“Sister Mary…” Nick hesitated. But she was intelligent. And devoted to her duty. “I assure you that you’re wrong. Illness is not merely what we can see. It’s not just based on the symptoms the patient reports and the patterns we build up of those symptoms. The best medicine requires an understanding of what happens inside our bodies and what we can learn when peering through a microscope.”
“The study of anatomy,” she said.
She was looking straight at him now. Nick was quite sure they were both thinking the same thing. The word anatomy hung in the air between them. “Yes,” he said, making no effort to avoid her gaze. If he backed off now, he would simply confirm her worst suspicions. He suspected the Catholic Church, along with all the rest of the clerical establishment, to be virulent in its condemnation of what it would see as showing disrespect for the dead.
Sister Mary seemed to make a conscious decision to avoid the perilous topic. She drew a deep and audible breath. “We seem to have strayed from the subject, Dr. Turner. You believe then that despite their having no symptoms except for this prickly rash, the children are diseased?”
“In a manner of speaking. This irritation may come from some sickened internal organ, but I can’t say that for sure, and frankly I doubt it. What I’m quite convinced of, because of previous observation, is that they are passing it to each other through ordinary contact. Or that you, in all innocence may have passed it from one to the rest.”
“Me!”
“You, Sister. That’s why I want you to wash your hands between putting soothing lotion on one and then another. You told me you were using calomel.”
“Yes. It’s the usual recommendation, is it not?”
“It is. Exactly the right thing. But if you touch the rash on one child and then touch another who is not infected, you transfer the germs.”
She had grown quite pale. “It is…almost unthinkable.”
He’d been afraid she would say diabolical. And mean exactly that and go screaming to the priest she’d considered consulting earlier, which would probably get him tossed out on his ear and forbidden to return. A pity if that happened, he quite enjoyed coming to St. Patrick’s Orphan Asylum. “It is a problem easily remedied,” he promised, as cheerfully as he could. “Ordinary soap, Sister Mary.”
There was a sharp rap on the door, and it opened before either Nick or Sister Mary could say a word. One of the older girls stepped in and bobbed a quick curtsy.
“’Scuse me, Sister Mary, he’s wanted. Right away.”
“Dr. Turner, Elizabeth. Not he. And wanted by whom?”
“A man, Sister. At the door. Mother Louise sent me. Said to tell him—I mean Dr. Turner. Mother said I was to say his cousin needed to see Dr. Turner at once. On an urgent family matter.”
Chapter Eleven
THE SAME TINY and beautiful and exotic creature Nick had treated when she was in danger of bleeding to death from a botched abortion was on the floor, huddled in a corner beside the elaborate bed draped in red. There was not enough light for him to see anything very clearly, but he had no doubt about the distended abdomen visible beneath a covering of silk shawls and wrappings. This time, despite his instructions to Sam Devrey about coitus interruptus, she had carried a pregnancy to term. And her moans made it apparent she was in labor. “How long has she been like this?”
Sam turned to Ah Chee. “How long exactly? Since the first pain.”
Ah Chee could not take her eyes from the big this-place-red-hair yi. Very too much confusion in her head. Should she weep for her plum blossom or thank Chuan Yin for a miracle? Red-hair yi stopped blood last time. Unless he do that little supreme lady tai-tai already dead. But very terrible joss for there to be men in the room when the baby came. That’s what she told the lord when he arrived while the birthing was still going on. But the plum blossom screamed and screamed, and the Lord Samuel stayed outside the bedroom for shen hour and you and xu. Then couldn’t wait anymore and went into the bedroom to see how it was with his supreme lady tai-tai. Then run and bring this-place-red-hair yi.
“How long?” Sam demanded again. “How long, Ah Chee? What time did the pains start?”
Ah Chee chose the truth simply because it was easier. “Since maybe two-ke of zi hour.”
“Dear God.” Sam turned back to his cousin. “Since just before midnight yesterday. Almost twenty-four hours.” Saying the words made him feel quite ill. Carolina had labored ten, perhaps twelve hours delivering Zachary. And Carolina was a robust American girl, while Mei-hua…What would he do if he lost her? What would there be of beauty or satisfaction in his world?
Ah Chee meanwhile had disappeared and quickly returned with the basin of water and bar of soap he’d demanded last time he was here. Nick began rolling up his sleeves. “I’ve heard of longer labor. I take it no midwife has been with her?”
Sam shook his head. “Just Ah Chee here. I didn’t think…As I told you before, the Chinese have their own way of—” Mei-hua’s shriek cut him off. He started towards her but shrank back. “Do something, Turner. I beg you. She can’t—”
“Get out. Take the old woman with you. No, wait, tell her to bring more candles. Or a lantern if there is one. I need more light.” The room was dim, only a few candles making long black shadows on the walls. “And where’s that peculiar smell coming from?”
As soon as Mei-hua screamed Ah Chee had rushed to the altar of Chan Yin. “Incense,” Sam said. He didn’t explain further, just grabbed Ah Chee and pulled her from the room.
Nick did not have much experience of birthing. Of late a number of doctors had become active in the business, but not he. Women had been doing quite well with midwifery for God knew how long. He could see little point in the medical profession becoming involved, except in cases like this when clearly the mother was entirely too tiny to cope. Kneeling on the floor beside her, it occurred to him that this might be an argument against the mixing of the races. The infant was crowning, but the girl’s pelvis was far too narrow and the baby’s head apparently too big.
The flesh either side of the vulva was torn and bloody, and every minute or so Nick could see the top of the baby’s head covered in matted black hair. Instinctively the girl was pushing with all her might whenever that happened, but she simply wasn’t strong enough, especially now after so much time and effort.
Nick thought of lifting her into the bed, but she seemed to be taking support from the wall behind her and the pile of cushions either side. Best leave her where she was, but he couldn’t simply let her go on suffering like this. There was Cesarean birth, of course. The literature was full of tales of attempts to cut the child from the mother’s body. Almost without exception, the mother died. Whether to condemn this young woman to death in favor of her babe was not his decision to make. He’d ask Sam Devrey if he must, but it wasn’t a question he looked forward to posing or an operation he felt confident would save either of them. Might be too late for the baby even now. He’d heard talk that long and difficult births like this often resulted in a child dead of strangulation.
Very well. What else?
He could crush the child’s head with his bare hands, or with the pair of retracting forceps that were in the black bag he’d taken from Bellevue when he left to visit St. Patrick’s.
There was another piercing scream. The baby’s head was crowning again. This time he actually got a look at the top inch, perhaps two inches, of the skull. Next time that happened, he could get a grip with the forceps. It was an awful thought, but the mother was his patient. Nick took the auscultation tube from his bag and pressed one end to her chest; the girl’s heart was racing at a pace that could surely not be sustained much longer. When he pressed the tube into the distended flesh of her lower abdomen, he could hear another heartbeat, also very rapid, but he seemed to remember reading somewhere that was normal. And the one thing he now knew for sure was that the baby was alive. His job was to keep them both that way. He’d read about an English family who in the sixteen hundreds m
ade a profession of rescuing difficult births with the use of a secret tool that turned out to be a sort of forceps. It was worth a try.
He was fishing for the forceps at the bottom of his bag when suddenly there was more light. The old woman had returned and was holding a lantern over his head. “Thank you,” he murmured, then went back to rummaging in his bag. There they were. Forged for him at a blacksmith’s shop back in Providence. There were lighter and more delicate such instruments available, but he’d never practiced enough surgery to make him feel the expense justified. Too late to wish for such an improved tool now. He drew the heavy black forceps out of the bag and heard the sound of a quick gasp behind him.
“Not do. Not this thing.” Ah Chee shouted the words into his ear. “Not do. Very bad. Do other thing.”
The only words Nick could make out were “not” and “bad.” “She’s going to die.” He nodded at Mei-hua. “Your mistress cannot continue to labor with this child.”
Holding the lantern with one hand, Ah Chee grabbed at the forceps. “Not do. Not do.”
Nick was quite sure she understood exactly his intention, but the decision was not hers to make. “Get your master,” he said. “Get him in here.” He put the forceps back in the bag. “I will do nothing until he comes. Go on!” He gestured toward the door of the room. “Leave the lantern and go get him.”
Ah Chee hesitated a second then put down the lantern and hobbled away.
He could see the girl’s tiny silk-wrapped feet as well. Even smaller than the serving woman’s. What could you expect from a race who deformed their women in such a manner? He bent over and listened to her heart again. Faster than before, though he’d not have thought it possible. And another contraction starting.
Mei-hua screamed. The baby’s head showed itself as she leaned forward, supporting herself on her elbows and straining to push out her child. Nick pressed down on her belly. For a moment he thought that might have helped just enough, but the head receded, the contraction passed, and she fell back gasping for air, sobbing and pouring sweat.
“These things. These things.” The old woman was back, and she was holding out a pair of long sticks and what looked like a slightly smaller version of a butcher’s cleaver. Jesus God Almighty. Was she suggesting those tools to crush the skull so he could draw out the child? Or that he hack the girl apart and get the child that way. “Where’s your master. I told you to—”
“Right here.” Devrey was standing in the doorway. “How…how is she?”
“Not good. There’s a decision to be made, and you must make it.”
Ah Chee was not entirely sure what the two men were talking about, but she was very sure what must be done for the plum blossom. She had been preparing to do it when the Lord Samuel arrived back with the this-place-red-hair yi. She had seen it done by proper birthing women on the sampans of Di Short Neck.
“Cut. Cut,” she told red-hair yi. “Cut. Make little bit more room. Then pull.”
Nick stared at her for a moment. “What are those wooden things?” He cut Devrey off while the man was telling him exactly what he’d expected to hear: that he should do anything necessary to save the life of the mother, the woman Samuel called Mei-hua. “The sticks, what are they for?”
“They’re called xingsheng,” Samuel said. “Chopsticks. They’re for eating. Picking things up. But in God’s name what’s that to do with—”
“Picking things up or pulling them towards you,” Nick murmured. After cutting to make a bit more room. It bloody hell should work. It was certainly worth trying. “Get out,” he ordered Devrey, looking for the small scalpel he always carried in his bag. “Here,” he ordered Ah Chee, “bring that lantern closer. Now lift it so I can see.”
Ah Chee appreciated the advantage of the tiny little knife thing over the cleaver, and lantern was a word she knew. She held it high. The plum blossom’s privates were on full display, which was very much too bad, but nothing to be done about it now. Maybe later the Lord Samuel would have to kill the this-place-red-hair yi because he had looked at the privates of the supreme lady tai-tai, not turned his back and pointed to a doll and told Ah Chee what to do, the way a proper Middle Kingdom yi would do.
Mei-hua was in the midst of a full contraction. Nick doubted she felt the additional pain of his quick cut of the thin skin between the vulva and the anus. Excellent. He’d enlarged the vaginal opening by a good inch. And here was the child’s head yet again.
Nick dropped the scalpel and felt the sticks instantly in his hand.
“Now pull. Now pull,” Ah Chee said.
Nick concentrated on inserting the slim, rounded wooden sticks into either side of the vagina between the baby’s skull and the mother’s flesh. He pressed them against the sides of the child’s head and drew the infant towards him. And the mother, bless her pluck, was pushing again, with more strength than he might have imagined she could summon at the end of such a long ordeal.
Samuel was sitting on the red lacquer throne, facing the bedroom. He heard the silence that followed Mei-hua’s last shriek of agony. He thought he heard Ah Chee and Nick Turner speaking. Nick Turner could not speak Chinese, so Ah Chee must speak some English. That was a fact he should consider more carefully, but he could not do so now when only one thing mattered.
He heard the first cries of an infant.
Nothing from Mei-hua.
He could not make himself move. The door to the bedroom opened, and Ah Chee appeared with a swaddled bundle in her arms. “Girl baby. Very much too bad. But supreme lady tai-tai be fine this-place-red-hair yi say. Have son next time.”
“Never.” Sam experienced the exquisite intensity of the rush of relief as if it were something liquid, a tide starting at his feet and moving up to his head. He made no move to look at the daughter Ah Chee held out for his inspection. “Never. Never. No next time. If there is, I will kill you. I swear it, old woman. If you allow her to become with child again, I will kill you. And,” he added, knowing it would be the ultimate convincer, “I will put Mei-hua aside and go and live only with the yellow hair concubine.”
Ah Chee did not hesitate. “Never. Never,” she agreed. “It will be exactly as the lord wishes.”
Manon had no doubt the girl was dying. In the years since she had taken up visiting the sick, she had stood beside any number of people approaching the end. There was a look about them, frequently a sound. Eileen O’Connor, not yet fourteen the other women on the ward said, had both.
Moments later the wheezing, struggling breaths so typical of the consumptive were silent, and her chest no longer moved. Manon listened carefully and heard only the soft murmuring of old Mrs. Kelly telling her beads at the far end of the room. Usually this place echoed with all kinds of moaning and sometimes wailing and caterwauling and cursing. The women were if anything more contentious than the men, but fifteen minutes earlier the entire ward had become as silent as a church. It was that unnatural and respectful quiet that had drawn Manon when she was hurrying past on her way home.
Only the soft clacking of the wooden beads now, and the girl dead. Manon brushed her eyes closed and pressed the slack jaw upward. Not a pretty youngster.
The murmured prayers continued. “…full of grace…Holy Mary, mother of God…”
The cackling of superstitious harpies, the ministers said, when they caught the Irish women mumbling these incantations. It seemed as if all of mighty New York City was terrified of the floods of Catholic immigrants, while at the same time it craved their labor. A few months before, the New York Protestant Association had held a public meeting to debate the proposition, “Is Popery Compatible with Civil Liberty?” Such ministerial nonsense.
None of those worthy gentlemen were around at this hour. Let the women tell their beads if they wanted. It had grown dark while Eileen O’Connor was going about her dying. Not enough light now even to see the patients lying on pallets on the floor because the beds were full. Nothing in their bellies since midafternoon, when they’d been given what p
assed for dinner at Bellevue. The ministers, meanwhile, were home with a glass of ale and an ample supper of bread and cheese, and they would sleep on feather mattresses, secure in the knowledge that they were the elect.
“…pray for us sinners, now and at the hour of our death, Amen.”
Finally the prayers finished, but the unnatural silence remained, as if the ward were holding its collective breath. Until finally another voice called out, “Is she gone yet? Is the little saint gone to God, bless her soul?”
“She has,” Manon said.
“Right, then I’ll be having her bed.” The speaker was struggling to get up from the floor.
“You will not! It’s me Eileen said as could have it. Promised she did!”
“She did nothing o’ the sort. Sure and didn’t the little saint say as—”
Manon saw the struggle as a ferocious dance of scrawny shadows on the floor at the far end of the ward. “Be quiet!” Her authority was born of her service. “Hush, all of you. Go back to your prayers. I’ll get her ready for burying, then we’ll arrange who moves up.” The O’Connor girl had been in a proper bed in a choice corner of the room, near a window. “You can draw straws to see who gets the bed.”
The pair involved in the scuffle quieted. A woman approached the bed carrying a basin and a sponge. “Sure and I’ll do it, Mrs. Turner.”
“No, Bridey. I shall. Leave the water and go back to your bed.”
“Remember what she said, Bridey,” a voice called from the shadows. “Sure and isn’t it exactly what the little saint predicted?”
Bridey set down the basin and disappeared into the shadows.
Manon had no notion what the prediction might have been. The wards were rife with conspiracies and intrigues she knew it best to ignore. That said, she had no real idea why she hadn’t stepped aside and let Bridey prepare the body for burial, just as she didn’t know why she felt compelled to remain beside Eileen O’Connor’s bed while she died. The girl was an ordinary consumptive as far as Manon knew, one of the thousands of Irish who arrived and swarmed over the city, poor and ill and frequently dead before their time, beyond the reach of the tiny handful of priests and the town’s few Catholic churches.
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