“Then you may invite me to the theater as soon as I am fully recovered and our son is old enough to stay with his nurse for the evening.”
Ryan hadn’t noticed the crib until then. He now saw that Mary was standing by it, completely ignoring their verbal banter, her entire attention focused on the small creature that lay peacefully asleep inside. “I must congratulate you, Arlington. I had no idea that your wife had given birth already.”
“We haven’t made the formal announcement just yet,” Lord Arlington admitted. “Once we do, we are bound to be overrun by people from near and far, all eager to have a look at my heir. We thought it best to wait a while, until Lady Arlington is fully recovered.”
“Was it a difficult birth?” Ryan asked before he could stop himself.
He was just about to apologize for asking when Mary turned to him. “You could say that.” She gave him a crooked smile, while her eyes sparkled with mischief.
“Wait. . .did you. . .?”
“I did indeed,” Mary said, looking just about as pleased as a cat that had just caught a canary.
Ryan let out a sigh of relief. “You have no idea how glad I am to hear it. For a while there I was quite convinced you might actually have operated on the poor woman, when in fact, all you did was deliver a baby—a healthy looking one, I might add.”
Lady Arlington chuckled ever so slightly. “You haven’t told him, have you?”
Mary shook her head.
“Told me what?” Ryan asked, feeling slightly puzzled. He was clearly missing something.
“Before you say anything, Lady Steepleton,” Lord Arlington added, “I want you to know how grateful my wife and I are for what you have done for us.” He turned to Ryan with a very serious expression, but when he spoke, his voice was gentle and reassuring. “I had my doubts at first too, you know. But Lady Steepleton truly deserves to be recognized for her accomplishment. She is quite a remarkable woman, Summersby; you are lucky to have her.”
“Would someone please explain to me what the devil you are all going on about?” Ryan said with growing frustration. “Delivering a baby is something that any midwife can handle without much difficulty. It is nothing exceptional unless. . .” The room seemed to close in on him as his eyes flickered from one person to the next. “Good heavens, were there complications? Excessive bleeding, perhaps?”
“Well, the thing is, Ryan. . .Mr. Summersby, I mean. . .I did operate on Lady Arlington.” Mary turned a steady eye on him.
“What!” Ryan exclaimed. Surely he must have misheard.
“She had puerperal eclampsia,” Mary told him simply.
“So you decided to cut her open? Good Lord, woman, what were you thinking?”
Mary’s eyes narrowed with sudden fury. “She would have died if I had not done so.”
“She might very well have died because of you. You are not an authorized surgeon, and what you are doing sets a very dangerous precedent. It might make others who lack the necessary qualifications think that they can go about cutting into people instead of seeking professional help.”
“My father taught me everything I know,” Mary retaliated. “Together, he and I experienced fewer fatalities in our patients than anyone else in this country.”
“That does not change the fact that you are practicing medicine. Hell, you are slicing people open without a license!”
Mary held her ground, staring back at Ryan with steel in her eyes. This was clearly not a battle that she intended to lose. “Let me ask you this,” she countered. “During your studies at Oxford, how often did you actually study a physical body, whether it be dead or alive?”
“That is not the issue here.”
“I think it is precisely the issue. The universities pack your heads full of information that is completely useless unless they also show you how to apply it. There is a big difference in having the organs described to you by a lecturer and actually taking an up close look at them.”
“That is what an apprenticeship is for,” Ryan snapped. His blood was beginning to boil; another moment and he’d probably see red. Heaven help him if she wasn’t the most infuriating woman he’d ever come across.
“But such apprenticeships hold no promise of a universal standard. In addition, most physicians and surgeons are reluctant to teach their future competitors, extending the period it takes a student to acquire the necessary skills to an indefinite amount of time.”
Seeing that Mary wasn’t about to give in, Ryan turned to Lady Arlington instead. “I would like to take a look at Lady Steepleton’s work, if I may.”
Lady Arlington nodded and placed her book on the table next to her bed. “You should not be too hard on her, Summersby.” She looked to Mary, who seemed ready to explode. “She did the right thing, you know. Even Dr. Helmsley, the physician I have been using for the duration of my pregnancy, has told us how rare it is for a woman to survive this kind of surgery.”
“Your physician condoned this?” Ryan could scarcely believe his ears. This was madness, complete and utter madness.
“He is the one who sent for Lady Steepleton in the first place,” Lord Arlington replied. “In fact, he explicitly told me that she was our best option.”
Ryan eyed Mary with a great degree of reluctance. Clearly, the fact that an actual physician had backed her up had only encouraged her to think that she had the right to operate. Did she have any idea of the danger in which she’d put Lady Arlington?
He watched as Lady Arlington folded down the covers and pulled up her nightgown enough to show her abdomen. There, a couple of inches below her navel, was a small scar, still graced by a neat row of stitches, but looking otherwise healthy and clear of any infection.
Ryan stared at it. It looked perfect. He frowned. This wasn’t at all the way in which a cesarean had been described in the books he’d read. He looked at Mary, who in turn was watching him with much interest. “I thought the incision should have been made just below the navel and in a downward motion—not across, the way that you have done it.”
Mary nodded. “Yes, I know. The lengthwise incision is the traditional way of performing the procedure, the one that is practiced by the majority of surgeons in this country. However, a variety of methods have been recorded, and would you know, this method, where a transverse incision is made, will result in far less bleeding in the patient than the other, more popular method, will. It makes you wonder why, after Lebas, Dunker, and Lauverjat all claimed success with the transverse incisions more than twenty-five years ago, the lengthwise incision is still so eagerly applied.”
Ryan could say nothing to that. He’d never even heard of these men before, but he had to admit that Mary had given him a great deal to think about. “It seems that there are a lot of contradictory opinions out there. I am surprised I never heard of this method before.”
Mary sighed as she came to stand next to him. “Yes, there are many differing opinions,” she said. “However, a procedure is either successful or it is not, and if it is not, then it is the physician’s and the surgeon’s job to apply a method that has been proven to be better. Unfortunately, these men of medicine are terrified of admitting that they may have been wrong, which implementing new methods is bound to suggest. Instead, they muddle on, without their patient’s best interest at heart and with only their own, personal gain in mind.
“Now, if you are ready, I believe that we have taken up enough of the Arlingtons’ time with our discussion. After all, the whole purpose of our visit here this evening is to remove Lady Arlington’s stitches.” She looked at her patient. “I am sure you must be quite eager to have them out.”
They sat in silence on their way back to Brook Street. Ryan waited in the carriage while Mary ran inside to change. When she returned, he gave her a faint smile. “I must say that you clean up rather well, Mary.”
“Thank you,” she said as she settled herself onto the seat across from him for the brief remainder of the ride back to Trenton House. After a moment’s silence, she looked at him very directly. “I hope that what you have witnessed this evening has made you understand how important my work is to me.”
“It certainly has, and I must admit that there is absolutely nothing that I can say to discredit you. You did an extraordinary job.”
Mary beamed with delight. “I am so pleased that you think so, Ryan. In fact, your opinion matters a great deal to me.”
“Then I am just as pleased as you, since you will no doubt listen to what I have to say.” He fixed Mary with a steady gaze that made her instantly uneasy. “This unruly behavior of yours has got to stop. Not only are you breaking the law by practicing without a license, but you are soon to be a married lady of the ton. It would be preposterous for you to continue doing what you do. If you need a hobby, then perhaps you can think of something a little more ladylike, such as miniature painting or botany.”
By the time Ryan was done, Mary was seething with rage. How dare he! The arrogance and patronizing male superiority! So angry was she that she had to clasp her hands in her lap to keep them from trembling. “I have no intention of doing any such thing,” she told him icily.
“Be reasonable, Mary, and stop acting like a child,” he all but shouted, then lowered his voice to a more moderate tone. “Of course you cannot keep up this charade. You have had a good run of it, I will give you that, but it is time to end it and accept the role that awaits you as a wife and mother.”
Mary’s jaw dropped. “Damn you, Ryan Summersby! I have saved seventy-three of the seventy-six patients I have ever treated. Do you have any idea what that means? I am not a green girl who cannot tell the difference between the spleen and the appendix, for heaven’s sake. Any person will be safer in my hands than in any other’s—save for my father, who was just as reliable as I, if not more so. Yet you would rather refer a patient to a licensed professional who will likely kill them instead of save them, just because he happens to have a piece of paper allowing him to practice?”
“I am sorry, Mary, but this is your own doing. You have ventured into an area of expertise exclusively reserved for men, and as my wife, I simply will not have it. Do you understand?”
The carriage came to a sudden halt. They’d arrived at Berkeley Square. Mary gathered what little self-control she had left and turned to him with a heavy heart. “Then I will not have you, Mr. Summersby.”
“I have told you already, my lady, that there is no undoing it—the entire ton knows about our engagement.”
“And whose fault is that?” she flared. “You and I are completely wrong for one another, yet for some absurd reason you are determined not to see that. So I suggest that you find a way to undo our engagement this instant, or God help me I shall cause a scandal far worse than any you have ever conceived off: I shall say no at the altar.”
Without another word, she stepped down from the carriage and made her way to the front door of Alexandra’s home, cursing the day she met Ryan Summersby as she went.