The Anatomy of Deception

  PRAISE FOR

  THE ANATOMY OF DECEPTION

  “A lucky break for mystery lovers. Fans of historical fiction will also love this tale that evokes the evolving medical profession and the art world in late 19th-century America…. A cameo appearance by painter Thomas Eakins and an exploration of his artistic philosophy add to the novel’s colorful and highly informative background.”

  —USA Today

  “Goldstone’s research informs every page.He weaves history, atmosphere, medical procedures, and forensic details into a fascinating story….”

  —Boston Globe

  “Vivid period setting and amazing medical detail.”

  —Marilyn Stasio, New York Times Book Review

  “An increasingly complex tale of murder, body-snatching, and skullduggery … A clever and entertaining tale.”

  —Los Angeles Times

  “Packed with historical asides.”

  —Entertainment Weekly

  “If you enjoyed The Interpretation of Murder, you’ll be gripped by this haunting and atmospheric thriller.”

  —Tess Gerritsen

  “This is really good stuff…. A must-read.”

  —The Gazette (Montreal)

  “Compelling … With this top-notch historical page-turner and his proven versatility in nonfiction, Goldstone can expect to win over many new fans.”

  —Publishers Weekly (starred review)

  “What makes [Goldstone’s] book so fascinating is the attention to the medical procedures and innovations of the time…. Readers who enjoy Anne Perry’s and Caleb Carr’s psychological thrillers will welcome Goldstone’s brooding, paranoiac addition to the genre.”

  —Booklist

  “For audiences increasingly drawn to CSI-type murder mysteries, Lawrence Goldstone reminds them that crime fighting can be just as gripping without all the high-tech wizardry. The Anatomy of Deception is an intriguing tale of death and dishonesty that takes the reader through 19th-century Philadelphia during the infancy of modern medicine…. [Anatomy will] hold a reader’s attention from the first page to the last.”

  —Associated Press

  “An intriguing tale of death and dishonesty.”

  —London Free Press

  “Will appeal to readers who enjoy historical novels or have an interest in medical history.”

  —Fort Worth Star-Telegram

  “Intelligent and clever … Will have you living in their times, on their terms, and rooting hard for the honorable people at their centers—outnumbered, as honorable people often are, but not necessarily overwhelmed.”

  —Sullivan County Democrat

  “Goldstone has blended the history of the scientific process with compelling suspense to provide an intriguing read.”

  —MLB News

  “The vividly described medical procedures of the time create a fascinating background to this forensics whodunit…. Style and imagination … Compelling suspense.”

  —Mystery Scene

  Also by Lawrence Goldstone

  Dark Bargain

  with Nancy Goldstone

  Deconstructing Penguins

  The Friar and the Cipher

  Out of the Flames

  Warmly Inscribed

  Slightly Chipped

  Used and Rare

  To Nancy and Emily

  March 14, 1889

  FOR DAYS, CLOUDS HAD HUNG over the frigid city, promising snow, an ephemeral late winter veneer of white, but the temperature had suddenly risen and a cold, stinging drizzle had arrived instead. Jostled along in the derelict hansom, clad in her maid’s blue worsted dress and plain wool cloak, her fingers and feet felt bloodless. The gloom that hung over the river penetrated the thin walls of the coach until it seemed as though she were breathing it.

  She tried to peer out but rain obscured the dirty window. The gas streetlamps were set so far apart that what little she could see came sporadically, in brief flashes. She had no idea where she was, and she wanted desperately to pound on the trap and tell the driver to turn around. She could hear the beating of her own heart.

  As the last haze of daylight vanished, the carriage turned. When she was very young, she had hated the dark, but here there would be no sympathetic, whispering adult rushing to comfort her. The cab slowed, the driver making his way carefully on the rutted streets. An odor of filth and decrepitude be-fouled the air.

  Finally, the driver reined the horse to a halt and she could hear his muffled voice telling her she had arrived. It was the first time in her life that she had ever been so alone.

  It was also the first time that she had ever been truly afraid.

  CHAPTER 1

  AT CHRISTMAS 1887, FIFTEEN MONTHS before this story began, the world was introduced to a fictional character destined for such immeasurable acclaim that he would overwhelm his creator’s efforts to be done with him. The essence of this character’s appeal was not derring-do, as in the dime novels of Beadle & Adams, but rather in his uncanny ability to unravel a set of data that had stumped lesser men and proceed to a logical and incisive conclusion. He was so coldly rational that he was often compared to a machine, the Analytical Engine of Charles Babbage. His name, of course, was Sherlock Holmes.

  To those of us engaged in medical research, however, the remarkable methods of Conan Doyle’s consulting detective were not at all revolutionary—they were merely a popularization of the modus operandi we employed in our quotidian efforts to alleviate human misery. The connection of analytic detection to medicine was unmistakable. Doyle himself was a physician, as were both Joseph Bell, widely considered the model for the character, and Oliver Wendell Holmes, the man for whom the detective was named. And while Sherlock Holmes may have trod the back alleys of Victorian London to ply his trade, the scenes of our crimes were no less exotic and often even more grisly.

  To make sense of nature’s felonies against the human body, you see, physicians are compelled to study not only the living, but also those who have succumbed. Our clues lie in internal organs, blood vessels, skin, hair, and fluids, and we need as much access to these as Holmes needed to footprints, handwriting, or hotel records. It is only through painstaking examination of the data wrung from this evidence that deductions may be made as to what has caused illness and death, which, in turn, aids immeasurably in the care and treatment of those who might still be saved.

  As Holmes’ popularity soared, it thus became sport among physicians to match wits with the fictional detective, eager to demonstrate that if they applied themselves to murder, theft, and mayhem, they would achieve similarly sterling results. Although for most in the medical field, this exercise was nothing more than a diverting parlor amusement, for me, the game was to be all too real. It started early on a mid-March Thursday in 1889, when I strode through the gate in the high stone wall at the rear of University Hospital in West Philadelphia and entered the Blockley Dead House.

  The Dead House, the morgue that served both University Hospital and Philadelphia General, was a squat, solitary brick building, a fetid vault filled with cadavers in various states of putrefaction. The air was thick and still, and heavy drapes were pulled shut day and night. It was a place of spirits, where the tortured souls of hundreds, perhaps thousands, who had died from abuse, disease, want, or ignorance would spend their last moments in the company of the living before they were removed for their solitary rest and placed in the ground forever. I have never been a believer in phantoms, but I could not walk through its door without feeling all of those abbreviated lives pressing down upon me.

  But this grim way station was also a place of science. In this incongruous setting, Dr. William Osler, head of Clinical Medicine at the University of Pennsylvania Medical Scho
ol, forced forward the boundaries of medical knowledge. Although not yet forty, Dr. Osler had transformed the Dead House into perhaps the most exciting and advanced laboratory for the science of morbid anatomy in the entire world. I had given up private practice in Chicago and come East specifically for the chance to work and study with this astounding man. Apprenticing to Newton or Boyle or Leeuwenhoek could not have been more exciting. Others would call Dr. Osler the modern-day Hippocrates, but to me he was simply “the Professor.”

  I arrived at the hospital that morning poised for a journey into the unknown, no less than Stanley at the threshold of Zanzibar. In the changing room, I replaced my suit with the trousers, pants, and cap that were provided to the staff. The outfits were faded and blue, with a military air. A persistent rumor had them as leftovers from the late Civil War, and I often wondered if my father had once been dressed in just this way.

  I was soon joined by those of my colleagues also invited to observe. There were nine of us that morning, a study in contrast. Some, like me, were experienced physicians; others had just begun internship. Most were products of Philadelphia or other large cities, although I myself had been raised on a small farm in southern Ohio. One of us was even a woman. Mary Simpson had been included at the Professor’s insistence, despite the extreme disapproval of anonymous members of the board of trustees who had been scandalized by such an affront to nature. Two Georges epitomized our differences. Farnshaw, at twenty-one the youngest of our group, had been raised in great wealth and came to study with the Professor after graduation from Harvard; Turk, at twenty-eight the oldest, was the product of an orphanage, and had worked his way through the university unloading merchant vessels on the Philadelphia docks.

  We assembled in the staff room and found the Professor already present and in a jaunty mood. William Osler was small, a sprightly man, scarcely five feet five inches, but he moved with such energy, such spring, that he appeared larger. He was already significantly balding, the loss of hair provoking him to pay scrupulous attention to his mustache, which was full and walruslike, perfectly framing his mouth and reaching to the jawline on either side. The backs of both hands bore signs of a recent eruption of verruca necrogenica, anatomist’s warts, a red and raised tubercular infection that gave the skin an appearance of dyed leather. It was a vile condition with which the Professor was regularly afflicted from contact with necrotized flesh, but he blithely treated each new outbreak with oleate of mercury until it receded.

  “Well, well, well,” he said, rubbing those reddened hands together, his speech, as whenever he was excited, lapsing into the flat Canadian cant that betrayed his origins, “this will be a fine day, a fine day indeed, eh? I believe there are five cadavers available. Let us not keep them waiting.”

  The Professor had every right to his enthusiasm. For all of his genius, it was rare he was given the opportunity to conduct a full day’s study in the Dead House. Like most of those who toil to advance human understanding, he was also engaged in a constant battle against human ignorance. Until the Anatomy Act in 1883, just six years earlier, the use of cadavers for teaching purposes was actually a crime. The great anatomist William Smith Forbes of Jefferson Medical College had only narrowly escaped a term in the penitentiary for “despoiling graves.” The liberalization of the law had done little to dispel the revulsion of many in society to the notion of cutting into a dead body, however, and resistance to the Professor’s researches remained strong. Although the more enlightened could occasionally be persuaded to allow Dr. Osler to determine the cause of death of a loved one or friend, for the most part our material was drawn, as it had been for centuries, from society’s most wretched classes.

  Even here, however, there was opposition. A number of groups had recently been formed to attempt to end the “ghoulish practice” of dissecting the poor after death. The most prominent and vocal of these was Reverend Squires’ Philadelphia League Against Human Vivisection. Either unaware or unconcerned that “vivisection” referred to the living, Reverend Squires blithely employed innuendo, humbuggery, and outright lies to entice society matrons to support his cause. He then used the money to thrust himself into the public eye, creating an outcry against the postmortem abuse of society’s least fortunate. As a result, although we did not have to compete with wild dogs for the corpse of a convict, as had Vesalius centuries earlier, cadavers available for examination had become increasingly scarce.

  Emboldened by the uproar, the official Blockley pathologist, Henri Formad, an eccentric, ill-tempered Russian, had taken to denying Dr. Osler use of the facilities. The Dead House attendant, a gaunt, lumbering creature whom the Professor had dubbed “Cadaverous Charlie,” had soon followed suit. Whereas Formad acted merely out of professional jealousy and spite, Charlie, buoyed by the stipend he had received from the League, refused the Professor access to cadavers out of what he termed, in his broken English, “bazic human decency.”

  But Charlie was an enterprising sort, and he had also shown himself willing to accept a second stipend from the Professor to absent himself from the Dead House for hours at a time and leave us to our work. For an additional remuneration, Charlie, as he had done on this occasion, would actually inform the Professor when a promising supply of unclaimed cadavers became available. Dr. Osler seemed unfazed at the necessity of paying for what should have been provided by a grateful citizenry, but I was appalled that so brilliant a scientist was forced to skulk about like a criminal.

  At seven-fifteen, when we exited University Hospital to begin our day, I strode quickly to overtake Turk. My colleague was not brilliant, but quick and clever, with an offhand wit I envied. I had made a number of overtures when he joined the staff, but Turk proved to be a man who resisted intimacy, and I had been unable to breach the wall of irony that he threw up around himself. The only member of the staff in whom he had shown any interest was the other George, Farnshaw, his complete opposite. But I continued to find myself drawn to Turk, even though my efforts at friendship were generally rebuffed.

  “Five cadavers,” I whispered softly, looking up at him as we crossed the path. Turk was over six feet and quite thin. He had the manner of those who are very tall of leaning down slightly, and it gave him a predatory appearance. “Dr. Osler must think he has unearthed treasure.”

  He nodded without turning to face me. “Yes. Treasure soon to go into the ground, instead of coming out of it. I hope he won’t keep us here through the night.” Turk was rumored to be well acquainted with the city’s more disreputable elements, although he was silent as to where and with whom he passed his free evenings.

  “It would be time well spent,” I replied.

  “You might think an evening elbow-deep in entrails is well spent,” Turk observed grimly. “I prefer the theater.”

  At the Dead House, we paused just outside the heavy oak door that had seemingly been installed to prevent the dead from escaping. Pipes and cigarettes were lit. Even those who did not ordinarily take tobacco did so here in an effort to kill the stench. Still, as we entered the building, we were immediately overwhelmed by an ambiance so powerful that it seemed as if we had struck a wall. The first moments were always the most difficult, when eyes teared, breath came in gasps, and stomachs refluxed. These reactions soon passed, however. Human senses have a remarkable ability to adapt quickly to even the most objectionable stimuli.

  The autopsy room was two stories high, with a gallery walkway on the second floor and a grimy skylight at the top. When the Professor attracted an especially large group of observers, the overflow stood upstairs, much as medical students in the 1530s had watched Sylvius perform his anatomies from the balcony of the operating theater at the University of Paris.

  The room itself contained three large postmortem tables, the tops of which were soapstone, the legs iron. Shallow channels were cut into each tabletop, leading to a drain covered by a brass grating in the middle, which allowed the fluids released during the examinations to be discharged. The drain led to a ventilating
shaft, which extended down into the floor and out of the building to a ditch in the rear that was regularly sprinkled with calcium oxide—quicklime.

  A set of drawers with a zinc top was set against one wall, holding bottles of fixatives, sponges, basins, enameled dishes, empty bottles, and museum jars. Next to the drawers sat a capacious sink and, adjacent to the sink, a table held the scales used for the weighing of organs. A crude, high, red-painted desk stood on the other side of the room, upon which rested the book for recording autopsy findings. During each procedure, the Professor provided a steady stream of dictation and one of the students took down the information. Dr. Osler reviewed the notes at the conclusion of each postmortem to ensure that the record was complete and accurate. A coat rack abutted the desk and held aprons and gowns, next to a case on the wall housing autopsy instruments.

  Beyond the sink, a doorway led into the mortuary, which contained a bank of cast-iron ice chests that could accommodate sixteen bodies. Charlie was responsible for maintaining the ice, which, even in early spring, required regular changing. A rear door led out to a gravel path where bodies and ice were received, and where wagons of undertakers took the remains away. Occasionally, simple services for the dead were conducted within the mortuary itself.

  On the second floor, four rooms were set aside for study and research. It was here that we performed urine analysis, prepared culture media, and examined slides. One of the rooms was a small library and records storage area.

  The Dead House held not only the deceased from the two hospitals, but also the bodies of paupers, criminals, and any unidentified, unclaimed corpse encountered within the city limits by the Philadelphia Police Department. Today’s subjects represented a typically diverse assortment. The five chests holding cadavers available for autopsy had been marked by Charlie with white chalk; he had also left a scrawled note detailing the particulars of each case. The Professor could choose from a carpenter who had succumbed to a respiratory disorder in the hospital, a male Negro and a young woman found dead in the streets, an elderly woman who had probably died of stomach cancer, and a Chinaman with a gunshot wound.