The Heart Specialist, by Claire Holden Rothman

Purchased at Chapters.ca

I owe a debt of gratitude to the 2009 jury for the Nobel Prize for Medicine for providing a timely lead to this review. Today they announced that the 2009 medicine Nobel goes to three Americans — Elizabeth Blackburn, Carol Greider and Jack Szostak — for their work on chromosomes. Blackburn and Greider become only the ninth and tenth women (out of a total of 192 laureates) to win the prize since it was first awarded in 1901. Indeed, the first female winner in the category — Gerty Cori — was not named until 1947.

So, you may rightfully ask, what on earth does that have to do with a blog that reviews literary fiction?

The Heart Specialist, by Claire Holden Rothman, was inspired by the real life story of Dr. Maude Abbot, one of the first female physicians in Montreal (at almost the same time as the first Nobel was awarded). Holden Rothman makes it clear that her heroine, Agnes White, is an inspiration, not a representation, of Dr. Abbot — but one of the central themes in this thoroughly rewarding novel is the immense difficulty that Canadian women faced in taking their rightful place in the scientific world as the nineteenth century came to a close. As the Nobel numbers above indicate, that struggle continues more than a century later.

Regular visitors to this blog probably have noted that KfC has some problems with historical novels as a genre. I struggled to finish both Hilary Mantel’s Wolf Hall and A. S. Byatt’s The Children’s Book, two 600-plus page blockbusters on this year’s Booker Prize shortlist, either of which may claim the prize when it is announced tomorrow. How did Holden Rothman succeed for this reader in her first novel (she has published two short story collections) when those two renowned novelists failed?

First, and most important, she made the novel Agnes White’s story (and she manages to tell it in only 325 pages). While breaking new ground for women in medicine is the constant framework for the story, it is only a framework. Agnes is introduced in a prelude, a memory of a moment that occured just before she turned five. She awakes to find her scandal-ridden doctor father — recently accused, but cleared, of murdering his crippled sister — weeping over her as he prepares to depart forever. It is a moment that she will never forget:

For the longest time I felt that I had chased my father away. My tears had sent him running. His face had been there one moment and then, after I shut my eyes and wept, he was gone. A child’s logic, I suppose, but logic nonetheless. What if I had kept still, I later could not help thinking. What if I had reached out my childish arms to embrace him? From that day on I lived with one thought paramount in my mind. I would find my dark, sad father and win him back. Though I could not claim to have known him well, and my first memory of him was almost my last, it did not matter. His face stayed with me through the years, as clear as on that night in January when he went away.

That introduces the first of Agnes’ motivations but it is another memory that drives what will become the quest of her working life. Her father’s specialty (he was a professor at McGill University before being released as a result of the scandal) was “morbid anatomy” and he kept a “Death Room” at home where he did dissections. When her mother died a few years after her father’s disappearance, Agnes managed to hide away his microscope and a box of slides — when the proper novel opens, at the age of 11 she has established her own dissection room in her grandmother’s barn (although she is working on animals, not humans, at this point). Her grandmother guardian wants all elements of her father erased from her life; a sympathetic governess, on the other hand, encourages Agnes’ interest in science.

She is smart and wins a full scholarship to McGill. She is equally successful there and passes her bachelor’s with flying colors. Agnes, and four other women, want to become the first female students ever in McGill’s medical school. Told that $250,000 must be raised to cover the extra costs of educating the women (they can’t share classes with males, after all), she succeeds with the help of some well-connected Montreal matrons. The entrance committee still refuses her entry, in a unanimous vote.

Agnes eventually graduates from Bishop’s University (a distant second to McGill as Montreal’s other English language school) as a doctor, but her fledgling practice is minuscule — people don’t go to women doctors. One of the professors at Bishop’s who had taken her under his wing is now dean of medicine at McGil. He offers her a job as custodian of McGill’s medical museum.

I am foreshortening the story dreadfully, but Agnes soon discovers that many of the preserved body parts (particularly hearts) in the museum are, in fact, from her father’s old collection. They have been provided by a former student of her father, Dr. William Howlett, who is now a rising star at Johns Hopkins University in the United States, arguably that country’s best medical school at the time. Howlett also happened to be on the McGill entrance committee that rejected her. To the obsessions of finding her father and her role in science, Agnes adds a third — impressing and serving this new mentor to her cause. The irony of a feminist being driven by two male models is not lost on the reader. What other choice is there?

Howlett certainly helps, in his way, and Agnes begins to acquire an international reputation. A particularly good part of the book, which I don’t have the space to explore in detail in this review, comes with the arrival of the Great War. Most of the McGill medical school heads off to set up a Canadian field hospital on the war front. Agnes is conflicted — she would like to go and do her patriotic part, yet the very absence of all those people has suddenly made her an attractive visiting international expert in the U.S. (still not in the war). Holden Rothman does a particularly good job of exploring how the war-driven need to expand the role of women creates its own internal conflict for the women involved — a theme that is also present in another Giller longlist book, Jeanette Lynes’ The Factory Voice (reviewed here).

Agnes White becomes a fully-developed character as all this unfolds — that for me is the major difference between my reaction to this novel as opposed to Mantel and Byatt. Instead of characters merely serving the historical story, this book is an exploration of how the story effects the character. (I’m fully aware that those who love Wolf Hall are going to dispute that assessment and argue it is all about a fascinating Thomas Cromwell. I found him more a narrative voice than a developed character, but I digress.)

The other thing that I very much appreciated in The Heart Specialist is that Holden Rothman never lets her prose style get in the way of her purpose. Again with Byatt and Mantel, I often found that soaring and inflated language served only to muddy an incomplete story. Straightforward prose may seem to be damning with faint praise, but in a complicated historical novel it is a definite asset. One more illustration, this time Agnes’ reaction after the McGill entrance committee has rejected her:

I stood, not trusting myself to speak. It was all I could do to get my body out of the chair and out of Laidlaw’s office, away from the intrusive eyes of these men whom I now understood had never intended to admit me, no matter what feats I performed. Dr. Howlett jumped up as soon as I rose and offered me his arm, but I did not take it. I could not stand any reminder of my gender. In the alcove the secretary looked up, but I looked right past her without speaking. One word and the floodgates would open.

The Heart Specialist explores some complex issues in an equally complex period of history, but the author makes sure that both are appropriately contained. It does this by focusing on how these circumstances effect its principal character, who comes to life in a fully-developed way. As today’s Nobel announcement shows, the issues remain timely. And the book does this in a reader-friendly prose style that never gets in the way of the story. While the theme and subject matter will not be to everyone’s taste, for this reader that made for a quite successful novel.