by Kaite Welsh
Unlike its dingy, malodorous surroundings, the interior of Saint Giles’s Infirmary for Women and Children was both well lit and clean to the point of reeking with carbolic. The waiting room, however, was filled with the same unfortunates as the streets outside—children in torn, dirty scraps of fabric that passed as clothing, and women whose discolored skin bulged out at unnatural angles around the chin and mouth. Phosphorus necrosis was one of the most common ailments here that the doctors treated, or at least attempted to. These women were all employed at the match factories where the white phosphorus with which they worked corroded their jaws and left painful, open abscesses from which stinking pus escaped. Those who showed no sign of phossy jaw were either accompanied by listless children with whooping cough or rickets, or were marked out for a very different profession by the cheap, gaudy fabric of their dresses, beneath which disease invariably lurked.
The clinic occupied a cramped, labyrinthine building that had once housed an abattoir. It seemed to teeter permanently on the edge of bankruptcy, for while there were countless philanthropists and ladies bountiful eager to help Edinburgh’s unfortunates, they were less willing to help the women who ran it. Prostitutes, it seemed, could be reformed—women who had taken a medical degree were beyond help. It was sustained primarily through the indefatigable energies of Fiona Leadbetter, the clinic’s founder and administrator, who had somehow inveigled her way into a philanthropic dinner and caught the eye of my uncle, a wealthy gentleman who required some charitable work for a niece with an interest in medicine he hoped to extinguish.
My work involved little more than holding surgical instruments, winding bandages, and assisting with basic routine examinations under Dr. Leadbetter’s stern but approving gaze, but I soaked up whatever knowledge I could. Fiona was the closest thing I had to an ally in this unwelcoming city and, while I was loath to trespass on her kindness more than I had to, the knowledge that I was not considered untouchable everywhere reassured me.
With her dark hair neatly pinned back and a lively gaze that belied the fact she had been on her feet for the best part of ten hours, Fiona exuded a cheerful authority. Heavy circles beneath her bright eyes suggested the toll the work took on her but, although her colleagues spoke in hushed tones of periodic bouts of depression, I had never seen her defeated.
“There you are, Sarah! Here, take these and go to the small examining room.” Rummaging in her pockets, she handed me a roll of bandages and pushed me toward the flimsy partition that offered the patients a modicum of privacy.
The patient, though docile at present, had clearly resisted treatment, if the overturned tray of instruments and shattered glass on the floor were anything to go by. And from the reek of her breath, I suspected that gin rather than subservience was the cause of her present calmness. The wound on her leg was ugly, a few weeks old and would probably turn septic even with medical attention. Next to her lay a bundle of filthy, pus-stained rags that had probably worsened the infection rather than help it heal.
She eyed me warily. “Wha’s she daein’?” she slurred. “I’ll no’ have a glaikit bitch like her pokin’ away at me.”
“I’ve just come to replace your dirty bandages with clean ones,” I told her soothingly, hoping that my apprehension didn’t show. She attempted a disdainful sniff, which turned into a heave, and I moved back hastily. The nurse, who had been trying to disinfect a fresh cut on the woman’s cheek, was less fortunate. Both patient and nurse were hauled off to the sluice, leaving me to clean up.
As I knelt to scrub the last of the human effluence from the floor, I mused that these were not quite the good works my relatives had had in mind when they informed me of their expectations regarding my conduct under their roof. Still, even my aunt had to admit that it was in many ways an ideal occupation. Thanks to the clinic’s strict regulations, I would not come into contact with any member of the opposite sex over the age of ten who was not a clergyman, and the grim realities of the medical profession were doubtless enough to send me rushing for the smelling salts and vowing never to wield a scalpel again. Most important of all, I would be faced with constant reminders of my fate should I stray from the path of righteousness they had laid out for me.
A noise jolted me out of my reverie. Such a reminder was standing before me, the tracks of tears long since dried outlined in the powder on her face.
“One of Ruby McAllister’s girls,” Fiona said in a low voice as she ushered the girl in. The whorehouse was one of a handful that entrusted the care of their wretched workforce into our care. I had been surprised, in my early days at the infirmary, to realize how many brothel owners preferred their girls to be seen by male doctors. Fiona had explained, with an angry grimace, that those doctors were often happy to exchange their services for those of their patients. Most of the unfortunates who darkened our doors plied their trade in the streets and were grateful for whatever help they could get, but the few coins they could recompense us with made barely a dent in the infirmary’s mounting expenses. Ruby McAllister was one of the few abbesses to permit her girls to see us.
Had I been aware that my first and only meeting with Lucy took place hours before she died, I might have softened the blow. As it was, I was tired and bad-tempered, my petticoats stiff with dried blood and my stomach loudly reminding me that I hadn’t eaten anything since a slice of burnt toast at luncheon. A few months ago, I would have been shocked. A year ago, I would have been appalled. But she wasn’t the first drab I’d seen all day, and doubtless wouldn’t be the last to cross the infirmary threshold tonight.
She certainly wasn’t the first to be diagnosed with an unwanted pregnancy.
“My monthly’s late,” she informed me starkly before shedding her gaudy, threadbare cape. From her dress—a vivid green garment that bore a passing resemblance to silk if one squinted—and the red hair that didn’t match her overplucked dark eyebrows, I knew that asking whether she had had intimate relations with a man was redundant, so I merely indicated the examination table and requested she remove her bloomers while we waited for Dr. Leadbetter to wash her hands. Hitching up her skirt, she lay staring at the ceiling and I wondered how many times she had adopted that pose. Probably more than she could count, assuming that she could count at all.
She didn’t flinch when Fiona began her examination, and something in me stirred at her lack of innocence. She couldn’t have been more than twenty under the thick layers of powder and paint, and I knew women decades older who would die before allowing a man to touch anything other than their hand. Propriety was just one more luxury that she could not afford.
“You can sit up now,” I said softly, moving to the sink to wash the instruments with boiling water and a slither of carbolic soap. I squinted dispiritedly at my reflection in the tiny looking glass. I had slept little the previous night, and it showed in the bruised-blue shadows beneath my eyes.
I turned back to see her eyeing the two-day-old newspaper we kept to soak up whatever bodily fluids our patients spilled, and with a jolt of surprise I realized that she was reading it. The print was small—small enough that reading it by candlelight tended to give me a headache, but her keen eyes devoured each line. Some of the working girls could read, but few of them with the ease and curiosity of this one. Literacy was the key to a better life than one spent on an infested mattress while a stranger wheezed and grunted on top of them.
“Would you like to take it?” I asked, still as nervous of the clinic’s patients as I was of my professors. Her eyes lit up for the briefest of seconds, but then her face hardened, and she snorted contemptuously.
“What am I gonnae do? Read while some poor bugger is going at it?”
I shrugged helplessly—she had a point.
“I’m afraid that you won’t have time for reading in a few months, Miss Collins,” Fiona informed her crisply. “I’d say your baby is due next May.”
By now, I was used to the salty language of our patients. Still, Lucy’s response to the news made even my
eyes widen. Dr. Leadbetter reminded her sternly that blasphemy was a sin, but I was secretly impressed by the originality of her cursing.
“You’ll help me though, aye?” Her eyes widened, and suddenly she looked like the child she was, begging for a way out of an impossible situation. “You wouldnae leave me in this condition?”
“You know I can’t do that,” Fiona warned. She should have told her it was murder, a wicked thing to even be considering, but I doubted that committing one more sin would imperil Lucy’s immortal soul any further than it already was.
“I cannae afford a bairn, miss! I can barely afford to feed myself most days. And who’s going to want to shag a knocked-up tart?”
Tears pricked at the corners of her eyes, and her voice thickened with emotion. It was an impossible situation, but there was nothing I could do. Besides, abortionists were ten a penny in an area as heavily populated with brothels as the Cowgate. If she really wanted to find a way of ridding herself of the unwanted burden, she’d find it.
“Lucy,” Fiona explained firmly, “you’re asking me to perform an illegal operation. I can’t risk my job—my life—by helping you. I wish I could, really. But there must be someone you can turn to for assistance. A family member, perhaps?”
“My brother helps me out sometimes”—she sniffled into a grubby handkerchief—“but he’ll kill me for this, I swear he will.”
“It’s only for a few months,” I said. “And there’s no reason that you can’t . . . work for most of them. Then perhaps an orphanage—I could get you an address if you—”
“Bitch.” A fleck of spittle hit my cheek. “Sanctimonious English cow. Just because no man would ever touch you if you paid him, never mind the other way around, you think you can pass judgment on me?”
If I flinched, Fiona took no notice.
“Miss Gilchrist is not the one sitting in judgment,” Fiona pointed out coldly. “Nor is she the one carrying a child. I suggest that you go home and reconsider your decision—not to mention your occupation.”
“If you won’t help me, there’s plenty of others who will,” she snarled, yanking on her drawers. “I dinnae care if it kills me to do it, I’m no’ getting stuck with a bairn.”
She flounced down the corridor, head held high, as though that would disguise the tears that streaked her rouge.
“Wait here,” Fiona instructed. “She can’t go wandering the streets hysterical, not in her condition. Silly, silly girl.”
Anger flared white-hot in my belly. Lucy hadn’t been a silly girl; she’d been a desperate woman making a living the only way she could, and I was in no position to judge her. But I let Fiona go, and before the door slammed shut behind her I was already lost in memories, with little care for anyone’s troubles but my own.
CHAPTER THREE
After the foul, dank air of the Cowgate, it was a relief to be back in the warmth of my aunt’s house. I wondered if I would ever come to think of it as home, or if that word would be forever associated in my mind with the rambling building in Kensington where it had been made painfully clear I was no longer welcome. Regardless of what I called it, the house had acquired a comforting sense of familiarity in the months since my arrival and I was looking forward to a few hours of peace and quiet in my room before succumbing to sleep.
I needed a bath before letting my aunt stand downwind of me—my cape reeked of cigar smoke, gin, and cheap perfume, and I had a horrid suspicion that my hair was the same. If my aunt found me smelling like a dockside whore again, I doubted that I would be allowed to visit the clinic—or anywhere else—ever again.
I closed the front door as quietly as possible, hoping to sneak upstairs before Aunt Emily registered my arrival. Unluckily for me, the woman had the ears of a bat.
I contemplated a dash for my room, but the drawing room door creaked open and she stood there with that omnipresent frown on her face. I pulled my cloak a little tighter around me in an effort to disguise the state of my clothes and my conspicuously absent gloves, and breathed a sigh of relief that I had at least fixed my hair in the carriage.
“You missed dinner. You’ll have to prevail on Cook’s good graces if you want something to eat.” She glared at me. “You know how I feel about punctuality, Sarah.”
“I came as soon as I could, Aunt Emily. My work at the infirmary detained me unexpectedly.” Telling her I had just come from dealing with a prostitute in a delicate condition wasn’t likely to endear me to her, but I was ready to spin a tale of unfortunate but virtuous patients whose poverty and ill-health were matched only by their devout faith. Luckily she accepted my explanation, and waved me upstairs.
“Make yourself decent and I’ll have a word with Cook about supper.” She sniffed the air and shuddered. “And ask Agnes to run you a bath. You smell of . . . well, I don’t even know.”
I smelled of the vomit a fourteen-year-old prostitute had deposited on my boots after the cabbie who had knocked her down dragged her into our waiting room before making himself scarce. Had he waited, he would have realized that the fault wasn’t his. The girl reeked of cheap gin, and it was mere coincidence that it took a hansom cab to knock her down—a stiff breeze would have done the job equally well. Judging it safest not to enlighten my aunt, I headed to my room and rang the bell for Agnes as I stripped off my soiled, stinking clothing.
Not for the first time, I wondered what on earth had possessed me to study medicine. Life as the spouse of some titled gentleman might be dull, but at least it would be clean. I forced the fantasy out of my head—that might have been the world I grew up in, but I could no longer call it home. My mother had been very clear on that matter. Kicking off my boots with a viciousness they didn’t deserve, I was glad when the arrival of Agnes offered me respite from my dark musings.
“A hot bath please, Agnes.” I offered her a conspiratorial smile that she failed to return. I’d be lucky if I got stale bread and a pitcher of water. For all that I was niece to the lady of the house, the servants had no more respect for me than my aunt did. I was here on sufferance only, and they knew that perfectly well. The silent housemaid—I was beginning to suspect that she was mute, since I hadn’t heard a peep out of her in the few months I had been living under my aunt and uncle’s roof—gave the briefest of nods and quit the room, leaving me to riffle through my wardrobe in search of a half-decent gown to make me look something approaching the lady I was supposed to be. I sighed in relief when Agnes and the between-stairs maid arrived with the hot water for my bath. Once alone, I sank into it, warming my chilled body and easing the cares of the day away.
Cleaner—and considerably less malodorous—I took my place by the fire, overjoyed to see that the promised toast was in fact a plate of toasted crumpets with a small dish of honey. Aunt Emily disliked my clothes, my morals, and most certainly my choice of profession, but even she wouldn’t see her own sister’s child starve. But, as with all my aunt’s gifts, this one came with a price.
Settling into her customary chair by the window—all the better to hear any scandal that might take place on the streets outside—she picked something up from the table. Wonderful. Reading to me after dinner had become one of her favorite pastimes. Occasionally biblical, but more usually a tract out of one of her blasted conduct books, there was always a dreary message aimed explicitly at me regarding repentance and submission. When I first arrived, she read Coventry Patmore’s The Angel in the House in its entirety. It took weeks. Tonight, though, my luck had really run out. The latest edition of Cornhill magazine—always addressed to my uncle, despite the fact that he preferred hunting to high culture—contained, to Aunt Emily’s delight, a scathing profile on the New Woman. There was nothing to do but smile demurely down at the sampler I was embroidering. The stitches were tiny and perfect; the one ladylike accomplishment I had managed to acquire in my twenty-seven years, and one that would stand me in good stead as a surgeon if I survived the grueling pace of my studies. As if sensing my thoughts, she glared at me over her lorgn
ettes and settled down to read aloud.
“‘The spirit of the majority of women serves more to strengthen their madness than their reason,’” she began.
I suppressed a groan and focused on my handiwork, while she and Cornhill demolished everything I held dear in biting prose. At least my needlework was beyond reproach. I feigned interest without actually having to absorb any of the tosh that the writer had penned. I didn’t need to pay attention to guess at the ridiculous claims he would spout.
Setting down the journal, she waited for my response. I judged it prudent to stay silent rather than unleashing a stream of invective about the author’s knowledge of women, men, and society in general.
She grimaced, suspecting my inattention. “Sarah, even you must see that this fad for the advancement of women is doomed to failure. Your uncle and I indulge you because . . . well, to be blunt, you must earn a living now that your inheritance has been . . . is no longer . . .” She started again. “You have no money, my dear. And your chance of making a halfway decent match is not improved by this foolish notion of becoming a doctor. As if any patient would consent to be treated by a mere girl! You must work, I see that, but there are professions suited for a gentlewoman of impoverished means. The more you bury yourself in books, the more you risk losing those few female qualities you do possess—not to mention your looks. You’re looking positively sallow these days, and you’re far too thin. It’s most unattractive, my dear.”
I couldn’t help noticing that Aunt Emily only ever called me “my dear” when she had just finished insulting me.
“This is where I’m needed, Aunt. I’m doing good work at the infirmary.” That, at least, was something she couldn’t argue with. But while Aunt Emily firmly believed in helping those less fortunate, she also felt that one should do it from a distance.
