This piece is an open editorial to ourselves. Any serious work about Virginia Rappe and the Arbuckle case must include a medical history and that medical history was on trial in 1921–’22 and still on trial today. Unfortunately, there is not enough surviving evidence or documentation about Rappe’s medical condition and history to write authoritatively and whatever sounds good, even ex cathedra, is from the armchair. Still, the well-intentioned writer can posit what is known about Rappe’s health and medical treatment and make at least one conclusion: more than one person was responsible for her death, in which she, too, may have had a hand, albeit a small hand.

If Arbuckle wasn’t culpable for the death of Virginia Rappe, he certainly would have benefited from her going away quietly. For a moment, he had his way. Rappe, though in agony, was removed to room 1227 of the St. Francis Hotel—not the St. Francis Hospital a few blocks away. This move happened not long after the event occurred and the party then continued. A certain hubris took over any thought about her, one of “out of sight, out of mind,” and it is unlikely that any attendees seriously thought her condition was as grave as it proved to be.

The doctors who saw Rappe facilitated this hubris by acquiescing to the requests of party attendees that she be treated in a hotel room rather than be taken to a hospital. Rappe was on her own with no family members or guardian angels demanding that something be done immediately. That delay exacerbated the problem.

Arbuckle was not alone in wanting Rappe’s problem to go away. Al Semnacher and Maude Delmont remained at the party in room 1220. Though Delmont, still drinking, took the time to check on Rappe in room 1227.

The one physician who suspected a bladder rupture, Dr. Arthur Beardslee, was somewhat cowed by Delmont’s take-charge attitude. His suggestions that Rappe be taken to a proper hospital were rejected. Delmont took her directions from the people in room 1220, she was the self-assigned go-between. Rappe’s stay in Room 1227 lasted beyond the time that the party had broken up and the attendees including Arbuckle had left the city. So Delmont and Rappe were left behind in a hotel room with no means to pay. That is possibly the turn of events that triggered Delmont’s willingness to sign a murder charge. But while the party was going on, Delmont was still on the team so to speak, she still saw herself as a privileged insider, someone who could call Arbuckle “Roscoe” (she claimed to have been at Keystone in the early days), and as such reached out to an old friend, Dr. Melville Erskine Rumwell, a physician she believed would determine that Rappe’s condition wasn’t so dire.

Dr. Rumwell dialed back Rappe’s condition to “alcoholism,” which, in 1921, was approximately what alcoholic poisoning means today. He wasn’t a stupid man. This apparent misdiagnosis suggests he didn’t take much time examining her and wanted as little direct involvement as possible. As a member of San Francisco society, Dr. Rumwell was conscious of his reputation. Whatever Delmont’s friendship meant to him personally was now complicated by another woman, Virginia Rappe, and all seemed intent on wishing away the potential seriousness of the situation to avoid “notoriety.”

Whether Rumwell examined Rappe in room 1227 is moot. He did arrange for nursing care to relieve the burden on Delmont. That suggests Rappe’s care was elevated to something more than alcoholism.

When Rappe was finally transported from the St. Francis to the Wakefield Sanitarium, a private hospital, she would live for less than forty-eight hours. Rappe’s nurses were probably instrumental in convincing Delmont to allow for an ambulance. Her confidence, too, in her friend Dr. Rumwell—she called him “Rummie”—might have been shaken. But only a little. When she called two of his colleagues at Stanford’s medical school, they probably told her she was in good hands. He had assisted both men in surgeries and it’s unlikely they would have said anything to disparage his skills or diagnosis.

But Rappe’s nurses didn’t trust him anymore. The night nurse, Vera Cumberland, suspected neglect on the part of Rumwell, who had taken a break to attend a party as Rappe’s condition worsened.

Had he made a proper diagnosis the night he first saw Rappe, Rumwell could have ordered emergency surgery and she might have survived. She actually had a robust constitution. But by the time Rappe got to Wakefield, Rumwell might have realized it was too late to save her. He apparently didn’t put up a good show of bedside manners and one might speculate he was distancing himself to blur his responsibility in the matter.

According to Delmont, one of the last conscious requests that Rappe made was to summon her one known friend in San Francisco, Sidi Wirt Spreckels. Visiting Ms. Spreckels may have been a reason for Rappe’s presence in San Francisco in the first place. Newspapers reported that Spreckels was just back from France. She was also recently widowed and in a legal battle over her late husband’s estate with his first wife (now “Mrs. Wakefield”). Spreckels had also suffered the indignity of a sheriff’s auction of her furs, a pending lawsuit filed by Tiffany’s over an unpaid diamond necklace, and other woes that made headlines of their own. (Eventually, the estate lawyer, James McNab, the brother of Arbuckle lawyer Gavin McNab, informed Spreckels that her late husband was bankrupt.)

Despite the risk of additional “notoriety”, Spreckels came to see Rappe on the morning of September 9, 1921. What she saw was appalling, such that she returned to her apartment at the Palace Hotel and communicated with Rappe’s former fiance Henry Lehrman about the situation. He may have suggested or seconded Spreckel’s decision to bring her own doctor back to the Wakefield.

That Spreckels reached out to Dr. H. Edward Castle, another physician high in S.F. society, for a “second opinion” indicated the doubts she had in Rumwell’s judgment.

Dr. Castle noted the bruising on Rappe’s body but could do nothing for her. She may have already died or did so in his presence (the reporting on his first Arbuckle trial testimony is scant).

The only thing that plagued Dr. Rumwell’s conscience was the matter of an autopsy. Spreckels and Delmont urged him on and he eventually relented. But until Rappe was dead, the only care she received was palliative. In effect Dr. Rumwell was a hospice physician.

His virtual hands-off treatment played well into the hands of Gavin McNab during the three Arbuckle trials.

As far as Rumwell’s own career went after the trials, his volunteer work, and his exploits on the handball court of the Athletic Club disappeared. Indeed, his career grew strangely quiet.