The Heart Specialist Read online

  Copyright © 2009, 2011 by Claire Holden Rothman

  All rights reserved.

  Published by

  Soho Press, Inc

  853 Broadway

  New York, NY 10003

  First published in Canada by Cormorant Books Inc.

  Library of Congress Cataloging-in-Publication Data

  Rothman, Claire, 1958–

  The heart specialist / Claire Holden Rothman.

  p. cm.

  ISBN 978-1-56947-945-2

  eISBN 978-1-56947-946-9

  1. Women physicians—Fiction. 2. Self-realization in women—Fiction.

  3.Montrial (Quibec)—Fiction. I. Title.

  PR9199.3.R619H43 2011

  813’.54—dc22

  2011007814

  10 9 8 7 6 5 4 3 2 1

  For Arthur Holden

  Cardiac anomalies may be divided, according to etiology,

  into two main groups: those due to arrest of growth at

  an early stage, before the different parts of the heart have

  been entirely formed, and those produced in the

  more fully developed heart by fetal disease.

  — MAUDE ABBOTT, “CONGENITAL CARDIAC DISEASE,”

  IN WILLIAM OSLER’S SYSTEM OF MEDICINE

  Still the heart doth need a language,

  Still doth the old instinct bring back the old names.

  — FRIEDRICH SCHILLER, PICCOLOMINI

  PRELUDE

  THE SMALL WATCHER

  Observe, record, tabulate, communicate.

  — WILLIAM OSLER

  My first memory of my father is of his face floating above me and weeping. The image dates back to 1874 during a particularly brutal winter in St. Andrews East, a town near the mouth of the Ottawa River in Quebec, about fifty miles from Montreal. The month was January. I would soon turn five.

  What mechanism triggers memory, selecting images to press into the soft skin of a child’s mind? Often it is trauma, although at that particular moment the word had not yet entered my lexicon. I had no idea why my father had come into my room or why he was weeping. All I knew when I opened my eyes was that something was wrong. Routines had been disrupted, rules broken. My safe, small world had come unhinged.

  My father smelled of pipe tobacco, a delicious smell that made me think of chocolate. I stared at the moustache drooping from his upper lip. I could have buried my face in that moustache, but of course I did no such thing. He was an imposing man whose moods were occasionally unpredictable. I just lay still and stared.

  Not long after he left us, when the fields and roads were still glistening with ice, I came across one of his pipes abandoned in the barn in back of the house. I didn’t even pause to think. I picked it up and stuck it in my mouth. It was an experiment, an attempt to copy what I had seen him do hundreds of times, an attempt to bring him back. The result was a shock. It tasted awful, nothing like the sweet dark-chocolate smell of my memory. I spat until my tongue hurt and I had no saliva left.

  That night, staring up at him from my bed, I was at a loss. I was only beginning to understand that there were people other than myself in the world, living lives separate from mine. To think that my father might cry confused me, so I shut my eyes, shutting out everything but his smell and the sounds of his quick and shallow breaths.

  He spoke to me in French, which he did sometimes when it was just the two of us. I have no recollection of what was said. It was not about the trial or his dead sister, that much is certain. He never spoke of these things to anyone in the house in St. Andrews East. He probably tried to reassure me. I suspect I knew even then that he was lying. I could sense that things were very wrong, and suddenly, just like my father, I too began to cry. I must have gone on for some time because when I looked up he was gone.

  He took only his clothes that night and the money he had scraped together for the baptism — Laure’s baptism, although at the time he would not have known it was to be Laure. He had chosen her name, just as he had chosen mine — Agnès — picking it out with my mother months before the births. Paul if a boy, Laure if a girl, names that worked in both French and English. In the end, Laure had to wait several years for her baptism. Grandmother took care of it, as she took care of so much else.

  For the longest time I felt that I had chased my father away. My tears had sent him running. His face had been there one moment and then, after I shut my eyes and wept, he was gone. A child’s logic, I suppose, but logic nonetheless. What if I had kept still, I later could not help thinking. What if I had reached out my childish arms to embrace him? From that day on I lived with one thought paramount in my mind. I would find my dark, sad father and win him back. Though I could not claim to have known him well, and my first memory of him was almost my last, it did not matter. His face stayed with me through the years, as clear as on that night in January when he went away.

  Contents

  Title Page

  Copyright Page

  I SAINT AGNES

  Chapter 1

  Chapter 2

  Chapter 3

  Chapter 4

  Chapter 5

  Chapter 6

  Chapter 7

  Chapter 8

  II ARS MEDICA

  Chapter 9

  III THE HOWLETT HEART

  Chapter 10

  Chapter 11

  Chapter 12

  Chapter 13

  Chapter 14

  Chapter 15

  Chapter 16

  IV THE HEART’S REASON

  Chapter 17

  Chapter 18

  Chapter 19

  V FIRE

  Chapter 20

  VI WAR

  Chapter 21

  Chapter 22

  Chapter 23

  Chapter 24

  Chapter 25

  Chapter 26

  VII THE CROSSING

  Chapter 27

  Chapter 28

  Chapter 29

  VIII RETURN

  Chapter 30

  Chapter 31

  Chapter 32

  AFTERWORD

  ACKNOWLEDGEMENTS

  I

  SAINT AGNES

  Saint Agnes’ Eve — Ah, bitter chill it was!

  — JOHN KEATS

  1

  JANUARY 1882, ST. ANDREWS EAST, QUEBEC

  All morning I had been waiting for death, even though when it finally came the change was so incremental I nearly missed it. I had laid the squirrel out on a crate and covered it with a rag to keep it from freezing. Blood no longer flowed from the wound on its head, although it still looked red and angry. A dog or some other animal must have clamped its jaws around the skull, but somehow it had managed to escape, dragging itself through the snow to Grandmother’s property, where I had discovered it that morning near the barn door. It had been breathing then, the body still trembling and warm.

  Now the breathing was stopped and its eyes were filmy. I blew on my fingers, which had numbed with cold, and went to my instruments bag. It was not leather like the one used by Archie Osborne, the doctor for St. Andrews East. It was burlap and had once held potatoes. Along with most of its contents, it had been pilfered from Grandmother’s kitchen. I took out a paring knife, a whetting stone and a box of pins in a tin that used to hold throat lozenges dusted with sugar. The blade of my knife was razor-thin and nicked in several spots. It didn’t look like much, but it was as good as any scalpel. I rubbed the whetting stone along the blade a few times then cracked the ice in the bucket with my heel and dipped in the knife to clean off the sugar dust.

  My dead house left a lot to be desired. It was too cold in January for stays of decent duration. After two winters of working here, however, I was accustomed to it. I had organized i
t well, with microscope in the far corner hidden beneath a tarpaulin and twenty-one of Grandmother’s Mason jars lined up on the floor against one wall, concealed by straw. Above the jars, on a shelf fashioned out of a board, was my special collection, which consisted of three dead ladybugs, the husk of a cicada beetle, the desiccated jaw of a cow and my prize: a pair of butterflies mounted with thread and glass rods in the only true laboratory bottle I’d been able to salvage from my father’s possessions two years earlier, before Grandmother had them carted away to the junkyard. I took only three things for myself — my father’s microscope and slides, a textbook and that bottle. Any more and my grandmother would surely have noticed.

  To a person glancing through the door, my dissection room appeared to be ordinary barn storage. Grandmother had forbidden me and Laure to play here, claiming the floorboards had rotted and we would fall through and break our legs. I had to use the back entrance for my visits, accessed by a path in the forest that abutted Grandmother’s land.

  The squirrel’s yellow teeth poked through its lips. Its paws, curled to the chest as if it were begging, resisted my efforts to open them. The animal was already beginning to stiffen, but whether this was from cold or rigor mortis I could not tell. Its legs were also hard to manoeuvre, but somehow I managed to get the body done, laying him out on his back like a little man. My pins had a delicate confectionary smell that was incongruous with the odour of newly dead squirrel. I sniffed as I fastened him down, wincing as the metal pricks punctured his hide. The last preparatory step involved the microscope, which I lugged to the crate next to the dissection area for easy access.

  My knife pierced the belly skin, releasing a gush of pink fluid that arced up, splattering the camel-hair coat Grandmother made for me last Christmas. I stepped back, staring stupidly at the line streaking my front, then reached for my apron. I had been careless. A fault I knew well, as Grandmother pointed it out to me every single day. She was right. I tended to forget about the most basic things: my hair was often half undone, my stockings sagged at my ankles.

  Up until that day in the barn I had worked mostly with plants and insects. The closest I had come to anything alive were the tiny creatures inhabiting the scum of ponds or nestling in the bones of meat on the turn. This was the first time an animal with blood still warm in its veins had fallen into my hands. I cut again, this time down the middle, adding two perpendicular slits at the ends to form doors in the animal’s belly. These I peeled back and pinned, exposing the dark innards. My fingers were wet and red. Behind me there was a gasp.

  Laure was in the doorway, mittens covering her mouth, her eyes starting to roll up in their sockets. She swayed, her pupils expanding into black holes.

  I swung my hands in back of me. “Laure,” I said quickly. “It’s all right. Nothing. I’ll wash it away.” I plunged my hands into the bucket.

  My sister is a very particular case. She cannot watch the gutting of a chicken. We have to make sure the kitchen door is shut fast and she is safely off in her bedroom when we prepare flesh for dinner.

  Laure had now stopped swaying, which I took to be encouraging, but her pupils had shrunk to pinpricks. She was standing as stiff as the squirrel on my table. While she stood there like a corpse, I rushed about, covering everything with the potential to upset her. I pulled the strip of flannel back over the squirrel, but immediately a ruby eye appeared on the abdomen and began to grow. I tore off my apron and once again plunged my hands into the icy bucket to scrub them.

  Laure moaned. Tears always followed the trance phase, with a headache that could keep her in bed for days. I called to her, but of course she was past listening. After another minute or so she was able to move and limped off toward the house, weeping and mumbling for Grandmother. The doctor we consulted gave it a French name: Petit Mal. He said it was less serious than Grand Mal, which was a full-blown epileptic seizure, but nonetheless, it was a condition we had to watch. No one knew the cause, although trauma — a childhood fever or even an emotion — was often at the root. The primary symptom was absence. Laure slipped into a trance and nothing anyone said or did could shake her out of it.

  The squirrel’s body was growing stiffer by the second, yet all I had managed were the preliminaries. I felt like weeping myself, in pure frustration. Laure almost never came to the barn. Why had she picked this of all possible days to try and find me? The squirrel grinned in silent mockery. You see, it seemed to say. Stick your fingers in the belly of a corpse and see if trouble doesn’t follow. I closed my eyes to shut out his yellow teeth. If I wanted to do any work at all it had to be now. Perhaps Laure wouldn’t be coherent and Grandmother would simply put her to bed. It was a slim chance but it was not a crime to hope. I reached for my apron.

  By the time Grandmother arrived I had managed to locate the heart and what I suspected must be the liver. Grandmother marched into the barn, her old eyes narrow and grim. She is a short woman, barely five feet tall, but people think she is taller because of how she walks. She would have made a great general in the Army, and not just because of her posture. She was wearing my dead grandfather’s workboots, the ones she kept by the kitchen door for emergencies, and she had forgotten her hat in her haste. Her hair had come partially undone and a couple of silver strands were snaking, Medusa-like, down her back. I had never before seen her in such disarray, and we stood gaping at each other for several seconds, quite unable to speak. Worse still, she was not alone. She had dragged Miss Skerry along with her from the house. Miss Skerry was the new governess, brought in expressly to “smooth my edges,” as Grandmother put it, and assist my passage into womanhood.

  Their eyes took in my knife and the filthy butcher’s apron. Then they saw the squirrel with its abdomen slit open.

  “Agnes,” said my grandmother. It came out quietly, a sigh, and suddenly she seemed to shrink. Her eyes, often hard, had something new in them, which alarmed me even more than the shrinking had. It was fear, I suddenly realized. My grandmother was afraid.

  She took the corner of my apron least marred by squirrel gut and tried to yank it over my head, but it caught on my ear. By then she had glimpsed my bloody coat. She let go of the apron and covered her eyes with her hands.

  I had never seen my grandmother cry. I had never imagined she was capable; she was so steady, so grim. I was the opposite, erupting into tears at the smallest provocation, slouching off to the barn or to the woods behind the house to vent my rage and sadness. Grandmother disapproved of these episodes, calling them “performances” and warning me that if I did not put such childish things away I was doomed to a hard and lonely life.

  But here she was crying herself, right in front of me and Miss Skerry. My mind went spiralling back what seemed a hundred years, although it was really less than ten, to another day and another adult weeping. My emotional nature, I had always thought, came from him — my father. In fact, Grandmother herself said this when she was angry, calling it my “Gallic blood.” I was the family misfit — dark and teary, with a mind that must have seemed disturbingly foreign in that small Presbyterian town.

  “It’s not what you think,” I said. “I didn’t kill it.”

  I was trying to reassure her, but I managed to do the exact opposite. It was the word “kill.” I should not have used it, for my grandmother was thinking of her son-in-law — my father — and his poor dead sister.

  I have never seen a picture of my father — we kept no photograph after he left so I could not see it for myself — but everyone in St. Andrews East said I was his spitting image. They were careful about saying it, not wanting to upset Grandmother, but sometimes it slipped out. Archie Osborne, the town doctor, said it almost every time he saw me. And I was keenly aware that I looked nothing like Laure, who was blue-eyed and fair, with the delicate bone structure of the White family women. My skin was like a gypsy’s, and my body stocky and squat. The ladies who came for tea at the Priory always remarked how pretty Laure was. It was hard not to, she looked so much like an angel wit
h her flowing, corn-silk hair. When they realized I was in the room, serving lumps of sugar, an embarrassed silence followed. “Agnes is so intelligent,” they would add, trying miserably to make amends.

  My intelligence, it was generally assumed, also came from my father — bookishness, an unfortunate trait for a girl, especially one who is not nice to look at. Grandmother’s theory was that I spent so much time reading I’d ruin my eyes. I did not believe her because she herself had bad eyes and the only book she ever opened was the Bible, and then only once a week, on Sunday.

  Grandmother believed my father was a murderer. She never said as much; in fact, she avoided all mention of him after he left. It was as if he had died, just like my mother. Grandmother even went so far as to change our name. Two years after my father disappeared, and several months after Mother’s funeral, Laure and I officially dropped Bourret and became Whites, and the accent was dropped from Agnès so that I became Agnes. My grandmother became our legal guardian.

  The squirrel was just too much for her. I only realized it after the fact or I would have been more careful, performing the dissection in the woods, where neither she nor Laure would ever have looked. It was like a sign that all my grandmother’s efforts to guide me, to provide me with a decent Christian home and name had been for naught. Nothing could change the fact that I was a squat, dark person with a foreign brain and foreign ways. For what was a thirteen-year-old girl doing out in the barn on one of the coldest days of January slicing open a squirrel?

  Bourret derives from the French word bourreau, which, strictly speaking, means “executioner.” In Quebec, however, it has other idiomatic uses. There is bourreau des coeurs, “lady-killer.” And bourreau d’enfants, “batterer of children.” In the case of my father’s family the name was prophetic. His youngest sister, Marie, was found battered to death and drowned on the shore of the Ottawa River, not far from the family’s home in Rigaud, about a day’s drive west of Montreal. It turned out, however, that the girl had actually been living in Montreal, in the attic of our home, for months before her death, although no one besides my parents and me had known this.