Down in the Valley

by Jane Shoup

  “Greg.”

  Her throat felt too tight to speak for a moment and she was painfully aware that her face had flushed. “I’ll need a place to operate,” she said as she sidestepped, forcing him to relinquish his hold. “Somewhere like a kitchen, where the surroundings can be made as sanitary as possible.”

  “I’ll see to it.”

  He turned and started back to the chow hall, and she took a deep breath and went back inside, still feeling warmth where his hands had been.

  The kitchen had been scrubbed clean and then wiped down with vinegar. The sharp tang of it hung in the air. Charity looked over her surgical instruments, which had been laid out after being boiled. A pile of clean rags was at the ready as was silk suturing, which had been soaked in carbolic acid. A dozen fat candles lit the area from the chandelier above the table. It wasn’t dark yet, but they couldn’t risk losing the light.

  “Are you ready?” Greg asked from the doorway.

  “I’ll need a few people to assist throughout the surgery, and Coy will need to be carried over here once I’ve put him under.”

  “Done.”

  She picked up the bottle of chloroform and a clean rag and started out, trying to look all business, although he could tell she was having second thoughts. He fell into step beside her. “You don’t have to do this.”

  “I have to try,” she said, looking straight ahead. “He asked and I said I would.”

  He nodded in acceptance and opened the door of the bunkhouse for her, not even bothering to announce her, since the men were expecting her. As they walked through the long room, men stood. It was hushed, the atmosphere somber. They all knew this was an exercise in futility, but he respected that she needed to keep her word. She needed to try. She sat in the chair beside Coy’s bed, while he went to the other side.

  “Are you ready?” she asked.

  “I feel kind of funny, being naked,” the kid whispered back.

  She smiled tenderly. “I know, but you won’t for long,” she said, hefting the bottle of chloroform. “I promise.” She unscrewed the lid.

  “Thank you,” he bit out.

  She nodded. “When you come to, you’ll have discomfort. Remember that you can take the laudanum. You can sip a little directly from the bottle if the pain is bad, or you can have it diluted in water.”

  He nodded.

  She doused the rag in the chloroform, set the bottle down and transferred the rag to her left hand before bringing it to Coy’s mouth and nose. “Just breathe normally,” she said in a soothing voice. “You’ll slip into a deep sleep and not feel any more pain for a while.” His gaze was locked on hers, and she gently smoothed his hair back with her right hand. Soon he wasn’t able to keep his eyes open any longer, and yet she still continued holding the rag close and stroking his hair. Howerton was moved by the gentleness of her touch. He pictured her tending to their young son flushed with the fever of a minor ailment.

  “I’ll need assistants,” she said.

  Several men spoke up, volunteering.

  She locked gazes with Roger, one of the younger men, who was standing close by. “Just like I’m doing, you’ll hold a rag near his mouth and nose once we get started.”

  “Yes, ma’am.”

  “And I’ll need one more.”

  “I’ll do it,” Max Jordan offered. “He’s a good friend of mine. I’ll do it.”

  “Thank you.” She straightened and rose. “You can take him,” she said to the men waiting to transport him.

  Howerton watched as they lifted Coy onto the stretcher. Charity recapped the bottle of chloroform and followed them outside. In the yard, men stopped what they were doing and now watched. Most took their hats off.

  “Good luck, Doc,” someone called.

  In the kitchen, Coy was laid out on the table and positioned on his stomach, per her instructions. She walked over to the stone sink and washed her hands well and then dipped them into a bowl of vinegar before drying them. As she walked over to Coy, Howerton rolled up his sleeves and followed her example.

  She doused the rag in chloroform again and showed Roger how closely to hold it over Coy’s mouth and nose. She then walked over to the makeshift operating table and looked at Greg as he joined her. “I’ll need rags throughout.”

  He calmly nodded.

  She looked at Max, who was standing against a far wall, awaiting instructions. “What’s your name?”

  “Max.”

  “Max, as you can see, there’s a pot of water boiling and there are tongs over there. When I ask, come get whatever instrument I hand you and put it into the water. It should boil for a few minutes, then pull it out and let it cool on the towel.”

  “Yes, ma’am.”

  “While it’s boiling, wash your hands well with soap, rinse them and then stick them in the bowl of vinegar before drying them off. This must be done before handing me any clean instruments.”

  He nodded quickly.

  “Can all of you tolerate the sight of blood?” she asked, looking first to Howerton, who gave her a short, confident nod.

  “Not a problem,” he assured her.

  “Yes, ma’am,” Max said. “No problem for me, either.”

  “I can, Doctor Werthing,” Roger said.

  “Don’t get too close to the rag,” Charity warned him. “What’s your name?”

  “Roger West.”

  “Roger, if you begin to feel faint, please speak up and let me know.”

  “Yes, ma’am.”

  She pulled the blanket off Coy’s body. “Max, will you set this aside?”

  “Yes, ma’am.”

  She peeled off the bandage and dropped it on the floor before irrigating the wound with a solution of carbolic acid. She picked up a small, knifelike instrument. “This is a scalpel,” she said, linking eyes with Howerton. “I have another right there.”

  He glanced at it and looked back at her with a nod.

  She took a deep breath, exhaled slowly and made an incision, extending the length of the wound. Foul-smelling fluid seeped out. “Rags,” she said calmly.

  Howerton handed them to her. “That’s a lot of pus.”

  “Sepsis,” she murmured. “Max, boil this, please,” she said, setting the scalpel down.

  He retrieved it, but it slipped from his hands and clanked on the floor. “I’m sorry,” he apologized.

  “It doesn’t matter,” Charity replied reassuringly. “Boiling kills the germs. But be careful, the edges are sharp.”

  Once again, Howerton experienced a flash of image. Of her, talking to their sons. Patiently instructing them. By God, he wanted her. He wanted to marry her. He wanted her to be the mother of his sons.

  “The wound is four, maybe five inches deep,” she said before she reached inside her patient, working partly by sight but even more by feel. She pulled a slimy, pale mass of intestines toward her.

  “Oh, geez,” Max muttered from the stove.

  “So, don’t look,” Roger snapped.

  “Scalpel,” Charity said, holding out her hand, which was covered in blood.

  Howerton handed it to her carefully. “What are you going to do?”

  “I’ll attempt to cut away the damaged section of intestine,” she said slowly as she did it. The room was silent for several seconds. “Then I’ll sew the good ends back together. I’ll need the silk suture. With the needle. It’s already threaded.”

  “She’s going to sew his guts up,” Max said softly.

  “You shouldn’t talk,” Roger chastised. “You’re going to bother her.”

  “No, it’s fine,” Charity said in an even voice. “I talk all the way through procedures. It’s . . . calming.”

  “So, talk,” Howerton said. “Is there any medicine for the infection he’s already got?”

  “No,” she said regretfully.

  He grunted. “There ought to be.”

  She set down the scalpel. “Max,” she said. She held out her hand to Howerton. “Needle.”

 
He handed it over and she bent closer and began sewing the ends of the intestines together with a deft touch. “There are herbs that help,” she said as she worked. “And ancient remedies that ought to be researched and developed, perhaps implemented again.”

  “Is that so?” Howerton asked conversationally.

  “As a matter of fact, ancient Roman medicine was quite similar to the medicine we practice today. Most people don’t realize that.”

  “I sure as hell didn’t know that,” Roger agreed.

  Howerton offered more rags.

  She glanced up at him with appreciation. “Extract the excess and then just drop it on the floor.”

  He did it, clenching his jaw. “How was it similar?” he asked, keeping his eyes on her hands.

  “The practice of medicine was split among different specialties,” she replied as she continued to sew tiny stitches, “and all surgical tasks were only performed by appropriate specialists.”

  Howerton reached for another rag and used it to sop the blood and pus from around the wound while trying to keep out of her way.

  “Can I ask a question?” Max put in as he set a freshly boiled scalpel down.

  “Of course,” she replied without looking away from her task.

  “Do you ever think about what you’re doing? That your hands are in a man’s guts. His insides.”

  “I think of it clinically. There’s damage here that needs to be cut away and the good ends sewn together. The body is a rather miraculous machine. I work on one small part and focus only on that.”

  Greg glanced at her, impressed by her concentration. Her voice was even, almost a monotone, but the answers intelligent. She was able to do what few could, two things at once and equally well. “You were talking about the Romans?”

  “They had very similar instruments to what we use today. They used painkillers and believed in taking sanitary precautions that we’ve only just recently returned to.”

  “So, obviously, we didn’t keep building on their knowledge,” he mused.

  “No. If we had, there’s no telling where we’d be.”

  “So what herbs could help him?”

  “Deer velvet, garlic, rosemary, sage, eucalyptus, those are several that can be helpful against infection.” She bent closer and inspected her work, then glanced at Roger. Her gaze sharpened with concern. “Max, take over for Roger, please.”

  Greg glanced over and saw how pale Roger was. Max hurried over and took over his job.

  “Roger, go sit against the wall,” she said.

  “Sorry,” he muttered. “I just . . . got . . . kinda . . . woozy.”

  “It’s fine. Just sit on the floor. You’ll be fine.”

  She glanced at Greg. “Can you irrigate for me, please?”

  He picked up the bottle of carbolic acid. “Just pour it?”

  “Yes. Where I’m working.”

  He did, frowning in concentration.

  “Thank you.”

  He glanced at Max to make sure he was keeping a proper distance from the chloroform; they couldn’t function properly with another man down. Max was keeping well back from it as he reached for another rag and stayed at the ready.

  For the next hour, Charity worked in silence except for calling for irrigation or a rag or finally the scalpel, which she used to cut the thread before carefully putting the intestines back in place. “If Roger is well enough, he can go and ask for some of the others to come for Coy.”

  “I can,” Roger said.

  Howerton looked at him. He was still pale, but he’d make it. “Tell them to stay right outside the door until we call for them.”

  “Yes, sir,” Roger said before starting to his feet.

  After Coy was taken back to his room, and only the two of them were left, Charity went to wash her hands. “You will stay the night?” Howerton inquired as he followed her. He stared at the pink suds that formed as she scrubbed. “You’ll want to be close in case he needs you.”

  She rinsed and reached for a clean towel. “I suppose whomever you sent for my bag explained the situation?”

  “Of course.” He moved in to wash his hands, and his arm touched hers. “They know where you are. Why don’t we go have that glass of champagne? Or something stronger. Then we’ll have some dinner.”

  “I don’t have a change of clothes,” she replied, stepping back from him.

  “Doll sent something. Along with word that Tommy is just fine.” He glanced at her to judge her reaction, but she only looked tired and somewhat wary as she offered the towel. He took it and dried his hands. As they walked back to the house, he considered offering his arm. In fact, it took restraint not to, but he sensed she needed a certain amount of space and control. “Does it seem too quiet here after the noise and bustle of the city?”

  “No. I love it. Especially the fresh air.”

  He was delighted to hear it, but refrained from showing any reaction. They walked up the steps and he opened the door for her.

  “This is lovely,” she commented as she walked in.

  “It could use a woman’s touch, I’m sure.”

  She gave a small shrug. “I think it suits you perfectly.”

  He heard the housekeeper’s footsteps and looked over at her. “Dinner in an hour, when Doctor Werthing’s had an opportunity to change and rest a little.”

  “Yes, Mr. Howerton.”

  “If you could see to it that a bath is prepared.”

  “Right away, sir.” She turned and left.

  “I’ll give you a little of the tour on the way to your room,” he said as he led her down the corridor. “Care for a drink?”

  “No, thank you. I’d best keep sharp.”

  He led the way into his office, announcing it perfunctorily, and poured a glass of scotch, which he offered her. She looked at him quizzically. “Yes, I heard you,” he said. “But is there anything else to be done?”

  She hesitated, and then accepted the glass.

  He poured another. “There’s not one chance in ten he’ll recover,” he stated. He turned and found her gaze riveted to his and in it was a touch of hurt. And stubbornness and a ferocious hope. “That’s no reflection on you.”

  She turned away from him and sipped.

  “Tell me, do you get emotionally involved with most of your patients?” he asked as he walked around to face her.

  “Who said that I do?” she asked coolly.

  He smiled.

  “Oh,” she said. “Those instincts of yours. Those instincts that are never wrong.”

  “Something like that.”

  She shrugged. “I suppose I do.”

  He came closer. Too close for propriety, although he didn’t give a damn. She looked at him defiantly and held her ground. He liked that. “Like I said, there’s not a chance in ten he’ll survive,” he said softly. “And I don’t want you to be hurt by it.”

  A myriad of expressions crossed her face and then she lifted her chin. “You needn’t worry about me, Mr. Howerton.”

  “Greg,” he reminded her.

  “I believe you said you were showing me to my room?”

  He grinned and gestured her onward.

  A quarter of an hour later, Charity opened the door of her room and peeked out into an empty hallway before hurrying to the bathroom at the end of the hall, where a hot bath was waiting. She was wearing only a robe, which felt wrong. And pleasingly wanton. What thoughts she was having, all the fault of Gregory Howerton and the way he looked at her, not even attempting to conceal his desire. It was as if he’d made up his mind to have her, which was . . . what?

  She wanted to fill in the blank with insulting, but that wasn’t true. She wasn’t insulted. She felt an attraction to him. No, that wasn’t accurate, either. She was drawn to him, like a moth to a flame, which was what she felt herself resisting. She had worked too long and hard to control her own destiny to fall for a man like him.

  She stepped inside the bathroom and shut the door. This room, like every other, had
been built for comfort and practicality, designed and decorated by someone with money and good taste. She slipped off the robe and climbed into the tub with a heavy sigh. For a few minutes, she relaxed and it was wonderful, but thoughts of Coy started her anxiety rising.

  Not one chance in ten was right, and yet she’d opened him up anyway. The bloating and distension of his abdomen had clearly indicated the bowel had been punctured, the intestines had leaked and infection had set in. Barring a miracle, it was too late. And she’d opened him up anyway.

  Had it been hubris on her part? She could have provided comfort and pain relief until he slipped away, but no; she’d cut him open. She leaned forward and hugged her knees as tears snaked down her face. She wiped them away with dripping, wet hands. It was infuriating. You wouldn’t catch Jack soaking in a tub and crying after operating on a patient. You wouldn’t catch one in ten male doctors doing such a thing.

  She shook her head and exhaled forcefully. This was fatigue talking. She had tried to save a man, despite the odds. It was not ego; it was that she wanted a miracle. For him, not her.

  Charity walked into the dining room, dressed in a simple, coral colored gown, and Greg stood. “Feel better?” he asked, despite her red-rimmed eyes. She’d cried.

  “I do. Thank you.”

  He walked over to pull her chair back for her. “I chose a Bordeaux, but if you’d prefer something else—”

  “Bordeaux sounds wonderful.”

  He seated her and walked back to his place. “You were magnificent today,” he said, raising his glass to her.

  “You’re kind to say so.” She sipped and nodded her approval.

  “You enjoy wine, then?”

  “Very much. This is delicious.” She took another sip. “You were very helpful in the operation. Thank you for that. It’s rare for a layman to be so calm under those circumstances.”

  “Tell me about Tommy. Who was with him when he came to?”

  “I was.”

  “What did he say?”

  She shook her head. “He said his wife’s name. He just wanted Em.”