The oldest, handsomest and best-loved

In his country practice, traveling miles by horse and carriage in all weathers, Ephraim began to feel the toll of West Virginia’s misty autumns, snowy winters, cloudy springs and humid summers. He would come home dog tired. He could not avoid the reality of approaching seventy and the equal reality of the need for income. His eldest two children were working but there were five more, the youngest only eight. He began to brood. He hated being an old man.

He opened the envelope, grunting in satisfaction at finding the banker’s draft — Helena had said the coal bill was due. And then as he read the letter his hands began to tremble. Looking at it again he went to the door and called Helena.

‘Is something wrong?’ she hurried from the back parlor.

‘I wondered if you would come out for a walk with me later.’ He would tell her the news gently, in a pleasant setting.

She hugged herself to his arm as they walked past an empty pasture. Where the woods began Ephraim stopped, took both her hands in his and chafed them, bent to warm them with his breath. ‘How would you feel about moving away from here?’ She pulled her hands away, startled. ‘I have had the most generous, wonderful, timely offer from Dr Abbott. It would mean living in the city — Chicago.’

Ephraim makes one last move — both in career and location. In Chapter 38, The Gleaner, after recuperating from a serious illness he accepts the offer of an editorial post with the journal of the Abbott Alkaloidal company. He and the family moved to Ravenswood, Chicago in 1899 where he lived and worked successfully until his death in January 1913, in his 85th year. The byline in his article above: The story of ‘The Gleaner,’ the oldest, handsomest and best-loved of the entire editorial staff of Clinical Medicine (Date ca 1906). Gleanings from Foreign Fields was Ephraim M Epstein’s regular column of translations from European medical journals. He also ran the Abbott medical library, fostering research.

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It is new, it is progress!

‘If the patient survives the treatment, he’ll survive the illness,’ Ephraim said. ‘But this new dosing method sounds much more efficient — and safe!’

‘Convenient, too. Regrettably some physicians condemn it as quackery,’ his young colleague replied.

‘Why? Clearly this is not watered-down plants in sugar-pills, it’s alkaloids: measured, isolated, active principles. It is new, it is progress, a God-send!

Before the month was out Ephraim wrote to the Abbott Alkaloidal Company for a subscription to their journal and got with it, free, a leather-bound pocket case containing nine vials, each filled with one hundred alkaloidal granules. Among his choices: aconitine for fever, digitalin for heart and circulation, codeine for pain, coughs and colics, morphine sulphate for pain. A month of using the method — easy to handle, pleasant, efficient, effective — and he knew this was a cause he must champion. His passion drove him to action.

When Ephraim’s medical career began in 1859, bleeding, purging and herbal medicine guess-work were the modes of healing; click here  and here for a quick time-travel back to his life as a med student. In The Last Cause (Chapter 37) Dr Epstein happens upon a new form of medication and decides this is the future of medicine. He writes letters, then articles for the company’s journal. Finally in 1895 he travels to Chicago to meet Dr Wallace C Abbott, company founder. Ephraim was right, this era saw the vanguard of today’s scientific medicine. Abbott Pharmaceuticals now is a huge international corporation. Only a couple of years earlier the Chicago World’s Fair (lit up at night in the photo) displayed the latest in electricity, machinery, transport, industry, agriculture. Medicine, too, is part of the glittering future ahead.

Tumors and gunshot wounds…

The ill health of human kind continued as ever: tumors and gunshot wounds, epilepsy and syphilis, pneumonia and cirrhosis, scarlet fever and ulcers, tuberculosis… for many conditions treatment was much the same as Dr Epstein had used nine years ago, before he gave up practice out of grief and guilt.

However, he had to learn about the medical advances. His old enemy from Monastir and Pola remained a scourge, but at least smallpox vaccination was becoming more accepted by the public. Yellow fever still broke out in port cities, but the search for its microbes was narrowing. Childbirth, as always, presented risks, but puerperal fever was less common, theories of cleanliness taking hold. Lister’s carbolic acid solution now swabbed most surgical procedures, and a recent medical journal said a solution of iodine had proved a good antiseptic. Ephraim’s faith in himself as a physician began to return.

In his mountainous West Virginia backwater Ephraim is in full time country medical practice. He travels the rough roads far in his horse and buggy, often taking one of the children — now there are seven — for company and to talk with them to improve their minds. In Chapter 36, Whither Thou Goest, Ephraim and Helena also get descriptions from his daughter Sister Sadie of the Czar’s new repressive May Laws of 1891 which suddenly forced more than ten thousand Jews to leave Moscow. But she, like he, is now Christian.  Doctor’s buggy photograph from http://www.countrydoctormuseum.org ; the museum is located in North Carolina.

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.

‘I cannot go on doctoring’

p1040596‘How can I trust myself? How can I know who may die at these hands.’

‘Ephraim,’ Helena murmured, trying to banish his thought with soothing.

‘I am cursed, cursed. God has punished me. I cannot heal, I kill.’

‘It was not you! It was Mr Maxwell’s mistake.’

‘But my hand wrote the scrip!’ Ephraim roared as stood up, making the chair fall over, and he left the room.

In Chapter 28, God Forsaken, Ephraim shakily emerges from grief over the death of his four-year-old son. Instead of quinine, the chemist had accidentally used morphine in medicine for the ill child. Ephraim blames himself. He descends into black depression. Of course I had to recreate his mental breakdown using my imagination. In his own words Ephraim Epstein says, ‘It [his son’s death] came near to breaking my heart and ending my life. I could not practise medicine any more.’ This abstinence was to last nine years. Meanwhile he has to find a way to support his wife and remaining child, baby Frieda.

They had to get the fever down

ivory-walking-stick-pommel-owned-by-darwin-wellcome-ac-ukEphraim bent and kissed his son on the cheek, in tenderness, and to check his temperature. The quinine would soon provoke the sweat. ‘I will sit by him,’ Ephraim said to Helena. ‘You go and sleep. Everything will be all right now.’

Early birdsong woke Ephraim. Good, the child had slept through. But the sweat should have begun. He reached for the boy — and died.  At that moment his heart and soul evaporated. His beautiful son, his William, lay with his eyes staring wide open, his face fixed in death.

 

 

In Chapter 27, The Darkness, Ephraim and Helena’s first child dies aged four. Investigation reveals that the death was caused by the misfilling of Ephraim’s own prescription. Instead of quinine, widely used at the time to reduce fever, the chemist had used morphine. Ephraim blames himself and withdraws into grief, hardly mourning the death of their second child, of convulsions, in the same year.

She Voices

she-voices-women-writers

Feisty writing women have a date with Ephraim… I’ll be reading from The Extraordinary Dr Epstein, a chapter included in the anthology Notes on a Page launched Saturday 3 December, 2 – 4 pm at Richmond Library in west London. He’s alongside short stories, memoir, lyrics, poetry… tea & cake too!

Notes on a Page is published collaboratively by Palewell Press and Dark Mourne Press http://www.palewellpress.co.uk/Palewell-Publications.html http://www.darkmournepress.com/

To circumcise or not?

babies-smiling-150923For many men the birth of a son is a great thing, and for Ephraim perhaps especially so when William was born to Helena in 1874. He knew what it was to be the first born son of his parents, the longed for male. This joy in a son was bred in his bones and could not be denied. Equally undeniable was consideration of circumcision. He himself was circumcised, of course, by a mohel at the bris at eight days of age, as all Jewish boys were. Ephraim’s personal life, his profession and his Jewish-Christian faith constellated in a crisis.

 

In Chapter 25, Doctor and Family Man, at last Ephraim has contentment, crowned by the birth of a son. But this raises issues. As his great granddaughter I can only assume that Ephraim was circumcised. I have dared to imagine that he had a dilemma over this issue for his own son. This is backed by factual circumstantial evidence: his published letter-battle with a southern physician in the professional Medical and Surgical Reporter in 1874, exactly the year of son William’s birth. The exchange escalated to the point of Ephraim’s fiery outrage on the whole issue of Jewish ‘superiority’. In his own words: ‘The singular perseverance of the Jews in health is a mean fiction…’ 

His conflict shows: he both defends and attacks Judaism. In medical circles at the time circumcision was thought to be good for health. But Ephraim believed it had become a religious political issue; the choice he made could be seen as taking sides. About his boy? My imagination has Ephraim decide against. And gives Helena very little say.

Ephraim in love

‘My dear Helena, having come to know you through your friendship with my daughter, I have grown to see you in another light. Could you think ever to become my wife?’

valentine-heartShe opened her mouth to speak and then closed it. His heart sank. ‘I was afraid of that. I am an old man, old enough to be your father. Please, let us forget –‘

‘No!’ she cried out. ‘It’s the surprise. I need time. And Sadie…’

‘Time, yes. Of course I cannot court you like the young men, but,’ he dared to touch her, one gentle touch to the back of her hand, ‘I can be ardent.’ She studied his face. ‘You do not forbid me to hope?’ She shook her head.

It was ridiculous. For the first time in his life Ephraim was a romantic in love.

In Chapter 24, Ephraim in Love, Dr Epstein courts Helena Greyer, half his age and his daughter’s best friend. Will Helena’s father, Dr Greyer, give permission? As important, will Sadie accept Helena as her father’s wife?

‘You are all grown up!’

1578Suddenly 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?