Mary burst into Lady Arlington’s bedroom like a jack popping out of its box. “I came as soon as I could,” she gasped, hurrying over to the bedside. She met Helmsley’s gaze. “It is so good to see you again,” she told him with a tight smile.
“You too,” Helmsley replied, “though I do wish that it had been under different circumstances.”
Lord Arlington looked not only shocked but extremely distressed. He addressed Helmsley in a clipped voice. “You brought a woman here to save my wife? That is your solution?”
“She is the best surgeon there is,” Helmsley told him defensively. “I know how unorthodox this is, but you need to trust my decision if you want your wife and child to live.”
The annoyance on the viscount’s face was quite apparent. “What are you planning to do?” he asked Mary irritably.
Ignoring the frustrated viscount, Mary turned toward Helmsley instead. “What is your assessment of the patient, Doctor?”
“That she is showing severe signs of puerperal eclampsia. She has complained of abdominal pains and has had four seizures since I arrived on the scene roughly three hours ago.”
Mary nodded thoughtfully as she looked over her ladyship’s fragile body, noting the swelling that had occurred in both her wrists and ankles. “Can you confirm these seizures?” she asked Lord Arlington.
He nodded as if in a daze.
“Here is what we are going to do,” she said in a sharp tone of authority. She looked across at the maid, who was still clutching her mistress’s hand. “I will need a clean white sheet, a pot of boiling water, and plenty of towels. Have it all brought into the kitchen. Go.”
The young woman didn’t miss a beat. Jumping to her feet, she ran out of the door to set about her task as quickly as she could manage, visibly relieved to finally be of some assistance.
“Now then,” Mary continued, turning her attention back to Lord Arlington, “we are going to have to move her downstairs to the kitchen. And to answer your question, I intend to give your wife a cesarean. Do I have your consent?”
“I. . .er. . .a cesarean?” Lord Arlington muttered, looking more confused than ever.
Mary sympathized, knowing full well that the speed with which she’d taken hold of the wheel must have completely thrown him. However, they had to hurry. She opted for complete honesty. “To put it bluntly, my lord, I will have to cut your wife open just below the navel, remove the child, then stitch her back up again. If all goes well, she and the baby will both survive.”
Lord Arlington stared at Mary with a look of unsurpassed horror. He began to shake his head, slowly at first and then with more vigor. “No,” he said. “Absolutely not.” He turned on Helmsley in anger. “What kind of a doctor are you? To bring a. . .a woman into my house who plans to. . .to cut open my wife like a butcher? No, I tell you, I will not allow it!” He was shaking.
Mary had expected this reaction Taking a deep breath to calm her own ragged nerves, she placed a soothing hand on Lord Arlington’s arm. “I understand your distress, but you have to understand that this is the only chance your wife has of survival. If I do not perform the procedure, she will die.”
“And you are sure of this?” His eyes were wide with fear and worry. “Absolutely and undeniably sure?”
“Yes,” she said.
He let out an anguished sigh. His shoulders slumped as if he’d just accepted an unacceptable defeat. “And is this something that you have done before?” he asked her hesitantly.
Mary studied him for a brief moment. She’d watched her father do it once, but she’d never actually had the opportunity to do it herself. Of course, there was the possibility that Lady Arlington might not live through the surgery, but Mary knew that her chances of survival were nonexistent if she didn’t go ahead with it. It had to be done, no matter what she had to say in order to convince her patient’s husband. “Yes, I have,” she lied. He still looked dubious, so she decided to add, “Quite successfully.”
“Very well then,” Lord Arlington agreed, wiping his hand shakily across his perspiring forehead. “You have my consent.”
Once in the kitchen, Mary took the white sheet that the maid had provided and spread it over the sturdy oak table that stood in the center of the room.
“Shall I lay her down?” Lord Arlington asked, eyeing the makeshift operating table.
“Not yet. We will need to get her out of that dress first,” Mary said before turning to the maid and handing her a large pair of scissors. “Perhaps you can help with that.”
“But it is one of her favorites,” the maid protested.
“And it will not do her an ounce of good if she is not alive to wear it, now, will it?” Mary snapped. Time was of the essence, which was something that these people clearly did not seem to understand. She let out a sigh of relief when the maid followed her orders without further delay. “Just leave her chemise,” she said.
Once this was done, Lord Arlington placed his wife on the table, grabbing one of the fresh towels and placing it across her pelvis to protect her modesty as much as possible. Her hair, soaked in her own sweat, was matted against her forehead, her eyelids fluttering ever so gently while her breath came in hoarse and shallow bursts.
Opening her bag, Mary pulled out a pair of retractors, a clamp, a pair of forceps, and a scalpel, all of which she dropped into the pot of water that the maid had put to boil. Removing a bottle of brandy from her bag, she pulled out the stopper and tossed it to Helmsley. She then proceeded to pour a generous amount of the amber liquid over Lady Arlington’s quivering belly. Some of it dribbled down her sides, pooling in the small spaces where her body failed to touch the table. With the tip of a clean towel, Mary wiped away the excess before turning a keen eye on the rest of the group. “Now, I want each of you to spend the next couple of minutes washing your hands—thoroughly. Take your time and remember to make good use of the soap. I want the lather to reach all the way up to your elbows.”
Lord Arlington stared at her as if she’d just turned green. “I hardly think that is necessary,” he said. “After all, you yourself have said that we are short on time. Should we not then try to get this over with as quickly as possible, or do you really mean to prolong my wife’s suffering while we stand about playing with water?”
“Lord Arlington,” Mary told him sternly, “I take very little pleasure in your wife’s suffering, and I assure you that I have no desire to prolong it more than necessary. However, since you do wish for me to explain myself to you, I will tell you this: while the majority of the physicians and surgeons in this country may be deaf to new ideas and innovative ways of thinking, I am not, and neither was my father.”
The viscount responded with nothing but a blank stare. Clearly, she would have to elaborate, however reluctant she was to waste what little time they had in doing so.
“Forty seven years ago,” she said, filling a washbasin with water and reaching for the soap, “a Scottish physician named William Buchan published a book that focused on personal hygiene. It was called Domestic Medicine, and although the original work was first sold in Edinburgh, it quickly grew in popularity and was reprinted in London only five years later.” She paused for a moment as she dipped the soap in the water and started working it between her hands until foamy bubbles began to appear. She then looked up to see if the name of the book she’d just mentioned had registered with anyone but was greeted by yet another round of vacant gazes. Only Helmsley bore a knowing smile upon his face, for he had heard her speak of Buchan many times before. Returning her gaze to her hands, she said, “In this book of his, Buchan advises everyone to wash their hands after handling the sick or anything else that might have become contaminated. He also advises that we do so before we eat our meals or enter into company with others. His reasoning for doing so was that he believed we would run less risk of becoming infected ourselves or of conveying an infection to others. Unfortunately, however, his advice has been greatly ignored within the medical community.”
Mary let out a lengthy sigh. “I don’t presume to understand why it is of such monumental importance, my lord, I only know that it is. My father and I have always done it before a surgery, and I do believe that it is part of the reason why the mortality rate of our patients has always been far lower than that of other surgeons.
“So, if your wife’s health is of any importance to you, then you will wash your hands without further complaint, and once you are done, you will refrain from touching anything else in this room unless I specifically give you permission to do so. Do I make myself clear?”
Lord Arlington stared back at her for only a fraction of a second before rushing over to the washbasin and grabbing the soap that she’d just now finished with. Mary caught Helmsley’s eye. There was a very distinct smirk upon his face as he gave her a quiet nod of approval. Good. She’d hate having to waste time arguing with him as well.
When Lord Arlington returned to his wife’s side a few minutes later, Mary looked at him and said, “I have taken the liberty of administering some laudanum. It should make it easier on her, but this is not going to be a painless procedure. I hope I can count on you to hold her down and keep her steady for me. Dr. Helmsley will help you while. . .” She turned to the maid. “I am terribly sorry, but I do not know your name.”
“It is Lucy Pinksworth, my lady.”
Mary acknowledged her with a quick nod. “Answer me honestly, Miss Pinksworth. Are you likely to faint at the sight of blood?”
“N. . .no, my lady. I believe I shall be quite all right.”
“Good, because I am going to need someone to keep the bladder out of the way while I open up the uterus. Do you think you can manage that?”
Lucy’s face paled momentarily, but then she appeared to pull herself together “I. . .yes, I believe I can,” she replied with a surprising amount of conviction as she watched Mary fish her tools out of the boiling water before setting them side by side on a clean white towel.
“All right,” Mary said as she drew a long breath. “Then let us get started.”
It took about an hour for Mary to complete the operation, and since the viscountess fainted from the pain very early on, Lord Arlington and Helmsley were left with very little to do. Lucy, on the other hand, performed admirably. She followed Mary’s instructions to the letter, without flinching as much as once.
“Congratulations, Lord Arlington,” Mary said as she lifted a squealing baby from its mother’s womb. “It looks as though you have a very healthy baby boy.” She handed the child over to Lucy and began the monotonous process of stitching up her patient.
As she finished the last of the stitches, Mary finally allowed herself to relax. She looked up at Helmsley, who was showing marked signs of relief. Lady Arlington and the baby were both alive for now. She knew that they weren’t out of danger yet, but a strong feeling told her that all would be well with both mother and child.