A HAZARD OF HEARTS (20 page)

The Senior Surgeon was a kind man, Elly
believed, but stubborn in his refusal to accept new ideas, of which antisepsis
was one. Nor did he take kindly to suggestions from staff, however senior. Elly
quailed at the thought of the imminent operation, due to be conducted without
anaesthetic. A child. A little boy, already terrified, torn from his mother,
suffering a gangrenous infection of the leg, and about to be subjected to the
horror of the knife and bone saw.

‘Doctor Houston...’

He hurriedly drew out his watch and examined its
face.

‘My goodness, can that be the time already? I must
go. I leave all in your capable hands, Matron. Good day to you.’ He raced off
down the hall, coat tails flapping about his knees.

Elly sighed and scanned her notes again. Simon Leonides,
aged five. The surgeon would be Doctor Phineas Gault. Well, she could at least
ensure that the theatre and instruments were scrubbed clean.

Half an hour later she stood beside the table
where a child lay strapped down, unable to as much as wriggle his one good
foot. Despite the effects of a dose of laudanum, panic-stricken eyes stared up at
her from a tangle of wispy brown hair, and gaslight flickered over a face as
pale as skimmed milk. The boy’s breath came in uneven gasps as his thin chest
pushed against the restraining leather. His infected limb had been stretched
out away from his body, already looking like some alien attachment, a pulpy log
of greenish-grey flesh, the toes starting to rot away. The clean instruments
lay on a nearby cloth-covered tray, ready for the surgeon. But Mr Gault was
late.

Elly tried to soothe the child, stroking his
head and promising him it would soon be over and he would see his mam. She
wiped his sweaty face and trickled a little water onto his dry lips, her own
eyes shadowed with the knowledge of what was to come, her mouth compressed with
anger at the unnecessary pain and danger, and at the surgeon’s callous
indifference to his patient’s mental agony while he waited and waited.

At last the surgeon bustled in brandishing a
filthy, rust-stained saw. ‘I found it at last. My favourite tool. I don’t like
to operate without it by me.’

A small man crowned with tight, dark curls, he
had tiny pigeon-toed feet that carried him forward in a peculiar trotting gait.
His face, set in discontented lines, had an unhealthy cheesy texture as though
it rarely felt the sun. Elly concentrated on the awful saw and the small grubby
hands holding it, the fingernails dark with encrusted blood.

‘Doctor, I have already cleaned the instruments
for you.’

‘No, thank you, Matron. I prefer to use my own. Ah,
I see the patient is ready for me. Well, let’s get down to business. I have a
busy schedule this afternoon, and already I have delivered two infants and
carried out a post- mortem examination of a most interesting case. The man died
of syphilis as a primary cause, but he had these peculiar lesions...’ He
prattled on.

Elly had ceased to listen, her gaze fixed in
horror on those dirty hands. She hastened to a nearby table, saying, ‘Doctor,
here is a basin of water with chloride of lime, if you’d care to wash now.’

‘Wash? Whatever for? I washed this morning. I
also particularly dislike the chemical odour. Throw it away, Matron.’ He stared
around him. ‘Now, I see the patient is well-restrained and all is in order, so
I shall not need your services after all. One of the wardsmen can take over when
I’ve finished.’

‘Doctor Houston asked me to stay with Simon to
comfort him and try to ease him over the terrible shock.’

Gault seemed nonplussed. ‘The shock? Oh, you
mean nerve pain.’ He glanced at the boy’s face for the first time. ‘He’ll
probably faint when I reach the bone. But if you’re worried about his screams I
can apply the gag.’

Elly swallowed her indignation and said firmly, ‘As
you know, Doctor, shock can kill, and your patient is very young. No doubt you
have heard of the recent use of ether to anaesthetise patients undergoing
radical surgery. I wonder whether you would care to try it in this case, since
I happen to be practised in administering the drug?’

‘Ether? Don’t believe in it. Radical nonsense. We
are meant to bear pain in this life. The Bible says so. And I must say I do not
appreciate uncalled-for advice from a mere nurse.’ Gault’s face had grown pink
under its cheesy surface.

Elly disregarded the warning. ‘Doctor, it can
only enhance your fine reputation to increase the number of patients who
survive your surgery. The death rate noted by my father in his practice
improved considerably when patients did not have to contend with severe pain
and shock –’

In what seemed like an echo from her last
terrible day at The Settlement, she heard him say, ‘I have absolutely no interest
in your father’s practice, nor in your advice, Matron. I now propose to proceed
with the operation.’ Gault strode over to the table, ignoring the child’s whimpering
as he sought reassurance from this strange man with the bad-tempered face.

Elly moved swiftly to the other side and leaned
protectively over the child. ‘For God’s sake, will you not wash your filthy
hands? You’ve attended two births and handled necrotic tissue this afternoon
and now you’re preparing to cut into healthy flesh. You will be passing along
infection.’

Gault’s voice trembled. ‘Get out. Get out now. I
don’t want you here. I shall report your insolence to the Committee.’

‘Report it to the full Board, if you like. I’ll
be doing battle with them anyway.’ Elly, flushed and trembling herself, placed
a hand on the boy’s shoulder. ‘I won’t leave this child until you’ve finished
your butchery and have gone on to the next victim.’

In answer, Gault picked up a knife from the tray
and sliced straight across the boy’s thigh, splitting skin and tissue to the
bone. Elly closed her ears to the boy’s shrieks. Her hands flashed to the
clamps as she moved into the familiar rhythm of surgery, praying for Gault to
be swift. When he grasped the filthy saw, she swallowed the bile in her throat
and tried to prepare herself. An unearthly scream was wrenched from the boy’s
throat as the blade bit, dragged across bone and nerve and back again, hacking
once, twice more before the severed leg dropped away. Elly glanced at the boy’s
face and saw he had, indeed, fainted. She measured his pulse while Gault busily
sewed away at severed blood vessels, then prepared a flap of skin to go over
the stump. The pulse beat faintly and the cloth beneath the child’s body was
saturated in a crimson tide.

‘He has lost a great deal of blood,’ she said.

Gault ignored her. If he prided himself on his
speed, Elly thought, he had every right to. Within minutes the job was done and
the surgeon stepped back, wiping the blade of his saw on his coat. The little
eyes bored into hers.

‘The patient is now in your care, Matron.’ He
moved with his peculiar gait to the door, then turned and added, ‘I shall not
forget this. You will regret your words today.’

Elly ignored him. She placed a pad saturated
with a solution of chloride of lime over the wound and bound it up, then
released the straps and lifted the child onto a wheeled stretcher. Under no
circumstances would she allow him to be thrown into the chaos of a male ward,
with only wardsmen to watch over him. Little Simon would go into the exclusive
care of Nurse Pearl.

Simon Leonides never recovered consciousness. In
the early hours of the morning, while Elly and Pearl and his mother watched
helplessly at his bedside, his small heart gave up the struggle.

The following day Elly received notice to attend
a special disciplinary meeting of the Board of Directors that afternoon.

Having already attended three monthly Board
Meetings, Elly now knew what to expect, although the faces around the table
varied from month to month and there had never before been a full attendance of
the twenty-four directors, four major-office holders, medical officers and
district surgeons. The room, wreathed in smoke from expensive cigars, was
crowded, with extra chairs brought in for those who could not command a seat at
the table. At its head presided the Honourable Edward Deas Thomson, Colonial Secretary
and intimate of the Governor himself. Beside him, his Vice-President, Captain
Dumaresq, M.L.C., tapped a pencil impatiently, and next to him, the Treasurer
and Secretary sat with solemn faces.

As Elly entered, the chatter died and
thirty-seven pairs of eyes focused on her. For this occasion she wore her best
woollen gown in midnight blue, severely cut and edged with simple braid, which
she hoped gave an impression of style and dignity. Her matching bonnet framed
her face charmingly, she knew, and made a good substitute for the braided
coronet she could no longer display. It took more than seven months to regrow
hair which had, in places, been cut within two inches of the scalp. Vanity
aside, she needed all the ammunition she could produce for this encounter.

Searching the room for a friendly face her gaze
skimmed over Doctor Hugh Houston, but he glanced quickly away. Doctor Phineas
Gault, on the other hand, pinned her with a dagger glare, his discontented
mouth primmed and ready to accuse. Her skin prickled as she felt again the
peculiar sensation of being watched with special attention. Was it the same man,
the owner of the brown eyes in a face she couldn’t remember, somewhere in the
crowd? But there was no time to search for him. Already the meeting had been
called to order by the President. Elly took the chair held ready for her, and
proceedings commenced.

Mr Deas Thomson cleared his throat. ‘As Chairman
of this special gathering I have to announce that it has been convened at the
request of several members following a most scandalous and scurrilous report on
this hospital printed recently in
The Empire
newspaper. There is also
the matter of a complaint against the Matron, Miss Ballard, put forward by one
of our Medical Officers, Surgeon Phineas Gault. In the first matter, since it
is known that Miss Ballard conducted a certain journalist through the hospital
with a view to commenting upon its standards, I believe we should ask her for
an explanation.’

Elly rose. ‘Gentlemen, I am perfectly prepared
to explain, and to apologise for the extreme attitude adopted by Mr J.G.
Patterson of
The Empire
. I have here a letter of apology addressed to
the Board and signed by him.’ She handed this to the Secretary before
continuing.

‘It’s true that I took the opportunity to show
him certain deficiencies in the building and facilities well known to you all
and which have been the subject of petition from me for the past three months. I
believe that, as a member of the public who support this Infirmary and
Dispensary, he had a right to know the truth and to request the help of others
who might be interested in improving our conditions. He did not have the right
to criticize my staff in such unbridled language, nor to impugn the work of
this Board of Directors. I specifically asked him not to do so and, at the
time, made clear to him that I wished only to excite public interest, not to
lay blame on anyone. Unfortunately, he paid no attention to my wishes, with the
result that unnecessary offence has been given. The initial fault was mine, and
I apologise most sincerely.’ She sat down to hide her trembling knees.

Mr Deas Thomson regarded her sternly. ‘Your
apology is noted, Matron. Nevertheless you should be aware of having far
superseded your role. Regrettably, your forwardness has only succeeded in
bringing the hospital you purport to care for so devotedly into disrepute, not
to mention the men who serve this institution without favour or reward.’

Elly bowed her head in apparent remorse, but she
felt only contempt. Where was the ‘service’ by a group of men who met simply to
hear themselves talk and who never by any mischance did anything to overcome
the huge problems she had listed for them? As for favour and reward, their
names gained the lustre of benevolence without a finger being raised.

‘If I might speak, Mr Chairman?’

The voice, rich in timbre, carried through the
room. Elly turned quickly to see a man of middle height but great presence rise
from a back corner. Beardless, although with a luxurious moustache, his face
was lined about the temples and mouth to show at least forty years of living.
He had a broad, high forehead, strong straight nose and black hair curling
thickly. His dark gaze had a compelling quality that she immediately recognised
and had been so conscious of at her first Board Meeting. This was the anonymous
surveillance she’d experienced as strongly as a physical contact. Feeling the
strength of this man’s personality, she was strangely heartened. He would help
her. She knew it.

The President inclined his head. ‘We should be
glad of your views, Mr Cornwallis.’

Cornwallis bowed and produced a folded paper
from his jacket. ‘I have here a copy of the article in question, and with the
greatest respect, would point out to my fellow members of the Board of
Directors that there is not one untruth to be found in it. The writer has not
misrepresented the hospital in any way. I have made it my business to delve
into his accusations and can only say that “disgrace” is almost too mild a word
to apply to conditions obtaining in the main buildings and ancillary
structures.’