The current earl, Devon, Lord Trenear, was a distant Ravenel cousin who had inherited the title unexpectedly after the last two earls had died in quick succession. Although Devon was a young man with no experience at running a large estate and managing its attendant financial obligations, he had shouldered the burden admirably. He had also taken responsibility for the three Ravenel sisters, Helen, Pandora, and Cassandra, all unmarried at the time, when he could have easily thrown them to the wolves.
At last the stately Jacobean house came into view, its squared-off shape ornamented with lavish scrolls, pilasters, arches, and parapets. For all its great size, the residence was welcoming and warm, comfortably mellowed with age. As soon as the carriage stopped, one footman was there to open the door while another reached in to assist Garrett.
“Take this,” Garrett said without preamble, handing the basket of supplies to him. “Be careful—most of these chemicals are caustic and highly flammable.”
The footman shot her a glance of suppressed alarm and gripped the basket carefully.
Garrett alighted from the carriage by herself and strode across the flagstone tiles to the front steps of the house, almost running in her haste.
Two women waited for her at the threshold: the plump silver-haired housekeeper, Mrs. Abbot, and Lady Cassandra, a fair-haired young woman with blue eyes and the kind of face that belonged on a cameo. Behind them, the grand entrance hall bustled with a sense of controlled panic, housemaids and footmen running back and forth with cans of water, and what appeared to be dirty toweling and linens.
Garrett’s nose twitched as she caught an ambient scent in the air, a taint of some kind of organic matter mixed with caustic chemicals . . . whatever its source, the smell was rank and rotten.
The housekeeper helped Garrett remove her hat and coat.
“Dr. Gibson,” Cassandra said, her pretty features drawn and anxious. “Thank goodness you arrived so quickly.”
“Tell me what happened.”
“I’m not altogether sure. A man was brought here earlier by the river police, only they asked us not to tell anyone about it. He was thrown into the river, and they said when they pulled him out, they thought he was dead, but then he started coughing and groaning. They brought him here because he was carrying one of Cousin West’s calling cards in his wallet, and they didn’t know where else to take him.”
“Poor fellow,” Garrett said quietly. Even a healthy man who’d been exposed to the toxic waters of the Thames would become seriously ill from it. “Where is he now?”
“They carried him into the double library,” Mrs. Abbot said, gesturing toward a nearby hallway. “It’s a dreadful mess in there. Lord and Lady Trenear have been trying to wash the filth from him and make him more comfortable.” She shook her head and fretted, “The carpets . . . the furniture . . . no doubt all ruined.”
“Why would an earl and countess personally tend to a stranger?” Garrett asked, puzzled.
A new voice joined the conversation as a man approached them from the hallway. “He’s not a stranger.” His voice was deep and easy, the accent refined.
As Garrett turned to face him, a shock of excitement and confusion stopped her breath. Ethan. Blue, blue eyes . . . the dark hair . . . the big, athletic frame . . . but it was not him. A leaden weight of disappointment settled over her, followed by a chill of premonition.
“I’m West Ravenel.” The man glanced beyond her to Cassandra. “Darling,” he murmured, “let me have a few moments with the doctor.” The girl left at once, accompanied by the housekeeper. Turning back to Garrett, Ravenel said quietly, “The wounded man is an acquaintance of yours. You’re here because he asked for you.”
Cold barbs of fear lodged in Garrett’s chest. The few bites of mincemeat she’d had earlier seemed to rise in her esophagus. Swallowing against the nausea, she forced herself to ask, “Is it Mr. Ransom?”
“Yes.”
More sharp spikes were driven into her chest, pinning her pounding heart in place. She felt her face contorting, spasming.
Ravenel spoke with measured slowness, trying to give her time to absorb the information. “There’s a bullet in his chest. He’s lost a great deal of blood. The wound doesn’t seem to be bleeding now, but his condition is very bad. He goes in and out of consciousness. We sent for you not out of any hope that you could heal him, but because he wanted to see you one last time.”
Garrett tried to think above a flood of sick horror. She wanted to scream, weep, collapse. But as she thought of the men who were responsible for harming him, a bolt of fury engulfed her, searing through the smothering despair. How dare they do this to him? The burst of rage steadied her and gave her strength. Her fist tightened around the handles of her leather bag.
“Show me to him,” she heard herself say in a level voice. “I’ll fix him.”
Chapter 16
“I don’t think you understand the severity of his condition,” Ravenel said as he led the way to the double library. “He’s hanging by a thread.”
“I understand his condition quite well,” Garrett said, proceeding along the hallway with heel-digging strides. “Any perforating wound of the chest is life-threatening. Furthermore, the Thames is contaminated with bacteria, nitrates, and poisonous chemicals. One can hardly do enough to disinfect him.”
“But you think there’s a chance of saving him?” he asked skeptically.
“I will save him.” Garrett gave an impatient shake of her head as she heard the quaver in her voice.
They entered the library, two spacious joined rooms lined with acres of mahogany bookshelves. The interior was arranged with a few pieces of stately, heavy furniture, including a massive table running along the center and a long, low settee. An expanse of sodden Persian carpeting was heaped with toweling and cans of water. A foul scent competed with the acrid freshness of carbolic soap, commonly used for horses and difficult household cleaning.
The small, slim form of Kathleen, Lady Trenear, and the far more substantial one of her husband, Devon, were bent over a still form laid out on the settee.
Garrett’s heartbeat was so rough that the lights in the room seemed to pulse in front of her eyes. “Good evening,” she said, trying to sound composed, without success.
Both of them turned toward her.
Kathleen, a red-haired woman with delicate, almost feline beauty, regarded her with concern. “Dr. Gibson,” she murmured.
“Countess,” she said distractedly, and gave a cursory nod to the tall, dark-haired earl. “Lord Trenear.” Her gaze went to Ethan.
If not for the continuous trembling that shook Ethan’s long frame, she would have assumed he was already dead. His complexion was waxen, his lips blue-tinged, his eyes closed and sunken. They had covered his body with a quilt but had left his shoulders and one arm bare. His hand lay palm upward with the fingers slightly curled, the nails lavender-gray.
Setting down her doctor’s bag, Garrett knelt on a folded towel beside the settee and reached for his wrist to check his pulse. It was nearly too weak to detect. His veins were colorless and flattened. Oh God. He’d lost too much blood. Anything she did was going to kill him.
Ethan jerked a little at her touch. The thick lashes lifted to reveal a flash of unearthly blue. His disoriented gaze settled on her, focusing with effort. A faint smile ghosted across his lips. “Garrett. My time’s . . . run short.”
“Nonsense,” she said firmly. “I’ll have you back to rights quite soon.”
She began to pull back the quilt, but his big, cold hand slid over hers, stopping her. “I’m dying, love,” she heard him whisper.
The words shook Garrett by the spine, as nothing ever had before. She was distantly amazed that she could manage a coherent reply. “I’ll thank you to leave the diagnosing to me.”
His fingers wrapped around hers. The feel of them was unfamiliar, devoid of their natural heat and strength. “Garrett . . .”
She used her free hand to ease the quilt down until the bullet wound was visi
ble. It was a surprisingly neat, small circle. Given the elasticity of skin, the bullet was undoubtedly larger than the hole’s diameter.
Ethan’s gaze fixed on hers as he spoke with effort. “The first moment I saw you, I knew you were my share of the world. I’ve always loved you. If I could choose my fate, I’d never be parted from you. Acushla . . . pulse of my heart, breath of my soul . . . there’s nothing on this earth more fair and fine than you. Your shadow on the ground is sunlight to me.”
He fell silent, his eyes closing. Tremors racked his body. Pain drew his eyebrows together as if he were concentrating very hard on something.
Clumsily Garrett drew away from him to rummage in her bag, yanking out a stethoscope. Her heart was dashing itself to pieces. She wanted to throw herself on him and howl in despair. I’m not strong enough for this, she thought. I can’t bear it. God, please don’t let this happen . . . please . . .
But as she looked down at Ethan’s ashen face, a mantle of calm determination settled over the blaze of anguish. She would not lose him.
Carefully she set the stethoscope at various points on his chest, from just above his collarbone down to the bottom of his rib cage. Although his breathing was far too rapid and shallow, his lungs didn’t appear to have been damaged. Clinging to that one small bit of good news, she reached into her supplies, found her hypodermic needle case, and prepared a syringe of morphine.
“Ethan,” she asked quietly, “can you tell me what kind of gun it was? Did you see how far away the shooter was standing?”
His eyes slitted open, staring at her without comprehension.
Devon, Lord Trenear, answered from behind her. “From the powder burns, it appears he was shot at point-blank range. There’s no exit wound. I would guess it was a large-caliber round shot at low velocity.”
She hoped he was right: the inward track of a heavy bullet through the flesh would be wider, which would make probing and removal easier.
“He said it was one of Jenkyn’s men,” Trenear continued. “A professional assassin would use one of the more modern bullets, with a conical shape instead of round. If so, it would be partially encased in a shell of copper or steel.”
“Thank you, my lord.” A pointed tip made it likely the bullet had pursued a direct course instead of bouncing and ricocheting inside him. And if the projectile was covered by a hard casing, the lead wouldn’t have fragmented.
Trenear gave her an astute glance, understanding that she was going to operate on Ethan right there, in a last-minute effort to save his life. His eyes were dark blue rimmed with black . . . Ethan’s eyes. Was she going mad? No, she wouldn’t think about anything except the work that awaited her.
“What do you need?” Kathleen asked, coming to stand beside her. “We have three large cans of boiled water, and more in the process of heating. We’ve been using it to wash him with carbolic soap.”
“Excellent,” Garrett said. “The footman has carried in a basket of surgical chemicals. If you would, my lady, please find the one labeled sodium hypochlorite, and pour the entire contents into one of the cans of water. Use that to disinfect every inch of the library table, and cover the surface with clean linen sheets. We’ll need as many lamps in here as you’re able to provide.” She turned to Devon. “My lord, can you send someone to fetch Dr. Havelock?”
“I’ll fetch him myself.”
“Thank you. Also, make certain he brings the Roussel transfuser. He won’t want to, but don’t let him come without it.” Continuing to kneel beside the settee, Garrett swabbed Ethan’s upper arm with antiseptic solution. Tilting the morphine syringe upward, she expertly forced the air from the small glass chamber until a clear drop appeared at the tip of the hollow needle.
Ethan stirred and blinked, seeming to regain his sensibilities. “Garrett,” he said carefully, as if he knew her but wasn’t quite sure of the name. His gaze flickered to the hypodermic needle in her hand. “Don’t need that.”
“You’ll be glad of it when I start probing for the bullet.”
His chest rose and fell with an agitated breath. “Don’t even think about opening me up like . . . a tin of boiled ham.”
“You’re going to receive proper medical treatment,” she informed him.
“If I made it through surgery, the fever would kill me.”
“You will make it through surgery, and you will definitely have fever. A nasty one. After being doused in that filthy river, you’re teeming with inflammatory microbes. Fortunately, I’ve brought a variety of antiseptic solutions. Before long I’ll have you as clean as a bobbin.”
“For God’s sake, woman—ahh, damn it, what is that?”
“Morphine,” she said, depressing the plunger slowly to release the medicine into the thick muscle of his upper arm.
Ethan subsided, realizing there would be no stopping her. “You haven’t one romantic bone in your body,” he muttered.
That sounded so much like his usual self that Garrett almost smiled. “I reassembled an entire disarticulated skeleton in medical school. There’s no such thing as a romantic bone.”
He turned his face away from her.
Garrett was wrenched with love and agonized concern. She felt her lips tremble, and she clamped them shut. She knew Ethan understood how close to death he was, and had resigned himself to what he thought was inevitable. He wanted to spend the last few minutes of his life lucid and aware, in the arms of the woman he loved.
But instead of caressing him, her hands would be plying surgical instruments. Instead of gazing at him adoringly, she would be examining inner contusions and lacerations.
No, her way was not romantic.
She wouldn’t be the woman he loved, however, if she didn’t use all her skills in an effort to save him.
Setting aside the hypodermic syringe, Garrett looked down at the perfect shape of his ear. She bent to rub her lips softly against the lobe. “Éatán,” she whispered, “listen to me. This is what I do. I’ll bring you through this and take care of you. I’ll be with you every minute. Trust me.”
His cheek nudged back toward her. She saw that he didn’t believe her. All the light in his eyes had vanished save a last glint or two, like the ember of a candlewick that had just been snuffed.
“Tell me you love me,” he whispered.
Panicked words fluttered and darted inside her . . . I love you I need you Oh God please stay with me . . . but she had the terrifying premonition that saying it would allow him to let go. As if she would be giving him permission to pass away peacefully instead of fighting for his life.
“Later,” she said gently. “When you wake up after the surgery, I’ll tell you.”
By the time Dr. Havelock had arrived, Ethan had been transferred to the massive oak library table. It had taken the combined efforts of West Ravenel and three footmen to move him as carefully as possible, in the fear of dislodging possible bone shards or lead fragments, or causing other damage. Ethan had slipped into a delirium, only letting out an occasional groan or wordless exclamation.
With Kathleen’s help, Garrett had wiped Ethan’s form from head to toe with disinfectant solution and shaved around the gunshot wound in preparation for surgery. They had draped a towel across his hips for modesty, and covered him with clean cotton blankets afterward. A blue-white pallor gave his flesh the illusion of cool marble perfection, sculpted and polished to a silky sheen.
It was somehow worse to see a man of such robust health reduced to this condition. The morphine had taken what effect it would, but Ethan was still in obvious pain, and Garrett didn’t dare give him any more with his blood pressure so low.
Garrett had never been so relieved as she was when Dr. Havelock arrived. His capable presence made her feel that together, they would pull Ethan through. Havelock’s distinctive shock of snow-white hair had been brushed back hastily, his cheeks and chin glinting with the day’s growth of silver beard. He examined Ethan with quiet efficiency, responding to the wounded man’s incoherent murmurs with a f
ew soothing words.
When Havelock had finished his evaluation, Garrett went with him to the far end of the library for a private conference.
“He’s on the verge of circulatory collapse,” Havelock said quietly, his expression grave. “In fact, I’ve never seen a patient with a capacity to endure such severe hemorrhage. The bullet penetrated the left pectoral muscle. I wouldn’t be surprised if an artery has been completely severed.”
“That’s what I thought—but if so, it should have been immediately fatal. Why has the bleeding stopped? If it were leaking into the chest cavity, his lung function would be impaired, but it isn’t.”
“It’s possible the artery has constricted and retracted within its sheath, thereby sealing itself temporarily.”
“If it turns out to be the axillary artery, would there be enough blood supply left for the arm if I tie it off?”
“Yes, there would be sufficient collateral circulation. But I wouldn’t advise it.”
“What would you advise, then?”
Havelock regarded her for a long moment, his gaze kind in a way she didn’t like. “Make the poor fellow as comfortable as you can, and let him die in peace.”
The words were a slap in the face. “What?” Garrett asked dazedly. “No, I’m going to save him.”
“You can’t. Based on everything you’ve taught me about antiseptic medicine, this man is so contaminated, within and without, there’s no hope. Subjecting him to unnecessary surgery is folly and selfishness. If we did manage to delay his death for a day or so, he would go through unspeakable agony. His entire body would become riddled with sepsis until all his organs failed. I won’t have that on my conscience, and I don’t want it on yours.”
“Let me worry about my own conscience. Just help me, Havelock. I can’t do this by myself.”
“Operating when the medical facts don’t warrant it—when it will only cause the patient needless suffering—that is malpractice by any standard.”
“I don’t care,” Garrett said recklessly.
“You’ll care very much if this destroys your career. You know there are many who would leap at the chance to revoke your medical license. The first female physician in England, driven out of the profession because of scandal and misconduct . . . what would that do to the women who dream of following in your footsteps? What about the patients you’ll never be able to help in the future?”