Tess Gerritsen: The Bone Garden: A Novel

Helplessly the young man shook his head. — I'm sorry, sir. —

Sighing, Dr. Crouch turned to the fourth student, a tall dark-haired young man. — Your turn, Mr. Marshall. What else might be done in this situation? A patient in labor, who is not progressing? —

The student said, — I would urge her to sit up or stand, sir. And if she is able, she should walk about the ward. —

— What else? —

— It's the only additional modality that seems appropriate to me. —

— And what of bleeding the patient as a treatment? —

A pause. Then, deliberately: — I am not convinced of its efficacy. —

Dr. Crouch gave a startled laugh. — You— you are not convinced? —

— On the farm where I grew up, I experimented with bleeding, as well as cupping. I lost just as many calves with it as without it. —

— On the farm ? You are talking about bleeding cows ? —

— And pigs. —

Nurse Agnes Poole snickered.

— We are dealing with human beings here, not beasts, Mr. Marshall, — said Dr. Crouch. — A therapeutic bleeding, I've found in my own experience, is quite effective for relieving pain. It relaxes a patient enough so that she may properly dilate. If the ergot and a cathartic don't work, then I will most certainly bleed this patient. — He handed the soiled towel back to Nurse Poole and moved on, to Bernadette's bed. — And this one? — he asked.

— Though her fever has abated, — said Nurse Poole, — the discharge has become quite foul. She spent the night in great discomfort. —

Again, Dr. Crouch reached under the sheet to palpate the internal organs. Bernadette gave a weak groan. — Yes, her skin is quite cool, — he concurred. — But in this case… — He paused and looked up. — She has received morphine? —

— Several times, sir. As you ordered. —

His hands came out from beneath the sheet, fingers glistening with yellowish slime, and the nurse handed him the same soiled towel. — Continue the morphine, — he said quietly. — Keep her comfortable. — It was as good as a death pronouncement.

Bed by bed, patient by patient, Dr. Crouch made his way down the ward. By the time he reached Aurnia's bed, the towel he used to wipe his hands was soaked with blood.

Rose stood to greet him. — Dr. Crouch. —

He frowned at her. — It's Miss… —

— Connolly, — said Rose, wondering why this man could not seem to remember her name. She had been the one to summon him to the lodging house where, for a day and a night, Aurnia had labored without success. Rose had been here at her sister's bedside every time Crouch had visited, yet he always seemed flummoxed when they met anew. But then he did not really look at Rose; she was just an accessory female, unworthy of a second glance.

He turned his attention to Nurse Poole. — And how is this patient progressing? —

— I believe the daily cathartics you prescribed last night have improved the quality of her contractions. But she has not complied with your orders to rise from bed and walk about the ward. —

Staring at Nurse Poole, Rose was scarcely able to hold her tongue. Walk about the ward? Were they mad? For the past five days, Rose had watched Aurnia fall steadily weaker. Surely Nurse Poole could see the obvious, that her sister could scarcely sit up, much less walk. But the nurse was not even looking at Aurnia; her worshipful gaze was fixed on Dr. Crouch. He reached beneath the sheets, and as he probed the birth canal, Aurnia gave a moan of such agony that Rose could scarcely stop herself from wrenching him away.

He straightened and looked at Nurse Poole. — Although the amniotic sac is ruptured, she is not yet fully dilated. — He dried his hand on the filthy towel. — How many days has it been? —

— Today is the fifth, — said Nurse Poole.

— Then perhaps another dose of ergot is called for. — He took Aurnia's wrist and felt the pulse. — Her heart rate is rapid. And she feels a bit feverish today. A bleeding should cool the system. —

Nurse Poole nodded. — I'll assemble the— —

— You have bled her enough, — cut in Rose.

Everyone fell silent. Dr. Crouch glanced up at her, clearly startled. — What relation are you again? —

— Her sister. I was here when you bled her the first time, Dr. Crouch. And the second time, and the third. —

— And you can see how she's benefited, — said Nurse Poole.

— I can tell you she has not. —

— Because you have no training, girl! You don't know what to look for. —

— Do you wish me to treat her or not? — snapped Dr. Crouch.

— Yes, sir, but not to bleed her dry! —

Nurse Poole said, coldly: — Either hold your tongue or leave the ward, Miss Connolly! And allow the doctor to do what's necessary. —

— I have no time to bleed her today, anyway. — Dr. Crouch pointedly looked at his pocket watch. — I have an appointment in an hour, and then a lecture to prepare. I'll stop in to see the patient first thing in the morning. Perhaps by then, it will be more obvious to Miss, er— —

— Connolly, — said Rose.

— — to Miss Connolly that further treatment is indeed necessary. — He snapped his watch closed. — Gentlemen, I shall see you at the morning lecture, nine A.M. Good night. — He gave a nod, and turned to leave. As he strode away, the four medical students trailed after like obedient ducklings.

Rose ran after them. — Sir? Mr. Marshall, isn't it? —

The tallest of the students turned. It was the dark-haired young man who'd earlier questioned the wisdom of bleeding a laboring mother, the student who'd said he'd grown up on a farm. One look at his ill-fitting suit told her that he indeed came from humbler circumstances than his classmates. She had been a seamstress long enough to recognize good cloth, and his suit was of inferior quality, its woolen fabric dull and shapeless and lacking the sheen of a fine broadcloth. As his classmates continued out of the ward, Mr. Marshall stood looking at her expectantly. He has tired eyes, she thought, and such a weary face for a young man. Unlike the others, he gazed straight at her, as though regarding an equal.

— I couldn't help but hear your words to the doctor, — she said. — About bleeding. —

The young man shook his head. — I spoke too freely, I'm afraid. —

— Is it true, then? What you said? —

— I only described my observations. —

— And am I wrong, sir? Should I allow him to bleed my sister? —

He hesitated. Glanced, uneasily, at Nurse Poole, who was watching them with clear disapproval. — I'm not qualified to give advice. I'm only a first-year student. Dr. Crouch is my preceptor, and a fine doctor. —

— I've watched him bleed her three times, and each time he and the nurses claim she's improved. But to tell God's truth, I see no improvement. Every day, I see only… — She stopped, her voice breaking, her throat thick with tears. She said, softly: — I only want what's best for Aurnia. —

Nurse Poole cut in: — You're asking a medical student ? You think he knows better than Dr. Crouch? — She gave a snort. — You might as well ask a stable boy, — she said, and walked out of the ward.

For a moment Mr. Marshall was silent. Only after Nurse Poole was out of the room did he speak again, and his words, though gentle, confirmed Rose's worst fears.

— I would not bleed her, — he said quietly. — It would do no good. —

— What would you do? If she were your own sister? —

The man gave the sleeping Aurnia a pitying look. — I would help her sit up in bed. Apply cool compresses for the fever, morphine for pain. I would see above all that she receives sufficient nourishment and fluids. And comfort, Miss Connolly. If I had a sister suffering so, that's what I would give her. — He looked at Rose. — Comfort, — he said sadly, and walked away.