CITY OF DREAMS

Ambitious historical novel of New York City’s medical practices from the 1630s to the 1780s, a first novel freighted with so much fact and family melodrama it almost sinks under its own weight.

Swerling’s narrative tracks two families, the Turners and the Devreys, through six generations of medical practice, economic success and failure, and bitter internecine feuds, treacheries, and reconciliations. This 150-year scope creates complexities that can be followed only by using a family tree, and luckily Swerling provides one. Still, there are so many characters that none gets developed fully, making it easy for the reader to lose track. The Turners are (mostly) surgeons and the Devreys are (mostly) physicians, though several women in both families are apothecaries. At the time, these were competing rather than complementary medical disciplines. The surgeons and apothecaries are clearly favored as Swerling takes us on a fascinating journey through the bold early conflicts between herbal healing and surgery and the mainstream practices taught in the medical schools of the day. The physicians, though more prestigious and “educated,” offer their patients little beyond bleeding and purging, while the surgeons provide dramatic scenes of early operations for breast cancer and bladder stones, along with tracheotomies and limb removals. Unlike the physicians, the surgeons experiment with blood transfusions, use laudanum to dull pain, and favor inoculations. Indian attacks, slave revolts, wars, plagues of smallpox and yellow fever, and the brutal everyday life of the city itself—rapes, castrations, venereal diseases, public whippings and burnings—supply carnage aplenty for members of each generation to practice their skills on and argue about.

The ongoing feuds here often seem like overwrought plot contrivances, a problem aggravated by this newcomer’s fossilizing tendency to pack her dialogue with exposition. But early medicine and city history undeniably make for an interesting read.