“My lady!” Lucy exclaimed, wrapping an arm about her mistress for support.
“Call my husband, Lucy, and hurry,” Rosemary groaned as she sank onto her bedroom floor, tears welling in her startled eyes. “And tell Firth to send for Dr. Helmsley. I think the baby must be on its way.”
It took less than an hour for Helmsley to arrive at the Arlington residence. He was greeted there by Lady Arlington’s terrified husband. “Thank God you are here, Doctor. I have no idea what to do. I. . .She is not making any sense, and. . .oh God. . .help her, please help her!”
Helmsley took a firm grip of the viscount’s lapels. “My lord, I know that this must be an extremely frightening experience for you, but you must get a hold of yourself; the servants are beginning to stare. Remember, you are the captain, and this is your ship. You will get through this storm one way or another.”
Lord Arlington nodded in understanding. Having captained many an oceangoing vessel, Helmsley hoped his words would have the necessary effect. It seemed they did, for the viscount immediately transformed into a man of command, straightening his spine and rising to his full height of just over six feet. “This way, if you please,” he said, leading Helmsley up the steep stairs that would take them to Lady Arlington’s bedroom. Neither man spoke a word, the only sound being that of their feet treading softly upon the plush runner and the occasional scrape of Lord Arlington’s wedding band as it rubbed against the banister.
As soon as he entered her ladyship’s bedroom, Helmsley’s throat tightened at what he saw. There, in the middle of her imposing canopy bed, her hair spread out about her head, lay the viscountess. She tossed her head jerkily from side to side, her eyes in constant motion as if they were searching for something. Her maid sat by her side, holding her hand in the hope of giving her mistress some small measure of comfort. Occasionally she would take a damp cloth and wipe the beads of sweat that were presently forming on her mistress’s brow. “You must help her,” the maid pleaded with a glimmer of hope in her eyes.
Helmsley steeled himself as he moved toward the bed, setting his bag on a nearby chair. “My lady?” he asked cautiously. “Can you hear me? I need for you to tell me how you are feeling—if you can.”
A few seconds crept by before Lady Arlington’s head stopped moving, her gaze suddenly fixed upon Helmsley. She looked momentarily confused. “I had no idea that there were two of you, Doctor. You must introduce me to your twin. Are you a doctor as well?” she asked, addressing the man only she could see.
Helmsley picked up a book that was lying on the bedside table and held it up before her. “How many books am I holding?” he asked.
“Two,” she replied. “Though they do appear to be a bit fuzzy around the edges.”
“And does it hurt anywhere?”
“Every now and again I feel an unbearable pain in my belly, almost as if. . .” She didn’t manage to complete her sentence before a blank look captured her face. Her eyes stared off into the distance, as if she were deep in thought.
“My lady?” Helmsley asked in an urgent voice, though he knew he wouldn’t get a response. With no time to lose, he grabbed the book he’d been holding a moment earlier and jammed it into her mouth, just as her eyelids began to flutter. A second later, her eyes rolled back into her head, displaying only the whites, and her whole body began to convulse.
With both his lordship’s and the frightened maid’s help, they managed to hold her down until the spasms subsided. This was as bad as it got, Helmsley knew. Lady Arlington was eight and a half months pregnant with puerperal eclampsia, and he did not have the surgical experience required to save her or her child. There was only one thing for it: he needed help.
“My lord?” he said, turning to Lord Arlington. “A word if I may.”
Although he was clearly uncertain about leaving his wife at such a moment, the viscount nodded his head and instructed the maid to call for help if she needed. He then followed Helmsley out into the hallway. “Will she die?” he asked with a note of anguish.
“There is a very real possibility that she might,” Helmsley told him honestly. “Her condition is quite severe, and we are really not left with very many options, I am afraid.”
“But there are options?” Lord Arlington asked hopefully.
“I cannot promise anything, but if you are willing to keep an open mind, then perhaps there might be one solution.”
Lord Arlington turned a sharp gaze on Helmsley. “Do whatever you can. My mind is open to anything as far as my wife’s and child’s safety is concerned.”
“Very well, my lord. Then I will send for someone to help us without further delay.”
Mary burst into Lady Arlington’s bedroom like a jack popping out of its box. “I came as soon as I could,” she gasped, hurrying over to the bedside. She met Helmsley’s gaze. “It is so good to see you again,” she told him with a tight smile.
“You too,” Helmsley replied, “though I do wish that it had been under different circumstances.”
Lord Arlington looked not only shocked but extremely distressed. He addressed Helmsley in a clipped voice. “You brought a woman here to save my wife? That is your solution?”
“She is the best surgeon there is,” Helmsley told him defensively. “I know how unorthodox this is, but you need to trust my decision if you want your wife and child to live.”
The annoyance on the viscount’s face was quite apparent. “What are you planning to do?” he asked Mary irritably.
Ignoring the frustrated viscount, Mary turned toward Helmsley instead. “What is your assessment of the patient, Doctor?”
“That she is showing severe signs of puerperal eclampsia. She has complained of abdominal pains and has had four seizures since I arrived on the scene roughly three hours ago.”
Mary nodded thoughtfully as she looked over her ladyship’s fragile body, noting the swelling that had occurred in both her wrists and ankles. “Can you confirm these seizures?” she asked Lord Arlington.
He nodded as if in a daze.
“Here is what we are going to do,” she said in a sharp tone of authority. She looked across at the maid, who was still clutching her mistress’s hand. “I will need a clean white sheet, a pot of boiling water, and plenty of towels. Have it all brought into the kitchen. Go.”
The young woman didn’t miss a beat. Jumping to her feet, she ran out of the door to set about her task as quickly as she could manage, visibly relieved to finally be of some assistance.
“Now then,” Mary continued, turning her attention back to Lord Arlington, “we are going to have to move her downstairs to the kitchen. And to answer your question, I intend to give your wife a cesarean. Do I have your consent?”
“I. . .er. . .a cesarean?” Lord Arlington muttered, looking more confused than ever.
Mary sympathized, knowing full well that the speed with which she’d taken hold of the wheel must have completely thrown him. However, they had to hurry. She opted for complete honesty. “To put it bluntly, my lord, I will have to cut your wife open just below the navel, remove the child, then stitch her back up again. If all goes well, she and the baby will both survive.”
Lord Arlington stared at Mary with a look of unsurpassed horror. He began to shake his head, slowly at first and then with more vigor. “No,” he said. “Absolutely not.” He turned on Helmsley in anger. “What kind of a doctor are you? To bring a. . .a woman into my house who plans to. . .to cut open my wife like a butcher? No, I tell you, I will not allow it!” He was shaking.
Mary had expected this reaction Taking a deep breath to calm her own ragged nerves, she placed a soothing hand on Lord Arlington’s arm. “I understand your distress, but you have to understand that this is the only chance your wife has of survival. If I do not perform the procedure, she will die.”
“And you are sure of this?” His eyes were wide with fear and worry. “Absolutely and undeniably sure?”
“Yes,” she said.
He let out an anguished
sigh. His shoulders slumped as if he’d just accepted an unacceptable defeat. “And is this something that you have done before?” he asked her hesitantly.
Mary studied him for a brief moment. She’d watched her father do it once, but she’d never actually had the opportunity to do it herself. Of course, there was the possibility that Lady Arlington might not live through the surgery, but Mary knew that her chances of survival were nonexistent if she didn’t go ahead with it. It had to be done, no matter what she had to say in order to convince her patient’s husband. “Yes, I have,” she lied. He still looked dubious, so she decided to add, “Quite successfully.”
“Very well then,” Lord Arlington agreed, wiping his hand shakily across his perspiring forehead. “You have my consent.”
Once in the kitchen, Mary took the white sheet that the maid had provided and spread it over the sturdy oak table that stood in the center of the room.
“Shall I lay her down?” Lord Arlington asked, eyeing the makeshift operating table.
“Not yet. We will need to get her out of that dress first,” Mary said before turning to the maid and handing her a large pair of scissors. “Perhaps you can help with that.”
“But it is one of her favorites,” the maid protested.
“And it will not do her an ounce of good if she is not alive to wear it, now, will it?” Mary snapped. Time was of the essence, which was something that these people clearly did not seem to understand. She let out a sigh of relief when the maid followed her orders without further delay. “Just leave her chemise,” she said.
Once this was done, Lord Arlington placed his wife on the table, grabbing one of the fresh towels and placing it across her pelvis to protect her modesty as much as possible. Her hair, soaked in her own sweat, was matted against her forehead, her eyelids fluttering ever so gently while her breath came in hoarse and shallow bursts.
Opening her bag, Mary pulled out a pair of retractors, a clamp, a pair of forceps, and a scalpel, all of which she dropped into the pot of water that the maid had put to boil. Removing a bottle of brandy from her bag, she pulled out the stopper and tossed it to Helmsley. She then proceeded to pour a generous amount of the amber liquid over Lady Arlington’s quivering belly. Some of it dribbled down her sides, pooling in the small spaces where her body failed to touch the table. With the tip of a clean towel, Mary wiped away the excess before turning a keen eye on the rest of the group. “Now, I want each of you to spend the next couple of minutes washing your hands—thoroughly. Take your time and remember to make good use of the soap. I want the lather to reach all the way up to your elbows.”
Lord Arlington stared at her as if she’d just turned green. “I hardly think that is necessary,” he said. “After all, you yourself have said that we are short on time. Should we not then try to get this over with as quickly as possible, or do you really mean to prolong my wife’s suffering while we stand about playing with water?”
“Lord Arlington,” Mary told him sternly, “I take very little pleasure in your wife’s suffering, and I assure you that I have no desire to prolong it more than necessary. However, since you do wish for me to explain myself to you, I will tell you this: while the majority of the physicians and surgeons in this country may be deaf to new ideas and innovative ways of thinking, I am not, and neither was my father.”
The viscount responded with nothing but a blank stare. Clearly, she would have to elaborate, however reluctant she was to waste what little time they had in doing so.
“Forty seven years ago,” she said, filling a washbasin with water and reaching for the soap, “a Scottish physician named William Buchan published a book that focused on personal hygiene. It was called Domestic Medicine, and although the original work was first sold in Edinburgh, it quickly grew in popularity and was reprinted in London only five years later.” She paused for a moment as she dipped the soap in the water and started working it between her hands until foamy bubbles began to appear. She then looked up to see if the name of the book she’d just mentioned had registered with anyone but was greeted by yet another round of vacant gazes. Only Helmsley bore a knowing smile upon his face, for he had heard her speak of Buchan many times before. Returning her gaze to her hands, she said, “In this book of his, Buchan advises everyone to wash their hands after handling the sick or anything else that might have become contaminated. He also advises that we do so before we eat our meals or enter into company with others. His reasoning for doing so was that he believed we would run less risk of becoming infected ourselves or of conveying an infection to others. Unfortunately, however, his advice has been greatly ignored within the medical community.”
Mary let out a lengthy sigh. “I don’t presume to understand why it is of such monumental importance, my lord, I only know that it is. My father and I have always done it before a surgery, and I do believe that it is part of the reason why the mortality rate of our patients has always been far lower than that of other surgeons.
“So, if your wife’s health is of any importance to you, then you will wash your hands without further complaint, and once you are done, you will refrain from touching anything else in this room unless I specifically give you permission to do so. Do I make myself clear?”
Lord Arlington stared back at her for only a fraction of a second before rushing over to the washbasin and grabbing the soap that she’d just now finished with. Mary caught Helmsley’s eye. There was a very distinct smirk upon his face as he gave her a quiet nod of approval. Good. She’d hate having to waste time arguing with him as well.
When Lord Arlington returned to his wife’s side a few minutes later, Mary looked at him and said, “I have taken the liberty of administering some laudanum. It should make it easier on her, but this is not going to be a painless procedure. I hope I can count on you to hold her down and keep her steady for me. Dr. Helmsley will help you while. . .” She turned to the maid. “I am terribly sorry, but I do not know your name.”
“It is Lucy Pinksworth, my lady.”
Mary acknowledged her with a quick nod. “Answer me honestly, Miss Pinksworth. Are you likely to faint at the sight of blood?”
“N. . .no, my lady. I believe I shall be quite all right.”
“Good, because I am going to need someone to keep the bladder out of the way while I open up the uterus. Do you think you can manage that?”
Lucy’s face paled momentarily, but then she appeared to pull herself together “I. . .yes, I believe I can,” she replied with a surprising amount of conviction as she watched Mary fish her tools out of the boiling water before setting them side by side on a clean white towel.
“All right,” Mary said as she drew a long breath. “Then let us get started.”
It took about an hour for Mary to complete the operation, and since the viscountess fainted from the pain very early on, Lord Arlington and Helmsley were left with very little to do. Lucy, on the other hand, performed admirably. She followed Mary’s instructions to the letter, without flinching as much as once.
“Congratulations, Lord Arlington,” Mary said as she lifted a squealing baby from its mother’s womb. “It looks as though you have a very healthy baby boy.” She handed the child over to Lucy and began the monotonous process of stitching up her patient.
As she finished the last of the stitches, Mary finally allowed herself to relax. She looked up at Helmsley, who was showing marked signs of relief. Lady Arlington and the baby were both alive for now. She knew that they weren’t out of danger yet, but a strong feeling told her that all would be well with both mother and child.
A soft sniffle caught Mary’s attention. “Thank you,” Lord Arlington choked as he looked at her through misty eyes. “Thank you, thank you, thank you.”
“You are most welcome, my lord,” Mary said as she placed a reassuring hand upon his arm. “Of course, we will need to monitor your wife closely for the next few days, but I do believe that she will be all right. The internal suture was done using catgut, so it will dissolve on its own,
but I shall have to take out the external stitches once the wound is fully healed. In the meantime, I will stay with you until she wakes up. Depending on how she is feeling, we will decide on a time for me to return and check up on her.”
CHAPTER FIVE
* * *
It was five thirty in the morning by the time Mary made her way to bed, so exhausted that she collapsed fully clothed on top of her covers, her feet dangling precariously over the edge. When she eventually woke up again, it was past noon, and by the time she made it downstairs, fully dressed and with her hair styled to perfection, it was almost one.
The minute she walked into the parlor, she froze. There were flowers not only on every surface but on the floor as well: roses in a wide array of colors, chrysanthemums, lilies, and carnations, all beautifully arranged in bouquets of varying sizes. Mary just stood there and stared. “Thornton?” The butler appeared at her side instantaneously. “What on earth is going on?”
“Well, I can take it to mean only one thing, my lady. You must have made quite an impression last night at Richmond House—these flowers have been arriving all morning. And now that it is past lunch time, you will probably be receiving your first caller at any—” The doorbell rang. “Moment,” he finished.
Mary stared at Thornton in horror. “You don’t mean to tell me that. . .but I just got out of bed. I cannot possibly receive anyone now.”
“I can fend them off for a while, my lady, but I cannot keep them at bay forever. There is a plate of food for you in the dining room, which will no doubt do you a world of good after all that gallivanting about last night.” He gave her a disapproving look. “In the meantime, I shall see who is at the door; after all, it is the polite thing to do.”
Mary paused only long enough to realize that once the front door was opened, whoever had decided to call upon her would be likely to spot her straight away, leaving her with little choice but to invite them in. With a soft rustle of her skirts, she immediately fled down the hallway and into the dining room, almost grateful to discover that no ostentatious bouquets of flowers had made it that far yet.
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