Monday, May 18, 2009

Stranger than Fiction

Urologist Michael du Preez is credited with unearthing the true identity of the legendary Dr James Barry – finally solving a mystery that had persisted for over 140 years. He talks to Scope about his years of research and efforts to have Dr Barry’s remains exhumed in a tireless crusade to pluck the Victorian doctor from semi-fictional sensation to the rightful ranks of medical history’s greatest minds.

The secret 19th century love affair between Irish-born Dr James Barry - one of the British Army’s highest-ranking doctors – and the governor of Cape Town, Lord Charles Somerset is sure to add a shake of Hollywood spice to the $15 million film “Heaven and Earth”, which is due to commence filming in South Africa. But regardless of artistic licence in the retelling of the enigmatic Dr Barry’s story, the truth remains far stranger than fiction.
Four decades after this illicit dalliance, charwoman Sophia Bishop was sent to lay out the body of the medical pioneer Dr Barry at his lodgings in London on the morning of 25 July 1865. The diminutive physician had served in garrisons across the globe for a long, illustrious and occasionally controversial career. Stripping away the nightclothes in order to wash his body, Bishop discovered the corpse of “a perfect female”.
The ensuing scandal astounded the conventional sensibilities of Victorian society. The declaration that one of the military’s top doctors was actually a woman became fodder for gossip press throughout the British Empire. Appalled army officials locked away Dr Barry's service records for almost a hundred years in the hope that the story would simply go away.
Quite the reverse was the case. More than 140 years of speculation as to the true identity of the mysterious Dr James ‘Miranda” Barry has cemented the doctor’s place in history, regrettably, more for Barry’s elaborate subterfuge than her skills as a doctor and surgeon, and her outstanding work as a humanitarian.
As speculation persisted over the years, books were written by historians and romantic novelists alike, however, even the most promising research proved inconclusive. Who was the infamous Dr Barry? Where did ‘he’ hail from? Could a woman of that era really hide her true identity for decades while living and working in a thoroughly masculine profession?
It was only after years of meticulous detective work by South African urologist Michael du Preez that Barry’s true identity was finally known. His research, published last year in the South African Medical Journal, revealed that the pint-sized doctor with the sandy curls and squeaky voice, who fought for better conditions for troops, shot a man in a duel, reached the top of "his" profession, had in fact began life as the daughter of a grocer from Cork.
Dr Barry’s real name was Margaret Bulkley.
Dr du Preez says he first heard the story as a boy in Cape Town, where Barry had introduced sweeping health reforms while he was an assistant surgeon to the local garrison. The young doctor also made medical history there by becoming the first surgeon to perform a successful Caesarean section in the British Empire.
“That, in itself, was an astonishing event in 1826,” remarks Dr du Preez, speaking to Scope from his home in Cape Town. “It would be about forty years before the next Caesarean section with survival on mother and child was performed. Apparently, according to the family tradition, the operation took place in the bedroom and not in the kitchen as one would have expected,” he notes, his attention to detail in conversation as apparent as it is in his acclaimed research paper.
Dr du Preez explains that when he retired in 2001 he set about gathering evidence to solve the mystery of Dr Barry once and for all. Isabel Rae, in researching her authoritative 1958 biography of the doctor (The Strange Story of Dr James Barry), gained access to army records that indicated Dr Barry may have been a niece of James Barry, the celebrated Irish artist and professor of painting at London's Royal Academy. It was this angle that Dr du Preez pursued; deducing that if Barry the doctor was a close relative of Barry the artist, then papers linked to the artist's family might provide some leads.
And he was correct.
Buried among a large collection of papers relating to Mr James Barry, Dr du Preez discovered evidence that the enigmatic doctor had started life in Ireland as Margaret Ann Bulkley, the daughter of Jeremiah, a grocer in Cork, and Mary-Ann, sister of the artist Barry.
Several key letters, some penned by the teenage Margaret and some by Barry the student doctor, were analysed by Alison Reboul, an expert on document analysis with the UK's Forensic Science Service, who confirmed they were all written by the same person.
“A representative selection of these letters has been subjected to document analysis and combined with other evidence conclusively established the identity of Dr James Barry, leaving no doubt that the doctor started life as Margaret Ann Bulkley,” says Dr du Preez.
These documents also revealed a conspiracy between Margaret's mother and some of her uncle's influential and liberal-minded friends to get her through medical school, after the teenager and her mother had moved to London having been left destitute through hapless family circumstances.
These powerful friends were the family solicitor Daniel Reardon, Dr Edward Fryer, an academically inclined physician, and General Francisco Miranda, a Venezuelan revolutionary, no less.
“It would not have been surprising if the grand idea had emerged of putting the nineteen-year-old through a medical education, to enable her to participate in his (Miranda’s) vision for the future Venezuela,” Dr du Preez muses.
But this would have involved nothing less than three years’ study at a medical school during an era when only men were admitted to study medicine in Britain.
Margaret would have been obliged to take the extraordinarily bold step of altering her appearance and her persona to that of a young man and sustaining the deception until after the final examinations.
“If this construct is correct, the young doctor could have resumed her female identity once qualified and on her way to Caracas, Venezuela,” says Dr du Preez.
The disappearance of Margaret Bulkley and the appearance of a young medical student called James Barry was carefully orchestrated. The Bulkleys were unknown in Scotland, so they planned to establish themselves there as aunt and nephew while Margaret studied medicine in Edinburgh.
Most exciting of all was the discovery of a letter the budding doctor had written to the family solicitor Reardon on arrival in Edinburgh in 1809. "Reardon was a meticulous man," stresses Dr du Preez. "On the outside of all the letters he received he wrote the date and the name of the sender. This letter was signed "James Barry" but on the outside Reardon had written "Miss Bulkley, 14th December".
“It is thus possible beyond any doubt to identify the individual who was to become Dr James Barry, neatly confirming the result of the handwriting analysis – a particularly significant discovery,” says Dr du Preez.
Barry graduated in 1812 and after six months as a pupil at St Thomas' Hospital in London, joined the army - surely a strange choice for someone with such a secret to hide. But Barry's options were limited: General Miranda had just been betrayed by fellow revolutionaries and thrown into a Spanish jail. There was no longer a job for Margaret in Venezuela.
"Put yourself in her position," suggests Dr du Preez. "You've spent all that time maintaining this deception, so what do you do now? If she had come clean and said she was a woman she couldn't have done anything in Britain. The army was actively seeking doctors, so she chose the army."
Dr Barry's rise through the ranks was swift and remarkable. After only two years, she received her first promotion to assistant staff surgeon in 1815 and was soon after posted to the Cape of Good Hope (South Africa). It was here that Barry's emerging personal and professional eccentricities first evoked comment. Her high-pitched voice, effeminate manner and short-fused temper were duly noted by Afrikaners. The epithet "Kapok Doctor" was bestowed when it appeared that the doctor was padding her shoulders with cotton.
But Barry proved herself a highly skilled and respected physician and was soon attending fashionable Cape families. Among them was the family of Barry's great friend and patron, Lord Charles Somerset, governor of the colony. Stories linking the pair romantically form a large part of Barry lore. Isabel Rae’s biography describes the original incident from which these stories may have sprung:
“A placard was affixed to one of the posts of the Hout St bridge [it] was seen and read, to all intents and purposes, by one man only who ‘found it to be a most disgusting anonymous letter reflecting upon the moral character of Lord Charles Somerset; it did, in fact suggest an immoral relationship between the Governor and Barry’.”
This “passionate love affair” is the central theme in the multi-million dollar film “Heaven and Earth”, which will recount the relationship between Lord Somerset (Pierce Brosnon) and Barry (Natasha McElhone). Given his acknowledged expertise on Dr Barry, and his own medical proficiency, Dr du Preez has been retained as historical and surgical advisor to the film.
“It has truly been remarkably interesting. Fortunately we have been able to source period instruments from our local Medical Museum, and I have had several discussions with the actors from whom I have gleaned much information, which would contribute to the interest and readability of any biography that might eventuate.
“Natascha MacElhone, cast as Dr Barry, had researched her character admirably and she always came up with searching questions and suggestions that would never have crossed my mind. That was really good,” he confides.
Although all cast and crew were on set to commence filming in Cape Town mid-February, the project has been temporarily suspended due to a funding shortfall, but filming is expected to recommence shortly.
Barry led a colourful personal life, quite apart from the alleged affair with Lord Somerset. She is reported to have fought a duel in Cape Town, and to have been sent home under arrest on numerous occasions after run-ins with her Army superiors.
But in particular, she made her mark as a medical innovator. When appointed colonial medical inspector, Barry used her power to stop widespread administering of drugs by unqualified persons. She pushed through vast changes in the care given to lepers and other inmates of institutions, regardless of race, arguing the benefits of fresh air and balanced diet long before such measures became standard. With Sherlock Holmesian deduction, she traced the cause of Cape Town's impure water supply, and arranged for a better system.
Dr Barry also instituted regular and detailed audits of garrison medical facilities and hospitals, checking on the health and hygiene of the troops and consulting on the treatment of tropical disease. Above all, she showed a rare compassion for the soldier and his family, devoting considerable energy to improving their welfare, a most unusual practice in those days when the enlisted soldier was poorly fed and treated with little respect. To this day her visionary service reforms – including separate quarters for married soldiers - benefit most modern military services.
Dr Barry was, without question, a pioneer in the fields of health promotion and preventive medicine and these standards became the hallmark of her subsequent postings, following 13 years in South Africa, to garrisons around the globe, including Barbados, Jamaica, St Helena, the West Indies, Corfu and, towards the end of her career 46-year career, Canada.
Eventually, poor health forced Dr Barry - then Inspector General of Hospitals - to return to England in 1864 where she was placed on half pay and retired in almost total seclusion, with her black manservant and dog “Psyche”, to her house in Marylebone, London. Her secret remained intact until her death from “dysentery” in 1865.
“I did make a serious attempt to obtain the opinion of a forensic osteologist about the configuration of Barry's pelvis, as well as DNA analysis for any evidence of Y chromosomal material, but after a year of correspondence with the functionaries in the Home Office, and with the informed interest and intercession of the amazing Boris Johnson - my local MP, Harriet Harman declined permission to expose the mortal remains, stating that it was not in the public interest.
“As far as I am able to judge, the public are very much interested in this extraordinary story of Dr James Barry,” argues Dr du Preez, obviously frustrated by this thwarted attempt to irrefutably confirm Barry’s gender.
“I do plan to continue my work,” he quickly adds. “I would like to be able to put together a proper biography - not one of those novelesque affairs which appear from time to time. I am interested in facts that can be verified, not unfounded speculations. It will require investigating archives in the Caribbean and the Mediterranean, as well as in Edinburgh London and Cork, and possibly Carlisle.
“I am quite excited just at the moment, because I think I have located a collection of books presented to the Public Library here, by Dr Barry, in about 1824. I believe that amongst this collection will be books, which Barry used while a Medical Student at Edinburgh. And there might even be handwritten notebooks - of the type which persisted even into my time, when photocopying was a messy wet and expensive process, and the computer was still a far off dream.
“James Barry is certainly an extraordinarily interesting subject, and I believe that there is much that still remains to be unearthed,” says Dr du Preez.
Through her subterfuge, Margaret Bulkley, as Dr James Barry, secured her place in history by being the first woman in Britain to graduate as a medical doctor and to fulfil an active army career dedicated to medicine and the amelioration of human suffering.
She elected to question every institution and sacred medical tenets of the day and was afraid of no one. But above all, she had a clear understanding of where the great scientific and social revolutions of the early 19th century were leading.
She chose to be a military doctor, not in a crusade for a woman’s right to join the profession, but simply to be one. The quickest course then was to become a man in the eyes of the world.
As they would say in her native Cork, that’s some woman for one woman.

The trouble with Barry

It is argued that Dr James Barry received scant recognition for extending the frontiers of military medicine because of her ability to upset the establishment with surprising regularity.
Shortly after being posted to Jamaica in 1829, Dr Barry took unofficial leave of absence and returned to England. The reason for her disappearance was demanded at a subsequent "interview without tea" with Sir James McGregor, the Director General. She answered, "I was fed up with my hair and wanted a proper haircut." To which McGregor replied, "It would seem Sir, that your audacity is equal to the prodigious growth of your hair."
Years later, during a short stint in Crimea, Barry was the only medical officer with the temerity to reprimand another equally formidable woman in the form of Miss Florence Nightingale. According to reports they disliked each other on sight. It was a mutual animosity that lasted throughout Barry's life.
On hearing of Dr Barry’s death Nightingale remarked: "After she was dead I was told she was a woman. I should say she was the most hardened creature I ever met throughout the army."

A question of sex

Dr Michael de Preez’s research has incited comments “from New Zealand to Venezuela and many places in between” - a large volume of which concerned Barry's gender.
“An interesting one was from a person who referred to Barry as transgendered, which I think is valid. Although like those Albanian women who have no more men in their families, I believe that the motivation for the young Margaret Bulkley was entirely career orientated, and had nothing to do with any emotional deviation.
“At the outset, it is my sense that, should the original plan of Miranda's have come to fruition, Margaret would quite likely have resumed her female persona once in Caracas. But that, of course, never happened. We shall never know,” says de Preez ruefully.

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