Tuesday, March 05, 2013

An examination of Claire Holden Rothman's The Heart Specialist

Although I'm using the next month to devote attention to small press historical novels, March is best known as Women's History Month. As such, I thought The Heart Specialist would be a good selection for both events.

Claire Holden Rothman's quasi-biographical novel about one of the first female physicians in Canada provides an eye-opening perspective on the obstacles that modern medicine's founding mothers had to overcome. 

Rothman bases her lead character on Maude Abbott, who graduated from a Montreal medical school in 1894 and became a world-renowned expert on congenital heart disease. I decided not to link to any online articles about her because then the career path of Agnes White, Dr. Abbott's fictional counterpart, would hold no surprises. However, because she's writing about an invented character, the author has greater freedom in developing Agnes's personal life, which she has creatively imagined.

Agnes is an unfashionable woman who takes interest in an unfashionable field of medicine, since few cures were possible for her unfortunate patients at that time.  We first meet her in 1882 as a curious child who would rather be performing dissections than playing dress-up.

Her mother is dead, and her father HonorĂ© Bourret, formerly a physician at McGill University, had abandoned the family in the wake of scandal after his sister's murder.  Agnes believes him innocent and looks for him in every older man she sees.  She and her fragile younger sister, Laure, are brought up in the QuĂ©becois village of St. Andrews East by their indomitable grandmother, who changed their last name to her own name of White.

One bright spot in Agnes's childhood is her governess, Miss Skerry, herself a woman of science and learning. There were limited choices open to educated women at the time: they could become governesses, schoolteachers, or, preferably, wives and mothers  There are no true role models for "unnatural" girls like Agnes, who must blaze her own trail and face the consequences.

Writing with empathy and conviction, Rothman takes us through Agnes's pioneering journey: the long hours of study, the intellectual triumphs, and the contemptuous doctors who are her only hope for a professional education but who refuse to let her advance. Even as a middle-aged physician during the WWI years, Agnes must take the back stairway, the one reserved for "waiters and women," when meeting a colleague for dinner at McGill's University Club. The unfairness of it all comes through powerfully.

For that reason, some of the author's choices are frustrating in a different way.  For the early part of her career, Agnes has a strong narrative voice, but she's given little dialogue with which to share it.  When her male colleagues and superiors speak, she mostly nods, smiles, or stutters.  Her emergence as an outspoken feminist wouldn't have helped her career; all the same, her excessive verbal passivity doesn't suit her ambitions or academic prowess, and I felt myself wanting to pull words out of her.

Likewise, while it gives her an appealing vulnerability, Agnes's social awkwardness is overemphasized, and her scientific detachment from her emotions edges close to stereotype.  The novel's title has an ironic double meaning that plays out predictably: she has experience aplenty with cardiology but fails to recognize love when it's under her nose.

Several intertwining forces shadow Agnes throughout the novel: her desire to please her long-absent father by following in his footsteps; the guiding influence of her mentor, one of her father's former students; and a defective three-chambered heart, stored and preserved in a glass jar.  At novel's end, the mysteries associated with all three are resolved in a realistic manner.

Agnes's tireless efforts are finally vindicated, and seeing her accomplishments publicly acknowledged, in the end, makes for a satisfying story.  Reading this book left me with immense respect for the brave women who were the first to break out of their strictures, as well as the struggles they endured in order to be taken seriously.

In the US, The Heart Specialist was published by Soho Press out of New York in 2011 ($25.00, hb, 325pp).  Cormorant Books, which specializes in new literary fiction, published it in Canada in 2009 ($21.00, pb).  This was a personal purchase.


  1. This sounds like the type of book that is right up my alley. Thanks for the heads up, Sarah. Wouldn't have discovered this without your blog!

    1. Hi, Jessica! This book flew under the radar in the US, although I understand it was a big seller in Canada. I don't remember where I first came across it, but I've had it on my shelves for about a year and figured this was a good time to read it. Glad I did!

  2. Anonymous8:41 AM

    Great review, Sarah. The bias against women in medicine continues despite the number of women doctors. My cousin has a PhD in Nursing ... the hospital refuses to allow her to use the title of doctor claiming that it might confuse the patients. Makes my feminist blood boil!

    1. How frustrating for her. Women in the sciences rarely have it easy!

  3. I've had this book on my TBR list for ages. Thanks for the honest review!
    One of the first biographies I ever read was about Elisabeth Blackwell, the first woman doctor.

    1. I had some issues with it but enjoyed it very much overall.
      Elizabeth Blackwell was someone I read about long ago, in school, although I'd never heard of Maude Abbott before coming across Rothman's novel.
      I find it interesting that I have a couple of other small press historical novels about women doctors I'd been considering writing up - Jun'ichi Watanabe's Beyond the Blossoming Fields, based on Japan's first female doctor, and another I can't recall at the moment.

    2. FWIW, that other novel was For a Modest Fee by Freda Jackson, about a medical woman in early 20th-century Alberta.