Exploring the Human Heart

Claire Holden Rothman’s novel The Heart Specialist has a fascinating subject: a Canadian woman doctor in the late nineteenth century, when many women were banned from the study of medicine. It begins with a compelling prologue: an adult narrator remembers the last time she saw her father, when she was five years old and he came into her bedroom in tears. And the book has a riveting first chapter: a thirteen-year-old waits for an injured squirrel to die so that she can dissect it. The novel as a whole meets some, but not all, of the expectations provoked by this gripping opening.

Rothman’s novel is loosely based on the life of Maude Abbott, one of Canada’s first female medical graduates and a world-renowned heart specialist. Rothman’s debt to Abbott’s life story is acknowledged primarily through the epigraphs to many of the novel’s sections, which consist of quotations from Abbott’s writing. Like Abbott, the protagonist and narrator of The Heart Specialist, Agnes White, is a woman with a tragic family history: her father abandoned the family after being tried and acquitted of murdering his sister; her mother died when she was young and she was raised by a grandmother; and her sister suffered from a mental illness. Like Abbott, Agnes has a keen, if often thwarted interest in medicine: she wants to study medicine at McGill University, but is barred because of her gender and has to study instead at Montreal’s Bishop’s College; and she becomes a well-known specialist on cardiac disease after taking over the specimen museum at McGill and writing several well-received treatises on the heart anomalies she finds there. However, Rothman diverges from Abbott’s life story in important emotional and psychological details. She makes White’s father a physician who worked at McGill (Abbott’s father was a minister), and she focuses on the heart in a metaphoric way, as an organ of love as well as life, taking as her starting point one of the comments made about Abbott, that “she did not realize she was loved.”
Rothman’s fictional portrayal of a woman fighting to make her way in a world that was often rigorously and systematically barred to women is fascinating. But the novel sometimes falters because of the choices Rothman makes in presenting this compelling story. The narrative intersects with Agnes White only at certain moments in her career, and many times I found myself speculating about the other moments that might have been even more captivating. For example, Rothman skips completely over Agnes’ training as a physician, choosing to end one section (dated 1890) with her rejection by McGill and her acceptance by Bishop’s (which wanted to promote itself as a more liberal school), and to start the next section eight years later, in 1898, when Agnes returns to Montreal after postgraduate medical studies in Europe. The result of this choice is that the difficult and complex experiences and decisions that Agnes would have had to make as the first (and, in her time, only) female medical student at Bishop’s, and in her later studies in Europe, are elided.

Another difficulty with the novel is the dialogue. Early in the story, it seems realistic and compelling, but as the novel progresses, the dialogue becomes at times verbose and wooden and at other times slangy and reversely anachronistic. In other words, the characters sometimes speak more formally and volubly than spoken dialogue should allow, or they paradoxically speak in a colloquial way that seems more appropriate to the early twenty-first century than to the late nineteenth and early twentieth centuries. For example, one of Agnes’ friends, in a section dated 1890, outlines in detail to Agnes and her sister the context of McGill’s opposition to women in medicine. The purpose of this speech is clearly to inform readers of the history of women in medical schools in Canada, but it comes across as an unconvincingly didactic statement to a friend. On the other end of the conversational spectrum, a few pages earlier, that same friend refers to a photograph of Agnes as a “mug shot.” Although the word mug used to refer to the human face was common in 1890, the first reference I could find to photographs of criminals, and colloquially to bad photos of anyone, as “mug shots” was in 1950.

Despite my disappointment that these sorts of formal choices mean that the narrative promise of the first few chapters is not entirely fulfilled, the story itself is still a gripping one, and I read to the end with great interest. Rothman’s portrayal of the one-sided relationship that Agnes White has with her mentor, Dr. William Howlett, who exploits her knowledge while at the same time promoting her work, is particularly intriguing (and is loosely modelled on Abbott’s relationship with real-life pathologist William Osler). It was a wise choice for Rothman not to bind herself in too restrictive a way to the biographical details of Abbott’s life. Thus Rothman invents a love interest for Agnes, but one that Agnes does not recognize because she is too obsessed by the love she feels for both her absent father and her distant mentor. The relationship between Agnes and the fictional subordinate who is devoted to her allows the metaphoric nature of the book’s title to become abundantly evident. Agnes is someone who understands completely the mechanical and physical functioning of the human heart, but does not understand its figurative workings in terms of loving and being loved. That is the lesson that Agnes needs to learn, and one that she does learn in a satisfying way by the novel’s conclusion.