Chapter 4
Nora peeked through the red curtain between the hospital hallway and the lecture room. Horace had hung velvet instead of installing a door because it was much easier to roll cadavers through curtains than to maneuver them through solid oak.
She didn’t like entering the lecture theater while doctors were still settling in.
Something about standing in the bare circle in the center, surrounded by rows of rising benches, made her feel as exposed as a menagerie animal.
Horace and Daniel usually finished straightening their instruments and tying their smocks while exchanging news with the students and doctors readying notebooks and pens.
Nora took a different approach—waiting for all attendees to settle before making an efficient sweep into the buzzing room and diving headlong into the subject without pause or greeting.
It was how Magdalena always corralled students’ attention, and it worked well enough that Nora had adopted the technique.
She straightened her apron and reviewed her meticulous notes in the dim light from the window at the end of the hall. Daniel and Horace attended her lectures whenever they could, but the bone spur surgery kept them away today, leaving her without allies if anything went awry.
You wouldn’t think academic lectures would get out of hand, but she’d seen all kinds of horrors at them, and not just on the dissection table.
Shouts, insults, accusations, brawls—they weren’t particularly uncommon.
So she peeked again, careful not to move the curtain enough to alert anyone to her presence.
She wouldn’t for the world be caught cowering outside her own theater.
Seventeen attendees. A good number, though not nearly as many as at one of Horace’s lectures. Everything appeared hazy through the slit between heavy velvet panels as the gentlemen moved about. That should be nearly everyone, and her watch said—
Some change in the buzz of conversation caught her ear—a sudden easing of syllables and then the distinct tones of a female voice. Mrs. Franklin had arrived. Nora had almost given up on her.
Abandoning her carefully planned entrance, Nora emerged through the curtains. Up in the risers, Mrs. Franklin’s usually phlegmatic face shone pink with excitement. Beside her, two other women in work-a-day wear stood uncertainly, scanning the room.
“Mrs. Franklin?” Surprised by the additional women, Nora couldn’t keep her greeting from sounding more like a question.
“I’ve brought Mrs. Bailey and Mrs. Howell. They’ve been in the business for over twenty years, both of them. We’re all interested.”
Nora caught the unfortunate expression of the doctor closest to Mrs. Franklin, and her face heated as she tried to rein in the situation before it stampeded away without her.
“All interested students are welcome,” she said, forcing a smile to remind everyone that this was indeed true.
It was not uncommon for learned men to visit medical lectures on a whim.
Even ladies had been known to accompany their curious escorts to enjoy the horrors of dissection or view natural spectacles, like the wombat.
But the attendance of female practitioners at this sort of lecture was something Nora had never seen in London before.
“Please be seated, everyone, and we’ll get started.” One man opened his mouth but swallowed whatever he’d meant to say when she continued. “I will be expounding on the use of forceps, as taught at the University of Bologna.”
Nora smoothed the sheet covering the dissected body she and Horace had spent two days pinning and preparing.
Though the decedent was past child-bearing age, she would still do for demonstration purposes.
Nora knew the impressive specimen would enthrall them—the abdomen was wide open from pubis to sternum, each pale organ displayed in strange stillness.
In the cradle of the hollow pelvis, the shrunken uterus lay almost invisible—only a strip of unimpressive tissue when not in miraculous use.
Imagining their admiring gasps, she clutched the corner of the sheet and whisked it aside with a snap.
No gasps. Instead, one of the midwives squawked in dismay and recoiled.
The doctor next to her gave her a disdainful look and moved farther away down the bench. Of course, none of these women expected a body opened like a cupboard, while the doctors expected nothing else.
Should have left the theatrics to Horace.
Hurrying on: “We’ll use the cadaver to demonstrate possible fetal positions and how the forceps can help us access areas our fingers cannot reach.”
“I’ve tried forceps on occasion,” one doctor spoke up. “If the va—” He hesitated, no doubt remembering the women seated behind him. “If the passage is tight enough to need them, they do naught but push the baby’s head higher into the birth canal.”
“A problem we’ll address,” Nora promised. “As you see, I have the short forceps, with which all students in the obstetrics course—physicians, surgeons, and midwives”—she nodded at Mrs. Franklin and her friends—“are trained at the University of Bologna.”
That ought to give the skeptics something to think upon.
Smiling, Nora plowed on, using a cloth model of a baby to show positions within the pelvis and the careful placement of the forceps to turn the child when necessary.
She was demonstrating a mento-anterior presentation when Mrs. Franklin raised her hand.
“I don’t know what words you’re using,” she stated baldly.
A hum of discontent rippled through the doctors like the uneasy revolution occurring simultaneously in Nora’s middle.
Ignoring it, she hurried to explain. “It’s quite simple.
Our cadaver is in the supine position, facing upward.
If someone is lying on their stomach, that is prone…
” She made it through cephalocaudal, but before she could define anterior, an unfamiliar doctor rose, making a show of looking at his pocket watch.
“Back at primary Latin? I have patients to see, if we’re not getting on to something helpful. ”
Nora’s eyes flashed to the spot where Daniel usually sat, filled today by a pockmarked young student.
“I think she’s trying to say ‘face-first,’” one of the midwives interjected, attempting to be helpful.
One student laughed, and the doctor beside him threw his hands up in exasperation.
“Yes, I was,” Nora said. “I was referring to a face-first presentation. Something most of you have never seen, I assume.”
“I’ve heard they right themselves before they come out that way because it’s not possible to fit,” a smartly dressed young man offered.
One of Mrs. Franklin’s companions (rather round, and she’d already giggled twice) burst into laughter. “Right themselves,” she repeated, shaking her head as if relishing the punch line of a joke. “Wouldn’t that be lovely?”
“I beg your pardon,” the offended man said with a deep frown.
“Don’t worry, love. You’re pardoned. But it’s perfectly possible to deliver them. We’ve all brought children into the world face-first. And we did it when the mother were neither up nor down or sootin—supine? Whatever you call it.”
Nora had seen two face-first presentations in Italy, but the nuns had managed to rotate the child before bringing it through.
“The baby emerged face-first?” she asked Mrs. Franklin, wanting to verify this rather spectacular claim. “And lived?”
“Came out looking right at me,” Mrs. Franklin confirmed. “Alive as you and I.” The other midwives nodded in confirmation.
“How did you overcome the symphysis pubis?” Nora glanced at the open cadaver, trying to understand the methodology.
If the child could not be rotated, the common solution in London was to collapse the head and bring it through piecemeal before it killed the mother.
In Italy, where doctors refused to kill a living child, it demanded a cesarean surgery.
The midwives stared back blankly. “The pubic bone in the front,” Nora clarified. “Didn’t the chin get stuck?”
“Excuse me,” Dr. Impatience and his watch interjected. “Is this lecture going to be taught by common midwives?”
Mrs. Franklin frowned, her face hard and offended. “I’d hate to be accused of teaching you anything.”
Nora raised her arms, hoping to draw the man and Mrs. Franklin’s attention away from each other. “I’d listen to a horse if it could tell me how to deliver a mento-anterior presentation. If I were you, I’d stay and listen.”
“Hmm. I’m afraid I’m slightly more selective. Good day, ma’am.” He bowed and left the room, wafting dissatisfaction in his wake.
“It seems a waste of your time and entrance fee to leave before she’s even had a chance to answer my question,” Nora called after him.
He didn’t reply, and it was easy to see that others were thinking of following. She lived with enough doctors to know their minds were not solely scientific. They were all painted with a vivid streak of drama. Perhaps herself included.
“Mrs. Franklin. Would you come show me how the child presented and how you delivered? As well as explain the aftereffects.” She held out the crude doll in invitation.
Mrs. Franklin hesitated, starting to refuse.
“If you’re telling the truth,” Nora goaded.
The woman’s face went from pink to crimson.
Just as planned, Nora had struck her pride.
Mrs. Franklin climbed down the risers and opened the gate to enter the demonstration floor.
“Lying on the back is fine for some deliveries,” she said with a serious frown.
“But all the doctors I know dismiss the other birthing positions.”
“Good Lord, are we going to discuss medieval birthing stools next?” one man complained.
Mrs. Franklin’s brow contracted. “You haven’t brought hundreds of women through. A stool is a necessity for some of them.”