The Winter Rose (9 page)

"Dr. Gifford, the tumor may be operable," India said. "Or benign. If I
could persuade her to allow a vaginal examination, I could take some
cells. Make a slide. See if by some chance it is benign and if her pain
is caused by the pressure it's exerting."

Dr. Gifford put his pen down. His expression was thunderous. "Dr.
Jones, you are a new doctor, and inexperienced, so I will make
allowances for you... up to a point. In case it has escaped your notice,
this is an exceedingly poor area. The patients who come to this
practice barely have money for treatment, never mind surgery. Even if
Elizabeth Adams could afford surgery, she would not survive it. She's
weak and malnourished. We are overwhelmed here, and must put our
resources where they will be rewarded."

India swallowed hard. This particular issue hadn't been covered in
her ethics class. "I'm sorry, sir. This is not the medicine I was
taught," she said.

"It's the medicine you must learn," Dr. Gifford said. "This is not a
text-book, Dr. Jones, this is reality. Elizabeth Adams is a lost cause,
but the peo-ple waiting downstairs may not be. That is, if you deign to
examine them before the turn of the next century." He closed Mrs.
Adams's file and stood. "No more than ten minutes a patient, Doctor.
Good day."

"You're leaving, sir?"

"Is that a problem?"

"No, sir."

"I have patients to visit at London Hospital. I merely stopped in on
my way to see how you're getting on. Not well, from what I've witnessed.
I hope I have not made a mistake."

"You have not, sir."

"I would hate to disappoint your dean. Good day, Dr. Jones."

"Good day, sir."

India put her head in her hands. What a terrible beginning. She could
not lose her position. The mere thought of explaining to Dean Garrett
An-derson that Gifford sacked her because she hadn't been up to the
demands of the job was unbearable. As she sat fretting, a snatch of the
dean's graduation address came back to her: The eyes of the world are on
you now. Many will applaud your every triumph. Many more, your every
failure....

India had heard the words people used against herself and other
medical women--immoral, indecent, unsexed. She'd felt the ugliness
behind them, and she knew she must never give Dr. Gifford any reason to
regret his decision to hire her. She must not fail.

She remembered how every quarter, the same few lines appeared in the
school's magazine at the dean's behest: "Medical women are earnestly
requested to send notice of any appointments they obtain, or any vacant
ap-pointments they know of, to the secretary of the Medical School."
There were so few appointments obtained by medical women, so few
available to them. India knew that if she lost this one, she wouldn't
find another. But what Dr. Gifford had done--lying to a patient about
her condition--was unconscionable. She didn't have long to dwell on her
dilemma, however, as Ella was already leading another patient into the
office--a little boy accompanied by his mother.

"Henry Atkins," she announced. "Worms."

After young Henry there was Ava Briggs, a sixteen-year-old girl with a
severely infected jaw. Her mother had had all her teeth pulled two days
ago. By a blacksmith. "As a birthday present," she explained. "No
man'll marry a girl with her own teeth. Costs him a fortune in dentist
bills." After Miss Briggs there was Rachael Eisenberg, married a whole
month and still not pregnant. And Anna Maloney, who thought she was
seventy but couldn't really remember and had been constipated for two
weeks. Fifteen more followed, and then at noon, just when India thought
she would surely drop, Ella bustled in with a teapot and hamper.

"Bring anything to eat?" she asked. India shook her head. "Didn't
think so. We'll share mine. Lucky for you I keep an extra plate around."

"Oh, I couldn't, Sister Moskowitz."

"It's Ella..."

India bristled at her informality.

"... and you'd better. I don't have time to pick you up off the floor when you faint from hunger."

India forced a smile. Something was gnawing at her, but it wasn't
hunger. She'd put aside her misgivings about Dr. Gifford earlier to
concen-trate on her patients, but could ignore them no longer.

"Roast chicken," Ella said, placing half a bird on the desk,
"parsleyed potatoes, and kasha." She frowned, dug deeper, then
brightened. "And noodle kugel!" She handed India a plate and fork. "Tuck
in."

"There's enough for ten here. Did you cook all this yourself?"

"My mum did. My parents have a caff on Brick Lane. Kosher food."

India speared a potato with her fork. She was still standing up.

"Sit. Eat. Rest. You'll need your strength for this afternoon," Ella ad-vised.

India sat. She picked at her potatoes some more, then put her fork down.

"Is something wrong?" Ella asked.

India told her about her contretemps with Dr. Gifford.

"Yes... so?" Ella said, between bites of chicken.

"So? So how can I possibly continue to work here? To do so would be to condone the worst sort of medicine."

"Don't you even think of leaving," Ella warned.

"But how can I stay? I understand the need for expediency and
practi-cality in a busy surgery--of course I do--but this isn't a
question of ef?-ciency. It's a question of ethics. Of morality."

Ella laughed. "Oh dear. Brought your morals with you, did you, Dr. Jones?

To Whitechapel? That was a mistake. Tomorrow, leave those little buggers home."

India did not laugh. She glared. "What Dr. Gifford did is
indefensible. He should have informed Elizabeth Adams of her true
condition, explained her prognosis, offered her a choice of treatment,
including no treatment if that's what she wanted. But the choice should
have been hers. Not his."

Ella stopped eating. She stopped joking. "Dr. Jones, why did you take this job?" she asked.

"To help the poor."

"Then help them."

"But Dr. Gifford--"

"Shit on Dr. Gifford."

India sat back in her chair, shocked. "What a thing to say! You work for him."

"No. He pays me, that's all. I work for them," she said, hooking her
thumb in the direction of the waiting room. "There are two dozen people
downstairs. Poor people. Sick people. A lot of them are kids. Put your
qualms and quibbles aside and help them. That's all the morality you
need. All right, Dr. Jones?"

India didn't reply at first. Then she said, "It's India."

Ella smiled. She put another piece of chicken on her plate before
clearing up. "Sneak a few bites between patients if you can. I'll send
the next one in."

India never touched the food. She drove herself mercilessly all
after-noon and into the evening, seeing children with rattling chests, a
docker's wife whose husband had cut off her finger during a fight,
laundresses who could barely move because of wrecked backs, girls with
scurvy, a prostitute with syphilis, a boy who'd been attacked by a bull
terrier, several children with dysentery, two toddlers burned in their
hearths, a tubercular baby, and a little boy who'd swallowed a
sixpence--and whose mother wanted it back. She was just finishing with
her last patient, a factory worker with a swollen liver, when the clock
struck the hour--seven p.m.

"I'm giving you a prescription for liver pills," she told the woman. "And I want you to abstain from alcohol."

"How's that?"

"No more drinking. No whisky, porter, ale... none of it."

The woman looked at her as if she were mad. "I'd sooner give up breathing."

"You will if your liver gets much worse," India replied.

The woman laughed merrily and took her leave. Not one ounce of
self-control, India thought, watching her go. Working-class people
astonished her. They had so little, and yet they spent their hard-earned
wages on alcohol, sweets, and unnourishing foods they called
relishes--trotters, bacon, pickles, and such. Like Mrs. Burns, the woman
who had the tubercular baby. The little girl had been thin and pale and
gumming a brandy snap.

"Your daughter needs wholesome foods like milk and vegetables," India
had told her, holding up the colorful illustrations she'd brought.

Mrs. Burns had given her a look. "Aye, missus. I do know what a carrot is."

India colored. She put the pictures away. "Is she getting any milk?" she asked.

"It's not often we've the money for milk," Mrs. Burns said. "And me old man, he's not too fond of greens."

When India pointed out that if there was money for brandy snaps,
there must be money for milk, Mrs. Burns said, "Ah, now, missus, the
poor little mite likes her sweets, don't she? And as me old gran always
said, �A little of what you fancy does you good.' "

Milk did you better. And spinach and porridge. India tried to tell
her pa-tients this, over and over again. She'd watched her professors at
the Royal Free Hospital do the same with their patients. Often to no
discernible effect.

She sat down now to write up her notes on her last patient, but
before she could start, Ella poked her head in to tell her there was one
more. "A Miss Emma Milo," she said. "I tried to tell her to come back
tomorrow, but she's in a bit of a state."

"What's wrong?"

"She won't say. Said she heard there was a lady doctor here and she has to see her."

"Send her up and then we'll go home."

She returned to her file. A few minutes later, a voice said, "Excuse me, miss?"

India looked up. A red-haired girl, no more than eighteen, stood in the doorway.

"Sit down," she said, gesturing to the chair in front of Gifford's desk. "How can I help you, Miss Milo?"

Miss Milo didn't reply. She was fretting the drawstring on her small silk reticule.

"Miss Milo?"

"I need something ething to prevent babies from coming. I've heard
there are such things. Devices that doctors have." She looked up at
India with eyes that were huge and pleading. "I thought with you being a
lady doctor, you might help me." She dropped her eyes. "Please, miss,"
she whispered. "Please."

"I'm afraid I can't help you," India said regretfully. "This is Dr.
Gifford's surgery, and he does not dispense contraceptives. I don't
agree with his policy, but my hands are tied. If you are having
relations and don't wish to become pregnant, you must stop having them."

The young woman smiled bitterly. "It's that easy, is it?" she said.

"Miss Milo, I--"

"Thank you," she said and then she was out of her chair in a flurry
of swirling skirts, and for an instant India saw another young woman
hurrying away--not Emma Milo, but Bea Mullins, Hugh's sister. Emma Milo
turned back once to look at India, but India didn't see her, she saw
only Bea--pale, bloodied, mutely accusing. She willed the vision away.
There was nothing she could do. Nothing. Gifford had made his views on
contra-ceptives clear during India's interview. He felt they were
immoral devices that encouraged licentious behavior in the lower
classes, and he would not prescribe them. India had thought him a
dinosaur. She'd wanted to tell him that the greater immorality was the
poverty and wretchedness that came from too frequent pregnancies, but
she bit her tongue. She'd had to--it was Gifford's job or no job.

It was the first compromise she'd made. She saw now that it would not
be the last. She sat back in her chair. Her eyes traveled over the wall
oppo-site the desk, over all of Dr. Gifford's awards and honors. No one
at med-ical school--not Professor Fenwick, not the dean--had warned her
of this. How many compromises were too many? Four? Ten? A thousand?
Would denying Emma Milo contraceptives make her moral? Was lying to
Eliza-beth Adams mercy? Or murder?

"Excuse me, Confucius, are you ready to go?" It was Ella.

India blinked, lost in her thoughts. "I am," she said, shuffling her
papers together. "I'll finish these at home." She was weary and wanted
to get her boots off her swollen feet and eat a bowl of soup. She turned
off the lights, made her way downstairs, and was just helping Ella tidy
the waiting room when the door opened. It was Dr. Gifford. He was
dressed in evening attire.

"How did you fare?" he asked.

"Very well," India said. "We got through the entire roster."

"Well done!" Gifford exclaimed, looking over the patient log. "Fifty-four patients seen. Not bad for a first day, Dr. Jones."

"Thank you, sir."

"I was just checking in. Must dash. Dinner with the bishop. You don't mind locking up?"

India was too tired to turn the key in the lock, but she said she
didn't mind a bit. Gifford was bidding herself and Ella goodbye when
there was a battering on the door.

"Hold on a mo', will you?" Ella shouted, opening it.

A boy was standing on the step. "Can you come help us? The baby's
stuck!" he cried. India groaned. The soup would have to wait. Wondering
what kind of bandages she should bring, she asked the boy, "What did the
baby get stuck in? A drain? A chimney flue?"

"No, no! It's stuck inside me mum! It won't come out! She's in a bad way, miss, you've got to come!" the boy said.

"You can handle this, can't you?" Gifford said.

"Of course, Dr. Gifford," India said, reaching for her kit bag. She
opened it to check her supplies and realized she was low on a few
things. "Ella, do we have gauze? And I'm nearly out of chloroform. Have
we any?"

Gifford, already on his way out, turned around. "That won't be neces-sary," he said.

"Beg your pardon, sir?"

"The chloroform won't be necessary," he said. "I do not allow the use of anesthesia on laboring women."

"But Dr. Gifford, there's no threat of danger to the mother. Simpson
and Kelly both agree that chloroform does not impede labor, and
furthermore--"

Gifford cut her off. "Thank you, Dr. Jones, but I do not require
instruction on anesthesia from my junior. I am well aware of chloral's
properties. Labor pain is Eve's legacy, and to ameliorate it would be
against God's will. Birth pains are good for women. They build character
and inhibit indecent feeling."