Tess Gerritsen - The Bone Garden - A Novel

— She is not ignorant of the possibilities. My sister has been around physicians all her life. She knows what can happen. —

Sewall took a sip and looked at the students. — I was only a bit older than you, gentlemen, when I was called on to perform my first amputation. You have had a gentle introduction. You've witnessed it under ideal conditions, in a comfortable room, well lit, with clean water and the proper tools at hand. The patient well prepared with generous doses of morphine. Nothing like the conditions I faced that day in North Point. —

— North Point? — said Wendell. — You fought in the Battle of Baltimore? —

— Not in the battle. I'm certainly no soldier, and I wanted no part of that stupid, wretched war. But I was in Baltimore that summer, visiting my aunt and uncle. By then, I had completed my medical studies, but my skills as a surgeon were largely untested. When the British fleet arrived and began their bombardment of Fort McHenry, the Maryland Militia had urgent need of all available surgeons. I opposed the war from the beginning, but I could not ignore my duty to my countrymen. — He took a deep swallow of claret and sighed. — The worst of the carnage was on an open field, near Bear Creek. Four hundred British troops had marched overland, hoping to reach Fort McHenry. But at Bouden's Farm, three hundred of ours stood waiting for them. —

Sewall stared at the fire, as though seeing that field again, the British soldiers advancing, the Maryland Militia standing their ground. — It started with cannon fire, from both sides, — he said. — Then, as they closed in, it advanced to musket fire. You're all so young; you probably have not seen the damage a lead ball can inflict on a human body. It does not pierce the flesh so much as crush it. — He took another sip. — When it was over, the militia had two dozen dead and nearly a hundred wounded. The British suffered twice that many losses.

— That afternoon, I performed my first amputation. It was a clumsy one, and I have not forgiven myself for my mistakes. I made too many that day. I can't remember how many amputations I did on that field. The memory tends to exaggerate, so I doubt it was as many as I imagine. Certainly I did not approach the numbers that Baron Larrey claims he performed on Napoleon's soldiers in the Battle of Borodino. Two hundred amputations in a single day, or so he wrote. — Sewall shrugged. — At North Point, I did perhaps only a dozen, but at the end of the day I was quite proud of myself, because most of my subjects were still alive. — He drank down his claret and reached for the bottle yet again. — I didn't realize how little that meant. —

— But you saved them, — said Edward.

Sewall snorted. — For a day or two. Until the fevers started. — He looked hard at Edward. — You know what pyemia is, don't you? —

— Yes, sir. It's blood poisoning. —

— Literally, ‘pus in the blood.' That was the worst fever of all, when wounds started to ooze a copious yellow discharge. Some surgeons believe that pus is a good sign— that it means the body is healing itself. But I believe quite the opposite. That it is, in fact, a signal to begin building the coffin. If not pyemia, there were other horrors. Gangrene. Erysipelas. Tetanus. — He looked around the room, at the three students. — Have any of you witnessed a tetanic spasm? —

The three students shook their heads.

— It begins with a locked jaw, with the mouth clamped into a grotesque grin. It progresses to paroxysmal flexion of the arms and extension of the legs. The muscles of the abdomen become rigid as a board. Sudden spasms make the torso bow backward with such violence that it can snap bones. And through it all, the subject is awake and suffering the most heartbreaking agonies. — He set down his empty glass. — Amputation, gentlemen, is only the first horror. Others may well follow. — He looked at the students. — Your friend Charles faces dangers ahead. All I've done was remove the offending limb. What happens next depends on his constitution, his will to live. And on providence. —

Upstairs, Eliza had ceased singing her lullaby, but they could hear the creak of floorboards as she paced Charles's bedroom. Back and forth, back and forth. If a mother's love alone could save a child, there would be no medicine more powerful than what Eliza now dispensed with every agitated step, every anxious sigh. Did my own mother hover with such devotion over my sickbed ? Norris had only one vague memory, of waking up in a feverish daze to see a lone candle flickering by his bed, and Sophia bent over him, stroking his hair. Murmuring: — My one true love. —

Did you mean it? Then why did you leave me that day?

There was a knock on the front door. They heard the parlor maid scurry down the hall to answer it, but Dr. Grenville made no attempt to rise. Exhaustion had pinned him to his chair, and he sat unmoving, listening to the conversation at the front door:

— May I speak to Dr. Grenville? —

— I'm sorry, sir, — the parlor maid answered. — We have had a crisis in the household today, and the doctor is not up to seeing visitors. If you would leave your card, perhaps he will— —

— Tell him that Mr. Pratt of the Night Watch is here. —

Grenville, still slumped in his chair, wearily shook his head at the unwelcome intrusion.

— I'm sure he'll be happy to speak to you another time, — the maid said.

— This will only take a minute. He will want to hear this news. — Already they could hear Pratt's heavy boots stomping into the house.

— Mr. Pratt, sir! — said the maid. — Please, if you could just wait while I ask the doctor— —

Pratt appeared in the parlor doorway, and his gaze swept across the men gathered in the room.

— Dr. Grenville, — the maid said helplessly. — I did tell him you were not taking visitors! —

— That's all right, Sarah, — said Grenville as he rose to his feet. — Clearly Mr. Pratt feels the matter is urgent enough to warrant this intrusion. —

— I do, sir, — said Pratt. His eyes narrowed as he focused on Norris. — So here you are, Mr. Marshall. I've been looking for you. —

— He's been here all afternoon, — said Grenville. — My nephew has taken seriously ill, and Mr. Marshall was kind enough to offer his assistance. —

— I wondered why you were not at your lodgings, — said Pratt, his gaze still fixed on Norris, who felt sudden panic. Had Rose Connolly been discovered in his room? Was that why Pratt was staring at him?

— That's the reason for this interruption? — asked Grenville, barely able to conceal his scorn. — Merely to confirm the whereabouts of Mr. Marshall? —

— No, Doctor, — said Pratt, turning his gaze to Grenville.

— Then why? —

— You have not heard the news, then. —

— I've been occupied all day with my nephew. I've not even left the house. —

— This afternoon, — said Pratt, — two young boys playing under the West Boston Bridge noticed what looked like a bundle of rags lying in the mud. When they took a closer look, they saw it was not rags, but the body of a man. —

— The West Boston Bridge? — said Dr. Sewall, straightening in his chair at this disturbing news.

— Yes, Dr. Sewall, — said Pratt. — I invite you to examine the body yourself. You'll have no choice but to draw the same conclusions I have, based on the injuries. In fact, it seems pretty clear to me and to Dr. Crouch that— —

— Crouch has already seen it? — asked Grenville.

— Dr. Crouch was on the wards when the body was carried into the hospital. A fortunate circumstance, actually, because he also examined Agnes Poole. He saw, at once, the similarities in the injuries. The peculiar pattern of the cuts. — Pratt looked at Norris. — You would know what I'm talking about, Mr. Marshall. —