A Question of Trust: A Novel

‘Miss Curtis, would you care to define for us precisely what that is?’

Miss Curtis, who was more the sort of doctor Laura had imagined she would find here, young and sympathetic, and who looked terrified, cleared her throat and said, ‘A stitch, Miss Moran.’

‘A stitch.’ Miss Moran looked at her witheringly. ‘And where would we be placing this stitch, I wonder? In her arm? Her cheek?’

‘No, Miss Moran. In her cervix.’

‘And how would we describe this stitch? In medical terms? Miss Kennedy?’

‘A suture, Miss Moran.’

‘Ah. Well, that didn’t take so long. Congratulations. I hope none of you are hoping to qualify too terribly soon. Yes, we shall be placing a suture in Mrs Knelston’s cervix, and this will give her a better chance – I do not say a certain one – of carrying to term. I shall of course perform the procedure myself, but one of you may examine her before and afterwards in order to note the placing. Now, Miss Curtis, would you tell us the date of the first cervical cerclage?’

‘I – think – that is, 19– no, 1890.’

‘Incorrect. Anyone else?’

A girl who looked a good option to replace Miss Moran in a dozen years or so said, ‘1902.’

‘Correct, Miss Burne. And the success rate is fair. You do realise that, I hope, Mrs Knelston? That this is not a guarantee of successful delivery, six months or so hence?’

‘Yes,’ said Laura. ‘It was explained to me on my first visit.’

‘And tell me, Miss Scott, when do we, or rather the midwife or obstetrician, remove the suture?’

‘At the onset of labour?’ said Miss Scott, her voice hopeful rather than confident.

‘Correct. It is crucial therefore that the midwife is aware of its presence. Otherwise there could be unfortunate consequences, such as tearing of the cervix. Why unfortunate, Miss Kennedy?’

‘I – I – well, it would make future conception less likely.’

‘Correct. Or even impossible. Now – get her prepared, please. I shall be ready in ten minutes. ‘

If there had only been one word of kindness from Miss Moran, Laura thought. One hint that her permission might be sought, for what seemed to be a multiple assault by the students on her already tender person, what followed might have seemed less dreadful. She was moved to an operating theatre, told to climb onto a table, swabbed down, shaved, her legs thrust into stirrups, and a brilliant light shone up her vagina. When Miss Moran arrived, only Miss Curtis had the consideration to whisper, ‘I don’t think it should be too bad.’

But it was much too bad. The double internal examination, first by Miss Moran and then Miss Kennedy, and then the barked instructions from Miss Moran to keep completely still as she advanced on her with needle and suture thread. She managed to keep still, but she did cry out – twice. Almost worse than the rest was when she was finally released from pain, Miss Moran instructed not just Miss Kennedy, but also one of the other girls to examine her.

On her release from the stirrups, she managed to say thank you. Then, with a sudden infusion of her normal spirit, she said, ‘I would just like to say something. When I read of this procedure, Miss Moran, I gathered there would be some kind of anaesthesia available. It would have been easier to bear when I was confronted by the reality had I known this was not the case.’

‘Anaesthesia!’ said Miss Moran. ‘This is a free hospital, Mrs Knelston, not some expensive nursing home. If you found that painful, then I would suggest you need to confront the reality of childbirth before it is too late.’

She pulled off her surgical gloves, nodded at the girls.

‘Take her back to the recovery room,’ she said. ‘You may stay for half an hour, Mrs Knelston, and then you may leave. Providing you are not experiencing any pain, of course. Do make sure you rest for the next few days – don’t go racing back to your domestic chores at home, or you could regret it.’

‘Miss Moran,’ said Laura, ‘I am experiencing considerable pain already, but that is entirely due to your ministrations. And what I shall be racing back to, as you put it, are not domestic chores, but my position as head of a primary school. I shall tell any girls who show an interest in studying medicine that a little kindness might not go amiss during painful procedures.’

The girls surrounding her drew back a foot or two, as if to disassociate themselves from such heresy, until Miss Moran had gone. Then they followed her: all except Miss Curtis, who whispered, ‘Well done. She’s a brilliant surgeon and obstetrician, but I wish she would be a little kinder. I certainly intend to be – if I ever qualify, which is a bit unlikely, I’m afraid. Can you walk?’

‘I think so,’ said Laura, wincing as she eased herself off the surgical table. ‘And thank you so much for your consideration.’

She felt dizzy suddenly and sank down again. ‘I’ll get you a wheelchair,’ said Miss Curtis. ‘And then some tea. Just wait a moment.’

She sat with Laura while she drank the tea. ‘You look better already, Mrs Knelston,’ she said.

‘I feel it,’ said Laura, ‘And thank you again. I’m Laura, by the way.’

‘Jillie. Jillie Curtis. I don’t know if I’ll ever make a surgeon.’

‘Well, I hope you do,’ said Laura, grinning. ‘I hope you’re chief surgeon here and you can sack Miss Moran for unkindness, or even brutality.’

‘I’m afraid that’s a bit unlikely. She really is top of her tree. Where are you going to have your baby?’

‘Hilchester General,’ said Laura. ‘Little town near Winchester.’

‘I hope it goes well.’ Jillie Curtis looked thoughtful for a moment, then said, ‘You should really go somewhere that’s a centre of excellence, you know. With your history. I’m just wondering –’

‘Yes?’

‘My uncle is one of the chief obstetricians at St Thomas’. I wonder if we could arrange for you to have your baby there – he’s a complete sweetie.’

‘But why on earth should they take me? What right would I have?’

‘Oh, Laura,’ said Jillie Curtis, smiling her sweet, gentle smile, and shaking her head in mock reproof. ‘Medicine’s exactly like everything else – it’s not what you know, it’s who you know. Look, I can’t make any promises, but I’ll ask him and write to you. Give me your address. Quick, I can hear them coming back.’

A week later, a letter arrived for Laura from Jillie. It said she was afraid it might be rather difficult for her uncle to find room for Laura in his ward, but if she was really worried, he would of course do his best. It’s all to do with the new National Health Service, she wrote. There’s so much more pressure on beds. Let me know, Laura, and if you are really worried I know my uncle will find a bed for you somehow.

Tom read the letter and looked at Laura, his face incredulous.

‘I can’t quite believe this, Laura.’

Penny Vincenzi's books