Race for the Dying

by Steven F Havill

“Yes.” Her voice was tiny, barely a whisper.

  “Some morning unease then?” She nodded, and Thomas rubbed his forehead thoughtfully, trying to visualize the pages of his new Saunders obstetrics text—one of the books no doubt dumped in a ravine somewhere when his shipping chest was ransacked. He listened for Dr. Wilhelm’s sonorous voice, echoing somewhere far back in his mind.

  “Well, Mrs. Beautard, this will be your second child? Little Henry is your firstborn?”

  “Yes.”

  “I was about to say you’ve had some experience with all this. You’ve not had the regular flow?”

  “No.” The blush deepened.

  “This month only?”

  “Yes.” The single word came out as a birdlike peep.

  “So we’re very early, which is good news. Any other discomforts? Passions for various foods? That sort of thing?”

  Mrs. Beautard tried a game smile and showed beautiful, even teeth guaranteed to melt any man’s heart. Perhaps she had melted the wrong heart, and now suffered the regret.

  “Well,” Thomas said cheerfully, “what we must do is tend to your general health in the coming months so our little Henry is rewarded with a healthy, bouncing little brother…or sister, as the case may be. Now—”

  She took a deep, shuddering breath. “I can’t have a second child,” she said.

  “What do you mean, you can’t? Did you suffer in the delivery of Henry? He’s what, six months old or so?” Again, he rummaged through his memory for the proper journal entry. The book belonged in his lap, not in Dr. Haines’ office.

  “Four months.”

  “His birth was normal in all respects? You appear to have recovered fully.”

  “Yes. That’s not what I mean. If his father…my husband…”

  The light gradually began to dawn. “Your husband is who?”

  “Lawrence Beautard,” the young mother said. “He works in the mill for Mr. Schmidt.”

  Thomas glanced up at Bertha. “It seems everyone works for Mr. Schmidt, and I have yet to meet him.”

  “Mr. Schmidt is a good man,” Mrs. Beautard said quickly. “He’s a good, fair, honest man.”

  “I’ve heard that. Your husband is not enamored of the idea of a second child? Is that what I’m to understand?”

  Mrs. Beautard closed her eyes. “He has little enough patience with this one,” she said, and looked down at the tiny face. “If the child cries while Lawrence is home…”

  “My heavens, Mrs. Beautard, that’s what infants do, isn’t it? Cry and eat and make interesting smells? And in between times, enthrall us all? Surely your husband realizes that. And surely he knows what causes pregnancy?” Immediately he regretted the levity, seeing no humor in the girl’s eyes.

  He reached out and stroked the corner of the blanket to one side. Henry Beautard was a well-formed infant, raven black hair across his forehead, fine features that he might have inherited from his mother. The baby lay listlessly, and when Thomas hooked his right index finger through the tiny hand that rested in the folds of blanket near the infant’s mouth, the infant’s grip didn’t respond.

  The half-lidded eyes puzzled the physician, and with his right thumb, he gently eased one of the eyelids upward. The pupil was tiny in the muted light, a mere dot of black surrounded by the wonderful violet coloration that the child had inherited from its mother. The other eye was equal.

  Thomas motioned with his hand. “Let the child lie on his back on your lap, if you please,” he said. Little Henry showed no response during this maneuver, and lay limp, eyes staring sightless at the ceiling. Thomas took his time adjusting the earpieces of his stethoscope, then slid the bell across the tiny chest. The cool touch brought an oddly disjointed, uncoordinated thrashing of the infant’s limbs, as if the little boy was trying to swim through mud. At first, Thomas counted without his watch, then frowned as he pulled the gold-cased timepiece out of his vest pocket. He sat for some time, listening, his eye locked on the second hand.

  “He needs changing,” Mrs. Beautard said as he pulled his stethoscope from his ears.

  “Yes, he does,” Thomas agreed. With the gentlest touch, he explored the infant’s abdomen. Such tender tickling should have produced a gurgling response of delight from the infant, but again, nothing.

  “Doctor,” Bertha said, and ran her hand down the infant’s tiny left arm.

  “I saw that,” Thomas said. The elbow was swollen, and as Thomas stroked down both sides of the infant’s forearm, he felt the unnatural curve of the bones and the warmth of inflammation. Using an index finger on either side of the arm between wrist and elbow, he explored the bone’s shape. After a moment, he straightened up in his chair.

  “On his stomach, if you please?” he said, and Mrs. Beautard deftly turned little Henry over so that he lay on her arm face-down. Again using just the index finger of two hands, Thomas felt across the silky skin of the shoulders, then down the tiny rib cage and spine, finally across the pelvis.

  “What happened?” he said as he sat back. “His left arm is broken—a greenstick to be sure, but broken nevertheless. The elbow is inflamed and swollen.”

  “He fell…”

  “Please, Mrs. Beautard. Infants who cannot yet crawl cannot yet fall. Have you given him medication? He should be a healthy, responsive child. Yet he clearly is not.”

  “No. I mean, only a little syrup now and then to ease his fussing. My husband…”

  Thomas leaned back in his chair, leaning his head on his fist. He regarded the young woman until she looked away.

  “Mrs. Beautard, you must talk to us,” he said. Henry uttered a tiny wail, his first sound since arriving at the clinic. Thomas reached out and pulled down the back of the infant’s diaper, trying not to recoil at the curdled soiling. “He takes nursing regularly?”

  “I am most careful,” Mrs. Beautard replied.

  “‘Careful’ meaning what?”

  “I sterilize the milk, just as I should.”

  “You don’t nurse the child?”

  This time, the flush was deep and lasting.

  “Please, Mrs. Beautard. Let’s not be ridiculous. We’re talking about what has been done since the dawn of time, and what shall continue to be done until the world ends.” His tone was sharper than he intended, and he leaned forward and lowered his voice to a near whisper.

  “You must talk to us. You don’t nurse this child yourself?”

  “Yes. I mean no, I do not.”

  “Why ever not? Are you productive?”

  This time, the reply was a short little nod, her face flushed bright. Bertha’s hand slipped forward and rested on the woman’s shoulder.

  “The mother’s milk is far superior to anything else. That is not open to debate,” Thomas said gently.

  “My husband…” She stopped, and Thomas waited. The room fell silent, so still that Thomas could hear the muffle of voices in Dr. Haines’ office next door. “My husband does not want me to nurse the child,” the young woman said finally.

  “Why ever not?” She didn’t answer, and after a few seconds Thomas repeated the question.

  “He says that… He says that I will lose my shape.”

  For another long moment, Thomas could do nothing but stare at the woman in disbelief.

  “And so you have been using cow’s milk?”

  “Yes. But he seems to tolerate it well. Still, when he cries and fusses, my husband loses his patience.”

  “I see. And what do you give Henry to soothe him?”

  “Just some of the syrup.”

  “The name of it?”

  “I have the bottle here,” she said, almost eagerly. “I thought to obtain another today from either Mr. Lindeman or Dr. Riggs.”

  From her apron she produced a small, blue bottle. Thomas turned it toward the light so he could read the label: “Sorrel�
�s Soothing Syrup, packaged by Dr. Peter B. Sorrel, of Port McKinney, Washington. The syrup that soothes fretful teething infants and toddlers, producing the habit of peaceful, uninterrupted rest.”

  Uncorking the bottle, he found just enough that he could wet the tip of a finger, tasting sweetness with the tang of alcohol, other lingering flavors that he could not identify, and an odd tickle on the edge of his tongue.

  “Mrs. Beautard, did Dr. Riggs tell you what the ingredients of this syrup were?”

  “No. He said only that it might ease the child’s fussing. And really, Doctor, it does.”

  Thomas looked down at little Henry, the child lost somewhere in his own private fog of opiates. “It must be hell to pay when he wakes,” he muttered to Bertha. “Mrs. Beautard, you must not administer medications that contradict what nature is trying to accomplish.” He realized that he was repeating a lecture he’d heard Dr. Wilhelm give several times. “Mother’s milk exists for a good reason,” Thomas continued. “When a child frets, it’s for a reason. It is a call to attend to discomfort, or for affection, or simply for company. We do not give medications unless there is something actually wrong that the medication might correct.”

  “My husband loses patience when the baby frets,” Mrs. Beautard responded. “And now, if there is a second child in the house…”

  “I see. He strikes the child?” Thomas asked. “Is that how the arm was broken?”

  “I’m sure he didn’t mean it,” Mrs. Beautard whimpered.

  “When did this happen?”

  “Saturday last. In the evening. My husband came home in foul temper. There had been a bad accident at the mill.”

  “What was the cause of that?”

  “I don’t know,” she replied. “But he had been drinking, know. Maybe he…” She shook her head. “I don’t know.”

  “This happens often?”

  She nodded. “But he’s a good man,” she said.

  “I’m sure he is,” Thomas said. “This is what we must do, Mrs. Beautard. First, Bertha will help you clean up little Henry. He’ll be happier when he’s presentable, I’m sure. I think that his system will purge the medications in due course, but it is absolutely essential…absolutely essential, that you give him no more of Sorrel’s. Do you understand me?” She nodded. “If there’s anything further we need to do other than letting nature take its course, I’ll let you know. Now, when little Henry is cleaned up, we’ll see to fashioning a little splint for that arm.”

  “I can’t…”

  “I beg your pardon?”

  “If my husband sees a splint, he’ll be furious.”

  “Why would that be?”

  “For one thing, your fee.”

  Thomas looked up at the ceiling hopelessly, then at Bertha, whose face remained a mask. “Mrs. Beautard, the arm must be splinted. Further, his elbow must be tended, first with a warm pad—not hot to blister, mind you—then with cold. For that, Mr. Lindeman has a supply of ice that you may crush, a little at a time.” He touched the infant’s elbow. “If we don’t help the healing process, he’s apt to be lame in that joint.”

  “For how long must this be done?”

  “Until the elbow is back to normal,” Thomas said. “Three times a day, for ten minutes each time. That’s where we’ll start. I want to see young Master Henry in two weeks’ time.” He smiled at the young mother. “We can only hope that the joy of impending motherhood will make your husband more reasonable,” Thomas said. “In fact, in two weeks’ time, when you bring Henry back so that I may examine his arm and elbow, might I suggest that you bring your husband as well?”

  Mrs. Beautard laughed shortly, a sudden exhalation loaded with derision. “If he knew that I was here, it would be my arm that was broken,” she said.

  “The offer stands,” Thomas said. “If you would like me to talk with your husband, I will.” After all, what more can be done to me, Thomas thought. “But will you return in two weeks’ time?”

  “Yes.”

  “Good. Then let’s tend to this young man,” Thomas said, and backed his chair out of the way. In half an hour, Henry Beautard was clean, powdered, and sporting a tiny splint on his left forearm that Thomas fashioned out of two pieces of clean lath stripping that Bertha produced from upstairs.

  “And no more Sorrel’s,” he admonished. “He must have the breast, and I don’t care what your husband says. The more you hold little Henry, the less he will fuss, I’m sure. In between times, show your husband how to hold the child so that no injury occurs. And tend to your own nourishment during the next few months.”

  The woman nodded wearily, and Bertha accompanied her to the front door. When the nurse returned, she closed the door of the examining room.

  “Opiates,” Thomas said before she asked. “I’m certain of it. Can you imagine?”

  “It is a common thing,” Bertha said.

  He looked at her in astonishment. “A common thing? How is that possible?”

  “She would be rid of the pregnancy,” Bertha said quietly, ignoring his question.

  “Rid of it? I think not,” Thomas said vehemently. “I would like the opportunity to talk with Mr. Beautard.”

  Bertha shook her head. “No, Doctor. I don’t think you would.”

  “You know him?”

  “Only in passing. But I know that there are limits to what is our business.”

  Thomas looked at her quizzically. “Whatever affects the health of our patients is our business, Miss Auerbach.”

  She reached out to pick up the empty bottle of Sorrel’s, but Thomas held out his hand. “I need that,” he said.

  Chapter Twenty-nine

  Dr. Haines disappeared at lunch, and shortly afterward, Gert James arrived with a picnic basket laden with fresh bread, thinly sliced chicken and beef, carefully wrapped fillets of the ubiquitous smoked salmon, and a potpourri of fruit and vegetables.

  A squat Mason jar held fresh buttermilk, a drink that Thomas detested but that Bertha cherished.

  Between a fisherman’s inflamed throat and a young lad whose mother was sure that his deafness was the result of self-abuse rather than earwax, Thomas managed to sample Gert’s food. Jimmy Doyle was not conscious enough to partake, but Thomas could see that, were the ward to fill with patients who needed continuing care, both a nursing staff and a cook—not to mention a kitchen—would be necessary.

  The smells lingering from the various patients dulled his appetite, even though he retreated to Haines’ office. He managed to relax for ten minutes before five men arrived, four carrying the fifth, and Thomas found himself glad that Dr. Haines had returned promptly.

  Thirty-six-year-old Howard Deaton, ashen, sweating, and wide-eyed with shock, had slipped at the wrong instant, and the back wheel of a loaded freight wagon had crushed his lower left leg. After his four companions had been ushered outside and a generous injection of morphine quieted the man, Haines examined Deaton’s boot, pointing out the crease from the wheel rim.

  “We’ll cut it right down the back and the side,” he said. “That way we can slip it off without doing more damage.”

  “Them are new boots,” Deaton moaned. He lay back on the table, an arm over his eyes. “You can’t be cuttin’ ’em.”

  “My good man,” Haines said, “trust me on this. A new boot is far less expensive than the alternative. Just lie still and let us do what we have to do.”

  Deaton mumbled something incoherent. The scalpel opened the leather as if it were paper, and while supporting the leg with his left hand, Haines slipped the boot off, prompting Deaton to jerk violently, back arching, gasping, his eyes rolling back in his head.

  “I think this stocking is welded to the skin.” Haines raised his voice a bit. “Howard, you might consider walking through the surf now and then,” but Deaton didn’t respond.

  With the stocking peeled off and the
trouser leg sliced off at the knee, they could clearly see the displacement of both lower leg bones, three inches above the ankle. “Simple enough,” Haines said, and moved to one side so Thomas could wheel closer. He closed his eyes as he ran his fingers down both sides of Deaton’s lower leg. Despite the morphine comforter, Deaton groaned, his upper body still stiff as a pine plank. Bertha wiped his face with a warm towel and murmured motherly things in his ear.

  “He’s lucky. Had he not been wearing those stout boots, the steel wagon rim would have sliced through his leg,” Haines said. As it was, the bruising was horrendous. “Both bones,” Haines added. “That’s what I see. The ankle isn’t involved. Bertha, we’ll want to wash this grimy limb from knee to toe. How’s the morphine holding?”

  “He’s nodded off,” Bertha replied. Sure enough, Deaton’s body had sagged and his jaw hung slack.

  “Good. Then let’s see what’s what.”

  Thomas nodded, his fingers telling him that both bones had snapped sideways, like sticks of firewood propped against a chopping block and stomped in half. “I don’t feel any large fragments.” he said.

  “Nor I, but there are bound to be chips. Still, if he’s lucky, we may see success with the fracture box. That will ease his trip to St. Mary’s tomorrow.”

  “But for this?” Thomas said. “St. Mary’s? Certainly, the fracture box is the place to start, but if there should be surgical intervention needed? He’ll be about on crutches in three or four weeks with plaster, barring complications. On the other hand, such a trip now…”

  “You believe there may be more internal damage than what we see here?”

  “Well, no, I think the fractures are relatively straightforward. There is no joint involved, which puts luck on our side. It seems to me that a full day in a jouncing ambulance makes for a pointless risk at this early stage.”

  “Thomas,” Haines said, and gently pushed the young man’s wheelchair away from the drugged patient. He lowered his voice to a gruff whisper. “At the moment, we are not staffed to care for patients in the ward. “One night, we can manage, I suppose. But not as a general course of things. If you’re thinking that Mr. Doyle should remain for the night as well…”