The Book of Hours (5 page)

“I never—”

“And you're not going to die.”

The reassurance, no matter how it was delivered, helped to calm him and clear his vision. Instead of expressing relief or gratitude, however, Brian Blackstone said simply, “Another of your thirty-second diagnoses.”

The words struck hard, particularly because it was at least partly true. Cecilia snapped open the catches to her bag and pulled out her stethoscope. “The pain is centered below your rib cage and on your right side, is that correct?”

“Yes.”

“Hold still.” She placed the stethoscope to his chest. The pulse was frantic from pain, but strong. Chest clear, though the breathing was somewhat irregular, as was to be expected. She freed her ears and set the instrument to one side. “Place your arms to your sides.”

She palpated his upper abdomen but found only the tightness of clenched muscle. “Do you feel nauseous?”

“I told you this afternoon—”

“Not from your previous illness. Now. Do you feel anything different at this present time?”

“I don't know. Maybe.”

Gently she prodded his sweat-dampened skin. “Is this where it hurts most?” She was rewarded with a wince and a nod. “Does it radiate downward along this line?” Another nod. “All right. From your dehydrated state, the perspiration, and the specific location of your pain, I can say with great certainty that you have experienced an attack of kidney stones.”

“Poor fellow,” Arthur murmured from somewhere by the doorway.

The expression of sympathy only heightened her ire. Cecilia searched in her bag and came up with a pair of vials and two syringes. She ripped open the containers and said, “Let me share a little something with you, since this will hopefully be the last time you and I ever meet. I did my undergraduate studies at Duke before studying medicine here in England at Oxford University. I was offered the chance to specialize at Guy's Hospital in London. I turned it down because all my life I've dreamed of practicing family medicine in a small English village. Something that I am absolutely certain will make no sense to you whatsoever.”

She ripped open the package of sterilizing gauze, swabbed his arm, prepared the tourniquet, and used her middle finger to thump up the vein. All the while she continued speaking. “I came here because this is the home village of my mother's family. I was one of fourteen candidates for the job. Despite what you might think, this is a highly sought-after location.”

“My dear,” Arthur protested quietly, “I hardly think this is the time or place—”

“When I had my final interview with the town's chief doctor, he said I was far and above the most qualified candidate,” Cecilia went on, ignoring Arthur entirely. She filled the first syringe, squeezed out the air bubbles, and inserted the needle into the vein. “Then he told me he was going to have to offer the post to someone else. The reason was simple. He did not think an American doctor, no matter how strong the connections to this place, would ever be able to overcome the inclination to chase the almighty dollar. Those were his exact words.”

She observed the patient's gradual relaxation as the strong painkiller took hold and released him from the agony. She pushed the plunger fully down, then placed a cotton swab on the point of entry and removed the needle. “I answered the only way I could, which was to say I would work at half pay through the six-month trial period. I went into debt to live and work here. This is a lovely village. It's bursting at the seams with history and charm. The longer I stay here, the more . . .” She halted because she had no choice. It felt as though a fist had closed about her throat. She swallowed down the constriction and the sorrow and finished, “Rose Cottage is also my home.”

She inserted the second needle a few millimeters up the arm from the first and went silent for the time it took to inject the muscle relaxant and observe his response. His body continued to slacken in stages. His eyes held her attention most of all. They were gray and surprisingly clear, but their calm was unearthly. As though he were detached from everything about him, including his own distress. Now that the pain was gone, he seemed scarcely connected to this place, this world, even his own body.

Cecilia rose to her feet, and in turning met Gladys's and Arthur's reproving stares. She knew then that she would have to be the one to break the news. “Castle Keep is going to be sold.”

“What?” Arthur's words were punctuated by a gasp from his wife. “When?”

It was the patient who responded, his voice utterly blank and uncaring. “Next week.”

“That's why he came to Knightsbridge, to collect his money and run.” Cecilia looked into the man's clear gray eyes, empty of even a hint of shame or remorse, and wondered what made him so utterly cold. “You might have the power to kick us out into the street and take off with all the riches you can carry. But the truth is, you've missed the opportunity of a lifetime. You've lost the prize.” She picked up her bag and started from the room, shepherding the elderly couple before her. “That is, if you ever had it at all.”

Four

W
EDNESDAY'S DAWN WAS LONG IN COMING, AS SLOW AS THE
pulse of returning pain. Brian lay on his pallet, drifting in and out of slumber. He knew the pain was not vanquished but merely set aside for the moment. Thankfully, his mind cleared before the agony resumed. He had much he needed to think over. But instead of dwelling on the surprises the night had revealed, Brian found his thoughts returning again and again to the doctor and her opinionated prattle.

Two years away from the United States, two years of traveling back roads and places with no roads at all, had left him with an ability to view all of life from a tourist's safety. Just passing through, involving himself in nothing. And yet one addle-headed woman packing more degrees than was healthy had wormed deep under his skin. Now that he was alone and the house was quiet and the pain stilled, Brian found a hundred different ways to put her in her place. Not all the world could be boxed up neat and tidy with a ten-second assumption. Dr. Lyons jumped to conclusions because it kept her from needing to think deeply about anything or anybody. She had built her entire life around the stopwatch a doctor used to ratchet up the number of patients. She might not be hunting for money, but she still carried all the bad habits, all the shortsightedness. Oh yes, he could tell her a thing or two. If only he had a chance.

But this was not the night's surprise. No. Brian had met a lot of doctors and liked very few of them. He had no time at all for the way some lorded over people in their moments of weakness. Or for the way others barricaded themselves away emotionally, discussing the most sensitive and tragic issues in the coldest of terms. They pretended it was to protect themselves from becoming over involved. But after years of observing doctors, Brian had decided that in truth many had never learned to care. Medical schools taught would-be doctors everything there was to know about the human body, except how to locate their own hearts. No, there was no surprise whatsoever in Dr. Cecilia Lyons's response to the vagaries of life.

What had astonished him in the night was his own reaction. Not to the doctor, but rather to the pain. Brian lay on his pallet and watched the first streaks of crimson appear in the sky outside the grand windows. The glass panes were centuries old, and their warped surfaces turned the simple scene of wintry dawn into a living impressionistic painting. He thought back to mornings he had greeted while in the hospital in Colombo, and to the days before the tummy bug had laid him low. He had watched numerous dawns from the shelter of palms on the coast of Thailand. And before that had been some remarkable sunrises, where desert met the sea, in northern Australia. Earlier still had come the soft gray light of a rainy New Zealand morn, and before that the semitropical heat of Tahiti daybreaks. On and on the list of names and places went, most of them scarcely remembered. Brian stared at the strengthening light and felt his pulse press upon the muted pain in his side, and he knew that he was seeing this dawn with a clarity he had thought lost and gone forever.

What had surprised him most about the night was that in the moment of his worst pain, he had wanted to live. So many dawns he had greeted as one already dead, one whose heart had been torn from his body, and whose corpse could not realize it was time already to cease the useless task of living. A year ago, the news that he was going to perish would have been greeted with a single word—Finally.

But as he lay and waited for the pulse of pain to return, he realized he no longer wanted to depart. Why, he could not say. He had no good reason to want to hang around. But he could not argue with what had resounded through the pain and the night.

Brian winced as the first discomfort sliced cleanly through his side. He knew an instant's fear, for he was certain the doctor had meant exactly what she said. Dr. Lyons was not going to return.

The pain subsided momentarily, long enough for him to knead his side and take an easy breath. But it was just a fleeting lapse; he could almost see the clean ice-blade of coming agony poised over his belly. He wanted to shout, to call and plead for someone to come and help. But the manor's interior walls were so thick he doubted anyone could hear. And certainly no one would be able to help stop the pain.

Fear of what he was about to endure pushed a sheen of sweat to his face. But it was not just the fear. Brian curled up on his side, pressing hard to shield himself from the torment, and heard the silent cry resound through his panic-stricken mind. He wanted to live. Cecilia was out the main gates and a hundred yards down the road before she finally accepted that she had to go back. No matter how hard she argued with herself, she could not leave her landlord unattended until the duty nurse made morning rounds. It might be another two hours before the nurse arrived, and Cecilia had seen enough patients with kidney stones to know those minutes could last a lifetime.

She turned back, resigned to the fact that she could not even become angry with the man. She was too busy worrying over little Tommy Townsend.

As she passed back through the front gates and crunched down the weed-infested drive, her mind continued to circle over the latest developments in the child's case. The previous day's examination had yielded nothing new. Cecilia took no comfort in the youngster's proving an enigma to her boss as well. Tommy was nearly five years old and was not growing. He suffered from undefined aches and pains. One day it was his chest, the next his knees. He slept too much. He was listless. His fever varied by as much as four degrees in a twenty-four-hour period.

As Cecilia pushed through the front door, crossed the gloomy front hall, and started up the stairs, she reflected that Tommy's mother was almost as great a worry as the child himself. Angeline followed every diagnostic test with an overwrought horror.

She was halfway up the stairs when it hit her—the test she had failed to carry out, principally because she had never heard of it being used. It harkened back to earlier times, when tiny babies refused to grow, and underweight children were a tragic norm. Cecilia hurried on, determined now to finish here and get to the office so she could call Angeline Townsend and prepare her for yet another night of worry and dread.

The world and the morning did not truly come into focus until she pressed the doorbell and heard the scraping sound inside. She felt a rising tide of guilt, which crested when Brian Blackstone opened the door and stood there clenching his side and breathing in tight little gasps.

“Here, let me help you back to bed.” She slipped under his arm and felt the perspiration that sheened the skin of his chest. These panic-sweats were a classic symptom of kidney stones, and along with the off-side pain offered one of the speediest diagnoses in medicine. Together they made the journey back down the hallway and into the formal parlor. The air of faded grandeur was even stronger in the morning light. As was the desperately grateful look Brian gave her as he returned to his pallet.

The man's gratitude left Cecilia feeling even worse. No matter that he was stealing away her beloved Rose Cottage. He was a patient, and he was in great pain. It went against the foundations of her profession to realize that she had caused him to suffer unduly. “How long since the pain returned?”

“About an hour.” His face twisted into a parody of a smile. “But it seemed like closer to a year from this end.”

She tried to return the smile but could not. She wanted to apologize for her behavior but found that impossible as well. So she glanced at her watch, counted back, and came up at five hours since the earlier injection. “I'll make sure to return and dose you again before this batch wears off.”

“Thank you,” he whispered, the abject relief so strong in his voice and eyes that it pierced her heart.

“I assume from your reaction last night that you've not had a previous attack.”

“Never.”

“The muscle relaxant should help you pass the stone, especially if it is just dust. If it is a larger stone, we'll know by tonight.” She did not bother to explain that the total blockage caused by a large stone would result in a pain not even her strongest drugs could dull. No need to worry him with what hopefully would not happen.

“I'm sorry for scaring everybody last night.”

The fact that he was doing what she could not halted her in the act of opening the syringe package. “That's all right.”

“I never knew a pain could be as bad as that and not kill me.”

Cecilia went back to preparing the first injection. “My third year of medical school, when we were first starting our hospital rounds, a doctor listed all the nightmare agonies we could expect to face in our patients. It was her way of preparing us for the shocks to come. Kidney stones were right up there with terminal cancer, childbirth, and cardiac arrest.”