Anna blinked at him, and really, it was a question that should need no answer.
She said, “Dr. Lister’s and Dr. Pasteur’s findings on antisepsis have been accepted by doctors and surgeons—” Anna paused to look at the jury, her expression almost inviting someone to disagree. Morgan Hancock of Women’s Hospital stared back at her, his mouth in a hard line. If he was going to challenge the very idea of bacteriology, they would be here a very long time. There was a pause, and he looked away.
“It is accepted,” Anna repeated, “that bacteria, which are too small to be observed by the human eye, are the cause of infection. Some types of bacteria are harmless or even beneficial, but there are also pathogenic bacteria that cause infection and illness. Bacteria are everywhere, but an infection starts, or can start, I should say, when pathogenic bacteria enter the body through a wound. Surely you’re aware of the way President Garfield died.”
She stopped herself, because James Garfield’s death was still a very controversial subject among doctors. If the coroner asked for clarification, there might be an extended debate. But he did not, and she went on.
“In Mrs. Campbell’s case, she used an instrument that was not sterilized—in a well-run operating room, every object that comes in contact with a patient is sterilized, made free of bacteria by means of heat. Mrs. Campbell inadvertently introduced pathogenic bacteria of many different kinds into puncture wounds in the uterus and intestines. If she had come into any good hospital at that point there’s a chance she might have been saved if all the septic matter had been evacuated, but only a very small chance. Would any of the jury care to disagree with me? Dr. Hancock?”
“No,” Hancock said, his voice gruff.
Anna allowed herself a small smile. “As it was, the infection ran riot, so to speak. There was so much damage and so many different kinds of bacteria, the natural defenses of the body were simply overwhelmed. The result was a systemic infection, and the huge amount of pus and purulent matter found in her abdomen. When she was brought to the New Amsterdam she was near death following from cryptogenic pyaemia, blood loss, and shock.”
“But you operated anyway.”
“I didn’t know the extent of the damage until I had her on the operating table. She died not five minutes after I made the first incision.”
“To be clear, you agree with the postmortem report on the cause of death?”
“I agree on the cause, but I do not agree about the agent. The postmortem reads ‘person or persons unknown’ performed the operation. I am fairly certain that it was Mrs. Campbell who operated on herself.”
“What makes you so sure of that?” Stanton asked. “For my part I am not convinced.”
Anna sat up straighter and looked at him directly. “I have treated many women who came to the New Amsterdam after a poorly done abortion. Some of them will say, in the vaguest way, that they went to someone for help. No one has ever volunteered the name of a practitioner—”
“An abortionist,” Anthony Comstock interrupted.
“As you like,” Anna said, without looking at him. “You may condemn those people who perform operations, but they are generally technically skilled. Some are less particular about hygiene, which is the cause of most complications in such cases. There was nothing skilled about the operation performed on Mrs. Campbell. It was clumsy, even violent.”
For a full ten minutes she answered very specific questions about the surgery and Mrs. Comstock’s condition. When the jurors began to argue among themselves about definitions, Hawthorn interrupted.
“Dr. Savard, it is your opinion that Mrs. Campbell operated on herself in such a violent way that she caused fatal injury. You believe that she could have done such a thing on her own though she was not a very large woman.”
“Mr. Hawthorn,” she said. “Mrs. Campbell ran a household, did the scrubbing and cleaning and laundry. Have you ever lifted a tub of wet linen? She didn’t lead a pampered life. She gave birth four times and miscarried twice. She was not frail. Whatever thoughts or emotions motivated her to such an extreme act, she was determined and capable, and she persevered through the pain. As women do, every day. In your place I would want to know what drove her to such a point that she saw no other option than this drastic procedure she performed on herself.”
“Well, I can think of another question.” Comstock’s voice rose over the steady murmuring in the gallery. He looked out, Sophie thought, to make sure he had everyone’s attention.
“How would a simple, uneducated woman know what to do? Where did she get the knowledge and the surgical instruments she used? Did she have some text or instructions to follow? Maybe something like the pamphlet that was found in her dresser drawer, ‘Female Health and Hygiene.’ Are you familiar with it?”