Two hundred students filled the stands …

…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?Laennec auscultating a TB patient, Paris, after T.Chartran wellcome.ac.uk

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

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And then the blow fell.

A letter from home at last, but it was bordered with black, the only words: ‘O my son Absalom, my son, my son Absalom!’ At the bottom his parents names and the numbers 1829 – 1853: the dates of Ephraim’s birth and his revealed conversion to Christianity. They had declared him dead. haworth

The room spun and he gripped the sides of the wooden chair he sat in. Trembling, he gathered his scarf and hat and hurried down the staircase into the biting air of gray November. He walked fast, blindly. He sped on, driven by grief, by horror: what had he done? He had found his own God. And now his parents had severed him.

Having successfully begun at seminary in Chapter 11, At Andover, Ephraim breaks down in health and mind at his family’s reaction to his conversion. He learns new lessons in endurance, finding support in the household of his teacher, Professor Calvin Stowe, and Mrs Harriet Beecher Stowe, author of Uncle Tom’s Cabin. Will Ephraim see his wife and daughter again? When I am a physician, he vows, then I will rescue them.

She shifted her bodyweight,

… he heard her breathing, she gave a low moan. He pressed his head against her flank and stripped his fingers down the length of the first teat to hear the stream of milk hit the bottom of the oak bucket. His hands were strong now, and hardened with calluses. If Papa, Mama, Zayde could see me… he thought of the yellow house of his childhood, felt again a fool to remember how he took milking for granted, believing any peasant or dairymaid could do it.

20150731_102921So, Ephraim got work at last, as a poorly paid, inexperienced farmhand. He crossed over the river to The Country Beyond (Chapter 7) and a labour bureau in Hackensack, New Jersey. After a season Squire Ackerman ends the job. Ephraim has to hope for farm work with blind Judge Sherman…

AmaReka… sounding like America,

… in Hebrew it meant hollow people — the so-called good life, all hard work and no respect for the old ways. Hollow indeed — if I get hard work I will thank the Lord, Ephraim vowed. He started a second letter to follow the one that announced his safe arrival after the nightmare voyage. They must believe! He set out telling some of the astonishment that was America. But after three lines he faltered, more depressed than ever. He tore off the strip of paper and crumpled it, carefully saving the rest of the sheet.

Times Square, NYC

AmaReka, America

It’s still New York City, 1850, in Chapter 6, Amereka, and Ephraim is down to his last few dollars as he struggles to find work. Should he give up and buy a ticket home?