by Elsa Holland
“What will you be covering today, Doctor?”
“Ah! Today, gentlemen, we will be covering the diversity and importance of cumulative circulation. For those new to the term, we will be seeing it on the very condition which Dr John Hunter mastered over a century ago.”
“A popliteal aneurysm?”
“Correct, Master Gregory, and if we are to see it as Dr Hunter, where can we expect it to be located?”
“In the knee,” three voices answered.
“Correct, and how is it treated?”
“Constriction of the femoral artery, Doctor.”
“Correct again, Master Gregory. And why was this an important turning point for surgery?”
He got a barrage of answers as students talked over each other, each flinging their own aneurysm ailments and suggesting treatments that made use of the body’s natural ability to find solutions. If the blood could no longer flow through a channel, if the damaged channel was constricted, even a main one, other smaller capillaries and veins would funnel the blood past the blockage and back on track.
A general “excellent, excellent” had the active participants beaming.
The students accompanied him on his rounds. Each patient was met, and their treatment discussed and agreed before surgery was undertaken by the students later in the day. There was banter back and forth, each operation debated and discussed in order of procedure and why. They wanted answers, they wanted to know they were well on track, possibly even ahead of the crowd, each holding the secret belief that they would be the one to make the difference which would turn the tide of modern medicine.
His last patient, however, he saw alone.
After all this time, one would have thought he’d become immune to handing a person an impossible choice. But when the moment came his chest contracted like a band was wrapped around it.
Entering the general ward, he walked between the overcrowded rows of beds to his patient. Mrs Cullan sat next to her husband’s bed and went to stand up. With a wave of his hand she sat back down.
“Mr Cullan. Mrs Cullan.”
After a small exchange, he began his examination. He lifted the sheet covering the leg and unwrapped the bandages. The smell was fetid, rotten and sour. Vaughn used a metal instrument to test the area between the gangrene and the healthy skin. Mr Cullan clutched the side of the cot, his fingers white from the force.
“The pain you feel now will be a fraction of the pain you will have as this continues to eat at your flesh and nerves. You will then die a very slow and very painful death as the infection poisons your blood and continues to slowly eat away at good flesh. There is no treatment for this condition except to cut the gangrene from the body. The removal must be at a point sufficiently away from the infection to ensure that none is left. We will not be sure how far it has traveled into the tissue. It is possible the infection has traveled further up the leg but is not yet showing through on the surface.”
Mrs Cullan started to sob quietly beside her husband. Mr Cullan gave him a nod to continue as his hand reached out and clasped his wife’s.
The band around Vaughn’s chest tightened.
“I can take the leg off. But there is a high chance you will not survive the operation. Should you make it through the days after the operation, there will be considerable pain to contend with. You may survive the procedure and yet succumb to a fever and not have the strength to fight it off. There is always the chance that, despite our best judgment, I may cut it at the wrong place to have the desired effect. Or worse still, it may already be entering the torso.”
Mrs Cullan wailed. Mr Cullan pulled her down to the bed and clutched her around the shoulders. He whispered words of reassurance he had no right to give. Even if he survived, Mr Cullan would have to make substantial changes to how he lived. Perhaps he would never be able to work again. His wife may have to do the unthinkable to be able to acquire the fundamentals of life; bread, water and shelter. They both knew it. Their world was no longer protected by Mr Cullan’s physical ability.
“I’ll leave you to consider the situation.”
Suddenly the corridors, brimming with the sick, the hopeless and the impossible to save, were too much for Vaughn. At pace, he walked through the maze of staff corridors then burst onto the back lawn.
The sun was lost behind clouds and there was the smell of rain. In more pleasant weather, the area would be scattered with the wheelchairs of the fortunate—the surviving patients.
His forehead wore a sheen of sweat. His heart beat too fast. A sea of humanity beat at the hospital’s front doors and only a chosen few survived the well-intended horrors inflicted within to see the sun on the other side. This small patch of lawn truly was the other side of hell.
Vaughn sat on a bench under a large oak. There wasn’t much time before morning surgery which would consist of, at most, an hour of procedures, then he would leave for the train. His entourage would be in the gallery and he would need to regale them though the procedures with confidence and enthusiasm, to inspire in the next wave of healers, with all the hope and enthusiasm he no longer felt.
The oak’s shadows hung around him, cooler even than the autumn air, orange and yellow leaves scattered the ground. The overly hot sensation had left but the pressure around his chest remained.
Even during his time in the military he’d never reacted this way. He’d stood in surgery tents and faced screaming men calmly and pragmatically as their limbs were sawed, sewn, cauterized. Anaesthetic was rarely available, and the military believed that to die screaming was honourable. More often than not, men died from the pure shock of the pain. And still his automated systems had maintained calm. Now though, when he should be revelling in the fact that he was at the top of his game, the sight of a wife’s white, clawed hands as she clutched the man she loved made him want to trade his life for anyone else’s.
He may not be able to continue for much longer, not unless something fundamental changed.
‘ I’m cold. I’m desolate. Apple, lure me with your warmth . . . ’
A whisper of leaves and a tickling on his cheek. Her face, those dark ebony locks cascading around her as she leaned down to kiss him.
His eyes opened. He’d drifted off. The wind blew and his own hair teased his face. And just like that his chest felt heavy again.
Vaughn pulled out his fob. Nine-fifteen. It was time. He stood and walked back to the door he had come through.
A man stepped out just as he stepped in. Their combined width stopped them both.
Vaughn waited for the man to step back. He didn’t.
“Vaughn.” The man stuck out his hand. “Vaughn, are you well?”
He focused on the man’s face. Recognised it. Pulled himself back.
“Dr Cox. Sir.” He clasped the other’s extended hand and shook it with perhaps a little too much vigor. Vaughn stepped back out of the door frame to allow Cox right of way.
Cox was the head of the informal power structure in Edinburgh’s medical community. The man was richer than anyone had a right to be and thus had no need to work, especially not in surgery. Vaughn had long suspected Cox liked the fear and the pain the profession delivered. An unsavoury yet unavoidable man.
“How are Lam and Frazer?” Cox stepped out, forcing Vaughn to retreat a few paces further back. The other man’s mouth tipped up fractionally.
“As good as you’d expect,” Vaughn said. What could he say? They both knew he’d been given two imbeciles, he’d taken them as a favour to Cox and to allow him to get closer to the man. A man he suspected of doing evil things.
“They’ll give up before you have to sign your name to them. Any movement on the forensic front?” Cox’s eyes were narrow, looking him over.
“Heading off to Glasgow later this morning.”
“Ah, the poisonings.” Cox’s interest dropped.
“Yes.”
“Nothing else then?”
Vaughn shook his head. It was his turn to regard Cox more closely.
“You know of something?”
“A contact in Manchester said something serious happened. I’ll relay your credentials to a contact I have in Scotland Yard.”
“I’ve worked with them before.”
“People will jostle to be part of this one, I’ll get your name to the top of the list.” Cox’s voice feigned disinterest, Vaughn didn’t believe that for a second. Cox had a personal interest.
“Much appreciated. Must run, good to see you again.” A firm handshake. If the job came through, Cox had a way to stay abreast of the situation and Vaughn would be beholden to relay details. Not ideal.
By the end of the farewell Cox had extracted a promise to meet over drinks and a late supper the following week.
CHAPTER 14
The pup was intense and quiet as he sat opposite Morrison on a crate, alternating between scribbling and drawing in his notebook. There were no notable facts punctuating the train trip back to London, that jubilant boy was gone.
It had been impossible to get the kid into the passenger carriage, so here they were, sitting in the baggage carriage like a couple of stowaways, with the box that contained the girl’s body. The pup next to it like a guard dog.
The train lurched to a stop, steel screeching on steel as the driver engaged the brakes.
“Kid . . .”
The pup nodded and closed his book, slipping it into the leather satchel slung over his shoulder, then stood. He placed his hand on the box containing the girl’s remains, almost as a communication, a reassurance.
Steam puffed out onto the platform, covering the first alighting passengers in fog. The bobbies were waiting, and they jumped into the baggage carriage and unloaded the box with well-practiced efficiency then headed towards the exit, the kid following closely behind.
Morrison grabbed the kid’s arm and turned him around. “Listen kid, I get this might be your first big show, but you can’t take it personally. Whoever she is, God rest her soul, her body is crime scene evidence now. It’s going to be prodded, poked, exposed and sliced as the quacks try and find more answers for us.”
The pup tugged out of his grip.
“I want to be there!”
Hell, the pup was hit hard. The first horrendous injustice either riled you up or took the wind out of your sails. He should be thankful it was the former.
“You don’t have to be there, we’ll get a report.”
The pup’s face screwed up as if Morrison were mad. “A report where they pick and choose what to write down; only we can discern the facts we need for the investigation.”
Morrison stilled. He regularly went in while the coroner worked, listened as they talked. On more than one occasion, the facts he needed weren’t in the report but in the discussion during the examination. Most investigators simply waited on the report.
Morrison poked the kid’s pigeon chest. “Where the fuck do you learn this stuff, kid? Who are you?”
The kid recoiled at his touch and his face shuttered.
It could be a lucky guess the kid was already showing he had more than the average level of smarts and he was a fast learner, but Morrison’s gut said something more was going on. That was the second time the kid had closed down when asked about his background. There were two things that sat behind that kind of behavior, a past the kid was ashamed of or a past that had secrets. The latter was never good.
Morrison leaned down so close that they were almost nose to nose. “I will find out your secrets, boy, and I will expose them.”
The pup’s eyes flared wide before that innate internal barrier slammed down again. At least the pup knew where they stood.
Morrison stepped back. The kid straightened his shoulders and turned to follow the box, his usually lily-white cheeks pink and blotchy.
“We’ll attend the sessions with the coroner,” Morrison said as he laid his palm on the kid’s back and propelled him after the bobbies and the corpse-filled box.
The kid flashed him a look of surprise. Surprise and caution.
CHAPTER 15
Edith took her tea out in the back courtyard and settled on the low stone wall that separated the courtyard from a small vegetable patch. The morning had been a good time to settle in, the amputee was still in a great deal of pain and she had given him more morphine. She’d done a general inventory of the theaters and quelled the panic at her mounting responsibilities.
There was no trace of the boy, the cadaver from last night. She had cleaned the theater down with disinfectants and boiled all the surgical tools. She was confident that all was as it should be for the next scheduled surgery six days hence.
Edith heard rustling in the bushes near the large stone wall separating the adjacent property, and investigation revealed the source of this morning’s disruption. It appeared Vaughn was the owner of the rooster. The majestically plumed cock was followed by a few hens as he scratched across the fallow soil.
Edith finished the tea and placed the mug down beside her, took a moment to enjoy the morning sun on her face as her free hand which was warmly tucked into her pocket, held the newspaper clipping in her fingers reminding her that freedom might be closer than she thought. She pulled the clipping from her pocket.
‘Medical Practitioners needed for God’s work,’ read the heading of the employment advert. Positions were often posted for missionary doctors to work in the colonies and beyond, but applicants were few. Missionary settlements were dangerous places; foreigners were often seen as another food source, and the chance of ending up in the jaws of a lion or poisoned by snake or spider bite was concerningly high and statistically higher than getting run over by a trolley car. Yet for her, across oceans, deep in an African jungle tucked far out of sight, she would be safe. Safer than any place on the continent, the Orient, the Far East or America. There, in a hut in the middle of a jungle, she would never be found. Found, caught, and killed.
All she had to do was use all the knowledge and skills she had already built and pass herself off as a doctor with some surgical skills, which would require showing the appropriate medical qualifications.
Vaughn’s face flashed in her mind; not the arrogant Butcher but the man in the dark corridor, the man whose spirit fought to keep some light within it. Guilt bit into her chest. She would betray that man. She was not the light he had made her out to be last night, but merely another layer of disappointment and betrayal to add to the burden of his already sinking faith in humanity.
She closed her eyes and lifted her face to catch more of the sun. The heat seeped into her, oblivious to the fact that she did not deserve its warmth. Africa would have a lot of sun. Perhaps it would burn away the sin of her deeds.
“Nurse Appleby?”
Edith opened her eyes to see a gentleman in a tan dust coat standing at the entrance of the dissection hall.
“Yes.” She threw the dregs of her tea into the garden bed as he walked towards her. He was tall and lanky and looked to be in his twenties, perhaps a little younger than her twenty-six years.
“I’m Thomas Ramsey. I wasn’t at breakfast and so we weren’t introduced.”
“The anatomist.” She stood up and held out her hand, feeling very modern.
He took it and smiled as they shook. “Yes.”
“Anatomy is one of my passions.” That at least wasn’t a lie. “I know the hours.”
He nodded and they both smiled. Time and ambient temperature were the enemies of the anatomist, so one worked when the bodies came in until the work was complete.
“It’s in a bit of a mess at the moment, we are refitting the gas lights with electric, but would you like to see the hall? Do you have time? I know he is demanding.”
Vaughn. The thought of him made her abdomen flutter.
“Let me put the mug back in the kitchen if you don’t mind waiting?”
CHAPTER 16
Mr Price came into the kitchen, with a purposeful air in his stride. Addressing the housekeeper, the cook and herself, he said, “Master will not be back f
or dinner. No canned meat for us, Cook—our Dr Vaughn has solved yet another case.” Price slapped the paper against his palm. “No black widows abound in Glasgow, just deadly tins of pork. He confirmed the cases were poisoning from adulterated canned meat.”
Cook twittered on about never opening a can of meat in her life. Edith thought to slip out of the room as the kettle whistled but Price began to relay to her his opinion of the authority’s actions now that they were aware contaminated meat circulated amongst the population.
“You may not be aware, Miss Appleby, but Dr Vaughn studied under the renowned toxicologist Robert Christenson.”
Edith nodded and made a face to show she was impressed. In fact, she knew of Vaughn’s background and thought it best to refrain from pointing out Christenson’s role in keeping women and their ‘weaker minds’ out of medicine as they would ‘bring the whole profession down.’
Mr Price had left the newspaper on the table, Edith picked it up and scoured the front pages. There was nothing there that related to her greatest fear . . . for now.
Edith excused herself and closed the kitchen door behind her. She headed toward the back door, the niggling tension in her easing now that she knew she wouldn’t have to confront him, nor their actions, until tomorrow.
In moments, she was passing the infamous corridor. Edith stopped, her eyes going to the place where he’d pressed her against the wall. A warm tingling started on her skin as she relived those tantalizing touches. It had not been as she had expected, not at all similar to the way she had felt when her Collector had forced kisses and touches on her. Those nauseating encounters had caused her Collector to surmise that she was not a real woman, that she didn’t feel pleasure and was cold.
The pleasure of Vaughn’s touch was completely unexpected. Edith pressed the palms of her hands over her cheeks. They didn’t feel hot to the touch even though she was sure her skin flamed.
