Chapter 5
Daniel lifted the edge of a yellowed bandage, assessing the degree of drainage. The slightest disturbance of the wrapping released a putrid odor. Dying flesh. Gangrene.
He looked up, met Horace’s eyes, and gave an infinitesimal shake of his head.
Horace frowned, pushing past Daniel and his best dresser, Bernard Jeffers. “Don’t be hasty. You haven’t taken a full look. Hand me the scissors.”
Daniel had mastered human anatomy and a dozen different sutures, but he was most proud of his hardest-earned skill—not rolling his eyes at Horace.
“I can smell gangrene from here. You can too,” he whispered, keeping his words from the resting patient, a sixty-year-old man, half-deaf, who’d been knocked down last week by a slow-moving engine in a train yard.
His demolished fibula normally dictated immediate amputation above the knee, but this unfortunate man had already lost his other foot in childhood.
Horace declared him the perfect case for a risky procedure to save the broken limb, since conventional treatment would prevent the patient from ever standing again.
“If we cut the leg off now, we can still get it all,” Daniel pressed.
Horace tsked and waved Daniel back.
Under Horace’s direction, Daniel had stifled his own protests and attempted the novel surgery, aligning the four pieces of bone and wrapping the limb in plaster. Plaster that, four days later, was yellow, soggy, and foul.
“The leg has to go, Horace,” Daniel insisted. “Now. Before it kills him. Clean up his leg for surgery, Jeffers.”
“Don’t be a fool. And don’t touch him.” Horace’s command carried fierce authority.
Jeffers looked between them, unsure which to obey. Daniel was about to repeat his order when another wave of stench rose up, forcing him to cough and turn away. The fetid odor was as bad as a week-old cadaver.
“Here you are.” Jeffers offered a handkerchief liberally anointed with menthol. Daniel thrust it under his nose, the fumes blurring his eyes with tears.
“Give me a moment. All I want is a thorough look.” Horace continued his steady cutting, dropping the sodden plaster into a bucket at his feet.
Daniel circled his shoulders, sore from the work of today’s earlier surgeries.
The heel spur removal was delicate work, not terribly taxing, but he’d also amputated an arm, set a fractured femur, and supervised Jeffers in three small procedures.
With practiced discipline, he inhaled through his mouth and closed his eyes. The sooner this leg came off, the better. Horace chuckled, and Daniel whipped his head around despite the smell. He saw no reason to laugh.
But Horace grabbed a pitcher of warm, weak tea, one of his favorite anointings for wounds, and flushed the leg. “Granulating!” Horace crowed once the multicolored pus was rinsed away.
“What are you talking about?” Daniel stepped closer, peering at the sutures.
The flesh around them was angry, red—and healing—not a putrid black, gray, or yellow. Daniel pressed one hand to the skin above the knee and the other to the ankle. Warm. “Dammit,” he muttered.
Horace chortled. “Feeling foolish?”
The patient shifted, angling for a look. Catching a whiff, his face went pale. “What’s appenin’ to my leg?” he moaned.
“Fair question.” Daniel turned to Horace.
“It looks much better than I expected, but you have no idea what’s happening beneath the skin.
” He touched the leg again, aching to see inside and know if the bones were knitting.
“We have no way of knowing if there is infection in the bone or if it will ever hold weight. We both smelled it!”
Horace leaned close to the patient, ignoring Daniel. “Your leg is healing very well so far.”
“Then what’s that awful smell?” the old man demanded.
“That is the smell of genius,” Horace said.
Daniel had to look away and cough again.
Jeffers leaned in for a look, the mint fumes of his handkerchief forcing tears from his irritated eyes. “May I?” he asked, waiting for a nod from Daniel before touching the skin. “I don’t understand,” he said, pressing gently. “We can smell the gangrene, but there’s not a trace—”
“Rinse with more tea and then plaster him again.” Horace adjusted his spectacles, cheeks pink with amusement. “You smelled old, foul bandages. Not necrotic tissue. That was rotting pus and blood, not flesh and bone.”
“How did you know?” Daniel asked, happy for his patient but nettled by Horace’s self-satisfaction.
“I didn’t,” Horace said with a shrug. “I was just patient enough to check. Go call in the others so we can educate them before we throw the bandages away.”
Jeffers stuffed his handkerchief into his pocket, clearly relieved to be sent on an errand and escape the sickening smell, however briefly. He paused at the door. “Dr. Croft, how does the smell not affect you?”
Horace looked at the young doctor in training. “You learn control with time. Then you can command your hands not to shake. Your head not to doze off after a night without sleep. Your nose to overlook upsetting smells. But I must have filled buckets with vomit when I was your age.”
Jeffers smiled, his shoulders loosening. Daniel hadn’t realized they’d grown so tense.
“It was good of you. To give Jeffers some encouragement,” Daniel murmured once his dresser had left the room.
“They all need it,” Horace said. “Besides, it’s no fun showing them up. Much more satisfying to do that to you.”
This time, Daniel did roll his eyes. “Get ready,” he said. “I can hear them coming.”
Right on cue, a half-dozen doctors and dressers filtered into the ward, surrounding the patient’s bed. Several handkerchiefs appeared, but Jeffers resisted the urge to employ his again.
Horace held up the putrid, sopping bandages, explaining the case in theatrical style, with gestures and embellishment.
Then, mercifully, he ordered the bandages removed from the room to be burned with the other diseased dressings and linen.
After Horace washed the leg thoroughly, only the echo of the former smell remained, replaced with the strong fume of soap.
The students began to disperse, revealing two colleagues conferring a short distance away, arms crossed, brows furrowed. They frowned at Daniel.
Whatever for? While he wouldn’t mind taking credit for this, the discovery—and the ensuing theatrics—were Horace’s. Ten minutes later, the last student was gone, off to observe another case, but Adams and Howe remained, still casting dark looks in Daniel’s direction.
Leaving Horace to examine the next patient, Daniel approached. “Is there a problem?”
“We’ve just come from your wife’s obstetric lecture.” Adams insisted on an absurdly pointed little beard that made it difficult for Daniel to think of anything else, but he perked up at the mention of Nora.
“And?” Daniel crossed his arms, all too accustomed to complaints about his surgeon wife.
“Oh, stop bristling,” Howe sneered. “We paid to go, didn’t we?” He fumbled his pocket watch in his loose fist. “The lecture would have been fine if she taught it.”
“What do you mean?” Daniel demanded.
“She had a trio of common midwives there. Halfway through, she invited one of them to explain a case—just because the creature had been lucky enough not to kill the woman. Once your wife let that hedge witch take over the lecture—”
“Take over the lecture?” Daniel echoed. That didn’t sound like Nora, with her careful notes and rehearsed presentations.
And three midwives? This morning, she’d said there would be one.
“There must have been a reason.” Though what it might be, he couldn’t imagine.
When midwives had “interesting” cases, they sent for her or Horace.
“Indeed,” Howe said. “Even if the woman’s claims are true—and I don’t believe them for a second—I won’t attend another lecture from your wife, no matter how impressive her résumé. And I certainly can’t recommend them to my students or anyone else. Deferring to midwives!” He shook his head.
“Nora doesn’t defer to them,” Horace said, drying his hands as he joined the conversation. “She uses them. As do I. The good ones are valuable.”
Howe frowned. “For fetching water and cleaning babies. Perhaps for uneventful cases when the child needs merely to be caught. But one never knows which births will be uneventful.”
“Your wife was supposed to be instructing doctors on delivering with short forceps.” Adams’s dark eyes glinted. “I’ve been using them for five years and—”
“You never thought of teaching anyone,” Horace said. “Why not? Didn’t want to cut into your own business?”
Adams flushed. “If she thinks she can put tools like that into the hands of illiterate women—”
Daniel grunted, a heavy weight in his stomach. Nora wouldn’t hand a midwife a pair of forceps. It sounded like a sure way to decapitate a child. “I’m sure you misunderstand. My wife wouldn’t—”
Beside him, Horace shifted in a way that sent warnings along Daniel’s spine. Surely she hadn’t—
“Nora is more concerned about knowledge than her pocketbook,” Horace spoke up. “She shares her skills—unlike you, trying to guard secrets.”
Adams barked a mirthless laugh. “And every dressmaker should publish her most desirable patterns for anyone to use, though she worked her entire life to develop her skills?”
“A dress is hardly the same.” Horace fastened his cuffs. “We’re in the business of treatments and cures, not silks and pearl buttons.” He glanced pointedly at Adams’s fine coat. “Or haberdashery.”
This conversation wasn’t headed anywhere productive. Daniel exhaled. Adams and Howe had influence. Horace might not mind quarrels, but it would be better for all of them to avoid one. Better still if he could convince Adams not to criticize Nora’s lectures.
“My wife is always curious. If she was intrigued by something this midwife said, she would have wanted to know more. What’s the harm in listening? A doctor should be able to hear and judge claims.”
“A doctor should know better than to give ear to every quack and chatterbox,” Howe retorted.
“I’ll ask her for the full story tonight.” Daniel calibrated his voice. Better to beat them in calm than in temper, though far less satisfactory. “She has enthusiasms, I know. But that’s what makes her so brilliant. None of us have managed a cesarean section.”
“Yet,” Howe said.
“If you don’t wish to hear her teach, I’m sure there are other doctors who will enthusiastically take your vacancies,” Horace said.
Adams raised his eyebrows into incredulous arches. “You can’t forever provoke everyone, Horace,” he warned. “Your days of stunning everyone in the surgical theater are already over. You will not always be untouchable, you know.”
Horace surprised Daniel by settling his weight onto one hip, his mouth falling into a relaxed grin. “And with good luck, you will not always be an ass, Adams.”
Daniel bit his lip and looked away.
Adams sputtered. “How dare—”
“Oh, come off it.” Horace waved a hand. “There’s very little in your medical repository I didn’t teach you. Stop putting on airs, and come look at this leg. I’m particularly proud of it, and you couldn’t have had a good look back there.”
“I’ll do no such thing,” Adams announced and stalked from the room. Howe lingered only a moment longer, casting one look at the man who, thanks to Horace, would keep his leg.
At least for a few more days. It was dangerous, sometimes, to hope.
Daniel shook his head. “I don’t blame you,” he said to Horace. “Adams is insufferable. But you’ve never had an ounce of tact.”
“With luck,” Horace said, “I’ll never need it.”
Daniel closed his eyes. “You’re going to teach my students to be as impossible as you are.”
“You know what Nora says,” Horace countered. “Impossible doctors are the best ones.”
Daniel inhaled. A bit of conventionality might do his life good now and then.