She made no protest but held it in her hands a moment, breathing in its delicate aroma as she surveyed the doctor over the rim. He placed a couple of the sandwich quarters on a small plate and moved it toward her.
“There, have those with your tea and the faintness should pass.”
“Yes, Doctor.” She began at first to nibble at one corner of the roast beef sandwich, but soon found she was famished despite—or because of—all she’d experienced in the past few hours.
“Here, have some more. You could use them,” he said as he put the platter close to her.
She stared at him in surprise. “Aren’t you having any?”
“You forget, I ate earlier.”
“So you did.” She continued eyeing him until he looked away. She detected a faint coloring across his cheeks and wondered at it. Had her scrutiny made him uncomfortable?
She tapped her fingernail against the tea mug, pondering as she watched him sip his tea.
“How do you stand it, day after day?” she asked after a few moments when it seemed as if he was unaware she was even there. She was not used to being ignored.
“Stand what? Ah…the blood, you mean?” he asked.
She nodded. “All of it. The screams of agony. The exposed—” She shuddered in memory. “I even saw someone’s bone.”
He toyed with a spoon. “You get used to it.” He grinned at her, revealing a dimple in one cheek, and she marveled at how young he suddenly looked. “That wasn’t always the case. I got quite sick the first few times I watched my uncle perform an operation.”
“Your uncle. He’s an apothecary?”
“Yes. More of a surgeon-apothecary. I apprenticed with him a few years before going to Guy’s training hospital. By then I felt quite the veteran among the first-year students. You could always tell the novices. They would faint around the operating table their first time.”
“The medical profession runs in your family?”
“Not entirely. Only my uncle and myself. My father was a Methodist lay preacher.”
She nodded, envisioning some man preaching in the open air. “Are you also a surgeon-apothecary?” she asked. The little bit of history he offered her made her suddenly hungry to know more about him. He hadn’t hesitated to risk his life to stay and take care of the injured during the riot.
“Strictly speaking, I am a surgeon, since I am a member of the Royal College of Surgeons, which conferred the license on me, and who frown on any dilution of medical practices.
“Even helping your young friend the other night would not come under a surgeon’s duties, even though I performed a surgical procedure on her.”
“Then whom should she have called upon?” Eleanor asked, horrified at the notion that a man of the medical profession wouldn’t attend someone during an emergency because it didn’t fall under his purview.
“A midwife or an accoucheur, if a man had been required.”
“But you came. Why?”
“Because in actual practice I am a surgeon-apothecary-midwife, as you have been able to witness over the last few occasions. On the days I lecture or operate at St. Thomas’s, I am strictly a surgeon. When I open my doors at the dispensary, or am called on an emergency, I treat anyone who comes along, whether the illness is internal or external.”
“And whether they can pay you or not,” she stated with quiet irony.
He shrugged. “Those are the ones who most need my attention. I earn enough as a lecturer and resident surgeon at St. Thomas’s to make up for any shortfall.”
She smiled. “Your profession is somewhat like mine.”
He raised an eyebrow.
“We stretch the narrow definition of the burletta—the only dramatic form we’re licensed to perform—until we are doing the same sorts of performances you would see at the royal theaters, only we mustn’t let on to the fact.”
He returned her smile. “I suppose the parallel is a just one. I never would have seen the connection.”
She stirred her tea. “You could also say we both deal with healing. You take care of the physical injuries. I attempt to bring respite to people through a few hours of laughter.”
His smile disappeared, leaving an uncomfortable silence. Had her second comparison displeased him?
“You’ve ruined your outfit,” he said softly.
She followed his gaze down to her gown. He was right. The front was hopelessly soiled with blood and dirt.
“It’s the second time you’ve ruined a gown when you’ve been in my company.”
“So it is,” she said, realizing it was the second time she’d assisted him in doctoring. What a strange turn of events. “You must ruin a good many shirts and neck cloths.”
“That’s why I don’t dress in the finest.”
She studied the cut of his coat. “No…I can see that. What a pity. You are not a bad-looking man, but as they say, clothes make the man.”
She caught that slight flush on his cheeks again. “Have I put you to the blush?” she asked, feeling inexplicably pleased. “Forgive me if I’ve been indelicate. We’re very frank about our looks in the theater. It is part of our livelihood.
“My physician is always tailored by Weston,” she continued. “He’s particularly proud of the knot of his cravat. Dr. Elliot, do you know him?”
“I know of him,” he answered. “He has quite a reputation.”
She could read nothing from his tone, and was left wondering how to interpret his remark.
“Thankfully, I’m usually as healthy as a horse, but Dr. Elliot does give me drafts for my throat to keep my voice at its best.”
Mr. Russell felt in his waistcoat pocket, then frowned.
“What is it?”
“I keep looking for my watch, before remembering I have no watch. It was stolen from me last week.”
“How dreadful. The streets are being overrun by cut-purses these days.” Quickly she drew out her own watch and snapped it open. “It’s just past four.”
“I need to be getting back to the dispensary. May I escort you to your carriage?”
She nodded and began to collect her things.
When she dropped him off at the dispensary, he turned to her. “I wish to thank you for your able assistance this afternoon. I did need your help.”
She lowered her lashes. “It is I who must thank you for your protection and for making me eat when I felt faint.”
“Think nothing of it.”
She felt a sense of regret when he stepped down from the chaise. After so many hours in his company, in danger and working side by side with him, she felt a bond with the dedicated young surgeon who smiled all too infrequently.
“Well, I must be off.” He stepped away from the carriage and lifted his hat.
As her carriage drove away, she glanced back. Mr. Russell stood watching her. She raised her hand in a wave, but he didn’t return the wave. Instead, he wheeled about and entered the dispensary.
Chapter Five
Ian dipped his pen into the inkstand.
Under the heading Respiratory Disorders, he wrote “Consumption and Phthisis.” Beside it he jotted the number three, the total number of cases he had seen that day. Next he wrote “Pleurisy and Pleuritic fever.” One case. “Catarrh.” Two cases.
Thankfully, the weather was still warm, so the dispensary hadn’t yet seen many respiratory cases. That would soon change as late summer gave way to autumn.
The next category was gastrointestinal. Several cases of colic, diarrhea, and worms among the infants and children. Two deaths. The columns grew. Ian pushed away from the desk in frustration. Too many children were dying.
His uncle had taught him the importance of meticulous record keeping. Although many times the number of fatalities was discouraging, Ian knew in the long run the only way to convince officials of the need for decent living conditions was to show them hard numbers.
At least more and more parents were bringing in their sick children. When he’d first opened the dispens
ary, the only children he’d seen were the ones on his visits to people’s homes. The people were used to hospitals and physicians refusing to treat children, claiming they were too hard to diagnose. He had found the opposite true. By paying close attention, he had found that many times their symptoms were actually more evident than in their adult counterparts.
He continued to record the day’s cases. Surgical treatments included ten broken bones set; eleven bruises; two head injuries; five tumors, of which three were untreatable, the other two possibly operable; six toothaches, with two ending in extraction; four leg ulcers; two abscesses.
He had scheduled one amputation tomorrow. A man had smashed his hand in a doorway, and now gangrene had set in and the arm begun to turn black. Even though amputation was always used as a last resort, in this case there was no help for it, if the patient’s life was to be spared.
He finished recording the day’s patient histories, scattered some pounce over the writing and dusted it off. He eased the kinks in his shoulders as he placed the pen back in the standish.
Taking a few moments to massage the back of his neck, he found his thoughts straying once again to Mrs. Neville.
Over the past few days since meeting her, her pretty face kept floating into his thoughts at odd moments of the day. No, not pretty, he corrected himself. Beautiful. She was the most exquisitely formed creature he’d ever beheld. Each time she looked at him, he was startled afresh by her silvery eyes, her delicate features, her golden hair.
Her figure was slim and dainty. Everything was pleasing to the eye. Even when tired and disheveled after assisting him, she still managed to look fresh and appealing.
He rubbed a hand over his jaw, knowing he had to get his thoughts under control. It did no good daydreaming about an actress. She might look pure and innocent, but he knew how deceptive the image was. Actresses were little better than prostitutes he reminded himself for the countless time.
But try as he might, he couldn’t seem to block her image from his mind.
Thankfully, he hadn’t run into her since the street riot, although he’d been to check on Miss Simms a few times. He’d had to stifle the sense of disappointment, for he knew she visited because Miss Simms waxed eloquent over how kind and generous “Eleanor” had been to her, coming to see her each day. It seemed most of her visits were reserved for late evening after a show or early afternoon before she went to the theater.
“Halloa!” a voice called from the doorway.
Ian looked up to see his friend’s tall frame leaning against the doorway.
“You looked so deep in thought I was afraid to disturb you, lest you be on the verge of discovering a new surgical technique that might aid all of humanity.”
Ian made an effort to chuckle. “Nothing of the kind. I’ve just finished up with the records for today. Come in, Henry, don’t stand there.”
Lord Cumberland eased away from the doorpost and maneuvered himself over to a chair in the cramped room that passed for an office. He sank down with a contented sigh as if the few moments standing had tired him out.
“Too many hours spent doing nothing?” Ian teased, eyeing Henry’s evening clothes. He was about Ian’s age with short-cropped hair cut in the latest fashion.
Henry grinned back shamelessly. “Doing nothing is an art form. Didn’t Byron say that? If he didn’t, he ought to have.”
“I keep telling you to find a useful occupation.”
Henry sighed. “And I keep telling you if you’ll only let me introduce you into society, I’d have a Herculean job on my hands.” He rubbed his hands together. “It would offer me just the challenge I need since the battlefield.”
Ian closed the ledger and set it aside, refusing to rise to the familiar bait. He leaned back in his chair. “So, what brings you to these humble surroundings this evening?”
“I come to invite you to a gathering of intellectuals, artists, and the pink of the ton.”
Ian yawned, used to these invitations, which he invariably turned down. It was a game between them by now, he supposed. “Let me guess. It’s being held at the home of the Duchess of Longworth, and she’s simply dying to meet a lowborn surgeon from St. Thomas’s.”
Henry snorted. “Lowborn, indeed. My wealthy and titled friends and acquaintances would love nothing better than to listen to an eminent surgeon who has not only trained on the battlefield but has been to Paris and brought back the latest techniques. They are agog at the thought of all those postmortems performed at the great teaching hospitals. I keep telling you, anatomy and pathology are all the rage. Bring some of your wax models and let the layman understand the mysteries of the human anatomy.”
When Ian said nothing, Henry continued. “There’ll be quite a crowd. It’s being held at Somerset House. You’ve never been there. We can cross over the new Waterloo Bridge. You’ll see the house in all its splendor, its colonnaded facade lit up over the Thames.
“It’s a rare opportunity. I wouldn’t be surprised if Prinny himself showed up. Come on, old boy, you know you’ll never get the funds you need for your children’s hospital if you refuse to go where the money is.”
“I doubt I’ll make much of an impression if I stand among them to lecture. They’d be bored silly.”
“Don’t be totty-headed! You know yours are some of the most popular lectures at St. Thomas’s.”
Ian was tempted, more than he’d ever been. After two years back from the Continent, he was finally willing to concede that public awareness had to be raised to the overcrowded condition of the poor if change was to come to the city.
“By the by, I read your article in the Medical Journal,” Henry remarked. “You might not think so, but many of these aristos read such journals. This is your opportunity to be among them, answer their questions, let them see you not as a fanatic, but as the dedicated surgeon you are.”
They argued good-naturedly for a while longer. Finally Ian rose with another yawn. “I’m sorry, but not this evening. Perhaps another time. I still have some work to do at home before I turn in.”
Henry stood as well, his look eager. “You mean that? I shall stop pestering you if you give me your word you’ll accompany me the next time I invite you to a social event.”
Ian looked at Henry a moment. What did he have to lose, anyway? Another evening’s work? But what might he gain? He gave Henry a brief nod. “Very well. The next time I’ll go wherever you say.”
Henry clapped him on the back. “That’s the way, old man. You won’t regret it. After all, I’m building your reputation each time I’m among the ton.”
Ian extinguished the lamps and locked the dispensary behind him. He felt for his watch and once again remembered it was gone. It must be near nine in the evening.
He bid Henry good-night, refusing his offer of a ride. He lived only a few doors down.
His neighborhood was one of the most gin-soaked in the city. Prostitutes and men headed in or out of the taverns. Many would end up in the roundhouse by evening’s end. Some children called out to Ian and waved.
He returned their waves. “Time for you to head home to bed,” he told them.
“Aw, Doctor, it’s too early for bed.”
He said nothing more, knowing that some had no home to turn in to, and the ones who did never knew what they would find there.
He picked up his pace, thankful the nights were still mild. Soon, the autumn chill would seep into bones, bringing with it coughs and fevers.
When he entered his house, he greeted Mrs. Duff, his housekeeper.
“I’ve put a snack for you in the study,” the plump, cheery-voiced woman told him as she helped him off with his coat. “If that will be all, I’ll be leaving.”
“Yes, thank you. I won’t be needing anything further.” He bent over and scratched the cat who was rubbing himself against his leg.
“Hello there, Plato.” The tabby, which had been a stray, immediately began to purr as Ian scratched behind its ears. “Had a long day? Any mice for din
ner?”
The two continued enjoying each other’s company for a few minutes before Ian straightened and proceeded up the stairs. After washing up, he went to his study.
As he ate the bread and cheese and munched on the apple left out for him, he read the latest medical journal. As soon as he’d finished, he turned eagerly to the package that had been delivered in the mail. It was postmarked France.
He still corresponded with a doctor he’d met at La Charité, one of the largest, most successfully run hospitals on the Continent if not the entire world. He clipped the strings of the oblong box and slit the wrappings with a penknife. He opened the box and drew away the wadded-up tissue paper. Carefully he took out the long cylindrical instrument, which resembled a flute. He turned it over in his hands, studying it curiously. Could it be a musical instrument?
After examining it a few moments, he dug around the box and found a letter. In it, his friend described an exciting new invention by the great physician Laennec. Ian had met him in Paris and observed his care and skill with the wounded French soldiers at Salpetriere Hospital.
The instrument was to aid in “auscultation,” a term created by the physician to describe the process of interpreting the sounds emanating from the body cavities, especially the lungs. Laennec called the new instrument the stethoscope, an “observer of the chest.”
Ian held up the instrument with a new sense of awe. He placed it to his ear as his friend described. How he wished he had a patient with him at that moment. His gaze fell on Plato, who was curled up on his desk, breathing in and out rhythmically.
Ian placed the other end of the long tube, which his friend said the French were calling le baton, at Plato’s chest. The cat stirred and stretched. This gave Ian better access to his chest cavity.
Sure enough, the sounds of heartbeat and breath became magnified, greater than Ian had ever imagined from the current method of putting one’s ear to a patient’s chest, which respect for modesty many times prevented.
His thoughts raced ahead, imagining the possibilities between the relatively new technique of percussion—tapping one’s fingertips against a patient’s chest wall—and now this incredible little baton-shaped object that could increase the interior sounds of a human body.
The Healing Season Page 6
