John had failed and another woman was dead. Soon the rumors would begin again, whispered through the sooty laneways and alleys of St. Giles, spreading fear and ignorance like a foul contagion.
The Angel of Death.
That was the name some of the locals called him. He could hardly blame them, although cold logic told him they were wrong. Still, Death trailed in his footsteps. No matter how fiercely he struggled to best it, in these dark places he rarely emerged victorious.
John dropped his scalpel into the tray lying on the floor next to the rough-hewn bed. A battered wooden table, a few mismatched and broken chairs, and an old trunk made up the rest of the tenant's furniture. In the fitful light cast by one old lamp and a few smoking candles, the room testified to the hardscrabble life eked out by the wretched souls in the London stews.
Roger Simmons, his assistant and medical student, carefully drew a tattered, grime-encrusted blanket over the body of their patient. Patients, rather, since John had been unable to save Mrs. O'Neill's baby, either. The stillborn infant lay in his mother's arms, joined with her for eternity, which John hoped was a more forgiving place than this dreary pest-hole.
“There wasn't another thing you could do to save her, Dr. Blackmore, and you know it.” Roger's rough voice, still bearing the faint traces of his upbringing in Spitalfields, broke the unearthly quiet of a room that had vibrated with a woman's screams just a short while ago.
“So you say.”
The words scraped raw in John's throat as he rubbed the blood from his fingers with a scrap of cloth. Once it had become clear Mrs. O'Neill was breathing her last, he'd cut her open in a futile attempt to save the babe. But, as usual, he was too late. The poor of St. Giles rarely sent for a doctor or surgeon to deliver an infantânot that most doctors would even set foot in the placeâand put their trust instead in neighbors or relatives to assist in the birth. If they were fortunate, they could perhaps afford a midwife, but in this benighted part of London even that was an unusual occurrence. So by the time someone became desperate enough to run to St. Bartholomew's Hospital to fetch him, the unfortunate woman was often beyond help.
“Sir, you know her pelvis was too small, too disfigured.” Roger carried on doggedly, wiping medical instruments clean before stowing them back in John's bag. “Her life was slipping away by the time we got here. A caesarean was the only chance we had to save the infant. You know how many of these women have rickets. Christ, we've seen it often enough these past monthsâespecially among the Irish.”
The certainty of that knowledge offered John little comfort.
He bit back a frustrated oath and threw the bloody cloth into the tray. It would take more than a few bits of cotton to scrub the gore from his hands and arms. And God only knew what it would take to wipe clean the stains that marked his soul.
He turned away from the bed, rubbing his neck, searching for the knots that felt like pieces of lead shot under his fingertips. Exhaustion leached through his veins, and he suddenly craved the solitude of his study. And a brandy. A very large brandy.
Roger gave him a sharp look as he shrugged back into his coat. “If you don't mind me saying so, sir, I'm thinking this would be a good time to make that trip up north you've been talking about. To visit Dr. Littleton. Why don't you leave tomorrow or the next day? Dr. Wardrop will be happy to see to your patients while you're gone.”
“You know I haven't the time to spare,” John replied as he retrieved his unused forceps from the tray and handed them to Roger. His assistant had an annoying tendency to fuss over him like an old hen, but John couldn't seem to break him of the habit.
Roger grimaced. “You need the rest, guv,” he said, slipping into his old pattern of speech. He only did that when frustrated. “You've been working flat-out for months, trying to make those old chawbacons at Bart's change their ways.”
John started to answer when a heavy thud sounded against the only door leading into the room.
“What's happenin' in there? I ain't hearin' my Mary screamin' anymore. Is the babe come?”
This time John didn't bother to hold back his curse. Derek O'Neill had been openly hostile when they had arrived an hour ago, fetched by a local woman who had once been a patient at St. Bartholomew's Hospital. O'Neill had made it abundantly clear that the last person he wanted to entrust his wife to was an English physicianâand a swell bastard at that, he had growled, flinging the epithet in John's face. Only the fact that his wife continually shrieked in agony had finally convinced the belligerent man to let them into the room.
John cast one quick glance over Mrs. O'Neill's body. He and Roger had cleaned her as best they could, but the woman's blood was everywhere. There hadn't been enough water or time to do a thorough job of it.
“Shall I let the man in, sir?” Roger looked almost as grim as John felt.
“A moment, please.” He buttoned his waistcoat, shrugged into his coat, swiped his fingers once more in a useless attempt to better clean them, and then nodded to his assistant.
Roger had barely cracked the door open when O'Neill shouldered his way into the room. The big, dark-haired immigrant, loud and blustering only a short time ago, took two steps before stumbling to a halt, his face turning pale as milk. His horrified gaze fastened on the bodies lying in the narrow bed.
John crossed the small space to stand in front of him, blocking out the gruesome scene behind.
“Mr. O'Neill, I'm very sorry. Your wife labored too long, and she was too weak to survive such an ordeal. She died before she could birth the child. We attempted to save your son, but that was beyond our powers, as well. I grieve that we were not able to help them.”
Eyes the color of mudâdark pools of anguishâshifted to meet his.
“A son?” O'Neill's brogue was a shattered whisper.
“Yes,” John replied, his throat pulled tight with bitterness and guilt.
The big man stepped around him and fell to his knees beside the bed, a low moan of pain coming from his throat. The sound rose, gaining intensity until it became a howling wail that raised prickles along the back of John's neck.
Drawn by the awful noise, Mrs. Lantonâwho had fetched him from the hospitalâand several other neighbors crowded into the doorway. Sadness etched the features of some. Others displayed the avid and morbid curiosity so often evoked by an agonizing death.
John held back the sharp words that threatened to fall from his lips. It would be cruel to reprimand them for using their curiosity as a defense against the calamities that so often befell them. He had come to understand it was a way to distance themselves from the mundane horror of daily life in the rookery.
He gestured to Mrs. Lanton. She crossed swiftly to his side.
“Does Mr. O'Neill have any relatives in London who could assist him?” he asked quietly.
She shook her head. “He's all alone now, sir, except for the likes of us. He and the missus,” her gaze drifted to the appalling tableau by the bed, then jerked back to him, “they only arrived in London six months ago. She was a love, but he's a bit of rough trade, if you get my meaning. Still, he was devoted to his Mary, that's for sure.”
“Is there anyoneâ”
John broke off as O'Neill surged to his feet. The Irishman turned from the bed to confront him, his face contorted by grief and fury.
“You killed 'er.” His voice was guttural and thick with hatred. “I hear what they say about you, what you do to our women. They don't survive once you get your hands on them, you bastard. Do they send you here to kill us, your mighty lords and masters in the City?”
Mrs. Lanton drew in a shocked gasp, but the growing crowd now jostling in the doorway began to murmur with anticipation. John ignored them, focusing on O'Neill, flexing his tired arms as he prepared for what might happen next.
The distraught husband took a menacing step forward. Roger circled around behind him, his hands clenching into sturdy fists. His assistant might have left the streets of Spitalfields long ago, but he was always game for any fight.
John gave his head a slight shake, signalling Roger to stay where he was.
“Mr. O'Neill, I am truly grieved for your loss,” John said gently. “I swear to you that my assistant and I did everything we could to help your wife and child. But we do not possess the power of life over death. Only the Lord can affect such a miracle. Your wife's soul is now in His hands.”
The platitudes stuck in his throat. Miracles tended to be in short supply in St. Giles, as they were in his own life.
O'Neill's face went from dead white to mottled red in seconds. “I say you killed 'er, and now I'm going to kill you.”
He lurched at John, his massive fist a blur in the air. John smoothly blocked the man's punch but didn't strike back. The man deserved his sympathy, not a beating.
His momentum carrying him forward, O'Neill staggered past John and tripped, crashing to the floor with a bonejarring thud. Roger threw himself on top of the Irishman and wrapped his forearm around his neck. O'Neill twisted violently as he tried to break Roger's punishing grip.
“Don't just stand there, you fools,” yelled Mrs. Lanton to the men gawking in the doorway. “Get in here.”
Three or four neighbors rushed in and helped restrain the raging man. They pushed O'Neill to the floor where he continued to struggle, crying out his grief in wrenching sobs. Cursing, John grappled his way through the tangle of limbs and peeled Roger from the pile of writhing bodies, hauling him to his feet. His assistant shook himself like a dog coming in from the storm.
“We best be off, Dr. Blackmore,” he said. “Not much more we can do here.” His gaze shot to the door, and to the rapidly growing mob out in the alley. “And it looks like things might be getting a bit ugly.”
John followed his glance, noting the suspicious looks directed his way and hearing the hostile tones in the build-up of voices outside.
“You would appear to be right,” he responded, trying to keep the bitterness from his voice. His failure slashed like a blade through his gut, as sharp and unforgiving as death.
He retrieved his medical bag and headed for the door. Mrs. Lanton followed him.
“You mustn't mind sir,” she whispered. “Some of these folk don't know any better. But there's plenty who do know all the good you do for our sick women and babies. And I don't forget what you done for me over at Bart's, neither. You saved my life, you did.”
He forced himself to smile into her careworn face. “Thank you, Mrs. Lanton.” He extracted a guinea from his pocket. “For Mrs. O'Neill's funeral.”
She pocketed the coin. “I'll take care of it, sir. Now you best be on your way.”
John took one more look at the anguished man sobbing on the hard-packed dirt floor, at the tiny, foul-smelling room, and at the pathetic, slight figure with her lifeless baby in her arms. Clenching his jaw, he pushed his way through the crowd at the door, eager to be gone from this squalid place of grief.
He and Roger strode along the dingy, narrow street toward Drury Lane, doing their best to ignore the scowls and muttered comments that followed in their wake. Bitterness still pulled at his gut, along with a low throb of something akin to despair.
He glanced over at his assistant. Roger had a small cut on his cheek and what would soon be a spectacular black eye.
“Blast you, Roger,” he growled. “I could have dealt with O'Neill. You needn't always try to protect me. You're just as breakable as I am.”
Roger shook his head. “Sorry, sir, but we can't have you damaging your hands. Besides, what would Dr. Abernethy say if you showed up for hospital rounds looking like you'd been in a brawl? You know he's waiting for any excuse to report you to the Board of Governors.”
John gave an irritated grunt in reply. Roger was correct, of course, but the knowledge still stuck in his craw. Abernethy was an idiot, but the chief surgeon would take the first opportunity to toss him out on his ear. If that happened, John would almost certainly lose his growing practice in Mayfair.
He strode into the bustle of Drury Lane, suddenly disgusted with all the messy compromises that made up his life. Perhaps Roger had a point. Perhaps it was time to get away from London, away from the politics of the hospital and the demands of his aristocratic patients.
More importantly, he had to get away before he had to stand by and watch another helpless woman succumb to an agonizing death.