Colorado to Ward C to receive an operation. Only a few minutes into the surgical procedure, complications arose; after forty-five minutes of extremely painful surgery, Meredith died. Although Dr. Holace claimed culpability for the tragedy, it was deemed unpreventable, uncontrollable, and unforeseeable by the academy’s medical council. Black shared in the feelings of guilt.
March 12, 1873
It was not my knife, but lo, were we not all present at the death? I cannot accept that we could not have prevented the very thing we caused. We cut her, and the blood spilled out. It’s the very opposite of what I intended: I wish to deal in salvation, not death. Her family, parents, and brothers returned home. A shroud and maybe a coffin with a little stain, if they can afford it, will carry the child. What manner of physician shall I become? How often will I encounter death?
The loss had a strong effect on Black, and his relationship with his colleagues seemed shaken. It was the latest in a long series of disagreements with his onetime mentor, Dr. Joab A. Holace.
I suppose I can understand his strict and linear approach to medical science, but I believe the journal of laws needs to be held lightly so that one may easily read from it when needed, but may also let go and be freed from its weight in an instant.
Black resented the failure, and (for reasons not entirely clear) he blamed Holace and the staff of Ward C for the girl’s death. It is possible that Black was wrestling with personal issues; he wrote often of nightmares and nervousness, both of which may have contributed to the failure of his professional relationships.
Again, I dreamt last night that a cadaver was brought into the dissection theater. When the cloth was lifted from the body, I saw the sunken face of my father. Then, in their aprons, they began cutting and removing pieces of him; when they finished, everyone left the auditorium. I looked and saw that he was dead but his organs remained alive—his vibrant heart trembling, his kidneys excreting fluid. And then I awoke.
In the fall of 1874, Black suffered the anguish of death once again—only this time, it arrived close to home. His wife, Elise, bore another child, Elizabeth, who tragically succumbed only a few days later to organ failure. By all accounts, Black was devastated by the loss.
Yet he continued his work in Ward C. Over the next four years, from 1874 through 1878, Black consistently proved himself an asset to his colleagues and made tremendous advancements in grafting, vivisection, and correctional surgery. These achievements raised the reputation of the academy to unparalleled heights.
Never before has a medical arts center delivered on so many of their optimistic promises as has the Academy of Medicine in Philadelphia. The young student is certain to gain a qualified and most beneficial education while studying within those walls.
—Alfred J. J. Strong, M.D., New York
Elise gave birth to another child, Victor, in the winter of 1876, but the boy’s arrival scarcely merits a mention in Black’s journals. The doctor, now twenty-five years old, was changing. Once energetic, he had become morose and cynical; many claimed that his eccentric and erratic behavior made him an increasingly difficult personality. He also suffered from a volatile temper and a quick impatience with differing opinions. The burgeoning strength in his convictions that had made him famous only a few years earlier was now working against him; his reputation at the academy and even his prosperity were in jeopardy. Still, his devotion to his research never flagged. He was so busy that he began to neglect his friends, family, and professional obligations to the academy.
The frost of autumn becomes the storm of winter. I cannot rest my mind in a place of tranquil thought. I am left to contemplate my childhood and drudge through its ugliness. I would be very pleased with a warm spring day and a sun-soaked room to work in, instead of this wet and grayed tapestry of nature’s dead season. Perhaps my spirits would be lifted if the faces I see daily were not also gray and dead.
During 1877, his last year in Ward C, Black worked less and less at the academy while devoting increasing amounts of his attention to private studies. He developed new, polarizing ideas regarding evolution that would ultimately separate him from the rest of the scientific community. At twenty-six years of age, he wrote notes and theories entertaining the notion that