Thursday, August 23, 2012

Book Review: Open Wound explores early medical research and the roots of human ambition

by Ariella Green, MSc, program planner

Medical historians may be familiar with the story of Dr. William Beaumont, but Jason Karlawish casts it in a new light in his novel, Open Wound: The Tragic Obsession of Dr. William Beaumont. The story is fascinating on many levels, but it is Karlawish’s portrayal of Beaumont’s unstoppable, desperate, and almost dangerous ambition that takes center stage in this engaging historical account.

In 1822, on a remote army outpost in Northern Michigan, a misfired shotgun leaves a wound in the torso of a young fur trapper, Alexis St. Martin. The young man seems certain to die, and is therefore deemed by the company unworthy of expensive medical treatment. William Beaumont, an assistant surgeon in the Army, defies his orders and, surprisingly, saves the young man’s life. St. Martin is left with both a permanent hole in his side, as well as a sizable debt of gratitude to the surgeon. Desperate to advance his career and achieve the recognition he feels he deserves, Beaumont immediately recognizes the value of St. Martin’s wound as a window into human digestion, and capitalizes on the opportunity to make St. Martin the subject of experiments he hopes will improve his fortune.

Karlawish deftly renders Beaumont as a man who endeavors to overcome his humble beginnings to gain respect and admiration as a surgeon. He has no formal training in medicine, and constantly judges himself against his university-trained peers. He is a man the reader may find difficult to like, but who personifies an intensely American determination to rise above his past. Convinced of his own greatness, but crippled by self-doubt, Beaumont cannot resist the opportunities offered by St. Martin’s condition, and eventually succumbs to his own ambition.

St. Martin is more than just Beaumont’s patient; he is his salvation, and his downfall. For St. Martin, Beaumont is a doctor and a savior, but also his jailer and benefactor. The two are locked in a complex dance of hostility, need, and codependence. Whose rights are more important: the doctor, who saves his patient’s life and seeks to advance medicine (as well as himself); or the patient, who is young and irresponsible, but a free man who can choose to walk away?

In his own time, Beaumont was criticized for his treatment of St. Martin and ultimately remained an obscure medical presence, undermined by the very ambition that dictated his life. But the story of the man with the hole in his side remains important, not only as a narrative of the early days of medical research and the emerging ethical issues, but as a cautionary tale and case study of that most American of personality traits – ambition.

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