All In Her Hands

Chapter 1

The house was quiet. Nora let out a sigh and plucked at the linen rag covering her chest. It had been a pressed blouse just this morning, before she’d had to sally out into the late-summer heat. But the air inside was almost as stifling.

She had one goal—to sit in the ice room with closed eyes until the waves of heat stopped radiating off her skin.

Then she could finally open the letter she’d received yesterday but hadn’t had time to read.

Navigating past a pile of newly arrived crates in the hallway, she glanced at the labels—India.

Horace must have gotten word of some exciting specimens.

Detouring around them, she stepped into the parlor and stopped, letter and ice room forgotten.

A tall, slender man was stretched across the sofa, slippered feet hanging off the edge.

The newspaper draped over his face lifted ever so slightly with each of his languid breaths. Daniel was sleeping.

Though her sore arms begged her to drop her heavy bag with a thump, she lowered it carefully to the floor so as not to startle him. Besides, it held too many precious medicines and instruments to treat it with anything less than the utmost care.

She tugged at her bootlaces to free her tired feet. Leaving the dusty boots in a heap, she tiptoed closer, studying her new husband. The newssheet, rising and falling with each exhale like the gentle swells of a calm sea, bore an article about American gold prospecting in California.

A trained surgeon, she lifted the paper with remarkable care and transferred it to the sofa arm, revealing his face—his sideburns trimmed with her usual precision.

Daniel could have done as well himself, but she enjoyed shaving him.

She liked any excuse to touch him, particularly those opportunities requiring a battle between deliberate motion and reckless proximity.

The first time, she’d gotten carried away and actually nicked him. Daniel had teased her for weeks.

Nora grinned, nudged her way onto the edge of the cushion, and bent, kissing his cheek. He looked younger than his thirty years when he slept.

“You’re home,” he said before he managed to open his eyes. His arms found her and tugged her close as he turned to his side and burrowed into the sofa to make room for her. “You missed supper. I hope it was an interesting case.”

“Nothing exciting. I was treating a girl with a fever in a rookery. When word spread a doctor was there, I had a line down the hall all the way to the front door. I opened a cyst, removed a dead fingernail, and tomorrow I have a child coming into the clinic. He’s tongue-tied and needs to have it clipped. ”

The poor didn’t mind so much when their doctor wore skirts. Since returning from Italy six months before, the clinic here had grown more and more empty. Most middle-class men simply refused to submit to her care. Nora took a deep breath. “How was your day?”

“Three surgeries. An amputation, a bone excision, and a bunion removal.”

Nora tamped down her jealousy, diverting her attention to Daniel as he pressed his lips into her hair, sending a rush of electricity over her scalp.

“Let me squeeze you for a minute, and then you can go eat.”

“I can’t eat yet. I’m still too hot. I meant to go to the ice room.”

A throat cleared behind her. Nora sat up. “Hello, Mrs. Phipps. Did you want something?”

The housekeeper wasn’t normally inclined to interrupt, but as general manager of the chaos contained in their household, specimen room, hospital ward, surgery, and clinic, she often needed to.

“I want you to be able to eat, perhaps sleep, and freshen your clothes.” Her presence was always more forceful than her rail-thin, diminutive stature justified.

“But I’m afraid a messenger’s come to the clinic.

Mrs. Franklin is asking for help. She’s on Milk Street.

It’s urgent.” Her voice softened. “I’m sorry, Nora. Cook is packing you a sandwich.”

Untangling himself, Daniel sat up, too. “I can come with you.” Mrs. Franklin was a skilled midwife, but if she needed help—

Nora glanced at him, his cheek red and indented where it’d been smashed against the button of the tufted pillow.

He must be tired, even more so than she, if he’d done three surgeries this afternoon.

And he was scheduled to work at St. Bart’s, one of London’s enormous teaching hospitals, again in the morning. “You need to sleep. I’ll manage fine.”

“Don’t walk,” he said. “Take the carriage and rest your feet for a few minutes.”

“The driver is already bringing it around,” Mrs. Phipps said as Nora wrestled her boots back on, her feet magically sorer than when she’d stripped them off only minutes ago. “I’ll have the sandwiches and your vaporizer put in.”

As she disappeared, she kindly closed the door.

Daniel came up behind her, resting his hands on her shoulders and working at her knotted trapezius muscles. “Are you certain, Nora? I’m happy to help.”

“Go up to bed.” She rummaged through her bag, opening the protective case of her newest acquisition—a beautifully crafted glass syringe. No cracks. Good. “I’ll join you as soon as I can.”

She hadn’t meant any innuendo, but he gave a complaining groan and kissed the back of her neck. “Not soon enough.”

She swallowed and waited for her stomach to return to its rightful place, then turned and placed a pert kiss on his head. “No fair making me regret going when I have no choice. And just so you know…” She paused at the doorway. “I’m going straight to sleep when I get home.”

“We’ll see.” The sound of Daniel’s laugh chased her down the hallway, the feel of his hands on her shoulders lingering until she was in the carriage, rolling toward Milk Street.

She wished she could have stayed home.

But she was needed, and this promised to be today’s most challenging case—probably the most demanding work she’d do all week.

A humbling thought. Six months ago, in the midst of the furor she’d caused by registering with the medical association as a surgeon free to practice in the city of London—without letting them know N.

Beady was a woman—she’d conducted a successful cesarean section, something no other English doctor could claim.

But the victory of her one incredible feat was fading, and she couldn’t make a career out of dangerous and rare surgeries.

If she kept doing only the work no other doctors would take—and no male patients would give her—next time she needed to do a cesarean, she’d be out of practice, dangerously so.

She couldn’t collect enough fees or keep her mind and fingers sufficiently trained dressing burns, treating bunions, and removing ingrown toenails.

Nora took another bite of her sandwich and extracted the letter in her pocket.

With traffic clogging the streets, she ought to have time to read it all.

And she was anxious for news of her teacher and mentor, Magdalena Marenco, a surgeon and professor of obstetrics and midwifery at the University of Bologna.

Magdalena would have good advice for her, whether she knew Nora’s current troubles or not.

Nora broke the letter’s seal with a quick flick of her thumb, smiling as she studied Magdalena’s handwriting.

It was so like her—flowing, bold letters that dominated the page.

Another bite—Nora shook some fallen crumbs off the paper—and she started to read, chewing as she devoured her former teacher’s words.

My darling Nora,

Yes, I’m sure your husband is excellent, but I also know that you have no real yardstick by which to judge.

After all, you never did sleep with Salvio Perra, which on the whole I think was wise.

He’s generous, but so easily offended. That becomes tiresome.

However, I’m glad you are happy and glad that Daniel makes you so.

I told Salvatore, and he looked like he’d bitten a lemon.

Nora huffed. Magdalena tended to be even more forthright in her letters than she was face-to-face. Wrenching off another bite of sandwich, she chewed furiously.

The recipe Dr. Croft sent for the primrose tincture is very nice. Please offer my thanks.

No, I’m afraid I have no female students since you left, excepting the midwives, of course.

At the mention, Nora saw the faces of her friends.

The midwife nuns had been separate from her, of course, by their vows and customs, but they’d worked hand in hand, nursing and bringing children into the world.

Here in England, most doctors considered a midwife as little more than a woman with a water bucket and some ragged towels.

They were certainly not trained to work in hospital like their Italian counterparts.

Licensed doctors, known as accoucheurs and obstetricians, now claimed the world of English childbirth, leaving midwives to attend to the impoverished and those too frightened of high mortality rates to go to charity hospitals.

I worry over it. In my mother’s time, the university had four women attending classes.

At present I am the only female, if I don’t count the nuns.

I want to train others—other women, I mean; there are enough men enrolling in my classes—but I have found no one willing to try.

Once I’m gone, what of the girls who’d like to learn then?

Who will help them, or show them that this is possible?

That women are not just capable of this work, but meant for it?

You must think of this too. I know in England right now there isn’t a way for them—

Nora swallowed, looking blindly through the carriage window.

There truly wasn’t. Unable to remove her from the medical register once she’d qualified, the college had instead made a new rule, barring women applicants entirely.

They might not be able to get rid of her, but they’d stop every other woman who tried.

Her stomach twisted with familiar guilt. She’d snuck her way in, unintentionally damming the way for any other woman to follow, though none had tried, yet.

It’s the college’s doing, not yours, she reminded herself and returned her attention to the letter.

You must think of the future, Magdalena continued. For the women who would and will work with you. For the sisters you will care for and save.

Throat tight, Nora refolded the letter. Magdalena meant well.

She was fierce and uncompromising in her beliefs, but what exactly did she think Nora could do about this?

She’d barely clung on to her license. She had practically no patients, certainly none who could afford to pay her.

The clinic stayed afloat only because Horace still attracted enthusiastic—and paying—crowds at his lectures and demonstrations.

She was tired, hungry—even after the sandwich—and probably destined to spend all night tending a woman in labor. And next week and next month, she’d do more of the same, waiting for the rare, sporadic cases to keep her mind and hands from rusting.

***

The driver stopped, and Nora scrambled to swallow one last bite as she hoisted up the delicate vaporizer and her kit bag. Wriggling from the carriage, she almost bumped into a thin young woman twisting her hands anxiously. “Are you Mrs. Gibson?” she asked. “Mrs. Franklin told me to wait for you.”

“Yes,” Nora answered, glad to have extra help. She passed the girl her instrument bag. “Careful with that.” She’d carry the vaporizer herself. It had just been recalibrated and repaired, and was every bit as fragile as her new glass syringe. “Take me to her.”

The girl rushed through an alley to a crooked staircase that clung to a filthy, soot-stained building with doors and landings at intervals leading to even dirtier flats.

“Mrs. Franklin’s worried,” the girl said, her words separated by breathless pants.

Nora struggled to keep pace—the steps were steep, and she didn’t trust the rickety railing.

They ducked inside a door, three floors up.

“Just in there.” The girl handed Nora her bag and retreated, only too eager to flee.

Nora didn’t blame her, but she didn’t understand, either.

Whenever Nora heard screams of pain, her blood quickened, propelling her toward the crisis, not away.

Her adoptive father, Horace Croft, renowned for his work in surgery, medicine, and science, was just as intrepid, luckily for her—and not only because he’d dared to develop and make use of her skill, once he’d seen that she shared his curiosity.

First, he’d plucked her, nearly lifeless, out of a flat not much better than this when her entire family perished from cholera.

His heedless rush into every undertaking had saved her life.

It had been a searing experience for an eight-year-old girl—losing her family to cholera, nearly dying, then awakening in the home of a strange surgeon with sobbing patients and specimen-filled shelves.

But since she’d nowhere else to go, she’d done her best to stay by trying to make herself agreeable and useful.

It took Nora years to trust the gruff stranger and even longer to approach his exacting trade with anything other than horror.

Unfortunately, Horace attended fewer surgeries since his stroke last year. His weakened left hand might be just as dexterous as the average man’s, but Horace was a renowned surgeon and not accustomed to being average at anything.

Nor did Nora aspire to the commonplace. Squaring her shoulders, she hurried toward the growing moans, willing her eyes to adjust to the dark and her nose to air that already smelled of blood and birthing.