A Lady in the Smoke (4 page)

He tucked a spoon in his pocket and carried the pot and a pitcher of milk to the threshold. “Let's find a place to sit,” he suggested, shouldering the door open so I could go through with the dishes and a sugar bowl.

He led me upstairs to the narrow room that had been empty earlier. It was almost too small to be considered a proper sitting room, but there were two armchairs, one on either side of a table that was large enough for the tea things. The air smelled of lamps whose wicks weren't kept properly trimmed and had smoked badly—but the hearth had been swept, and there were supplies for a fire. Outside the single window, which looked onto a narrow alley, the rain fell, blurring the red bricks of the building opposite.

I set the tea things down, found the matchbox on the mantel, and lit a table lamp. By its light, I could see the room more clearly. The walls were papered in a garish green that showed worn spots. On one wall, a foggy mirror hung above a wooden cabinet with a few books behind glass. On the other wall, above two straight-backed wooden chairs, hung a painting of cows in a field, an imitation of one of the seventeenth-century Dutch masters. I perched on one of the ugly chintz-covered chairs. It smelled of Macassar oil, no doubt accumulated from the hair of dozens of men who had sat there previously. Into my mind leapt the image of Lady Lorry's elegant ballroom; the contrast with this shabby chamber was so stark that I felt a laugh forming in my throat.

The doctor had rolled some newspaper into spears and settled them on the grate; now he tonged some coal from the hod into the fireplace. I handed him the box of matches, and he sparked and held one to the newspaper, then sat back on his heels. His hair was disheveled and his shirt was so stained that it would probably have to be thrown away. I realized I probably looked equally frightful, with my bedraggled skirts and a bandage strapped across my forehead, and again I had to stifle a laugh.
What would Lady Lorry say if she could see me now?

The fire crackled and spit from the rain dripping down the chimney onto the hot coals, but soon it was burning well and taking the chill from the room. I poured the tea into our cups, then spooned sugar into mine. I took a sip and grimaced. It was dreadful, even with the sugar.

He sat down in the other armchair. “Is it horrid, then?”

His
r
was softer than my English one. It came out like a purr. Scottish, I was almost certain.

“Rather.” I smiled. “But at least it's hot.”

He leaned back and took a long breath, his eyes meeting mine. “I can't tell you how grateful I am. The quicker I can be in those cases, the better. Truly, your help made all the difference.”

I felt my face flush.

“I don't even know your name,” he continued. Our fingers had touched dozens of times throughout the night, as I handed him materials, or as he shifted the lamp I held. But now he offered his hand forthrightly to me, as though I were an equal, or one of the new suffragists. “I'm Paul Wilcox.”

Ever since we'd finished in the scullery, I'd been dreading this moment, wishing I could somehow avoid telling him who I was. Over the past six hours, we'd developed an easy, even friendly, understanding. Revealing my title would change things. It always did. And very suddenly, I realized I didn't want that.

“Miss Fraser. Elizabeth Fraser.” I kept my voice steady as I said it; it was the legal truth, after all, even if it was also a lie. I felt his hand close warm and steady over my own, while his eyes met mine, measuring.

“You're not a nurse, surely.”

I shook my head.

“So how is it that you don't faint, Miss Fraser? Most men I know couldn't have borne what you did tonight—and with no disrespect to your sex, ladies are usually even less stalwart.” He smiled, the corners of his eyes crinkling. “Did you see that maid who brought us the sheets? She wouldn't even open her eyes.”

So he'd noticed too.
I gave a small laugh. “Well, I've helped take care of horses, when they were injured.”

He raised his eyebrows slightly. “Surely
that's
not your profession.”

“No. I just meant that I've helped take care of our horses sometimes.”

“Out of curiosity, how do you sedate a horse?” he asked.

I remembered the day Athena came to us, how she'd fought and kicked. “Laudanum and sugar-water.”

He looked startled. “Laudanum and sugar-water?”

“Horses lap it up. After that”—I shrugged—“it's just a question of making sure they fall in the right direction.” I paused meaningfully. “They're rather hard to shift, once they're down.”

He laughed outright. “I imagine they are.” He took a sip of the tea, winced, and held the cup between his hands for its warmth. “So you and your mother live here in the country, not in London?”

“In Levlinshire. We'd been in London for a few weeks.” I hesitated. “You remember my mother then? There were so many of us in that field.”

He gave me an odd look. “Of course I remember. How is she?”

“She's sleeping peacefully. Or she was, when I left her.”

“When you've finished your tea, we'll go see her.”

I nodded.

“If she's well, she can be moved,” he added. “No doubt you'll want to get home, and she'll be more comfortable there.”

“Dr. Wilcox—”

“
Mr.
Wilcox,” he corrected me. “I'm not a physician; I'm a railway surgeon.”

I'd never heard of such a thing. “Do you work for the railway, then?”

He shook his head. “No. I help people who've been in railway accidents.”

That truly surprised me. “Are there enough people in railway accidents to keep you busy?”

“Dozens—though not all the accidents are as bad as yours, thank god.”

I sat back in my chair. “So you
only
help victims of railway accidents? You wouldn't care for someone who had fallen off a ladder, or been taken ill with a fever?”

“Of course I would, if called upon. But railway injuries are my specialty, and these accidents can result in some peculiar outcomes.”

“What do you mean by ‘peculiar'?” I asked uneasily.

Now he looked sorry that he'd brought up the subject and shook his head reassuringly. “I don't see any signs that your injury is one of those. But, if you'd like, I can give you an example, to explain what I mean.”

“Yes, please.”

“You've heard of Charles Dickens, the novelist?” he asked.

“Of course.” I'd read all of his novels at least twice over.

“In 1865, he climbed out of the disaster at Staplehurst and dragged two other passengers out with him. Then he went back for his case because it had the manuscript for
Our Mutual Friend
in it, and afterward he spent several hours helping other victims, bringing them water and such. He even managed to walk partway home. But the next day, he became dizzy and was shaking so badly that he could barely sign his name; two weeks later, his legs started twitching, and he had such nightmares that he couldn't bring himself to get in bed at night. He'd stay up until he collapsed at his desk.”

“That's odd. Why did he get worse instead of better?”

“Quite often, people who are in railway disasters suffer a special kind of nervous damage, which happens belatedly. Some medical men call it ‘railway spine' or ‘railway brain.' My mentor, John Erichsen, and I believe it has at least something to do with fright and shock, as well as an injury to the spine, but none of us completely understands it yet.” He gave an encouraging smile. “I don't want you to worry. And it's perfectly normal for people to have some nervous disorder for the first few days following an accident—such as what you betrayed yourself just now.”

I stared. “What did I do?”

He gestured toward the fire. “A coal sparked and fell. It barely made a sound, but you jumped in your chair and spilt your tea.”

Dismayed, I looked down at my lap. I wouldn't have believed him, but there was the proof, a cluster of spots the size of shillings, spreading on the silk.

How could I not realize that it had happened?

“Miss Fraser, as I said, your unease is normal.” He paused and, after a moment, added gently, “You'd have to be some sort of monster to witness what you did and not be affected.”

His sympathy was so frank and unexpected that it nearly undid me. Tears pricked at my eyes, and I had to swallow the tightness in my throat. Finally, I said, “Does it go away? The nervousness?”

“Yes, with time. The difficulties usually occur only in those whose nerves are already weakened by what we call a ‘complicating factor'—a previous condition, say, or a tendency to be susceptible to suggestion.” He gave a faint shrug. “You know the sort—people who are always fretting about their illnesses.”

I choked on my tea. Mama's nerves were
always
disturbed, and “susceptible” didn't begin to describe her. She'd only to hear about a new illness before she began to wonder if she had it. “Then I think you should see my mother now.” I set down my cup and rose from my chair.

He looked surprised, but he took me at my word. “I'll fetch my bag from downstairs.”

I drew the curtains apart to let in some light, and Mr. Wilcox approached the narrow bed.

Mama appeared to be fast asleep, but as he laid his hand on her arm, her eyelids fluttered open. It took a moment for her eyes to focus; they settled briefly on me, then skidded away, taking in the beds, the walls, the washstand, as if she were trying to find a familiar object, something to tell her where she was.

“Hello,” Mr. Wilcox said, using the same soothing tone that I'd use to calm a skittish horse. “You're at the Travers Inn, and you're safe. My name is Mr. Wilcox. I'm a surgeon, and I specialize in railway injuries, so I've come to check on you. How are you feeling?”

Mama didn't reply, but her eyes shifted to his face and remained there.

Why didn't she answer?

I was used to her silence when she was under the influence of her laudanum—but she hadn't taken any in nearly a day.

Mr. Wilcox laid his hand gently on her forehead, and his expression remained cheerful. He opened his bag, and although there were many silver instruments and some bottles inside, he brought out only his stethoscope. He listened intently to Mama's chest, moved the stethoscope to her abdomen, and then slid the disk underneath her, so it lay behind her back.

He moved so carefully that he barely disturbed my mother at all; indeed, she seemed to calm under his touch. He took her pulse and smiled encouragingly, lifted a candle and brought it toward her face and away several times, examined her hands and arms and her legs, and at last removed the white gauze from her left ankle to check it. My mother tensed, but she didn't make a sound. As for myself, I had to stifle my gasp.

Her ankle was badly swollen at the joint and showed purplish partway up her leg. He rewrapped it gently and then asked me to help turn her so that she was lying facedown. Mama submitted to everything without a murmur, and I thought I even heard a sigh of relief when she was settled, with the pillows arranged under her ankles to keep them raised. Though the entire examination took no more than a quarter of an hour, he seemed to have gathered what information he needed and put Mama at ease. But as he put his instruments away, his mouth tightened in a way that worried me.

I followed him out into the hallway. “Is her ankle broken?” I asked anxiously.

“I think it's just a severe sprain. The bones seem fine.” His voice was subdued.

I kept with him toward the stairs. “Then what is the matter? Why isn't she talking? And why did she need to be turned like that?”

“It's just for the next few hours. Situating her so her spine is the highest part of the body can prevent venous congestion around the spinal cord. But more important, this position eliminates pressure upon the vertebral column, so it recovers more quickly.” We walked together down the stairs. “It's best to have her lie this way for at least three out of every five or six hours for the next few days. I'm sure you can ask one of the maids to help you if you can't turn her yourself.”

I halted in mid-step. “Do you mean we can't go home?”

He shook his head, and then motioned to the doorway of the sitting room. “May we speak for a few minutes?”

My heart lurched, and with a knot forming in my stomach, I followed him into the room. He turned to face me. “Miss Fraser, does your mother take an opiate?”

I hadn't expected him to be so direct, and I felt a wave of shame for her weakness. “Laudanum, for her nerves,” I admitted. “How could you tell?”

“By her eyes.” His expression was sober. “The Italians call laudanum ‘belladonna,' you know, for the way it makes women's eyes look so dark and beautiful. But it can be a dangerous habit. How often does she take it?”

“I—I'm not sure.”

“Only on occasion? A few times a week? Or every day?” His voice was pragmatic and without judgment, as if he were only gathering facts, and I felt some of my embarrassment fade.

“Usually at night, before bed, to fall asleep.” He waited expectantly, and I continued, “Sometimes when she wakes. And then other times, when she's nervous. She took an extra dose yesterday morning because she's frightened of trains.”

“What is she like when the laudanum wears off? Is she easily upset? Fretful? Anxious?”

“Yes. All of those.” I swallowed. “She's irritable and—well, nothing pleases her.”

I saw a flicker of sympathy in his eyes—and something else that came and went before I could name it. But he said only, “So she missed her dose last night and again this morning.”

“Yes.” The knot in my stomach tightened. “Is that a problem?”

“If she's been taking it regularly, suddenly depriving her of it can be just as dangerous as taking it in the first place. You don't have any with you?”

My thoughts darted back to the moment when she had tried to pull her reticule off the spring in the railway carriage and I'd told her to leave it. Had I held a secret hope that we could leave her habit behind so easily? I felt a stab of guilt, and anger at my stupidity. “No. She usually carries a bottle with her, but we—I—left it on the train.”

He frowned. “I don't have any to hand. I can obtain some, but I fear dosing her without knowing how much she's been taking. Do you have any idea? Does she take a teaspoon at a time, or two, or—”

“I'm not sure. She's always kept the bottles in her bedroom, in different places.” I felt the embarrassment return as I realized how this sounded.

“Always,” he repeated. “How long has she taken it?”

“On and off, for the last fifteen years or so,” I answered reluctantly. “There've been times when she stopped, but lately, it seems she needs it more.”

He walked over to the window and looked out onto the alley. His hands were deep in his pockets, and though I couldn't see his face, I could sense tension in his whole frame.

“Why does this matter so much?” I could hear the tightness in my voice. “Isn't it better if she
isn't
taking it?”

“Her nerves have become used to it,” he said over his shoulder. “Without it, she'll develop tremors, and eventually there could be nausea and vomiting, as well as agitation and trouble sleeping.”

“But she slept last night,” I protested. “You saw her just now—she was sleeping until you woke her, even without her usual dose.”

“Because she'd had extra yesterday.” He turned toward me. “This isn't the first time I've encountered opiate use in railway patients. What I've found is that an accident excites the nerves, so laudanum patients temporarily need more than usual to sustain their normal level of calm. The problem is that at higher doses, laudanum can cause diminished breathing and heart rate. Not knowing her usual use, we will just have to be careful.”

My fingers clenched at the fabric of my skirt.

His expression was pained. “I'm sorry, Miss Fraser. I know I'm frightening you. But I think it's best you know. We must keep her quiet and calm for the next week, or possibly a fortnight. She shouldn't be moved; she needs plenty of rest; and I'll administer the smallest amount of laudanum possible to keep any symptoms at bay. If we do all this and watch her closely, I'm sure she'll be all right.”

I took a deep breath, relieved at his words. “Of course. I'll do everything. I'll write home at once to send for our things—”

“Before you go, I have a few questions. They won't take long.” He drew out a small pocketbook and a pencil from his pocket. “Has your mother ever had whooping cough?”

“Not that she's ever mentioned.”

“Smallpox? Diphtheria? Pleurisy?”

I shook my head after each.

“And you are her only child?” When I hesitated, he raised an eyebrow. “She had a miscarriage?”

I winced. “No. But it was a difficult birth, and he—Henry—died shortly after.” The weeks following Henry's death still pained me to remember.

“When was this?”

“Fifteen—no, sixteen years ago. I was four.”

He wrote several lines in his book.

“Could something that happened so long ago be important?” I asked.

“Sometimes. Not always.” He put away his notebook. “The most important factors to her recovery are resting her nerves and managing her laudanum. Do you know of a trained nurse you could hire? It might be best to have one stay with her for the time being.”

I was already thinking of Jane Grace, a nurse who was cousin to our housekeeper, Mrs. Ellsworth. Kind and intelligent, she had been with Miss Nightingale in the Crimean War and worked afterward in one of the large hospitals in London. After Henry had died, she had come to take care of my mother for several months. She'd been utterly unruffled by my mother's fits of ill temper, and Mama liked her well enough.

I nodded. “I know a nurse who might be able to come. And if she's unavailable, I'm sure she can suggest someone else. But I'll take care of Mama until she arrives.”

“Very well. I should have the laudanum to you by tomorrow, I hope, but for now…” From his bag, he drew a small glass jar, which he handed to me. “This is a special salve. It smells peculiar, I know, but it will help reduce pain and increase blood flow to the muscles and nerves, so they can retain their usual tone. Apply it two or three times a day onto your mother's back, arms, and legs. Not the sprained ankle, of course.”

He was reaching into his bag for something else, so I opened the jar and took a sniff. The contents set fire to my nostrils.

A smile tugged at the corner of his mouth. “It isn't meant to be inhaled.”

I tried to stop gasping.

He handed me a small packet. “This is tea. It's a special blend that will help keep her stomach calm. See that she drinks four or five cups daily.” I nodded, and he removed a small bottle with a dropper and set it on the table. “Do you have a pocket watch?”

“Yes, upstairs.” I had one in the buttoned pocket of my cloak.

“Have you ever taken a pulse?”

I shook my head.

“Then I'll show you how.” He reached out his hand. “May I?”

Hesitantly, I gave him mine.
He's a doctor,
I told myself,
for god's sake. Be sensible!
He brushed back the long sleeve on my dress, and touched his fingers to the inside of my wrist, below my thumb. His fingers were warm against my skin, and my heart jerked into an unsteady rhythm that I hoped he couldn't feel. “Do you see how I am placing my fingers?” he asked, then let go of my hand. “Now, you do it.”

I placed my right fingers over my left wrist.

“No, do it on me. I need you to be able to find it on her.”

He positioned my first and second fingers near the base of his thumb. I held my breath, stilling my entire body, so that I could find the faint pulse of his blood. There it was, steady as a clock.

I was glad he could no longer feel mine.

“Can you feel it clearly enough to count?” he asked quietly.

I nodded and met his gaze. The light was brighter now, and I could see his eyes weren't brown as I thought, but hazel.

For a moment, neither of us moved.

Then he turned away to pick up the small bottle and dropper. “The sudden withdrawal of the laudanum can cause her pulse and blood pressure to rise, so until I can get you more, I want you to take her pulse at the top of every hour. If it rises above one hundred and five beats per minute, you should administer this.”

“What is it?”

“A mild sedative. It will bring her pulse back within a healthy range and help soothe her nerves. Put six drops in some broth, or even water, to help her swallow it.”

“All right.” I watched as he began to close his bag. “Are you going to bleed her?” That's what our physician had done sometimes to ease Mama's nerves after my father died.

“No.” He slid the straps into the buckles. “Usually railway injuries require an influx of fluids, not a loss of them.” He fastened the last clasp. “But you'll want to keep the room dim to minimize excitation.”

A dim room, the salve, the tea, and the sedative drops. I could manage that. “Is there anything else?” I asked.

“Your mother will need distraction, something to keep her mind off the accident.” He gestured behind me, and I turned to look at the cabinet of books. “Is there anything in there that she might find amusing?”

I opened the glass door and glanced through the volumes on the top shelf.

“Nothing too sensational,” he said, a smile shading his voice. “I wouldn't choose Mr. Collins or Mrs. Braddon.”

Most of the books were inexpensive copies of sermons or sensational penny dreadfuls, none of which Mama would enjoy. My eyes were drawn to the one fine leather-bound volume on the second shelf. I pulled it out, and to my surprise it was a title I recognized. “It's the first volume of
The Eustace Diamonds,
” I said aloud. The very same book was in one of our trunks, somewhere in the wreckage.

“You didn't like it?” he asked.

I looked up.

“You had a peculiar look on your face just then,” he said.

“Did I? I was thinking about how our copy was in our trunk. On the train.” I ran my fingers over the seams in the binding. “The heroine's name is Elizabeth too—only they call her Lizzie and she's rather wicked. Have you read it?”

“No. I haven't seen it at Moody's yet.”

I flushed. Stupid of me. Of course he would read it by subscription. A surgeon didn't have the money to spend on gilt-edged volumes of novels.

If he saw my embarrassment, he didn't let on. “Once your nurse arrives, I don't want you to spend more than an hour or so in the sickroom, for the sake of your own spirits. But I think it would be good for you to read aloud to your mother. Your voice, being familiar, may help reassure her, and the story itself will redirect her mind from the accident.”

“I'll try some when she wakes.”