Chapter 14

Opening for the Defendant by Mr. Barstow

It was now Barstow's turn to present evidence in defense of Dr. Cooper. Five lay persons and ten physicians were called for that purpose. We shall quote segments of their testimony that make points in Cooper's favor.

Barstow's objective during the questioning of the next few witnesses was to convince the jury that Mrs. Hodges had in fact made a quite satisfactory recovery from the cesarean section. We previously referred to the testimony of Mrs. Margaret Karr regarding Mrs. Hodges' health after the operation. When called to testify, Mrs. Karr gave a full account of Mrs. Hodges' change of outlook following her subversion by Wooster. We shall now hear from several other witnesses regarding the health of Mrs. Hodges since the cesarean operation.

Testimony by Dr. Martha A. Thurston

As we have already related, Dr. Thurston brought Mrs. Hodges to Cooper who operated on her for stenosis at the vaginal orifice. Soon after the operation Mrs. Hodges became pregnant. Dr. Thurston followed the case with interest and, as the referring physician, was rather disappointed that Dr. Cooper had not invited her to at least observe the cesarean section. Nevertheless, there were no hard feelings and Dr. Thurston called on Mrs. Hodges after the cesarean "as a friend."

Barstow. Did you see her after the performance of the Caesarian operation?

Thurston. Yes, sir. I saw her while she was in bed, before she had recovered from her labor, before the wound had perfectly healed.

Q. What did she say at that time?
A. She spoke of her wonderful escape from death; how happy she felt, and how gratified she was on account of the operation. She spoke of the great satisfaction Dr. Cooper had given her; she spoke highly of the operation and highly of him. .

Q. When did you see her again after that and what did she say?
A. It might have been in February (1858). She said that Dr. Cooper could have used instruments and delivered the child, without resorting to the Caesarian operation. I told her that I looked upon her condition as better and far preferable to that of very many who had been operated upon otherwise. She did not seem to fall in with me on that point. I told her that I thought that the Doctor had done the very best possible for her, and I would advise her not to say anything against the Doctor. She said she would do all she could to injure him. She said she meant to do him all the harm she could; she meant to stop his practice if possible. She seemed very much exasperated indeed. That is all she said in reference to the Doctor.

Q. Describe to the jury the appearance of Mrs. Hodges at that time, so that the jury may be enabled to form a correct opinion as to the state of her health at that time.
A. I can testify as to her appearance. She appeared to be very comfortable. . . She appeared from all indications I could (see) to be enjoying very good health. I remember that she went outdoors to take her meals.

Q. How far did she go to take her meals?
A. She went the distance of a long block - to the end of it.

 

Testimony by Mrs. Catherine Roper

As matron of Cooper's Pacific Clinical Infirmary, Mrs. Roper was well acquainted with Mrs. Hodges and followed her progress from the time of her operation at the Infirmary for vaginal stenosis. She was on friendly terms with the patient who sent for her after the cesarean section. Mr. Stanly, one of the plaintiffs' attorneys, conducted the following interrogation:

Stanly. Do you remember (Mrs. Hodges) coming to the Infirmary after her confinement?

Roper. Yes sir, but I first saw her at her own house after her confinement.

Q. Did you visit her while she was sick in bed?
A. She sent for me.

Q. Was this before the child was taken out?
A. Oh no. I did not see her during her labor and for some time afterwards. I did not think that it was right for visitors to go and see her for the first few days after the operation, and I didn't go.

Q. How long after the operation was it before you visited her?
A. I should think that it was four or six weeks after the operation before I went to see her.

Q. How was she then.
A. She appeared in good spirits. She laughed, she talked, she drank some porter, she jested, and seemed to be in a good condition altogether.

Q. What did she say?
A. After I had been there a little while, she said she would like a drink of porter. I handed her a tumbler of it, and she drank it nearly all. Then she asked me if I would like to see the incision. I told her that I would. She showed it to me. I told her that I was very much astonished to see how it had healed, and how well it looked. It looked red, but perfectly healthy and well.

Q. When did you see her again?
A. Not for some weeks afterwards, and then she came out to the Infirmary.

Q. Did she walk out?
A. It was rather early in the morning when she came. Dr. Cooper had gone out. It appears to me that it was about nine o'clock. I said that I was very much surprised to see her. I asked her how she came. She said that she had waited for an omnibus, but as she did not see any, she had walked the whole distance. I said: "You must be very tired." "Oh, no," she said, "I feel excellent - I feel excellent." "Why," said I, "I would not walk to your house; I am sure you didn't do right. I wish you to lay down and rest." I fixed her a comfortable bed on the sofa, but I could not get her to lay down. She seemed to feel too proud to lay down. In a few moments Dr. Cooper came in. He was very much pleased to see her, and she said she felt very well, indeed, and that she felt that she owed her life to him. She said: "Dr. Cooper, I could not stay away any longer. I had such a propensity to come here that I think I could have walked twice the distance." The Doctor told her that he did not expect to see her out so soon, and that she must be careful and not overstrain herself.

Q. Do you know whether she was engaged in teaching at that time?
A. No - not that day.

Q. When did you see her the next time?
A. The next time I saw her was a week, or perhaps two weeks, after the first visit. She came down to the Infirmary, and it was early in the morning and I told her, I recollect, that she must rise very early, because it was not long since we had been at breakfast. She said: "I am going to give a lesson to a family. I called in at the place where I am teaching, and they were at breakfast, and I thought that I would just run down and see you." I asked her if she walked, and she said "Yes." I asked her what she gave lessons in. She said: "You know, Mrs. Roper, that there are a great many persons in this city of the mushroom quality. They came to California poor and ignorant, and as they have had good luck and made money they want to put on the finest airs. But they never learnt anything scarcely at home." She said that most of them were married ladies, and I supposed from what she said that this woman she was teaching was married. She said she gave lessons in reading and writing. I asked her if she was going to walk back? "Why?" she said, "I have no difficulty in walking at all."

Q. In this interview did she say anything about Dr. Cooper?
A. While she was there talking with me that morning, the Doctor came in. She looked up and said: "O! you dear man! How I do love you! You saved my life." I give her exact words, I don't use my language.

Stanly (sarcastically). Of course not. Please say that exactly over again, and slowly, so that I can write down the whole of it. McDougal (Cooper's attorney). She'll repeat it with pleasure.

Stanly. Well, don't superintend the counsel on both sides, and answer for the witnesses too.

McDougal. I was telling you how accommodating our witness would be.

Stanly. I thought you promised to behave yourself the balance of the trial. Go on, or repeat that last exclamation of yours, Mrs. Roper, if you please.

Roper. It was not what I said; it was what Mrs. Hodges said. When the Doctor came into the room she lifted up her hands and said: "O! you dear, good man! How I do love you, for you saved my life." (Loud laughter outside and within the bar. The court commanded silence.)

Q. Was anything said concerning the operation that was performed?
A. Mrs. Hodges said: "I don't know of a man on the coast to whom I am so much indebted , or in whom I have so much confidence." "Why, Doctor," said she, "I am indebted to you for my life. I am so grateful that I don't know how to express myself." The Doctor said that he was glad that she recovered so quick. He didn't appear to like much the way Mrs. Hodges endeared him.

Stanly. Of course not.

Roper (continuing). The Doctor left the room and went down stairs. When the Doctor had gone out, Mrs. Hodges said: "O! I couldn't express my feelings; I felt like following and embracing him." She said that the Doctor had saved her from a separation from her husband; that but for the Doctor she should have had to have gone to New York, so that the whole city would not know that she was mal-formed. "Dr. Cooper," said she, "has saved my life, and I shall never be able to repay him for what he has done for me.": I give you the language in which she expressed herself.

The guileless and explicit testimony of the gossipy Mrs. Roper must have shaken the confidence of Mrs. Hodges' attorneys in the poor woman's claims of disability. In a crude effort to discredit Mrs. Roper by implying a liaison with Dr. Cooper, Stanly put the following questions to Dr. Wooster when he later returned to the stand:

Stanly. I want to ask about Mrs. Roper. Have you known her?

Wooster. I know the woman by sight. I have seen her often.

Q. Is she a married woman? (Note: Mrs. Roper had already responded fully and satisfactorily during her testimony to detailed questions regarding her marital and family status.)
A. I always supposed her to be single.

Q. Where have you seen her?
A. I have seen her with Dr. Cooper, once at the Lyceum, and once with him at the Mechanic's

Fair. She is frequently present at his operations.

Barstow. We protest against this attempt to injure the character of Mrs. Roper.

Wooster. I know nothing against the woman's character at all. I only say that I never saw her husband, or heard that she had one.

Hoping that he had planted suspicions regarding Mrs. Roper's morals in the minds of the jurors, Stanly changed the subject.

Testimony by Mrs. Barbara Kriemer

Mrs.Kriemer and her husband, Jacob, were the proprietors of the neighborhood grocery store where Mrs. Hodges frequently shopped. She and Mrs. Kriemer became friends and Mrs. Hodges employed her to stay with her throughout her labor. As we have seen, Mrs. Kriemer was an unwilling assistant during the cesarean operation. After the operation, Mrs. Kriemer continued to be sociable and was even a confidante of Mrs. Hodges. The following selections from Mrs. Kriemer's testimony were chosen because of their relevance to Mrs. Hodges' health following the cesarean.

Heslep. How long was she confined to her bed (after the cesarean)?

Barbara Kriemer. She was in bed about a month after the operation before she set up. She had the operation on the 10th of November, and she was down to dinner on Christmas.

Q. You have been asked about her health since you were there. Are you any judge as to whether a person is in good or bad health?
A. I think I can see if a person is in health or not.

Q. Have you any other sign of Mrs. Hodges' health except her looks and general appearance?
A. She looks perfect well, that is all I know.

Q. Have you had any experience in determining as to whether a person is in good or bad health?
A. I see a person look perfect well, and I think so.

Q. Was there not a large lump where she was cut?
A. No sir, no marks at all. It looked smooth, like a little cut on my hand.

Q. Were there no lumps or rough surfaces?
A. No sir. It was all nice and perfect smooth. You can hardly see it where it is cut.

Q. When did you see these wounds last?
A. I seen them after Christmas. It was about six or seven weeks after the operation. . .

Q. What is her appearance in regard to health since the operation?
A. She has got good health; she is perfect well and fat. She told me about two or three months ago that she is so fat that she is ashamed. She is perfect well.

Judge Hager. Did you know Mrs. Hodges before she was confined?
A. Yes sir - three or four months before.

Judge Hager. What was her appearance then, as to health, compared to what it is now, or at the time you last saw her?

A. She was not then as fat and hearty as she is now. Now she is perfect well. She looks fatter since her confinement. . .

Q. Did you call upon her at any time when she informed you about her sleeping with her husband?

A. About three months ago she come down to my house and she say she was in the family way again. She say she felt very sorry, and she didn't know what she could do. After that she told me she took some medicine.

Q. What kind of medicine?
A. She told me it was a kind of (yellow) powder. She got a pint of gin at my store, and she say she take that with some powder. She told me the powder, but I forget what it was.

Q. Did she tell you what she took the powder for?
A. She said she took the medicine so that she would not have that.

Q. Have what?

Heslep. O, the jury understand.

A Juryman. We understand.

 

Testimony by Jacob Kriemer

The residence of Mr. and Mrs. Kriemer was located "about thirty feet" from that of Mrs. Hodges. Thus the Kriemers had a well-positioned observation post and they enjoyed a neighborly informality of relationship with Mrs. Hodges that enabled them to provide the Jury with intimate details of her condition.

Barstow. Have you been in the habit of seeing Mrs. Hodges frequently during the past two years?

Jacob Kriemer. Yes, sir.

Q. Were you at her house at the time she was ill?
A. Yes, sir. I watched there 14 or 15 days after the operation.

Q. Did you see the wound upon her person?
A. Yes. sir. She asked me to come up stairs one day. She said, "Mr. Kriemer, just come here; I want to show you my wound - how nice I got cured." I said I was very glad to hear it. She said, "Mr. Cooper do me great work, and Mrs. Kriemer do me good work." Then she opened her clothes outside and showed me her wound. It was pretty near healed.

Q. Was it grown together?
A. It was, it was.

Q. Did you observe whether there was anything rough in the appearance of it?
A. I feel it healed up right smooth. Of course it was so; the woman herself say she feel it right straight smooth.

Q. Have you been in the habit of seeing Mrs. Hodges since that time?
A. I frequently goes up there, and she comes many times to my house.

Q. What has been her appearance as to health?
A. She very well, she say..

Q. Did she ever tell you about her being too fat?
A. About 4 to 6 months ago she come down to my store, and she say: "I been perfectly well. I most ashamed I get so fat." She asked me to feel of her arm, she was so fat.

Q. Was your wife present at that time?
A. Yes, sir.

Q. Have you seen her since?
A. I see her pass my house in the street.

Q. How often do you see her pass your house?
A. Most every week, twice or three times.

Q. How does she appear?
A. She appears pretty good.

Q. All the times you have seen her, did you notice how she was traveling?
A. I see her traveling nicely this week. I believe I saw her last Saturday on this week, on a milk dray. I think I see her with her brother taking a ride.

Q. Have you seen her on foot within the last 2 or 3 months?
A. I saw her this week; no, not this week - I saw her last Saturday.

The testimony of Dr. Thurston, Mrs. Roper and Mr. and Mrs. Kriemer essentially dissolved the plaintiffs' claim that Mrs. Hodges was disabled by hysteria or other alleged sequelae of the cesarean section. She was not only reliably observed to be well nourished and physically active, but her pelvic organs had so far recovered from the operation that within a few months thereafter she was again pregnant. Mrs. Hodges had a stillborn baby on 14 April 1858, just five months after the cesarean. The yellow powder in a pint of gin must have had the desired effect although Mrs. Kriemer's recollection as to the date Mrs. Hodges took the potion seems to have been about six months off the mark.

Ludwig A. Emge, "San Francisco's first successful cesarean section." Western Journal of Surgery, Obstetrics and Gynecology. Part 2. 1938 Mar; 46 (3): 169.

To counter the testimony of the plaintiffs' expert witnesses who condemned Cooper's cesarean section out of hand, Barstow called to the stand his own corps of experts who emphasized the principle, already stated by Dr. Nuttal, that a surgeon could not render a valid opinion in a case without personally examining the patient.

Testimony by Dr. R. Beverly Cole

Dr. Cole, Surgeon General of the Vigilance Committee and adversary of Toland in the McGown trial of the previous year, was a Cooper supporter and on frigid terms with the Pathological Clique. He doubtless welcomed the opportunity to discomfit the medical establishment by his testimony in this trial:

Barstow. Will you state, Doctor, whether in your judgment a surgeon can determine the operation which ought or ought not to be performed in any case of importance, without seeing the patient?

Cole. I should judge not - not unless you might say he might approximate an opinion, all the circumstances of the case being present. Without every circumstance, and even the minutiae of the case be detailed, it would be impossible for him to give an intelligible opinion.

Q. In a case stated thus (Wooster's case report was read to the witness), can you determine from this, what operation ought or ought not to be performed.?
A. I could not, sir

Q. State whether you have seen Mrs. Hodges repeatedly.
A. Yes, sir.

Q. What was her appearance as to health in that intercourse.
A. She appeared in perfect health. I have never seen her when I could have judged that she was in ill-health.

Q. Where have you seen her?
A. I have seen her walk in the streets repeatedly. I have seen her once on Stockton street, and several times on Washington street. Once I rode in the omnibus by her side. I have never seen anything in her carriage or countenance that exhibited bad health.

At this juncture, counsel for the plaintiffs conducted a cross-examination and asked the now familiar "tricky" questions about pelvic measurements, the smallest dimension compatible with normal delivery, etc. Counsel began his interrogation with a sly "friendly" question intended to disarm the witness:

Heslep. I recognize in the witness before me a good anatomist.

Cole. Thank you.

Q. Now you and I will get along together.

Judge Hager. Well, proceed together in some form.

Heslep. You stated that you could not form an intelligent opinion as to what ought or ought not to be done, from the statement of the case given.
Cole. I am quite sure that no one could, for the reason that there has not been a sufficient detail of the case stated. . .

Q. Did you not give an opinion as to the King case without seeing it?

A. No, sir.

Q. Did you see him the day he died?

A. No, sir. I saw him however when he was ill, and after he was dead.

Heslep was frustrated at being unable to trap Cole in an inconsistency with respect to the treatment of James King of William, and was wary of the self-confident doctor because of his reputation as a truculent witness in the McGowan case. Therefore, Heslep changed course and put to Cole for analysis some complex clinical scenarios designed to elicit from him an inadvertent response at odds with his initial position on the necessity to see a patient before deciding on treatment. Failing again, Heslep played his trump card, a futile attempt to insinuate bias by identifying Cole as an employee of Cooper and implicated with him in a questionable enterprise.

Heslep. Are you employed now in the Infirmary of Dr. Cooper?

Cole. I lecture there, sir.

Q. You are building up a Medical Institute there, are you not?
A. I am engaged in an enterprise of that kind.

Q. You hope to be one of the professors. Dr. Cooper is the chief man, isn't he?
A. No, sir. I don't know as his relations with the concern are any more intimate than my own.

Q. What are your relations now?
A. I am a lecturer now.

Q. Not in a professorship?
A. I am merely giving informal lectures at present.

 

(Witness excused.)

We must forgive Dr. Cole for his evasive answer to the final question posed to him by Mr. Heslep. On 22 September 1858, exactly two months prior to the beginning of the malpractice trial of Dr. Cooper, the Board of Trustees of the University of the Pacific in Santa Clara established a Medical Department in response to a petition submitted by Drs. E. S. Cooper, Isaac Rowell, James Morison and R. Beverly Cole. On the same date, the University appointed each of these petitioners to a professorship in the new Medical Department. Dr. Cole was named Professor of Obstetrics, Diseases of Women and Children and Physiology and Dr. Cooper was appointed Professor of Anatomy and Surgery. The founding of Cooper's long-envisioned medical school had quietly taken place even as his trial for malpractice was pending on the docket of the Fourth District Court in San Francisco.

Testimony of Dr. Isaac Rowell

Unknown to the court at the time of the trial Dr. Rowell had become Professor of Materia Medica in the new Medical Department of the University of the Pacific. There was something else about Dr. Rowell unknown to the attorneys for the plaintiffs. Immediately after Rowell's swearing in to testify for the defense, someone whispered to Mr. Heslep that the doctor was reputed to be an atheist. If this allegation were true, his oath which called upon a Supreme Being to aid the witness in telling the truth ("so help me God") would be null and void. Heslep at once seized the opportunity to embarrass the defense and possibly disqualify Rowell as a witness:

Heslep. I wish to question this witness in regard to his views in regard to the obligations involved by the administration of an oath.

McDougal. What is the object?

Heslep. It is to determine the competency of the witness.

McDougal. Well, we object. The laws of this State do not require of a witness that he shall belong to a church before he can go on the stand.

Stanly. Now, who's said anything about a church, General McDougal?

Heslep. The object of the enquiry is to ascertain whether the witness believes in future rewards and punishments, and that he will be held accountable hereafter for perjury committed in this life. In other words it goes to determine the degree of conscience that controls the infant witness. Now we may suppose that in a case of this character, the witness in his statements does or does not regard a future accountability.

Barstow. (Interrupting.) I object to any statements of this kind. I object to any such an assault on the character of this witness.

After extensive legal sparring and repeated objections from the defense, Dr. Rowell finally conceded that, although he belonged to no church, he believed in one God; and that, although he did not believe in happiness beyond this life, he prayed for it. At this point Judge Hager intervened mildly but for some unaccountable reason allowed the plaintiffs' attorneys to continue harassing Rowell about theological issues until they literally tired of the game. As they suspected, Rowell's testimony would be adverse to their case.

In accordance with his strategy, Barstow again called attention to the principle that a surgeon must see the patient before deciding on treatment in a complex case:

Barstow: (Wooster's history of the Hodges case was read to Dr. Rowell.) Will you say whether, upon that statement of the case, a surgeon could determine what operation ought or ought not to be performed for delivery without being present and seeing the patient?

Rowell. I should think that it would be a question of great magnitude, and one in which any one might doubt what it was best to do, not being present.

Q. Would not surgeons differ in such a case?
A. Able surgeons might differ in such a case, and certainly they could not determine what ought to be done without seeing the case.

Q. Then take the case as given. What opinion could you give under such a statement?
A. I should be very unwilling to risk my reputation upon any act that I might recommend, without I saw the case myself. I don't think that any prudent man would be willing to give advice under such circumstances. It would be very unwarrantable advice to follow, unless he saw the case.

With such testimony as the above from Rowell and other witnesses, Barstow undermined the plaintiffs' experts who, without seeing the patient, had contended dogmatically that the cesarean section was completely unjustified. The plaintiffs' attorneys were now in a perfect frenzy to counteract the contrary statements of Barstow's witnesses, but without success. The outlook for Cooper, so bleak at the outset of the trial, was beginning to look more hopeful.

Furthermore, Wooster's credibility was seriously in doubt. The following testimony by Rowell (also confirmed by other witnesses) contradicts statements made by Wooseter under oath at the beginning of the trial, and stamps him as a perjurer "of the blackest dye."

Barstow. Do you recollect any conversation with Dr. Wooster in November or December last (1857) about an operation for cesarean section?

Judge Hager. Did you hear him speak with regard to that operation, as to whether it was performed on his patient or not?

Rowell. He spoke of the woman as his patient - "my patient," he said. He said that he had a difficult case, and that his time was entirely occupied with that case.

Barstow. Did he state whether Dr. Cooper performed the operation or not?

Heslep. Stop! we object to that question?

Judge Hager. Did Dr. Wooster speak in regard to the propriety of the operation, whether it was right or wrong?

Rowell. He did say that he approved it.

Barstow. Did he say whether it was advisable or necessary, or well performed, or skillfully performed, and a great triumph in surgery, or words to that effect? Did he converse about the operation and where did the conversation take place?

A. (The conversation took place upon the sidewalk where) we met, and after the usual salutation about business, etc., I asked him where he had been. He said that he had been engaged in a very responsible and a very tedious case, and he went on to relate what it was. He said: "We had finally to resort to the Caesarian section." That was the first intimation I had had that it had been performed in town. The question very naturally arose on my part, as to why he performed the operation. He said, in the course of that conversation, that the operation was necessary, and that I would have seen that it was necessary, or that I would have decided that it was necessary, if I had been present. He said that the operation was "inevitable" - I think that that was about the language he used. He said that the operation was well performed, and then bid fair to result favorably.

Q. When was this?
A. A few days after the operation had been performed. I don't recollect precisely the number of days. . .

Q. Did you have any other conversation with him at any other time, on the same subject, or did he afterwards speak to you about it?

A. It was a subject of frequent conversation for some weeks after the patient was convalescent. I cannot give the precise dates. I recollect of his speaking of the operation as "a great triumph in surgery," as "a big thing for our climate," and as "a big feather in our cap."

Q. He spoke then of himself and Dr. Cooper?
A. I believe that was his language and that his reference at one time.

Q. Have you had any other conversations since that time, Doctor?
A. (After the published notice of the operation in the January 1858 issue of the Pacific Medical and Surgical Journal), Dr. Wooster spoke to me . . .and said that a more extensive notice should have been given of it, but modesty on his part forbade it as he was connected with the case.

 

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