In New York City in the 1840s, a physician named Dr. Austin Sloper flourished. In America, “you must either earn your income or make believe that you earn it,” and the medical profession—with its emphasis on both practicality and science—is an especially honored means of doing so.
James establishes the setting and one of the main characters, Dr. Sloper. He also introduces a major theme—the importance of earned income among the American upper class—and the centrality of science and reason to Dr. Sloper.
Dr. Sloper is a clever man, and because of this has become a local celebrity. He is witty and moves among the highest social circles in New York. He has led a fortunate life—as a young man, he married Catherine Harrington, a charming woman whose substantial dowry had helped Dr. Sloper establish his practice. Aside from the fact that he makes a good living, Dr. Sloper’s choice of profession is motivated by his desire to learn something interesting and to do something useful.
Dr. Sloper is intelligent and highly regarded within society. His medical skills speak for themselves, but he values social approval for its own sake, too. While he married for love, his wife’s income helped secure his social standing. At the same time, he works for a living, even though he technically doesn’t have to.
The Slopers’ first child, a promising little boy, died at age three, despite Dr. Sloper’s best medical efforts. Two years later, Mrs. Catherine Harrington Sloper gave birth to a daughter, Catherine, “an inadequate substitute” for the son, and died herself less than two weeks later. Though Dr. Sloper privately faulted himself for these losses, the broader community didn’t blame him, and his practice didn’t suffer.
The tragic losses of his wife and little son will haunt Dr. Sloper for the rest of his days, though other people understand that even a skilled physician can lose loved ones to illness. From the first time she is mentioned, Dr. Sloper’s surviving daughter is described as a disappointment to him, and her birth is couched in loss.