2012-07-28 / Top News

Karlawish Pens Novel Based on Fort Mackinac Doctor Beaumont

By Matt Mikus

Jason Karlawish Jason Karlawish Jason Karlawish dives into the history of Dr. William Beaumont, a physician known for early research on the human digestive system, in his historical novel, “Open Wound.” The novel touches on Dr. Beaumont’s attempts to gain fame and fortune, while grappling with the care and concerns of his patient, Alexis St. Martin.

Dr. Karlawish is a professor of medicine and medical ethics and health policy at the University of Pennsylvania. He also cares for patients suffering from cognitive disorders like Alzheimer’s at the Penn Memory Center, and his research focuses on bioethics. He also believes in the power of a strong narrative, and has written essays calling for the scientific profession to use narrative discussion and stories to disseminate scientific research to the general public.

Dr. Karlawish made his first visit to Mackinac Island Wednesday, July 4, after completing the novel in 2011. At the Island Book Store, he signed copies of his book, published in October, 2011.

In 1822, William Beaumont, a surgeon at Fort Mackinac, treated the trader St. Martin for an accidental gunshot wound that left a hole to his stomach, through which the physician conducted digestive experiments. Dr. Beaumont’s discoveries formed the basis of what is known about digestion today.

“While doing my fellowship in Chicago, someone reintroduced me to the story of Beaumont,” Dr. Karlawish said, “and I thought this would make a great story to help explain why researchers do what they do, both good and bad. His story is very much like the story of a young American man who comes from humble roots. He went to a state school, and he really wanted to make it in America, and wanted to do some good, and he wanted to make some money.

“What’s interesting about William Beaumont is his success was going to be by using his patient as a research subject. That created some opportunities, and some opportunities for Alexis, as well, but it also created ethical challenges, some that I don’t think he negotiated as well as he could have.”

Based on the patient-doctor relationship of Dr. Beaumont and Alexis St. Martin, the book looks at the drive for success and the ethical decisions physicians face. Today, the drive for discovery is supplemented by grant dollars and the potential to be able to patent the discoveries.

“The issues that Beaumont struggled with are all the more present today in medical research,” Dr. Karlawish said. “Right now, researchers are lauded by not only their discoveries but their patents for discoveries. I’m not saying that’s wrong, but it makes it complicated. It adds another incentive to not only discover new things, but also make a lot of money.”

Rather than focusing on the facts of Dr. Beaumont’s life, and that of his patient, Dr. Karlawish decided to write a novel, freeing him to examine what may be the reason for Dr. Beaumont decisions in life. If he were to write nonfiction, Dr. Karlawish would be limited by what the history books have recorded.

“We read history for the facts, but we read fiction for the truth,” Dr. Karlawish said, “and I didn’t want the facts to get in the way of the truth. I thought the best way to get those insights is to tell it as a story and not as a history.”

Many of the characters and settings in the life of Dr. Beaumont were already predetermined by historical documents. What Dr. Karlawish wanted to show were the reasons why Dr. Beaumont made the choices he did in his life.

“The ‘Why’ is the hardest part,” Dr. Karlawish said. “What is his character? Where did he come from?

“First, you have to realize you are walking that line” between history and fiction. “The moment you forget that, you lose your credibility.”

From historical documents, it’s clear that when Dr. Beaumont first treated the young voyageur, he left him at the American Fur Company’s warehouses, but returned to take Mr. St. Martin up to the post hospital at Fort Mackinac to be treated. When asking why Dr. Beaumont decided to return, Dr. Karlawish can weave fiction in with fact to present the story.

He spent four years working on the novel, switching between writing and research. Dr. Karlawish said he would write using the research he had gathered to accurately reflect the scenes in the novel. If his novel deviates from the actual history, he clarifies why he made the change in the story in his afterword. His research took him to St. Louis, Chicago, and Yale, where he would research the life to accurately portray a realistic presentation of Dr. Beaumont.

“It was kind of a circular process,” Dr. Karlawish said. “I would do some research, then write the story, then hit a wall and do more research.”

While writing, he decided to hold off visiting Mackinac Island until after the book was complete. His years of research had created an age where Mackinac Island was an economic powerhouse with a military presence, powered by the fur trade and protected by soldiers at Fort Mackinac.

“What’s hard to do as a writer is to construct a place and character in your mind,” Mr. Karlawish said,

His favorite experience in writing was early in the novel, when Dr. Beaumont realizes he can use St. Martin’s misfortune to his benefit.

“It’s when Beaumont realized that this guy’s wound is his ticket to success,” Dr. Karlawish said. “He can study digestion through this hole. He starts thinking, ‘I could change my life with this man.’ I had a lot of fun writing that chapter.”

While writing, Dr. Karlawish discovered many prominent themes of Americana in Dr. Beaumont’s life, such as the belief that hard work can lead to success, but sometimes the drive to success can lead to questionable choices.

“I don’t think Beaumont as a bad man,” Dr. Karlawish said. “I also don’t think he was a great man, just a man struggling to make it in the world. He reminds me of the temporary Americans trying to do the same thing. In a country of free enterprise, what he did is very typical of what happens now.”

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