Doctoring the Truth

Snip! Snip! Snip! My long, dark tresses fall to the floor. My mother continues until my hair is shorn as short as any boy’s. “Put your brother’s old clothes on now,” she says, handing over a shirt and breeches.

I look at my mother. We both know this is the only way for a woman to train as a doctor in 1809, but I am twenty years old and not flat-chested enough to pass scrutiny as a man. “I’ll bandage your breasts,” my mother says hurriedly. By the time we have finished, Margaret Ann Bulkley has been transformed into James Miranda Barry, an identity that will be kept for the rest of my life.

It is November 30^th when James and his ‘aunt’ board the fishing vessel that will carry them from their native Cork across the sea to Scotland. James is aware of his good fortune: some of his late father’s liberally minded friends have written letters and persuaded acquaintances that this fifteen-year old boy deserves to study medicine at the University of Edinburgh. All Barry has ever wanted is to be a doctor, and his uncle’s reputation as an Irish Romantic painter carries enough weight for him to be accepted into the Medical School as a literary and medical student. His short stature and slight figure produce speculation, despite the bandages – but it is not his gender that is in question but his age: the rumour is whispered that he must be a pre-pubescent boy, a child genius, and that he shouldn’t be allowed to sit his final examinations due to his youth. The Earl of Buchan fortuitously intervenes, enabling Barry to qualify as an MD in 1812; and after a year in London, he successfully qualifies as a surgeon.

The army seems the next logical step. Barry is commissioned as a Hospital Assistant and is soon promoted to Assistant Surgeon to the Forces. His slender, womanish fingers are defter than most of his colleagues’ at making incisions and sewing up again afterwards; and he seems to have a stronger stomach than the other Assistants, taking guts and gore in his stride, never once blenching or feeling faint. At all times, he works with masculine detachment, refusing to let his emotions cloud his judgement.

England, May 1816. I have managed to keep my secret and my career flourishes. I will soon be posted to Cape Town with a letter of introduction from my former patron, Lord Buchan, to the Governor, Lieutenant-General Lord Charles Henry Somerset.

Cape Town, July 10th, 1816. I have been here only a few weeks when Lord Charles’ daughter becomes ill with cholera and I am sent for at once. I look at Lord Charles – at his handsome face and his broad shoulders – and something stirs inside me. I would say anything to make this man smile. I hesitate, not wanting to promise a cure that may not be delivered; but the sight of the girl’s mother, Lady Francesca, finally sways me: she is sufficiently like my own mother to tug at my heartstrings and make me swear to bring her daughter back to full health.

July 19th, 1817. The child is safe. Lord Charles and his family praise my ability, but her ‘miraculous’ recovery is, in fact, a result of common sense rather than divine intervention. Surely I cannot be the only one intelligent enough to realise that poor sanitation and contaminated water supplies are responsible for much of the disease prevalent in the South African capital? I merely advised the family to boil all their drinking water whilst I administered calomel and opium to the ten year old girl. Now she is declared out of danger, I find myself welcomed into the family, treated as a close friend of Lord Charles and a favourite of Lady Francesca.

August 3rd, 1817. Charles has asked me to become his personal physician. I cannot refuse for I am already more than a little in love with this handsome man less than ten years older than I am. Although I like Lady Francesca, I cannot help the intense attraction I feel towards her husband; and the evenings he and I spend together, sequestered in Charles’ study with a bottle of port and some good cigars, only add to my confusion.

August 3rd, 1817. Tonight, as the lamps are burning low, Charles asks me if I have ever had a woman. I tell him I am not that way inclined, noting his eyebrows shoot up in surprise. However, he says nothing. Such ‘unnaturalness’ is reviled or at best ignored. Taking the biggest gamble of my life, I begin unbuttoning my shirt, determined to show my friend my true self. Once I have divested myself of my breeches, he understands fully...

Afterwards, we agree that Lady Francesca would only be upset were she to learn of the new relationship between her husband and his physician.

It is two years later when Lady Francesca comments that Barry is putting on weight, little dreaming that her husband has fathered an illegitimate child. Lord Charles, afraid of scandal, suggests that the pregnancy be terminated: the African women, he says have herbs that can induce a miscarriage. But James has sworn the Hippocratic oath, promising “not [to] give to a woman a pessary to cause abortion” and to “abstain from all intentional wrong-doing and harm”. His career and reputation are on the line, but he must adhere to the promises he has made.

Eventually, a compromise is reached. James will absent himself from the governor’s family for a while, ostensibly to visit a distant cousin who is recently widowed and in her sixth month with child. Lady Francesca is immediately sympathetic, offering to let the poor creature stay with them for her confinement; but James refuses, claiming that the lady is too ill to travel. He returns five months later, bringing with him a two months old baby: his cousin died, he says, and he is the only surviving relative the child now has. Lord Charles’ wife, charitable to a fault, immediately insists that the little girl become one of the family. “For you are my adopted brother,” she says, smiling fondly at James, “and so this little one shall be my adopted niece.” James and Charles swiftly resume their former intimacy, although this time, they are more careful – which as just as well since James has no other female kin who can be used to explain a baby’s appearance.

Little Margaret – named for Barry’s sister who, he says, died when he was twenty – is three when her adopted Uncle Charles appoints Barry as Colonial Medical Inspector. At first, James is angry with his lover, seeing the position as a bribe to ensure that their affair remain secret; but Charles assures him that the post is well deserved and, indeed, Barry’s accomplishments in the ten years he spends working in the Cape are staggering: in addition to his work improving sanitation and water systems, he improves conditions for enslaved people, prisoners and the mentally ill, and sets up a leper sanctuary, causing Lady Francesca to exclaim in admiration, “It is no wonder that we women are known as the weaker sex for anyone seems a lazy and ineffectual individual when compared with the tireless devotion to duty of our dear Doctor Barry!”

In 1827, the thirty-eight-year old Barry is promoted to Surgeon of the Forces. He is still unable to believe that he has advanced this far in his army career without ever undergoing a medical examination, but officers are exempt from such administrative nonsense and this has certainly been an advantage for someone who entered the ranks as a Hospital Assistant, never expecting to advance so rapidly in such a short space of time.

He bids a fond farewell in 1828 to the Somersets, knowing that he is unlikely to find another adopted family in his new post in Mauritius. There is no question of Margaret accompanying him – how can a single man take care of a small child? – but he knows he is leaving her in good hands with her natural father and foster-aunt. Once in Mauritius, he quickly carves himself a niche as a favourite with the officers’ wives who all flirt with him shamelessly, allured by his gentle hands and soothing bedside manner.

For someone who is often cold and abrupt when issuing orders, Barry is surprisingly sensitive when it comes to coaxing hypochondriacal women back into health. “Come now, Mrs Fanshawe,” he tells one lady who claims to be suffering from extreme melancholia, “no one with eyes as pretty as yours can stay sad for long. Put on a new gown and receive some of your friends and you will be feeling back to normal in no time – particularly,” and here he lowers his voice roguishly, “when not one of them will look half as ravishing as you do in your lavender tea dress!”

“Doctor Barry!” the woman replies, simpering into her handkerchief, “you would make a very good woman!”

Barry’s heart pauses momentarily.

“But I would much rather see you become a very wicked man!” she continues coquettishly.

Barry relaxes once more. His secret has not been discovered after all.

“Madam,” he says gravely, “I am truly flattered – alas! I prefer the company of men.” He holds her gaze for an instant, allowing her to take in the meaning of his words.

If anything, this confession makes him even more popular with the army wives, for each one determines to succeed where all others have failed. Undeterred, Barry continues to charm them all whilst preserving his identity as a somewhat effeminate but excellent doctor.

Mauritius, March 1829. I have been here a year now but this morning a letter arrived that has shaken me to my very core. Francesca writes that Charles is gravely ill. Although it means risking my career, I must depart immediately for England and the Somersets’ family residence.

SS Good Hope, April 1829. Charles occupies my mind fully: I thought of little else on the journey back to Cape Town and he is still uppermost in my mind on this long voyage from Africa to Portsmouth. Francesca mentioned some of the symptoms in her letter and my heart stills whenever I imagine the worst. I treated Charles for syphilis years ago when he developed blotchy red rashes on his soles and palms and started losing his hair. I thought the mercury injections I’d given had eradicated the pox, but what if Charles has merely been experiencing a latent stage until now? Has the syphilis returned; and does that mean that I too am at risk?

Worcester, England, May 1829. I am shocked to see how visibly Charles has aged. The once handsome face is now disfigured by weeping sores, and skin and bones seem irreparably damaged. Nonetheless, my heart still quickens at the sight of my former lover. You are still the man who taught me about love, and for that, I will be eternally grateful. I force myself to examine Charles methodically while Francesca waits outside the room. It is as I thought: the advanced stages of Cupid’s disease are affecting the internal organs and cardiovascular system, and even mercury injections will be of little use now.

July 1831. Days stretch into weeks and weeks become months – so much time to fill when one’s heart is slowly breaking. It has been almost two years now. I am aware that I could be court-martialled for leaving my post without permission, but I cannot abandon my grand passion. He is the father of my child.  Francesca and I take it in turns to nurse the man we both love; her demeanour suggests she remains as oblivious to my true feelings as she is to  my gender. I have not explicitly said what ails her husband, but I think she has guessed. How can she show such fortitude in continuing to care for a man who has been so constantly inconstant?

November 1831. The funeral takes place one wintry morning, the weather aptly reflecting my frozen heart. For once, I have no words. Vocabulary has been removed from my heart like an unwanted growth. There is no sharper scalpel than grief. At the graveside, I stand with Francesca, my hand holding hers while my mind replays those long-ago evenings in Cape Town. Firelight flickers as you wrap your arms around me, your marble limbs turned golden by the flames. Francesca sobs. It is a wife’s prerogative. As for myself…  I am a valued family friend, a so-called ‘adopted’ brother, but there is no suitable outlet for my anguish. I  feel like Hamlet, forced to watch in frustration as Laertes flings himself into Ophelia’s grave. I cannot mourn Charles as a lover. My tears must go unshed.

Leaving England soon after this, Barry finds himself posted first to Jamaica and then to Saint Helena. It seems he is fated to spend all of his career abroad when he is sent next to the Leeward Islands and Westward Islands of the West Indies. As he did so effectively in Cape Town, Barry focuses on improving what he can, tackling both medicine and management as well as the conditions of the troops. No one is surprised when he is promoted again – this time to Principal Medical Officer: when it comes to administration, he is a whirlwind, seeing immediately what needs to be done and organising everyone and everything effortlessly.

1845. I have contracted yellow fever and take temporary sick leave, returning to England for the first time since Charles’s death. By now, my daughter is twenty-six and married to a country curate. It is a good match for a girl who is technically illegitimate and I feel grateful to Francesca for treating my so-called niece so well.

Once recovered and cleared for duty, Barry is sent to Malta. Now in his fifties, he shows no signs of slowing down, dealing with a cholera epidemic in 1850 and earning the grudging respect of most of the officials he has so far offended. Feeling he has nothing to lose since Somerset’s death, he now cultivates rudeness to the point of making it an art form, yet this does not prevent him from being promoted to the rank of Deputy Inspector-General of Hospitals in Corfu. The post is a prestigious one, but Barry has set his heart on the Crimea and is disgruntled to have his wishes thwarted. He compensates by spending his leave there instead.

As the years pass, his interest in the Crimea grows as England becomes part of an alliance of several countries involved in a war there with Russia. Reports have filtered through to England about the horrific conditions for the wounded soldiers and Barry is desperate to help in some way but is refused. His frustration grows when he hears of a woman some thirty years his junior who has been sent there, under the authorisation of the Secretary at War, Sidney Herbert, with a staff of 38 women volunteer nurses that she has trained herself; and he wonders bitterly whether he too might have had the same opportunities as a woman in the field of medicine had he, like Florence Nightingale, been born to wealthier parents. When he finally meets the woman during a visit to Scutari Hospital in 1854, he cannot avoid becoming embroiled in an argument with her.

“Do you think,” he asks somewhat aggressively, “that you would have accomplished more had you been a man?”

Nightingale, who has taken exception to his heavy-handed approach and tactless manner, replies spiritedly that she has for some time believed that women can be equals to men.

“It must be easy to follow a career when your father gives you an income of £500 per annum,” Barry says acidly.

“No amount of money can compensate for the struggles women have to face in defying the social codes expected of them!” she exclaims in a passion. “Were you not a man, you would soon realise that!”

And, indeed, Barry is aware that he would not have been able to study for a medical degree as a woman – let alone qualify as a surgeon or join the army. Nevertheless, he cannot help feeling irritated that she has carved out a name for herself without having to put on a pair of breeches.

In later years, Nightingale will remember their meeting, calling Barry a blackguard and claiming that he “behaved like a brute”, and it will be Nightingale’s name in the history books and not Barry’s.

A last official posting to Canada sees Barry continuing to improve sanitary conditions. A strict vegetarian, he takes a keen interest in the common soldier’s diet as well as that of their families and does what he can to educate them about nutrition. As before in The Cape, he fights for better medical care for prisoners and lepers, inciting the wrath of officials and military officers when he campaigns on behalf of the poor and other underprivileged groups. Florence Nightingale may be improving nursing standards in a few hospitals in the Crimea, but he, Barry, will affect thousands more lives in the British Empire.

It is only in 1865, after dying of dysentery in London at the age of 76, that Barry’s secret is discovered. He has spent 56 years as a man, insisting on always undressing in a room on his own, but the charwoman who lays him out goes to the press with her scandalous story, condemning contemporary doctors for not knowing that the man she has been cleaning for was really a woman. All of a sudden, many people claim to have “known all along”; whereas the British Army, embarrassed by the woman’s story, seal all records of their former employee for the next one hundred years. So successful are they in suppressing the truth that over a hundred and fifty years after Barry’s death, his name and true identity remain virtually unknown.