Chapter Twelve
Ralph came home for the midday meal excited to tell Theo about a new patient.
The unfortunate Mr Miller had been out on his bicycle with deliveries of haberdashery when he’d made the foolish decision to coast down Gold Hill.
Eyewitnesses had reported him gathering speed, the handlebars juddering over the cobbles, before the front wheel jacked and Miller was pitched head first to the ground.
He was brought to the hospital immediately, unconscious, with his left ear and eyelid all but torn away and his skull gleaming through the wound.
Theo had a mouthful of chicken fricassee but couldn’t swallow. Ralph was sometimes too detailed with his descriptions.
‘He woke while the wound was being dressed, and I noted a vertical fracture with a shallow depression at its centre,’ he said eagerly. ‘But while he remains alert and can talk and move normally, there’s no need to risk an operation.’
‘Could he recover without it?’
‘Perhaps. But if he loses consciousness again, if his speech becomes slow, his eyes sensitive, and he seems stupid . . . then I must act, and quickly.’
The food turned to ashes in Theo’s mouth. Ralph was too preoccupied to notice. She put down her knife and fork.
‘The same symptoms as Missy,’ she said quietly.
‘Hm?’
‘Those must have been the same symptoms Missy showed, the Monday morning before she died. When you decided to operate.’
Ralph looked up, frowned briefly. ‘Yes,’ he said. ‘That’s correct. Though, in her case, an infection was also present.’
‘She had a fever? I don’t remember you telling me that before.’
He looked down at his plate, steadily loading his fork with green beans.
‘I’m sure I must have done. In any case, infection is not an issue here. The man was brought straight to us, and his wound was dressed with sterile iodoform gauze. Quite unlike the initial treatment Melissa received.’
‘But hers was only a graze.’
‘Do not speak of it, Theo. It only upsets you.’ Ralph’s tone was final.
‘But it’s true, this is a far more serious wound, and far more likely to cause a rapid deterioration, if there is unseen bleeding beneath the skull.
’ He ate in silence for a while, then said: ‘Meningeal haemorrhage is so hard to treat successfully, with trephining or any other means, because treatment is almost always delayed – the patient seems well, walks and talks as normal. By the time the pressure on the brain becomes serious and treatment is sought, it is too late. But, this time, I have a chance.’
‘Then . . . it was too late for Missy? She should have had the operation sooner?’
‘Regrettably so. But enough, my dear. Enough about that girl.’
Theo pushed the food around on her plate while Ralph shovelled his down with unappealing haste, and she tried without success to think of a topic of conversation unconnected to brains or bleeding or death.
In fact, she couldn’t find her voice at all.
Her husband mopped up the last of the sauce with a piece of bread and hurried back to the hospital.
Soon after they’d gone up to bed that night, there was an urgent banging at the door and a message for the doctor to come at once – Mr Miller was showing all the warning signs. Ralph scrabbled back into his clothes and dropped a brief kiss on to Theo’s forehead.
‘I cannot say when I will be back.’
She lay sleepless after he’d gone, her thoughts circling as night turned slowly into day. When everything was performed correctly this time . . . Trying and failing and trying again differently . . . Mr Miller’s grave injury was not a tragedy to Ralph, it was an opportunity.
‘Who gives a doctor permission to act?’ she asked Audrey, as they did her hair in the morning. She met her maid’s eyes in the mirror, through a gentle haze of powder. ‘Permission to give treatment, that is.’
‘The patient, I suppose,’ Audrey said, not seeking an explanation of the question. ‘When the patient goes to him, or calls him out. Then he just gets on with it, doesn’t he?’
Theo paused. ‘And if the patient is a child?’
‘Then the parents.’
‘Yes. And if the child has no parents?’
‘Then . . . I don’t know. If they have a guardian or a relative, then that person. If not, then . . . well, surely the doctor will not perform any treatment, since the child won’t pay him, and probably won’t know to call him in the first place.’
Theo nodded slowly. ‘Do you . . . did you know your parents, Audrey?’
‘I never knew my father, and Ma died when I was little. She fell down the stairs.’
‘How awful – poor woman!’
‘Blind drunk, by all accounts.’ Audrey lifted her eyebrows. ‘I only remember little bits and pieces of her.’
‘So, when you arrived at St Agnes’s . . . did that make Mrs Vine, the matron, your legal guardian? Or was it one of the ladies of the charitable society?’
‘Don’t know, miss. All I know is a fashionable lady came to the workhouse one day, and fetched me to Hallewell. As to what was legal about that and what wasn’t, I can’t say.’
‘No, of course you can’t. Forgive me, Audrey.’
‘What’s it all about, miss?’
‘Just . . . something that happened a long time ago. You know I . . . I first became acquainted with my husband when he treated a friend of mine. Another girl from St Agnes’s.’
‘Missy Cartwright.’
‘That’s right. She was turning fifteen when she was treated, you see. Still a child . . .’ Theo shook her head. ‘Never mind.’
Audrey finished her hair in silence, then tidied away the brushes and unused pins.
‘Is that who you saw on the night we went skating?’ Audrey said, cheeks flushing. ‘Someone from back then?’
‘You . . . saw him?’ Theo tried not to say his name, even in her head, in case it spoke itself later on in her sleep.
‘Not properly. I saw you take off after someone, and it looked to be the fellow with the dark hair and the army coat.’ Audrey took a breath. ‘Then I saw how upset it made the master and I didn’t like to mention it.’
‘It’s all right, Audrey. He . . . yes. He was – is – someone I grew up with. A childhood friend. But we fell out when Missy died.’
‘It was his brother who hanged for it.’ Audrey gave her an apologetic look. ‘The other girls told me, right at the start.’
‘Then, you know it all,’ Theo said bleakly.
‘Not all, I think,’ Audrey murmured.
After a pause, Theo asked: ‘Did you see where he went? Or who he was with?’
Audrey shook her head. ‘Sorry, miss. There was so many people, all moving about.’
Theo looked down at the box of hair combs and brooches on the dressing table, but all she saw was that dark hair, that army greatcoat, that glimpse of his face lit by naphtha lamps, all vanishing into darkness.
After breakfast, Theo decided to go to the hospital, to ask after the patient and – hopefully – to congratulate Ralph.
She hadn’t ever done so before, but she couldn’t stop thinking about Mr Miller and his operation.
She had a strong urge to meet the man, and to know more.
So, she packed cheese, apples and some currant buns into a basket, and set off.
Sister Hendry, whose displeasure at having to defer to Theo, as Dr Anscombe’s wife, was as plain as the nose on her face, showed her into his private room on the first floor of the hospital.
‘Dr Anscombe is still with the patient, but I will tell him you’ve come.’ Her lips pressed hard together for a moment. ‘You’ve not chosen the best moment, Mrs Anscombe. He might not be able to see you. Perhaps it would be better if—’
‘It’s quite all right,’ Theo interrupted her. ‘Thank you, Sister. I will wait for him here.’
She’d never been in Ralph’s room before.
In fact, she hadn’t been to the hospital at all since before they were married, but she remembered it so clearly that the intervening years shrank to nothing.
The smell of carbolic and metal and starch; the peculiar hush made up of a thousand tiny echoes.
Ralph’s desk was crowded, but everything was in its place.
There were piles of pens and paperwork, and instruments made of brass and wood, including a large microscope.
The only incongruous thing was a pair of ladies’ gloves: sky blue, small and elegant. Theo didn’t recognise them as hers.
One wall was occupied by an enormous mahogany cupboard.
It had wide drawers at the base, and double doors above them.
Theo had no idea what was kept in it. On impulse she went to look, but the doors were locked.
She stared at the cupboard. Her husband had a whole realm, there at the hospital, about which she was permitted to know nothing beyond what he chose to tell her.
She thought of Fortescue’s cold, knowing gaze over the dinner table, and the feeling it gave her of being allowed no secrets, no privacy whatsoever.
She thought of Dr Ogilvy’s unwanted examination.
The way he had told only Ralph whatever it was he’d observed inside her.
She wanted to look in the cupboard.
After a full minute of careful listening, she was confident nobody was coming.
She swept her eyes slowly around the room.
A skeleton hung in the corner, its bones all wired together.
He’d been a murderer in life, Ralph had told her.
Hanged early in the century, when to be a friendless convict was to lose all rights to your mortal remains.
The skull stared balefully, and Theo looked away.
On the walls were Ralph’s various degrees and qualifications, alongside an illuminated transcription of the Hippocratic oath.
Practise two things in your dealings with disease: either help or do not harm the patient.
His chair was solid oak, with leather upholstery; the bookshelves crammed with medical journals and anatomical works.