Читать книгу The Healing Season - Ruth Morren Axtell - Страница 11

Ian dipped his pen into the inkstand.

Under the heading Respiratory Disorders, he wrote “Consumption and Phthisis.” Beside it he jotted the number three, the total number of cases he had seen that day. Next he wrote “Pleurisy and Pleuritic fever.” One case. “Catarrh.” Two cases.

Thankfully, the weather was still warm, so the dispensary hadn’t yet seen many respiratory cases. That would soon change as late summer gave way to autumn.

The next category was gastrointestinal. Several cases of colic, diarrhea, and worms among the infants and children. Two deaths. The columns grew. Ian pushed away from the desk in frustration. Too many children were dying.

His uncle had taught him the importance of meticulous record keeping. Although many times the number of fatalities was discouraging, Ian knew in the long run the only way to convince officials of the need for decent living conditions was to show them hard numbers.

At least more and more parents were bringing in their sick children. When he’d first opened the dispensary, the only children he’d seen were the ones on his visits to people’s homes. The people were used to hospitals and physicians refusing to treat children, claiming they were too hard to diagnose. He had found the opposite true. By paying close attention, he had found that many times their symptoms were actually more evident than in their adult counterparts.

He continued to record the day’s cases. Surgical treatments included ten broken bones set; eleven bruises; two head injuries; five tumors, of which three were untreatable, the other two possibly operable; six toothaches, with two ending in extraction; four leg ulcers; two abscesses.

He had scheduled one amputation tomorrow. A man had smashed his hand in a doorway, and now gangrene had set in and the arm begun to turn black. Even though amputation was always used as a last resort, in this case there was no help for it, if the patient’s life was to be spared.

He finished recording the day’s patient histories, scattered some pounce over the writing and dusted it off. He eased the kinks in his shoulders as he placed the pen back in the standish.

Taking a few moments to massage the back of his neck, he found his thoughts straying once again to Mrs. Neville.

Over the past few days since meeting her, her pretty face kept floating into his thoughts at odd moments of the day. No, not pretty, he corrected himself. Beautiful. She was the most exquisitely formed creature he’d ever beheld. Each time she looked at him, he was startled afresh by her silvery eyes, her delicate features, her golden hair.

Her figure was slim and dainty. Everything was pleasing to the eye. Even when tired and disheveled after assisting him, she still managed to look fresh and appealing.

He rubbed a hand over his jaw, knowing he had to get his thoughts under control. It did no good daydreaming about an actress. She might look pure and innocent, but he knew how deceptive the image was. Actresses were little better than prostitutes he reminded himself for the countless time.

But try as he might, he couldn’t seem to block her image from his mind.

Thankfully, he hadn’t run into her since the street riot, although he’d been to check on Miss Simms a few times. He’d had to stifle the sense of disappointment, for he knew she visited because Miss Simms waxed eloquent over how kind and generous “Eleanor” had been to her, coming to see her each day. It seemed most of her visits were reserved for late evening after a show or early afternoon before she went to the theater.

“Halloa!” a voice called from the doorway.

Ian looked up to see his friend’s tall frame leaning against the doorway.

“You looked so deep in thought I was afraid to disturb you, lest you be on the verge of discovering a new surgical technique that might aid all of humanity.”

Ian made an effort to chuckle. “Nothing of the kind. I’ve just finished up with the records for today. Come in, Henry, don’t stand there.”

Lord Cumberland eased away from the doorpost and maneuvered himself over to a chair in the cramped room that passed for an office. He sank down with a contented sigh as if the few moments standing had tired him out.

“Too many hours spent doing nothing?” Ian teased, eyeing Henry’s evening clothes. He was about Ian’s age with short-cropped hair cut in the latest fashion.

Henry grinned back shamelessly. “Doing nothing is an art form. Didn’t Byron say that? If he didn’t, he ought to have.”

“I keep telling you to find a useful occupation.”

Henry sighed. “And I keep telling you if you’ll only let me introduce you into society, I’d have a Herculean job on my hands.” He rubbed his hands together. “It would offer me just the challenge I need since the battlefield.”

Ian closed the ledger and set it aside, refusing to rise to the familiar bait. He leaned back in his chair. “So, what brings you to these humble surroundings this evening?”

“I come to invite you to a gathering of intellectuals, artists, and the pink of the ton.”

Ian yawned, used to these invitations, which he invariably turned down. It was a game between them by now, he supposed. “Let me guess. It’s being held at the home of the Duchess of Longworth, and she’s simply dying to meet a lowborn surgeon from St. Thomas’s.”

Henry snorted. “Lowborn, indeed. My wealthy and titled friends and acquaintances would love nothing better than to listen to an eminent surgeon who has not only trained on the battlefield but has been to Paris and brought back the latest techniques. They are agog at the thought of all those postmortems performed at the great teaching hospitals. I keep telling you, anatomy and pathology are all the rage. Bring some of your wax models and let the layman understand the mysteries of the human anatomy.”

When Ian said nothing, Henry continued. “There’ll be quite a crowd. It’s being held at Somerset House. You’ve never been there. We can cross over the new Waterloo Bridge. You’ll see the house in all its splendor, its colonnaded facade lit up over the Thames.

“It’s a rare opportunity. I wouldn’t be surprised if Prinny himself showed up. Come on, old boy, you know you’ll never get the funds you need for your children’s hospital if you refuse to go where the money is.”

“I doubt I’ll make much of an impression if I stand among them to lecture. They’d be bored silly.”

“Don’t be totty-headed! You know yours are some of the most popular lectures at St. Thomas’s.”

Ian was tempted, more than he’d ever been. After two years back from the Continent, he was finally willing to concede that public awareness had to be raised to the overcrowded condition of the poor if change was to come to the city.

“By the by, I read your article in the Medical Journal,” Henry remarked. “You might not think so, but many of these aristos read such journals. This is your opportunity to be among them, answer their questions, let them see you not as a fanatic, but as the dedicated surgeon you are.”

They argued good-naturedly for a while longer. Finally Ian rose with another yawn. “I’m sorry, but not this evening. Perhaps another time. I still have some work to do at home before I turn in.”

Henry stood as well, his look eager. “You mean that? I shall stop pestering you if you give me your word you’ll accompany me the next time I invite you to a social event.”

Ian looked at Henry a moment. What did he have to lose, anyway? Another evening’s work? But what might he gain? He gave Henry a brief nod. “Very well. The next time I’ll go wherever you say.”

Henry clapped him on the back. “That’s the way, old man. You won’t regret it. After all, I’m building your reputation each time I’m among the ton.”

Ian extinguished the lamps and locked the dispensary behind him. He felt for his watch and once again remembered it was gone. It must be near nine in the evening.

He bid Henry good-night, refusing his offer of a ride. He lived only a few doors down.

His neighborhood was one of the most gin-soaked in the city. Prostitutes and men headed in or out of the taverns. Many would end up in the roundhouse by evening’s end. Some children called out to Ian and waved.

He returned their waves. “Time for you to head home to bed,” he told them.

“Aw, Doctor, it’s too early for bed.”

He said nothing more, knowing that some had no home to turn in to, and the ones who did never knew what they would find there.

He picked up his pace, thankful the nights were still mild. Soon, the autumn chill would seep into bones, bringing with it coughs and fevers.

When he entered his house, he greeted Mrs. Duff, his housekeeper.

“I’ve put a snack for you in the study,” the plump, cheery-voiced woman told him as she helped him off with his coat. “If that will be all, I’ll be leaving.”

“Yes, thank you. I won’t be needing anything further.” He bent over and scratched the cat who was rubbing himself against his leg.

“Hello there, Plato.” The tabby, which had been a stray, immediately began to purr as Ian scratched behind its ears. “Had a long day? Any mice for dinner?”

The two continued enjoying each other’s company for a few minutes before Ian straightened and proceeded up the stairs. After washing up, he went to his study.

As he ate the bread and cheese and munched on the apple left out for him, he read the latest medical journal. As soon as he’d finished, he turned eagerly to the package that had been delivered in the mail. It was postmarked France.

He still corresponded with a doctor he’d met at La Charité, one of the largest, most successfully run hospitals on the Continent if not the entire world. He clipped the strings of the oblong box and slit the wrappings with a penknife. He opened the box and drew away the wadded-up tissue paper. Carefully he took out the long cylindrical instrument, which resembled a flute. He turned it over in his hands, studying it curiously. Could it be a musical instrument?

After examining it a few moments, he dug around the box and found a letter. In it, his friend described an exciting new invention by the great physician Laennec. Ian had met him in Paris and observed his care and skill with the wounded French soldiers at Salpetriere Hospital.

The instrument was to aid in “auscultation,” a term created by the physician to describe the process of interpreting the sounds emanating from the body cavities, especially the lungs. Laennec called the new instrument the stethoscope, an “observer of the chest.”

Ian held up the instrument with a new sense of awe. He placed it to his ear as his friend described. How he wished he had a patient with him at that moment. His gaze fell on Plato, who was curled up on his desk, breathing in and out rhythmically.

Ian placed the other end of the long tube, which his friend said the French were calling le baton, at Plato’s chest. The cat stirred and stretched. This gave Ian better access to his chest cavity.

Sure enough, the sounds of heartbeat and breath became magnified, greater than Ian had ever imagined from the current method of putting one’s ear to a patient’s chest, which respect for modesty many times prevented.

His thoughts raced ahead, imagining the possibilities between the relatively new technique of percussion—tapping one’s fingertips against a patient’s chest wall—and now this incredible little baton-shaped object that could increase the interior sounds of a human body.

He reread his colleague’s letter. Nothing had yet been published on the stethoscope. Laennec hadn’t even given any public lectures. But those who worked with him were amazed at the range of diagnostics available with the use of the baton. He described the differences being distinguished in the various diseases of the chest. The lungs of a consumptive had their own distinctive sounds, those of a pneumonic another.

Ian placed the instrument carefully back in its wrappings. Tomorrow he would take it with him on his rounds after surgery.

After he’d cleared off his desk, he headed to the other side of his study and lit the lamps in that area.

Sitting down at his microscope, he began examining the different cultures he’d brought home with him from the dispensary.

Gangrenous matter, ulcerous tissue, a rotted tooth, a slice of a tumor he had cut out and preserved in alcohol. He stared at the tiny orbs moving about under the lens, the different striations, the tiny world brought to visibility under the specially ground lens. He stared fascinated, carefully describing each sample in the notebook at his side.

How did the tissues form abnormalities, the illness attack the healthy organs? These questions challenged the best physicians and surgeons of his day. He compared the healthy tissue to the diseased; he read every journal with the discoveries of his colleagues across the Channel. He thought back to the years he’d spent in France, visiting the large teaching hospitals, studying the effect of spacious wards and good ventilation.

He compared the diseases of the poor in the City with those of the wealthy.

He could only come to one conclusion. The filth and squalor of the living conditions of the poor contributed much to their illnesses and mortality rates.

As the clock struck midnight, Ian finally rose and stretched, realizing how little he knew—how little any of them knew.

When he’d put everything away, burning the putrid matter and washing his slides, he sat back down at his desk and drew forward his Bible.

He opened it to where he’d left off the previous evening and continued reading. The stories of Jesus’ earthly ministry never failed to fascinate him. A pastor, physician, teacher, exhorter, prophet—all in one man. The part of Ian that yearned to preach to the masses the way his father had, rescuing souls from eternal damnation, met the physician in him who wished to cure every bodily illness that caused such human suffering and premature death in the world.

“And the whole multitude sought to touch Him: for there went virtue out of Him, and He healed them all.”

Ian gazed at his own hands. Would that virtue flowed out of them to heal all he ministered to. Where had that healing power gone to since the days Jesus walked the Earth?

Despite the excitement of the new inventions, how paltry they seemed in light of the healing power of God. These instruments served to better illuminate disease, but they did nothing to hasten a remedy.

What had happened to the church in the intervening centuries that had caused the disappearance of the miracles of Jesus’ ministry?

Ian sighed as he closed his Bible. He had surgery tomorrow and must be up early. He needed to get some sleep.

First, though, he bowed his head and clasped his hands atop the black cover of his Bible.

Dear God, I thank You for Your hand on my life. Please continue guiding me in Your perfect will. His prayers turned to the more pressing cases he’d attended to that day and he prayed for each patient.

Another face kept intruding.

Dear Lord, I don’t know the state of Mrs. Neville’s soul. I don’t know why I keep thinking of her. Ian rested his head on his clasped hands. If it’s wrong, take the thought of her from me. Purify my thoughts of her. Let me see her as another soul that needs to know of Your goodness and mercy. Oh, God, make Yourself real to her. Bring her to repentance and salvation in Your dear Son, Jesus’, name.

Though his prayer had ended, thoughts of Mrs. Neville persisted for quite some time before he eventually fell asleep.

Eleanor and her daughter passed the fields at a brisk clip. The top of the carriage was pushed down to receive the afternoon sun. The two had just enjoyed an ice at a confectionary shop at the nearby village.

Eleanor gazed at her ten-year-old daughter in admiration. Sarah looked fetching in the new bonnet and parasol Eleanor had brought her. They matched Eleanor’s exactly.

Sarah had thought that stupendous. Now she twirled the parasol around, laughing in delight each time they passed a farmer in his field. She waved at all they rode by, human and animal alike.

The leaves on the poplars shading the lane were just beginning to fade from green to yellow.

“Oh, Aunt Eleanor, may we stop here for a moment,” she cried, pointing to a lovely willow-lined pond.

“Of course we may.” Eleanor immediately bade the coachman to pull over.

They descended the coach and waded through the tall grasses until reaching the pond. They found a dry bank to sit upon and watch the ducks swimming lazily across the dark water.

“Tell me again about my mama and papa,” Sarah said in the soft tone she always used when speaking of her real parents.

Eleanor looked down at the dark-eyed, dark-haired girl with the dimpled smile. How Eleanor loved that smile. She didn’t know whom Sarah took after, but she was eternally grateful she had nothing of her natural father’s looks—ugly, lecherous knave that he was.

Eleanor put her arm around the girl, who never tired of hearing the tale. “Well, let’s see…your mother, she was the most beautiful lady I ever met—even prettier than the most fashionable lady of the ton. She had your hair and eyes. How they sparkled when she smiled, just like yours.” She squeezed Sarah’s shoulders.

“More importantly, she was lovely inside, too, where it matters most.”

“And you were her best friend?” asked Sarah the way she always did at that point.

“Yes. Although she was about five years older than I, we became fast friends from the day we met. We told each other everything, just the way you and I do now. She was married when I first met her. She’d made the most brilliant match, a true love match. Why, it was more romantic even than Princess Charlotte’s to Prince Leopold.”

She could feel Sarah shiver beneath her arm. “Ooh! How romantic! How did they meet?”

“It’s funny, because in a way it was the same as the princess met the prince. Your father, too, came from a far-off land similar to Coburg. Transylvania, deep in the Carpathian Mountains.”

“Transylvania,” breathed Sarah. The very syllables sounded romantic.

“Count Otto von Ausberg from Transylvania was tall, dark and handsome. He had the bearing of a prince. Oh, did he look handsome in his gold-braided uniform, just like we saw Prince Leopold when he first came over to court Princess Charlotte!”

They smiled at the memory of seeing him beside Princess Charlotte, waving at the crowds from a balcony at Carlton House, when he was the Prince Regent’s special guest.

Eleanor sighed to heighten the drama of the tale. “Alas, your papa was a poor, impoverished nobleman like Prince Leopold when he first came to London.

“Your mama’s parents, on the other hand, were ever so rich. They disapproved of a match between your parents. But your mama and papa were so very much in love. Finally, they were forced to run away together. They were poor, but so happy together.

“I never saw a couple as happy as they—until they had you!” She turned to Sarah. “You can’t imagine any more joy, but there it was. When you arrived, they were even more full of joy.”

Sarah’s smile disappeared. “But then came the sad part.”

“Yes, my dear, then came the sad part. They both died from an awful outbreak of fever that year. Your mother first then, within a week, your father. I had taken you away at the first sign of illness. Your mother begged me to. She didn’t want you catching it, you were such a wee baby.”

“Why didn’t you keep me as your own?”

“Oh, my dear, how I wish I could have, but I was just a girl myself. I had no husband. So I did the next best thing I could. I found a couple for you to stay with. Mama and Papa Thornton could offer you a nice home and family until someday you would be grown up enough to come and live with me. Since the day I brought you here, I’ve come and visited you every week.”

“Yes. I do so love your visits.” Sarah played with the tassel at the end of her parasol. “What about Mama’s family?”

“Her parents had died after your mama ran away. They had no other children, so there was no help from anyone on that side. You were all alone in the world.” She wondered if Sarah would still believe every detail of this story as she got older. Eleanor hoped that with the repetition, each fact would become so engrained in Sarah’s memory, it would be impossible to question the veracity of the tale.

She patted her knees. “Well, we’d best continue back. Mama and Papa Thornton will wonder what’s keeping us. We don’t want to be late for tea.”

Sarah scurried up and gave Eleanor a hand. The two dusted the grass off each other’s skirts, then headed back to the carriage.

When they arrived at the prosperous farmhouse where Sarah lived, they were greeted by a married daughter of the Thorntons who had come by for a visit. Sarah ran off to show the woman’s two daughters her new parasol. Eleanor followed Mrs. Thornton and her daughter to the large kitchen in the back.

Mrs. Thornton poured them each a cup of tea. “Eleanor, you mustn’t bring Sarah so many fancy gifts each time you come to visit her. Her wardrobe can scarcely contain the gowns she has.”

“Oh, Louisa, I can’t help it. I see something pretty and I immediately think of Sarah.”

“It’s not right,” Mrs. Thornton said with a shake of her head. “She needs to live at her station. Look at my daughter Lydia’s children. They’re not poor by any means. They’re well dressed, clean and proper behaved. You couldn’t ask for anything more. But they’re not rich and they don’t go acting as if they are.”

Lydia nodded in agreement.

Eleanor pursed her lips. This subject had come up more than once of late. She looked forward to the day she could take Sarah away for good to live with her. Soon.

“Well, in another year or two, Sarah will be going away to Miss Hillary’s Academy for Young Ladies,” Eleanor replied in her most soothing tone. “There she will be on an equal footing with all the young ladies.”

“Humph,” was all Mrs. Thornton said. But she didn’t remain silent long. After a sip of tea, she added, “What good will it do Sarah to study amongst all those lords’ and ladies’ daughters, when she don’t come from the same world? When they have their come-outs, where will Sarah be? Right back in this village but with notions way above her station. She won’t be able to follow her new friends from the young ladies’ academy. They certainly won’t welcome her into their circle when they know her humble parentage. No high-and-mighty lord will have her for his wife.”

“There are plenty of respectable young gentlemen she can marry,” countered Eleanor, who had given her daughter’s future lots of thought over the years. “She could marry a solicitor or a—a—doctor—” A fleeting image of the one she had recently met invaded her thoughts. “There are many men who are not of the ton, but who are gentlemen nonetheless.”

“But will she have them if her head has been filled up with such notions of society, starting with all these tales of her own ma and dad? I’ve been saying it for years, dear Eleanor, you haven’t done her any good telling her those Banbury tales.”

Eleanor gave a careless laugh. “Louisa, you worry too much. I have it all figured out. Sarah will go to Miss Hillary’s school and she’ll move to London with me. By then I shall have a nice place in Mayfair. When it’s time for her come-out, I shall put out discreet inquiries and I’m sure we’ll meet several eligible young bachelors.”

“Who’ll be wanting to know the amount of her dowry.”

Eleanor sat up straighter in the ladder-back chair. “I have been putting money away for her since she was an infant. She’ll have her dowry.”

Once again Mrs. Thornton harrumphed, but said no more.