The Witch’s Daughter (23 page)

As Eliza sprayed quantities of carbolic over the table and into the air, she continued to search the faces looking down at her. She noticed two new students sitting together, both possessed of the same abundant red hair, and remembered there were two brothers starting their studies that morning. Then, on the edge of her vision, a lone figure caught her attention. He sat near the back of the amphitheater at a distance from the others. He was tall and wore a dark frock coat with restrained but elegant collar and silver buttons. He carried a black cane on which he now rested both hands in front of him. Even in the clammy confines of the amphitheater, he had chosen to remain in his cape and top hat, the silk of which gleamed under the gaslight. Eliza knew at once that he was watching her. Not in the casual, time-passing way some of the others might but intently. Closely. With acute interest. She tried to shake off the sudden feeling of unease that had settled about her and was relieved to see the door of the theater open. Phileas Gimmel, FRCS, strode into the room followed by an orderly wheeling the hapless patient.

Dr. Gimmel was a man who commanded respect without ever appearing to wish for it. He had about him the air of one who was driven, one with boundless enthusiasm for his profession and a genuine desire to impart his wisdom to others. He had also a roguish gleam in his eye and a ready smile that had quelled the nerves of many a student and patient alike. An awed hush descended as the great man took center front, addressing the students as if they were his audience in a rather different sort of theater.

‘Gentlemen! How happy I am to see so many eager and attentive faces. It gladdens my heart to know that such fine young men have the vocation to come here and to learn all that medical science has to offer. One day, some of you will, God willing, be standing on this very spot, poised on the threshold between life and death that all surgeons must tread. It is upon the arrival of that moment that I ask for your most earnest concentration today, gentlemen. For when that moment comes, you will stand here alone. The responsibility for your patient will rest on your shoulders, no matter how ably you are assisted.’ He paused to glance at Eliza. ‘All that you will be furnished with is the knowledge and experience that you gain in this place of learning. I can teach only those who would learn, gentlemen. To learn, you must be humble. You must be prepared to admit your ignorance. You must allow yourselves to be filled with the vital information presented to you via the skills and dedication of those who have gone before you down the long path to enlightenment.’

He turned and nodded to the nurse. She and the orderly raised the moaning patient out of his chair and onto the table. The man was gray with pain and clutched at his stomach with both hands. Dr. Gimmel continued. ‘We have a straightforward case before us this morning, Gentlemen. Our patient, as no doubt even the slowest among you will already have observed, is a young man of lean build, in good health except for the severe abdominal pain that has brought him to us. After a thorough examination, I have concluded that the appendix is inflamed, dangerously so, and to leave it in situ would be to pass a death sentence upon this poor fellow.’

On cue, the patient let out a plaintive cry. Dr. Gimmel nodded.

‘It is a misfortune, without a doubt, for any man to find himself with such an ailment. It is, however, this patient’s great good fortune to find himself so afflicted within the reach of the ever-outstretched arms of the Fitzroy. Fear not, my good man.’ He laid a palm briefly on the patient’s brow. ‘Your troubles will soon be at an end.’

Eliza stepped forward with a tray bearing a blue glass bottle and a piece of lint. She watched the doctor as he carefully placed the lint over the patient’s mouth and nose and applied measured drops of chloroform. An image flashed through her mind of another operation some fifty years or more earlier, before she had come to the Fitzroy. Before surgery had been blessed with effective anaesthesia. She remembered the haste with which the surgeon had been forced to proceed. She remembered the screams rising to shrieks as the bone saw had hacked its way through the patient’s thigh. She remembered the terror on the young man’s face and the way he strained and struggled against the ties that bound him until pain and exhaustion mercifully caused him to lose consciousness. Those had been dark days for surgical procedures. Eliza had quickly learned, however, that there were ways she could ease such terrible suffering. Mesmerism had been widely practiced for years, and though frowned upon, it was legal. She had been able to present herself as a mesmerist and so use the craft to benumb the patients and render them in all ways senseless. As mesmerism became outlawed, she had been forced to cease the practice for fear the true nature of her skills would be uncovered. It was only the use of first ether and then chloroform that had allowed her to resume her work.

Now she watched as the young man on the operating table slipped peacefully into a deep sleep. It was later his true courage would be tested, during the dangerous days of recovery. If indeed he was to survive the surgery itself.

Dr. Gimmel proceeded confidently, continuing to address his students as he worked. He took a scalpel from the tray and made a deft incision. The nurse leaned forward to clear blood from the wound. Eliza placed a set of retractors in the surgeon’s outstretched hand.

‘As you can see, gentlemen, however effective the applied anaesthesia, the surgeon still faces the ever-present hazard of blood loss. Indeed, uncontrolled bleeding remains the second most common cause of fatality in the operating theater. No doubt you will have read all this many times in your studies, but there can be no substitute for seeing it for yourselves.’

As he spoke, blood ran in a syrupy stream off the table and onto the doctor’s shoes. Without pausing in his work, he used a foot to nudge the sawdust box into position. One of the paler students fainted.

‘Happily, the area in which our efforts are focused today does not involve any of the major arteries, and therefore we can continue secure in the knowledge that what we are seeing here, though dramatic, is in fact superficial in terms of blood loss. Ah, there is the offending item.’

Eliza passed him a scalpel and a clamp. He grasped the gut above the swollen appendix and then attempted to make another incision to remove it. To Eliza’s horror, she saw him miss his target and nick a piece of healthy intestine. The doctor hesitated, then tried again, frowning, head low, peering into the abdominal cavity. More blood flowed. Seconds passed in unusual silence. A droplet of sweat followed the curve between Dr. Gimmel’s eye and nose and stopped, dangling, at the edge of his nostril. At last his scalpel found its mark. Eliza caught the removed body part in a dish while the surgeon stitched the severed gut. He straightened up. ‘My assistant will now close the wound for me. Observe and learn, gentlemen. Acknowledge that needlework is no longer the preserve of the female of the species. You yourselves will be required to produce such neat and effective sutures as Eliza is now so ably doing.’ He wiped his forehead with the back of his hand, leaving a bloody smear across his brow.

Later, in the doctor’s study, Eliza sat at the small desk by the open window and wrote up notes on the morning’s work. From the street came the clanging of the omnibus headed for Shoreditch and the rattle of the ever-busy wheels of the hansom carriages behind sleek horses. The weather was warm, and Eliza thought briefly of how pleasant it would be to walk through the leafy coolness of Regent’s Park. The rose garden was past its best by this time of year but was still scented and full of cheerful blooms. She promised herself a trip there on her next free day. Behind her, seated at his broad mahogany desk, Dr. Gimmel was atypically subdued. Eliza watched him as he sat, spectacles in hand, rubbing his closed eyes. She knew he was troubled by what had happened during the appendectomy, but it was not for her to broach the subject. Had his mistake been an isolated event, she might not have given it much thought, but this was not the first time she had witnessed him make an error at a sensitive moment in surgery. He was still the brilliant, visionary man who had inspired her nearly five years earlier. He still emitted the same verve and courage that pushed him to pioneer techniques and procedures other surgeons might shy away from. But something had changed. Something in his abilities had altered in recent months, and the results were alarming.

He became aware of her watching him and hastened to recover his more usual humor.

‘So, Eliza, my dear, let us see what challenges await us tomorrow.’ He picked up the appointments book in front of him, squinting at his secretary’s writing. ‘A kidney removal in the morning—a private affair, not for our students, alas. And after luncheon, aha, a new patient. And an interesting one. Her own doctor has referred her to me. He writes, “Miss Astredge is a young woman of good family whose life has afforded her thus far every care and privilege, and yet she fails to thrive. Indeed, her general health seems to be failing with alarming rapidity. She does not complain of any pain or even discomfort, but she is clearly suffering, and if matters are not addressed, well, we can assume the outcome will be tragic.” He offers no suggestion as to what malady the poor woman suffers from. That we shall have to determine for ourselves.’

‘Do you suspect cancer?’ Eliza asked, crossing the room to stand before him.

Dr. Gimmel smiled, the sage with his favorite pupil once more.

‘And if I do,’ he asked, ‘where might I look for it in this case?’

‘I would suggest the liver.’

‘Your hypothesis being?’

‘It is well known that cancer of this organ may not present pain until late in the progression of the disease. The symptoms are also concurrent with the failure of the liver, allowing the patient to take no nourishment from food, despite a normal appetite.’

‘Excellent, Dr. Hawksmith. I fear you will have my place at this desk before very long if I do not keep my wits about me. You will assist me in my examination of this young woman on the morrow. For today, we have achieved sufficient, I believe. You may take the afternoon off.’

‘But your ward rounds … and I understood there was a further procedure scheduled for three o’clock.’

Dr. Gimmel waved aside her protestations. ‘Nothing that will not wait. I fear I am not at my best today. Fatigued from our busy week, no doubt, nothing more.’ He stood up. ‘Nevertheless, I will surprise Mrs. Gimmel by arriving home early, and so allow her the pleasure of fussing over me, just this once.’

Eliza picked up her large leather bag, dropping an anatomy book into it before snapping shut the clasp. For a fleeting instant, she considered taking that walk but quickly decided the park would wait. There were more useful ways she could employ this unexpectedly vacant afternoon.

She stepped lightly out of the main door of the hospital and turned left along the noisy street. A bat-eared boy selling newspapers shouted from atop an upturned box. A gypsy woman attempted to press lavender into Eliza’s hand. Even in the wide avenues around Fitzroy Square, there was a rush of traffic. Carriages, hansom cabs, omnibuses, and wagons jostled for position, ignoring shouts from pedestrians who struggled to negotiate the mêlée. Eliza walked the two short streets to the Tottenham Court Road, where she caught the eastbound omnibus, paying sixpence for an inside seat. The vehicle clattered over cobbles and past lofty buildings, clearing a path through the constantly moving landscape of figures. It headed up the incline through High Holborn and made its halting progress through the city. Eliza was unaccustomed to traversing London at times other than rush hour and was pleasantly surprised by the relative lack of people. It was not until she alighted on Whitechapel Road that the swirling humanity around her became more familiarly dense and frenetic. Here were narrow alleys and crowded routes, not the broad avenues of Fitzrovia. Gone were the elegant tall houses with their raised ground floors and imposing front doors. Here the dwellings were built with consideration only for quantity and a degree of shelter. Rows of small cottages stood backs to one another as if braced against assault, feet in the street, two small rooms downstairs and two smaller and low-ceilinged up. Aside from these were the dour tenements and the workhouses, the breweries and the warehouses, and the almighty factories, those machines of commerce that drove the engine that carried the wealth from the aching muscles of the poor to the velvet-lined coffers of the rich. Eliza picked her way through the fast-moving current of people. She found a certain security in being among such a mass. Here, women, men, and children alike became part of a huge single body, no longer individuals, rather pieces of a colossus, the living, breathing, breeding giant that was the city’s poor. Here, she was hidden. Here, she could remain undetected. Undiscovered. Safe. What hope had any man of seeking out a solitary figure in such chaos? Even one possessed of such powers as Gideon Masters. Here at least, Eliza could let down her guard, if only fractionally.

She weaved through the small market that filled Cuthbert Street on Fridays, pausing to buy an apple from a barrow. As she paid for her purchase, she caught sight of Benjamin David standing in the doorway of his draper’s shop, enjoying the warmth of the late August day. The tailor and his wife had been kind to Eliza, making her welcome when she first arrived. She enjoyed the company of the elderly couple and often dined at their home above the shop. The two exchanged waves before Eliza pressed on. The organ grinder on the other side of the street played a waltz to which everyone seemed to move as they did their best to avoid bumping into one another. Minutes later, Eliza arrived at her own front door. Or rather, the front door of the house belonging to Mrs. Garvey, where she had lodged for nearly three years. The house had once been a sweet shop and sported a deep bow window that protruded into the street. The silhouette of Eliza’s landlady could be clearly made out behind the lace curtain at the window. It was her favorite place to sit and watch the comings and goings of the neighborhood. Very little of note escaped Mrs. Garvey’s avaricious eye.