When I started reading about medicine in the latter part of the 19th century, three themes struck me:
First, Ignaz Semmelweis, Louis Pasteur, Joseph Lister and Lawson Tait were responsible for the revolution in bacteriology and asepsis that that sent medical science leaping forward.
Second, things were evolving so fast that for a long time there was no infrastructure and doctors and researchers developed their own protocols. Any theory, no matter how specious the underlying science, could be pursued, and with human subjects. Probably the best known instance of this was J. Marion Sims, who was credited, for many years, as the father of gynecological science. Eventually his methods came to light, and they weren't pretty: he was a southern slave holder when he first started practicing medicine, and he used female slaves to test and refine his theories on surgical treatment of gynecological problems. Systematically, over a period of years when there was no anesthesia, he operated on the same female slaves again and again. As a result he did actually develop a way to fix fistulas -- tears in the vaginal walls that sometimes protruded into bladder or colon, and were horrific for the sufferer -- surgically. He also invented the speculum.
When asked about his use of slaves, he gave the usual answers: his slaves were thankful for his help. This kind of experimentation went on throughout the 19th century, and not only with slave women. For example, there was a theory that hysteria and insanity originated in the female reproductive organs. I can show you multiple medical journal articles claiming that a woman could be cured of her unnatural leanings (which could mean anything) by female castration (excision of the external genitalia) and complete hysterectomy. There are reports of this surgery being done and claims of success. I imagine that a woman who was forcibly hospitaled and subject to this kind of mutilation would either shut down emotionally, or be consumed by anger.
Third -- and what struck me especially was that all this was happening as women were finally breaking into medicine. Because they were not allowed into traditional medical schools, they set up schools and hospitals and infirmaries and societies of their own. Even then, by law, in some parts of the country, female physicians were restricted to treating women and children, and for the most part this meant the poorest and most vulnerable.
So the thing that interested me was how these three things came together. How a woman could train as a scientist and a physician and in the process, be exposed to these theories and practices without rebeling. Because not all female physicians had a problem with the state of affairs, but many did. A female physician who spent all her time treating the poor and destitute was confronted, first and foremost, with issues of reproduction. Poor women, undernourished, overworked, often died in childbed -- even after antiseptic measures were universally accepted as necessary. Men were working overtime to restrict access to birth control, and abortion was outlawed. Anthony Comstock went after any physician who broke these laws, and was sometimes successful at sending them to prison.
These were the things that I had in mind as I began writing The Gilded Hour and thinking about the two female physicians at the center of the story.
A brief summary of the book:
The year is 1883 and New York City is aflutter with extraordinary change. As the Brooklyn Bridge nears completion in the background, the gap between severe poverty and extreme wealth and splendor is visible on every corner. Anti-vice crusader Anthony Comstock is determined to purge the city of anything indecent, and will stop at nothing to make sure his agenda is pursued. Anna Savard and her cousin Sophie Savard have become successful physicians, graduates from the Woman’s Medical School, and they treat the city’s most vulnerable occupants.
Anna works with orphaned children who remind her of her own upbringing as an orphan herself. When she encounters four children that have lost everything, she is faced with dealing with the pain of her past or choosing to allow love into her life. Sophie, the orphan daughter of free people of color, is an obstetrician. Comstock’s anti-vice crusade puts any physician administering contraception or abortions in harm’s way. Sophie struggles between upholding the oath as she took as a physician and helping a young, desperate mother, and fearing for her own life if she dares defy Comstock. Her choices catapult both her and Anna into the orbit of this very dangerous man.
Fans of the Wilderness series will see some glimmers of the characters they have grown to love, but new readers will enjoy THE GILDED HOUR as a standalone novel set in one of the most exciting times in America’s—and New York City’s—history.