The Land of Pain

Pain is both enemy and idol in Michael Downs’s “The Strange and True Tale of Horace Wells, Surgeon Dentist.”

By Maria BrowningJuly 26, 2018

The Land of Pain

The Strange and True Tale of Horace Wells, Surgeon Dentist by Michael Downs. Acre Books. 320 pages.

WHEN I WAS a small girl, I was taken to a country dentist who drilled my rotten teeth without any anesthetic. He didn’t generally eschew the use of novocaine, but he was of the opinion that young children didn’t experience enough pain to warrant it. I am of the opinion that he was quite wrong.

You’d think that experience would leave me with a horror of dentists, but what it actually did was make me profoundly grateful to live in an era when terrible pain is no longer an inevitable part of seeing one. When, in my early 20s, I calmly sat in another dentist’s chair while he chiseled out my impacted wisdom teeth, it seemed like a miracle to me. And in a sense it was a miracle, one wrought through a combination of Valium, novocaine, and nitrous oxide — that last a gift bestowed through the work of a 19th-century New England dentist named Horace Wells, who discovered the pain-relieving properties of the gas in 1844.

Wells, who lived and practiced in Hartford, Connecticut, was a troubled soul who met his death by suicide in 1848 while jailed in the Tombs in Lower Manhattan. He was just 33 years old, and he died without ever receiving full professional credit for his discovery. Michael Downs spins the sad facts of Wells’s life into a gloomy, hypnotic story in his debut novel, The Strange and True Tale of Horace Wells, Surgeon Dentist.

Though Downs sticks closely to the established history and focuses on his protagonist’s inner life, the book seems not so much a character study or psychological novel as a meditation on the power of pain — the terror it holds for us and its paradoxical allure.

We meet Downs’s Horace at age 14 as he tends his sick father through long nights of fever and agony. A doctor arrives and compels the boy to restrain his father while he cups the boils that cover the sick man’s back. An errant bat is trapped in the room, and in Horace’s mind it becomes an avatar of suffering: “He watched his father wince and flinch, saw his jerks and twists, how they matched the bat’s flight. Father’s pain, he thought.” This notion of pain as a literal thing, a malignant entity that haunts and torments, will remain with Horace throughout his life.

His father’s suffering overwhelms Horace, snuffing out love, pity, even horror. He is sent into a kind of trance — “of the sensations born from the soul, he felt nothing at all.” This power of others’ pain to alter him, to render him lost to himself, will be another enduring fact of Horace’s existence. When, as an adult, he serves as the agent of pain, drilling and ripping out the teeth of his patients, he says to his wife, “Who I become is not Horace Wells. That man — who has been a husband, a father, a son — he becomes lost, and a fiend remains who is more practiced at causing pain than any man should be.”

So, a boy traumatized by witnessing a parent’s pain (and, not incidentally, by a desperate act he commits in response), goes on to become a man who reluctantly seeks out and inflicts hurt. Horace is not a sadist — or at least, not much of one, though there are some passing instances when his obsession with pain gets tangled up with his erotic impulses. He’s more a conflicted servant of pain, enthralled by it even as he hates it. He keeps trying to break the spell by abandoning his practice, but like an addict who can’t kick the habit, he finds himself haunting the dockside taverns for down-and-outers in need of his services.

Horace is reasonably aware of his psychic predicament. “Repulsed and drawn all at once, and inflicting pain to cure it! Horrible,” he tells himself. But awareness does not lead to resolution, and his inner conflict damages the whole of his life. It poisons his relationship with his wife and child and adds a toxic bitterness to his professional rivalries.

Then he discovers that the already well-known high delivered by inhaling nitrous oxide also blocks sensations of pain, and everything changes. Wells is determined to promote this new wonder, but of course he’s not the only dentist or doctor hoping to bring glory on himself by offering the world painless treatment. His chief competitor is a former student and partner, William Morton, who is peddling an ether-based alternative. Just as the youthful Horace was undone by his father’s agony, the adult Horace is unable to cope with this personal betrayal without coming to the brink of madness. He’s again self-aware of his terrible fault yet driven by impulse. Detachment is not an option. “In the land of pain,” he tells Morton, “everything is in excess.”

The real Horace Wells, of course, suffered from psychosomatic illness for much of his adult life, made worse by the stress of professional disappointment. He ultimately became addicted to the recreational use of ether and chloroform. While living alone in New York, having separated from his family, he went out into the street in a fit of delirium and threw acid on two women. This was the crime that landed him in the Tombs, where he slit his femoral artery with a razor.

Downs’s fictional Horace suffers from incipient psychosis even in boyhood, and arguably the central tension in the novel is between the sane Horace, a man of science with deep sympathy for suffering, and the deranged Horace who is simply obsessed with pain, both his own and others’. There’s no question that it’s Horace’s mad self who triumphs. Neither healer nor humanitarian, this Horace is selfish and destructive — and cowardly, as well. The power of Downs’s storytelling lies in giving us glimpses of the man Horace might have been if pain, “that slippery thing,” hadn’t cast a spell on his soul.

Any novel with physical pain as its central subject is bound to have a fairly high wince factor, and there are a number of scenes in Downs’s book that make the reader confront, starkly, the truth of suffering, both animal and human. Are there more such scenes than necessary? A case could be made that this story actually softens the realities of 19th-century life, and nothing here seems truly gratuitous. On the other hand, I have to admit that there were a few moments when I resented Downs’s superbly crafted depictions of hurt and death. Perhaps, like Horace, I’m too sensitive.

In any case, Downs tells a fascinating story in skilled, often elegant prose, and he treats all his characters with great sympathy. Horace’s long-suffering wife, Elizabeth, is a tragic figure but no doormat, and even Morton, the closest thing to a villain in the piece, seems capable of genuine warmth toward Horace, though his gentle feelings are no match for his ambition.

Horace Wells unquestionably did a great service with his discovery, but his fictional counterpart gives the lie to any notion of victory over suffering. It’s impossible to read his story without thinking of the thousands dying today from the very drugs peddled to quell their pain. There are no more screams echoing from the dentist’s parlor or the operating theater, but Horace’s nemesis thrives. As the sad dentist so aptly says, “Pain has no limits. It’s infinite. Like God.”


Maria Browning’s work has appeared in Guernica, Literary Hub, and Still. She is the managing editor of Chapter 16.

LARB Contributor

Maria Browning’s work has appeared in Guernica, Literary Hub, and Still. She is the managing editor of Chapter 16.


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