MARSALI SLEPT the rest of the day and all through the night. I was tired from the journey but managed to doze in the big chair by the kitchen fire, Henri-Christian cradled in my lap, snoring heavily. He did stop breathing twice during the night, and while I got him started again with no difficulty, I could see that something had to be done at once. Consequently, I had a brief nap in the morning and, having washed my face and eaten a bit, went out in search of what I’d need.
I had the most rudimentary of medical instruments with me, but the fact was, tonsillectomy and adenoidectomy didn’t really require anything complex in that line.
I wished that Ian had come into the city with me; I could have used his help, and so could Marsali. But it was dangerous for a man of his age; he couldn’t enter the city openly without being stopped and questioned by British patrols, likely arrested as a suspicious character—which he most assuredly was. Beyond that… he’d been afire to look for Rachel Hunter.
The task of finding two people—and a dog—who might be almost anywhere between Canada and Charleston, with no means of communication other than the foot and the spoken word, would have daunted anyone less stubborn than a person of Fraser blood. Agreeable as he might be, though, Ian was as capable as Jamie of pursuing a chosen course, come hell, high water, or reasonable suggestions.
He did, as he’d pointed out, have one advantage. Denny Hunter was presumably still an army surgeon. If so, he was obviously with the Continental army—some part of the Continental army. So Ian’s notion was to discover where the closest part of the army might be just now and begin his inquiries there. To which end he proposed to skulk round the edges of Philadelphia, creeping into taverns and shebeens on the outskirts, and, by means of local gossip, discover where some part of the army presently was.
The most I had been able to persuade him to do was to send word to Fergus’s printshop telling us where he was bound, once he’d discovered anything that gave him a possible destination.
In the meantime, all I could do was say a quick prayer to his guardian angel—a most overworked being—then have a word with my own (whom I envisioned as a sort of grandmotherly shape with an anxious expression) and set about doing what I’d come to do.
I now walked through the muddy streets, pondering the procedure. I had done a tonsillectomy only once—well, twice, if you counted the Beardsley twins separately—in the last ten years. It was normally a straightforward, quick procedure, but then again, it wasn’t normally performed in a gloomy printshop on a dwarf with a constricted airway, a sinus infection, and a peritonsillar abscess.
Still… I needn’t do it in the printshop, if I could find a better-lighted place. Where would that be? I wondered. A rich person’s house, most likely; one where candle wax was squandered profligately. I’d been in many such houses, particularly during our time in Paris, but knew no one even moderately well-to-do in Philadelphia. Neither did Marsali; I’d asked.
Well, one thing at a time. Before I worried any more about an operating theater, I needed to find a blacksmith capable of fine work, to make the wire-loop instrument I required. I could, in a pinch, cut the tonsils with a scalpel, but it would be more than difficult to remove the adenoids, located above the soft palate, that way. And the last thing I wanted was to be slicing and poking round in Henri-Christian’s severely inflamed throat in the dark with a sharp instrument. The wire loop would be sharp enough but was unlikely to damage anything it bumped into; only the edge surrounding the tissue to be removed would cut, and then only when I made the forceful scooping motion that would sever a tonsil or adenoid neatly.
I wondered uneasily whether he had a strep infection. His throat was bright red, but other infections could cause that.
No, we’d have to take our chances with the strep, I thought. I had set some penicillin bowls to brew, almost the moment I arrived. There was no way of telling whether the extract I might get from them in a few days was active or not—nor, if it was, just how active. But it was better than nothing, and so was I.
I did have one undeniably useful thing—or would, if this afternoon’s quest was successful. Nearly five years ago, Lord John Grey had sent me a glass bottle of vitriol and the pelican glassware necessary to distill ether using it. He’d procured those items from an apothecary in Philadelphia, I thought, though I couldn’t recall the name. But there couldn’t be many apothecaries in Phila delphia, and I proposed to visit all of them until I found what I was looking for.
Marsali had said there were two large apothecary’s shops in town, and only a large one would have what I needed to make ether. What was the name of the gentleman from whom Lord John Grey had acquired my pelican apparatus? Was he in Philadelphia at all? My mind was a blank, either from fatigue or from simple forgetfulness; the time when I had made ether in my surgery on Fraser’s Ridge seemed as distant and mythical as Noah’s Flood.
I found the first apothecary and got from him some useful items, including a jar of leeches—though I boggled a little at the thought of putting one inside Henri-Christian’s mouth; what if he managed to swallow the thing?
On the other hand, I reflected, he was a four-year-old boy with a very imaginative elder brother. He’d probably swallowed much worse things than a leech. With luck, though, I wouldn’t need them. I had also got two cautery irons, very small ones. It was a primitive and painful way of stopping bleeding—but, in fact, very effective.
The apothecary had not had any vitriol, though. He had apologized for the lack, saying that such things must be imported from England, and with the war… I thanked him and went on to the second place. Where I was informed that they had had some vitriol but had sold it some time previous, to an English lord, though what he wanted with such a thing, the man behind the counter couldn’t begin to imagine.
“An English lord?” I said, surprised. Surely it couldn’t be Lord John. Though, come to that, it wasn’t as though the English aristocracy was flocking to Philadelphia these days, save those members who were soldiers. And the man had said “a lord,” not a major or a captain.
Nothing ventured, nothing gained; I asked and was obligingly told that it was a Lord John Grey, and that he had requested the vitriol be delivered to his house on Chestnut Street.
Feeling a little like Alice down the rabbit hole—I was still a bit lightheaded from lack of sleep and the fatigues of the journey from Scotland—I asked the way to Chestnut Street.
The door to the house was opened by an extraordinarily beautiful young woman, dressed in a fashion that made it clear she was no servant. We blinked at each other in surprise; she plainly hadn’t been expecting me, either, but when I inquired for Lord John, saying I was an old acquaintance, she readily invited me in, saying that her uncle would be back directly, he had only taken a horse to be shod.
“You would think he’d send the boy,” the young woman—who gave her name as Lady Dorothea Grey—said apologetically. “Or my cousin. But Uncle John is most particular about his horses.”
“Your cousin?” I asked, my slow mind tracing the possible family connections. “You don’t mean William Ransom, do you?”
“Ellesmere, yes,” she said, looking surprised but pleased. “Do you know him?”
“We’ve met once or twice,” I said. “If you don’t mind my asking—how does he come to be in Philadelphia? I… er… had understood that he was paroled with the rest of Burgoyne’s army and had gone to Boston in order to sail home to England.”
“Oh, he is!” she said. “Paroled, I mean. He came here, though, first, to see his father—that’s Uncle John—and my brother.” Her large blue eyes clouded a little at the mention. “Henry’s very ill, I’m afraid.”
“I’m so sorry to hear it,” I said, sincerely but briefly. I was much more interested in William’s presence here, but before I could ask anything further, there was a quick, light step on the porch and the front door opened.
“Dottie?” said a familiar voice. “Have you any idea where—oh, I beg your pardon.” Lord John Grey had come into the parlor and stopped, seeing me. Then he actually saw me, and his jaw dropped.
“How nice to see you again,” I said pleasantly. “But I’m sorry to hear that your nephew is ill.”
“Thank you,” he said, and, eyeing me rather warily, bowed low over my hand, kissing it gracefully. “I am delighted to see you again, Mrs. Fraser,” he added, sounding as though he actually meant it. He hesitated for a moment, but of course couldn’t help asking, “Your husband… ?”
“He’s in Scotland,” I said, feeling rather mean at disappointing him. It flickered across his face but was promptly erased—he was a gentleman, and a soldier. In fact, he was wearing an army uniform, which rather surprised me.
“You’ve returned to active duty, then?” I asked, raising my brows at him.
“Not exactly. Dottie, have you not called for Mrs. Figg yet? I’m sure Mrs. Fraser would like some refreshment.”
“I’d only just come,” I said hastily, as Dottie leapt up and went out.
“Indeed,” he said, courteously repressing the why? that showed plainly on his face. He motioned me to a chair and sat down himself, wearing a rather odd expression, as though trying to think how to say something awkward.
“I am delighted to see you,” he said again, slowly. “Did you—I do not wish to sound in any way ungracious, Mrs. Fraser, you must excuse me—but… did you come to bring me a message from your husband, perhaps?”
He couldn’t help the small light that sprang up in his eyes, and I felt almost apologetic as I shook my head.
“I’m sorry,” I said, and was surprised to find that I meant it. “I’ve come to beg a favor. Not on my own behalf—for my grandson.”
He blinked at that.
“Your grandson,” he repeated blankly. “I thought that your daughter … oh! Of course, I was forgetting that your husband’s foster son—his family is here? It is one of his children?”
“Yes, that’s right.” Without more ado, I explained the situation, describing Henri-Christian’s state and reminding him of his generosity in sending me the vitriol and glass apparatus more than four years before.
“Mr. Sholto—the apothecary on Walnut Street?—told me that he had sold you a large bottle of vitriol some months ago. I wondered—do you by any chance still have it?” I made no effort to keep the eagerness out of my voice, and his expression softened.
“Yes, I do,” he said, and, to my surprise, smiled like the sun coming out from behind a cloud. “I bought it for you, Mrs. Fraser.”
A BARGAIN WAS struck at once. He would not only give me the vitriol but also purchase any other medical supplies I might require, if I would consent to perform surgery on his nephew.
“Dr. Hunter removed one of the balls at Christmas,” he said, “and that improved Henry’s condition somewhat. The other remains embedded, though, and—”
“Dr. Hunter?” I interrupted him. “Not Denzell Hunter, you don’t mean?”
“I do mean that,” he said, surprised and frowning a little. “You do not mean to say you know him?”
“I do indeed mean that,” I said, smiling. “We worked together often, both at Ticonderoga and at Saratoga with Gates’s army. But what is he doing in Philadelphia?”
“He—” he began, but was interrupted by the sound of light footsteps coming down the stair. I had been vaguely conscious of footsteps overhead as we talked but had paid no attention. I looked toward the doorway now, though, and my heart leapt at the sight of Rachel Hunter, who was standing in it, staring at me with her mouth in a perfect “O” of astonishment.
The next moment she was in my arms, hugging me fit to break my ribs.
“Friend Claire!” she said, letting go at last. “I never thought to see—that is, I am so pleased—oh, Claire! Ian. Has he come back with thee?” Her face was alive with eagerness and fear, hope and wariness chasing each other like racing clouds across her features.
“He has,” I assured her. “He’s not here, though.” Her face fell.
“Oh,” she said in a small voice. “Where—”
“He’s gone to look for you,” I said gently, taking her hands.
Joy blazed up in her eyes like a forest fire.
“Oh!” she said, in a completely different voice. “Oh!”
Lord John coughed politely.
“Perhaps it would be unwise for me to know exactly where your nephew is, Mrs. Fraser,” he observed. “As I assume he shares your husband’s principles? Just so. If you will excuse me, then, I will go and tell Henry of your arrival. I suppose you wish to examine him?”
“Oh,” I said, recalled suddenly to the matter at hand. “Yes. Yes, of course. If you wouldn’t mind…”
He smiled, glancing at Rachel, whose face had gone white at seeing me but who was now the shade of a russet apple with excitement.
“Not at all,” he said. “Come upstairs when you are at leisure, Mrs. Fraser. I’ll wait for you there.”
RATHER MESSY
I MISSED BRIANNA all the time, in greater or lesser degree depending upon the circumstance. But I missed her most particularly now. She could, I was sure, have solved the problem of getting light down Henri-Christian’s throat.
I had him laid on a table at the front of the printshop now, taking every advantage of such light as came in there. But this was Philadelphia, not New Bern. If the sky wasn’t overcast with clouds, it was hazed with smoke from the city’s chimneys. And the street was narrow; the buildings opposite blocked most of what light there was.
Not that it mattered that much, I told myself. The room could have been blazing with sun, and I still couldn’t have seen a thing in the inner reaches of Henri-Christian’s throat. Marsali had a small mirror with which to direct light, and that would perhaps help with the tonsils—the adenoids would have to be done by touch.
I could feel the soft, spongy edge of one adenoid, just behind the soft palate; it took shape in my mind as I carefully fitted the wire loop around it, handling it with great delicacy so as not to let the edge cut either my fingertips or the body of the swollen adenoid. There was going to be a gush of blood when I sliced through it.
I had Henri-Christian braced at an angle, Marsali holding his inert body almost on his side. Denzell Hunter kept his head steady, clamping the pad soaked in ether firmly over his nose. I had no means of suction other than my own mouth; I’d have to turn him quickly after I made the cut and let the blood run out of his mouth before it ran down his throat and choked him. The tiny cautery iron was heating, its spade-shaped tip thrust into a pan of hot coals. That might be the trickiest part, I thought, pausing to steady myself and steady Marsali with a nod. I didn’t want to burn his tongue or the inside of his mouth, and it would be slippery….
I twisted the handle sharply and the little body jerked under my hand.
“Hold him tight,” I said calmly. “A little more ether, please.”
Marsali’s breath was coming hard, and her knuckles were white as her face. I felt the adenoid separate cleanly, come adrift, and scooped it between my fingers, pulling it out of his throat before it could slip down into his esophagus. Tilted his head quickly to the side, smelling the sheared-metal smell of hot blood. I dropped the severed bit of tissue into a pan and nodded to Rachel, who pulled the cautery iron from its coals and put it carefully into my hand.
I still had my other hand in his mouth, keeping the tongue and uvula out of the way, a finger on the site of the ex-adenoid, marking my place. The cautery iron seared a white line of pain down my finger as I slid it down his throat, and I let out a small hiss but didn’t move my finger. The scorched scent of burning blood and tissue came hot and thick, and Marsali made a small, frantic noise but didn’t loosen her hold on her son’s body.
“It is well, Friend Marsali,” Rachel whispered to her, clasping her shoulder. “He breathes well; he is not in pain. He is held in the light, he will do well.”
“Yes, he will,” I said. “Take the iron now, Rachel, if you will? Dip the loop in the whisky please, and give me that again. One down, three to go.”
“I HAVE NEVER seen anything like it,” Denzell Hunter said, for perhaps the fifth time. He looked from the pad of fabric in his hand to Henri-Christian, who was beginning to stir and whimper in his mother’s arms. “I should not have believed it, Claire, had I not seen it with my own eyes!”
“Well, I thought you’d better see it,” I said, wiping sweat from my face with a handkerchief. A sense of profound well-being filled me. The surgery had been fast, no more than five or six minutes, and Henri-Christian was already coughing and crying, coming out of the ether. Germain, Joanie, and Félicité all watched wide-eyed from the doorway into the kitchen, Germain keeping tight hold of his sisters’ hands. “I’ll teach you to make it, if you like.”
His face, already shining with happiness at the successful surgery, lit up at this.
“Oh, Claire! Such a gift! To be able to cut without giving pain, to keep a patient quite still without restraint. It—it is unimaginable.”
“Well, it’s a long way from perfect,” I warned him. “And it is very dangerous—both to make and to use.” I’d distilled the ether the day before, out in the woodshed; it was a very volatile compound, and there was a better than even chance that it would explode and burn the shed down, killing me in the process. All had gone well, though the thought of doing it again made me feel rather hollow and sweaty-palmed.
I lifted the dropping bottle and shook it gently; more than three-quarters full, and I had another, slightly larger bottle as well.
“Will it be enough, does thee think?” Denny asked, realizing what I was thinking.
“It depends what we find.” Henri-Christian’s surgery, despite the technical difficulties, had been very simple. Henry Grey’s wouldn’t be. I had examined him, Denzell beside me to explain what he had seen and done during the earlier surgery, which had removed a ball lodged just under the pancreas. It had caused local irritation and scarring but had not actually damaged a vital organ very badly. He hadn’t been able to find the other ball, as it was lodged very deeply in the body, somewhere under the liver. He feared that it might lie near the hepatic portal vein and thus hadn’t dared to probe hard for it, as a hemorrhage would almost certainly have been fatal.
I was reasonably sure that the ball hadn’t damaged the gallbladder or bile duct, though, and given Henry’s general state and symptomology, I suspected that the ball had perforated the small intestine but had seared the internal entrance wound shut in its wake; otherwise, the boy would almost surely have died within days, of peritonitis.
It might be encysted in the wall of the intestine; that would be the best situation. It might be lodged actually within the intestine itself, and that wouldn’t be good at all, but I couldn’t say how bad it might be until I got there.
But we did have ether. And the sharpest scalpels Lord John’s money could buy.
THE WINDOW, after what seemed to John Grey to be an excruciatingly prolonged discussion between the two physicians, remained partly open. Dr. Hunter insisted on the benefit of fresh air, and Mrs. Fraser agreed with this because of the ether fumes but kept talking about something she called germs, worrying that these would come in through the window and contaminate her “surgical field.” She speaks as though she views it as a battleground, he thought, but then looked closely at her face and realized that indeed she did.
He had never seen a woman look like that, he thought, fascinated despite his worry for Henry. She had tied back her outrageous hair and wrapped her head carefully in a cloth like a Negro slave woman. With her face so exposed, the delicate bones made stark, the intentness of her expression—with those yellow eyes darting like a hawk’s from one thing to another—was the most unwomanly thing he had ever seen. It was the look of a general marshaling his troops for battle, and seeing it, he felt the ball of snakes in his belly relax a little.
She knows what she’s doing, he thought.
She looked at him then, and he straightened his shoulders, instinctively awaiting orders—to his utter amazement.
“Do you want to stay?” she asked.
“Yes, of course.” He felt a little breathless, but there was no doubt in his voice. She’d told him frankly what Henry’s chances were—not good, but there was a chance—and he was determined to be with his nephew, no matter what happened. If Henry died, he would at least die with someone who loved him there. Though, in fact, he was quite determined that Henry would not die. Grey would not let him.
“Sit over there, then.” She nodded him to a stool on the far side of the bed, and he sat down, giving Henry a reassuring smile as he did so. Henry looked terrified but determined.
“I can’t live like this anymore,” he’d said the night before, finally making up his mind to allow the operation. “I just can’t.”
Mrs. Woodcock had insisted upon being present, too, and after a close catechism, Mrs. Fraser had declared that she might administer the ether. This mysterious substance sat in a dropping bottle on the bureau, a faint sickly odor drifting from it.
Mrs. Fraser gave Dr. Hunter something that looked like a handkerchief, and raised another to her face. It was a handkerchief, Grey saw, but one with strings affixed to its corners. She tied these behind her head, so the cloth covered her nose and mouth, and Hunter obediently followed suit.
Used as Grey was to the swift brutality of army surgeons, Mrs. Fraser’s preparations seemed laborious in the extreme: she swabbed Henry’s belly repeatedly with an alcoholic solution she had concocted, talking to him through her highwayman’s mask in a low, soothing voice. She rinsed her hands—and made Hunter and Mrs. Woodcock do the same—and her instruments, so that the whole room reeked like a distillery of low quality.
Her motions were in fact quite brisk, he realized after a moment. But her hands moved with such sureness and… yes, grace, that was the only word… that they gave the illusion of gliding like a pair of gulls upon the air. No frantic flapping, only a sure, serene, and almost mystic movement. He found himself quieting as he watched them, becoming entranced and half forgetting the ultimate purpose of this quiet dance of hands.
She moved to the head of the bed, bending low to speak to Henry, smooth the hair away from his brow, and Grey saw the hawk’s eyes soften momentarily into gold. Henry’s body relaxed slowly under her touch; Grey saw his clenched, rigid hands uncurl. She had yet another mask, he saw, this one a stiff thing made of basket withes lined with layers of soft cotton cloth. She fitted this gently to Henry’s face and, saying something inaudible to him, took up her dropping bottle.
The air filled at once with a pungent, sweet aroma that clung to the back of Grey’s throat and made his head swim slightly. He blinked, shaking his head to dispel the giddiness, and realized that Mrs. Fraser had said something to him.
“I beg your pardon?” He looked up at her, a great white bird with yellow eyes—and a gleaming talon that sprouted suddenly from her hand.
“I said,” she repeated calmly through her mask, “you might want to sit back a little farther. It’s going to be rather messy.”