Oh Christ, she thinks, I will have to cut it off.
‘What do you think?’ Horner asks from the doorway.
Katherine says nothing. She holds her breath and touches the arm. It is scalding to the touch. She lifts it. The boy moans. There is a connective string of something between it and the stained linen sheet below, and a thin gruel of watery pus dribbles on to her wrists. She lets it down. She hurries to the door and pushes past and vomits on the grass. She hears men laughing as she retches. After five or six heaves, the retches turn dry and painful. Jack arrives and offers her some ale from his bottle.
‘I’ll need more light,’ Katherine announces. ‘And air. We’d better bring him out.’
‘Should we not wait until tomorrow?’
‘No,’ she says. ‘It must be soon, if we are to save him. This evening.’
Thomas and Jack exchange a look, then they wrap cloths around their mouths and go back in. They bring him out. Jack has his ankles and Thomas his armpits. The boy’s arm lies across his pale belly. They lay him on the patchy grass. The sheep watch in silence. The boy is breathing very quickly. She bites her lip and returns to the wound. Using her own knife she lifts the bandage. It is a gash, black now, drying at the edges, something wet within. It hardly matters what that is like though, for now she sees the swelling has extended beyond the elbow. She will need a saw.
‘When did it happen?’ she asks.
‘Three mornings ago,’ Horner says. ‘It was one of those things. Montagu’s men. They were too far north. We were too far south …’
He shrugs.
‘It will have to be cut off,’ Katherine tells them. ‘Here.’
She points to the upper arm, a finger’s length above the tidemark of the discoloration. She lifts the sheet off the boy’s face. He looks half dead already. Men are gathering on the parapet above.
‘Kill him now,’ one of them calls. ‘You’d be doing him a kindness.’
‘Do you have any tools?’ she asks Horner. ‘A knife. A saw. A needle. A curved needle if you have it, and a good length of horse’s tail. And I’ll need plenty of linen. Clean, mind, and a good new bowstring. And wine. And urine, fresh.’
‘I absolutely know we have no wine,’ Horner says. ‘That was all drunk months ago, but we have some of Sir Ralph’s spirit. The friars at Hulne make it for him. As for urine, you can have any amount of that. Right now, if you please.’
She recalls Mayhew cutting a bone after Towton.
‘And I’ll need a beeswax candle. It must be beeswax. And a fire in a brazier.’
Horner nods.
‘Very well. Let us try the kitchen first.’
He guides her down to the keep’s kitchens. It is gloomy down there, with high windows letting in a little light and air, and it smells strongly of mutton grease, but at least it is warm and Katherine finds what she is looking for: a sharp-enough knife, though without the curved blade, and even a butcher’s saw. There is a pair of powerful scissors, blunt enough for her purpose, and she takes a stirring spoon. She waits for some water to boil on the fire. A large-eyed boy – an underemployed spit turner – watches her glumly from the shadows until the water is frothing and she is about to plunge the implements in the pot when Horner asks why she’s washing them.
‘They’re only going to get dirty again,’ he says.
She looks, puzzled, at the blue-black blade, the crusted snags of the saw’s teeth. Why does she clean them? She really doesn’t know. It just seems right. She plunges them and swirls them around, then wraps them in clean linen. She takes a small iron poker by the fire’s side, too. Meanwhile Horner organises the urine.
‘Come on, everyone! Into the pot.’
He collects half a gallon in a green glazed jug.
‘Not bad,’ he says, holding it up and shaking his other hand dry.
They go up and out into the thin autumnal sunshine to where the boy is laid out. She glances up at the keep to see the blurred shape of Grey at his window, and sees clouds in the reflection, scudding fast, west to east, and the sun goes in again.
Thomas is looking at her.
‘How do you feel?’
She is not sure. She doesn’t have that feeling she once had – of certainty. She holds up her pale hands. They are still, but feel heavy, as if – dead. For a moment she doubts herself.
‘I don’t know,’ she says.
‘Will it hurt?’ Jack asks.
‘Course it will, boy,’ Horner says. ‘Though we might first stun him with a cup of Sir Ralph’s distillation?’
He holds up an earthenware flask. Thomas takes it, removes the stopper, breathes it and coughs. His eyes water.
‘Strong stuff,’ Horner laughs. ‘Shall I send for more? Or a priest? Or both?’
‘No,’ Thomas says, stoppering the flask. ‘He won’t need a priest. He’ll live.’
Thomas smiles at her. He is proud of her. Christ, she thinks, I hope this goes well.
‘Come on then,’ Horner says.
Men are gathering round, joining those on the parapet above, though some drift away again when they catch the stench of the arm. It has a coating miasma.
‘Don’t breathe it in,’ one of them says. ‘It’ll kill you as sure as a headsman’s axe.’
One of Horner’s men brings a small perforated brazier in his cloak-wrapped hands. It lights up his face as he places it down next to her, and for a moment the smell of the burning coal masks that of the boy’s rotting arm. She passes him the poker.
‘Get it good and hot,’ she says and he slides it in among the coals and starts blowing on them. Sparks rise.
Now that she has started, Katherine finds herself doing things without thinking. She first lets Thomas pour some of the distillation between the boy’s cracked lips. It makes him cough, but they hold him down, and they give him more. And more still. She wishes she had some of the dwale that she had for operating on Sir John, or some of that midwife’s soporific, but this will have to do. Besides, she is becoming sure that speed is of the essence here. She kneels next to him on the grass and she sees at once that the skin above the blackened swelling is gaining a rosy hue, and she imagines it a harbinger of the blackness, as if it is spreading up the limb from the wound. She wonders what it is that will finally kill the boy. Does the infection get into the blood and from there to the heart? Is that it? Does the heart then turn black like the swelling limb? Either way, she knows she must cut the arm well above the rosy fringes of the swelling if she is to prevent the boy’s death, and she must do it quickly.
After a while the boy seems unconscious again. He begins long racking snores. Good, she thinks. She first loops the bowstring around the arm, above the bulge of his muscle. It goes around three times and then she ties it off and inserts the spoon under it and twists it within the bowstring, tightening it so that it bites into the flesh. Then she stops and feels the arm. She knows she must first find the artery. That is the biggest blood vessel. She has seen that cut and blood leap from the wound to splatter the ceiling. She presses her fingers into the muscle. There. She feels the throb of it. Good.
‘Thomas,’ she says. ‘Twist the spoon.’
Thomas leans forward and does so. She keeps her fingers on the artery.
‘Again,’ she says. ‘And again.’
The jump of the boy’s pulse lessens, its kick diminishing. Finally it stops.
Thomas is watching her closely.
‘All right?’
She nods. She reaches for the knife and she makes an incision, shallow, cutting the skin above the elbow, above the blackness. It is below the heft of his arm, where the muscle is biggest. She cuts right the way around and thinks, this is why Mayhew’s knives are curved. Then she cuts upwards, towards his armpit. The boy writhes.
‘It is all right,’ Thomas says.
‘Don’t let go of that spoon!’ she snaps.
He returns to his duty.
Now she peels the skin from the flesh of his arm and the boy really bucks.
/> ‘You aren’t supposed to flay him,’ Horner says.
‘Give him something to bite on,’ Jack says. ‘Can we use this?’
He has the strap of the bag holding the ledger.
Thomas shrugs. Why not?
‘Give him some of this first,’ Horner suggests, and he tilts the bottle so that the boy must swallow another slug of the liquor or drown.
When it is swallowed and the boy is slack again, Jack places the leather strap between the boy’s teeth.
Katherine is unaware of anything else now going on around about. It is just her and the boy under her knife. She pours some urine into the wound, rinsing away the blood. She saw Mayhew do this after Towton. She is looking for the artery, the thick one that carries the blood under pressure. She cuts down, very slowly. Slice by slice, pass by delicate pass, the blade’s edge sliding through the meat of his arm. And now there it is, the artery, limp now. Next to it, nestled in the pink flesh of the muscle, is the other vessel still plump with blood. It is springy under her fingertip.
‘Undo the spoon, one turn,’ she says, and Thomas slackens the noose. Immediately the fat artery swells, and there is blood in the wound. Good, she thinks.
‘Tighten it again,’ she says. Thomas does so. The artery subsides.
Now she gets the curved needle Horner took from the saddler. She passes it behind the artery and makes a tight loop around it. She ties it off, then does the same thing again, a finger’s width lower. She does the same with the thick blue vein next to it. Those are the two you must watch for, she thinks.
‘See?’ Thomas asks Horner. ‘He really knows what he’s doing.’
Horner grunts.
She takes the knife and slices the flesh around the vein and the artery. The boy is rigid with pain. Now she bites her lip. This is it. She cuts in two swift tugs up through both vessels, between the knots. There is a thimbleful of blood from each, but no more. She stares. Thanks be to God.
‘Urine,’ she says, and she slops more into the wound. Now she cuts quickly, through the muscle and the hard white ligaments, right down to the bone. There is more blood. Too much? She does not know. The smaller vessels need to be sealed.
‘Pass the poker,’ she says, and the man by the fire does so. It is a gleaming red tip. She takes it and presses it to the flesh. There is a hiss and a meaty smell. They lean back to let a curl of smoke rise up and vanish in the sky.
‘Bacon!’ someone says.
‘Shut up,’ another mutters.
She reheats the poker and passes it over the pink flesh again, turning it grey and brown. The smell is now disgusting.
‘Loosen it,’ she tells Thomas. He untwists it one turn. There is still blood from one or two of the vessels. She takes the blunt scissors, and she teases them out and then ties them off with the horsehair. It is tricky, fiddly, with the blood and the urine.
‘Need three hands for this job,’ Jack mutters. He is stroking the boy’s head, absent-mindedly keeping him calm, not realising that he has already fainted.
More urine.
The flesh is cut all the way through now, and all that remains is the bone.
‘Where is the candle?’ she asks. Horner holds it up.
‘The last good one,’ he says.
‘Light it, will you?’ she tells him. He puts it to the brazier.
And now, here is the saw: a long blade with a curved wooden handle. She moves the arm so that it is at full angle from his body.
‘Hold it, will you?’
Horner looks at her.
‘I’m not touching that.’
‘Just stand on it.’
He does so, gingerly, and when he steps on the hand watery pus bubbles through the broken and blackened skin. The smell is very strong, almost overpowering, and Horner gags and retches. She lets the saw run. It cuts on the pull. She goes quickly. The boy is awake again, screaming, bucking against Thomas and Jack. It takes about ten saw cuts before she is through, and the limb is detached into a shallow pool of dark blood. Something steams on the saw teeth.
‘Get rid of it, will you?’
Horner kicks it scuffling across the grass, the fingers flapping. Some in the audience laugh but others groan. She takes the urine and pours it over the stump from which blood is running freely. She balls some linen against it. How did Mayhew do this? How? With the knife blade.
‘Bring the candle!’ she calls. ‘Hold it above. Tip it now, so it drips.’
The wax drips onto the side of the knife where she holds it under the bone. It is burning fast, the wax dripping quickly. When enough wax has built up and it is beginning to harden, she presses it into the marrow and then presses the linen back over the hole.
‘Carry on,’ she says.
It takes four goes of pressing the wax into the bone before it begins to clog among the filaments of marrow. She stares at it another long moment before she exhales. It has stopped bleeding.
‘Fuck me,’ one of the men mutters. ‘Bloody well fuck me sideways.’
But it is not over yet. She tells Thomas to untie the bowstring. He does so. She stares at the wound for the length of time it might take to recite the Credo and she waits a moment longer too before she nods. He removes the bowstring entirely. Jack takes the spoon. Katherine is sick with nerves. She fumbles for more horsehair and the needle again, and then she pulls down the flaps of his skin and folds them over, and then she begins to stitch them together. Before she finishes sealing the wound she stops.
‘Blow it out,’ she says, nodding at the candle. Horner does so and is about to tuck it in his purse.
‘No,’ she says. ‘I need the wick.’
He grumbles but breaks the candle for her, and he holds the two pieces apart so that she can tug it out. She folds the wick and places the folded end into the wound. This is something she saw Mayhew do. It is supposed to draw out any malignant humours. She places a final stitch in the skin to hold the wick in place and she gives it the gentlest tug. It gives grudgingly. Perfect, she thinks.
Then she forces some linen into the jug of urine, soaking it up. This she presses to the wound. A dribble of pink fluid fills the waxy wick, and drips to the ground. But there is no blood.
The boy strains still.
‘Not dead yet,’ Thomas encourages.
She wads up more linen and presses it to the wound. She remembers the chaos of Towton, and the day before the battle, when she removed an arrow from the Earl of Warwick’s thigh, and thought she had cut the main blood vessel. Mayhew had stood by her, his hand on her shoulder it felt like, until the blood had ceased and they knew the Earl would at least not bleed to death on the beaten earth of the barn floor. She wonders what those standing around now would think if she told them she’d had the Earl’s life in her hands, and had saved it.
Some of the other boys are playing with the limb, now. They’ve dragged it off and are hitting it with sticks and screaming with delight. Then a dog comes and seizes the arm and drags it away with the boys cursing after him, but before they can retrieve it more dogs come, and there is so much snarling and snapping, the boys forget it, and come back to watch.
She stands there, her hands covered in dried blood and fat, and she looks around at the men who are ringed about her and the wounded boy. Grey is still at his window, a candle lit behind him, throwing his shape against the glass. She watches him raise his hand and take a drink.
‘Bloody hell,’ Horner says. ‘I’d’ve never believed it if I hadn’t seen it.’
‘Told you,’ Thomas says. ‘Kit’s a surgeon. Best surgeon.’
‘Let’s get him in,’ she says, nodding at the boy. He is deathly pale, his hair sodden with sweat, his breathing lively and irregular. His eyes are pressed closed.
‘Bit lighter than he was,’ Jack notes as they pick him up.
The guerite chamber still smells of rot, but they are permitted a few rush lamps and soon the smell is mixed with tallow.
‘Even worse,’ Thomas says. ‘Are there any herbs we can burn?�
��
‘Herbs?’ Horner laughs. ‘This is Northumberland. Listen. Sir Ralph wants you guarded day and night, and so I will leave Jack here with you. You can talk about old times. How you killed one another’s family.’
When he has gone, Jack asks if the boy will live.
She doesn’t know.
‘Well, he’s not dead yet,’ Thomas says.
‘Not yet,’ Jack agrees, ‘but how many days until All Saints?’
13
THE FIRST FEW days after the operation are the worst. Katherine and Thomas are confined to the chamber of the guerite, and must take turns sitting up with the boy. She sniffs the wound almost hourly and removes the dressing every day to tease the dribbling wick from the sutured skin in tiny increments, letting the wound heal behind it. The boy is in pain all the time, delirious with it, screeching with it, writhing with it, and there is nothing they can do except hold him down, stop him wrenching at the dressing, and try to force some of Sir Ralph’s spirit into him. If they can get enough of it down, it seems to place him somewhere between life and death.
‘Is he in purgatory?’ Jack whispers.
And Katherine places a hand on the boy’s neck to feel something, then shakes her head.
‘Not yet,’ she says.
Jack is still with them, and she has been surprised to find she does not mind, or fear his company as much as she’d think. He has even been protective of them, sending others away, including one man who wanted her to come with him to cure his brother who has leprosy. He is cheerful, usually, and if there is anything to be overcome, he always knows of somewhere it is worse.
‘Scotland!’ he’ll say. ‘Oh, Christ! You should see the women there,’ or ‘Scotland! They eat bats there. Bats!’
Kingmaker: Broken Faith Page 20
