The Anatomist: A True Story of Gray's Anatomy (5 page)

Though he had left behind his role as instructor, Brodie maintained a keen interest in the medical school he had helped found, and, through one channel or another, word of the talented Henry Gray came to his attention. The most likely messenger was Brodie’s nephew-in-law, Thomas Tatum, one of St. George’s top surgeons and an anatomy instructor for almost twenty-five years. That Brodie and Gray met is a certainty, but when? Interestingly, an answer is suggested in a dinner invitation that survives to this day—Sir Benjamin and Lady Brodie inviting Henry Gray to their home on Monday, the twenty-eighth of April—though the year is uncertain. A little detective work tells me that this day/date combination occurred only three times during Gray’s adult life—in 1845, 1851, and 1856. Of the three, the first date offers the most intriguing possibilities. Monday, April 28, 1845, is eight days before Gray registered at St. George’s medical school. I find supremely satisfying the idea that this is when he first met Benjamin Brodie, the legendary man to whom, thirteen years later, he would dedicate his great work, his
Anatomy.
I picture an intimate gathering, with Dr. Brodie personally introducing Henry to a few distinguished colleagues, the young man’s eyes as round as the Wedgwood plates as he shook hand after hand. But why would Sir Benjamin and Lady Brodie have invited this young nobody to their Savile Row residence? Well, it turns out, Gray had won a prestigious “junior prize” in anatomy as a sixteen-year-old, and the lad’s burgeoning talent had clearly impressed Dr. Tatum. Indeed, it was Tatum who, the following week, would cosign Henry Gray’s registration as a medical student.

But there’s a final reason I hope this early date was in fact their first meeting, for the warm invitation would serve as a prologue of sorts to Gray’s career just as another note from Brodie would serve, sixteen years later, as a fitting epilogue. Upon receiving news of Henry’s sudden passing, Dr. Brodie, at age seventy-eight and in failing health, wrote to a colleague: “I am most grieved about poor Gray. His death, just as he was on the point of obtaining the reward of his talents,…is a great loss to the Hospital and the School.

“Who is there to take his place?”

HENRY VANDYKE CARTER
prepared for the first day of his first year of dissection in the same way a student today would: he shopped. After taking a quick look around the new laboratory at Kinnerton Street, the eighteen-year-old went and placed an order for a dissecting “gown,” a kind of loose cassock (a precursor to the green cotton scrubs of today), and then headed to Savigny & Co. and bought a “case of scalpels,” he reports in his diary on Saturday, September 29, 1849. Carter could not afford a copy of the standard anatomy guide, Quain’s
Elements of Anatomy
—“Funds low,” he notes in his usual clipped style—so he would just have to make do without.

The winter session would begin with speeches and an awards ceremony on Monday, and lectures and lab work on Tuesday. Carter, who had spent the past year and a half sitting through classes in anatomy, botany, physiology, chemistry, materia medica, and medical jurisprudence, would finally get his hands bloodied. “All prepared,” he writes before bedtime Monday night.

But it takes two to take the next step. “Not dissect for subject not ready,” he writes the following day (“subject” meaning cadaver), which may have been for the best since Carter’s gown was not ready yet either. Finally, on Wednesday, October 3, he makes his debut as an anatomist. Under the watchful eye of Dr. Athol Johnson, he begins with a part of the body both relatively simple to dissect and, if you picture Michelangelo’s
David
as the ideal, lovely to behold: the inguinal canal, the area where the lower abdominal muscles slope down toward the groin. At the close of the day, Carter confides: “[I] like dissecting. More difficult than [I’d have] thought without guide.”

This last little admission is the kind of ironic detail that brings a smile to my lips, knowing as I do the role H. V. Carter will go on to play in creating the most famous anatomy guide of the past two centuries. Another such moment comes three pages later, with the first mention of Henry Gray. So synonymous has the name
Gray
become with
anatomy
—as familiar a pairing as
Webster
and
dictionary
—that it is jarring to see it spelled incorrectly, as Carter does on October 31, 1849. The error is unusual for him, an impeccable speller otherwise, and suggests that the two men did not know each other well yet. As for the mention—“See Grey, promise” is all he writes—it makes no sense to me. But that’s fine; it is part of the odd dynamic that develops between diarist and reader as the lopsided omniscience borne by both gets traded back and forth. Which is to say that at any given moment, on any given day, Carter experiences far more than he ever puts into words, just as I, on any given page, know far more than he about the course his life will take.

For Carter, keeping a diary had been intended originally as a character-building exercise, a good “habit” for a young man to keep (good habits being prophylaxis against bad ones). For me, deciphering his diary has been like performing a dissection in reverse—a slow piecing together. The process has required spending numerous hours in the microfilm reading room at the library, where Steve and I have gotten to know the tics and quirks of each microfilm projector and become familiar with the microfilm-reading regulars. Those of us who gather there are an odd little community of time travelers. Most everyone reads newspapers, an old-fashioned pastime made more so by the age of the newspapers themselves—antique issues of the London
Times,
say, or a monthlong run of the defunct
Chicago Herald.
Steve and I are not so different. The daily news we’re reading just happens to be in the form of a diary.

In what now reads like an epigraph, Carter started his diary with an aphorism that sounds as if it were taken from a Victorian-era self-improvement book: “Let the same thing, or the same duty, return at the same time everyday, it will soon become pleasant.” He would frame each entry, beginning with the time he woke, closing with his bedtime, and capturing the hours in between in a few deft lines. Just as a painted portrait acquires depth and texture with the accretion of paint, an image of H. V. Carter emerges only after many weeks of entries. A serious, disciplined young man, he reads the Bible and prays daily, and goes to church—often twice—on Sundays, but he is also only seventeen years old and had moved from a town of ten thousand to one of more than a million, so naturally a boyish excitement bursts through every so often. He is left almost speechless one day by a sighting of Queen Victoria, while a few weeks later, he is fascinated by troops practicing formations in Hyde Park. At the same time, his eyes are also being opened to unpleasant realities. On May 23, 1849, the day after his eighteenth birthday, Carter begins serving a “clinical clerkship” at the hospital, a position in which he would shadow staff surgeons and take their case notes. Just two days later, he witnesses a horrific procedure, the amputation of a boy’s leg. “Chloroform not used,” he writes that evening, which comes as a chilling reminder that anesthesia during surgery was not yet standard practice.

At times, Carter’s prose is so immediate and concise, it is as though he were dictating a telegram. “Cholera case,” he writes on July 6. “First I’ve seen. Came in yesterday 6:30
P.M.
Died 6:30
P.M.
today. Terrible disease.” The next day, he attends the postmortem examination of this patient and is stupefied; the man doesn’t look dead enough to be dead. (Cholera, a bacterial disease spread mainly through contaminated drinking water, causes devastating diarrhea and dehydration.) By August 1, the cholera outbreak has so overwhelmed London’s hospitals that Carter must watch as St. George’s shuts its doors to new patients.

Contrasting with entries on the latest death tolls are warm passages on his life in the home of John Sawyer. Sawyer, forty-five, the same age as Carter’s father, ran a private practice and apothecary out of his Park Street residence, and he and his wife had five daughters, ranging from nineteen years old down to six. Although Carter paid an annual fee for room and board, it is clear that he was embraced as a part of the family and that this home away from home provided much solace. On Sundays, he often joined the Sawyer family on walks through the nearby parks and spent the afternoons playing the role of indulgent big brother to the younger Sawyer children. And on Sunday evenings, he oftentimes accompanied the second eldest daughter, Mary, to chapel. Carter always comes across in his diary as a polite and proper young gentleman, never mentioning anything untoward, yet his hormones were definitely speaking to him. “Avoid temptations,” he includes in a list of gentle reprimands, and, “Be careful to improve your thoughts when alone.” If idle hands are the devil’s tools, as the saying goes, then the devil was two mitts shy once winter session 1849 got under way.

Seemingly overnight, Carter’s diary turns into a chronicle of anatomizing. Not only does he dissect in class most days of the week but sometimes at home as well, using souvenirs, for lack of a better word, he had gotten at postmortems. “Got two eyes,” he reports one night, obviously pleased, as if
one
eye would have been a big disappointment. “Got kidney and heart,” another day. And, once, “Had offer of brain, but declined,” a rare demurral. He also obtains parts from the hospital’s morgue, the aptly named Dead House. Somehow, though, his hunger to dissect never sounds ghoulish. To read Carter’s entries is to watch a young man chasing after knowledge at full tilt. He misses lectures because he loses track of time in the lab. He works through lunchtime, missing out on eating. From lecture to lab, lecture to lab, he sometimes returns to Kinnerton Street three times in a day. Ever fastidious, Carter will often record how long he spends dissecting, as if he were a runner training for a race, pushing himself to beat his own record. Though he takes off Christmas Day, he is in the lab New Year’s morning.

Carter’s growing mastery of dissection does not go unnoticed. Ten weeks into the session, instructor Prescott Hewett asks him to make a “preparation” for the anatomical museum. In other words, he would dissect some body part, which would then be bottled and preserved in “spirits” (alcohol) for students to study for years to come. In general, a preparation would have been done by a faculty member, but Carter was obviously gifted. And excited! For three days, he nervously awaits word of his assignment. He is given a hand, it turns out. “With
name
to be added,” he writes, meaning his name will be affixed to the bottle for posterity.

With the preparation turning out well, Dr. Hewett presents his protégé with a copy of Quain’s
Anatomy,
a much-appreciated gift. Carter inscribes his name in the book and, on his way home, purchases a protective cover for it. His pleasure overflows to the next day, when he pages through the illustrations and paints all the arteries red. This “Q” is “fine work!” he writes.

By this time, January 1850, Henry Gray had been promoted from demonstrator of anatomy to the hospital’s postmortem examiner. The twenty-three-year-old had also just enjoyed the honor of having a paper read before the Royal Society. That he was so rapidly making a name for himself made a deep impact on Carter, as shortly becomes clear in the younger man’s diary: “Must work!” he admonishes himself. “
Gray
getting on!” It is as though Gray were the pacesetter, and Carter, following a similar career path, does not want to lag behind for a moment.

That same day, Dr. Hewett had offered him a new project: to preserve some anatomical specimens not by dissecting but by drawing them instead. The subjects would be hospital patients with unusual maladies. Keen to help out, Carter agrees, and, two weeks later, he finds himself in the women’s-only “nurse’s room,” performing the delicate task of painting a woman’s diseased breast. Carter “manage[s] tolerably” and finishes in an hour, after which the breast is surgically removed. His next subject is a thigh of unspecified pathology.

Nowhere in his diary do I get the impression that Carter ever imagined he would be bridging medicine and art. True, his father was a working artist and he had grown up drawing and painting, but he had come to London to learn new skills, not brush up on old ones. Asking him to draw was like asking someone who is bilingual to translate—no big deal. However, Hewett, who as a young man had hoped to be a painter himself, even studying in Paris, was definitely impressed with Carter’s work. He called it “capital,” Carter reports proudly.

As true in real hospitals as in soap opera ones, there were not a lot of secrets in the corridors of St. George’s. Word reached Henry Gray of Carter’s abilities, and Gray, it so happened, was in need of an artist’s eye.
Would you mind looking at some drawings I’ve had commissioned?
he inquires one day. The discussion that followed must have had an interesting dynamic because, in this area of expertise, Carter was Gray’s superior.

The drawings were made for an essay Gray was writing on the spleen. One illustration was “miserable,” Carter recalls that evening. Another, “shabby.” What’s more, in Carter’s view, the fee the artist was asking was preposterous. Henry Gray himself, though, made an excellent impression: “Gray very clever and industrious: a good model.”

On first reading this entry, I was pleasantly surprised by the nineteen-year-old’s forthrightness in assessing the artwork.
Good for you, H.V.
Embedded within this same passage I found something even more illuminating, though it is written so quietly it would be easy to miss: “Offered own assistance.” Carter than adds matter-of-factly, “Gray will let do some.”

Will let
me
do some, he’s saying,
I thought to myself, filling in the implied pronoun. At that moment, I felt as though the research gods were smiling down on me. Here was proof that they began working together almost two years earlier than historians have thought, I realized with a start. And it was not Henry Gray who first proposed the idea, as I would have assumed, but H. V. Carter. For him, Friday, June 14, 1850, started and ended like any other day—which is to say, like any other diary entry—but sometime between wake-up and bedtime, a historic partnership was formed.