“Do you not agree, Dr. Hunter?”
“I do, yes,” he said mildly. “We are in disagreement regarding the degree of amputation required, not its necessity. What is the boiling water for, Friend… Fraser, he said?”
“Claire,” I said briefly. “Sterilization of the instruments. To prevent postoperative infection. As much as possible,” I added honestly. Stactoe made a very disrespectful noise at this, but I ignored it. “What do you recommend, Dr. Hunter?”
“Denzell,” he said, with a fleeting smile. “Friend Stactoe wishes to amputate below the knee—”
“Of course I do!” Stactoe said, furious. “I wish to preserve the knee joint, and there is no need to do it higher!”
“Oddly enough, I’m inclined to agree with you,” I told him, but turned back to Denzell Hunter. “But you don’t?”
He shook his head and pushed his spectacles up the bridge of his nose.
“We must do a mid-femoral amputation. The man has a popliteal aneurysm. That means—”
“I know what it means.” I did, and was already feeling behind Mr. Ormiston’s knee. He emitted a high-pitched giggle, stopped abruptly, and went red in the face with embarrassment. I smiled at him.
“Sorry, Mr. Ormiston,” I said. “I won’t tickle you again.”
I wouldn’t need to. I could feel the aneurysm plainly; it throbbed gently against my fingers, a big, hard swelling right in the hollow of the joint. He must have had it for some time; a wonder it hadn’t burst during the sea battle or the arduous portage to Ticonderoga. In a modern operating room, it might be possible to do the lesser amputation and repair the aneurysm—but not here.
“You’re right, Friend Denzell,” I said, straightening up. “As soon as Mrs. Raven brings the hot water, we’ll—” But the men weren’t listening to me. They were staring at something behind me, and I turned to see Guinea Dick, stripped to a breechclout because of the heat and glistening with sweat, all his tattoos on display, advancing upon us with a black glass bottle held ceremoniously between his hands.
“Him captain send you grog, Joe,” he said to Mr. Ormiston.
“Well, God bless the captain for a good un!” Mr. Ormiston said in heartfelt thanks. He took the bottle of rum, drew the cork with his teeth, and began to swallow with a single-minded determination.
Sloshing and splashing heralded Mrs. Raven’s return with the water. Nearly every fire had a kettle on; finding boiling water was no difficulty. She had, bless her, also brought a bucket of cold water so that I could wash my hands without burning myself.
I took one of the short-bladed, brutal amputation knives, preparing to plunge it into the hot water, only to have it snatched from my hand by an outraged Lieutenant Stactoe.
“What are you doing, madam!” he exclaimed. “That is my best blade!”
“Yes, that’s why I propose to use it,” I said. “After I wash it.”
Stactoe was a small man with close-cropped, bristly gray hair; he was also two or three inches shorter than I, as I discovered when I stood up and faced him, eyeball to eyeball. His face went a shade or two redder.
“You will ruin the temper of the metal, subjecting it to boiling water!”
“No,” I said, keeping my own temper—for the moment. “Hot water will do nothing but clean it. And I will not use a dirty blade on this man.”
“Oh, won’t you?” Something like satisfaction glimmered in his eyes, and he clutched the blade protectively to his bosom. “Well, then. I suppose you’ll have to leave the work to those who can do it, won’t you?”
Guinea Dick, who had remained to watch after delivery of the bottle, had been following the progress of the argument with interest and, at this point, leaned over and plucked the knife from Stactoe’s hand.
“Him captain says her does for Joe,” he said calmly. “Her does.”
Stactoe’s mouth fell open in outrage at this gross insult to his rank, and he lunged at Dick, grabbing for the blade. Dick, with reflexes honed by tribal warfare and years of British seamanship, swung the blade at Stactoe with the obvious intent of removing his head. He would likely have succeeded, save for Denzell Hunter’s equally good reflexes, which sent him leaping for Dick’s arm. He missed but succeeded in knocking the big Guineaman into Stactoe. They clutched each other—Dick dropping the knife—and staggered to and fro for an instant before both overbalanced and crashed into Ormiston’s cot, sending patient, rum bottle, hot water, Denzell Hunter, and the rest of the instruments sprawling across the stone floor with a clatter that stopped every conversation in the building.
“Oooh!” said Mrs. Raven, deliciously shocked. This was turning out even better than she had expected.
“Denny!” said an equally shocked voice behind me. “What does thee think thee is doing?”
“I am… assisting Friend Claire in her surgery,” Denzell said with some dignity, sitting up and patting round the floor in search of his spectacles.
Rachel Hunter bent and picked up the errant spectacles, which had slid across the stones, and restored these firmly to her brother’s face, while keeping a wary eye on Lieutenant Stactoe, who was slowly rising from the floor, much in the manner of a hot-air balloon, visibly swelling with rage.
“You,” he said in a hoarse voice, and pointed a small, trembling finger at Dick. “I shall have you hanged for assaulting an officer. I shall have you, sir”—swinging the accusatory digit toward Denzell Hunter—“court-martialed and broke! As for you, madam—” He spat the word, but then stopped dead, momentarily unable to think of anything sufficiently terrible with which to threaten me. Then, “I shall ask your husband to beat you!” he said.
“Come ’n’ tickle me, darlin’,” a slurred voice said from the floor. I looked down, to see a leering Mr. Ormiston. He had kept hold of the rum bottle during the wreck, continued to employ it afterward, and, face suffused with rum, was now making random pawing motions in the vicinity of my knee.
Lieutenant Stactoe made a noise indicating that this was the frozen limit, if not well beyond, and, hastily bundling up his fallen instruments, he marched off, bristling with knives and saws, dropping occasional small objects in his wake.
“Did thee want me, Sissy?” Denzell Hunter had got to his feet by this time and was righting the fallen cot.
“Not so much me as Mrs. Brown,” his sister said, a dry note in her voice. “She says it is her time, and she wants thee. Right. Now.”
He snorted briefly, and glanced at me.
“Mrs. Brown is an hysteric, in the literal meaning of the term,” he said apologetically. “I think she cannot deliver for another month yet, but she suffers false labor on a regular basis.”
“I know her,” I said, suppressing a smile. “Better you than me, mate.” Mrs. Brown was an hysteric. Also the wife of a colonel of militia and therefore—she thought—well above the services of a mere midwife. Hearing that Dr. Denzell Hunter had worked with Dr. John Hunter, who was accoucheur to the Queen!—obviously, my services could be dispensed with.
“She is not bleeding, nor her water broke?” Denzell was asking his sister in a resigned voice. Guinea Dick, totally unperturbed by the recent conflict, had restored the bedding to the cot and now squatted, lifted all fifteen stone of Mr. Ormiston as if he were a feather bed, and deposited him and his bottle gently thereon.
“I think him ready,” he announced, after scrutinizing the patient, who was now lying back, eyes closed, happily murmuring, “Just a little lower, dear, aye, that’s it, tha’s it…”
Denzell looked helplessly from Mr. Ormiston to his sister to me.
“I will have to go to Mrs. Brown, though I think it not pressingly urgent. Can thee wait a little while and I will do this for thee?”
“Her does it,” said Dick, glowering.
“Yes, her does,” I assured him, tying back my hair. “But what her is going to do it with is another question. Have you any instruments that I might borrow, Dr.—er, Friend Denzell?”
He rubbed his forehead, thinking.
“I have a decent saw.” He smiled briefly. “And I do not mind if thee wishes to boil it. But no heavy blade. Shall I send Rachel to ask one of the other surgeons?”
Rachel’s face closed a bit at this suggestion, and I thought that perhaps Dr. Hunter was not all that popular with the other surgeons.
I eyed Mr. Ormiston’s very solid leg, estimating the thickness of flesh to be cut, and put a hand through the slit in my skirt to the sheath of my knife. It was a good, sturdy knife, and Jamie had just sharpened it for me. A curved blade would be better, but I thought the length was sufficient…
“No, don’t trouble. I think this will work. If you would find your brother’s saw, Miss—er, Rachel.” I smiled at her. “And, Mrs. Raven, I’m afraid the water’s gone, would you—”
“Oh, yes!” she cried, and seizing the pan, clattered off, kicking one of Lieutenant Stactoe’s oddments on the way.
A number of people had been watching the drama of Mr. Ormiston’s foot, fascinated. Now that the lieutenant was gone, they began to sidle nearer, looking fearfully at Guinea Dick, who grinned genially at them.
“Can Mrs. Brown wait a quarter of an hour?” I asked Denzell. “It will be a little easier if I have someone who knows what they’re doing to support the leg while I cut. Dick can restrain the patient.”
“A quarter of an hour?”
“Well, the actual amputation will take a little less than a minute, if I don’t encounter any difficulties. But I’ll need a bit of time to prepare, and I could use your help in ligating the severed blood vessels afterward. Where has the rum bottle gone, by the way?”
Denzell’s dark brows were almost touching his hairline, but he gestured to Mr. Ormiston, who had gone to sleep and was now snoring loudly, the rum bottle cradled in his arm.
“I don’t propose to drink it,” I said dryly, answering his expression. I pulled the bottle free and poured a little onto a clean rag, with which I began to swab Mr. Ormiston’s hairy thigh. The lieutenant had fortunately left his jar of sutures, and the oddment Mrs. Raven had kicked was a tenaculum. I would need it to seize the ends of severed arteries, which had an annoying tendency to pop back into the flesh and hide, squirting blood all the while.
“Ah,” said Denzell, still at a loss but game. “I see. Can I… help?”
“If I might borrow your belt for a ligature?”
“Oh, yes,” he murmured, and unbuckled it without hesitation, looking interested. “I collect thee has done this before.”
“Many times, unfortunately.” I bent to check Mr. Ormiston’s breathing, which was stertorous but not labored. He’d downed nearly half the bottle within five minutes. That was a dose that would likely kill someone less inured to rum than a British seaman, but his vital signs were reasonably good, fever notwithstanding. Drunkenness was not by any means the equivalent of anesthesia; the patient was stunned, not unconscious, and would certainly come to when I began cutting. It did allay fear, though, and might dull the immediate pain slightly. I wondered whether—and when—I might ever be able to make ether again.