I have many people to look after, but my heart never leaves my daughter. One minute, she boils with fever, overcome by Heat. The next minute, she shivers as Cold skulks in like a terrible frost. I keep watch on her hands and feet, because once Cold settles in those extremities and begins creeping toward the torso, little can be done to reverse its course and keep it from reaching the heart when death is imminent.
One day when I unwrap Ailan’s bindings, I’m horrified to discover that beans have flared up on the soles of her feet. While I was away, Ailan completed her footbinding, but her feet are still in a fragile stage. Now they need to stay exposed to the air so that when the pustules burst, they’ll drain freely and not molder into infection under binding cloth. I do not know what this will mean for the future of her feet—if refinement will be needed or if we’ll need to start the process from the beginning. I survived smallpox and I’m a doctor, so I tell myself not to be afraid. But I’m terrified of what the disease might mean for her future.
Miss Chen, who has a relatively mild case of heavenly flowers, is as devoted to the care of her son and daughter as I am to Ailan. When she offers to help me, I accept. We may have been competitors when it came to the seniority of her son and whether or not I would ever give birth to a son who would supersede Manzi in stature and position, but this did not stop her from caring for Ailan until I arrived, for which my gratitude will last an eternity. Miss Chen says not one fearful word about what will happen when Master Yang lays eyes on her, assuming she recovers. Instead, she’s diligent and selfless as she applies pain-relieving salve on a boy of seven, dabs at suppurating pustules on the cheeks of a girl of fifteen, and wets the lips of a toddler too weak to lift his head. She helps me measure ingredients and sometimes stirs the pot as herbs are brewed. Not surprisingly, given that she’s a Thin Horse, she has knowledge I haven’t been exposed to, which gives her insights into our situation.
“How can we as women not blame this scourge on men?” she asks with a hint of bitterness one night as we sip tea next to our sleeping children. “When men travel, they stay in crowded inns. They eat food and drink tea prepared by strangers. They converse with other sojourners. They’re exposed to typhoid and cholera…” She takes a breath before rattling off the rest of her list. “Diphtheria, typhus, and smallpox. When they come home, they bring these malignant elements to those of us—wives, children, servants, and concubines like me—who reside in the inner chambers. Tell me. Are men not the cause of every woe the world must endure?”
I glance around at the sick on their mats. “I blame mothers.”
“Mothers?”
I can’t disguise the disdain in my voice when I say, “Any mother who has the opportunity to hire a smallpox-planting master and does not do it has failed in her duty not only to her children but to the future generations of her husband’s family.”
A long silence follows this. Miss Chen sets down her cup and rests her fingers against her son’s forehead. I sense her trying to suck his fever into her body. Manzi seems to be rallying. His cheeks are filling out again, although they’ll never reach the roundness that Master Yang and my husband were born with, but his sister is deteriorating, having reached the stage when all she does is sleep. I’ve given her doses of ginseng, burnt licorice, astragalus root, and cinnamon heart in a final attempt to reverse the course of her fate, but my hopes are ebbing. Still, when I watch Miss Chen’s devotion, I’m reminded how lucky her children are to have a mother who can nurse them at any hour of the day or night when so many others are in here alone.
Miss Chen turns and meets my eyes. “I don’t remember my mother, and I don’t remember seeing a smallpox-planting master after the Tooth Lady bought me, but obviously I never received variolation. And now you reproach me for not doing my duty as a mother to my children?” She pauses to let her accusation sink in. “Not everyone is a believer in variolation. How sick will a child get? Will he or she die or be scarred from the process? Things can go wrong—”
“I know, but—”
“I’ve also had to consider my daughters’ futures. I don’t know what their father has planned or what Lady Kuo might arrange for them. I could not risk that they might end up with even a few scars on their faces caused by variolation. Unlike you,” she adds pointedly, “Fourth Daughter doesn’t have extra attributes—an education or generations of imperial scholars in her lineage—that would guarantee a bright future even if her cheeks are slightly marred.”
Fourth Daughter shifts on her mat and opens her eyes. The younger children don’t understand what’s happening to them, but I suspect she knows what’s coming.
“Your mother must have done something to preserve your face,” Miss Chen says to me. “Is there anything you can do for my daughter’s coming scars?”
Scars are the least of Fourth Daughter’s problems, but I’m guessing Miss Chen is focusing on this concern to allay her daughter’s fears about the path before her. I try to sound optimistic.
“This is not a case of trying to restore virginity with a decoction made of pomegranate skin and alum,” I say. “But ointments can be applied that will help in the healing process.”
Only a few hours later, I find not a trace of pulse in either of Fourth Daughter’s wrists. When an infant dies, it’s painful for the mother to endure, but their connection has been fleeting. This is not so with an older child, even if it is only a daughter. Miss Chen weeps as I wrap the girl in cloth. Then the concubine and I drag the shroud to the back gate of the compound, where we’ve left other bodies to be fetched and buried. Miss Chen sways unsteadily as we turn to walk away. When I take the concubine’s elbow to buoy her, she speaks in a low voice—to herself, to me, to the universe, I can’t tell which. “At least my daughter won’t have my life.”
The doubts I had after Meiling’s miscarriage threaten to overwhelm me now. Can I honestly say I’m helping anyone? Has one smallpox patient fully recovered under my care? Maybe Doctor Wong had the right idea: stay away, let nature follow its course, and protect his reputation by avoiding a long tabulation of death marks next to his name. I can almost hear his sneering words. You are not a proper doctor. You are only a woman. I wish I were a giant gingko tree hundreds of years old, with the deep roots it takes to stand strong against mighty winds. Instead, I feel like a sapling in a typhoon, desperately trying to hang on.
Neither Miss Chen nor I gets any sleep that night as we sit vigil over Manzi and Ailan. Both children have taken a turn and now seem to be following Fourth Daughter’s path. I can’t let this happen, but I’ve done all I know to do. Only one person can help me. To ask for this sacrifice is almost more than I can bear, but I must do whatever is necessary to keep my daughter on this earth. When daybreak comes, the air feels as heavy as a goose-down quilt. I go to the gate that leads to the main part of the compound. Three more people have taken sick overnight. I let them in and point the way to the Hermitage. Then I wait on my side of the gate for one of the guards to fetch Lady Kuo. Soon enough, I hear her keeck, keeck as she approaches.
I report on the situation and end by asking, “Can you send a palanquin to bring my grandmother?”
My request shocks her, for it tells my mother-in-law just how dire things are inside the garden that I would be so unfilial as to invite my grandmother into such a dangerous situation.
The new patients are settled when Grandmother Ru arrives, bringing Miss Zhao with her. Instead of wearing fine silk gowns and decorations in their hair, they’re attired in cotton tunics and skirts dyed in indigo with matching scarves tied around their heads. Grandmother wastes no time on niceties. “Take me from patient to patient,” she says. “I want to see each case. We will decide now who will live and who will die. We will not spend time on those we cannot save.”
Over the next several days, I’m humbled to watch Grandmother. Both her wisdom and her emotional strength help me through the frightening hours. No one in the Hermitage is more important to me than my daughter. And no one is more important to Miss Chen than her son. Having two new sets of hands to treat the sick allows the concubine and me to spend more time with Manzi and Ailan, especially during those hours before sunrise when evil spirits come to prey on the weak and mothers need to attach themselves to their children to keep them from being dragged to the Afterworld.
* * *