…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.