Dr. Schaefer pleaded with the parents. "Julie, didn't I deliver you of two children and did you suffer?"
"No," said the weeping mother. "It was all perfect. Horace, I don't know if we should give the permission. I'm so upset; I can't think."
Jonathan said, "Mrs. Kimberley, it isn't in your hands to give the decision. It's in Jeff's, the husband's. Well, Jeff?"
Jeffrey looked despairingly at Louis Hedler and Humphrey Bedloe, who had come up to them. "It's quite true, Jeff," said Dr. Hedler, and Dr. Bedloe nodded silently. "Oh, God," muttered the young man. He caught Jonathan by the arm.
"Tell me, Jon! If you operate—will she live?"
"I don't know. As of this minute, I don't think so, Jeff. She has sepsis. She's terribly infected. I won't go into the details; you wouldn't understand them, anyway. She will assuredly die without the operation; with it she has one chance in a thousand. That's all I can promise you. She's far gone."
" 'Far gone?' Jon, can't you give us any hope?"
"Not much. Practically none. I can only do what I can to undo this terrible damage."
"I forbid it," said Dr. Schaefer, his voice breaking into a huskiness. "It would be criminal to deprive this young lady of her childbearing capabilities! That's what he wants to do! It will be murder!"
"If she dies," said Jonathan to the young husband, "it will be murder, indeed. But I won't be the one who committed it I won't remove the uterus if it is possible to let it remain, Jeff. Ill have to see. The choices are desperate, and I know it only too well. Hortense may die, either on the operating table or a few hours later—or she will die without the operation— or she will live, after the operation, unable to bear children in the future. The choices are not mine."
"There's no other alternative?"
"The very faintest one, that she will live after the operation and be able to bear other children. The very faintest one. I can't give you any hope. It would be cruel to do it. I can only offer you my knowledge and my promise that I will do all I can, all that any man can do."
Dr. Schaefer again appealed to the parents. "Does my experience count for nothing in comparison with this man's 'new' and superficial knowledge? Do you want a—" He stopped. But the parents knew what he had almost said.
"I don't know, I don't know!" the mother wailed, clinging to her husband.
Jonathan sighed and looked at his watch. "Each minute that goes lessens Hortense's chances. Give me your answer, Jeff. It's all in your hands."
Dr. Bedloe put his hand on the mother's shoulder. "You've heard, Julie. It isn't in your hands. I know Jon Ferrier. Yes." he added, in a tone of deep shame, "I know him. I wronged him, Julie. I, too, was afraid of him because he knew more, and I hated him for that reason, too."
Jonathan's black eyebrows raised themselves in somber mockery. "Well, Jeff?"
"I give my permission," said the young man. "Where's the damned paper? Hurry, Jon, for God's sake, hurry!"
He signed the paper, the pen shaking in his fingers. "You have condemned that child to death," said Dr. Schaefer.
"No, you did," said Jonathan, folding the paper. "But I'll try to save her from your judgment of execution."
He looked at Robert, who followed him out of the room. In the corridor Jonathan began to race and Robert ran after him. Once in the scrub room, the young men began to wash their hands, over and over, and over and over, while the skeptical nurses stood silently by exchanging meaningful glances. Now Jonathan seemed to relax. "Old Bedloe's a hack and he's always known it. Now he admits it. That's like the sun rising west. There may be some hope for him. How did I get myself into this, anyway? Hortense isn't my patient. Kick me, Bob, kick me hard."
"Do you think there is any chance?"
"Who knows? I don't. Will my horses win at Belmont in September? I can answer that as easily as I can answer your question. Didn't they teach you at Johns Hopkins that a doctor never asks, nor answers, such a question? If they didn't, then I will immediately lose respect for them. Come on, another soaping. Seventeen times, remember. Must be something cabalistic about that, don't you think?"
Then Robert knew that he was deliberately relaxing himself, making himself objective, detached, before facing the ordeal in the operating room. Jonathan confirmed this at once by saying, "The patient has one thing in her favor. She's very young, and youth often confounds physicians." Hortense
Nolan had become "the patient" to him now and Robert felt an easing of the tension in his own shoulders.
"Did I ever tell you the story about the old goat of a surgeon and a student nurse?" asked Jonathan, resoaping his hands. He then proceeded, to the embarrassment of the silent young nurses nearby, to tell a most lewd story, with suggestive gestures of dripping fingers, gestures which only extreme innocence could not have understood. Robert glanced at the nurses, who had bent their heads sternly, and he laughed loudly. "It's an old story," said Jonathan, pleased. "You mean you didn't hear it in your grand Johns Hopkins?"
"They were careful of our delicate sensibilities," said Robert
"How nice," said Jonathan. "And I suppose they never told you that some nurses might have the clap, too?"
"They implied it," said Robert. The nurses shifted indignantly on their feet.
Capped, gloved, gowned and masked, the two doctors entered the operating room, which was brilliantly and blindingly lighted from overhead. It smelled of whitewash and soap and ether and carbolic acid. Dr. Bedloe and Dr. Hedler and the two interns were already waiting for them, dressed like themselves. It was Dr. Bedloe who was administering ether to Hortense Nolan, whose bright hair was wrapped in a towel and who seemed pathetically small and already dead on the operating table. "That's about the best thing you do, Humphrey," said Jonathan, his voice muffled behind the mask. "You learned one thing, anyway. Oxygen ready, too?"
He looked at the nurses, searching for one infringement of the asepsis technique. He looked carefully at the instrument tray, glittering under the fights. "I assume," he said, "that these have been sterilized?"
"Jon," said Louis Hedler, "don't you think that's enough levity?"
"Oh, I'm full of jokes," said Jonathan, nodding to the nurse nearby. "Solution of carbolic first. That's right, dear. Now, swab the operating field with alcohol, and I hope it's alcohol and somebody hasn't drunk it and substituted water."
He saw the deadly whiteness of Hortense's cheeks and heard the gasping sound she made as she inhaled the ether. Her eyes were shut and the fids had the blueness of death on them. "She's under," said Dr. Bedloe, feeling the girl's pulse. "I don't dare give her any more, Jon."
The nurse at the instrument tray laid a scalpel in Jon's gloved hand. This was the moment Robert always dreaded. The actual operations never disturbed him, for he had assisted at many and performed over a score of the simpler ones. But to him, still, the fragile outlining, with the scalpel, on the white flesh, and thin red wake that followed, make his heart quake with dread. It seemed to him that only a sadist could be so unconcerned at the first violation of the human body; the very delicacy of the first strokes appeared cruel and gloating. "Did I ever tell anyone here the joke about the elderly matron who thought she was pregnant?" asked Jonathan, as the nurses moved closer with sponges and sutures.
"Yes," said Dr. Hedler. "Last week. Most improper."
The tension in the operating room increased. Now everyone was silent, but the interns dutifully took notes. Dr. Bedloe's forehead had taken on a livid tint, for he was remembering that it was he who had called Jonathan. He watched without a movement; his eyes hardly blinked.
Then Jonathan said, as the instruments clicked in and out of his hand, "There's one thing certain, now. The infection has spread to the endometrium. And look at this abscess of the uterine wall! Thank God it's walled-off. We hardly ever see that. That's youth, for you, and a good sturdy constitution. Well evacuate it. We'll put in tubes for drainage. No salpingitis or parametritis, thank God again. How did this child escape that, after old Emil's efforts to kill her
? More sponges; counting them, I hope? Tie off this artery, Bob, or are you a statue? Come on, come on, move faster! Where's that Johns Hopkins' technique?"
The minutes moved on. Dr. Bedloe said, "I don't like this, Jon. Her pulse is weakening. Her pressure is down, 92/110." His voice trembled.
"She isn't just having her tonsils out," said Jonathan. Sweat was pouring from his forehead. He bent his head aside and a nurse wiped the uncovered portions of his face. He looked at the clock ticking ominously away on the wall. Nearly an hour.
"The blood loss," said Dr. Hedler.
"I know, I know," said Jon. "Quick! This spurt Damn you, Bob, move faster!"
"I think she's going," said Dr. Bedloe.
Jonathan said, "Look at old Emil's infernal sutures! No wonder. And, as I suspected, placental remnants. Someone should cut his throat, and it would give me great pleasure—"
Dr. Bedloe started the oxygen. "How much longer?" he implored. "I have to try to bring her out, Jon."
"Go on, then. It's one way or the other." His hands flew. He probed and cleaned, sewed. "Anyway, the uterus is all right now. Did I ever tell you—?"
The girl on the table uttered a great unconscious groan. "Good for you, Hortense," said Jonathan. "Stay with me, darling. Bob, you can start tailoring now."
Robert found his hands shaking. The girl's pulse and heart rate and pressure were all increasing, and her belly was beginning to tense. "Ether!" said Jonathan. "Not much, but enough to relax the belly, damn it!"
He watched critically as Robert made his neat stitches. "Good," he said. He did not look at his patient. He appeared to be concentrating on Robert's work. "I'll have to give her oxygen again," said Dr. Bedloe.
"All right. Do it. Watch that flap there, Bob. Girls, you have all the sponges, I hope?"
His hands were bloody, and his clothing. He stood and watched and only his eyes seemed alive, watching everything, darting from the girl's face and then to Robert's hands. Hortense groaned again, and the sound was terrible in the silent room. "She's still well under," said Jonathan. "Don't wet your trousers, Humphrey. She's still relaxed. Don't give too much oxygen for a couple of minutes."
It was two hours before Hortense Nolan was wheeled away into strict isolation, far from the obstetrical floor, and accompanied by nurses who would attend no one else. The four doctors, unaccompanied now by the blatantly admiring interns, went to the sitting room of Hortense's former suite. The girl's parents and husband were waiting, and they started with simultaneous cries to their feet, "Where's my child?" exclaimed the mother, staring at them with dread. "Why didn't you bring her back?" Her hands flew to her mouth. She dared not ask the question.
Jonathan said, "She's in an isolated room now. She can't come back to this floor. Jeff? Now listen to me, all of you. She has a chance; just a chance. But she won't have even that one miraculous chance if old Emil is permitted in her room, with his own nice little infection and his nice old curious hands. If you let him in, even for a second, I'm off the case. Is that understood, clearly understood?"
Jeffrey Nolan had begun to cry. The parents clutched each other. Jonathan's exhausted eyes smiled at them. "A chance," he repeated. "Just a chance. I wouldn't bet too much on it, but you can hope a little. And, there's another thing. If she lives—I still say, if she lives—shell have other children, but why anyone would want to inflict life on an innocent soul I don't know. It's one of those unsolved mysteries that always plague me."
"Jon," said Dr. Bedloe, and took the younger man's hand. "I can't tell you—"
"Don't," said Jonathan.
"Jon," said Dr. Hedler, "Hortense will be under my personal supervision."
"Oh, God," said Jonathan. "Spare us all that, Louis. If any doctor is allowed in here when I'm away, he must be either Moe Abrams or Bob here or Jed Collins. No one else. Is that understood, too?"
Dr. Hedler, who looked like a very pallid toad indeed, smiled painfully. "All right, Jon. You don't have to insult us. Is it really necessary?"
"Very," said Jonathan. "I didn't go through all that to have some hack undo it all. I know you're nice old fellows, but I don't want you in the room with Hortense. Strict asepsis at all times. Me, Abrams, Collins. Yes, and Bob here. He is careful to wash his hands. He's heard all about Lister and Semmelweis. It might be an excellent idea to read about them someday, Louis."
"We observe absolute asepsis and sterilization, Jon, at St. Hilda's."
"Now, that is very lovely. But the fact still remains that in spite of all that, men like old Emil have access to the delivery rooms and the obstetrical floor. What do all the precautions mean when one single man can ruin it in a single moment?"
Dr. Hedler hesitated. He looked at Dr. Bedloe. "I think," he said, "that we'll take away Emil's privileges. Remove him from the staff."
Jonathan smiled. "If I've accomplished nothing else today, thank God I accomplished that. Some poor girls will live rather than die, though what the hell anyone wants to live for I don't know. If there's any whiskey or brandy in the house, bring it. Jeff and Julie and Horace need it, or we'll have other patients on our hands."
Jeffrey followed him to the door and tried to speak. "Now,
CHAPTER TEN
The two young doctors went to see Hortense before leaving the hospital. She was rapidly coming out from the anesthetic. Jonathan took her pulse, nodded silently to himself. Young Dr. Abrams was sitting nearby. "She opened her eyes once," he said. "Doctor, I want to tell you that never have I seen such a wonderful—"
"Nonsense," said Jonathan. "You're just an intern, Moe. You'll see much better. And much worse. How's Mrs. Nolan's blood pressure?"
"Excellent. Almost normal. I won't leave her, Doctor, until Jed can relieve me. We're going to take turns, as you ordered."
"And no one must come in, not her husband, not her parents, not another doctor except Dr. Morgan, or intern, until I give the word. And watch those nurses!"
The doctors left the hospital together. "Aren't we the cock of the walk?" said Robert. "Who runs this hospital? You?"
"I'd love to. For a couple of months. Old Louis would be the first out on his ass. Poor old swine. I don't envy you taking my place on the staff, Bob. There'll be times when you'll wish I'd absentmindedly used a scalpel on his throat in the operating room."
The deep purple twilight was all about them on the busy street. Jonathan lighted a cigarette. "Stinking things," he said. now," said Jonathan. "Save all your strength for your prayers, Jeff. Remember, the girl is still in the utmost danger. We won't be sure for at least two more days. Pray, Jeff."
"But I don't have the strength just yet to struggle with my pipe. In a way I'm sorry for old bungling Emil."
" 'Doctors must always close ranks,' " said Robert, lighting his own pipe.
Jonathan laughed. It was a faint and exhausted sound. "Yes, we must, mustn't we? What if our patients saw us as we are? By the way, have you settled on that house yet? I ought to have told you. It was Mrs. Winters'. Her children had put it up for sale."
Robert paused for just a moment. Then he said with firmness, "Yes, I have settled on it."
"Good. They wanted fifteen thousand, but I beat them down to ten. For you. Good night. But go in to see Hortense before midnight. This is your first case, Bob."
The July night was hot and very still. Jonathan rode his horse slowly and wearily homeward. His eyes felt full and aching and his hands were faintly trembling. He had long ago learned to be objective about his cases, but sometimes he could not push them from his mind. He was less certain about Hortense than he had appeared. The chance of her surviving, the chance of the infection having been halted, were very poor. It was now, he thought, in God's hands, as they say. And I wouldn't trust those hands for a single minute! Not after what I've seen them really do when He's in the mood.
The streets of the town seemed full of clinging steam and the gutters were pungent, and the drains. The gaslamps were haloed with rainbowed rings. Jon could hear the rattle of wheels on c
obblestones, the sound of laughter in dark alleys, disembodied voices on porches. Hambledon's odors appeared both nostalgic and too heavy to Jonathan Ferrier. He could smell the river, fishy in the heat, and the sweetness of linden trees and the almost anesthetizing fragrance of full-blown roses and the dust on the grass. Footsteps and the clatter of horses' hoofs echoed in the hot night. Doors opened, shut, banged closed. Somewhere there was a thin singing of a gramophone, the distant shout of a young boy, the cry of a child, the call of an anxious mother in the dark; the giggle of a girl. It was all about him, but he felt himself unseen, unheard, unknown. It was as if he were already an apparition visiting old known places, alone and silent. It was well. Soon he would be gone and it would be as if he had never lived. He looked toward the mountains and they were only deeper shadows against a dim sky faintly sparkling with stars. He looked at the houses he passed and saw the yellow light against blinds or caught a glimpse of a small parlor and nondescript furniture, and men in shirtsleeves reading under lamps or a mother rocking a baby, or children at tables playing dominoes. He, Jonathan Ferrier, saw it all, but now it was strange and remote and he had no part in it. He had no home here. He had no one.
Dear Mavis, he thought. I should have killed you, nice and quietly, long ago.
He passed the swinging doors of saloons and heard the raucous laughter in their noxious depths. He was thirsty. He wanted a cold beer. He remembered that it had been many hours since he had eaten anything. He pulled up his horse. Then he went on. He looked down an intersection and saw. the distant square with its iron statue of General Sherman. It looked like a dream or a painted scene and not reality at all. The gaslights blinked and shifted. He went on and now as he approached the section where he lived it seemed a little cooler and the air was fresher and there was a small breeze from the river. The houses became larger and more isolated on dark lawns, and half hidden behind clusters of trees. His ancestors had known and had helped build this town, but he had no part in it and never would again.