The Physician's Daughter

The Physician's Daughter

by Martha Conway
The Physician's Daughter

The Physician's Daughter

by Martha Conway


    Qualifies for Free Shipping
    Choose Expedited Shipping at checkout for delivery by Thursday, February 29
    Check Availability at Nearby Stores

Related collections and offers


From the author of The Underground River comes this compelling new novel of female perseverance. Set in the aftermath of the Civil War, The Physician's Daughter is the story of two people trying to make their way in a world that is struggling to escape its past.

It is 1865, the American Civil War has just ended, and 18-year old Vita Tenney is determined to pursue her lifelong dream of becoming a country doctor like her father. But when her father tells her she must get married instead, Vita explores every means of escape - and finds one in the person of war veteran Jacob Culhane.

Damaged by what he's seen in battle and with all his family gone, Jacob is seeking investors for a fledgling business. Then he meets Vita - and together they hatch a plan that should satisfy both their desires. Months later, Vita seemingly has everything she ever wanted. But alone in a big city and haunted by the mistakes of her past, she wonders if the life she always thought she wanted was too good to be true. When love starts to compete with ambition, what will come out on top?

Product Details

ISBN-13: 9781838778514
Publisher: Bonnier Books UK
Publication date: 09/01/2022
Pages: 432
Product dimensions: 6.00(w) x 9.25(h) x 1.40(d)

About the Author

Martha Conway has been nominated for an Edgar Award and won the North American Book Award for Best Historical Fiction. Martha teaches creative writing for Stanford University's Continuing Studies Program and UC Berkeley Extension. Born in Cleveland, Ohio, she is one of seven sisters. She now lives in San Francisco with her family.

Read an Excerpt

Chapter One

‘Hysteria is often excited in women by indigestion.’
(On Diseases Peculiar to Women, Dr. Hugh Lenox Hodge, 1860)

June 1865
Lark’s Eye, Massachusetts

VITA WAS SITTING ON THE front stairs in a shaft of sunlight reading On Diseases Peculiar to Women when they carried the Boston man into her house.

Her mother and sister had gone to visit Aunt Norbert in town, and Vita was waiting for her father to emerge from his office, which was directly across from the staircase. She knew he was in there although for the last thirty minutes – she squinted at the watch pinned upside down to the shoulder of her dress – she’d heard nothing, not even the shush of a newspaper page turning.

‘What does he do in there all day?’ Vita asked Sweetie, her brother’s parakeet, perched on her shoulder. Sweetie repositioned her claws and butted her soft pale head against Vita’s ear – the triangular fossa. Triangular fossa, scapha, auricular lobule, Vita recited to herself. Parts of the outer ear.

The book’s pages were mostly uncut since it had only arrived yesterday, from England; everything was still slow because of the war. In one hand Vita wielded a silver letter opener like a surgeon’s knife, slicing the crisp, cream-colored pages to reveal row after row of dark print like so many ants marching from one idea to the next. But her neck was getting sore, and the light from the landing window dropped to almost nothing whenever a cloud passed over the sun. She was about to give up her vigil when she heard the sound of carriage wheels on the gravel drive, and then a man shouting:

‘Dr. Tenney! Dr. Tenney!’

A minute later the front door banged open and two men came into the house carrying a third man by the armpits and ankles. As Vita stood up, Sweetie flew off her shoulder to the fixed safety of the newel post.

‘Dr. Tenney!’

Maneuvering, the men knocked over the little oak table with its double-wick lamp. Now there was glass on the floor.

‘Dar?’ Vita called. Like her brother and sister, Vita always called her father Dar and her mother Mitty – her older brother Freddy’s attempt at saying their names, Arthur and Marie, when he was a baby.

Her father opened his door and stood in the doorway, unshaven and wearing the same gray waistcoat he’d been wearing for three weeks straight. For some reason he looked at Vita first.

‘Stop that shouting.’

Sherman Tillings, who owned the saddlery and the public stable and had a wife named Thankful, was at the injured man’s head; Vita didn’t recognize the other man.

‘We was just changing horses for the Boston coach,’ Mr. Tillings explained. ‘He collapsed on the porch, didn’t say a word. Where can we set him?’

Her father directed them to the long sofa against the windows in his office, where the light was best.

‘Not one word,’ Mr. Tillings went on, lowering the man onto the green velvet upholstery. ‘A Boston man. You see where his forehead is swelling? Cracked the rail when he fell.’

The man’s face – closed eyes, open mouth – had a waxy tinge, like skin on hot milk. Was he breathing? Vita, who had seen many an injured man brought into their house, stared at his chest but couldn’t make out a rise and fall.

‘Shall I fetch a blanket?’ she asked. It’s important to keep the extremities warm, her father always said. He sat down on the stool next to the sofa and put his ear to the man’s mouth. Then he placed two fingers against his wrist.

‘No pulse,’ he announced.

He told Tillings to prop the fellow up while he opened a bottle of whiskey. Holding the bottle by the neck, he pushed back the man’s head and poured a glug down his throat. ‘To encourage the swallowing reflex.’ But the man didn’t swallow. Two uneven streams ran down either side of his beard.

‘Get a hot poker, set it against his head, that’ll shock him awake,’ Tillings said.

‘Or blow tobacco smoke into his mouth,’ suggested the other man – the coach driver? – who was small and freckled with wiry red hair.

‘Nonsense.’ Her father began massaging the man’s chest. ‘But perhaps I can work up the heart.’

‘Work it up?’ Vita asked. The human heart, with its auricles and ventricles and valves, its precise oscillation, was, to her, a miracle of engineering. She had seen her father perform countless exceptional procedures – setting badly broken bones, draining pustulous head wounds, and once he made an incision into a man’s bladder to extract a stone the size of a fig – but she had never seen him restart a stopped heart. Scientifically, it seemed impossible, but there was so much she didn’t know. She stepped closer.

‘I thought you were getting a blanket,’ her father said.

When she came back into the room they were pushing the man forward and back, bending him at the waist as though he were a lever. They stopped long enough for Vita to spread the tartan blanket over his legs. The man’s eyes were not altogether closed although he was clearly unseeing. He had a craggy round face with a cluster of white warts under one eye; whiskey drops glistened on his beard. She touched the top of his hand. It was still warm. Of course, she thought, it will take a while for blood in the body to cool.

The three men began again to pull him up and shake him, set him down, pull him up. Meanwhile her father was becoming angrier and angrier, as though the unlucky man was clinging to death just to vex him.

‘Enough!’ he said at last. ‘He’s clearly past saving.’

Mr. Tillings, his face solemn, stepped back and took off his hat. By now the Boston man’s mouth was fully open, and his neck and shoulders seemed unnaturally still. For a moment, looking at him, Vita could almost understand it: how the body, with its layered, exact systems and its rhythmic machinery, might at any moment halt absolutely. Here was proof. However, the next moment the man, a stranger on her father’s green sofa, didn’t seem quite real.

‘Rupture of the heart,’ her father said with his usual authority. But how did he know?


After the men left – Vita could hear Mr. Tillings arguing with the coach driver about the man’s belongings as they carried him out of the house – she watched her father pour himself a shot of the whiskey, drink it, and pour a second shot. He had a long thin nose with wide nostrils, which widened further into little round caves of distaste when he was annoyed.

They widened now. ‘I’ll just get on with my work, then,’ he said, seeing that Vita was still standing there.

But this was her chance.

She looked around, steeling herself for her task. She hadn’t been in her father’s office for weeks; no one had. He wouldn’t even let Gemma clean it. As children the room had always been off limits to them, which meant that whenever Dar was gone Vita and her brother Freddy would sneak in. Dar had a peculiar collection of what he called ‘my curiosities,’ which included ancient nested bleeding bowls, Roman instruments for pulling teeth, and a set of mandibles he’d gotten as a prize while studying medicine at Yale – a seagull, a porcupine, and a snake. Framed pictures of iridescent beetles hung on the walls like soldiers awaiting inspection, and he kept a two-tailed lizard in a jar of liquid on his desk.

Once Freddy bet Vita a penny that she wouldn’t touch both tails of the lizard; she won the penny easily. Sometimes even without Freddy, if Dar was out, Vita pulled books from the bookshelves to read about the uses of quinine or how to reset a dislodged shoulder. She had always been healthy – no trouble sleeping, a good appetite, and although she was clumsy (her father was always scolding her for that), she never broke any bones. There were times she almost wished she had an affliction that she could diagnose. But at least she could read about them, and as a child – before the war – the more gruesome the illnesses were, the more she liked them.

Now the bookshelves were visibly covered with fine ashy dust. Vita half expected to find something horrible or secretive in here, something her father didn’t want to be seen. However, except for the stacks of yellowing newspapers piled up on the floor, the room seemed much the same. What struck her most was the smell, which was heavy and densely male: sweat and stale tobacco smoke and wool clothes that needed airing. She looked down at his set of mandibles and picked up her favorite, the snake. A bone as smooth as glass.

‘And take that blanket with you as you go,’ he said. ‘Best to have Mrs. Oakum wash it.’

She put the snake mandible back on the painted tray with the others, turning it slightly so it faced the door.

‘Dar,’ she said, lifting the blanket and beginning to fold it. Her heart pumped out a couple of hard beats. ‘I’ve discovered something. Well, I’ve known it for a long time. But it’s important.’

She waited for him to look at her but he didn’t. He slid his hand in his pocket and then took it back out.

She went on in a rush: ‘I want to study medicine. I want to be a doctor, like you.’

‘What’s that?’ He put his hand in his other pocket and pulled out a pouch of tobacco.

‘A doctor. I want to study to become a doctor. I’ve looked into it, and there are colleges that I can apply to. That accept women, I mean. Medical colleges. One in Philadelphia and one in Boston.’ Although she’d practiced this speech a hundred times, she found herself stumbling her way around the points she wanted to make. ‘I could start in the fall. It wouldn’t cost that much. If you let me.’

Dar set the tobacco pouch down on his desk and turned to lock his whiskey and shot glass into the cabinet behind him. He said, with his back to her, ‘You want to help people, is that it?’

She hadn’t thought about it that way. ‘Well – yes. I suppose. That is, I’ve always been interested in biology and medicine. The art of healing.’ One of his own pet phrases.

‘The art of healing, I see. And you’ve decided to apply to medical college so you can do that?’


‘And you would like to attend this fall? This is what you’re proposing?’

She nodded, but he still wasn’t looking at her. ‘I – yes. If I can. If they’ll have me.’

For a shining, unreal moment she thought he would say all right then, go. His mood swings had become excessive in the last few months. For days at a time he ignored her, and then suddenly he berated her for nothing.

‘Well then,’ he said now, ‘you’re a fool.’

Her heart dropped. ‘Why?’

He began to fill his pipe. ‘Obviously you don’t know the first thing about it. You can’t just apply to medical college; first you must find a sponsor, a doctor who will mentor you so that you can gain practical experience. A preceptor, he’s called. You assist him during the day, seeing patients and so on, and then you go home at night to study up on your own. Cheselden on the bones, Jones on the muscles, Vansweiten on humoral pathology. Also Haller, Quincy; I could name a dozen more. You must know these texts inside and out before you even begin to approach the college dean. He’ll ask you, you know. You’ll be required to submit to an interview, and he’ll want to know what you’ve read and what you’ve memorized. It took me almost a year to learn enough just to be interviewed, and I was a fast reader.’

‘I’m a fast reader,’ Vita said.

‘Anyway it’s unnecessary. There are quite enough men in the world to serve as doctors. You’d only get in their way.’

She had thought of this argument. ‘There may be women who are more comfortable seeing a woman – having a woman examine them.’

‘Then they’re being childish.’ He bent to turn the snake mandible around so it faced his desk instead of the door. ‘It’s unnecessary,’ he said again. ‘You’re eighteen years old now, and the war is over. The time has come for you to accept your station in life.’

She felt the heat rise in her face. ‘My station in life? What station is that?’

‘Vita. Lower your voice.’

Vita’s voice was naturally low-pitched and loud – ’mannish,’ her younger sister Amelia called it – and the slightest hint of emotion made it go even louder. It surprised people in part because Vita herself was so small; Amelia, at seventeen, was taller than Vita was at eighteen. Vita had her mother’s thick black hair, whereas Amelia was blonde like Dar. The only thing that Vita shared with her father, as far as she could tell, was a bad temper. Though of course Dar never admitted he had a temper. He called his outbursts ‘setting things to rights.’

‘What is my station?’ Vita repeated. She was still clutching the tartan blanket; one lopsided triangle had fallen outside the folds and she squished the errant piece up, trying to hide it. Her hands were shaking.

‘You know very well. To marry, to have babies. Boys in particular. That’s every woman’s duty after a war. To replace the men we’ve lost.’

But here his voice faltered, and Vita felt something dark and raw pulse in the deepest part of herself. It had only been two months since they received the telegram about Freddy. Their horses still wore black ribbons in their manes.

‘It’s time you married. I’ve thought it out. You’ll have a double wedding, with your sister. That will save on expense.’

‘A double wedding? But, Dar, I’m not – I don’t have anyone to marry, even if I wanted to. What I want is to follow in your footsteps.’ Maybe appealing to his vanity would help? ‘I want to be a doctor, like you. Like Freddy was going to.’

But at that he turned on her, suddenly furious. ‘You think you can replace your brother?’

She felt the blood drain from her face. ‘No! Nothing like that!’

‘You hope to profit from our loss, like a turkey vulture?’

‘Of course not! I only meant that I want to study medicine, like . . . like he would have.’

Her father was glaring at her now, his nostrils flaring. His cheeks, above his untrimmed beard, were an angry, mottled red. He yanked his door open and stood with his hand on the doorknob, pointedly waiting for her to leave. This conversation was over.

‘No one can take the place of my son.’

Chapter Two

’If the groom attempts to kiss his bride any place other than the cheek or the hand, she should announce that nature calls her to the toilet. This will generally dampen his desire.’

(Instruction and Advice for the Young Bride, Mrs. Ruth Smythers, 1894)

Vita didn’t want to take the place of her brother. She wanted, more than anything, for Freddy to still be alive.

At night she sometimes dreamed of him, but his voice was always different, or his hair, or he said things to her that he would never have said in real life. In her dreams he was blander, more complacent. He wasn’t the prankster she knew as a child. Once he put molasses inside Amelia’s boot and he got in real trouble for that since it was always gummy afterwards.

But he was a good brother too, usually letting her in on his games if she asked. He loved being outdoors; climbing trees and fishing, or just walking around the marshes. As a boy he kept little stones or sticks in his pockets that he said looked like animals – a cat, a sitting bear, a giraffe. He was forever bringing home injured birds or motherless kittens. While I’m away, he told Vita, you’re in charge of my pets.

He was seventeen when he signed up with the 28th Regiment of Massachusetts. He survived the battles of Antietam, Fredericksburg, and Gettysburg, but at Hatcher’s Run he took a bullet above the elbow and an infection set in. The company’s assistant surgeon decided not to take off the arm, and ten days later Freddy died of gangrene.

On the morning the telegram arrived, a full week after peace had been signed and they’d all been rejoicing because they thought Freddy had made it safely through, Vita’s insides seemed to crumble into ash. She was coming down the staircase reciting to herself the bones of the cranium – frontal, parietal, temporal – when she saw Mitty standing at the front door with a black-edged envelope in her hand. In that instant she knew.

How did they get through the first day? They must have eaten but Vita couldn’t remember what they ate or even sitting at the dinner table. During the night she kept waking up and sobbing into her pillow, and in the morning she found a tiny goose feather in the wet pocket of her gum – the gingiva. She kept it as a memory of her initial grief, which throbbed less as the weeks passed but never went away.

Vita paced the length of her bedroom, digging her nails into the palms of her hands. Once Dar understands how serious I am, she thought, he’ll come around. Won’t he? She worried that, in his eyes at least, she had never been good enough. Sometimes he praised the work she had done for Freddy – a graph or an equation – and that was gratifying. Of course he thought Freddy had done it and praised him, not her, but she knew. Dar didn’t think women were capable of ‘logic and straight lines’; he’d said this more than once, even around Mitty, who once bested their old tutor on a point of geometry. Mitty’s face always flushed with emotion when he said this, but she didn’t try to argue.

Why get into a quarrel, she said when Vita asked her about it. You can’t change other people, you can only change yourself. Wise words, but not particularly helpful. Vita didn’t need to change herself. It was the rest of the world that needed to change.

The sky darkened, and tree branches bent back and forth dramatically in the wind. She heard the front door open and close, and two voices floated up – Mitty and Amelia getting home just before the rain. Vita didn’t go down to see them. Her bedroom was her sanctuary even though it was dark and messy and usually chilly, even in the spring. In the summer, after a humid rain, the walls smelled like raspberries. They lived in a three-story gray saltbox with inconveniently sloped ceilings, and most of the windows were clustered on the house’s southern side (her bedroom faced north). Her father bought the house for its large front parlor, which became his office. All the other rooms were small and cramped, and the pantry made Vita think of an upright coffin.

Her earliest memory had the flavor of sawdust: she was four years old and having a tantrum in the back hall, which had been fitted out the week before with closets. What had she been so upset about? She couldn’t remember. Her chubby legs didn’t have enough room to kick properly without hitting a wall, and that made her angrier. She screamed and kicked and banged her fists as she lay there on her stomach. Carpentry dust rose from cracks in the floorboard, and every large breath – absolutely necessary for a prolonged, solid wail – brought with it a gritty taste.

‘You’ll get a splinter,’ her mother had said, watching her from the doorway. And her father: ‘Ignore her.’

Even at so young an age, Vita sensed that the place she lived was not the place she belonged.

She began to hunt around her bedroom for a pencil bigger than a cigar stub; when she was upset, she wrote lists. The room was cluttered with paper and books, notebooks filled with her observations, and piles of old science journals – her father had several subscriptions mailed to the house. Although there were the usual combs and hairpins on her dressing table, she also kept, in a mason jar lid, the remains of a dry June bug she had dissected.

At last she found a pencil in use as a bookmark (On the Motion of the Heart and Blood in Animals), and licked its end. The combination of the smooth lead and the rough end of shaved wood against her tongue always soothed her. She turned to a blank page in her notebook.

Who does he imagine I’ll marry? she wrote.

She tried to think of all the men she knew who had survived – or never went off to – the war.

Clarence Witt: missing an arm
Tom Fuller: missing a leg
Andrew Meany: not right in the head

Blind; scarred; long gray hairs sprouting from their ears (that was Robinson Jameson, who was at least sixty years old) – they all had something. Vita was a scientist and had trained herself to be observant. Also dispassionate. Even so, by the end she felt tears in her eyes.

There was a knock at her door, and her sister Amelia walked in looking brushed and neat.

‘Dar said you’re in a temper. Did you quarrel again?’

Amelia was the beauty of the family with smooth blonde hair and a nose on the shorter side of Roman. Their mother called Vita handsome rather than pretty, praising her long neck and wide mouth – like a goose, Vita thought.

‘Mitty sent this up for you,’ Amelia said, handing her a piece of cake. ‘Also, look at this. Aunt Norbert gave it to me.’

She held out a narrow pamphlet bound in pliable pasteboard. The title, in heavy black type, modeled the look of scientific tracts: Instructions for the Young Bride, and underneath, in type just as large: By the Wife of a New England Reverend.

Vita read the first sentence aloud:

‘To the sensitive young woman who has had the benefits of a proper upbringing, the wedding day is, ironically, both the happiest and most terrifying day of her life.’

‘Is it satire, do you think?’ Amelia asked.

Vita shoved a big bite of cake into her mouth and skimmed the rest of the paragraph.

‘I don’t think it’s satire,’ she said.

From the B&N Reads Blog

Customer Reviews