1860's Medicine: Laurie Kingery (Part 1/3)

I'm pleased to host guest blogger and fellow ER nurse, Laurie Kingery. Laurie works combined ED (both adult and pediatrics) at a Level I trauma center. She will be posting this week about her research into medicine during the 1860's and her novel The Doctor Takes a Wife. Welcome, Laurie!

Researching THE DOCTOR TAKES A WIFE

In 2009, when I was in the planning stage for my book, The Doctor Takes a Wife, the second book in the "Brides of Simpson Creek" series for Love Inspired Historicals, I wanted to give my hero, Dr. Nolan Walker, late of the 20^th Maine regiment in the Civil War, a major crisis to surmount. It was all very well to depict a doctor in a small Texas hill country town delivering babies, setting broken bones, and riding to outlying ranches in his black doctor's buggy, but I wanted to give him a dramatic role that twenty-first century readers could relate to. First I thought of a cholera epidemic—there were certainly plenty of those back in the days of unchlorinated drinking water and easily contaminated food, and I could remember hearing about cholera epidemics portrayed on the old TV westerns such as Rawhide and Wagon Train.

But very frankly, cholera is a disease of profuse vomiting and diarrhea. As a veteran emergency room nurse I am certainly used to dealing with those symptoms (though not due to cholera, thankfully) and I was pretty sure readers didn't want to read about that in a romance any more than I wanted to write about it.

But this was the time when we were all bracing for the worldwide pandemic of H1N1 influenza. The first few fatal cases had been diagnosed in Mexico and Texas, and experts were predicting the possibility of deaths on a scale not seen since the influenza epidemic of 1918. Vaccine producers were gearing up to produce immunizations. At work we were told the staff would get vaccinated, "or else." Hysteria was definitely in the air.

So the subject of influenza was definitely a timely topic, but influenza epidemics also occurred in the 1800's, though not on the scale of the "Spanish flu" in 1918. Bingo—my fictional community would endure an influenza epidemic, and my hero Dr. Walker could indeed do heroic things. Then came the question of how to research the topic.

During this time I heard an interview of John Barry, the writer of The Great Influenza, a book about the 1918 influenza epidemic. Due to the threat of an H1N1 epidemic, the book was receiving renewed attention. Thankfully, the library carried the book on CD, so as I drove to work I could listen and research my book.

The story of the 1918 influenza epidemic was both fascinating and frightening. At the height of World War I, the epidemic began mildly enough in an army camp in Kansas. When the troops moved east, it appeared to die down for awhile, and then erupted worldwide. By the time it faded away, it had killed an estimated 100 MILLION people, "more than the Black Death killed in 24 years, more than AIDS killed in 24 years," to quote one review. At one point, cities were running out of coffins for the corpses. It could kill at astonishing speed. The book cited an incident of a healthy person boarding an omnibus for a trip across town being felled by the virus and dying before he reached his destination. A scary fact was that the younger "healthy" adults, such as soldiers, seemed the most likely to die. I heartily recommend the book, though it is long, goes into a lot of pathophysiology, and goes way back into history to give background on the state of medicine at that time. But the author takes care to make it interesting and understandable.

Although several individuals lost their lives during my fictional epidemic in THE DOCTOR TAKES A WIFE, it didn't compare to the 1918 epidemic, of course. But it provided great scope, I think, to show what limited resources the physicians of that time had to combat such illnesses and their complications—mainly willowbark tea to treat fever (a source of acetyl salicylic acid, from which modern aspirin is made), sponge baths to lower fever, fluids, laudanum and prayer. Next I'll post an excerpt from the story showing a crisis point in the book, when Nolan Walker is afraid he will lose the woman he loves, Sarah Matthews.

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You can find out more about Laurie at her website: http://www.lauriekingery.com/index.html