Boston of the 1830s is awash with immigrants, mostly poor and definitely under class in the opinion of the proper Bostonians of the time. Rose loves her sister Aurnia but has trouble believing that she married an ogre, who even now does not join them at the charity hospital where Aurnia is in a difficult labor. The scenes at the lying in ward are savage. Garretson is such a master at painting medical detail that you can almost smell the festering and purulence. In those days labor wards were virtual death sentences where women regularly died of childbed fever. Doctors did not know about germs or hand washing. Infection was unknowingly spread by the medical staff assigned to care for the women, dirty hand by dirty hand.

The mystery in the book is who is the woman buried in Hamill's garden and what happened to Rose Connolly and her family. But the real story is the development of the medical profession in the 1800's. Boston was a center for medical education then as now. There were famous professors willing to mentor the few, mostly upper class students who were accepted to medical school. But the patients could only be treated with a few concoctions and bleeding, the treatment of choice for almost anything. Of course, mostly the patients got better or not on their own, except in the surgical cases where, if the operation without anesthesia didn't kill them, infection would.

The physicians in America were trying to learn about the basics. How the muscles worked and how the organs looked. To do this they needed corpses for dissection. With the idea of donating one's body to science at least 100 years away, medical schools were reduced to purchasing material from whomever was able to provide it. This generally meant resurrections, men who dug up the newly buried for profit. As Gerritsen demonstrates it was a nasty business but one that in hindsight furthered medical science at a time when precious little was known.

The plot of ‘The Bone Garden’ is thick and labyrinthine in both centuries. In the present, Julia befriends an older gentleman who has letters pertaining to the earlier story. In 1830's Boston, Rose is a witness at one of a string of murders by a mysterious figure with a white death mask face and billowing wings who slashes victims stem to stern with cuts in the shape of a cross. The Boston police suspect a medical student, Norris Marshall. Marshall is one of the few students not from the upper layer of society; he is a reluctant resurrectionist in order to pay for his schooling. Margaret, the baby Aurnia gives birth to, survives her mother and becomes, for reasons that seem inexplicable, threatened with kidnapping or worse, when Rose refuses to give her up.

Tess Gerritsen is a physician and a writer. All of her books contain wonderfully detailed medical descriptions, most graphic and horrifying but all well written. In this book, I was fascinated by the history of medical education in America. It is surprising how little was know just 200 years ago compared to the current store of detailed knowledge we have of the workings of the human body. I liked that Gerritsen focused on the women of the 1830's who literally risked their lives giving birth and who had no way of averting pregnancy after dangerous pregnancy. That part I loved. I was not so taken with the scattered bits of the mystery plot itself. When ultimately we find out the murderer's identity, I simply could not suspend my disbelief that far. It was not, for me, believable.

I am not disappointed in the book as a whole even after the sighing over the ending. I learned a great deal and I got a peek at a period in history I knew little about. I met some strong characters and got to know a little about the physician Oliver Wendell Holmes. ‘The Bone Garden’ still gets my recommendation.

Janice A. Farringer lives in Chapel Hill, North Carolina, USA. A former contributing editor to January Magazine, she is a freelance writer and poet.