Yet he was terrified,

He was terrified, how could he dare to practice again? The dream made Ephraim understand his God-given duty to return to medicine. He saw that he had let his own doubts stand in the way. But he did not know if he was capable; so much had happened in medicine since 1878. He was a fool, a coward, he’d run away from doctoring and forced these wandering years on his loyal loving wife. After all her sacrifice, could she forgive a turn-around?

 

‘Still bearing fruit when I am old, still green and full of sap,’ Ephraim quotes Psalm 92 in Chapter 35, Still Full of Sap. He is awed by becoming a father again at age 58. The birth of a boy, Leo, can never make up for the death of William, but at last Ephraim feels the call to his former profession. After nine years he ends his self-banishment and in 1887 applies to the state of West Virginia for his medical license.

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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