Chapter 12
Daniel rolled a shoulder against the tight knot forming in his trapezius muscle. The operating tables at Bart’s were not designed for tall men, and though surgeries were kept as short as possible—often under twenty minutes—his neck and back squeaked out their complaints.
“You’ll notice Mr. Jeffers is constantly checking the vaporizer and mask to ensure the patient is getting the exact dose calculated for his weight.
Dr. Croft has not lost a single patient to ether.
” He angled his voice toward the four students huddled on the other side of the table.
“I’d rather you not take notes during the procedure,” Daniel said evenly.
“They go so quickly. It is more important to observe and feel the techniques.”
The student lowered his charcoal pencil right away.
“When retrieving a ball from a gunshot, you want to follow the path of entry as cleanly as possible to avoid extending the injury,” Daniel said, indicating the wound on his sedated patient, an older man who’d set off his pistol accidentally and shot himself in the calf.
Instead of making a clean exit, it had traveled down his leg and lodged inside.
“Doesn’t Croft recommend leaving balls in place?” one of the students asked as Daniel selected a rounded metal probe.
“Internal balls, sometimes. But this one is close to the surface and would likely cause considerable pain before it encapsulated itself in a cicatrix.”
The newest student shifted and frowned.
“Scar tissue,” Jeffers supplied kindly. He’d been a mere student himself two years ago.
Fortunately, the retrieval went smoothly, and the patient woke without sputtering or confusion as the medical students applauded quietly, their smiles relieved and admiring.
“Now Mr. Jeffers will show you the correct way to dress the wound, which will be especially important to those of you who pursue the work of a military surgeon.” Daniel hung his smeared smock on the wall hook and slipped out of the room to rinse the blood from his hands.
“Successful surgery?” Dr. Adams called. He’d spotted Daniel’s stained hands, held up in the distinctive pose of doctors protecting their shirt cuffs, as he strode down the hallway.
“Uneventful, yes. Just removing the ball from an accidental shot.” Daniel nodded to the two doctors with Adams. He knew them only obliquely, as neither were surgeons.
He stepped forward, but none of them moved aside to let him through. “I should clean my hands before the blood dries,” Daniel said with a smile.
“Of course.” Adams smoothed his beard. “We were just discussing the petition.”
Daniel’s fingers curled toward his palms. “What petition?” He’d been involved in more than his share of hospital infighting. If something was brewing, he intended to stay far away—didn’t want even a whiff of it.
“There was an article in the Provincial about an unusual delivery…”
Daniel’s stomach sank a good six inches. The article must be Nora’s. He’d read it just the other day. “Forgive me, gentlemen. I really must look after my hands.” He wiggled his itching fingers impatiently and started walking.
“We’ll accompany you. I’m anxious to hear your thoughts.”
“Wonderful.” The word sounded pleasant despite his grinding teeth.
Leaving the others behind, Adams followed Daniel into the washroom. Daniel located a clean basin, pumped it full of water, then dipped his hands. The water was cold and soothing, but though it was tempting to pause, he reached for the soap and began working up a lather.
“I’m no Silas Vickery.” Adams hooked a thumb on his trouser pocket.
Daniel raised his head just enough that Adams could see his raised eyebrows. “That’s good.”
Vickery, the head of Bart’s board, was twice Adams’s size and three times as vicious. He was less known for medical innovation than for his extreme dislike of Horace Croft. Daniel avoided him at all costs.
Adams held up his palms. “I have no desire to start a feud with my colleagues.”
“Nor I,” Daniel agreed cautiously.
Adams waved a piece of paper as Daniel dried his hands, paying scrupulous attention to the spaces between his fingers and his nails. “This petition argues that innovation in obstetrics must come from doctors. There can be no safe experimentation by the unlearned.”
“Like midwives,” Daniel said levelly.
“Exactly,” Adams said.
“One could argue that there is no true safe experimentation at all,” Daniel said.
“Yes, but a physician—a well-trained one—can assess risks, determine if an idea is—”
“My wife is a physician,” Daniel announced flatly.
Adams balked. “But the women she’s working with certainly are not.”
“Our degrees hardly make us immune. Whose idea was it to transfuse Mrs. Colman with milk?” Daniel asked, and Adams flushed.
“Her acute postpartum bleeding required immediate action.”
“And her immediate reaction was most unfortunate,” Daniel said dryly. Heart palpitations, rashes erupting all over her body, acute nervous shock were all quite unfortunate. Together, they’d nearly been fatal.
Adams continued, his voice as pointed as his sharp beard, “Physicians must present a united front to effect change. Look how long the last medical reform bill took. If we squabble among ourselves—”
“I’m not squabbling.” Daniel folded the towel and laid it next to the basin. “I’m in favor of training midwives. I’ve no wish to attend every delivery in London. You know we can’t. There are not enough doctors, and many patients can’t afford our fees anyway.”
“But they can’t be allowed to displace physicians. I make little money from deliveries and lying-in fees when you consider the time involved, but they keep families loyal to me and bring in new generations of wealthy clients.”
Daniel knew well enough how happy surgeons would be to forgo obstetrics all together, but it was expected for family doctors to attend to every birth or risk losing the household’s business.
Adams continued, “Not to mention, it will stunt discovery. Procedures like your wife’s cesarean will never be adopted if she ties herself to mere midwives. And the regulation of doctors, surgeons, and apothecaries is of prime importance. Charlatans and impostors have no place practicing medicine.”
“Are you talking about regulation or restriction?” Daniel asked. He had another surgery waiting. He should have been back before now, and his bladder was protesting that it, too, needed attention.
“Aren’t they one and the same?” Adams asked.
Daniel shook his head. “No. And you’re proposing a completely unworkable solution. What will you do? Prosecute women who have their children at home? Prosecute their mother or sister for helping them?”
“Hardly.” Adams somehow managed to straighten his already impeccable posture. “But we can make it clear to the public there is no such thing as a qualified, professional midwife. If the women would only come here where there is an abundance of doctors and surgeons, then—”
“They won’t come,” Daniel countered. “They’re afraid of the hospital. Many more die here.”
“They die here because they come as a last resort after a meddling woman with no medical knowledge has done permanent damage.”
“That’s not true.” Daniel kept his voice even. “And your protest needn’t be so extreme. Many experienced midwives—”
“Help us modify it, then. We must be united as licensed professionals. And when Vickery’s article comes out in the Provincial—”
Daniel’s eyes narrowed. “What’s Vickery saying now?”
“He and several physicians are countering your wife’s position—ironic play on words, isn’t it?—on childbirth and the education of midwives in this field. Cordially, of course.”
Daniel closed his eyes for a long blink, savoring the darkness and the break from Adams’s meticulously groomed face. First a petition, now opposing articles and papers. “He needn’t witch hunt my wife. She merely reported on the results of an unusual labor.”
“It certainly was,” Adams agreed solemnly. “A wealthy woman who gave birth like an animal in the woods, under your wife’s supervision.”
“What would you have done, Adams?” Daniel crossed his arms, hoping to hide the thumping in his chest. “If your patient dropped to the floor as the child crowned? Would you have forced her up? Would you even be able to? The laboring woman was larger than my wife.”
“Precisely.” Adams searched Daniel with a bottomless gaze. “She hadn’t the strength or ability. But if you or I had been there…”
The possibility hovered in the air, as heavy as the grim clouds darkening the window. Daniel shook his head. “Mother and child are safe. Let it be, Adams. I have no desire to brawl with you.”
Adams tipped his head in courteous acknowledgment of the compliment.
“And I respect you. Enough to give you advance warning that opposition is rekindling against Mrs. Gibson.” He brandished the paper again.
“Mr. Roland is disgusted over the rumors that the article is about his wife, you know. Your name on the list will appease him.”
Daniel frowned. Mrs. Roland’s husband was a wealthy man. An influential one known for his caustic temper. He’d make a terrible enemy.
“I haven’t even read the thing.” Daniel dried his hands with unnecessary violence.
“It’s all here.” Adams pushed it so close the thing was impossible to ignore.
With a sigh, Daniel read the rambling introduction.
He begrudgingly agreed with the language—the consistency of standards, the licensing of those who collected fees for medical procedures.
“Be practical,” he said with a shake of his head.
“Under these conditions, most of our students couldn’t attend a birth. Some doctors as well.”
Adams lowered his eyebrows. “Nonsense. Any doctor or student well versed in anatomy—”
“The standards should apply to all—not just midwives.” Daniel tipped his head back, stretching the painful muscles in his neck as he squeezed his shoulder blades together.
“We need to start somewhere.” Adams studied him carefully. “Your wife is once again defying the profession she petitioned so hard to join. It won’t end well for her, Gibson.”
“Are you threatening my wife?” Daniel tilted his head, eyebrow lifting.
“Not at all. I’m merely warning you out of respect. Right now, I haven’t spoken with a single doctor opposed to this petition except her. She’ll be excoriated if this keeps on. But if you add your name…I’m giving you a chance to do something to prevent it.”
Daniel’s eyes narrowed. “Whose name do you really want? Mine or hers?”
Adams laughed. “Well, they’re the same, surely. Either way, you’ll be setting the example.”
Dammit. “I want Nora left alone,” Daniel said. “No more articles or rumors.”
“Of course.” Adams offered his fountain pen.
Daniel gripped the metal cylinder and scrawled a hasty, crooked signature.
Nearly unrecognizable. Let these idiots think whatever they wished, as long as they stopped harassing Nora.
“There.” He thrust the paper and pen back at Adams. “I agree no one should impersonate a doctor or undertake procedures for which they are not trained.”
“You see? We are of precisely the same mind.” Adams tucked both items back in his pocket. After bidding a good afternoon, he vanished with remarkable speed, leaving Daniel uneasy in his wake.
As he readied his instruments for his next patient, the conversation replayed in jagged fragments, almost nonsensically. He’d agreed only to safe standards. If anything, it was an argument in Nora’s favor—to train more midwives. He fumbled placing a retractor next to his scissors.
Focus, he told himself. Distraction is dangerous.