The Moon by Night (41 page)

“I guess so,” Geraldine said wearily. “I been so cold for so long I can't tell if I'm froze or thawed.”

Wilhelmina, through her tears, cackled a little. “Ain't she something, though? Game little chicken. Anyways, Gerry, didn't you hear the doc? He's gonna admit us, so we'll be staying here awhile. Beats that cold old hole at Meg Fancy's, don't it? Swells stays here, they do. I seen 'em. We'll be swells, Gerry, for a day or two. We'll just pretend we're swells.”

“You do that,” Marcus said dryly. “Dr. Varick, you've done fine, but on second thought I'll take over their care. I'd have to be the admitting physician anyway. Thank you.” He effectively elbowed Stephen aside. “Tell Carlie to bring the supply cart down, please. That will be all.”

Stephen left with a shrug and gave the message to Carlie.

The emergency department was equipped with two three-tiered rolling carts that had all of the supplies, except surgical instruments, that were usually needed for either the dispensary or the emergency room. Carlie checked them over and over again when he was on shift. He had already checked them three times that night, but he stood in front of one of them and under his breath said the names of the supplies and drugs as he looked at each item. When he was satisfied that Dr. Pettijohn would find no fault, he rolled the cart down the hallway. The curtains to Wilhelmina's cubicle were open, so Carlie stood still and watched Dr. Pettijohn finish dabbing Wilhelmina's arm with sweet oil and then wrap it.

Impatiently Dr. Pettijohn motioned to Carlie. “Here, roll it on in here, Carlie.”

He rolled it in. Dr. Pettijohn poured an enormous dosage of laudanum into a glass and thrust it toward Wilhelmina. “Here, this will help you sleep. At least, I hope it will, so maybe my other patients can sleep too.” He went to Geraldine's bed and threw the covers down. “I'm going to look you over, Geraldine, and make sure this baby's all right,” he said with frigid politeness.

Carlie stood stock-still, shocked. Dr. Pettijohn had moved from touching Wilhelmina's infected arm to examining another patient. He hadn't washed in the carbolic acid basin on the cart.

Carlie had often seen Dr. Pettijohn make just a cursory wave through the carbolic acid stands in the ward, and he had seen him neglect to wash altogether on busy nights in the emergency room. But this time even Carlie could see that Wilhelmina's arm was unclean. He wondered if Dr. Pettijohn had just forgotten. But with a sigh, he knew he couldn't—shouldn't—try to correct a doctor. Doctors knew a lot more than he did.

Marcus had just shoved the glass of laudanum into Wilhelmina's left hand, so she was struggling to sit up to drink it. Carlie noticed her difficulty and hurried to help her sit up, sliding his arm under her shoulders and propping her up. She drank, then smacked her lips. “Mmm-mm. That's good whiskey, even if it is raw! I never cared for that refined stuff, anyways—”

“That is laudanum, madam,” Marcus snapped without turning.

Wilhelmina and Carlie exchanged half-frightened looks. “Yes, sir,” she said, suddenly weary. “If you say so.” Gently Carlie laid her back down and took the glass from her. He put it into a covered pot on the bottom of the cart.

Then furtively, his eyes darting warily toward Marcus's back, he scrubbed his hands for long minutes in the basin of carbolic acid.

Thou shalt not be afraid for the terror by night;

nor for the arrow that flieth by day;

Nor for the pestilence that walketh in darkness;

nor for the destruction that wasteth at noonday.

Psalm 91:5–6

On Wednesday Cheney came in at two in the afternoon, feeling rested and fortified from her two days off. She had slept and caught up on some reading. She and Shiloh had done Christmas cards, and they had taken Sean and Shannon to Duvall Court on Tuesday. Her mother had been surprisingly complaisant, allowing the dogs into her house. They had been fairly well behaved, except for an unfortunate incident with a tray of cinnamon muffins that Madame Gallot had placed on a tea table. Before anyone noticed, the dogs had eaten six of the eight muffins. To be scrupulously fair, the low table was nose high, but Shiloh had said that they must learn to resist temptation just like him and all the rest of the mutts. When Shiloh had scolded them, they looked so downcast, with drooping ears and tails and tragic eyes, that even Irene had told Shiloh not to fuss at them anymore or they might start weeping with despair.

After tea Cheney and Shiloh and the dogs had passed out on the thick Turkish carpet in the parlor in front of a roaring fire. Irene and Richard and the parlormaid had tiptoed out, and they had slept for two hours. Cheney couldn't remember when she had had such a fun yet relaxing day.

But as soon as she came into the hospital, she sensed that she was going to need all the fortitude she could muster. The dispensary was busy, with Nurse Abbott scurrying about, pushing the supply cart. A child was wailing. At the nurses' station, Mrs. Flagg looked up at her with eyes shadowed by weariness.

“Good afternoon, Dr. Duvall. I hope you enjoyed your time off?”

“I certainly did,” Cheney answered, taking the patient charts and perusing them as she removed her hat and scarf and gloves. “Three check-ins, I see…one infant born—Baby Girl Cranmer? The mother hasn't named her yet?”

“No, Doctor,” Mrs. Flagg said in a low voice. “Miss Geraldine Cranmer has puerperal fever.”

Cheney's head jerked up. “What! Who diagnosed it?”

“Dr. Buchanan.”

“Oh no,” Cheney groaned. “But—I see she's actually Dr. Pettijohn's patient, is she not?”

“Yes,” Mrs. Flagg answered hesitantly, looking around. Nurse Alsop walked by, carrying a pile of clean towels and blank patient files. A young man, carrying a book in one hand and a box of chocolates in the other, stopped at the desk. “Could you direct me to Mrs. Brownlee's room, please?”

“No, I cannot,” Mrs. Flagg said sternly. “She cannot have visitors because her condition may be contagious. Please go over there and wait, sir, and someone will be with you shortly.” She turned back to Cheney, who was still studying the charts. “Dr. Duvall, I believe that Dr. Buchanan particularly wanted to speak with you before you began your shift.”

“Oh, is he here? Where shall I find him?”

“If you'll go to the doctors' sitting room,” Mrs. Flagg said, rising, “I'll find him and let him know you're here.”

Cheney went to the sitting room and put up her hat, cloak, reticule, and gloves. She filed through the coveralls to find her size and pulled it on.

Dev came in and kissed her cheeks, as he did sometimes. “Hello, Cheney, dear,” he said. “You are lovely today. I'm so glad you look rested and refreshed.”

“Meaning I'm going to need it?” she asked, a rhetorical question since she could see the gravity behind Dev's light greeting. Taking his hand, she led him to the sofa and pulled him down beside her. “Go ahead. Tell me the bad news.”

“We now have five in-house patients with influenza. Mrs. Brownlee and Mr. Reese are in grave condition,” Dev said, watching her face. She grimaced but nodded.

He continued, “Dr. Pettijohn admitted two…ladies…on Monday night. Miss Wilhelmina Jones had a burn on her arm that had turned gangrenous, and I amputated Tuesday morning. Miss Geraldine Cranmer was admitted with her and delivered a girl Tuesday morning. The child is undersized and seems rather listless. However, she is tolerating Nestlé's Infant Milk Food, so that is encouraging. What is not encouraging is that Miss Cranmer has puerperal fever.”

“Dev, how could this happen?” Cheney asked with distress. “Please don't tell me you think she contracted it here.”

Puerperal fever, or as it was commonly called, childbed fever, was a deadly infection that was rampant in the days before a brilliant young doctor named Ignaz Semmelweis discovered that simply scrubbing the hands thoroughly prevented doctors from transmitting the deadly infection to mothers when they examined them. Since his studies and the publication of Joseph Lister's carbolic acid antisepsis program, childbed fever was virtually never seen in hospitals that followed the protocols. It had gone from being a very common, usually fatal, infection to an extremely rare affliction among postpartum women who received hospital care. Even hospitals and physicians who still did not adhere to Lister's full carbolic acid antisepsis program had learned to scrub with the antiseptic before examining pregnant or postpartum women.

Dev answered evenly, “She is a prostitute, she drinks heavily, her personal habits are careless. She didn't have any infectious symptoms when she checked in, Cheney, but it's entirely possible that she was developing some sort of septic condition unrelated to the pregnancy. We'll know more when—” He stopped abruptly.

“I know, Dev, and don't think you're being cold-blooded when you say it,” Cheney said quietly. “We'll know more when we do the autopsy. I can tell already, just from what you've told me, that she very likely will die. How is the amputee?”

“She seems to be doing as well as can be expected considering her general debilitation from the life she's led,” Dev answered cautiously. “But she is very close to Miss Cranmer. She's an older woman and seems to have sort of adopted her. So it is difficult to judge how Miss Cranmer's illness, and the baby's ultimate prognosis, will affect Miss Jones. At any rate, Cheney, I wanted to talk to you about your patient Cornelius Melbourne.”

Cheney sat up straighter, a move that betrayed her tension. “I know. I saw on the chart that you moved him to a private room. What is it, Dev?”

He reached over and took her hand. It was cold, and he rubbed it lightly between his. “I want you to examine him, Cheney, because it's very possible I'm wrong. You are his physician, and you have a better understanding of his condition than do I. But I have been monitoring him closely, and I believe he has contracted tetanus.”

Cheney's face paled with shock, and she gripped Dev's hands convulsively. Then she rose and paced to the window, staring out at the bleak winter scene. There was no sign of life in the colorless ground and gray sky and spiky skeletons of the trees, but it did have a spare, stark beauty of its own.

“What stage?” she asked in a tight voice.

“He just started complaining of feeling tightness in his jaw and of his mouth feeling sore from gritting his teeth. He said it was much like when your teeth chatter when you have a high fever, but he didn't feel feverish. He just kept gritting his teeth, he said, without meaning to.”

“Oh, Lord have mercy on his soul,” Cheney whispered in a raw voice. She turned around and now her face, so bright and glowing before, was a mask of sadness and even despair.

“Oh, Dev, I tried so hard to clean out that wound! I swear, Lawana and I took long minutes that were so tense because he was so gravely injured, but still I insisted that we take the time to check and double-check! I couldn't see anything below the level of the dermis, not a speck!”

He rose and went to her, taking her by the shoulders and looking down into her anguished eyes. “Cheney, you know better than this. You said yourself that he was covered in mud. I'm not at all surprised, by the nature of the wound and the conditions of the accident, that he contracted tetanus. You did everything humanly possible to protect him, but sometimes, in spite of our utmost care, patients can still be afflicted with such terrible things as erysipelas and septicemia and pyemia.”

“Why? Why did it have to be tetanus?” Cheney said bitterly. “The highest fatality rate of any disease, except hydrophobia. He's young; he's strong; he could have fought off almost anything else!” She jerked away from him and turned back to the window. With an awkward movement she brushed her hand against her face. Dev stood silently behind her, just waiting. After long moments she took a handkerchief out of her coverall pocket, scrubbed her face with it, and turned around. “I'm ready now. I know that you're right, Dev, but I'm going to examine him thoroughly.”

“Of course, Cheney. I might be wrong. I've been wrong before.”

“Oh? And when was this?” she said with rough amusement. “Never mind, Dev, I was just teasing you. Anyway, I would like to ask you two favors.”

“Anything.”

“Would you please come in with me when I talk to him? You make patients feel very secure, and he's going to need all the help he can get.”

“Of course, if you think it's best, Cheney.”

“I do. And now, would you please pray with me before I go to work? I'm still a little frayed about the edges.”

He took her hand again. “I surely will. But, Cheney, is Shiloh here? Would you like me to go get him?”

She started to answer, then hesitated, her brow furrowed. Finally she said in a low voice, “No, not right now. It's too complicated to explain to him quickly.”

“All right, then. Let's go to the chapel, Cheney. I try to remember to go in there and say a prayer whenever I come in, but I usually am so taken up with ‘the cares of this world,' you might say, that I forget,” he finished lightly as they left.

“‘The cares of this world,'” she murmured sadly. “‘These are they which are sown among thorns….' That's not us, Dev. And I pray to God that it won't be Cornelius Melbourne's fate either.”

They prayed for each other and for their patients. Even as she prayed, that chattering irreverent voice inside her head went on and on about how she was neglecting her Christian walk because she wasn't praying and studying the Bible with Shiloh every day, as they had promised each other. And the reason she wasn't doing that was because she was so busy that she was neglecting both Shiloh and the Lord. And particularly she didn't press Shiloh to pray with her because she felt horribly guilty about never mentioning Cornelius Melbourne to him.