Modern history

The Doctor

A hundred miles from the sea, not far from the bank of the Schuylkill River in West Philadelphia, was a large yellow brick Victorian. The fine golden façade was popular among the city's nouveau riche. The house at 4038 Spruce Street was four stories with a mansard roof, nine Ionic columns supporting a sweeping front porch, and a marble staircase with a wrought-iron banister curving inward to the street. From its east wall sprouted its identical twin at 4036 Spruce, creating the impression of a huge nineteenth century mansion with the arms of a sphinx. A dozen four-story brick sphinxes huddled side by side on the block, scores of gray predawn windows concealing the enormous families and energies of the new bourgeois Edwardians. Once rolling farms and estates during the Gilded Age, the neighborhood was now a horsecar suburb for professional people fleeing industrial Philadelphia across the Schuykill. One of the first suburbs in America, it was a Victorian dream of nostalgia and nature in an ordered state. Halos of gas lamps smudged the coal-sooted shadows of English gardens and finely forged gates; sprawling Norman castles, Tuscan villas, other reverential manors of Old Europe commanded broad swathes of lawn down to the dazzling brightness of the river.

In the early morning the dusky outlines of the factories of Baldwin locomotives and Rohm & Haas Chemicals, Stetson Hats and Disston Saws, Whitman's Chocolates and Breyer's Ice Cream appeared in a lacework of smoke and coal dust and telegraph wires draping the “workshop of the world.” In refinery and foundry, warehouse and mill, men and thousands of children under ten worked in the gray clerestory light before dawn. Across from the city, in the fashionable town of Camden, New Jersey, Walt Whitman had not so long before boarded the white river ferry Wenonahand crossed to Philadelphia and back for hours, marveling at the “long ribands of fleecy-white steam, or dingy-black smoke,” glorying in the roar of progress and industry that he proclaimed the muscle of the great American era. “I cross'd and recross'd, merely for pleasure—for a still excitement. What exhilaration, change, people, business . . .” During Whitman's last years in the 1890s, the shad in the river had acquired the “peculiar taste” of coal oil. Now, on this morning in 1916, in a mystery to men of the time, the fish were almost gone. The process by which chemicals and human and animal waste consumed the oxygen fish needed to spawn was not then known. By 1916, Philadelphia had developed and dammed its rivers for commerce for parts of four centuries, expressed in a popular nineteenth-century sculpture “Allegory of the Schuylkill River,” depicting a wild-bearded river god in chains.

Shortly before daybreak, a slim and dapper gentleman of a certain age descended the marble steps of 4038 Spruce for his morning stroll. Dr. Eugene LaRue Vansant sported garb of the last century—beige seersucker suit, heavy gold watch fob, shore-white pants, white Oxford shirt, white shoes, panama hat, and bow tie, trailing a nimbus of fine cigar smoke. The doctor had dressed for the seashore, where the food was grand, the air delightful, a doctor could act like a man, and a man, if he wished, a boy. Eugene hoped to escape the restlessness and fatigue that had dogged him for days. Nervousness, he called it, or if his patients pressed him for the scientific name, neurasthenia. It was the epidemic of the new century, the disease of modernity. Insomnia, hypochondria, skin rashes, hay fever, premature baldness, and nervous exhaustion were its symptoms, and William and Henry James, Edith Wharton, Theodore Dreiser, and Theodore Roosevelt were among its sufferers. That neurasthenia implied a certain elevated sensibility, culture, and status was no consolation to Eugene during the nights he couldn't sleep.

Dr. Vansant heard it often said in America after 1900, “a man had to run faster just to catch up.” But for an Anglo-Saxon gentleman raised in the frontier days of Abraham Lincoln and Andrew Johnson, there was hardly time to catch a breath. Just as a man was getting used to a few things—macadam, alarm clocks, elevators, unconscious thoughts, evolution from apes, telephones, pizza, frank talk about sex, big cities, mass magazines, movies, “the problem of the young,” the first concrete baseball “park,” the death of God—the scientists announced that time and space were illusions. The key paper of Einstein's general theory of relativity, smuggled into England in the spring of 1916, created confused fears not only over the collapse of Newton's laws but of the moral foundation of the Judeo-Christian world. In time, Dr. Vansant's son Charles's generation would postulate modernity: There were no absolutes—of time and space, of good and evil, of right and wrong. “Anarchy,” William Butler Yeats wrote in 1916, had been “loosed upon the world.”

Fretful thoughts and forebodings had kept the doctor up in the feather bed in the second-floor master bedroom. Nineteen sixteen was the most unsettling year he had known, as the pace of bad news in the Ledger raced unabated. Recently, the American Medical Association, based in Philadelphia then, had called for “preparedness” camps to train eight hundred American doctors to take army mules into the field (ambulances hadn't yet been invented) in the event of American entry into the European war. The doctor's friends and colleagues at the AMA had been heroes and medical legends in the Civil War and Spanish-American War, but he had been too young to serve. Privately, Eugene's colleagues filled him with stories of the futility of medicine in the face of weapons that butchered men beyond repair. That year, a Victorian gentleman's worst fears about the modern age were realized: Tens of thousands of soldiers died at the Somme in an unleashing of “all the horrors of all the ages,” wrote a young war correspondent, Winston Churchill.

Lying awake as he had many nights since the snow melted, Eugene Vansant ruminated about his own inability to serve his country once again, this time because he was too old. And about his son Charles, who was old enough to be called to the European front should Wilson fight the kaiser. The hot weather made sleeping difficult. Next to him, Louisa slept fitfully. The doctor's wife was fifty-six, elderly for a Victorian woman, wearied from bearing him six children, two of whom died in infancy. She was heavy-set and the heat was hard on her. Moths and mosquitoes blew in on the warm night air from the bay window over the street.

In the morning, Eugene could feel moist tropical airs sweeping into the city, air associated, in the doctor's training, with disease. Vansant had been alarmed by reports in the Ledger the previous week of a rapidly spreading epidemic of “infantile paralysis” in New York City that had killed hundreds of children and young adults. Panicked authorities, who closed schools, theaters, vaudeville houses, stadiums, and hotels, hadn't a clue how the disease traveled—through dirt, physical contact, perhaps the hot, humid air. It would be thirty-nine years before Jonas Salk, then one year old in New York City, would develop the vaccine for the disease, later known as poliomyelitis, or polio. The epidemic was spreading to northern New Jersey and Pennsylvania.

Dr. Vansant had treated a number of cases in past years, as the terrible affliction began, and often ended, in the throat, and parents turned to him, a specialist in the emerging field of laryngology, as a savior. A sore throat, headaches, fever, and nausea were followed by paralysis of the limbs—including the muscles of the larynx, causing death by asphyxiation. Dr. Vansant was powerless to stop the course of the disease, and it had broken his stoic reserve more than once to watch a child die. It brought back painful memories from his youth in the nineteenth century, rattling in the City Hospital horse cart to the river tenements, where rag-shrouded creatures shrank from his touch. Doctors were considered agents of death, and the poor went to hospitals to die; the agony ended in the dead house with a coroner performing a candlelit autopsy. Dr. Vansant had no desire to revisit the dark days of medicine, when all a physician could offer was mercy.

As one of the leading laryngologists in the United States Vansant was familiar with the foremost medical thought on infantile paralysis: The best way to protect a child was to remove him from the city to the countryside for the tonics of isolation, rest, and clean air. And the cleanest air in the United States blew pure and free across the Atlantic and over the lovely New Jersey shore, Dr. Vansant and many Americans believed.

Dr. Vansant was looking forward to a long, soothing, and restorative stay. The shore was a place to escape the crowding and disease of civilization. By autumn, when the cool weather blew in, the epidemic would be a distant memory, and perhaps Wilson's neutrality would hold.

If any age could cure the disease of infantile paralysis, Dr. Vansant believed, it was his era of scientific “modern medicine,” the age of miracles. “Scientist” was a new word of the nineteenth century, replacing “natural philosopher,” and Dr. Vansant was exceptionally proud to be a scientist in the days when that distinction was worn like a title at court.

Eugene Vansant was a practitioner of the most powerful science of all in the new century, that of medicine. He practiced in the golden era of American medicine, when doctors enjoyed a new and radiant status. The turn of the century was not just the grand scientific age of ocean liners and telegraph lines, moving pictures and the electric light; it was a time of medical marvels. Pasteur discovered that microorganisms caused disease; the British surgeon Joseph Lister developed antiseptic surgery; vaccines sent into retreat such ancient scourges as typhus, smallpox, yellow fever, cholera, and the black death. By 1900, human populations were booming; men were living longer. Nature itself was under control in the great age of science and optimism. And of all the men who symbolized mankind's control of nature at the turn of the century—industrialists like Vanderbilt, engineers such as Brooklyn Bridge-builder Roebling, inventors like Edison and Ford, Progressive politicians who would improve the very nature of man—physicians were beginning to surpass them all. The ancient dreaded practitioners of leeching and bloodlettings had become, in the new century, the “saviors of humanity.”

In the winter of 1916, Eugene Vansant turned fifty-seven years old, an age when most men at the turn of the century had died of old age or were putting their affairs in order. But Dr. Vansant was fit and wiry-strong, walked briskly without the aid of a cane, and had not a hair that was white. He was a small, fine-boned man easily underestimated by other men, but his firm jaw and large, noble forehead were said to be scientific evidence of fine character and intelligence (a dozen fellow Philadelphia scientists had weighed their colleagues' brains after death to test the principles of phrenology). His walrus mustache was a relic of a different time, but it gave him a certain Rooseveltian force. Those who noticed a likeness to T.R. kept it to themselves, as the doctor was not known for his sense of humor. Wire-rimmed spectacles framed startling, intense blue eyes, a habitually nervous, icy gaze difficult for men to meet. The piercing eyes enhanced Dr. Vansant's reputation as a brilliant if imperious physician, innovator of Victorian treatments and tools for the ear, nose, and throat—confident a scientific approach could cure anything.

His fine reputation earned Dr. Vansant referrals from doctors in Philadelphia as well as from outlying towns and other cities. His thriving practice allowed him to acquire many pieces of Philadelphia real estate in addition to his stately home on Spruce Street, substantial holdings in railroad stocks and bonds, and a seashore house in Cape May, New Jersey, a fashionable enclave of Baltimore and Philadelphia society, where the family summered. He belonged to the Union League, one of the nation's most prestigious private clubs, where he dined with actors, titans of industry, and statesmen such as President Rutherford B. Hayes. The doctor's wife, Louisa, the former Louisa Epting of Pottsville, Pennsylvania, was an heiress to one of the great fortunes in the Age of Coal, and a grande dame of Philadelphia society.

But when he counted his blessings, the doctor placed his family ahead of his material bounty. He was a devout member of Walnut Street Presbyterian Church, where the pastor denounced the excessive materialism of the modern age, and Dr. Vansant hewed to the Victorian conviction that home, his wife, and four children were the sacred harbor in the tempest of the world. There were, contrary to modern perceptions, emotional and playful Victorian fathers, but Dr. Vansant was not one of them. To his three daughters and son he turned the stoic, disciplined countenance of nineteenth-century manhood. Yet there is little doubt, according to family members, that Eugene Vansant shared the Victorian sentiment for family. As English author John Ruskin's father, a wine merchant, once wrote: “Oh! How dull and dreary is the best society I fall into compared with the circle of my own Fire Side and with my Love sitting opposite irradiating all around her, and my most extraordinary boy.”

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