John Conroy stepped forward and said, "Friend, blood-letting is not wise. Margaret Falconbridge has suffered a separation of the placenta and is hemorrhaging. What must be done is to deliver the child and stop the bleeding."
Willoughby barely looked at him. "Mrs. Keen, I suggest you assist His Lordship to his private chambers."
"Yes, Doctor," she said and waited anxiously while Falconbridge tore himself away from the unconscious Margaret. The baron was a thin, severe looking man in his forties, known for being humorless and a crack shot at pheasant shooting, and not very popular among his tenants and the villagers. Margaret was his second wife, and he was as yet without an heir.
Falconbridge turned to John Conroy, noticing him for the first time. "What are you doing here?"
"I was summoned," Conroy said.
The baron nodded vaguely, cast a final woeful glance at his wife, and then strode out of the room with the housekeeper close on his heels. When the door closed behind them, Willoughby set his medical bag on the bed and undid the buckle. "You can go, too," he muttered without looking at the Conroys. "I'll take over now."
Dr. Willoughby pulled a stethoscope from his bag and applied it to Her Ladyship's chest. It was the old fashioned kind—a long wooden tube, one end of which was applied to the patient's chest, the other end for the doctor's ear. The length was designed to keep a doctor's face from coming too close to a female bosom, and the instrument was not nearly as accurate as the modern stethoscope Hannah's father used.
"My daughter can help," John Conroy said. "She is a trained midwife."
Willoughby ignored the suggestion as it was beneath consideration. That a country girl of little breeding should attend to the wife of a baron.
Hannah took no offense. She had never imagined she would attend to ladies of title and high birth.
Willoughby re-considered his choices for treatment. All disorders of the body, from a simple head ache to cancer, were universally treated with one of four prescribed methods: bleeding, purging, vomiting and blistering. In this case, purging of the bowel to relieve pressure on the womb was out of the question as the patient was unconscious and would not be able to swallow the mercury preparation. Likewise Willoughby could not administer an emetic to cause vomiting. He decided that blistering, created by the application of a caustic chemical on the skin, would not be sufficient in this case. That left his initial choice of blood-letting.
"Friend, I suggest thee hurry," Conroy said. "The baby has but minutes."
"Sir, the baby is fine," Willoughby replied as he set aside the stethoscope and placed his hands on Lady Margaret's large, round abdomen. "The labor was false. And the hemorrhaging you are so overly concerned about is simply a matter of Her Ladyship having too much blood. It is putting pressure on the womb. After I have treated her, the pressure will be relieved and her pregnancy will resume its normal course."
He paused and lifted his nose, sniffing. "What is that?" pointing to the bowl of purple liquid on the writing desk.
"Tincture of iodine."
"Tincture of what?"
"Iodine. An element extracted from seaweed."
"Never heard of it." Willoughby wrinkled his big nose. "Why is it there?"
"I wash my hands in it."
"And why would you do that?"
"It is a solution of anti-sepsis and it—"
"Oh not that humbug!"
"The solution will protect—"
"It is a French idea, sir, and totally unfounded."
"Protect the patient," Conroy finished quietly.
"Protect her from what?"
"From anything the doctor might infect her with."
"And that, sir, is another absurd notion, French, too, I believe, or possibly German. Protecting a patient from her doctor indeed. Doctors are gentlemen, sir, and gentlemen have clean hands."
"I implore thee to please wash thy hands before touching Margaret."
Ignoring him, Willoughby removed sharp lancets from his bag and set them on the counterpane. John Conroy said in alarm, "Then thee truly does intend to bleed her?"
"Precisely so," Willoughby replied as he tied a tourniquet around the baroness's upper arm. "Twenty-four ounces should do it," he murmured, looking around for a receptacle to catch the blood.
Conroy said softly, "Friend, this is not the time for blood-letting."
Willoughby gave him a look. He did not like the Quakers' refusal to address anyone with honorific titles such as Sir, Madam, Your Honor, or even Your Majesty. "I will ask you again, sir—" Willoughby began before he suddenly stopped, drew a long intake of breath and sneezed heartily into his bare hand. Running his finger under his nose and then down his coat, he said, "I am asking you to leave now, or shall I call for someone to escort you out?"
Conroy watched as Willoughby reached with the same hand for a lancet. "Friend, I mean no disrespect, but I ask that, for the sake of our patient, thee washes thy hands first."
Willoughby scowled. He wanted to tell Conroy to stop calling him Friend. And then he thought: Conroy. Irish. "Lady Margaret is not our patient, sir, she is mine. Now get out."
"Brother Willoughby," Conroy began.
"I am not your brother, sir, nor your friend!" Willoughby bellowed. "I am a licensed physician with a medical degree from Oxford University and I will thank you to address me respectfully."
Conroy blinked. What could be more respectful that "friend" and "brother?" He turned to his daughter, nodded, and collected his coat and medical bag. As they left the bedroom, they saw Dr. Willoughby retrieve the chamber pot from beneath the bed and place it under Lady Margaret's arm. "We will pray for her," Conroy murmured to Hannah.
When he heard the door click shut behind the Conroys, Willoughby shivered and wondered if he should call for more coal in the fireplace. The long cold ride through the rain had left his clothes damp, and his flesh was chilled. When he sneezed again, cupping the explosion with the hand that held the lancet, he looked around for the cause of the sudden sneezing.
When his eye fell on the bowl of purple solution—what had the Quaker called it? Iodine?—Willoughby decided that that was the source of his sudden sinus problem. As soon as he bled Her Ladyship, he would open a window and pour the blasted poison to the ground below.
Tapping the pale arm until a blue vein rose, he made a cut with the lancet and watched the blood trickle into the chamber pot, sure in the knowledge that he was practicing medicine as Hippocrates had practiced it two thousand years ago.
Miles Willoughby was sixty-five years old, having been born in 1781 to an English peer, and because he was the youngest of four sons and therefore destined to inherit neither title nor estates, he had decided to make his way in the world as a gentleman physician. He had attended Oxford University where he had learned Greek, Latin, science and mathematics, human anatomy, botany, and skills in blood-letting and applying leeches, the foremost treatments of the day.
As Willoughby watched the rich blood drain from Her Ladyship's arm, he thought of the impudence of that Quaker to insinuate that the oldest tried and true method of treatment should be avoided in this case! Miles Willoughby had been practicing medicine longer than that upstart had been alive. And who was he—a country doctor who never even went to medical school, who in fact had served an apprenticeship, like a common tradesman—to tell a gentleman physician what was to be done?
And that foul smelling concoction now filling the air! Miles Willoughby was convinced that the notion of anti-sepsis was a European conspiracy to set medicine back thousands of years. He had already heard of the crackpot notion that doctors should wash their hands—it was a theory coming out of Vienna. They even had the audacity to claim that doctors were the cause of infections!
"There now, Your Ladyship," he said when the chamber pot was a quarter full. "Let's see how we are doing." Although Lady Margaret was unconscious, Willoughby spoke to her in the reassuring way he had for years, especially with female patients whom he believed needed the fatherly touch b
ecause they really were like children.
He would have liked to lift her nightgown to see if the hemorrhaging from the womb had abated. But while such intimate visualization was permitted in lower class women, for a lady of Margaret Falconbridge's rank it was unthinkable, even for a gentleman physician. So he decided that a little more blood-letting from the arm was called for.
Mrs. Keen escorted the Conroys from the upper floor, but when they reached the bottom of the stairs, John Conroy paused and, looking back up the massive staircase, said, "I think perhaps we should not leave so quickly, Hannah. We will wait."
Instead of being taken to a parlor or drawing room, as a doctor of Willoughby's social standing would have been, John Conroy and his daughter were taken to the kitchen. Hannah noticed that her father looked weary. "We should go home, Father."
He shook his head. "Not just yet, daughter. I am worried about that poor woman upstairs." John Conroy lifted his face to the ceiling, as if to peer through the stone and wood and mortar and observe what was happening above. He was fearful for Margaret Falconbridge's life, yet he knew he could not interfere. Closing his eyes, he offered a silent prayer to God, asking for guidance.
As a young man, John Conroy had known that he wanted to pursue a career in service to others, such as law or business that would lead, perhaps, to a position in the managing of a humanitarian institution. But Quakers were forbidden to enter Cambridge or Oxford Universities where such professions were taught. And so when young Conroy had voiced his frustration to the local Bayfield physician, the doctor had confessed that he had been hoping to retire in a few years and had been entertaining the idea of training a successor. He had offered John the apprenticeship, which would be eight years, at the end of which John Conroy would receive his medicinae doctor certificate.
While serving the apprenticeship—visiting patients with his mentor, reading Greek and Latin, learning how to diagnose and treat—John had found that he enjoyed helping people in this way, and wondered if perhaps there was something more he could do. When he suggested he might consider becoming a surgeon, his mentor did not discourage him. But the older doctor secretly suspected that the young Quaker was too kind-hearted and compassionate to handle the terrible screams he would hear in the surgical theater (not to mention the hemorrhaging the surgeon caused, the gangrene and pus that inevitably followed, and the high death rate among such patients). He advised John to avail himself of the public operating theaters in London. And so John Conroy had gone to the city and had bought a ticket for a seat in the public gallery of St. Bart's Hospital to watch a surgical procedure—a woman undergoing the amputation of a cancerous breast.
While John did not pass out as some in the audience had—at the sound of the patient's agonizing shrieks and the sight of the rivers of blood—one thing did convince him that he could never be a surgeon. For the sake of the patient, a surgeon must be fast. In fact, surgeons were timed with stopwatches. A cancerous testicle or breast must be amputated in under a minute or the patient would die of shock. John Conroy was too slow and methodical to be a surgeon.
Physicians, on the other hand, dispensed medicines that eased pain and discomfort. The quiet Quaker had decided that bedside medicine was best suited to his temperament, and as it turned out, Dr. Conroy did more than dispense pills and ointments, wrap sprains and set bones. He listened to his patients' woes, even if it was about failed crops or a cow's milk drying up, knowing that a friendly ear was sometimes the best medicine.
Now he was troubled. News should have reached them of the birth of the child. He feared that Miles Willoughby was not focusing on the baby but on the number of ounces of blood he could squeeze from Margaret.
Miles Willoughby could look back proudly on a distinguished career, the first thirty years of which had been as a practitioner in London, catering to the elite and blue-blooded of Belgravia, where he had also had a fine home. When he turned fifty, however, Willoughby discovered that the dampness and fog no longer agreed with his joints, and so he had left London for life in the milder climate of Kent, where he had taken over the practice of a retiring physician who was not only himself a man of upper class breeding but who boasted a clientele that included two Members of Parliament, a High Court judge, and an Earl.
In the fifteen years since, Willoughby had carved a pleasant life for himself in the Bayfield countryside. He enjoyed the prestige, weekends at estates, invitations to balls and hunts, and he especially liked the way people deferred to him. All he had to do was take care of "vaporous" ladies (bloodletting in every case), colicky children (leeches on the abdomen), and the occasional gentleman's back pain (opium mixed with brandy). Anything less pleasant, such as boils to be lanced, or the more noxious illnesses, he referred to colleagues in London, whom he called specialists (although they were simply men who were not as fastidious as Willoughby), and sometimes to surgeons, who were a step down the social ladder from physicians.
Willoughby was pleased now to see the blood from the baroness's arm slow to a trickle, which meant the excess had been successfully drained from her body so that the congestion of the womb had been relieved. "Well done, Your Ladyship," he said as he removed the tourniquet and set aside the chamber pot swimming with dark blood. "I'll just take your pulse and then I shall call in your ladies to have you bathed and changed, and then you can visit with your husband." He would also give her some arsenic tablets as a tonic.
He shifted his thumb and finger on her limp wrist. He frowned. He looked at her face, which was the normal pale color after a blood-letting. But then he noticed that her chest was not rising and falling.
Dropping her arm, he pressed a fingertip to her neck, feeling on the right side and then the left for a throb in the carotid artery.
There was none.
"Lady Margaret?" he said. He patted her cheeks. Then he bent and pressed his ear to her chest. No heart sounds.
He straightened and frowned down at her. "Lady Margaret?" And then he placed his hands on her abdomen and felt no movement within. "Good Lord," he whispered. The baroness and her child were dead.
How was that possible? He looked at the lancet and tourniquet, then at the dark blood in the chamber pot. He had performed this procedure hundreds of times. What could have gone wrong? And then his eye fell upon the bowl of foul, purple solution sitting on the writing desk. Willoughby's heart jumped in shock. The Quaker had poisoned the air! Collecting himself, he went to the door and, knowing that Falconbridge was pacing in the hall beyond, said, "Your Lordship may come in now."
When the baron stepped into the bedchamber, Miles Willoughby closed the door behind him and said, "I am sorry, Your Lordship. I did all that I could."
Falconbridge stared at him. "What are you talking about?"
"If only I could have been here sooner."
Falconbridge ran to the bed and took his wife by the shoulders. "Maggie? Wake up, my darling!"
Then he looked at the rounded abdomen where his child once slumbered but was now entombed. He lifted a tear-stained face to Willoughby. "How did it happen?"
"Everything was going as I expected, the blood-letting was easing her distress when suddenly she expired."
"But she was fine this afternoon when I rode to fetch you. Just a little queasiness."
"I blame myself, Your Lordship. When I saw the bowl of toxic fluid, I should have thrown it out at once. But, of course, my main concern was with seeing to Her Ladyship—"
Falconbridge blinked. "Toxic fluid?"
Willoughby pointed to the bowl on the writing desk and Falconbridge immediately realized he had been detecting a strong odor in the air. It was coming from the bowl. "What is it?" he asked, rising from the bed.
"The good Lord only knows," Willoughby said, throwing up his hands. "The Quaker had set it out for reasons that are beyond me. It is not normal medical practice, I assure you. But I do chastise myself for not throwing it out. I fear the air has been poisoned and in fact you and I would do well to leave this room at once, Your
Lordship."
Falconbridge stared into the pungent-smelling fluid, feeling its fumes assault his nostrils and swim up into his head to engulf his brain. Margaret was dead. The baby dead. He felt the room tilt and sway, heard the wind howling beyond the windows. "What am I going to do?" he sobbed, and covered his face with his hands.
Willoughby laid a fatherly hand on the baron's shoulder and said, "I will take care of things for you, Your Lordship. I suggest, however, that we detain the Quaker and his daughter and send for the constable. A crime has been committed here tonight."
Luke Keen came into the kitchen. "Sorry, sir, but His Lordship has asked that you be detained. Come this way, please." The estate manager led the Conroys to a small library off the main hall, where no fire burned in the grate, and only one candle had been lit so that the room was cold and gloomy. "If you'll wait here," he said, not meeting them in the eye, and then he left, closing the door behind himself.
"What do you suppose—" Hannah began, when Willoughby came striding in, looking somber and officious.
"How is Margaret Falconbridge?" John Conroy asked. He had removed his wide-brimmed Quaker's hat and stood taller than the older doctor.
"Lady Margaret," Willoughby said archly, "has died."
"Oh no," Hannah whispered, standing at her father's side. "And the child?"
"It perished as well."
"Thee could not save them?" Conroy said.
Willoughby drew himself up as tall as he could, and jutted out his whiskered chin. "And how was I to do that when you poisoned them both?"
Conroy's eyebrows arched. "What does thee mean?"
"You poisoned her with that concoction in the bowl."
"Dr. Willoughby," Hannah interjected. "Iodine cannot cause illness. It prevents illness."
Willoughby skewered her with a look. A lifelong bachelor, the Oxford-trained English gentleman was contemptuous of women, as he was of Irishmen, foreigners, and Quakers. "I did not say you made Her Ladyship ill," he said archly. "I said you poisoned her. You filled the air with toxins."
This Golden Land Page 2
