ES Thomson on the History of Medicine

Today’s guest blog is by E. S. Thomson who has a PhD in the history of medicine and works as a university lecturer in Edinburgh.  She was shortlisted for the Saltire First Book Award and the Scottish Arts Council First Book Award. Beloved Poison is her debut novel.

The history of medicine is a splendidly bizarre and shocking source for the historical crime writer to draw upon.  From Rose Tremain’s fabulous Restoration, to the dazzling complexity of Iain Pears An Instance of the Fingerpost, medicine and medical matters have provided a rich gothic pallet for the historical and crime novelist’s art.

For me, medical history offers too much that is unusual, macabre and extraordinary to be left between the pages of history books.  For my novel, BELOVED POISON, the dark and exciting history of early nineteenth century medicine offered an evocative, alarming and inspiring world.  Individuals provide us with a way in: John Hunter, anatomist extraordinaire, amassed one of the largest collections of anatomical specimens in the whole country – along the way testing the idea that gonorrhoea and syphilis had the same origins by smearing infected pus onto his own penis.  Hunter was unofficially in cahoots with the resurrectionists, taking bodies in at the back door of his home-cum-anatomy-school, while his wife opened the front door to society ladies.  Once dissected – organs sliced and pickled in formaldehyde, arteries and veins injected with coloured resin to preserve their filigree pathways – Hunter boiled up the bodies in a great copper cauldron til their bones were clean – as good a place as any to hide a murdered corpse, surely?  Others, such as toxicologist Robert Christison, tried numerous poisons on themselves, with an emetic standing by so they could induce vomiting once the symptoms had been noted.  A thrilling, risky approach to medical and scientific discovery, it is also one in which murder might be concealed as accidental overdose.   

Along with Hunter and Christison, men such as Joseph Lister (pioneer of antiseptic surgery) William MacEwen (the man who put doctors into white coats), Robert Knox (disgraced by the Burke and Hare scandal) and Joseph Bell (the doctor Sherlock Holmes is based upon) all had reputations or notoriety that I drew upon to flesh out the characters in my novels.   What would it take for the ambition and jealousy of such individuals to spill over into murder?  How might those who have been schooled in the art of life and death abuse their power?  How difficult might it be to uncover the truth once such men had taken a life rather than preserved it?

Aside from those at the top of the profession, history gives us a unique view of the people at the bottom:  the patients.  Riddled with diseases for which there was no cure, or with minds and bodies ravaged by syphilis – both the pox and the clap (incurable before the twentieth century) offer us limitless potential for madness, horror and death – the patients, of whatever class, were at the mercy of those who purported to treat them. 

Consider too what we might call the ‘ancillary services’: resurrectionists have been the stuff of fiction since … well, since Burke and Hare.  How many innocent citizens ended up on the anatomists’ tables via foul means?  The tools of the grave robber would be familiar to most medical students prior to the Anatomy Act of 1832.

And what of the atmosphere of the historical crime novel?  Public health and sanitary reform might be words of the dullest hue, yet to any writer worth their salt they conjure up an atmosphere that, quite literally, reeks of death.  The stink from decaying matter, the great quantities of human and animal waste that gathered in pits and pools, in mounds and middens – so many opportunities to kill, to asphyxiate, to drown, to bury alive in a mountain of stinking refuse.  Falling (or being pushed) into any body of water in the city – the Fleet Ditch, the Thames, the Westbourne to name but three – would almost certainly result in death.  Drinking water drawn from a street pump could signal a painful and undignified end for hundreds if the cholera was in town.  Such a fate might be an occupational hazard for those living in the metropolis, but it might also be an opportunity for murder that might easily go undetected.  The history of medicine is a giant topic of limitless potential to the historical crime fiction writer.  How lucky we are to have such material to inspire us.

Beloved Poison by E S Thomson is out now (Constable £14.99)

Liz Coley talks about Questions without answers

Today’s guest blog is by author Liz Coley who has travelled widely and visited over 13 different countries including the United Kingdom, Belize, Canada, Greece, Croatia, France and Italy.  She is the author of numerous short stories and seven novels, the most recent being Pretty Girl-13. 

The worst crimes of humankind take place behind closed doors, secretly and often unpunished. The victims are children, silenced by terror, threats, trauma, misplaced love or the refusal of others to hear and believe. The perpetrators are trusted friends, relations, parents, babysitters, priests—only infinitesimally rarely are they strangers. It is nearly inconceivable to the ordinary person that another human being could sexual abuse an infant or child. What kind of degenerate species are we? Don’t we have natural rules and conscience and a moral sense? Yet it happens daily to our innocents. The burden of their stories is too weighty to bear, the legacy of psychic scars too deep.

But this isn’t why I wrote Pretty Girl-13.

In the 1970’s, a sensational story erupted in print and television of a woman given the pseudonym Sybil. Perhaps exaggerated, perhaps dramatized, it nonetheless captured the imagination of a generation and brought into clear focus one of the most extreme reactions to childhood physical, sexual, and/or emotional abuse—the splintering of the forming personality into self-protective chambers, alternate personalities. In the psychiatric community, a huge debate ensued about multiple personality disorder—real or pretend. Recovered memories or implanted memories? Created by trauma or suggestibility? The number of diagnoses multiplied exponentially in the United States (but not abroad). Was it a previously unrecognized or misdiagnosed condition or a psychiatric bandwagon? (Consider the contemporary debate about the rise in autism diagnoses.) Decades later, Dissociative Identity Disorder (DID) is recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) used by mental health professionals to classify physical and psychological conditions of the mind. Physical evidence abounds that early abuse causes changes in brain volume. In DID there is significant shrinkage specifically in the hippocampal region, which is the memory center of the brain, and the amygdala, which is involved in emotional learning and long-term memory processing. The neuroimaging work by several researchers, including Dr. A. A. T. Simone Reinders of Kings College London, shows actual changes in brain activity during personality switching and provides objective evidence of different mental states. Still, passionate skeptics exist.

But this isn’t why I wrote Pretty Girl-13.

In 2011, the United States went to war in the Middle East, sending hundreds of thousands of our young adults inadequately armored into harm’s way. Firsthand, they grasped the expression “shell-shocked” as sudden death and dismemberment from improvised explosive devices became the regular order of the day. The soldiers of WWI who waited helplessly in

trenches to be blown to bits were an unrecognized experiment in surviving post-traumatic stress syndrome. “Buck up, lad. That’s over now. Stiff upper lip,” was supposed to get them through. We see the terrible legacy of PTSD in the population of Vietnam veterans who couldn’t return to normality and found their lives spiraling downhill. The soldiers of our modern wars are returning to a mental health system inadequately staffed and prepared to deal with their psychic wounds. Too old to develop protective compartments in their memories, they look for ways to dampen and process the traumatic effects of helpless horror, bereavement, and guilt. There is one suicide a day.

But this isn’t why I wrote Pretty Girl-13.

Authors don’t write messages. They write stories to pose and possibly answer questions—but mostly to pose them. As a bit of a futurist, the questions I like to ask anticipate where we are going in science and medicine, things we will have to deal with eventually.

I had been reading in a scientific digest magazine an article about the new field of optogenetics, which has evolved in a decade from a futuristic speculation by famed Francis Crick (1999) to the “Method of the Year” and a “Breakthrough of the Decade” in 2010. When I wrote my story in 2009, the term “optogenetics” was only three years old. Some early successes in using laser light to switch modified genes on and off were being reported even in popular magazines. Reading the original scientific articles was somewhat heavy going, but with a background in Molecular Biophysics and Biochemistry, I understood the implications and was dazzled by the progress. Animal models had already suggested optogenetics could work as a cure for forms of neural blindness, epilepsy, and Parkinson Disease. If memory and learning neurons could be isolated, could they also be controlled?

And that’s why I wrote Pretty Girl-13, to ask the question: if you could erase memories of the most terrible things that haunt you, should you do it? Would you still be you? Would you be better or worse, stronger or weaker? How does self-hood and identity depend on memory? Maybe the answer depends on who you were to begin with. My protagonist Angie tries it both ways. It is up to the reader to draw his or her own conclusions.