… awe filled Ephraim at the power of wind, the power of the Lord. The heaviest storm season in these northern waters had begun, and the swells and heaving of their ship on the vastness of the ocean increased. When the gusts hit, down they went to their hell hole still reeking of urine, feces, vomit, rot. Ephraim focused on hope: how long, how long to America, the promised land of opportunity?
The worst of all storms follows in The Perilous Journey by Sea (Chapter 4) in the leaky ship Howard on a voyage of nine weeks that should have taken three. ‘Repent your sins and be baptized in the name of Jesus Christ!’ threatens a shipboard pastor…
Ephraim hesitated. He was aware that he was a focus of female speculation. Yes, the time was ripe. But though he had met some fine, educated women in Cincinnati, none had spoken to his heart. And he had wondered how his daughter would feel.
‘I was wondering — you don’t mind my saying?’ Sadie continued after a nod of his head encouraged her, ‘I was thinking you could make Miss Pettifer happy.’
‘Out of the question,’ Ephraim said abruptly. Good heavens, what a thought. The woman was nearly forty. He had felt his daughter flinch at the vehemence of his denial, so he pretended to consider. ‘I have never thought of her that way.’
It is 1870 and Ephraim himselfis forty-one. In Chapter 23, Sadie, he is enjoying an established family, community and professional life. But daughter Sarah — who insists on calling herself Sadie, her new American name — reveals she has a will equal to his own.
Suddenly among the faces and figures of passengers descending from the train, Ephraim pushed through the crowd to embrace his daughter, thrilled at how she had grown into full and beautiful womanhood. His Sarah was small and gracefully built, her hair swept up in a mop of curls framing her forehead, long locks at the nape. A frivolous hat perched atop her coiffure to match her full-skirted maroon travelling costume.
‘Papa! You look just the same,’ she pulled back to take in his top hat, waistcoat, trim dark beard. ‘Not like a cowboy at all!’
At last Ephraim and his only child reunite. At last he can have a family life, a thriving medical practice, a home in a bustling, civilised city. As Chapter 22, Home Sweet Home, continues… will Sarah prove the doting docile daughter he imagines? Or will she take after her difficult, stubborn mother?
Once again, Ephraim arrived in a new city to start a new life and this time it was an easy, comfortable beginning. Cincinnati, the lively, pleasant city along the banks of the Ohio River, greeted him with open arms, starting with a big bear hug from Uncle Jacob. ‘Look around, look around! They call this city the Queen of the West. What do you think?’
Out of the dubious, raw wild west of Kansas, lured by his will o’ the wisp Uncle, Ephraim finds sophisticated life in Cincinnati, a city already a hundred years old. In Home Sweet Home, Chapter 22, he opens a medical practice, attends clinics at the University hospital… all he lacks is his daughter. And perhaps a wife?
Finally, the awful truth was that along with the earnest and civic-minded the gateway to the West drew hustlers, con men, failures, cheats and criminals. Living near the center of Leavenworth Dr Epstein was called out to saloons where drink and cards routinely led to fights. A different class of patients began to turn up needing treatment for gun wounds, knife slashes, bloodied faces. They were the dregs of society, worse than any he had encountered in the navy, Turkish ghettoes or New York slums.
It’s Kansas 1868, in Chapter 21, America Regained, but not the Kansas Ephraim hoped for. How can he possibly let his 19-year-old Belarusian daughter join him here?
Ephraim unpacked his crates of medical texts, literature and books of faith, and commissioned a signboard. What finer place to be than Leavenworth, Kansas, the gateway to the West! As promised, there was certainly need for physicians here. He soon met the very best people of the city. Attorneys, bankers, manufacturers and merchants were among these civic-minded citizens, aspiring, sincere, self-made men. He shared their belief in American as the land of opportunity, and caught their enthusiasm for America’s duty to civilize this great continent — its manifest destiny.
Freed by his dear mother’s death to return to America and Christianity, Ephraim leaves behind Europe and his daughter for the second time. Full of optimism, in Chapter 21, America Regained, 1867-69, he sets up medical practice in a booming western town. But before long he encounters the darker side of the great American dream.
…looking down at the revolving wooden operating table beneath the skylight high above, the patient already lying under white sheets; Ephraim and Burns adjusted their sightlines from the sixth tier. What would the surgery be?
The buzz of speculation quieted as Dr Wood entered, his black silk gown fastened tightly at neck and wrist — modestly black, as he had no need to display its evidence of previous operations, unlike boastful surgeons so proud of their blood-stiffened whites. His house surgeon followed, wearing an everyday suit, its left buttonhole dangling a dozen or so waxed ligatures ready for service.
In Chapter 13 Ephraim continues and completes his three-year medical course, with training practice at Bellevue Hospital in New York, 1858-59. The surgery demo scene (thankfully not pictured above!) is historically true, as is Dr James Rushmore Wood (1813-1882). Medicine had a long way to go and Ephraim grows with it. But for now, the 29-year-old has to wait to learn what destiny his sponsors plan for him. My thanks for medical history and the image to the Wellcome Library. In 1860, a year after Ephraim’s graduation, the college changed its name to Columbia Medical School
… in Cincinnati Ephraim and Sadie had told Helena how the Epstein family celebrated Chanukah. Though the Jewish festival of lights was based on history and the German tradition muddled up Christianity with pagan folklore, the two celebrations had in common the deepest faith of all —
— the miracle of light in darkness. Now, along with readings from the Gospels of the story of the son of God born in a stable, the children heard about the candelabrum and the oil for one day which lasted for eight in the Temple. Jesus would have known this story too, Ephraim made sure they understood.
We jump ahead here to Chapter 35, Still Full of Sap, in Bethany, West Virginia 1885-87 in order to celebrate Christmas. Ephraim here is happily married and father of four young children. Next time, back to his chronology, continuing med school in New York City 1858. Meanwhile, happy celebrations to you.
…had settled to a routine, the course of study at New York’s College of Physicians and Surgeons was intensive. The college had two main halls — the upper, with a skylight, was for anatomy, physiology and surgery. The afternoons saw Ephraim next door in the lab building, training in dissection and chemistry. His entire being — even that part of him committed to the Lord — was engaged, stimulated and challenged by the pace and breadth of learning. He thought of his father forbidding such worldly learning. He tried not to think of Mama at all.
In Chapter 12, Bellevue, Ephraim embarks on three years of sponsored medical study and training, finding friends and a new mentor but now severed from his wife and beloved Mama. It’s 1856-7 when advanced medicine relied on ‘heroic therapy’ — drastic treatments including purging, sweating and bleeding. Photo here is from the Science Museum, London, a case and lancet for opening a vein. It is dated 1792, but bleeding was the common treatment from earliest known history up into the later days of Ephraim’s practice as a physician.