Tag Archives: germ theory

Historical Fiction at the AWP Conference

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I’ve spent a good part of the last three days at the annual AWP Conference. AWP is an organization of writers and teachers of writing (the acronym supposedly stands for “Association of Writers & Writing Programs,” in which case it should really be “AWWP,” but never mind), and I had no idea there were so many writers in the United States. It was completely overwhelming. And exhilarating (look at all these people who care so passionately about writing!). And depressing (look at all these people who so desperately want to get published!).

But what I really want to talk about is, of course, historical fiction. Out of the hundreds of panels on offer, there were only three devoted to historical fiction, all well-attended. (Well, I really only know about two of them, because for some reason two of the three were scheduled to meet at the same time.)Listening to the panelists, I was gratified to hear echoes of many of the thoughts and feelings I’ve had during my own writing process: the need to find a gap or a mystery in the historical record, so that your imagination has room to play; the necessity of, as one panelist put it, gathering so much information about your period that you “drown” in your research (that was from Jane Alison, author of The Love-Artist, a novel about Ovid); the lingering anxiety that nevertheless you’ll get something wrong and be exposed as a fraud.

I certainly know the last feeling well–even though, by the time I started writing A More Obedient Wife, set in the 1790’s, I’d been working as a historian in that period for almost seven years. Maybe you can never really shake that anxiety when you’re writing about the past. (Although there are those rare birds, like Edward P. Jones, who are immune to it. He wrote his novel The Known World, about black slaveowners in the antebellum South, without doing a lick of research. One of the panelists–Robin Oliveira, who wrote My Name Is Mary Sutter–said she heard him respond once to a question about how he could do that. “It’s my book,” she quoted him as saying, “and I can do what I damn well please.”)

But what I wanted to ask the panelists and didn’t get a chance to was this: isn’t there also a sense in which we can know the past BETTER than the present? True, we can never be entirely sure of the details of daily life in the way we are of those that surround us now. But the past is not a moving target. It’s fixed, static–whatever happened there has already happened.

Maybe more important, we have a perspective on the past that we can never have on the present, because we know–in historical terms–what happened next. In that sense we have an advantage over our characters, who have no idea what lies down the road. We know which institutions and ideas will become discredited in the future. And we know which ones will ultimately win acceptance.

Take, for example, a character in the novel I’m working on, a doctor of the early 19th century whose ideas about the cause of disease anticipated germ theory. His contemporaries ridiculed him–disease caused by tiny invisible animals that somehow entered the body?–and he lost a good deal of his practice. Now, in the 21st century, I can simply present his experience, without authorial comment, and both the reader and I will know something that he doesn’t: that he was basically right. Another of my characters is a woman who dared to undertake what was considered a man’s job, and who argued, over sometimes fierce opposition, that women had the potential to be the intellectual equals of men if they were only given the same educational opportunities. Someday, she lamented at one point, her ideas would be recognized as valid. And we–the writer and the reader–will know that they were.

That kind of layering–the layer of what the writer and reader know, as compared to what the characters know–is one of the things I love about historical fiction. The closest thing I heard to it at the AWP panels was from a writer named Kelly O’Connor McNees, author of The Lost Summer of Louisa May Alcott, which is set before Alcott became a successful writer. “I knew what she would go on to,” O’Connor McNees said, “and she didn’t know. I had to admire her audacity.”

I suppose that’s what all of us aspiring writers need: audacity. We need to act like we’re all going to end up like Louisa May Alcott, even though we know that can’t be true.

Tiny Animals That Cause Disease?

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So much for Eliza’s brother Thomas. What of her father, Dr. John Crawford? Alas, poor Crawford. Like his daughter, he suffered for being ahead of his time.

Crawford’s learning went beyond his medical expertise. According to the eulogist at his funeral, he was well read, conversant in French and German, and well acquainted with Latin and Greek. But medicine was his profession and his primary concern, and he did his best to use his knowledge to serve the cause of public health.

In 1800, after having been in Baltimore for four years, he submitted a report on local health conditions to the City Council. That summer, he introduced the new practice of vaccination to the city–no small accomplishment, since vaccination was far safer than the previous method of immunizing people against the dread disease of smallpox, called variolation or inoculation. When you’re inoculated, you’re actually given a case of smallpox–and you keep your fingers crossed that it’s a mild one. (For some reason, when smallpox is deliberately introduced into your system by a doctor, it’s usually–but not always–a mild case.) But when you’re vaccinated, instead of smallpox you’re given cowpox–a disease that causes few or no symptoms in humans but has the effect of immunizing them against smallpox. (The word vaccination actually comes from the Latin for “cow.”)

Edward Jenner had first experimented with vaccination in England in 1796. He wrote up his findings in 1798, but it took a little while for the idea to reach these shores. According to a pamphlet about Crawford published in 1940, Crawford actually introduced vaccination to Baltimore at the same time Dr. Benjamin Waterhouse introduced it in Cambridge, MA. But because Waterhouse devoted a great deal of energy to publicizing his success (and, some say, to profiting off of it), and Crawford did not, Waterhouse has gotten all the credit.

The following year Crawford helped to organize a “General Dispensary” in Baltimore. This appears to have been an institution devoted to the medical needs of the poor, with a particular emphasis on the yellow fever that plagued Baltimore–and other American cities, including Philadelphia–on a regular basis. Crawford was involved in other good works as well: he was a member of the Hibernian Benevolent Society, a director of the Baltimore library, and, in 1802, a founder of the local penitentiary. (This qualifies as a a “good work” because a penitentiary–where prisoners were supposed to become “penitent” and reform–was an improvement over a jail, where they were just warehoused until they were released.)He was also an elder of a Presbyterian church and, for many years, he held the position of “Right Worshipful Grand Master” of the local Masonic order. And he was apparently generous in his personal life. Years after his death, his son-in-law recalled the hospitality he provided to “all who were unhappy.”

But Crawford’s opinions got him in trouble. First there was some theological difficulty. In an 1806 letter to his friend Benjamin Rush–the foremost American physician of the day, who, unfortunately for the population at the time, was an enthusiastic proponent of massive bleeding as a cure for yellow fever–Crawford lamented that his opinions about the doctrine of revelation had cost him a lot of his business. Apparently Crawford believed that revelation–the process of God’s revealing himself–was coeval with creation. Personally, I don’t have a position on this question, but even if I did I can’t imagine that I would care what my doctor thought about it. Things were different in the early 19th century, though. “The premature disclosure of my opinions,” Crawford told Rush, “has afforded a means to the envious and malignant to prejudice those I had every reason for valuing myself on, so as to deprive me of all the valuable practice in this City.”

And that wasn’t Crawford’s only controversial opinion. The following year Rush recorded in his diary that Crawford “had lost all his business by propagating an unpopular opinion in medicine, namely, that all diseases were occasioned by animalculae. He said he was sixty-two years of age and not worth a cent, but in debt.”

Basically, Crawford was saying that tiny animals–“animalculae”–somehow entered the human body and caused disease. Sounds pretty weird, huh? But in fact, Crawford was anticipating germ theory by many decades. While Crawford wasn’t the first person to propose a theory like this, he was considered something of a crackpot for doing so. (Are there theories around these days that sound nuts to us but that will, in 50 or 100 years, be proved eminently sensible?)

So that was pretty much it for Crawford. Nobody wanted to go to a doctor who espoused not only the idea that revelation was coeval with creation, but–get this!–that disease was caused by germs. Who cared that he’d saved untold lives by introducing vaccination to the city? He died in 1813, heavily in debt. His estate consisted primarily of his collection of 400 books–the finest in the city, it was said. The books were sold to the fledgling University of Maryland, where they became the nucleus of its medical library, one of the oldest in the country. The sale brought $500, but that wasn’t nearly enough to cover the claims against him.

In his will, he left his daughter Eliza any money left over from his estate after his debts had been paid–an empty bequest, as it turned out. But of course, long before he died,he had given her something else: an education, and a sense of her own worth, despite the fact that she was female. And as we’ll soon see, she put those things to pretty good use.