City of God (7 page)

Ah Chee slapped her hand on the display of flounders at the front of the fishmonger’s stall. “No good fish. Too small. You no have better fish? Bigger? More fresh?”

“Here now! Don’t handle the merchandise if you’re not intending to buy.” The fishmonger sounded indignant, but he knew this peculiar old woman and what would please her. He pulled a basket of glistening and slithery mackerel from under the counter and grubbed through them until he found one he judged would suit his customer. The fish was alive and squirming in his hands—“God’s truth, missus, how much fresher can it be?”—still he held it out for her to sniff. He’d grown accustomed to this ugly little creature’s ways in the three years she’d been coming to his stall. These days he hardly noticed her yellow skin or her peculiar eyes. Couldn’t help but stare at the stunted feet though.

Ah Chee, still intent on the fish, gave a reluctant nod. “Good enough for poor old woman like me. You take five pennies. I take your old stinking fish.”

The fishmonger wrapped the squirming mackerel in a bit of paper and dropped it in the little woman’s basket. “Six cents it is, and none of your arguments. That’s the price and it ain’t gonna change.” He held out his hand and Ah Chee counted out the coins, mumbling under her breath all the while.

Six cents was a fair price, though she would never let him see she thought so. And the fish was magnificently fresh and fat. She would buy a bit of ham as well, then she could make the Land Sea Golden Wonder Soup that was the absolute terrific best thing for supreme lady with a child in her belly.

She hobbled quickly across the way to the stall of the pigman. “Small piece that meat,” she said, pointing to a rosy pink ham. “Not much too fat bad stuff.”

The man cut her a thin slice of the ham and they dickered over the price until she agreed to pay four pennies, then went to buy two big duck eggs. They were more expensive than they should have been, but still she was left with enough to tuck a few more coins into the special purse. Which, considering the Lord Samuel’s plans and Ah Chee’s plans, was bound to be terrific very much important.

S
INCE
1816
THE
almshouse of the city of New York had occupied a red-brick complex on a sprawling tract of land stretching north-south from Twenty-second to Twenty-eighth streets, and east-west from the East River to Second Avenue. At least so said the signposts. To Dr. Nicholas Turner, just arrived from Rhode Island, the numbered streets and avenues seemed pretentious nonsense. The buildings were surrounded by woods and fields, and the populated part of the town ended at least half a mile to the south. But according to the driver of the hansom cab he’d taken from the pier, proposed streets and avenues were laid out and numbered and marked all the way up to the far end of Manhattan island, where One hundred and sixty-eighth Street could be found. City planning, they called it. Turner glanced around, trying to imagine these trees and hedgerows all disappeared, and buildings as far as the eye could see. Absurd.

The March wind off the river was bone-chilling, made worse because he hadn’t been truly warm since the evening before, when he had boarded the coastal steam packet from Providence for the fourteen-hour journey. The miserly breakfast of black tea and stale
biscuits he’d been offered before disembarking had not helped. Indeed, the whole notion of coming to New York seemed mad now that he was finally here.

All the same, here he was. Turner squared his particularly broad shoulders. He’d wanted a new challenge, a change from sleepy Providence, and it seemed that’s what he’d got.

The word “Almshouse” was etched above the granite arch of the Twenty-sixth Street central entrance. The buildings on either side housed an orphanage, a workhouse for the destitute who were able to labor, and a poorhouse for those too old or too infirm to be put to any use. The hospital where he was to work was in the middle, dividing the poorhouse for men from that for women. It was supposed also to serve the sick of the city who could not pay for medical care, though probably few of them used it. Almshouses were the same the world over. Hospitals as well, for that matter. Given a choice, even the poorest of the poor preferred to die in whatever hovel they called home, where if nothing else they were spared regular visits from clergymen haranguing them about morals.

Enough stalling. Turner hefted his pair of valises—both heavy with more books than clothes—and strode beneath the arch into the place known everywhere simply by the single shudder-inducing word, Bellevue.

Abandon hope all ye who enter here.

“I apologize for not receiving you in my private residence, Dr. Turner. It’s being refurbished at the moment. This office was the only place available.”

“No apology required, Dr. Grant. This is after all where I am to be working.”

“Here at the Almshouse Hospital. Yes, exactly. If you’re quite sure…”

Grant let the words trail away and waited for him to say something. Nick knew what the other man expected.
I didn’t realize how bad it would
be. I’m afraid I must change my mind.
But that wasn’t the case. Even in Providence they knew about Bellevue.

At first sight the hospital lived up to its reputation. Just to get this far he’d had to thread his way between pallets spread on the floor because the wards were full, and to dodge ambulatory patients who wandered around as if they had no notion where to go or what to do. Most patients wore little or no clothing and the pallets were without sheets or blankets. The stench of death and disease permeated even this quite decently appointed small office at the far end of the entrance hall.

It said “Director” on the door. That was the title of the man appointed to run the entire almshouse operation. By long tradition a doctor, he functioned as an administrator, and was empowered to hire a single Senior Medical Attendant to look after the hospital patients and oversee the work of one resident doctor and a few medical students. In practice they were those who could not manage to get themselves assigned to supervised work in the town’s private hospital, New York Hospital on Broadway at Anthony Street. It was reputedly a decent place. In contrast to Bellevue, it was funded by private charity and served those known as the deserving poor, decent folk fallen on hard times. Worthy work, perhaps, but not for twenty-eight-year-old Nicholas Turner. A practicing physician for seven years, had seen the Bellevue position advertised in the
Evening Post,
known exactly what it was likely to be, and applied by mail and been hired—sight unseen—in a matter of days.

“I’m sure, Dr. Grant,” he said.

“But a man such as yourself…You were in private practice in Providence, were you not?”

“I was.” Then, when the other man’s look of puzzled skepticism didn’t alter, “Let me be quite frank, Dr. Grant. I don’t think private practice suits me. I’ve never been particularly good at what I believe is called bedside manner. And as I wrote in my application, I have an interest in medical research. Surely here, with so many from such a wide variety of backgrounds, I shall see a good deal that is new to me.”

“Oh, yes. A wide variety. Mostly the paupers are Irish, of course. I’m told we’re getting some thirty thousand a year since England removed
restrictions on their leaving, and they all seem to wind up in New York. But a goodly number of other nationalities are represented, bring all sorts of strange ailments with them. Taken all together, there are around two thousand inmates here at Bellevue.”

“Inmates? I thought the prisoners had been separated from the almshouse a few years back when they opened the penitentiary up at Ossining.”

The older man seemed suddenly to wake to the notion that he might lose this excellent prospect for his hospital. “They will be, Dr. Turner. Any day now, I assure you. There’s yet another penitentiary being built on Blackwell’s Island a bit up river from here. Finished soon, they tell us. The male prisoners we have here will all go there.”

“The male prisoners? Then there are also women?”

“Some,” Grant admitted. “Prostitutes mostly. The ministers have their way occasionally, and a great drive is made to pick up the more rowdy sorts. Working on the streets. You know.”

Nick nodded. He did know. No need to leave Providence to see crabs and the French disease.

Grant was attuned to his reaction. “There are pickpockets as well. The women are quite good at that, I’m told. The Dubliners particularly.”

“And they’re imprisoned here at Bellevue?”

“Well, most are kept at the old bridewell next to City Hall, but we do get the overflow. Not for long, however. There’s talk of yet another prison to be built. Center Street, I hear.”

“It seems there is a never-ending need for prisons here in New York.”

“The Irish, as I said. Dirt poor most of ’em. Roman Catholics. Refuse to work. Waiting for glory in the next life.”

“Indeed. I would have thought”—Nick nodded towards the hall and the pallets on the floor—“the mere idea of this place would encourage better habits.” In Providence newspapers were full of job notices that said no Catholics or Irish need apply. He had no doubt whatever it was the same in New York.

Grant was apparently not susceptible to irony. “I realize the conditions
are not everything we would wish. Hippocratic oath, promise to heal. All that. But the budget the Common Council provides…” The director of Bellevue waved a hand as if the matter was not worth further discussion. “The hospital serves some two hundred of the inma…er…residents on any given day. As you say, you’ll see it all here.”

The office was warmed by a Franklin stove. It was almost too efficient; from being chilled to the bone Nick had gone to sweating. He was ready to get out of this small space, start moving about, see the rest of what awaited him. “Bellevue will suit me quite well, Dr. Grant. I’m quite sure.”

The other man was still attempting to convince himself. “And there is the matter of your grandfather, Andrew Turner. One of my predecessors, wasn’t he?”

Andrew Turner, who died in 1818, had taken on the job of director of Bellevue (then known as the City Hospital) before the Revolution and had continued for a decade after.

“Indeed,” Nick said. “Also my three times great grandfather, Christopher Turner.” In colonial times Christopher Turner had made his reputation for brilliant surgery at the first Almshouse Hospital, which stood where City Hall was now. Nick had been taken to see the spot when he was a lad on a visit to Grandfather Andrew.

“I’m aware,” Grant said, “that you have a distinguished medical lineage, sir.”

“I shall try to live up to it.”

“Very well, you shall have a tour. Then I shall ask again if you’re quite sure this post is for you.”

“And I am quite certain I shall tell you again that it is.” Nick had already given instructions that his house in Providence was to be sold.

Grant smiled and stood up. Nick did the same. He was at least a head taller than the man who would be his superior. And while Tobias Grant, though bald as a cue ball, cultivated a full beard, Nick Turner was clean shaven. He had the Turner family red hair, and it always seemed to him that a redhead with a beard looked like a pirate.

“You can leave your bags,” Grant said. “Presuming your response
remains that you will take us on, I’ll have someone bring them to your rooms.”

The place was wretched beyond belief, filth and disarray and misery past any normal man’s ability to imagine; in truth Nick had expected as much. He had not foreseen black magic.

The dispensary was in the basement, an evil-smelling dungeon hung about with ropes and pulleys and winches and lined with huge barrels and flagons and beakers, some bubbling atop coal stoves and others fitted with hoses that dripped strange fluids slowly into an assortment of pails. Along with all the chemical odors it stank of dead rodent, and there were mouse and rat droppings everywhere. Nick suspected Jeremiah Potter the chief apothecary might actually encourage the vermin. Eye of newt and toe of frog, that sort of thing.

Potter was wizened and old, with tufts of hair sprouting from both ears, and blind, or near enough as made no difference. A monocular was screwed in place in his left eye. The right was missing, and in its place he’d inserted a white ball painted with a fantastic and exaggerated black eyeball.

“Don’t need to see. Been here forty years. Know where everything is,” he’d told Nick the first time they met. “Do it all by touch and taste and feel.”

“I’d be careful what I tasted if I were you,” Nick said. “Now tell me what’s available. I don’t suppose you have a written list.”

“Don’t have time to write nothing down. Don’t need to. Docs come down and tell me what the symptoms is and I give ’em what’s needed. Never have no complaints. Anyway, report directly to the director, I do. Nothing to do with the Senior Medical Attendant. Jeremiah Potter, Chief Apothecary, runs his own department.”

“Quite. I’m also told you charge me and the resident doctor and the medical students for whatever you prescribe.”

“Course I do. How else am I going to pay for all what’s needed down here?”

“From the hospital budget I imagine.” He had ignored the apothecary’s snort of derision. “Leaving myself out of it, how are the other doctors supposed to afford your”—he’d started to say rubbish, then decided there was no point in making Potter an enemy—“the medicaments you concoct. They can’t afford it. I can’t afford it.” His salary was a hundred eighty a month augmented with room and board, though so far most of the food he’d been served was inedible. He’d taken to having his main meal of the day at a nearby farmhouse where a widow cooked for a few locals. The resident got a hundred, and the students—a changing roster of two or three from either the school of medicine at Columbia College or the one that was part of the new University of the City of New York—were supposed to pay ten dollars a week for the privilege of working on the Bellevue wards, three dollars of which had long been a perquisite of the Senior Medical Attendant, skimmed off before he turned the balance over. Nick had already informed the students that he would waive his bonus; they could pay only seven dollars a week as long as in return they promised conscientious execution of their duties. To further make the point he’d established a series of fines for lateness and other signs of slacking.

Jeremiah Potter was not concerned with any attempt to improve the quality of care at Bellevue. “Not my lookout how much money them student doctors has,” he’d insisted on Nick’s first visit. “They pays me and gets it back from the patients. That’s how it’s supposed to be done.”

“Good Christ, man, the patients are paupers. If they were not, they wouldn’t be here.”

“Not my lookout,” the old man repeated. And he’d walked away.

After five days at Bellevue, Nick intended this second encounter to end differently. “We need tincture of calomel on all the wards. Not as a purge.” It was common practice to dose the constipated with mercurous chloride as calomel was scientifically known, but Nick had his doubts about the wisdom of that. “To treat flea bites and other skin lesions. I want four quarts at least delivered to my office every morning, including Sunday. It’s a work of mercy. No preacher alive could object.”
The apothecary closed shop on Sunday, saying he was busy with his devotions.

“I’ll send up double the supply on Saturday,” Potter said now. “Cost you three dollars a fortnight. Payable in advance.”