City of Dreams (32 page)

The quantity of laudanum, perhaps. Bess would have access to far more than any ordinary patient. Could be she’d taken enough to create this odd disconnection between her self and her pain.

Cuffy, however, couldn’t see into her mistress’s eyes, only hear her agonized yells. The girl was sobbing almost as loud as Bess. Even Hetje, standing by Christopher’s side, was whimpering. Only Amba remained silent.

Christopher looked at the African girl. She seemed to sense his glance and looked from Bess’s face to his. She smiled, as if … No, that was absurd. A black savage, what did she … The smile, however, was definitely one of encouragement. Suddenly she opened her mouth and emitted a kind of hoot punctuated by a clicking noise. And she never stopped staring into his eyes. The noise she made was strange, but not terrifying. It had the sound of joy in it, the promise of hope.

Black savage or no, she helped him decide. He and Bess had agreed to the operation. Bess was in no position to change her mind. He had no excuse for doing so.

With one downward plunge of the scalpel Christopher severed two-thirds of Bess’s right breast from her torso. What remained was held in place only by the section containing the tumor. And thanks to the technique learned from his grandfather’s journals, there was a good-size flap of skin left with which to cover the wound when he was done.

Bess continued to scream, Cuffy to sob, and Amba to hoot. Hetje was silent. Christopher ignored them all and concentrated on his task. “Hand me that threaded needle from my case.” He had to shout twice to get Hetje to hear him over the din, but finally she pressed something into his hand. Christopher did not look away from his patient.

He’d prepared the ligature earlier, while mentally rehearsing Lucas’s instructions.
The Bleeding of the large Arteries is to be stopped by passing the Needle twice through the Flesh, almost round every Vessel, and tying upon it, which will necessarily include it in the Ligature. In order to discover the Orifices of the Vessel, the Wound must be cleansed with a Sponge wrung out of Warm Water.

Hetje was still sopping with the blood-soaked rags she’d been using right along. “Use a fresh cloth,” Christopher snapped. “Dip it in that water by the fireplace first.” As if by following Lucas’s advice down to the last comma he could assure himself of his grandfather’s brilliant skills.

Amba was still hooting, and Bess was thrashing with more force than before. Her screams were somehow different as well, more heartfelt. The rum and the laudanum were starting to wear off. And the worst was yet to come. “Hold her tight,” Chris said. “And damn it, girl, stop that extraordinary wailing. No one can hear my instructions and I can’t hear myself think.”

Amba fell silent. Now all he had to listen to were Cuffy’s sobs and Bess’s agonized yells. The one piece of advice he’d gotten from Nicholas rather than Lucas was that a surgeon must stop his ears against his patient’s cries, however heartrending.

He had come, as Jane would put it, to the doing of the thing: it was time to remove the cancer that was stealing away Bess’s life. Christopher chose his longest and narrowest scalpel.
It is Imperative not to pierce the Tumour itself …
He lifted the bloody lump of formless flesh that had once been what Bess had called “a pappe any man would find exceeding pleasing.” The growth moved with it.

Thanks be to God. His diagnosis had been correct. The tumor did not adhere to the muscle underneath or to the ribs.

With one sure and swift cut Christopher released that part of the breast from her body. Next the knots in the underarm.
The possibility of extirpating these … very much questioned by Surgeons … done it when they have not laid backwards and deep.
He didn’t think they were backward and deep, but God help him, he could be wrong. He’d know soon enough.

He chose the smallest blade so he could efficiently cut around the hardened knobs. The first cut he made no deeper than a quarter-inch. The knot lifted easily on the tip of his scalpel. So did the second. The third and the fourth were joined. Both came free in one cut.

Christopher sighed with pleasure. It was done. The entire bloody mess lay on the bed beside Bess. She and her pappe were separated. The cancer was no more with her.

For the past few moments it was as if he’d been attached to his instruments, as if he felt and heard and thought and smelled only through them. Now he was once more in the room, with his patient and her three black slaves. He heard Bess’s cries of torment—more whimpering than screaming, now that he’d stopped cutting—Hetje’s stertorous breathing, and Cuffy’s terrified sobs.

Only Chris and Amba were silent. He lifted his eyes. This time he discovered the African girl already staring at him. “Hallelujah,” Chris said. Amba smiled. He smiled back. “Hetje, get me an empty bucket.” He spoke without turning his head. “I believe there’s one over there by the fireplace.” Amba nodded at him meanwhile, as if she wanted him to know he had earned her approval. Then, deliberately disobeying his instructions, she opened her mouth and gave one more tongue-clacking hoot. She stopped before he could again reprimand her. She was still smiling. He lowered his gaze.

Hetje brought him the old tin pail. Christopher took it from her and with his hand swept the formless mass of fat and skin and muscle and cancer off the bed and into it. The large round ball of the tumor could be easily distinguished atop the pile of discarded flesh.

Christopher wasted no time examining the growth. “Fetch me some wine,” he instructed. “Be quick.”

Hetje did as he said, but this time he washed the wound himself, trusting no one else to be sufficiently thorough. When it was as clean as he could make it, he dusted the area with stanching powder and began to stitch. Finally he dressed the whole with bandages soaked in wine. Only then did he allow Cuffy and Amba to move from the positions they’d held for over an hour.

Chris moved as well. He gave in to the great need to stretch his legs, even extended his arms above his head, linked his fingers, and pushed at the sky. Truth was, at that moment he felt he might be able to touch it.

The pair of young slaves were standing beside the door, waiting for instructions. “You may go,” Chris told them. “But first, you both did exceptionally well. Your mistress has an excellent chance of being restored to health. I shall be sure to tell her—”

“Master! Come!”

Hetje’s voice. Christopher turned back to the bed. Bess had been barely conscious when he finished operating; now he expected to find her sleeping with exhaustion. Instead she was half sitting in the bed, leaning on Hetje’s arm. “She ain’t but barely breathing, Master. I be sitting her up to make it better, but it don’t be helping a whole lot.”

Bitter as it is for the Surgeon who has done his Best, it must be faced that a kind of
Cyanosis
oft follows on a successful Surgery, as if the Body has borne too much, lost too many of its vital Fluids. The Skin turns blue and the Breath comes only with great Difficulty, though there is no apparent Obstruction. This Condition inevitably leads to Death and Sadly, short of never Operating on any but those who are Young and in the Prime of Health, I know of no manner of Preventing it.

Sweet bloody Jesus. After all this. To lose her now, after all they’d both been through … Damn it, he wouldn’t! Not without a struggle. Lucas might not have known a way of preventing Cyanosis
due to loss of Vital Fluids,
but he bloody well did.

The pipette and the hollow needle were always at the bottom of his case. There was a pig bladder in there as well. Even the latest version of the succession of brass valves he was forever having the smith make for him. What he did not have was blood.

Bess kept chickens out back in a coop at the far end of her garden. He seemed to recall there was a pig out there as well. He took a step closer to the bed and put his hand over her heart. The beating was very fast, a peculiar, almost hollow thump he’d come to recognize. She had seconds left, not minutes. There was no chance he could get an animal slaughtered and bled in the time she had left.

Though he’d dismissed them, Amba and Cuffy had stayed when they heard Hetje’s cry. They were staring at him, waiting for him to do something. Hetje as well. Three black women, all of whom apparently held their mistress in true affection. All required to follow his instructions without hesitation. Christopher looked at each of them in turn.

No, he could not do it.

It was impossible to even consider, far worse than Jeremy Clinton’s chidings about the blood of a Quaker being put in the body of an Anglican bishop. Negro blood in a white woman. Unthinkable.

There was only one option available. Christopher tore off his jacket and began rolling up the sleeve of his shirt.

“What do you mean, she’s resting and cannot be disturbed? My mother does not rest. And she has never once in her life refused to see me.” Tamsyn pushed by the slave standing in the door. A young black girl followed on her heels. Tamsyn turned to her. “Here, take the babe”—she handed little Sofie to the young slave— “and wait for me here.”

There was a strange smell outside Bess’s room. Tamsyn caught the scent before she was halfway up the stairs. A dark earthy odor, not so much unpleasant as unfamiliar. And the door to the bedroom was closed. “Mama, are you in there? Are you unwell?”

That Zachary had been treating her mother for something, Tamsyn knew. But she was not sure for what. “Nothing to bother you with,” he’d said repeatedly.

“I’m old, I’ve the usual aches and pains” had been Bess’s response to questions. “What profit in having a son-in-law who is a trained medical doctor from Edinburgh if you never consult him?”

Tamsyn looked at the closed door for a moment. Then she tapped on it. “Mama, you must answer me. I am becoming very feared that something is seriously amiss.”

When there was no response she turned the knob.

The transfusion had been in progress for just under five minutes. The change it had wrought was truly extraordinary. Bess’s cheeks were a healthy pink. Her breathing was easy and natural. Her eyes were closed, but you had only to look at her to know that she was sleeping, not senseless. Chris was lightheaded. He put it down to exultation. He wanted to shout out loud for the sheer joy of it. He knew how to do it now. He could put blood back in patients, not merely take—

“Oh, dear God! What is happening here?” Tamsyn stood in the open door, paralyzed. “Christopher, in the Lord’s name … what unholy thing are you doing?”

“Close the door, Tamsyn. Your mother needs warmth. Then come closer and I will explain. I cannot, as you perhaps recognize, stand to greet you just now.”

He was sitting beside Bess’s bed, exactly as he had for the hour it took him to perform the operation, but this time his bare arm was extended over hers. And between the two, the wasted arm of the patient who had been ill for some months and the young muscular arm of the surgeon in his prime, there was a glass pipette through which blood could drip from his open vein into hers.

Tamsyn took a few hesitant steps. She looked at Hetje, standing on the other side of the bed, at Cuffy and Amba over by the fireplace. “What has happened here?” she whispered. The slaves looked back at her and did not reply. “Please, Christopher. You must tell me what you are doing.”

“I am giving your mother some of my blood. To replace the large quantity she lost when I cut off her breast.”

Though she covered her mouth with her hand, Tamsyn’s gasp was audible. Christopher chose to ignore it. “There, I think that is sufficient for the moment. Hetje, you will find a few more ligatures in my case. Not threaded. Bring me one. And some of the lint I use for packing wounds.” Then, to Tamsyn, “Hetje assisted me during the surgery, as your mother insisted. And I must say, she proved wise in the matter. Hetje did excellent service.”

The old woman meanwhile had brought him the things he asked for. Christopher disconnected the makeshift apparatus from his arm first. He was careless of the wound he’d made when he opened his own vein, as he’d have time to treat it more thoroughly later, but he used the ligature to tie a tourniquet above the cut. He was, he realized, a little dizzy from loss of blood, not simply lightheaded with success.