Chapter 1
Two Years Later
The Clerkenwell Clinic was experiencing its third surprise inspection in two months. This time, the inspector had come with an auditor in tow, which was making the entire process even more tiresome than usual.
“I need to speak to Miss Lazarus,” the auditor was saying to Mae, leaning entirely too close to her face as he did so. “The doctor told me she was upstairs.”
“The Miss Lazarus on the construction manifest was Miss Hannah Lazarus, who is now Mrs. Hannah Beck,” she replied as patiently as possible, doing her level best not to stare at the way his wig was separating from his forehead in the presence of the layer of sweat that had been building there.
“Mrs. Beck is not here today, as I’ve been telling you.
The Miss Lazarus in the nursery is Dinah Lazarus, Mrs. Beck’s younger sister.
She will not have the information you are seeking. ”
“Well, I would speak to her anyway,” the man exclaimed, showering Mae with a thin layer of spittle and reacting not at all to the way she flinched away from it. “I came all the way down here!”
“No one is stopping you,” she said, taking a step back and lifting her apron to dab at her face.
“But I would caution you against going into the clinic nursery unless you had the chicken pox as a child. You do not want to catch it as an adult, and I’m afraid it is always going around in that particular room. ”
He hesitated, a dramatic curling frown drooping along his wrinkled chin. “Will someone not bring her out to speak to me, then?”
“Sir, wee Dinah is but a child herself,” Rosalind Everly said, stepping into the face-off with the grace of a mother breaking up her bickering children, her Scots brogue lowered to a soothing octave of peace.
“But Miss Casper and I were both here for the erecting of the clinic walls that year, should you have any questions we might answer.”
The auditor rounded on Rosalind, squinting at her through his spectacles. “You,” he said warily. “I know you.”
“Do you?” she replied politely. “I don’t believe we’ve met before.”
He continued to squint while Mae brushed a hand over her mouth to hide her amusement. Rosalind’s minor celebrity as the gossip sheets’ beloved Miss Manners had brought the clinic much attention and patronage over the last several months.
Unfortunately, all the attention and patronage were likely the cause of the surprise inspections.
Mae wasn’t going to make the connection for the auditor if he couldn’t be fussed to do it himself.
“Six bottles of witch hazel solution and only one bottle of ether,” the other man, the inspector, was saying as he dug around in Mae’s carefully organized supply closet. “Seventeen rolls of unused gauze.”
“Please do not touch the gauze,” Mae pled, turning to watch him run his dirty fingers over the rolls as he counted and re-counted them.
He did not look at or otherwise acknowledge her.
“Three lancing needles,” he continued. “What is this? Madam, what is this?”
“Forceps,” Mae answered through her teeth. “Please put them back.”
He held them out in front of him and clicked them together like kitchen tongs, blinking rapidly. “We do not have these in my local infirmary,” he announced, sniffing. “What manner of quackery are they for?”
Mae took a steadying breath and closed her eyes, inhaling deeply through her nose.
“Childbirth, sir,” Rosalind answered for her, blinking her wide hazel eyes with enough innocence that the man immediately dropped the forceps in apparent horror, letting them clatter to the unswept ground. “Oh, bother,” Rosalind said, watching them fall.
“Where is Dr. Casper?” the inspector demanded, taking a delicate step back from the forceps lying harmlessly on the ground. “Is he performing … is he doing … is he …”
“We have a midwife,” Mae told him as her grandfather reacted to the sound of his name and started making his way across the central room from his perch near the entrance. “She is here on Tuesdays, Fridays, and Sundays. You have met her, Mr. Evans. Twice.”
“Am I needed?” Dr. Casper asked, placing a knobby hand on Mae’s shoulder and looking from the auditor to the inspector with a raise of his bushy white brows. “Who’s been throwing around the surgical equipment?”
The inspector turned to him as though he had come to offer rescue in a stormy sea.
“Ah, Dr. Casper. Finally, someone to answer me plainly,” he said with a sigh.
“Your granddaughter is … erm, a capable assistant, I am certain,” he said, flicking his eyes quickly to Mae and back again.
“But I am relieved to hear that you have hired on two new physicians to assist with your works. May I meet them?”
“I still need to speak to Miss Lazarus!” the auditor exclaimed.
Mae spun on the ball of her foot toward the auditor with her eyes wide.
“You can find her at the Flaming Fox in St. James,” she said in a low whisper.
“She will be there tonight until midnight. She has an office in the back. Go now and you might even catch her before her very large husband arrives for the evening and demands to know why you’re questioning his wife. ”
“M-Mr. Beck,” the auditor stammered, glancing back down at his document. “Thaddeus Beck? The … he is also …”
“Yes,” said Mae, flashing her teeth at him. “He should be on your documents too. If you wish to meet them here, I suggest you send advance warning next time so that we may arrange for everyone to be present, as is typically polite in these situations.”
“I will not be spoken to this way by a … by a …” he said, looking Mae head to toe.
“A woman?” Rosalind guessed, tilting her ringlet-haloed head to the side.
“A subordinate who barely stands to my elbow!” he shot back, eyes gone wide and wild.
Mae paused, momentarily too stunned to react.
Of all the bigotries he might have come out with in a moment of confronted candor, a disdain for her unimpressive height had not even registered on her list of guesses.
She looked down at her feet and back up at the man, blinking a few times, and then knelt down to retrieve the forceps, at a loss for anything else to do in the moment.
“Ah, Mr. Evans! I was not expecting to see you again so soon!” came a cheery voice from the stairs as they were joined by yet another participant in this morning’s melee. “Surely this isn’t yet another surprise inspection. Ah, and you’ve brought a friend!”
Mae turned with a resigned sort of gratitude to their newest resident volunteer, a young man whose auburn head shone like a beacon as he approached an immediately wary inspector and his auditor. He held out his hand, flashing a wide smile. “Pleasure. I’m Ezra Barnett.”
“Ah,” said the auditor. “The new doctor? The Jewish one?”
“Jewish,” he agreed with a raise of his brows, “but not a doctor. I’m a newspaper man myself. I must say, I’m finding all these back-to-back inspections quite fascinating.”
“We all are,” Mae echoed, dry as dead grass as she examined the forceps for dents.
“Tell me, are all the charity clinics in London getting the same attention?” Ezra pressed, leaning against the nearest wall and crossing his arms over his chest. “Or is it just this one on account of our resident Miss Manners? That was my doing, you know. When I talk about this newest development of endless harassment, all the same eyes will fall upon it.”
“Evans, the Lazarus girl isn’t even here,” the auditor announced suddenly. “There’s no reason to stay.”
“Dinah is here,” Ezra said, puzzled. “She’s right upstairs, being an absolute beast.”
“He means Hannah,” Rosalind replied, sighing. “Mrs. Beck. Not Lazarus. Not anymore.”
“Let us make an appointment for sometime next week and try again!” the auditor replied, turning his back on Rosalind. “I’ll write to Mrs. Lazarus-Beck and we’ll come back.”
“Beck née Lazarus, surely,” Dr. Casper said jovially.
The auditor gritted his teeth but did not acknowledge the comment. “It’ll be more useful when the new doctors are actually present, I daresay.”
“Yes, of course,” Ezra replied in a saccharine tone. “The Jewish one, at least.”
“And the foreigner,” Dr. Casper added, raising his brows. “Haven’t you heard? The other chap’s from India. Trained by the Germans. I’m sure you’ll find much to say about him as well, but he doesn’t start for another fortnight.”
“India,” echoed the auditor weakly. “Yes, all right.”
They exited the clinic quickly after that, leaving nothing behind but some rearranged witch hazel bottles and an abused pair of forceps in their wake.
Mae sighed, her arms sagging at her side, the forceps clanging against her calf through her skirts. “Is the other doctor actually from India, or were you just goading that man?”
“He is,” her grandfather said, turning to her with a grin that was short a couple of teeth.
“His last name is so long, it took an entire additional sheet of paper in the letter. But his accolades are exemplary. Dr. Bethel and I agree it is very exciting, and he understands perfectly well that you are actually the authority here, my sweet Mae.”
“Oh, well,” she said with no small amount of exhaustion. “That’s obviously the most important thing.”
“We’ll just call him Dr. Ravi,” Dr. Casper continued. “Can you imagine some fishmonger ’round Seven Dials asking for a stitch job and trying to fumble his way through the likes of Go-vin-da-char-ya when he can probably scarcely spell ‘Jones’ or ‘Smith’?”
“Grandy,” Mae said, frowning. “Control yourself.”
He only continued to grin.
“No one’s asking them to spell it,” Rosalind said softly, her hazel eyes gone wide. “Just to say it.”
“Why are they continuing to poke around?” Ezra threw in over her, still glaring at the path the auditor and inspector had taken out of the clinic. “They’re obviously looking for some reason to sanction us, but why?”
“I could tell you, lad,” Dr. Casper said, his grin easing off his face. “But you won’t like it. And you can’t print it.”
Ezra turned back to him, his brow furrowed. “Why the devil not?”
Dr. Casper sighed. “Because it will only exacerbate the onslaught. Have you ever cornered a known liar with proof of a lie? They lash out violently. It’s the same thing. Rosalind, my dear girl, this is not your fault, and I need you to look at me and acknowledge that before I say anything else.”
Rosalind startled, blinking rapidly as she turned her attention to the doctor, clearly unsettled by his sudden and unprecedented serious tone. “Of course, Dr. Casper,” she said, biting her lip. “Of course.”
He heaved a great, crackling sigh and waved his hand toward Mae’s private procedure room, leading the little crew behind the privacy of the closed door before continuing.
Mae had her suspicions about why all this was happening.
Quite a few of them, truth be told. But she hadn’t spoken about it directly with her grandfather yet.
At the root of it, she had assumed it all came down to professional pride.
The clinic was doing too well. It was too visible.
Too lauded. Too well attended by the needy.
It was a simple explanation, but things often were very simple, at their root.
However, this parade into privacy was giving her pause and a quivering thrum of anxiety right in the center of her chest.
Was it something else? Something worse?
They lined the walls of the little treatment room while Dr. Casper took the stool, wincing as his knees bent and crackled.
“Once upon a time, I was a respected doctor in this city,” he began with a wry quirking of his lips. “I was at Guy’s. I was a surgeon. This was before the Gordon riots.”
“The what,” Rosalind whispered.
“Another story for another time, my sweet girl,” he said with a chuckle. “A good one.”
“A very good one,” Mae agreed.
“There is a backbone to the administration and progress of medicine in this world that is not often talked about or made visible to the world at large, though it is not exactly a secret either. Teaching cases. Do all of you know what that is?”
Mae immediately straightened, her jaw tightening. “I do.”
“Well, I know you do,” he said, clicking his tongue in annoyance. “I’m talking to the lay clergy.”
“I’m a vicar’s wife, sir,” Rosalind said with a little smile. “But no, aside from the implied meaning, I can’t say I’ve heard that term.”
“It’s poor people,” Mae snapped. “Who don’t get treatment like the important folk do. Instead, they’re either used as experimental fodder or as trial runs on new practitioners so it won’t matter as much if they err.”
“What?!” Ezra barked, startling away from the wall.
“Mae is forgetting,” Dr. Casper said, in a tone like he was about to soothe this new knowledge, “sometimes these procedures are performed in a surgical theater with a large audience for purposes of demonstration. Often without bothering with expensive extras like pain-killing medicines or sedatives. It is, I’m afraid, an absolutely integral part of modern medicine. ”
“Neither of you know about this because you’ve never been at risk of having it done to you,” Mae said, wincing.
“But I’d wager if you go ask the patients in the waiting area right now, several of them can tell you more in great detail.
That is why they come here instead of going somewhere fancier and better known.
They know I’m not going to do that to them. ”
“Yes,” said Dr. Casper, blinking. “They know you’re not going to do that to them.
Everyone knows that now, thanks to Rosalind’s fame and Ezra’s quill.
The influx of learning cases that the nearby hospitals have relied on, especially right now, during the High Season, when many visiting medical professionals and hobbyists are in London, has been so punctured by our clinic that we’ve had to hire not one, but two new doctors, Mae. ”
Mae breathed out, reaching out to steady herself against the wall. For a moment, her vision swam.
“They aren’t going to stop at inspections and audits,” Ezra said, so that Mae would not have to.
“Probably not,” agreed Dr. Casper. “We’ve already started to prepare for this, of course. It’s why we brought on the new doctors, so that Mae would not be in danger of accusations of malpractice nor I of fraud, but I’m afraid it is likely only the beginning. The Season has only just begun.”
“So,” said Rosalind, her fingertips touching her cheeks. “What now? What else do we do now?”
Dr. Casper sighed, glancing at Mae. “That is the question. Isn’t it?”
Mae could only nod.
She did not have an answer.