by Wilbur Smith
He offered Robyn the inner curve of his elbow where the thin white scars over the blue blood vessels marked where he had been bled before. We no longer live in the dark ages, Robyn told him tartly. "This is 1860, and she pushed him down on the bolster and covered him with a grey ship's blanket against the shivering and chilling nausea which she knew must soon accompany such a wound. It did not come, and for the next twenty hours he continued to manage the ship from his bunk, and he chafed at the restraint she placed on him. However, Robyn knew the pistol ball was still in there and that there must be drastic consequences. She wished that there was some technique that could enable a surgeon to locate the whereabouts of a foreign body accurately, and then allow him to enter the rib cage and remove it.
That evening she fell asleep in the rope chair beside his bunk, awakening once to hold the enamel cup of water to his lips when he complained of thirst and noting the dryness and heat of his skin, and in the morning all her fears were confirmed.
He was only semi-conscious, and the pain was fierce.
He moaned and cried out at the smallest movement. His eyes were sunken into plum-coloured cavities, his tongue was thickly coated with white and his lips were dried and cracked. He pleaded for drink and his skin was hot, the heat increasing every hour until it seemed to be burning out the core of his being, and he was restless and flushed, tossing in the narrow bunk, fighting off the blankets with which she tried to keep him covered, and whimpering in his delirium at the agony of movement.
His breath was sawing painfully in his swollen and bruised chest, his eyes were glittering bright, and when Robyn unwound the bandage to sponge his body with cool water there was only a little pale fluid staining the dressing, but her nostrils flared as she smelled it. It was so horribly familiar, she always thought of that stench as the fetid breath of death itself.
The wound had shrunk, but the crust that had formed over it was so thin that it cracked at one of Clinton's restless movements and through it rose a thick droplet of custard-coloured matter. Immediately the smell was stronger. This was not the benign pus of healing, but the malignant pus that she so dreaded to see in a wound.
She swabbed it away carefully, and then with cold seawater sponged his chest and the hard hot swollen flesh below his armpit. The bruising was extensive and it had changed colour, dark blue as storm clouds, tinged with the yellow of sulphur and the virulent rose of some flower from the gardens of Hell itself.
There was one area just below the point of his shoulder blade particularly sensitive for he screamed when she touched it, and a sparse prickle of sweat broke out across his forehead and amongst the fine golden bristles of his unshaven cheeks.
She replaced the bandage with a fresh dressing and then forced between his dry lips four grams of laudanum mixed with a warm draught of calomel. She watched while he fell into a restless drug-induced sleep. Another twenty-four hours, she whispered aloud, watching him toss and mutter. She had seen it so often.
Soon the pus would suffuse his whole body, building up steadily around the ball deep in his chest. She was helpless. No surgeon could enter the rib cage, it had never been done before.
She looked up as Zouga stooped into the cabin. He was grave and quiet, standing beside her chair for a moment and placing a hand on her shoulder comfortingly.
He improves? " he asked softly.
She shook her head, and he nodded as though he had expected the answer. You must eat. " He offered her the pannikin. "I brought you some pea soup. It has bacon in it, it's very good."
She had not realized how hungry she was and she ate gratefully, breaking the hard ship's bread into the broth and Zouga went on quietly, I loaded the pistols with less than a full charge, as little as I dared. " He shook his head irritably. "Damned bad luck. After Mungo's ball hit the trigger guard, I'd not have expected it to have entered the chest, it must have lost most of its power."
She looked up quickly. "It struck the trigger guard you did not tell me."
He shrugged. "It's not important now. But the ball was deflected."
She sat very still in her chair for ten minutes after he was gone, and then purposefully she stood over the bunk and stripped back the blanket, unwound the bandage and examined the wound again.
Very carefully she began to sound the ribs beneath it, pressing in with thumb gently to feel for the give of shattered bone. The ribs were all firm, yet that was no proof that the ball had not driven between two of them.
She pressed her thumb into the swelling towards the outside of his chest, and although he thrashed around weakly, she thought she felt the rasp of bone against bone, as though the rib had been chipped or even as if a long splinter had been cracked off it.
She felt a little flutter of excitement, and extended her examination gradually backwards, guided by his delirious cries of pain, until once again she reached the lower point of his shoulder and he came upright in the bunk with another wild yell of agony, breaking out once more into the burning sweat of high fever. But with the tip of her finger she thought she had felt something, something that was neither bone nor knotted muscle.
The excitement quickened her breathing. From the angle at which Clinton had stood, half-turned away from Mungo St. John, she now believed that it was possible that the ball had followed a different path from that which she had assumed.
If the pistol had been undercharged with powder, and if the ball had struck the trigger guard, it was just possible that it had not had the velocity to penetrate the, rib cage, it had been turned by the bone and ploughed along under the skin, skidding along the groove between two ribs following the track that she had just probed, and lodging at last in the thick bed of the latissimus dorsi and tenes major muscle.
She stood back from the bunk. She could be very wrong, she realized, but if she was he would die anyway, and that very soon. I will cut for it, she decided, the decision direct and swift. She glanced up at the skylight in the roof of the cabin. There was only an hour or two of good daylight left.
Zouga! she called as she raced from the cabin. "Zouga!
Come quickly! " Robyn administered another five grams of laudanum before they moved Clinton. It was as large a dose as she dared, for he had taken nearly fifteen grams in the preceding thirty-six hours. She waited as long as she could in the failing light for the drug to begin taking effect. Then she passed the word to Lieutenant Denham to shorten sail, reduce engine revolutions and make the ship's motion as easy as possible.
Zouga had chosen two seamen to assist them. One was the boatswain, a burly and greying sailor, the other was the officers" steward who had impressed Robyn with his quiet, controlled manner.
Now as the three of them half-lifted Clinton and rolled him on to his side, the steward spread a sheet of fresh white canvas on the bunk under him to receive the spilled blood then Zouga swiftly knotted the lengths of soft cotton rope around Clinton's wrists and ankles. He had chosen cotton in preference to the coarse hemp which would tear the skin, and he made the bowline knots that would not slip under pressure.
The boatswain helped him to tie down the ends at the head and foot of the bunk, stretching out the almost naked white body so that for an instant it reminded Robyn of the painting of the crucifixion that stood in Uncle William's study at King's Lynn, the Roman legionaries spread-eagling Christ upon the cross before driving home the nails. She shook her head irritably, driving the memory from her mind, concentrating all her attention on the task ahead. Wash your hands! " she ordered Zouga, indicating the bucket of almost boiling water and yellow lye soap the steward had provided.
"Y? Do it, she snapped, in no mood to argue. Her own hands were pink with the heat of the water and tingled with the harsh soap, as she wiped her instruments with the cloth dipped in a mug of the pungent ship's rum, laying them out on the shelf above the bunk, and then with the same cloth swabbed the hot discoloured flesh at the base of Clinton's shoulder blade. He jerked against his bonds and muttered an incoherent protest, but she ignored it and nodded to the boats
wain.
He seized Clinton's head, drawing it back slightly, and thrust a thick pad of felt, a piece of wadding for the maindeck cannon, between his teeth, holding it in place. ZougaV He took Clinton's shoulders and locked them in his powerful fingers, preventing Clinton from rolling on to his belly. Good."
Robyn took one of the razor-sharp scalpels from the shelf, and then with the forefinger of her other hand probed brutally down to where she had felt that hard foreign body.
Clinton's back arched and he let out a shattering cry that was muffled by the wadding, but Robyn felt it clearly this time, hard and unyielding in the swollen flesh.
She cut swiftly, without hesitation, opening the skin cleanly, following the direction of the muscle fibre beneath, dissecting down through layer after layer of muscle, separating the bluish membrane capsules that covered each of the muscles with the hilt of the scalpel, probing deeper and deeper with her fingers towards that elusive lump in the flesh.
Clinton writhed and heaved at his bonds, his breathing rasping in the back of his throat, his teeth locked into the felt wadding in a fierce rictus so that cords of muscle stood out along his jawline and white spittle frothed upon his lips.
His wild lunges made her task that much more difficult, and her fingers were slippery with blood in his hot flesh, but she found the rubbery pulsing snake of the lateral thoracic artery and worked past it gently, pinching off the smaller spurting blood vessels with the forceps, and tying them with a loop of catgut, torn between the need for speed and the danger of doing greater damage.
Finally she had to use the blade again, and she reversed the scalpel and paused a moment to locate the lump with the tip of her forefinger.
She could feel the sweat sliding down her cheek, and she was aware of the strained tense faces of the men who held Clinton as they watched her work.
She guided the scalpel down into the open wound, and then cut down firmly and a sudden bright yellow fountain spouted up through her fingers, and the cloying stomach-twisting stench of corruption that filled the hot little cabin made her gasp.
That sharp rush of pus lasted only a second, and then there was something black and sodden blocking the wound. She picked it out with the forceps, releasing another lesser welling up of the thick custardy matter. The wad, Zouga grunted with the effort of holding down the struggling naked body. They all stared at the soft rotten object in the teeth of her forceps.
The patch of cloth had been carried deeply into the flesh by the passage of the ball, and Robyn felt a surging lift of relief, she had been right.
Quickly she went back to work, running her finger into the tunnel cut by the ball until she felt it with her fingertip. There it is! " She spoke for the first time since she had but the metal pellet was slippery and heavy, she cut, could not prise it loose and she had to cut again and then lock the teeth of the pair of bone forceps over it. It came out with reluctant suck of clinging tissue, and she dropped it impatiently on the shelf. It made a heavy clunk against the wood. There was a temptation to come out immediately, to sew up and bind up, but she resisted it and took an extra ten seconds to probe the wound thoroughly. She was almost immediately justified, there was another rotting and stinking taller of cloth in the wound track. A piece of the shirt. " She identified the white shreds, and Zouga's face mirrored his disgust. "Now we can come out, " Robyn went on complacently.
She left a bristle in the wound to allow the remaining pus to drain off. It stuck out stiffly between the stitches with which she closed up.
When she stood back at last she was smugly satisfied with her work. There had been nobody at St. Matthew's who could lay down stitches so neatly and regularly, not even the senior surgeons could match her.
linton had collapsed with the shock of deep surgery.
C His body was wet and slick with his sweat, and the skin at his wrists and ankles had been smeared away where he had fought against his bonds. Let him loose, " she said softly.
She felt a vast pride, almost of ownership, in him now, as though he were her special creation, for she had dragged him back almost bodily from the abyss. Pride was sin, she knew, but it did not make the sensation any the less agreeable, and in the circumstances, she decided, she had earned the pleasure of a little sin.. . .
Clinton's recovery was almost miraculous. By the next morning he was fully conscious, and the fever had abated to leave him pale and shaky, with just enough strength to argue bitterly when she had him carried up into the sunshine and laid behind the canvas wind shelter that the carpenter had rigged under the poop. Cold air is bad for gunshot wounds, everybody knows that And I suppose I should bleed you before closing you up in that hot little hell hole you call a cabin, Robyn asked tartly.
A navy surgeon would do so, he muttered. Then thank your Maker that I am not one."
On the second day he was sitting up unaided and eating voraciously, by the third he was managing the ship from his litter, and on the fourth day he was on his quarterdeck once more, although his arm was in a sling and he was still pale and gaunt where the fever had wasted away the flesh from his face, but strong enough to keep on his feet for an hour at a time before resorting to the rope chair the carpenter had rigged at the rail.
That day Robyn withdrew the bristle from the wound and was relieved at the tiny quantity of benign pus that followed it out. They watched the little town of Port Natal come up ahead of them, the primitive buildings huddled under the whale-backed mountain they called the Bluff like chickens under the wing of the hen. Black joke did not call, even though this was the furthest outpost of the British Empire on this coast, but steamed on briskly into the north, each day becoming perceptively warmer with the sun standing higher at noon and the sea changing to the darker azure of the tropics beneath Black Joke's bows, and once again the flying fish sported ahead of them on filmy silver wings.
The evening before they reached the Portuguese settlement of Lourenco Marques on the deep hight of Delagoa Bay, Robyn dressed the stitches in Clinton's side, making small cooing and clucking sounds of satisfaction and approval as she saw how cleanly they were healing.
When she helped him into his shirt and then buttoned it for him, like a mother dressing her child, he told her gravely, I am aware you have saved my life. "Even though you do not approve of my methods? " she asked with a twinkle of a smile. I ask your forgiveness for my impertinence. " He dropped his eyes. You have proved yourself to be a brilliant physician."
She made a modest murmur of denial, but when he insisted, "No, I truly mean that. I think you are gifted, Robyn protested no further, but moved slightly to make it easier for him to reach her with his good arm, but his declaration of faith in her skills seemed to have exhausted his courage for the moment.
That evening she vented some of her frustration by confiding to her journal that, "Captain Codrington is clearly a min that can be trusted by a woman, in any circumstances, though a little more boldness would make him a great deal more attractive."
She was about to close the journal and lock it away in her chest, when another thought occurred to her, and she thumbed back through the preceding pages each crammed with her small neat script, until she reached the single sheet that had become a milestone in her life.
The entry for the day before Huron reached Cape Town she had left blank. What words were there to describe it? Each moment of it would be engraved forever on her memory. She stared for many minutes at the empty sheet, and then she made a silent calculation, subtracting one date from another. When she had the answer she felt a chill of foreboding, and went over the calculation again, reaching the same answer.
She closed the journal slowly and stared at the lantern flame.
She had missed her lunar courses by almost a week, and with a prickle of dread lilting the fine hair at the nape of her neck she laid her hand upon her own belly as if there was something to feel there like the pistol ball in Clinton's flesh.
Black joke called at Lourenq Marques for coal bunkers, despite the tovr
n's notoriety as a fever port. The swamps and mangroves that half-circled the town to the southwards spread the miasmic airs across the port.
Although Robyn had only very limited first-hand experience of the peculiar fevers of Africa, she had made a close study of all the writings on the subject, the most notable of these being probably those of her own father. Fuller Ballantyne had written a long paper for the British Medical Association, in which he recognized four distinct types of African fever, the recurrent fevers with a definite cycle, he divided into three categories, quotidian, tertian and quartan, by the length of the cycle.
These he called the malarial fevers. The fourth type was the black vomit, or the yellow jack.
In his own unmistakable style, Fuller Ballantyne had shown that these diseases were neither contagious nor infectious. He had done so by a horrifying but courageous demonstration to a group of sceptical brother physicians at the military hospital at Algoa Bay.
While the other physicians watched, he had collected a wine glass of fresh vomit from a victim of the yellow jack. Fuller had toasted them with the awful draught and then drunk it down at a single swallow. His colleagues had waited, with a certain keen anticipation for his demise and had some difficulty in hiding their disappointment when he showed no ill effects and set off a week later to walk across Africa. Fuller Ballantyne was a man it was easier to admire than to like. The episode had become part of the legend that surrounded him.
In his writings her father insisted that the disease could only be contracted by breathing the night air of tropical areas, particularly those airs released by swamps or other large bodies of stagnant water. However, some individuals most certainly had a natural resistance to the disease, and this resistance was probably hereditary. He cited the African tribes who lived in known malarial areas, and his own family and that of his wife who had lived and worked in Africa for sixty years with only mild afflictions.
Fuller wrote of the "seasoning fever', the first of which either killed or gave partial immunity to the subject. He used the example of the high mortality rate amongst newly arrived Europeans in Africa.
