The Outlandish Companion
Page 40
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#: 470989 S8/Research & craft [WRITERS] 23-Aug-97 03:52:17
Sb: #470986-#SPOILER—Penicillin Fm: Diana Gabaldon 76530,523 To: All
[continued]
Kenny Lindsey had asked Roger to sing the _caithris_ for Rosamund; the formal Gaelic lament for the dead. “She wasna Scots,” Kenny had said, wiping eyes bleared from tears and a long night’s watching. “Nor even Godfearin’. But she was that fond o’ singin’, and she fair admired your way o’ it, MacKenzie.”
Roger had never sung a _caithris_ before; I knew he had never heard one. “Dinna fash,” Jamie had murmured to him, hand on his arm, “all ye need to be is loud.” Roger had bent his head gravely in acquiescence, and went with Jamie and Kenneth, to drink whisky by the malting floor and learn what he could of Rosamund’s life, the better to lament her passing.
The singing vanished; the wind had shifted. It was a freak of the storm that we had heard them so soon—they would be headed down the Ridge now, to collect mourners from the outlying cabins, and then to lead them all in procession back up to the house, for the feasting and singing and storytelling that would go on all night.
I yawned involuntarily, my jaw cracking at the thought of it. I’d never last, I thought in dismay. I had had a few hours’ sleep in the morning, but not enough to sustain me through a full-blown Gaelic wake and funeral. The floors would be thick with bodies by dawn, all of them smelling of whisky and wet clothes.
I yawned again, then blinked, my eyes swimming as I shook my head to clear it. Every bone in my body ached with fatigue, and I wanted nothing more than to go to bed for several days.
Deep in thought, I hadn’t noticed Brianna coming to stand behind me. Her hands came down on my shoulders, and she moved closer, so I felt the warmth of her touching me. Marsali had gone; we were alone. She began to massage my shoulders, long thumbs moving slowly up the cords of my neck. “Tired?” she asked.
“Mm. I’ll do,” I said. I closed the book, and leaned back, relaxing momentarily in the sheer relief of her touch. I hadn’t realized I was strung so tightly.
The big room was quiet and orderly, ready for the wake. The girls had lit a pair of candles, one at each end of the laden table, and shadows flickered over the whitewashed walls, the quiet coffin, as the candle-flames bent in a sudden draft.
“I think I killed her,” I said suddenly, not meaning to say it at all. “It was the penicillin that killed her.”
The long fingers didn’t stop their soothing movement.
“Was it?” she murmured. “You couldn’t have done any differently, though, could you?”
“No.”
A small shudder of relief went over me, as much from the bald confession as from the gradual release of the painful tightness in my neck and shoulders.
“It’s okay,” she said softly, rubbing, stroking. “She would have died anyway, wouldn’t she? It’s sad, but you didn’t do wrong. You know that.”
“I know that.” To my surprise, a single tear slid down my cheek and dropped on the blotter, puckering the thick paper. I blinked hard, struggling for control. I didn’t want to distress Brianna.
She wasn’t distressed. Her hands left my shoulders, and I heard the scraping of stool legs. Then her arms came around me, and I let her draw me back, my head resting just under her chin. She simply held me, letting the rise and fall of her breathing calm me.
“I went to dinner with Uncle Joe once, just after he’d lost a patient,” she said finally. “He told me about it.”
“Did he?” I was a little surprised; I wouldn’t have thought Joe would talk about such things with her.
“He didn’t mean to. I could see something was bothering him, though, so I asked. And—he needed to talk, and I was there. Afterward, he said it was almost like having you there. I didn’t know he called you Lady Jane.”
“Yes,” I said. “Because of the way I talk, he said.” I felt a breath of laughter against my ear, and smiled slightly in response. I closed my eyes, and could see my friend, gesturing in passionate conversation, face alight with the desire to tease.
“He said—that when something like that happened, sometimes there would be a sort of formal inquiry, at the hospital. Not like a trial, not that—but a gathering of the other doctors, to hear exactly what happened, what went wrong. He said it was sort of like confession, to tell it to other doctors, who could understand—and it helped.”
“Mm-hm.” She was swaying lightly, rocking me as she moved, as she rocked Jemmy, soothing.
“Is that what’s bothering you?” she asked quietly. “Not just Rosamund—but that you’re alone? You don’t have anybody who can really understand?”
Her arms wrapped around my shoulders, her hands crossed, resting lightly on my chest.
Young, broad, capable hands, the skin fresh and fair, smelling of fresh-baked bread and strawberry jam. I lifted one, and laid the warm palm against my cheek.
“Apparently I do,” I said.
The hand curved, stroked my cheek and dropped away. The big young hand moved slowly, smoothing the hair behind my ear with soft affection. “It will be all right,” she said. “Everything will be all right.”
“Yes,” I said, and smiled, despite the tears blurring my eyes. I couldn’t teach her to be a doctor. But evidently I had, without meaning to, somehow taught her to be a mother.
“You should go lie down,” she said, taking her hands away reluctantly. “It will be an hour at least, before they get here.”
I let my breath go out in a sigh, feeling the peace of the house around me. If Fraser’s Ridge had been a short-lived haven for Rosamund Lindsey, still it had been a true home. We would see her safe, and honored in death.
“In a minute,” I said, wiping my nose. “I need to finish something, first.”
I sat up straight and opened my book. I dipped my pen, and began to write the lines that must be there, for the sake of the unknown physician who would follow me.
[end section]
#: 471087 S8/Research & craft [WRITERS]
23-Aug-97 12:02:31 Sb: #470988-SPOILER—Penicillin Fm: Elise Skidmore S/L 6 71576,375 To: Diana Gabaldon 76530,523
Dear Diana,
As usual, this piece of writing from you is wonderfully done. While I don’t know anything about the medical aspects, the emotional ones ring true. I am always a bit awed when I read these excerpts. You make it look so easy.
Now, I haven’t a clue what “cupping and blistering for epileptic fits” is, but I was wondering at your use of “fits.” I was always told that term was incorrect, that “seizure” was the “proper” word. I know you’re dynamite at research (as this whole excerpt proves), so I’m wondering, would Claire have used “epileptic fits”? When I was around 10–11 (’64-’65), my girlfriend’s mother used to have these seizures all the time and I can remember being told about it back then so I don’t think it’s a PC thing. With Claire being a doctor, I’d think she’d be more sensitive about the wording, but then, I could be wrong. It’s happened before. :-)Elise
#: 471147 S8/Research & craft [WRITERS]
23-Aug-97 15:49:11 Sb: #471087-SPOILER—Penicillin Fm: Diana Gabaldon 76530,523 To: Elise Skidmore S/L 6 71576,375
Dear Elise—
No, the proper word—and the one Claire would use herself—_is_ “seizure.” However, what she’s doing there is not contemplating epilepsy _per se_, but thinking of Rawlings’s casebook descriptions. And he, being an eighteenth-century practitioner, very likely did say “fits.”
“Fits,” by the way, was common usage in the American South, well into this century. My great-grandmother, from Kentucky, wasn’t at all countrified, but she said “fits,” and so did most of her family.
Cupping and blistering, by the way, was a process in which small fires were lighted on the skin, to draw evil humours to the surface.
In re “
You make it look so easy.” Just to put things in perspective, this is just about two weeks’ work you’re looking at.
#: 471158 S8/Research & craft [WRITERS]
23-Aug-97 16:44:19
Sb: #471087-SPOILER—Penicillin
Fm: Elise Skidmore S/L 6 71576,375 To: Diana Gabaldon 76530,523
Dear Diana,
Thanks for explaining the reasoning behind why you used “fits” vs. “seizure.” Makes perfect sense to me and I just _knew_ you had good reason for it.
In re “You make it look so easy.” Just to put things in perspective, this is just about two weeks’ work you’re looking at.
Well, that’s the mark of all champions, making what’s really tough look like a piece of cake. Kudos to you. I thought the excerpt was very well done. Those two weeks were well spent.:-) Elise
#: 471256 S8/Research & craft [WRITERS]
23-Aug-97 22:50:22
Sb: #471087-SPOILER—Penicillin
Fm: Marte Brengle 76703,4242
To: Elise Skidmore S/L 6 71576,375
Cupping is exactly what one might think—the application of small, thick-rimmed cups to the skin. The person doing the cupping first lights a bit of some kind of aromatic herb (usually) and tosses the flaming material into the cup, then quickly turns it upside down onto the patient’s back. As the flaming material burns up the oxygen, a vacuum forms and the skin rises inside the cup.
My grandmother (Evelyn Eaton) gives a rather vivid description of having this done to her in one of her collections of autobiographical short stories (originally printed in the _New Yorker_). I believe it’s “Every Month Was May” but could possibly be “The North Star Is Nearer.” My mother’s got my copies of the books so I can’t check, but the story itself is memorable.—M
#: 471379 S8/Research & craft [WRITERS]
24-Aug-97 10:36:30
Sb: #471256-SPOILER—Penicillin
Fm: Elise Skidmore S/L 6 71576,375
To: Marte Brengle 76703,4242
So tell me, did this actually help cure anything? Doesn’t sound real pleasant to me.:-)Elise
Fm: Marte Brengle 76703,4242
To: Elise Skidmore S/L 6 71576,375
My grandmother had “catarrh” which was an all-purpose term for a heavy chest cold, and yes, apparently the cupping did help. It was about all that was available in rural France in the 1930s.—M—
Fm: Rosina Lippi-Green 102014,1664
To: Diana Gabaldon 76530,532
Diana,
I’ve read it twice. I’m not surprised it took you a while to write it, it’s very, very finely put together.
I can’t comment on the medical aspects, of course, but I think the form and rhythm of it—starting with the formal description and moving into the introspection, ending with the conversation—works beautifully.
rosina
Fm: Diana Gabaldon 76530,523
To: Rosina Lippi-Green 102014,1664 (X)
Dear Rosina—
Thanks!—Diana
Fm: Coleen 103361,1003
To: Diana Gabaldon 76530,523
Gosh, Diana, it feels right, emotionally and medically. The medical record is objective, as one would expect, and the doctor is experiencing the mixed emotions during writing that (I think) most healers have experienced. I identified mostly with the emotions and especially the confessional aspect of the situation. Even when you did everything possible, you feel like there must have been something more you could have done. Very well written. The piece has, of course, made me pause to think about possible solutions to Claires anaphylaxis problem… if there were some epinephrinelike plant—ephedra perhaps? Just thinking out loud…
Fm: Diana Gabaldon 76530,523
To: Coleen 103361,1003 (X)
Dear Coleen:
Oh, good; glad it works for you. Re the ephedra—we got it out here in the Southwest, but evidently not in the Eastern/Central region, according to the _Peterson Field Guide to Medicinal Plants_. There’s _lots_ of stuff listed as “allergenic,” but my general impression is that they mean people are easily allergic to ’em, not that they relieve allergic symptoms.
The only anti-allergenics from the Eastern region are (evidently) wild licorice, chamomile, and wild yam. Wild yam might actually be a possibility, in that diosgenin from yams is the basis for the steroid hormones used in a good many modern drugs—like oral contraceptives and asthma medications—BUT (the book says), such drugs are derived “from elaborately processed chemicals found in the wild yam.” Claire wouldn’t have anything beyond simple pressing, distilling, extraction, and/or steeping, which might not be sufficient to the purpose.
It’s still a thought, but I think one might have procedural problems with administering an antidote to anaphylactic shock—even if you knew of one—insofar as for most such things, you have to steep the herb in boiling water or otherwise do something time-consuming to it, in order to extract the active principle. Judging from the anecdotes I’ve heard from Kit and others, I don’t think you’d have time to do that, if someone went into full-blown anaphylaxis right in front of you—and anaphylactic shock wouldn’t be a sufficiently common occurrence in that setting for a physician to keep the remedy always on hand (given that most herbal medicines have to be made fresh at fairly short intervals; they don’t keep well).
Thanks!—Diana
Fm: Coleen 103361,1003
To: Diana Gabaldon 76530,523
Hmm… interesting dilemma. I also wondered if maybe caffeine from coffee or theophylline from tea would help—but I remember Claire’s aversion to the traditional English tea (or even the theobromine from chocolate… yum). I know it’s not for this patient since it’s such a poignant part of Claire’s learning experience… I’m just doing the typical problem-solving that’s been drilled into my head.
No, these probably wouldn’t work for acute, severe anaphylactic reactions, only for respiratory signs, or asthma attacks… Purified cow’s adrenal? LOL—the person she tried that on would probably end up being allergic to cow protein!
Persistent, ain’t I?
Coleen
Fm: Diana Gabaldon 76530,523
To: Coleen 103361,1003
Dear Coleen—
Oh, Claire likes tea.
Why don’t you tell me exactly how to purify a cow adrenal, just in case I ever need to know this?
Diana
Fm: Coleen 103361,1003
To: Diana Gabaldon 76530,523
Hi again, Diana,
Hmm… I remember seeing the TV show dramatizing how the Canadian team discovered insulin… I don’t think they gave the specifics of how to purify pancreas though
Coleen (who is actually looking to see if she has anything on the discovery of adrenaline, even if you were being facetious
Fm: Susan Martin/SL8 74101,113
To: Diana Gabaldon 76530,523
Diana,
I can’t speak to the medical part—nothing stuck out to me, but then IANAD. As to the emotional part, lovely. Well done!
—Susan
Fm: Diana Gabaldon 76530,523
To: Susan Martin/SL8 74101,113
Dear Susan—
Thank you!
—Diana
Fm: Mira Brown 100425,170
To: Diana Gabaldon 76530,5
23
Hi, Diana,
Hope the migraine is better. Mountain Dew with avocado and bagels?
To the scene: I echo much of what Rosina has already said. Love the loneliness, the desperate need for contact with the other doctor, the need for reassurance that eventually comes from Brianna.
Also, the “orderly room” filled with the smell of wood and food, complete with the corpse and candles. I’ve seen it in villages back home—it still makes me shiver a bit but also has that wonderful “life goes on” quality.
However, strictly as a reader
Years ago I was involved in a road accident (it wasn’t me driving) and between someone’s massive incompetence, high snow, ice, etc., I was brought to the hospital having virtually bled to death. Apparently, there’s more to blood transfusion than just establishing that I was A+. But, the emergency team had no time for niceties—they grabbed the first A+ to hand. I was very lucky and it happened to be a perfect match, but the boys were still terribly upset when I woke up, because I could have died on them—apparently. The thing is, that was a modern hospital, and they still had no option. Neither did Claire. I could understand her self-recriminations if she had a number of choices and made the wrong one. Even then it would have hardly been a murder. You’ve tied both her hands behind her back with the state the woman was brought in, the woman’s and then her husband’s refusal of amputation and insistence on pigeon poultice (pigeon poultice?!—did they really do that?), the absence of any other medication, etc.… Would a mature woman and a practicing, experienced doctor really blame herself that much for taking the *only* option open to her? I think I’d rather see anger that she wasn’t allowed to do her job as she saw fit, at the futility of the woman’s death.