they could finally see the water. Gulls skimmed past a background of silvery clouds. — Yes, — he said quietly. — It was almost certainly related. What he described in his letter barely begins to touch on the horrors of childbed fever. — He sat down at the dining table, across from Julia and Henry, and the light through the window behind him cast his face in gloomy shadow. — In Holmes's era, — said Tom, — it was so common that during epidemics, one of every four new mothers died of it. They died so quickly, hospitals had to cram them two to a coffin. In one maternity ward in Budapest, laboring mothers had a view of the cemetery through the window, and a view of the autopsy room down the hall. No wonder women were terrified of childbirth. They knew that if they went into the hospital to have a baby, there was a good chance they would come out in a coffin. And you know the worst part of all? They were killed by their own doctors. —

— You mean through incompetence? — said Julia.

— Through ignorance. In those days, they had no concept of germ theory. They wore no gloves, so doctors used their bare hands to examine women. They'd perform an autopsy on a corpse that was putrid with disease, then they'd go straight to the maternity ward, with filthy hands. They'd examine patient after patient, spreading infection right down the row of beds. Killing every woman they touched. —

— It never occurred to any of them just to wash their hands? —

— There was one doctor in Vienna who suggested it. He was a Hungarian named Ignaz Semmelweis, who noticed that patients attended by medical students were far more likely to die of childbed fever than those attended by midwives. He knew that the students attended autopsies while the midwives didn't. So he concluded that some form of contagion was being spread from the autopsy room. He advised all his colleagues to wash their hands. —

— It sounds like common sense. —

— But he was ridiculed for it. —

— They didn't follow his advice? —

— They hounded him out of his job. He ended up so depressed, he was committed to a mental institution. Where he cut his finger and suffered blood poisoning. —

— Like Charles Lackaway. —

Tom nodded. — Ironic, isn't it? That's what makes these letters so valuable. This is medical history, straight from the pen of one of the greatest doctors who ever lived. — He looked across the table at Julia. — You do know, don't you? Why Holmes is such a hero in American medicine? —

Julia shook her head.

— Here in the United States, we hadn't heard of Semmelweis and his germ theory. Yet we were dealing with the same epidemics of childbed fever, the same appalling mortality rates. American doctors blamed it on bad air or poor circulation or even something as ridiculous as wounded modesty! Women were dying, and no one in America could figure out why. — He looked down at the letter. — No one, that is, until Oliver Wendell Holmes. —