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In THE WAY OF ALL FLESH, the pseudonymous Ambrose Parry returns us to the Edinburgh of 1847, a world in women of all social classes shared a common terror of potential death in childbirth accompanied by agonizing pain with nothing in particular to alleviate it. It was as well a world in which a scientific approach to medicine struggled with religious objections based on Genesis 3:16 in which childbirth appears as a punishment for Eve's transgression. This was a position that several Edinburgh physicians opposed. Most notable among them was Dr James Simpson, who developed the anaesthetic use of chloroform in obstetrics and surgery and who appears here as the mentor of one of the main characters, Will Raven, and the employer of the other, housemaid Sarah Fisher.
There is a mystery about who exactly Will is. He is young, not quite twenty. As a medical student, he had somehow impressed Dr Simpson, despite the fact that his background was far from the usual one of the successful doctor. Will is clearly poor and, though no one knows it but himself, he is being pursued for money he owes to a local and fearsome gangster. But despite, or perhaps because of, his youth, he carries a burden of guilt that leads him to seek justice for the young women, some prostitutes, some housemaids, who are turning up dead, their corpses mysteriously contorted.
Simpson's employee, Sarah Fisher, would love to be a doctor herself. She is certainly bright enough for it, but knows it is an impossible dream. When she inquires about a post as shop assistant in a druggist's, she is told firmly that assistants "must inspire confidence in our customers. For that, only a man will do." Like virtually every other possible career, medicine is closed to her as a woman. She is acutely aware of her vulnerability in domestic service. One serious misstep may find her on the street "without a character," a circumstance that could lead very quickly to that other possible job for a woman, prostitution. This awareness makes her sympathetic to the housemaids and prostitutes whose deaths are troubling Will and she is willing to join him in his search for who or what is killing them.
These two protagonists may sound like familiar characters from a modern historical novel, but that does not do either of them justice. Will is not yet twenty and to contemporary readers improbably young to be finished with medical school and assisting at deliveries. But his resumé is pretty much identical to that of his mentor, the real Dr Simpson, who was, at the time this book is set, just 36. All the same, Will betrays his youth as he struggles to find a way to reconcile his moral and ethical promptings with his need to make a living out of medicine. Though she may sound like it, Sarah is not your standard "plucky young woman" who also shows up with some regularity in novels set before the vote was won. She can never forget how precarious is her social position, how unfairly she is denied the opportunity to exercise her talents, and how these restraints are the lot of all women on the grounds of their gender alone. She is as a result not reckless but cautious when she needs to be and courageous when she must.
The soundness of the research that informs the book should come as no surprise, since "Ambrose Parry" is the pseudonym of Dr Marisa Haetzman, a consulting anaesthetist with a Master's degree in the History of Medicine. The plotting, sly wit, and satisfying, if slightly over the top conclusion reflects Ambrose Parry's other half, Dr Haetzman's husband Chris Brookmyre.
While it is probably fair to say that THE WAY OF ALL FLESH is more history than mystery, it is nevertheless an engrossing trip to an Edinburgh more noir than genteel. By no means an escape trip to a stirring, if fantastic historical period, it does take us back to a time, not all that distant, when both patient and physician were called upon to be heroic. That we do not have to cope with the prospect of undergoing unmedicated surgery should make us grateful to the Doctors Simpson of the 19th century who were willing to take chances even with their own lives to relieve pain.
Incidentally, if you're thinking of a Christmas present, this book is very handsomely produced, with decorative borders, appropriate typeface, and street map endpapers of Edinburgh in 1847.
§ Yvonne Klein is a writer, translator, and retired college English professor who lives in Montreal. She's been editing RTE since 2008.
Reviewed by Yvonne Klein, November 2018
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