The Anatomy of Deception - Hardcover

Lawrence Goldstone, with his wife Nancy, is the author of two critically acclaimed narrative histories of science. He has written for the Boston Globe, Los Angeles Times, Chicago Tribune, and Miami Herald. He lives in Westport, Connecticut.

Chapter One


At Christmas 1887, fifteen months before this story began, the world was introduced to a fictional character destined for such immeasurable acclaim that he would overwhelm his creator’s efforts to be done with him. The essence of this character’s appeal was not derring-do, as in the dime novels of Beadle & Adams, but rather in his uncanny ability to unravel a set of data that had stumped lesser men and proceed to a logical and incisive conclusion. He was so coldly rational that he was often compared to a machine, the Analytical Engine of Charles Babbage. His name, of course, was Sherlock Holmes.

To those of us engaged in medical research, however, the remarkable methods of Conan Doyle’s consulting detective were not at all revolutionary—they were merely a popularization of the modus operandi we employed in our quotidian efforts to alleviate human misery. The connection of analytic detection to medicine was unmistakable. Doyle himself was a physician, as were both Joseph Bell, widely considered the model for the character, and Oliver Wendell Holmes, the man for whom the detective was named. And while Sherlock Holmes may have trod the back alleys of Victorian London to ply his trade, the scenes of our crimes were no less exotic and often even more grisly.

To make sense of nature’s felonies against the human body, you see, physicians are compelled to study not only the living, but also those who have succumbed. Our clues lie in internal organs, blood vessels, skin, hair, and fluids, and we need as much access to these as Holmes needed to footprints, handwriting, or hotel records. It is only through painstaking examination of the data wrung from this evidence that deductions may be made as to what has caused illness and death, which, in turn, aids immeasurably in the care and treatment of those who might still be saved.

As Holmes’ popularity soared, it thus became sport among physicians to match wits with the fictional detective, eager to demonstrate that if they applied themselves to murder, theft, and mayhem, they would achieve similarly sterling results. Although for most in the medical field, this exercise was nothing more than a diverting parlor amusement, for me, the game was to be all too real. It started early on a mid-March Thursday in 1889, when I strode through the gate in the high stone wall at the rear of University Hospital in West Philadelphia and entered the Blockley Dead House.

The Dead House, the morgue that served both University Hospital and Philadelphia General, was a squat, solitary brick building, a fetid vault filled with cadavers in various states of putrefaction. The air was thick and still, and heavy drapes were pulled shut day and night. It was a place of spirits, where the tortured souls of hundreds, perhaps thousands, who had died from abuse, disease, want, or ignorance would spend their last moments in the company of the living before they were removed for their solitary rest and placed in the ground forever. I have never been a believer in phantoms, but I could not walk through its door without feeling all of those abbreviated lives pressing down upon me.

But this grim way station was also a place of science. In this incongruous setting, Dr. William Osler, head of Clinical Medicine at the University of Pennsylvania Medical School, forced forward the boundaries of medical knowledge. Although not yet forty, Dr. Osler had transformed the Dead House into perhaps the most exciting and advanced laboratory for the science of morbid anatomy in the entire world. I had given up private practice in Chicago and come East specifically for the chance to work and study with this astounding man. Apprenticing to Newton or Boyle or Leeuwenhoek could not have been more exciting. Others would call Dr. Osler the modern-day Hippocrates, but to me he was simply “the Professor.”

I arrived at the hospital that morning poised for a journey into the unknown, no less than Stanley at the threshold of Zanzibar. In the changing room, I replaced my suit with the trousers, pants, and cap that were provided to the staff. The outfits were faded and blue, with a military air. A persistent rumor had them as leftovers from the late Civil War, and I often wondered if my father had once been dressed in just this way.

I was soon joined by those of my colleagues also invited to observe. There were nine of us that morning, a study in contrast. Some, like me, were experienced physicians; others had just begun internship. Most were products of Philadelphia or other large cities, although I myself had been raised on a small farm in southern Ohio. One of us was even a woman. Mary Simpson had been included at the Professor’s insistence, despite the extreme disapproval of anonymous members of the board of trustees who had been scandalized by such an affront to nature. Two Georges epitomized our differences. Farnshaw, at twenty-one the youngest of our group, had been raised in great wealth and came to study with the Professor after graduation from Harvard; Turk, at twenty-eight the oldest, was the product of an orphanage, and had worked his way through the university unloading merchant vessels on the Philadelphia docks.

We assembled in the staff room and found the Professor already present and in a jaunty mood. William Osler was small, a sprightly man, scarcely five feet five inches, but he moved with such energy, such spring, that he appeared larger. He was already significantly balding, the loss of hair provoking him to pay scrupulous attention to his mustache, which was full and walruslike, perfectly framing his mouth and reaching to the jawline on either side. The backs of both hands bore signs of a recent eruption of verruca necrogenica, anatomist’s warts, a red and raised tubercular infection that gave the skin an appearance of dyed leather. It was a vile condition with which the Professor was regularly afflicted from contact with necrotized flesh, but he blithely treated each new outbreak with oleate of mercury until it receded.

“Well, well, well,” he said, rubbing those reddened hands together, his speech, as whenever he was excited, lapsing into the flat Canadian cant that betrayed his origins, “this will be a fine day, a fine day indeed, eh? I believe there are five cadavers available. Let us not keep them waiting.”

The Professor had every right to his enthusiasm. For all of his genius, it was rare he was given the opportunity to conduct a full day’s study in the Dead House. Like most of those who toil to advance human understanding, he was also engaged in a constant battle against human ignorance. Until the Anatomy Act in 1883, just six years earlier, the use of cadavers for teaching purposes was actually a crime. The great anatomist William Smith Forbes of Jefferson Medical College had only narrowly escaped a term in the penitentiary for “despoiling graves.” The liberalization of the law had done little to dispel the revulsion of many in society to the notion of cutting into a dead body, however, and resistance to the Professor’s researches remained strong. Although the more enlightened could occasionally be persuaded to allow Dr. Osler to determine the cause of death of a loved one or friend, for the most part our material was drawn, as it had been for centuries, from society’s most wretched classes.

Even here, however, there was opposition. A number of groups had recently been formed to attempt to end the “ghoulish practice” of dissecting the poor after death. The most prominent and vocal of these was Reverend Squires’ Philadelphia League Against Human Vivisection. Either unaware or unconcerned that “vivisection” referred to the living, Reverend Squires blithely employed innuendo, humbuggery, and outright lies to entice society matrons to support his cause. He then used the money to thrust himself into the public eye, creating an outcry against the postmortem abuse of society’s least fortunate. As a result, although we did not have to compete with wild dogs for the corpse of a convict, as had Vesalius centuries earlier, cadavers available for examination had become increasingly scarce.

Emboldened by the uproar, the official Blockley pathologist, Henri Formad, an eccentric, ill-tempered Russian, had taken to denying Dr. Osler use of the facilities. The Dead House attendant, a gaunt, lumbering creature whom the Professor had dubbed “Cadaverous Charlie,” had soon followed suit. Whereas Formad acted merely out of professional jealousy and spite, Charlie, buoyed by the stipend he had received from the League, refused the Professor access to cadavers out of what he termed, in his broken English, “bazic human decency.”

But Charlie was an enterprising sort, and he had also shown himself willing to accept a second stipend from the Professor to absent himself from the Dead House for hours at a time and leave us to our work. For an additional remuneration, Charlie, as he had done on this occasion, would actually inform the Professor when a promising supply of unclaimed cadavers became available. Dr. Osler seemed unfazed at the necessity of paying for what should have been provided by a grateful citizenry, but I was appalled that so brilliant a scientist was forced to skulk about like a criminal.

At seven-fifteen, when we exited University Hospital to begin our day, I strode quickly to overtake Turk. My colleague was not brilliant, but quick and clever, with an offhand wit I envied. I had made a number of overtures when he joined the staff, but Turk proved to be a man who resisted intimacy, and I had been unable to breach the wall of irony that he threw up around himself. The only member of the staff in whom he had shown any interest was the other George, Farnshaw, his complete opposite. But I continued to find myself drawn to Turk, even though my efforts at friendship were generally rebuffed.

“Five cadavers,” I whispered softly, looking up at h...