"Bonjour, Madame." The deep, rich voice spoke above me, and I glanced up at the towering form of Mother Hildegarde. There was a whish past my elbow, and Bouton landed on the mattress with a thump that made the patient groan slightly.
"What do you think?" said Mother Hildegarde. I wasn't at all sure whether she was addressing me or Bouton, but took the benefit of the doubt and explained my observations.
"So, there must be a secondary source of infection," I concluded, "but I can't find it. I'm wondering now whether perhaps he has an internal infection that's not related to the leg wound. A mild appendicitis, or a bladder infection, perhaps, though I don't find any abdominal tenderness, either."
Mother Hildegarde nodded. "A possibility, certainly. Bouton!" The dog cocked his head toward his mistress, who jerked an oblong chin in the direction of the patient. "A la bouche, Bouton," she ordered. With a mincing step, the dog pushed the round black nose that presumably gave him his name into the carter's face. The man's eyes, heavy-lidded with fever, sprang open at this intrusion, but a glance at the imposing presence of Mother Hildegarde stopped whatever complaint he might have been forming.
"Open your mouth," Mother Hildegarde instructed, and such was her force of character that he did so, even though his lips twitched at the nearness of Bouton's. Dog-kissing plainly wasn't on his agenda of desirable activities.
"No," said Mother Hildegarde thoughtfully, watching Bouton. "That isn't it. Have a look elsewhere, Bouton, but carefully. The man has a broken leg, remember."
As though he had in fact understood every word, the dog began to sniff curiously at the patient, nosing into his armpits, putting stubby feet on his chest in order to investigate, nudging gently along the crease of the groin. When it came to the injured leg, he stepped carefully over the limb before putting his nose to the surface of the bandages round it.
He returned to the groin area—well, what else, I thought impatiently, he's a dog, after all—nudged at the top of the thigh, then sat down and barked once, wagging triumphantly.
"There it is," said Mother Hildegarde, pointing to a small brown scab just below the inguinal crease.
"But that's almost healed," I protested. "It isn't infected."
"No?" The tall nun placed a hand on the man's thigh and pressed hard. Her muscular fingers dented the pale, clammy flesh, and the carter screamed like a banshee.
"Ah," she said in satisfaction, observing the deep prints left by her touch. "A pocket of putrefaction."
It was; the scab had loosened at one edge, and a thick ooze of yellow pus showed under it. A little probing, with Mother Hildegarde holding the man by leg and shoulder, revealed the problem. A long sliver of wood, flying free of the splintered cartwheel, had driven upward, deep into the thigh. Disregarded because of the apparently insignificant entrance wound, it had gone unnoticed by the patient himself, to whom the whole leg was one giant pain. While the tiny entrance wound had healed cleanly, the deeper wound had festered and formed a pocket of pus around the intrusion, buried in the muscle tissue where no surface symptoms were visible—to human senses, at least.
A little scalpel work to enlarge the entrance wound, a quick grip with a pair of long-nosed forceps, a smooth, forceful pull—and I held up a three-inch sliver of wood, coated with blood and slime.
"Not bad, Bouton," I said, with a nod of acknowledgment. A long pink tongue lolled happily, and the black nostrils sniffed in my direction.
"Yes, she's a good one," said Mother Hildegarde, and this time there was no doubt which of us she was speaking to, Bouton being male. Bouton leaned forward and sniffed politely at my hand, then licked my knuckles once in reciprocal acknowledgment of a fellow professional. I repressed the urge to wipe my hand on my gown.
"Amazing," I said, meaning it.
"Yes," said Mother Hildegarde, casually, but with an unmistakable note of pride. "He's very good at locating tumors beneath the skin, as well. And while I cannot always tell what he finds in the odors of breath and urine, he has a certain tone of bark that indicates unmistakably the presence of a derangement of the stomach."
Under the circumstances, I saw no reason to doubt it. I bowed to Bouton, and picked up a vial of powdered St.-John's-wort to dress the infection.
"Pleased to have your assistance, Bouton. You can work with me anytime."
"Very sensible of you," said Mother Hildegarde, with a flash of strong teeth. "Many of the physicians and chirurgiens who work here are less inclined to take advantage of his skills."
"Er, well.…" I didn't want to disparage anyone's reputation, but my glance across the hall at Monsieur Voleru must have been transparent.
Mother Hildegarde laughed. "Well, we take what God sends us, though occasionally I wonder whether He sends them to us only in order to keep them out of greater trouble elsewhere. Still, the bulk of our physicians are better than nothing—even if only marginally so. You"—and the teeth flashed once more, reminding me of a genial draft horse—"are a great deal better than nothing, Madame."
"Thanks."
"I have wondered, though," Mother Hildegarde went on, watching as I applied the medicated dressing, "why you see only the patients with wounds and broken bones? You avoid those with spots and coughs and fevers, yet it is more common for les maîtresses to deal with such things. I don't think I have ever seen a female chirurgien before." Les maîtresses were the unlicensed healers, mostly from the provinces, who dealt in herbals, poultices, and charms. Les maîtresses sage-femme were the midwives, the top of the heap so far as popular healers were concerned. Many were accorded more respect than the licensed practitioners, and were much preferred by the lower-class patients, as they were likely to be both more capable and much less expensive.
I wasn't surprised that she had observed my proclivities; I had gathered long since that very little about her Hôpital escaped Mother Hildegarde's notice.
"It isn't lack of interest," I assured her. "It's only that I'm with child, so I can't expose myself to anything contagious, for the child's sake. Broken bones aren't catching."
"Sometimes I wonder," said Mother Hildegarde, with a glance at an incoming stretcher. "We're having a plague of them this week. No, don't go." She motioned me back. "Sister Cecile will see to it. She'll call you if there's need."
The nun's small gray eyes regarded me with curiosity, mingled with appraisal.
"So, you are not only a milady, you are with child, but your husband does not object to your coming here? He must be a most unusual man."
"Well, he's Scottish," I said, by way of explanation, not wishing to go into the subject of my husband's objections.
"Oh, Scottish." Mother Hildegarde nodded understandingly. "Just so."
The bed trembled against my thigh as Bouton leaped off and trotted toward the door.
"He smells a stranger," Mother Hildegarde remarked. "Bouton assists the doorkeeper as well as the physicians—with no more gratitude for his efforts, I fear."
The sounds of peremptory barks and a high voice raised in terror came through the double doors of the entryway.
"Oh, it's Father Balmain again! Curse the man, can't he learn to stand still and let Bouton smell him?" Mother Hildegarde turned in haste to the succor of her companion, turning back at the last moment to smile engagingly at me. "Perhaps I will send him to assist you with your tasks, Madame, while I soothe Father Balmain. While no doubt a most holy man, he lacks true appreciation for the work of an artist."
She strode toward the doors with her long, unhurried stride, and with a last word for the carter, I turned to Sister Cecile and the latest stretcher case.
Jamie was lying on the carpet in the sitting room when I came back to the house, with a small boy sitting cross-legged on the floor beside him. Jamie was holding a bilboquet in one hand, and had the other poised over one eye.
"Of course I can," he was saying. "Anyday and twice on Sundays. Watch."
Placing the hand over his eye, he fixed the other piercingly on the bilboquet and gave the ivory cup a toss. The tethered ball leaped from its socket into an arc, and dropped as though guided by radar, landing back in its cup with a snug little plop.
"See?" he said, removing the hand from his eye. He sat up and handed the cup to the boy. "Here, you try it." He grinned at me, and slid a hand under the hem of my skirt, clasping my green silk ankle in greeting.
"Having fun?" I inquired.
"Not yet," he replied, giving the ankle a squeeze. "I was waiting for you, Sassenach." The long, warm fingers curled around my ankle slid higher, playfully stroking the curve of my calf, as a pair of limpid blue eyes gazed up at me, all innocence. His face had a streak of dried mud down one side, and there were dirty blotches on his shirt and kilt.
"Is that so?" I said, trying to pull my leg free of his grasp inconspicuously. "I should have thought your little playmate would have been all the company you needed."
The boy, understanding none of the English in which these exchanges were conducted, ignored them, intent on trying to work the bilboquet with one eye closed. The first two attempts having failed, he opened the second eye and glared at the toy, as though daring it not to work. The second eye closed again, but not all the way; a small slit remained, gleaming alertly below the thick fringe of dark lashes.