She had finished wiping down the stools, boxes, and other impedimenta for the morning surgery, and straightened up, a small frown between her brows.
“Do you remember the woman you saw yesterday? The one with the retarded little boy?”
“Not something you’d forget,” I said, as lightly as possible. “Why? Here, can you deal with this?” I gestured at the folding table I used, which was stubbornly declining to fold up properly, its joints having swollen with the damp.
Brianna frowned slightly, studying it, then struck the offending joint sharply with the side of her hand. It gave way and collapsed obediently at once, recognizing superior force.
“There.” She rubbed the side of her hand absently, still frowning. “You were making a big thing of telling her to try not to have any more children. The little boy—was it an inheritable condition, then?”
“You might say that,” I replied dryly. “Congenital syphilis.”
She looked up, blanching.
“Syphilis? You’re sure?”
I nodded, rolling up a length of boiled linen for bandaging. It was still very damp, but no help for it.
“The mother wasn’t showing overt signs of the late stages—yet—but it’s quite unmistakable in a child.”
The mother had come simply to have a gumboil lanced, the little boy clinging to her skirts. He’d had the characteristic “saddle nose,” with its pushed-in bridge, as well as a jaw so malformed that I wasn’t surprised at his poor nutrition; he could barely chew. I couldn’t tell how much of his evident backwardness was due to brain damage and how much to deafness; he appeared to have both, but I hadn’t tested their extent—there being exactly nothing I could do to remedy either condition. I had advised the mother to give him pot liquor, which might help with the malnutrition, but there was little else to be done for him, poor mite.
“I don’t see it so often here as I did in Paris or Edinburgh, where there were a lot of prostitutes,” I told Bree, tossing the ball of bandages into the canvas bag she held open. “Now and then, though. Why? You don’t think Roger has syphilis, do you?”
She looked at me, openmouthed. Her look of shock was obliterated by an instant flood of angry red.
“I do not!” she said. “Mother!”
“Well, I didn’t really think so,” I said mildly. “Happens in the best of families, though—and you were asking.”
She snorted heavily.
“I was asking about contraception,” she said, through her teeth. “Or at least I meant to, before you started in with the Physician’s Guide to Venereal Disease.”
“Oh, that.” I eyed her thoughtfully, taking in the dried milk stains on her bodice. “Well, breast-feeding is reasonably effective. Not absolute, by any means, but fairly effective. Less so, after the first six months”—Jemmy was now six months old—“but still effective.”
“Mmphm,” she said, sounding so like Jamie that I had to bite my lower lip in order not to laugh. “And exactly what else is effective?”
I hadn’t really discussed contraception—eighteenth-century style—with her. It hadn’t seemed necessary when she first appeared at Fraser’s Ridge, and then it really wasn’t necessary, she being already pregnant. So she thought it was now?
I frowned, slowly putting rolls of bandage and bundles of herbs into my bag.
“The most common thing is some sort of barrier. A piece of silk or a sponge, soaked with anything from vinegar to brandy—though if you have it, tansy oil or oil of cedar is supposed to work the best. I have heard of women in the Indies using half a lemon, but that’s obviously not a suitable alternative here.”
She uttered a short laugh.
“No, I wouldn’t think so. I don’t think the tansy oil works all that well, either—that’s what Marsali was using when she got pregnant with Joan.”
“Oh, she was using it? I thought perhaps she’d just not bothered once—and once is enough.”
I felt, rather than saw her stiffen, and bit my lip again, this time in chagrin. Once had been enough—we just didn’t know which once. She hunched her shoulders, though, then let them fall, deliberately dismissing whatever memories my thoughtless remark had conjured.
“She said she’d been using it—but she might have forgotten. It doesn’t work all the time, though, does it?”
I slung the bag of surgical linens and dried herbs over my shoulder and picked up the medical chest by the leather strap Jamie had made for it.
“The only thing that always works is celibacy,” I said. “I suppose that isn’t a satisfactory option in the present case?”
She shook her head, her eyes fixed broodingly on a cluster of young men visible through the trees below, taking turns at pitching stones across the creek.
“That’s what I was afraid of,” she said, and bent to pick up the folding table and a pair of stools.
I looked round the clearing, considering. Anything else? No worry about leaving the campfire, even if Lizzie fell asleep; nothing on the mountainside would burn in this weather; even the kindling and firewood we had stored at the end of our lean-to the day before were damp. Something was missing, though … what? Oh, yes. I put down the box for a moment and knelt to crawl into the lean-to. I dug about in the jumble of quilts, coming out finally with my tiny leather medicine pouch.
I said a brief prayer to St. Bride and slipped it round my neck and down inside the bodice of my dress. I was so much in the habit of wearing the amulet when I set out to practice medicine that I had almost ceased to feel ridiculous about this small ritual—almost. Bree was watching me, a rather odd look on her face, but she said nothing.
I didn’t, either; merely picked up my things and followed her across the clearing, stepping carefully round the boggiest spots. It wasn’t raining now, but the clouds sat on the tops of the trees, promising more at any moment, and wisps of mist rose from fallen logs and dripping bushes.
Why was Bree worrying about contraception? I wondered. Not that I didn’t think it sensible—but why now? Perhaps it was to do with the imminence of her wedding to Roger. Even if they had been living as man and wife for the last several months—and they had—the formality of vows spoken before God and man was enough to bring a new sobriety to even the giddiest of young people. And neither Bree nor Roger was giddy.
“There is another possibility,” I said to the back of her neck, as she led the way down the slippery trail. “I haven’t tried it on anyone yet, so I can’t say how reliable it may be. Nayawenne—the old Tuscaroran lady who gave me my medicine bag—she said there were ‘women’s herbs.’ Different mixtures for different things—but one plant in particular for that; she said the seeds of it would keep a man’s spirit from overwhelming a woman’s.”
Bree paused, half-turning as I came up beside her.
“Is that how the Indians see pregnancy?” One corner of her mouth curled wryly. “The man wins?”
I laughed.
“Well, in a way. If the woman’s spirit is too strong for the man’s, or won’t yield to it, she can’t conceive. So if a woman wants a child and can’t have one, most often the shaman will treat her husband, or both of them, rather than just her.”
She made a small throaty noise, partly amusement—but only partly.
“What’s the plant—the women’s herb?” she asked. “Do you know it?”
“I’m not positive,” I admitted. “Or not sure of the name, I should say. She did show it to me, both the growing plant and the dried seeds, and I’m sure I’d know it again—but it wasn’t a plant I knew by an English name. One of the Umbelliferae, though,” I added helpfully.
She gave me an austere look that reminded me once more of Jamie, then turned to the side to let a small stream of Campbell women go by, clattering with empty kettles and pails, each one bobbing or bowing politely to us as they passed on their way down to the creek.
“Good day to ye, Mistress Fraser,” said one, a neat young woman that I recognized as one of Farquard Campbell’s younger daughte
rs. “Is your man about? My faither would be glad of a word, he says.”
“No, he’s gone off, I’m afraid.” I gestured vaguely; Jamie could be anywhere. “I’ll tell him if I see him, though.”
She nodded and went on, each of the women behind her pausing to wish Brianna happiness on her wedding day, their woolen skirts and cloaks brushing small showers of rainwater from the bayberry bushes that lined the path here.
Brianna accepted their good wishes with gracious politeness, but I saw the small line that formed between her thick red brows. Something was definitely bothering her.
“What?” I said bluntly, as soon as the Campbells were out of earshot.
“What’s what?” she said, startled.
“What’s troubling you?” I asked. “And don’t say ‘nothing,’ because I see there is. Is it to do with Roger? Are you having second thoughts about the wedding?”
“Not exactly,” she replied, looking wary. “I want to marry Roger, I mean—that’s all right. It’s just … I just … thought of something …” She trailed off, and a slow flush rose in her cheeks.
“Oh?” I asked, feeling rather alarmed. “What’s that?”
“Venereal disease,” she blurted. “What if I have it? Not Roger, not him, but—from Stephen Bonnet?”
Her face was flaming so hotly that I was surprised not to see the raindrops sizzle into steam when they struck her skin. My own face felt cold, my heart tight in my chest. The possibility had occurred to me—vividly—at the time, but I hadn’t wanted even to suggest such a thing, if she hadn’t thought of it herself. I remembered the weeks of watching her covertly for any hint of malaise—but women often showed no symptoms of early infection. Jemmy’s healthy birth had been a relief in more ways than one.
“Oh,” I said softly. I reached out and squeezed her arm. “Don’t worry, lovey. You haven’t.”
She took a deep breath, and let it out in a pale misty cloud, some of the tension leaving her shoulders.
“You’re sure?” she said. “You can tell? I feel all right, but I thought—women don’t always have symptoms.”
“They don’t,” I said, “but men most certainly do. And if Roger had contracted anything nasty from you, I’d have heard about it long since.”
Her face had faded somewhat, but the pinkness came back at that. She coughed, mist rising from her breath.
“Well, that’s a relief. So Jemmy’s all right? You’re sure?”
“Absolutely,” I assured her. I had put drops of silver nitrate—procured at considerable cost and difficulty—in his eyes at birth, just in case, but I was indeed sure. Aside from the lack of any specific signs of illness, Jemmy had an air of robust health about him that made the mere thought of infection incredible. He radiated well-being like a potful of stew.
“Is that why you asked about contraception?” I asked, waving a greeting as we passed the MacRaes’ campsite. “You were worried about having more children, in case …”
“Oh. No. I mean—I hadn’t even thought about venereal disease until you mentioned syphilis, and then it just struck me as a horrible realization—that he might have—” She stopped and cleared her throat. “Er, no. I just wanted to know.”
A slippery patch of trail put paid to the conversation at that point, but not to my speculations.
It wasn’t that a young bride’s mind might not turn lightly to thoughts of contraception—but under the circumstances … what was it? I wondered. Fear for herself, or for a new baby? Childbirth could be dangerous, of course—and anyone who had seen the attendees at my surgery or heard the women’s conversations round the campfires in the evening could be in no doubt as to the dangers to infants and children; it was the rare family that had not lost at least one infant to fever, morbid sore throat, or “the squitters”—uncontrolled diarrhea. Many women had lost three, four, or more babies. I remembered Abel MacLennan’s story, and a small shiver ran down my spine.
Still, Brianna was very healthy, and while we did lack important things like antibiotics and sophisticated medical facilities, I had told her not to underestimate the power of simple hygiene and good nutrition.
No, I thought, watching the strong curve of her back as she lifted the heavy equipment over an entangling root that hunched across the trail. It wasn’t that. She might have reason to be concerned, but she wasn’t basically a fearful person.
Roger? On the face of it, it would seem that the best thing to do was to become pregnant again quickly, with a child that was definitely Roger’s. That would certainly help to cement their new marriage. On the other hand … what if she did? Roger would be more than pleased—but what about Jemmy?
Roger had sworn a blood oath, taking Jemmy as his own. But human nature was human nature, and while I was sure that Roger would never abandon or neglect Jemmy, it was quite possible that he would feel differently—and obviously differently—for a child he knew was his. Would Bree risk that?
On due consideration, I rather thought she was wise to wait—if she could. Give Roger time to feel a close bond with Jemmy, before complicating the family situation with another child. Yes, very sensible—and Bree was an eminently sensible person.
It wasn’t until we had arrived, finally, at the clearing where the morning surgeries were held that another possibility occurred to me.
“Can we be helpin’ ye at all, Missus Fraser?”
Two of the younger Chisholm boys hurried forward to help, relieving me and Brianna of our heavy loads, and without being told, started in at once to unfold tables, fetch clean water, kindle a fire, and generally make themselves useful. They were no more than eight and ten, and watching them work, I realized afresh that in this time, a lad of twelve or fourteen could be essentially a grown man.
Brianna knew that, too. She would never leave Jemmy, I knew—not while he needed her. But … later? What might happen when he left her?
I opened my chest and began slowly to lay out the necessary supplies for the morning’s work: scissors, probe, forceps, alcohol, scalpel, bandages, tooth pliers, suture needles, ointments, salves, washes, purges …
Brianna was twenty-three. She might be no more than in her mid-thirties by the time Jem was fully independent. And if he no longer needed her care—she and Roger might possibly go back. Back to her own time, to safety—to the interrupted life that had been hers by birth.
But only if she had no further children, whose helplessness would keep her here.
“Good morn to ye, ma’am.” A short, middle-aged gentleman stood before me, the morning’s first patient. He was bristling with a week’s worth of whiskers, but noticeably pallid round the gills, with a clammy look and bloodshot eyes so raw with smoke and whisky that his malady was instantly discernible. Hangover was endemic at the morning surgery.
“I’ve a wee gripin’ in my guts, ma’am,” he said, swallowing unhappily. “Would ye have anything like to settle ’em, maybe?”
“Just the thing,” I assured him, reaching for a cup. “Raw egg and a bit of ipecac. Have you a good vomit, and you’ll be a new man.”
The surgery was held at the edge of the big clearing at the foot of the hill, where the great fire of the Gathering burned at night. The damp air smelled of soot and the acrid scent of wet ashes, but the blackened patch of earth—some ten feet across, at least—was already disappearing under a crisscross of fresh branches and kindling. They’d have a time starting it tonight, I thought, if the drizzle kept up.
The gentleman with the hangover disposed of, there was a short lull, and I was able to give my attention to Murray MacLeod, who had set up shop a short distance away.
Murray had gotten an early start, I saw; the ground by his feet was dark, the scattered ashes sodden and squishy with blood. He had an early patient in hand, too—a stout gentleman whose red, spongy nose and flabby jowls gave testimony to a life of alcoholic excess. He had the man stripped to his shirt despite the rain and cold, sleeve turned up and tourniquet in place, the bleeding bowl held across the patient�
�s knees.
I was a good ten feet from the stool where Murray plied his trade, but could see the man’s eyes, yellow as mustard even in the dim morning light.
“Liver disease,” I said to Brianna, taking no particular pains to lower my voice. “You can see the jaundice from here, can’t you?”
“Bilious humors,” MacLeod said loudly, snapping open his fleam. “An excess of the humors, clear as day.” Small, dark, and neat in his dress, Murray was not personally impressive, but he was opinionated.
“Cirrhosis due to drink, I daresay,” I said, coming closer and looking the patient over dispassionately.
“An impaction of the bile, owing to an imbalance of the phlegm!” Murray glowered at me, clearly thinking I intended to steal his thunder, if not his patient.
I ignored him and bent down to examine the patient, who looked alarmed at my scrutiny.
“You have a hard mass just under the ribs on the right, don’t you?” I said, kindly. “Your piss is dark, and when you shit, it’s black and bloody, am I right?”
The man nodded, mouth hanging open. We were beginning to attract attention.
“Mo-therr.” Brianna was standing behind me. She gave Murray a nod and bent to mutter in my ear. “What can you do for cirrhosis, Mother? Nothing!”
I stopped, biting my lip. She was right. In my urge to show off by making the diagnosis—and keep Murray from using his stained, rusty-looking fleam on the man—I had overlooked the minor point that I had no alternative treatment to offer.
The patient was glancing back and forth between us, plainly uneasy. With an effort, I smiled at him, and nodded to Murray.
“Mr. MacLeod has the right of it,” I said, forcing the words past my teeth. “Liver disease, surely—caused by an excess of humors.” I supposed one could consider alcohol a humor, after all; the folk drinking Jamie’s whisky last night had evidently found it hilarious.
Murray’s face had been tense with suspicion; at my capitulation, it went quite comically blank with astonishment. Stepping in front of me, Brianna seized advantage of the moment.
The Outlander Series 7-Book Bundle Page 448
