The Empress and the English Doctor by Lucy Ward

A killer virus...an all-powerful Empress...an encounter cloaked in secrecy...the astonishing true story. Within living memory, smallpox was a dreaded disease.

Over human history it has killed untold millions. Back in the eighteenth century, as epidemics swept Europe, the first rumours emerged of an effective treatment: a mysterious method called inoculation. But a key problem remained: convincing people to accept the preventative remedy, the forerunner of vaccination.

Arguments raged over risks and benefits, and public resistance ran high. As smallpox ravaged her empire and threatened her court, Catherine the Great took the momentous decision to summon the Quaker physician Thomas Dimsdale to St Petersburg to carry out a secret mission that would transform both their lives. Lucy Ward expertly unveils the extraordinary story of Enlightenment ideals, female leadership and the fight to promote science over superstition.

FIVE MINUTES WITH lucy ward

INTERVIEW FOR PUSHKIN HOUSE BY ANDREW JACK (@AJACK)

How did you become interested in Russia?

I was a teenager in the 1980s, and - like everyone then - I was constantly aware of the Cold War and the narrative of Russia as an ever-present threat. I wanted to see it for myself. When I was 17, I asked all my relatives to club together to pay for an Intourist trip for me to Moscow and Leningrad. I was astonished as this almost mythical place came to life: familiar and yet so ‘other’. I couldn’t get it out of my system.  Later I went on the Trans-Siberian during a sabbatical, and then I lived with my family in Moscow in 2010-12, when relations with the West were relatively good. My children went to a Russian school, which was a wonderful doorway into the culture.

What inspired you to write the book?

I studied Russian history at school, and first learnt about Catherine the Great mainly in terms of her expansionist foreign policy, yet even then there were references to her relationships and the now-familiar sexual smears. It infuriated me. Later, as a lobby journalist at Westminster, I spent a lot of time thinking about women in power and how they get presented publicly, and reflected again on Catherine’s extraordinary political talent and public misrepresentation. After I came back from Russia in 2012, I met by chance (in a school playground!) a descendant of an English Quaker physician called Thomas Dimsdale, who was summoned to St Petersburg in 1768 to inoculate Catherine II and her son Paul against smallpox. I was gripped, and made her tell me everything. Eventually I was given access to the family’s archive, which included correspondence with Catherine and her medical notes, together with many of the gifts and portraits she gave her doctor. That amazing collection underpins the story.

How challenging was the research?

I signed the contract on the book at the end of March 2020, just as Covid-19 was starting. Everything shut – every archive and library, and I couldn’t make a second planned research trip to St Petersburg. Fortunately, in addition to the Dimsdale collection, I was able to access a wealth of documentation online: not only major Russian archives but, on the medical history side, the digitised records of the Royal Society, the Lind Library and the Royal College of Physicians. Eighteenth century newspapers proved an excellent resource: they show the economic and cultural impact of smallpox, and the competing adverts for inoculators as they increasingly fought to attract custom well beyond the elite. So I was able to get multiple perspectives. There is more research to be done on the spread of inoculation after Catherine’s campaign, but we know she had a significant impact through hospital-building and widespread inoculation programmes.

What surprised you?

It’s interesting in the context of the coronavirus pandemic to see how countries coped with a far more brutal virus: the economic consequences, the way towns, schools, markets and courts closed, and people consciously self-isolated; plus the emotional impact on families of losing loved ones. Most striking to me was how far medicine and public health efforts progressed thanks to inoculation in the eighteenth century. Understanding of contagion improved dramatically, and doctors even came up with plans to eradicate smallpox from Britain that involved track and trace, isolation and furlough. I found remarkable the speed with which Catherine recognised the potential of this technology, and her willingness to trust the numbers. She was very consciously rational, reflecting a combination of taking an educated interest in the science and being very clear about who she trusted as an expert.

How do you assess Catherine overall during the period?

By 1768, the time of her inoculation, she had stabilised her position after the coup that brought her to power. She had embarked on domestic reforms, was poised to begin flexing Russian muscles with the first war against Turkey, and was using cultural diplomacy to try to position Russia as a westward-facing European state. Her interest in the cutting-edge science of inoculation, symbolic of enlightened thinking, was part of that same mission. But her approach was subtle. She understood that inoculation is on the borderline between science and emotion, that it’s all about trust. She recognised the need to set a personal example. So through one action she protected herself and her son but also saw she could promote herself as a mother and protector of her people, in an extraordinary piece of statecraft. To go back to my first point, the most interesting thing Catherine did with her body, in my view, was to present it as a scientific case study. 

Do you see any contemporary lessons for Putin’s response to Covid-19?

Russia appears to have tried to discredit western vaccines, which then added to existing concern and scepticism within the country. Despite the Soviet Union having led the way in pushing for a global campaign to eradicate of smallpox, support for vaccination is always fragile. Russia has found itself having to row back and promote its own vaccines while still not recognising western versions. I was even approached regarding a possible TV version of my book to bolster positive attitudes to vaccination, but it would have replaced Thomas Dimsdale with a handsome young Russian doctor. While that might have made appealing television, it wasn’t actually true! It may be that politics can never be disentangled from public health, but using it around vaccination is exceptionally unwise and unfortunate. Other global leaders were falling over themselves to be photographed getting vaccinated, but not Putin. People can draw their own conclusions. 

Do you have plans for another book?

If anyone will give me a contract! I’m exploring another fascinating eighteenth century story that I stumbled across while researching my first book, and it’s set me off on a mission to save a painting. I like the idea of a handhold from one book to another.