Emily Turner is a third-year doctoral candidate at the University of Sussex, where she is studying the medical humanities with a specific focus on locating archives of patient publications produced in mental health institutions between 1850 and 1950. You can find out more by following her at https://twitter.com/emilyjessturner, or read more of her journalism and academic writing at https://emilyjessicaturner.wordpress.com.
A detailed and often macabre tale blending historical reality with fictional drama, Ambrose Parry’s The Way of All Flesh is set in a evocative rendition of 1840s Edinburgh.
The novel follows nineteen year old medical student Will Raven, who is apprenticed to professor of midwifery Sir James Young Simpson. A character based upon the real life of the Scottish obstetrician (1811-1870), the fictional Simpson reflects his real life counterpart’s scientific brilliance and sometimes eccentric nature. The real Simpson was famed for his use of his home – 52 Queen Street – as a meeting place for interesting members of society: a location depicted in The Way of All Flesh, a novel in which the city is a key character, its brothels, docks, taverns, and grand houses facets of a personality. Scottish dialect – ‘sleekit’, ‘deid hoor’, ‘aye’, ‘drouth’ – serve to further the novel’s depiction of the cultural identity of the city.
The reader follows master and apprentice as they move in the medical sphere of Edinburgh, and attend several difficult births in both the city’s Old and New Towns. Details of these deliveries are not glossed over, and the medical duo deal with every obstetrical difficulty from placenta praevia to fetal craniotomy, while also combating the tide of ignorance leading to patients rejecting the use of ether – objections encouraged by the propaganda spread by corrupt and hypocritical ministers, advocating a literal interpretation of Genesis.
Against this narrative backdrop, a series of strange deaths occur throughout the city, leaving the bodies of young housemaids and female sex workers horribly contorted. In his hunt for a possible serial killer, young Raven joins forces with Sarah Fisher, a quick witted housemaid whose longing for a future in medicine is thwarted by the constraints of her gender.
For Victorianists interested in the scientific sphere, the best attribute of The Way of All Flesh is the level of real historical detail depicted within the novel. Chris Brookmyre and Marisa Haetzman are the joint writing team behind ‘Ambrose Parry’, and the novel grew out of research, undertaken by Haetzman during her Masters degree dissertation, on the use of anesthesia in the Edinburgh Royal Maternity Hospital during the 1840s.
Now a consultant anaesthetist, Haetzman’s medical knowledge is echoed in Raven’s internal monologue: ‘Were any of his organs contused? He could imagine blood dribbling between the layers of the pleura, putting pressure on his bruised lung, constricting its expansion’.
From themes, to characters, and to context, the ‘true story’ behind Edinburgh’s medical sphere is interwoven throughout every aspect of the novel. The integration of ‘real’ Victorian figures and events within the fiction brings to mind Peter Ackroyd’s The Limehouse Golem – a novel also echoed in details from Parry’s plot, such as the fear of a murderous monster at large in the docks, and a character Raven calls ‘Gargantua’ prowling the city streets.
‘Gargantua’ also references his (possibly) real-life counterpart – ‘Irish Giant’ Charles Byrne, whose burial wishes were cruelly ignored by those who valued his corpse for medical science. In this vein, references to particular developing sciences occasionally progress the narrative, while other allusions sometimes serve simply to add some background colour to the story (such as ‘Gargantua’s’ allusion to Byrne).
For example, the novel’s pivotal moment hinges on the discovery of chloroform: Simpson’s championing of anaesthesia and ongoing experiments in ether continually inform the doctors’ practices. In contrast, pseudosciences such as homeopathy, galvanism, hydrotherapy, hysteria, and phrenology are all mentioned in passing by the novel’s characters. Other scientific practices beyond the medical also appear – early photography is briefly depicted, as the characters visit the studio of David Octavius Hill and Robert Adamson, where the two men utilise the calotype beside their assistant Jessie Mann. Like Simpson, Hill and Adamson are metafiction creations, based on the two real life Scottish photographers of the 1840s – as is their assistant Mann, deemed to be the first female photographer.
The Way of All Flesh is rather a ‘Who’s Who’ of influential medical figures of the era, and it is fascinating to see the ‘real’ history reflected within the narrative. Surgeon James Syme, chemists David Waldie and William Gregory, ‘always gets a man’ detective James McLevy, Royal Maternity Hospital physician Dr Zeigler, chemist William Gregory, toxicologist professor Robert Christison, and physicians Dr George Keith and Dr James Matthews Duncan all make appearances in the novel, along with references to medical men wider afield, such as founder of modern hydrotherapy, Vincenz Priessnitz.
The authors (referred to hence as the singular Parry) position this evolving, sometimes controversial scientific sphere within the wider context of a mid-nineteenth world, defined not only by medicine but by divisive religion, the new metropolis, changing social values, and money. A topic undercurrent running through The Way of All Flesh is the Disruption of 1843 – a schism within the Church of Scotland, and an occurrence depicted by the real David Octavius Hill in his capacity as a painter. This work, titled The First General Assembly of the Free Church of Scotland signing the Act of Separation and Deed of Demission on 23rd May 1843, is regarded to be the first work of art painted with the help of photographic images, many of which were taken by Hill himself.
Edinburgh is the only setting appropriate for this novel: the author Q&A printed at the back of the book states that 1847 was ‘a time when Edinburgh led the world in the field of medicine, so its setting is absolutely pivotal to the book. It was a city of colossal cultural and scientific significance […] It was also a city of stark social contrasts, the dire poverty and cut-throat violence of the Old Town existing in parallel with the grand households of the New Town’. The dual life of the metropolis is a theme which recurs throughout The Way of All Flesh: a place of ‘public decorum and private sin, city of a thousand secret selves’, the novel evokes a very Victorian awareness about the duality of mankind’s behaviour in polite society and behind closed doors.
This society of double standards is demonstrated in the abortion access open to the women of New Town – private doctors providing home visits – and the backstreet options open to sex workers, housemaids, and working class women: a sharp knitting needle, or a mysterious French midwife offering a secret solution in exchange for your wages. A rogue infant leg, found in an alley gutter, is a spectre haunting the novel – a reminder of exactly how brutal reproduction can be for those unable to access proper care.
The depth and breadth of research informing this novel is impressive. There are, however, aspects of The Way of all Flesh – in its function as a novel – which are questionable. A ‘Dead Girl’ opens the book. Although acknowledged by the text – ‘No decent story ought to begin with a dead prostitute, and for that, apologies’ – this opening falls into several recognisable tropes without complicating them, or appropriately addressing their context. Evie Lawson – the murdered sex worker and the catalyst for the remainder of the narrative – is viewed in her death through the lens of her profession: ‘the sheets on the bed were swirled up around her, testament to more writhing than she ever feigned in her counterfeit passion, and he feared it lasted longer than any of her customers ever did’. Parry is quick to establish the sexual relationship between Raven and Lawson as well as their friendly connection beyond services rendered, thus ensuring that Lawson falls into both the Disposable Sex Worker and Platonic Prostitution tropes to differing degrees.
Although the novel does touch on how the villain targets economically and socially vulnerable members of society, arguably this awareness of the trope is derailed by the novel’s replication of aspects of these tropes. It is also peculiar that Raven states that he wishes to ensure that Evie’s story doesn’t end with her death, but for the reader, her death marks the beginning of her story as the instigation of the larger narrative – and she is solely depicted through Raven’s reminiscences and regrets.
This depiction of a sex worker is, perhaps, strangely unchallenging of the literary conventions around the depiction of a Victorian ‘pinch-cock’, as Raven refers to sex workers, and aligns with a wider conflicting exploration of gender in the novel. These signifiers of male/female roles are, of course, unsurprising for the era in which The Way of All Flesh is set.
Raven, whose masculinity is defined partly in relation to the women around him – Sarah he refers to a ‘mere girl’ – is also positioned as a defender of women, confronting a domestic abuser. He is also demonstrated to be a figure aligned with traditional signifiers of masculinity – a brawler with a ‘craven instinct’, often looking for a fight. These nineteenth century delineations of gender would be understandable if their representations didn’t often fall into modern tropes of the Victorian era: for example, there is, of course, the necessary corset scene to ‘attract a husband’, a Miss Mina Grindlay calling for her bodice to be pulled tighter.
In terms of narrative, there are a few strands which are introduced – the abusive Mr Gallagher, the superfluous love story – but do not seem to be explored fully. Perhaps, as it is intended that this will be the first of a series of books, these will be returned to in later titles. There are several other strands – both narrative and thematic – which are introduced throughout The Way of all Flesh and are hopefully fleshed out as the series progresses. These include tensions with Irish immigrants – the text mentions ‘fears expressed about the possibility of hordes of starving Irishmen finding their way along the track from Glasgow’ – and discourse surrounding social control, combating the so-called ‘relentless spawning of the poor’. It would be very interesting to see how Parry integrates themes of national tensions between Scotland and Ireland and the development of early eugenics theory, and their impact on the social and medical spheres of Edinburgh in this era.
It would also have been interesting to see a further exploration of class – particularly with regards to Sarah, who is as limited by her economic and social standing as she was her gender. This is achieved more fully with Raven: Parry’s Edinburgh – as the book’s tagline states – is a town of medicine and murder, but also a place governed by money. Raven is a man with a debt to pay, and is trying to keep one step ahead of the collectors. As a man with a impoverished background, money is a spectre which haunts Raven in ways that other doctors, of generally more privileged backgrounds, elude. A full century before the NHS was introduced in Scotland, Raven’s home-visits with his mentor are often viewed in terms of the finance they can provide the man-midwives, and the young man’s decision to take an ill-advised private job is an attempt to raise funds to pay off his debt. Simpson, in contrast – a man who uses rolled-up five-pound banknotes to cease the rattling of a window – is a man who has the luxury of only inhabiting ‘a realm of books and theory’.
For housemaid Sarah, the reader is continually reminded of the limitations that her femaleness presents, but not so frequently the intersection between her gender and her class. In the Q&A with Parry, printed at the back of the book, the authors state that the series will ‘focus upon the restricted roles offered to women at the time, and the ways in which their contributions were hidden and marginalised in a culture of male aggrandisement’. These limitations are often linked closely with gendered roles of women of differing social classes – hopefully future titles in the series, which emphasises the duality and double standards of the society in 1840s Edinburgh – will further explore the female role of a character such as the upper class Mrs Graesby in connection with the gendered position of Sarah, as Simpson and Raven are juxtaposed.
In short, this medical mystery explores the privilege and poverty of Janus-faced Edinburgh: worlds of medicine, religion, money, society and social mores collide within its pages. The novel creates an evocative universe which feels like the beginning of a wider insight into the complex and varied world of the 1840s Scottish metropolis. Very much a worthy read for any Victorianist attempting to justify novel-perusal as research.