Thursday, January 30, 2025:

How I get my plots, Part Three

Welcome, I’m Mary Louisa Locke, the author of the USA Today best-selling Victorian San Francisco Mystery series and the Caelestis Science Fiction series. In this daily newsletter, I reflect on my life as an indie author trying to age gracefully. Occasionally, I will also publish some of my shorter fiction in this newsletter to read for free.

Daily Diary, Day 1611:

This is post is primarily from the author’s notes at the end Lethal Remedies, the seventh book in the Victorian San Francisco mystery series.

Staying true to the mission of the Victorian San Francisco Mystery series, which is to feature different occupations held by women in the late nineteenth century, I wanted this novel to be about women in the medical professions. Beyond that, as usual, I didn’t have a plot in mind when I started my research.

The first source that I consulted was Regina Morantz-Sanchez’s Sympathy and Science: Women Physicians in American Medicine (1985), which provided a good academic review of the topic, including the general changes in the medical profession, the development of competing medical theories, the difficulties women had in getting medical training, the rise of female-only medical schools, and the problems female physicians faced practicing their profession that led them to set up dispensaries (the nineteenth-century term for walk-in clinics and hospitals) where female doctors and nurses could get clinical experience.

But the general source that I found most helpful was the collection of articles in “Send Us a Lady Physician:” Women Doctors in America, 1835-1920, edited by Ruth J. Abram in 1985. This collection became the source for much of the very specific historical information that I used in Lethal Remedies.For example, it is this book that describes the tools found in a doctor’s medical bag, including obstetric instruments. It also discusses the rise of homeopathy in the nineteenth century as an alternative to “regular” medicine, providing detailed descriptions of the do-it-yourself homeopathic guides and kits that were popular among women in the mid-nineteenth century. As an aside, negative portrayals of homeopathic medicine in Lethal Remedies is due to certain plot necessities, not my personal opinion about homeopathy or any other alternative medical practices.

For historical background, I also read the two major fictional depictions of women physicians published in the late nineteenth century. The first was Doctor Zay by Elizabeth Stuart Phelps, written in 1882. This novel tells the story of the attempts by a young man to woo a successful homeopathic female physician who doesn’t want to give up her medical career for marriage. The second novel, A Country Doctor, written in 1884 by Sarah Orne Jewett, describes a young woman who, under the mentorship of an old-fashioned small-town doctor, becomes a doctor herself.

The next step in my research was to look for information on women practicing medicine in the far west at the end of the nineteenth century, since the secondary sources primarily concentrated on women practicing medicine in the Northeast. Unfortunately, the sources in this area were very limited.

However, I found some short biographical sketches on a few female physicians, including Dr. Lucy Wanzer, the first woman to graduate from the University of California’s medical school, and Dr. Charlotte Blake Brown, whom I had introduced briefly in Scholarly Pursuits as Annie’s physician during her pregnancy.

The information on Drs. Wanzer and Brown was primarily about the Pacific Dispensary for Women and Children, the institution they, along with Dr. Maria Bucknell, founded in 1876. This dovetailed with what I had learned about the importance of dispensaries that were run by women, and that led me to decide that the Pacific Dispensary would be the perfect setting for my upcoming novel.

By 1882, the Pacific Dispensary had become both a walk-in clinic and a hospital that served women and children. It was staffed by three female attending physicians, a single resident physician, and a matron and her nursing assistant, four nurses in training, and assorted servants. I knew I would find my cast of characters among the dispensary’s female staff and patients and the wealthy women in the city who donated money to the institution and made up the dispensary’s Board of Trustees.

Having established in previous stories that Annie provided audits and financial advice to female-run charities—see the short story I just put up for free, “Mr. Wong Rights a Wrong,” I was able to get Annie involved in investigating crimes connected with the dispensary. I just needed to figure out what crimes she would be investigating, in other words, develop the mystery plot.

Here, two academic works became very useful. The first, and probably more important, is Conduct Unbecoming a Woman: Medicine on Trial in Turn-of-the- Century Brooklyn (1999) by Regina Morantz-Sanchez. This is a fascinating study of the female physician Mary Dixon Jones and the dispensary she ran to provide clinical and hospital services to women in Brooklyn in the 1880s. A scandal involving the dispensary had erupted when a local newspaper accused Dixon of medical malpractice. This newspaper campaign first resulted in a trial against Dixon, in which she was found not guilty of manslaughter, and a subsequent trial against the newspaper for libel, in which the newspaper was found not guilty as well.

This book revealed how divided the medical profession was over the appropriate methods of treatment for gynecological problems, including the increased practice of surgical intervention through what was then called an ovariotomy. Dr. Dixon’s frequent use of this operation and her financial success seems to have prompted a degree of jealousy from male physicians who were already worried about competition from the growing number of female doctors in the region.

The second book that helped in developing the plot is A Prescription for Murder: The Victorian Serial Killings of Dr. Thomas Neill Cream (1993) by Angus McLaren. Dr. Cream was a nineteenth-century physician whose occupation made it easy for him to poison people, including his own wife and several patients. His medical profession facilitated his access to poison and shielded him from suspicion.

These two sources were the most useful in helping develop a mystery plot, but the setting itself played a large role in grounding the story in a reality, particularly the information I learned about the Pacific Dispensary itself. An official published report issued by the dispensary in 1876, provided its mission statement, its by-laws, and a listing of some of the early founders and Board members. Reports in the San Francisco Chronicle and Langley’s Directory provided the names of the female attending physicians, the female resident physician, the female nurses, and the male consulting physicians who were connected to the dispensary in 1882, when the book was set.

In doing this research, I discovered that the dispensary had moved several times in its first six years of operation, and I was able to pin down its address for the spring of 1882. Even more exciting, there was a newspaper article about the newly remodeled building on Thirteenth Street. Bless the reporter who literally walked through the building, describing almost every room, the number of beds and cribs, and the locations of the servant and medical staff rooms. As a result, there was very little about the interior of the Pacific Dispensary in 1882 that I had to invent.

For example, here is a description I put in Lethal Remedies about one of the rooms for infants, which came from that article:

That thought fled when she followed Dr. Brown into the room across the hall where she had heard the infant’s cry. At the front of the house, the room was filled by the morning sun. Six good-sized cribs stood in rows, each holding children who ranged from small infants to a sturdy toddler who sat playing with a stuffed animal. Two of the cribs had women sitting next to them, probably the children’s mothers. A nurse, who Dr. Brown introduced as Mrs. Miller, looked up from the crying infant she was holding and nodded briefly at them.

Dr. Brown introduced the two mothers to Annie and then said, “Did you notice the quilts on the beds downstairs and on these cribs? They were provided by the Fruit and Flower Mission and Sewing Bee, organized by the Plymouth Congregational Church on Eleventh Street. They also bring in fresh flowers every day and fresh fruit in season. We are so thankful for their support.”

What this article didn’t provide was details about the building’s inhabitants. And this is where, since I am writing fiction, not non-fiction, I had to make some choices about which characters would be real people, which would be highly fictionalized versions of real people, and which characters would be totally fictitious.

I had already briefly introduced a real person, Dr. Charlotte Brown, in Scholarly Pursuits, but now I was going to give her a speaking role, albeit a limited one. She was also the one person for whom I had the most extended biographical detail and a wonderfully detailed scholarly article by her about the first ovariotomy that she performed in the Pacific Dispensary. So, the details of her life in the novel are accurate, though, of course, I invented what she said and thought. I also sent her on a fictional trip with Dr. Wanzer, one of her other co-founders of the dispensary, to explain why they weren’t directly involved in most of the events of the novel.

The staff of the dispensary (nurses, matron and her assistant, servants) are a mixture of real and imagined people, depending on how important they are to the story. For example, I let the four nurses in training keep their real names (although I knew nothing about them), but the Matron is pure fiction. There actually was a young disabled boy living in the dispensary during this time, but everything else about theh character Jocko, including his name and his eventual surgery, is my creation.

Dr. Skerry and Dr. Granger and his son are fictional characters but are based on real people (with names changed to protect the innocent) who had a feud described in an entertaining newspaper article. I didn’t change the name of Dr. Allen, the doctor who, at least according to the San Francisco Chronicle, used his position running a local charity to provide a lavish lifestyle for his young mistress and her mother.

Hilda was also inspired by a newspaper article about a young pregnant Swedish servant, her doctor, and an attempt by the reported father of the girl’s baby to get the doctor arrested when she tried to sue him for the cost of her care of the girl. The whole affair ended up in fisticuffs in a dark stairway, in a case where truth was definitely stranger than fiction.

Ella Blair is an entirely fictional character, although the real dispensary resident doctor of 1881-82 did, like Ella, graduate from the Medical College of the Pacific. And, of course, Mitchell is a character I created back in my second novel, Uneasy Spirits. He has shown up occasionally in other stories before now, but I had fun developing his character more fully for this novel, including finally giving him a first name.

Everyone else (Annie, Nate, Laura, the servants and other residents of the boardinghouse, and Caro Sutton) has become completely real to me, despite their being completely fictional.

From all these sources, I found a fascinating mystery plot.

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