Yet Mitchell later marveled that his readers had been so taken by his story. As he explained in his unpublished autobiography, “The unfortunate George Dedlow’s sad accounting of himself proved so convincing that people raised money to help and visited the Stump Hospital to see him. If I may judge it by one of its effects, George Dedlow must have seemed very real.”23 By responding in such immediate and visceral ways, Mitchell’s readers insisted that narrative treatments of bodily trauma were barred from the realms of fiction. Denied a generic classification or an author, readers assumed that the story conveyed new truths of the sort that Mitchell himself had wondered at day after day in the Civil War hospitals. In a way, the story became a phantom limb; Mitchell’s subsequent statements would make it into a fraudulent version of reality, but his readers’ responses suggested that it conveyed new and troubling information about postbellum bodies and identity. Indeed, the apparently seamless generic switch and bait suggests that all case histories are equally (un) able to communicate the reality of bodily experience.
The story Mitchell would later tell of how “The Case of George Dedlow” was produced and published echoes the mystical tone of his description of his medical composing process; it also smacks slightly of disingenuousness. He claims that he wrote the story on a dare: “A friend came in one evening and in our talk said, ‘How much of a man would have to be lost in order that he would lose any portion of his sense of individuality?’ This odd remark haunted me, and after he left I sat up most of the night manufacturing my first story, ‘The Case of George Dedlow, related by himself.’”24 For some unexplained reason, he then left the tale in the hands of a “delightful lady, Mrs. Caspar Wistar.” When Mrs. Wistar’s father, “Dr. Furness, a Unitarian minister,” got his hands on the manuscript, he sent it to the editor of the Atlantic Monthly merely because he was “much amused.” Mitchell then writes, “To my surprise, I received about three months afterwards a proof and a welcome cheque for Eighty-five Dollars.” Thus the story’s transference from nearly supernatural inception (the story “haunted” him) to anonymous publication to unforeseen compensation seems apocryphal itself. It is as if the story passed effortlessly—one might say divinely—from thought to print, unmediated by the mundane problems of composition, editing, and publication. Mitchell reveals that his medical and fictional narratives materialized from the “mystery” of “some inward somewhere,” the “haunting” of bodily conundrums not far removed from those he saw in the Civil War hospital.
At the same time, Mitchell was keenly aware that empirical science was becoming the professional creed of American doctors.25 Trained in this new milieu, Mitchell certainly felt pressure to present his new truths as persuasively as possible. Despite the amorphous nature of his composing process, the triumph of Mitchell’s medical work lay in his ability to obtain objective detail by “ocular and microscopic examinations” and to posit a taxonomy of what paralysis “looks like, how it manifests itself in the skin” (Gunshot 36, 77). However, his patients’ bodies and invisible symptoms continually subverted this scientific project. Mitchell had to vouch not only for the reliability of his observations but also for the authenticity of his patients’ stories and the symptoms they presented. Again and again he attempts to convince his readers, and perhaps himself, of the veracity of the amazing bodily phenomena he witnesses. He argues passionately that one patient could not possibly be faking, for “he had never been in a hospital before” (Gunshot 104). The true difficulty of these types of injuries was that the body was an unreliable indicator of its own status—it gave even well-meaning patients false and unreadable symptoms, defied the known laws of physiology, healed itself seemingly without reason. A doctor could not establish nerve injury when patients knowingly or unwittingly presented falsified texts to the doctor. For both doctor and patient, then, these nervous maladies opened a fault or fissure in their worlds. Mitchell’s desire to write a taxonomy of nerve injury contributed to the alienation of both physician and patient by providing physicians with new tools to systematize, objectify, and finally to appropriate not only the disease but also “the human experience and particular meaning the disease holds for the patient.”26 Doctors began to assume an adversarial relation to their patients, insisting that their diseases conform to the narratives of illness the medical establishment provided.
In Gunshot Wounds Mitchell briefly touches upon the issue of patient authenticity, an issue that grows to obsessive proportions in his pamphlet “On Malingering.” In this correlative text, Mitchell and his colleagues put both doctor and patient on trial, outlining the various ways physicians can poke, prod, burn, faradize, cut, etherize and generally survey their patients in order to ferret out the dreaded malingerer.27 What is most disturbing to the doctors is that malingerers purposely blurred the boundaries of illness, health, and self-representation that were already so fuzzy in medical discourse of the period. The notion of a “true self” at stake in this article becomes bound at points to contemporaneous anxiety about the disappearance of social distinction. For example, Mitchell writes that he is not alarmed that the otherwise “endur[ing] and tenac[ious]” malingerer would “pretend disease” but, rather, that he would carry on the double game of “an assumed character” (“Malingering” 371). Karen Halttunen has argued persuasively that the emergence of confidence men at midcentury resulted from an increasingly uncertain social system where, it was feared, men and women could pretend to a social status that they did not hold.28 In pursuing malingerers, Mitchell believed that he would force patients to reveal an essential self that was, if not physically diseased, at least morally corrupted. For example, in etherizing a suspected malingerer in order to ascertain who is hidden beneath the hysterical exterior of one patient, “The tongue let out the thoughts, and the brain forgot to hold the eyes convergent, and then remembered it again with a sort of betrayed look most curious to see” (“Malingering” 391). Mitchell crows with success at his ability in this case to unveil the poser.29 His rehabilitative work both returns health to the ill and stabilizes the identities of those who dare to feel something they should not given the way that social norms dictated bodily performances at the time. Mitchell’s early experience with Civil War malingerers may have confirmed his suspicion of lazy inferiors, be they working-class men or upper-class women, which manifested itself most disturbingly in his domineering treatment of late nineteenth-century female neurasthenics.
On the whole, it was not malingerers themselves but the possibility of malingering that threatened the carefully constructed system of scientific diagnosis doctors were building at the time. Like the neurasthenia that would spread later in the century, the malingerer could infect others with his illness: “So long as one man succeeds … so long will ten others continue to imitate him” (“Malingering” 369). The doctors were loathe to admit that in cases of nerve injury only the patient possessed the “power of telling where exactly he has been touched” (Gunshot 115). In the face of such unflagging uncertainty and disempowerment, doctors desperately tried to regain control of the illness experience, initially devising a list of procedures and tests to be performed upon the patient to determine his health. When their tests revealed no organic condition, the doctors still cured the patients, though it was through the torture of “dry galvanism, actual cautery, setons and blisters” used normally to relieve neuralgic pain, as well as unnecessary anesthetics, that the malingerer was forced to reveal his true character (“Malingering” 371). Emily Dickinson’s famous lines “I like a look of agony / Because I know it’s true” cut only one way for these doctors. Whereas the pain their patients manifested as a result of their invisible wounds was always suspect, pain carefully administered by