Where the Light Enters

by Sara Donati

  “You are cranky,” said Dr. Channing. “Pour the tea and pull up a chair. I don’t doubt you’ll have your own version of this story to tell.” He turned toward Anna. “Pardon me, I should have introduced you. This is my nurse, Susan Wylie. During the war she worked under Miss Dorothea Dix on a half-dozen battlefields. After it was all over she came to work for me, but she never quit the habit of ordering people around. Stayed after this”—one hand lifted toward his eyes—“though I’ve tried every way I can think to send her off.”

  “There’s a lesson to learn in that.” Wylie glanced at Anna as she began to pour the tea. “Don’t think so much.”

  * * *

  • • •

  MUCH OF WHAT Dr. Channing had to say verified the history of the Camerons and Grahams that Jack and Oscar had cobbled together. James and Adele Cameron’s daughter Ruth had married a man called Hubert Graham, against her father’s wishes. Six short months after Ruth married Graham, Nora was born. Apparently Ruth had multiple miscarriages after Nora’s birth, until Neill came along some ten years later. Ruth died days later of childbed fever, and the husband not long after, of what, they never said.

  “So one day Cameron hears that he has two grandchildren, and his daughter is dead.”

  Nurse Wylie frowned at the knitting she had taken up. “Addy wanted to take the children in, but he only wanted the girl. The baby—Neill—was sent off to a nurse-maid in the countryside and then later to boarding school.”

  Anna said, “He never met his grandparents?”

  “Oh, now and then they allowed him to come into the city. But not often.” She sniffed loudly in disapproval.

  “If I may ask,” Anna said. “Did you know the Camerons well?”

  Dr. Channing stroked the cat on his shoulder. “I knew Cameron pretty well. I had the running of the Northern Dispensary for fifteen years—”

  “Sixteen,” corrected his nurse.

  “Wylie knew Mrs. Cameron well,” he finished.

  “That’s so,” said the nurse. “I saw a lot of Addy. She came to the dispensary, running errands for her husband.”

  Anna had wondered how her aunt had come to be acquainted with Channing, but now it made sense. The Northern Dispensary was directly across the lane from Amelie’s cottage and medicinal garden. She said as much to Dr. Channing, and he gave her a broad smile.

  “Oh yes, many times I was glad to have Amelie so close by when I had a woman in labor who wasn’t coming along. There was nobody better when it came to a bad presentation. I saw her turn babies stuck like a cork in a bottle.”

  Nurse Wylie hummed her agreement.

  “Where was I?” Channing asked. “Yes, Cameron. He was a strict Methodist, you will have heard that. But as long as his wife was alive I think Nora did all right.”

  “Adele Cameron was more than a good woman,” Nurse Wylie volunteered. “She was a saint, putting up with that bastard all those years.”

  “Wylie,” the doctor chided. “Forgive her, Dr. Savard. She was too long in the army, dealing with soldiers.”

  “I’ve heard far worse,” Anna said. She turned to the nurse. “So what changed when Mrs. Cameron died?”

  She stopped knitting and leaned forward. “Addy doted on that girl. Having her made up a little for losing Ruth. Whenever she came by the dispensary she’d have to tell me about her granddaughter, how smart Nora was, how quick to learn. She could do sums in her head, pluses and minuses and divided bys, backward and forward. The girl could read before she was big enough to hold a book by herself, and she was overflowing with questions, wanted to know how everything works.

  “The problem was, the two of them had to keep it all hid away from Dr. Cameron. To his way of thinking a woman ain’t worth a tinker’s damn beyond cooking, cleaning, bearing children, and raising them. A woman who wanted to go to school was risking hellfire, is how he saw things. But Addy protected the girl. Then she died, and everything changed.”

  Anna did not want to feel sympathy for Nora Smithson, but it was hard not to imagine the life she had led. Orphaned, she had been fortunate to have grandparents willing to take her in, but in the process she had lost her brother. Her grandmother had encouraged her and loved her, but for too short a time to make a lasting difference. Finally Nora was left to the less-than-tender mercies of a grandfather who despised her on principle. An intelligent young girl deprived of every outlet, pressed into nursing, and at the same time, no doubt, she had had full responsibility for the household and her grandfather’s care.

  Anna said, “She was protective of her grandfather. He was all she had, after all. He stood between her and living on the street. She had no choice but to be the things he expected her to be. But at some point Neill came back. How did that happen, do you know?”

  Dr. Channing said, “I heard about it from Cameron. One day he got a letter from the grandson, who was still at boarding school. Saying he wanted to become a doctor and would his grandfather guide him. Cameron liked that, so the boy came back to the city and enrolled in college.”

  Nurse Wylie said, “So you see how it was. Here’s Nora working herself to death for years, getting nothing from Cameron except sharp words when his dinner is two minutes late—because she’s been at his beck and call all day—and her brother comes dancing in and gets everything.”

  “I imagine she must have been very angry,” Anna said. “Even if she couldn’t admit it to herself.”

  “Anger drives her like steam drives an engine,” Dr. Channing said.

  “This all makes sense,” Anna said. “Until you come to the day she went to Amelie on the point of no return with septicemia. From the day-book we know that Amelie sent Nora to see you, Dr. Channing. Can you tell me anything about that? She did come to you?”

  “She did,” he said.

  There was a longer silence.

  “I’ve got a copy of the relevant day-book pages here. Would you be willing to look at them and tell me whether they agree with your memory of events?”

  She took the folded pages from her Gladstone bag and almost made the mistake of handing them to Dr. Channing. “I can read them to you, or if you’d prefer that Nurse Wylie—”

  “Oh, go on and read,” said the nurse. “My eyes aren’t the best anymore.”

  When she had finished reading, Channing said, “Yes, that’s about right.”

  “So in your medical opinion, she is barren.”

  He considered for a long moment. “The inflammation left her with deep scarring to the cervix and uterus. I doubt her fallopian tubes fared any better. I would be shocked if she could conceive, much less carry to term.”

  Anna was unsure how far she could go with her questions. There was one issue in particular that no one had raised that Dr. Channing might be able to answer: the identity of the man who had got a child on Nora. For the moment, she decided, she needed to focus on the medical history. “Did you write notes for Amelie about the case?”

  He nodded. “As always. I take it Amelie didn’t share those with you.”

  “She wouldn’t. I’m sure she’s had many sleepless nights about revealing as much as she has.”

  “But I would have given permission if she had asked,” said Dr. Channing. “I am perfectly willing to share my notes with you on this case, as brief as they are. What I won’t do is discuss Amelie’s notes.”

  Anna wasn’t sure she understood the distinction, but for the moment she put that aside. “You are willing to—” She considered what word to use here, and decided not to soften the question.

  “You are willing to violate a patient’s privacy?”

  He wasn’t offended, she was glad to see.

  “Her right to privacy does not outweigh the threat she poses to others. We are not talking about monomania.”

  Anna hesitated.

  “You disagree?”

  “I think she d
oes suffer from monomania,” Anna said. “She is obsessed with pregnancy and motherhood, to the point of delusion. But it seems that her troubles began with her grandfather. To have forced an abortion on her against her will or even her understanding until it was too late, that is an insult that will have long-lasting repercussions for such an intelligent young woman. Her derangement is emotional, not intellectual.”

  “And still, if she has done harm to her husband or brother, the only possible diagnosis is delusional insanity,” Dr. Channing said.

  Anna sat back while she came to terms with that idea. Over the last few years there had been changes to the criminal code that required the courts to consider the sanity of anyone accused of a violent crime. When a father killed a five-year-old son because the voice of Moses of the Old Testament had told him he must, a commission on lunacy was appointed to examine his state of mind and determine whether he could be held accountable. Doctors who specialized in diseases of the mind were called to testify. Dr. McDonald, the superintendent of the Ward’s Island Insane Asylum—a place she would not send a rabid dog—was someone whose name appeared in the newspapers with increasing frequency. What would someone like McDonald make of Nora Smithson?

  Certainly it struck Anna as appropriate that such questions be raised, but there was so little medical science understood about the workings of any mind, much less a deranged one. How was it possible to distinguish between true insanity and a sane person without conscience or remorse? She would not like to have to testify for or against Nora Smithson on this subject. She didn’t know any doctors who were qualified to do so, though some claimed that expertise. The very idea of a commission on lunacy was in itself nonsensical.

  She tried to collect her thoughts and focus on a crucial starting point.

  “If moral insanity is her diagnosis, you must believe she is capable of violence.”

  “I know that she is,” said Dr. Channing. “She suffers from delusions of persecution and sees threats everywhere—but especially from doctors, nurses, and midwives. Some months after Amelie sent Nora to me so I could take over her care, her grandfather showed up at the dispensary with serious wounds to his right hand. You were in reception when he came in, weren’t you, Wylie?”

  Nurse Wylie’s knitting needles began to clack more rapidly. “I was. He stood there spouting like that stuck pig people are always talking about.”

  “He wasn’t in danger of his life,” Channing said. “It took some twenty stitches, but he healed well enough.”

  “Dr. Channing, please.” Wylie shook her head as if she despaired of her employer’s good sense. “Of course Cameron was in danger of his life. She slashed his hand with a scalpel, three times. And a dirty scalpel it was, too. The muck I cleaned out of those slashes would have got into his blood and septicemia would have done the rest.”

  “You never told me that,” Dr. Channing said, his tone verging on peevishness. “I didn’t see him until you cleaned him up.”

  While they argued this point Anna wondered how she could put what she was thinking into a reasonable question.

  “You mean to say Nora attacked her grandfather with a scalpel.”

  “Oh, yes,” said Wylie. “He bleated about it to me. Said he didn’t know what got into the girl.”

  Anna was glad, in that moment, that Dr. Channing couldn’t see her and that his nurse’s attention had returned to her knitting. She was sure her own expression would give away more than would be wise, just now. Three strikes of a dirty scalpel, that was too vivid and familiar an image to ignore.

  She cleared her throat. “Dr. Channing,” she began. “Do you happen to know how big a part Nora played in her grandfather’s medical practice? Was she involved in treating patients?”

  “She was. Especially after the injury to his hand.”

  Wylie snorted softly. “Couldn’t hold a pen much less a scalpel. No, it was all Nora toward the end.”

  Anna said, “Her brother is a surgeon. Maybe he assisted now and then?”

  Neither of them seemed to have an opinion on this, but there was no time to approach the question from a different direction; the clock on the mantel struck nine and Anna remembered where she was supposed to be. She said, “Dr. Channing, might I have a copy of your patient notes for Nora? I could stop by tomorrow if that would be convenient.”

  “You can take them now,” he told her. “As soon as Amelie’s letter came I had Wylie copy them out for you. But I hope you’ll come back. A little conversation now and then keeps me going.”

  * * *

  • • •

  ANNA KNEW THAT her family would be waiting for her at Sophie’s, in the house that everybody referred to as Doves, thanks to Lia. Whose brother was about to leave this world.

  And still, walking through Stuyvesant Square, she stopped to sit on a bench that she knew very well. As students they had escaped to this very spot whenever a free quarter hour and good weather happened to coincide. No doubt it was still popular with the medical students. Probably Elise sat here now and then.

  It was Elise who had brought the mention of Dr. Channing in Amelie’s day-book to Jack’s attention. Clever Elise. That slender thread, followed to its end, had revealed things Anna had not let herself consider but now would never be able to put out of her head.

  Jack and Oscar had marked James McGrath Cameron as the primary suspect in the multipara murders. Neill Graham was a less likely but still viable suspect, and that was before they knew of his connection to Cameron.

  Nora Smithson they saw as someone who could solve the case; as her grandfather’s nurse, she could have testified for the prosecution before his death, or at the very minimum, documented his crimes afterward. They had asked to see Cameron’s medical office records, but she had claimed that they had all been destroyed.

  The idea that Nora might have murdered nine women in a way calculated to cause as much pain as possible had not occurred to any of them.

  Women could be violent and cruel; Anna saw that for herself, day in and day out. They hurt those closest to them, and themselves. But these crimes were beyond the pale and Anna could hardly imagine how they came to be. She thought of Janine Campbell, an exhausted mother of four little boys and wife to a man who treated her with less care and respect than he would have expended on a hunting dog. Janine risked everything to save herself and her sons, and handed over money to Nora Smithson in payment for services to be performed.

  Had Nora stayed in the background and let her grandfather talk to Janine? Had he examined her in his gruff way, reciting Bible verses to her? Once ether had begun and Janine was insensible, did he simply leave the room and let Nora perform the surgery, or had he directed her every move?

  Without a doubt, Anna knew that it was Nora who had carried out that fatal final step: three stablike incisions between the uterine horns penetrating into the bowels, flooding her with fecal bacteria.

  When her grandfather died, Nora had stopped. Whatever mania drove her, it had not yet overwhelmed her capacity for self-preservation. Without her grandfather’s name to draw in patients, without his office and surgical instruments, she had stopped. Or at least, Anna must consider the possibility, she had changed her methods. It was all too possible to imagine that the person who had caused nine painful deaths would go on to tie down an innocent for months on end, injecting her with morphia to keep her quiet. Because she wanted the child Nicola Visser carried, or she wanted to see her suffer?

  Sophie’s notes on her examination of Nora Smithson had included a direct quote, the answer she gave to Sophie’s question about pain. Of course she was in pain, Smithson had said. And quoted the Bible:

  In sorrow thou shalt bring forth children.

  There were institutions that took in the criminally insane. The most she could hope for Nora Smithson was that she would live the rest of her life in one of those places. Or, if she was honest with herself, Anna
must admit that death would be preferable. The Bloomingdale Lunatic Asylum had been shut down in 1880 after a newspaper article exposed horrific conditions and systematic mistreatment of the inmates, but Anna doubted conditions were much different in any of the insane asylums, except those that catered to the very wealthy at a very high price. That would be beyond Nora’s means; she would be committed to one of the state asylums. Confronted with the hangman’s noose or a place like that, Anna knew that she would choose death for herself.

  But what would become of Nora Smithson was a problem for the courts, and only if Jack and Oscar could assemble the evidence to convict her. After a year of listening to them talk about their cases, she understood the most basic elements necessary to establishing a criminal charge. Means, motive, and opportunity must be proven as a starting point. Means and opportunity would present no difficulties, but explaining the motive would require discussion of subjects most men would reject out of hand.

  Anna was neither detective nor lawyer. As a physician she had nothing to offer; her knowledge of the anatomy and physiology of the brain were useless when it came to the mysterious workings of the human mind. What drove one woman to suicide and the next to murder, that was a question she thought must have to do with anger, and whether it was turned inward or outward. She had only her intuition as foundation for this theory. Science had not come so far, and might never.

  And still, lawyers would call on doctors to testify. The prosecution would pay alienists to declare that Nora Smithson was sane and responsible for her evil acts; the defense would do the opposite.

  Finally Anna got up and continued on her way to Doves, wondering how she would tell Jack about this newest development in a household of people clustered around a dying boy.

  It was when she came to cross Seventeenth Street and she looked up that she saw Noah Hunter, who stood at the front door, hanging a wreath wrapped in white silk. White silk, for the death of a child.