If the patient couldn’t keep down even water—I didn’t think the MacNeills were vomiting; I didn’t recall that smell among the others in the cabin. Probably not cholera, then; that was something.
Brianna sat on the floor by the elder child, the little girl’s head in her lap, pressing a cup against her mouth. Lizzie knelt by the hearth, face red with exertion as she kindled the fire. The flies were settling on the motionless body of the woman on the bed, and Marsali crouched over the limp form of the baby on her lap, frantically trying to rouse it to drink.
Spilled water streaked her skirt. I could see the tiny head lolled back on her lap, water dribbling down a slack and horribly flattened cheek.
“She can’t,” Marsali was saying, over and over. “She can’t, she can’t!”
Disregarding my own advice about fingers, I ruthlessly thrust an index finger into the baby’s mouth, prodding the palate for a gag reflex. It was there; the baby choked on the water in its mouth and gasped, and I felt the tongue close hard against my finger for an instant.
Sucking. She was an infant, still breastfed—and suckling is the first of the instincts for survival. I whirled to look at the woman, but a glance at her flat br**sts and sunken ni**les was enough; even so, I grabbed one breast, squeezing my fingers toward the nipple. Again, again—no, no droplets of milk showed on the brownish ni**les, and the breast tissue was flabby in my hand. No water, no milk.
Marsali, grasping what I was about, seized the neck of her blouse and ripped it down, pressing the child to her own bared breast. The tiny legs were limp against her dress, toes bruised and curled like wilted petals.
I was tipping back Hortense’s face, dribbling water into her open mouth. From the corner of my eye, I saw Marsali rhythmically squeezing her breast with one hand, an urgent massage to make the milk let down, even as my own fingers moved in an echo of the motion, massaging the unconscious woman’s throat, urging her to swallow.
Her flesh was slick with sweat, but most of it was mine. Trickles of perspiration were running down my back, tickling between my bu**ocks. I could smell myself, a strange metallic scent, like hot copper.
The throat moved in sudden peristalsis, and I took my hand away. Hortense choked and coughed, then her head rolled to the side and her stomach heaved, sending its meager contents rocketing back up. I wiped the trace of vomit from her lips, and pressed the cup to her mouth again. Her lips didn’t move; the water filled her mouth and dribbled down her face and neck.
Among the buzzing of the flies, I heard Lizzie’s voice behind me, calm but abstracted, as though she spoke from a long way off.
“Can ye stop cursing, ma’am? It’s only that the weans can hear ye.”
I jerked round at her, only then realizing that I had in fact been repeating “Bloody f**king hell!” out loud, over and over as I worked.
“Yes,” I said. “Sorry.” And turned back to Hortense.
I got some water down her now and then, but not enough. Not nearly enough, given that her bowels were still trying to rid themselves of whatever troubled them. Bloody flux.
Lizzie was praying.
“Hail Mary, full of grace, the Lord is with thee . . .”
Brianna was murmuring something under her breath, urgent sounds of maternal encouragement.
“Blessed is the fruit of thy womb, Jesus . . .”
My thumb was on the pulse of the carotid artery. I felt it bump, skip, and go on, jerking along like a cart with a missing wheel. Her heart was beginning to fail, arrhythmic.
“Holy Mary, Mother of God . . .”
I slammed my fist down on the center of her chest, and then again, and again, hard enough that the bed and the pale splayed body quivered under the blows. Flies rose in alarm from the soaked straw, buzzing.
“Oh, no,” said Marsali softly behind me. “Oh, no, no, please.” I had heard that tone of disbelief before, of protest and appeal denied—and knew what had happened.
“Pray for us sinners . . .”
As though she, too, had heard, Hortense’s head rolled suddenly to one side, and her eyes sprang open, staring toward the place where Marsali sat, though I thought she saw nothing. Then the eyes closed and she doubled suddenly, onto one side, legs drawn up nearly to her chin. Her head wrenched back, body tight in spasm, and then she suddenly relaxed. She would not let her child go alone. Bloody flux.
‘Now and at the hour of our death, amen. Hail Mary, full of grace . . .”
Lizzie’s soft voice went on mechanically, repeating her words of prayer as mindlessly as I had said mine earlier. I held Hortense’s wrist, checking for the pulse, but it was mere formality. Marsali curled over the tiny body in grief, rocking it against her breast. Milk dripped from the swollen nipple, coming slowly, then faster, falling like white rain on the small still face, futilely eager to nourish and sustain.
The air was still stifling, still thick with odor and flies and the sound of Lizzie’s prayers—but the cabin seemed empty, and curiously silent.
There was a shuffling noise outside; the sound of something being dragged, a grunt of pain and dreadful exertion. Then the soft sound of falling, a gasp of breath. Padraic had made it back to his own doorstep. Brianna looked to the door, but she still held the older girl in her arms, still alive.
I set down the limp hand that I held, carefully, and went to help.
61
A NOISOME PESTILENCE
THE DAYS WERE GROWING SHORTER, but light still came early. The windows at the front of the house faced east, and the rising sun glowed on the scrubbed white oak of my surgery floor. I could see the brilliant bar of light advancing across the hand-hewn boards; had I had an actual timepiece, I could have calibrated the floor like a sundial, marking the seams between the boards in minutes.
As it was, I marked them in heartbeats, waiting through the moments until the sun should have reached the counter where my microscope stood ready, slides and beaker beside it.
I heard soft footsteps in the corridor, and Jamie pushed the door open with his shoulder, a pewter mug of something hot held in each hand, wrapped with rags against the heat.
“Ciamar a tha thu, mo chridhe,” he said softly, and handed one to me, brushing a kiss across my forehead. “How is it, then?”
“It could be worse.” I gave him a smile of gratitude, though it was interrupted by a yawn. I didn’t need to tell him that Padraic and his elder daughter still lived; he would have known at once by my face if anything dire had happened. In fact, bar any complications, I thought both would recover; I had stayed with them all night, rousing them hourly to drink a concoction of honeyed water, mixed with a little salt, alternating with a strong infusion of peppermint leaf and dogwood bark to calm the bowels.
I lifted the mug—goosefoot tea—closing my eyes as I inhaled the faint, bitter perfume, and feeling the tight muscles of my neck and shoulders relax in anticipation.
He had seen me twist my head to ease my neck; Jamie’s hand came down on my nape, large and wonderfully warm from holding the hot tea. I gave a small moan of ecstasy at the touch, and he laughed low in his throat, massaging my sore muscles.
“Should ye not be abed, Sassenach? Ye’ll not have slept at all the night.”
“Oh, I did . . . a bit.” I had dozed fitfully, sitting up by the open window, roused periodically by the startling touch on my face of the moths that flew in, drawn to the light of my candle. Mrs. Bug had come at dawn, though, fresh and starched, ready to take over the heavy nursing.
“I’ll go lie down in a bit,” I promised. “But I wanted to have a quick look first.” I waved vaguely toward my microscope, which stood assembled and ready on the table. Next to it were several small glass bottles, plugged with twists of cloth, each containing a brownish liquid. Jamie frowned at them.
“Look? At what?” he said. He lifted his long, straight nose, sniffing suspiciously. “Is that shit?”
“Yes, it is,” I said, not bothering to stifle a jaw-cracking yawn. I had—as discreetly as possible—collected samples from Hortense and the baby and, later, from my living patients, as well. Jamie eyed them.
“Exactly what,” he inquired cautiously, “are ye looking for?”
“Well, I don’t know,” I admitted. “And in fact, I may not find anything—or anything I can recognize. But it’s possible that it was either an amoeba or a bacillus that made the MacNeills sick—and I think I would recognize an amoeba; they’re quite big. Relatively speaking,” I added hastily.
“Oh, aye?” His ruddy brows drew together, then lifted. “Why?”
That was a better question than he knew.
“Well, partly for the sake of curiosity,” I admitted. “But also, if I do find a causative organism that I can recognize, I’ll know a bit more about the disease—how long it lasts, for instance, and whether there are any complications to look out for specially. And how contagious it is.”
He glanced at me, cup half-raised to his mouth.
“Is it one you can catch?”
“I don’t know,” I admitted. “Though I’m fairly sure it is. I’ve been vaccinated against typhus and typhoid—but this doesn’t look like either one of those. And there are no vaccines for dysentery or Giardia poisoning.”
The brows drew together and stayed that way, knotted as he sipped his tea. His fingers gave my neck a final squeeze and dropped away.
I sipped cautiously at my own tea, sighing in pleasure as it gently scalded my throat and ran hot and comforting down into my stomach. Jamie lounged on his stool, long legs thrust out. He glanced down into the steaming cup between his hands.
“D’ye think this tea is hot, Sassenach?” he asked.
I raised my own brows at that. Both cups were still wrapped in rags, and I could feel the heat seeping through to my palms.
“I do,” I said. “Why?”
He lifted the mug and took a mouthful of tea, which he held for a moment before swallowing; I could see the long muscles move in his throat.
“Brianna came into the kitchen whilst I was brewing the pot,” he said. “She took down the basin, and the pannikin of soap—and then she took a dipper of water steaming from the kettle, and poured it over her hands, one and then the other.” He paused a moment. “The water was boiling when I took it off the fire a moment before.”
The mouthful of tea I had taken went down crooked, and I coughed.
“Did she burn herself?” I said, when I had got my breath back.
“She did,” he said, rather grimly. “She scrubbed herself from fingertips to elbows, and I saw the blister on the side of her hand where the water fell.” He paused for a moment, and his eyes met mine over the mugs, dark blue with worry.
I took another sip of my un-honeyed tea. The room was cool enough, just past dawn, that my hot breath made tiny wisps of steam as I sighed.
“Padraic’s baby died in Marsali’s arms,” I said quietly. “She held the other child. She knows it’s contagious.” And knowing, could not touch or pick up her own child without doing her best to wash away her fear.
Jamie moved uneasily.