Tag Archives: medicine 1850s

It is new, it is progress!

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‘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.

Yet he was terrified,

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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.

Ephraim was hooked

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Ephraim was hooked. Education, fine minds, the good of all — this work had to be done. He offered to join the campaign to start the University of Dakota, for his Baptist circuits provided an ideal opportunity to build support. Mr Kettering gladly welcomed the respected, highly-educated Dr Epstein. The founding trustees were tough, intelligent men and Ephraim savoured working with them as equals conferring over petitions, deadlines and charter requirements. With a cause to fight for Ephraim became fully his old self. His dispirited determination ceased, his withdrawals to his desk were now charged with energy. Helena rejoiced in his zeal; at last her husband was the confident, enthusiastic man she had fallen in love with.

Finally, two years after the awful death of his little son, Ephraim regains purpose in life, though he still feels unable to practice medicine. In Chapter 31, Orion Rising, his engagement in the new cause of a university for the raw Dakota Territory is interrupted by the devastating Great Flood of 1881. By mid-April 400 miles of the Missouri River had been inundated and the worst destruction is in the 25 miles between Yankton, where Ephraim lives, and Vermillion — the town designated as home to the university. The whole settlement of Vermillion has been washed away. Lesser men would be fazed, but Ephraim?

 

‘I cannot go on doctoring’

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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

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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.

To circumcise or not?

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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.

Home, Sweet Home

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Illustrated_Cincinnati1875Kenny-51-e1449778349610Once 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?

A terrible mistake

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Cartel-de-Se-busca-de-los-Hermanos-Dalton-legendsofamerica_com_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?

America Regained

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Spirit of the West gast-pgEphraim 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.

Book Giveaway Countdown1

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COUNTDOWN DAY 1 to the 150th anniversary of the famous Battle of Lissa, and a chance to win a signed copy of the book about the ship’s surgeon who was there.

Ephraim M Epstein, 1829 - 1913

Ephraim M Epstein, 1829 – 1913

It was a magnificent battle, valiantly fought and won in two hours. Italian casualties ran to hundreds. Austria had only thirty-eight lost, 138 hurt. Like other naval Surgeons, Dr Ephraim Epstein combined all three branches of medicine. He was physician, diagnosing and prescribing; he was apothecary, preparing and dispensing medicine; and he was surgeon, performing operations. As he worked, Ephraim learned more about the triumph: how proud the men were of their Admiral, how he had drilled them in manoeuvers, in gunnery, how he planned the ramming. Most of all he showed he loved his men, he  believed in them. Late at night, exhausted and exhilarated by all he had witnessed, Ephraim began to compose  a description of the extraordinary day.

For a chance to win a copy of The Extraordinary Dr Epstein, answer the quiz question on Wednesday 20 July 2016.

Posts over the last week are excerpts from The Extraordinary Dr Epstein, Chapter 20, Battle. Ephraim’s epic poem about the battle won him an award from Emperor Franz Joseph. Author great granddaughter still seeks that poem! Go HERE for a non-fiction page on the famous Battle of Lissa, why it was fought, what else it is famous for and what happened next. As for Dr Epstein, his 600 florin award and many more adventures lie ahead, including true love and America’s wild West.