Gastric Fistula

Gastric Fistula, eimear gavin, short story, fiction, short fiction, science history and fiction, Rob Nisbet -

Canada 1822

The crack of a musket shot.

Then a man screaming.

Canada. Fort Mackinac to be

precise, was inhospitable even in summer.

Inhospitable – a fitting adjective: the hospital

was a converted storehouse. Bitterly cold in

winter, the fires filled the place with plenty

of smoke but little heat. Snow crept into the

wards as a grimy slush. And now, in June, the

roof leaked drizzles of rain, as full of holes as

the Sixth Regiment, nine years earlier when

the British had blown-up the main magazine

at York.

Doctor William Beaumont had spent a

full two days, back then, amputating arms and

legs and trepanning fractured skulls to relieve

pressure on the brain. He had seen his share

of blood and guts, so it was to Dr Beaumont

that Alexis St Martin was carried.

St Martin was a voyageur. He plied

his canoe to the far reaches of Lake Huron,

the second largest of the Great Lakes, trading

with the Indian trappers and selling pelts to

the American Fur Company on Macinac Island.

He was stretchered in by two of the

townsfolk, being careful not to slip on the

wet floor. Beaumont had him laid on a bed,

manoeuvred away from the dripping roof.

“He suffered a musket wound,”

someone said. “An accident. Shot out his


There was a hole in the upper left

abdomen; the man’s breakfast of bread and

rabbit sloshed through.

Beaumont ensured that his assistants

held the man still as he made his examination;

the wound was as large as his hand.

“His name’s St Martin,” said a voice

as Beaumont swabbed at the blood and loose

shards of rib.

Three years later

Unable to continue working as a

voyageur, St Martin was employed by Dr

Beaumont as a handyman. The holes in the

hospital roof were duly repaired. The gastric

fistula in St Martin’s stomach however failed

to close.

Beaumont removed the dressing and

cleansed the scar, creased like the bark of a

tree, around the cavity leading through to the

stomach. “I wonder,” said he, “would you

permit me some experimentation with gastric


St Martin stared into Beaumont’s

gaze, judging his intentions, then he agreed.

Beaumont lowered quarter-ounce

pieces of food into St. Martin’s stomach on

strands of silk string, removing them after

one, two and three hours to observe the rate

of digestion. There was movement in the

muscles of the stomach, was digestion a

mechanical process of grinding?

The process appeared to be chemical.

Gastric juices had solvent properties, like

acid, dissolving corned beef in two hours.

Juice extracted to a glass vessel worked five

times slower, even when body temperature

was maintained. Cold juice had no effect at

all. Chicken digested slower than beef,

vegetables slower still, and St. Martin’s mood,

when foul, hindered digestion still further.

Exercise was found to quicken the process.

When Dr Beaumont came to publish

his observations, he deliberated for some

time before settling on a name for his book.

‘Experiments and Observations on the Gastric

Juice and the Physiology of Digestion’. Not

the snappiest of titles, but one he hoped

would be remembered in years to come.


London 2022

The pop of a champagne cork.

Then everyone cheering.

London. The Shard hospital to be

precise, glinted in the glow of a summer

sunset. From the observation terrace,

converted from offices, even London could

look serene.

It was Professor White’s moment: a

celebration of all he and his assistant, Martin,

had achieved. They watched the editors of

the newspapers and magazines gather for the

naming of their new endoscopic capsule.

White grinned, thinking of how much

the sponsors had spent, must have cost them

an arm and a leg.

“Relieved?” asked Martin, “now that

it’s over? No more pressure.”

White felt that he had seen more than

his fair share of Martin’s guts. A voyage of

twenty-four meters, he had plied his capsule

to the far reaches of Martin’s digestive tract.

White stood on a small podium and

addressed the company of dignitaries in their

suits and furs. “A toast, ladies and

gentlemen,” he announced. “To the world’s

first fully manoeuvrable endoscopic capsule.

And to the research team who made it


“I’d like to pay particular tribute to

my long-suffering assistant, Martin Prince,

who is, in my opinion, far too fond of a full

English breakfast. Porridge is far easier to

navigate through.”

The editors laughed and ensured their

assistants had noted this quote, ready for

their next edition.

“The name of the capsule,” continued

White, “will reflect this magnificent building,

the Shard Hospital, our ‘beautiful mountain’.

It will be called Beaumont.”

Three years earlier

Professor White gave Martin a

capsule to swallow. “This one’s the size of a

vitamin pill. But I know that I can make it

smaller still. About the size of a grain of rice,

and fully manoeuvrable.”

Martin adjusted the chunky belt of

sensors around his abdomen. “The smaller

you make the capsule, the bigger the

associated paraphernalia.”

“We must be able to track the

capsule, beam power to it and receive the

pictures. It’s good of you, Martin, to permit

me these experiments.”

Martin stared into Professor White’s

gaze, and saw his passion. Then he

swallowed the capsule.

“I managed to pull a few strings,”

White said. “We’re getting state of the art

equipment in the next budget, and rather

exciting new premises. I’ve said we need it to

keep ahead of the Japanese teams.”

Martin watched the monitor screen

as the capsule slid down into his gastric juices.

“This new capsule is better resistant

to hydrochloric acid,” White said. “Don’t

want you digesting this one too much, they’re

too expensive.”

Martin lay back on a raised bed as

Professor White controlled the movement of

the capsule and camera sliding through his

part digested bacon, egg and sausage.

“Beaumont?” Martin’s face was

sceptical. “You haven’t really named it after

the shard, have you?”

White winked. “Got to keep the

sponsors happy,” he said. “But just between

you and me… There’s another Beaumont, Dr

William. Look him up. It’s quite a story.”



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