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Seen through the viewpoints of both husband and wife, this biographical novel is a fascinating story of their individual struggles and their partnership, all informed by the author's firsthand knowledge of medicine (she's a retired physician) and primary source research into her characters and the era. I read it avidly from start to finish. I was glad to have the opportunity to ask Susan some questions about her work. Hope you'll enjoy reading this interview!
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Dr. William Stewart Halsted is no longer a household name, although Till Taught by Pain makes a convincing case that he should be. What had you learned about Halsted in med school, and what spurred you to look into his personal life in more depth?
We were taught very little history of medicine in medical school, so I’d never even heard his name until my pathology residency. While I was learning about breast cancer, someone made a passing reference to the Halsted method of radical mastectomy, mainly to point out that it had been discredited. It was a drastic and mutilating surgery, and I was given the impression that it was something of a crime committed against women way back in the past. But it’s really more nuanced than that. It was one step along a very long and ongoing path to treating cancer.
My interest in Halsted was sparked while reading a dual biography of Freud and Halsted, who both became addicted to cocaine while experimenting with the drug for medical purposes. (I’d initially picked up the book because I was curious about Freud’s addiction.) There is an anecdote in the book about how Halsted “invented” rubber gloves for his OR nurse (Caroline) who suffered a terrible dermatitis from the chemicals used for hand washing before surgery. It’s presented as a prelude to their courtship. That’s what grabbed my attention. The more I looked into this “Gloves of Love” story, the more complicated and fascinating both he and she became.
Halsted and Caroline come from very different backgrounds. I appreciated all the detail about their families, and how their upbringings added layers of interest and also complications to their partnership, considering they married just 25 years after the Civil War ended. Had you been interested in writing about late 19th-century America before conceptualizing this book?
It was more the other way around. I wasn’t specifically looking to write in this time and place, but Halsted’s story drew me into it. Their lifetimes spanned the Civil War through WWI, so there was a lot to digest. I had some built-in support from my husband, who is a historian focusing on the 19th century U.S., and my son, who is a high school history teacher, but writing in this time period taught me how little I knew about it. Fortunately, the research phase was fascinating, and I came out with way more interest in and knowledge of turn-of-the-20th century U.S. history than I had going in.
How did you choose the viewpoints, telling Halsted’s story in third person and Caroline’s in first?
I initially wrote the book from two third-person viewpoints. I’m much more comfortable writing in third person. But Caroline’s story was overwhelmed by Halsted’s, and she seemed to fade into the background. My wonderful developmental editor suggested switching to first person for both, but I couldn’t put myself convincingly in the head of a man in the throes of addiction and withdrawal. I needed him in third person. However, I found that writing Caroline’s viewpoint in the first person pulled her forward and brought her out of Halsted’s shadow.
The novel explores the notion of complicity and secrecy when it comes to addiction, and how Caroline – and Halsted’s close associates, too – acted to hide his drug dependence. Do you feel Caroline hasn’t been given sufficient credit in terms of ensuring her husband’s successful career? How complex was it to research a topic that was kept quiet during Halsted’s lifetime?
I definitely feel Caroline hasn’t been given enough credit! There isn’t much of substance about her in the historical record, but she was accounted to be a smart woman, able to hold her own with her brilliant husband. One problem I had researching her is that she is seen largely through the eyes of a few of his colleagues who considered her odd and anti-social, and that characterization has been carried forward as fact.
I don’t see how Halsted could have reached such heights and kept his addiction secret without Caroline’s support. Of course, that begs the question: should she have enabled his drug abuse? He was an impaired physician. Even she (in my fictional account) questions this.
It is complicated to research something that is currently accepted as true but that wasn’t common knowledge at the time of the story’s setting. Given how closely guarded a secret his addiction was, I do wonder how many people knew or suspected. It was fascinating to see how the secret was covered up and then uncovered over time. In letters exchanged by his colleagues, there are sometimes tantalizing hints, but no one comes out and names the problem. In a biography written shortly after his death, it is acknowledged that he had some trouble with cocaine early in his career, but it’s emphasized that he had completely recovered by the time he moved to Baltimore. Then as now, there is stigma attached to addiction so I imagine friends and colleagues who suspected it tried hard not to believe it. The question remains: Does this taint his legacy or make him more human, more complex?
What are some favorite facts and stories you learned about from research into archival records?
My favorite finds in the archives are personal letters. Halsted is remembered as a reserved, private man with a biting wit. Yet in his letters, he is very polite and often playful. Perhaps even flirtatious. I have a letter that Harvey Cushing (another giant in the history of surgery) wrote to his fiancée, describing the aftermath of a carriage accident that injured Caroline, where he inserts a description of “the delicious coffee I’ve told you about and some bread and white unsalted butter. All very Halstedian.” To me, that comment demonstrated the admiration of a young mentee mixed with his amusement over his mentor’s quirks. I can “hear” him talking to his Katie, poking fun at the great surgeon. The young always feel slightly superior to their elders, don’t they?
Caroline’s letters were the most important to me, because they were revealing of her personality, and that was hard to get at otherwise. Very few of her letters are extant, unfortunately, and nothing touches on her husband’s addiction. But there are early letters to her aunt where she discusses her upcoming marriage that give a good glimpse into her state of mind. And my favorites are the rare surviving letters to Halsted, written when she was at their summer home in North Carolina while he was still back in Baltimore. She gives him day-to-day news. She gives him very explicit instructions on where to find the spaghetti she wants him to bring with him when he comes down. And in one, she adds a P.S., “Thank you for the candy. Don’t send anymore.” That really warmed my heart, to think of him sending her candy while they were apart, and her joking response that she shouldn’t be eating it. None of these anecdotal finds were earthshaking, but the big events of Halsted’s life, and Caroline’s, can be found in the biographies and histories of Johns Hopkins Hospital. For a historical novelist, the archives present a way to discover the personal side of the protagonists, and that helps to bring them to life.
You’ve written one YA novel about a 12th-century royal woman, a Regency romance series, and now literary biographical fiction set in the late 19th and early 20th centuries, which makes for a really interesting publishing journey! How did this come about – did your interests change over time, or was it more a matter of finding the right publishers for the subjects you wanted to write about? Do you have any suggestions for authors who want to explore a variety of styles and subjects in their historical fiction?
My interests changed over time.
Way, way back when I started writing, I was deeply into medieval history, particularly that of France and England. I didn’t intend to write a YA novel, but my kids were in their tweens/early teens at the time, so I was reading a lot of YA fiction with them, and that must have influenced the way I wrote.
In the years between the publication of The Queen’s Daughter (2010) and now, I wrote several other manuscripts that are now stuffed away in the drawer, but I came back to writing biographical fiction because I am especially drawn to novels that are firmly grounded in real people and events. At the same time, as a physician who’d been in the field a long time, I found myself more and more interested in the history of medicine. And when I came across Halsted and Caroline, I knew I wanted to write their story.
The romance series was something else entirely. I read romance to relax and escape. When the pandemic hit, I needed that escapism more than ever, so I decided to try writing romance as well as reading it. Counting on Love resulted. It was accepted by Dragonblade, and they publish series, not standalones, so I got to write three more novels to tell the love stories of each of the siblings. I suppose my suggestion for other authors who want to branch out and write in different styles or subgenres is to not chase trends but to write what you love to read. If you do want to take your writing in a different direction altogether, start by reading a lot in that genre or subgenre. And then, go for it!
We were taught very little history of medicine in medical school, so I’d never even heard his name until my pathology residency. While I was learning about breast cancer, someone made a passing reference to the Halsted method of radical mastectomy, mainly to point out that it had been discredited. It was a drastic and mutilating surgery, and I was given the impression that it was something of a crime committed against women way back in the past. But it’s really more nuanced than that. It was one step along a very long and ongoing path to treating cancer.
My interest in Halsted was sparked while reading a dual biography of Freud and Halsted, who both became addicted to cocaine while experimenting with the drug for medical purposes. (I’d initially picked up the book because I was curious about Freud’s addiction.) There is an anecdote in the book about how Halsted “invented” rubber gloves for his OR nurse (Caroline) who suffered a terrible dermatitis from the chemicals used for hand washing before surgery. It’s presented as a prelude to their courtship. That’s what grabbed my attention. The more I looked into this “Gloves of Love” story, the more complicated and fascinating both he and she became.
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| Pub. by Regal House (Nov. 4, 2025) |
Halsted and Caroline come from very different backgrounds. I appreciated all the detail about their families, and how their upbringings added layers of interest and also complications to their partnership, considering they married just 25 years after the Civil War ended. Had you been interested in writing about late 19th-century America before conceptualizing this book?
It was more the other way around. I wasn’t specifically looking to write in this time and place, but Halsted’s story drew me into it. Their lifetimes spanned the Civil War through WWI, so there was a lot to digest. I had some built-in support from my husband, who is a historian focusing on the 19th century U.S., and my son, who is a high school history teacher, but writing in this time period taught me how little I knew about it. Fortunately, the research phase was fascinating, and I came out with way more interest in and knowledge of turn-of-the-20th century U.S. history than I had going in.
How did you choose the viewpoints, telling Halsted’s story in third person and Caroline’s in first?
I initially wrote the book from two third-person viewpoints. I’m much more comfortable writing in third person. But Caroline’s story was overwhelmed by Halsted’s, and she seemed to fade into the background. My wonderful developmental editor suggested switching to first person for both, but I couldn’t put myself convincingly in the head of a man in the throes of addiction and withdrawal. I needed him in third person. However, I found that writing Caroline’s viewpoint in the first person pulled her forward and brought her out of Halsted’s shadow.
The novel explores the notion of complicity and secrecy when it comes to addiction, and how Caroline – and Halsted’s close associates, too – acted to hide his drug dependence. Do you feel Caroline hasn’t been given sufficient credit in terms of ensuring her husband’s successful career? How complex was it to research a topic that was kept quiet during Halsted’s lifetime?
I definitely feel Caroline hasn’t been given enough credit! There isn’t much of substance about her in the historical record, but she was accounted to be a smart woman, able to hold her own with her brilliant husband. One problem I had researching her is that she is seen largely through the eyes of a few of his colleagues who considered her odd and anti-social, and that characterization has been carried forward as fact.
I don’t see how Halsted could have reached such heights and kept his addiction secret without Caroline’s support. Of course, that begs the question: should she have enabled his drug abuse? He was an impaired physician. Even she (in my fictional account) questions this.
It is complicated to research something that is currently accepted as true but that wasn’t common knowledge at the time of the story’s setting. Given how closely guarded a secret his addiction was, I do wonder how many people knew or suspected. It was fascinating to see how the secret was covered up and then uncovered over time. In letters exchanged by his colleagues, there are sometimes tantalizing hints, but no one comes out and names the problem. In a biography written shortly after his death, it is acknowledged that he had some trouble with cocaine early in his career, but it’s emphasized that he had completely recovered by the time he moved to Baltimore. Then as now, there is stigma attached to addiction so I imagine friends and colleagues who suspected it tried hard not to believe it. The question remains: Does this taint his legacy or make him more human, more complex?
 |
| author Susan Coventry |
What are some favorite facts and stories you learned about from research into archival records?
My favorite finds in the archives are personal letters. Halsted is remembered as a reserved, private man with a biting wit. Yet in his letters, he is very polite and often playful. Perhaps even flirtatious. I have a letter that Harvey Cushing (another giant in the history of surgery) wrote to his fiancée, describing the aftermath of a carriage accident that injured Caroline, where he inserts a description of “the delicious coffee I’ve told you about and some bread and white unsalted butter. All very Halstedian.” To me, that comment demonstrated the admiration of a young mentee mixed with his amusement over his mentor’s quirks. I can “hear” him talking to his Katie, poking fun at the great surgeon. The young always feel slightly superior to their elders, don’t they?
Caroline’s letters were the most important to me, because they were revealing of her personality, and that was hard to get at otherwise. Very few of her letters are extant, unfortunately, and nothing touches on her husband’s addiction. But there are early letters to her aunt where she discusses her upcoming marriage that give a good glimpse into her state of mind. And my favorites are the rare surviving letters to Halsted, written when she was at their summer home in North Carolina while he was still back in Baltimore. She gives him day-to-day news. She gives him very explicit instructions on where to find the spaghetti she wants him to bring with him when he comes down. And in one, she adds a P.S., “Thank you for the candy. Don’t send anymore.” That really warmed my heart, to think of him sending her candy while they were apart, and her joking response that she shouldn’t be eating it. None of these anecdotal finds were earthshaking, but the big events of Halsted’s life, and Caroline’s, can be found in the biographies and histories of Johns Hopkins Hospital. For a historical novelist, the archives present a way to discover the personal side of the protagonists, and that helps to bring them to life.
You’ve written one YA novel about a 12th-century royal woman, a Regency romance series, and now literary biographical fiction set in the late 19th and early 20th centuries, which makes for a really interesting publishing journey! How did this come about – did your interests change over time, or was it more a matter of finding the right publishers for the subjects you wanted to write about? Do you have any suggestions for authors who want to explore a variety of styles and subjects in their historical fiction?
My interests changed over time.
Way, way back when I started writing, I was deeply into medieval history, particularly that of France and England. I didn’t intend to write a YA novel, but my kids were in their tweens/early teens at the time, so I was reading a lot of YA fiction with them, and that must have influenced the way I wrote.
In the years between the publication of The Queen’s Daughter (2010) and now, I wrote several other manuscripts that are now stuffed away in the drawer, but I came back to writing biographical fiction because I am especially drawn to novels that are firmly grounded in real people and events. At the same time, as a physician who’d been in the field a long time, I found myself more and more interested in the history of medicine. And when I came across Halsted and Caroline, I knew I wanted to write their story.
The romance series was something else entirely. I read romance to relax and escape. When the pandemic hit, I needed that escapism more than ever, so I decided to try writing romance as well as reading it. Counting on Love resulted. It was accepted by Dragonblade, and they publish series, not standalones, so I got to write three more novels to tell the love stories of each of the siblings. I suppose my suggestion for other authors who want to branch out and write in different styles or subgenres is to not chase trends but to write what you love to read. If you do want to take your writing in a different direction altogether, start by reading a lot in that genre or subgenre. And then, go for it!
~
Susan Coventry is a retired physician with a lifelong historical fiction obsession. Her first novel, The Queen’ s Daughter, was a YA historical set in the Middle Ages. She has since switched from YA to adult novels and moved on from medieval Europe to the turn-of- the-20th-century U.S. She lives in Louisville, KY with her historian husband, Brad Asher. Visit her website at https://susancoventry.com.
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