• • •
LATER, BUTTONING HER shoes, Anna watched Sophie put the last pins in her hair. There was another subject she wanted to raise. She just couldn’t imagine holding her own news back for a whole day.
When she looked up again, her cousin was studying her.
Sophie said, “What is it? Jack?”
Anna drew in a deep breath and nodded.
“Has it come that far?”
She lifted a shoulder and held out a hand, palm up. “Let’s just say that I need to speak frankly to him before things go any further.”
Sophie’s usual calm manner had returned, and Anna was glad of it. She said, “What are you going to tell him, exactly?”
“Everything,” Anna said. “I have to tell him everything.”
“Yes,” Sophie said. “Do that, and leave no room for misunderstanding.”
• • •
THEY WENT TO work as if it were any other day, Anna off to the New Amsterdam where she had three surgeries scheduled, students to meet with, and patients to see; Sophie took the el and then an omnibus all the way north to the Infant Hospital and made the rounds with medical students, examined incoming patients, signed three death certificates, and taught a nursing student how to care for a surgical incision that was still draining. She put everything into her work, and still when she allowed herself to look at the watch pinned to her bodice, the hands seemed not to have moved at all. At three, when she had finished with a difficult case she went to see Dr. Granqvist, who served as the hospital’s administrator.
Pius Granqvist was a fifty-year-old native of Sweden, a man who had been working with sick children for all of his career. He was nondescript, fairly short and thin with a frizzle of dark hair on the very top of his head and bushy eyebrows that he twisted at the ends into kinked horns. On first meeting him she had wondered if children found him frightening, but then she saw how his smile transformed him. His whole face changed shape, his mouth too wide, his nose too small, and his eyes disappearing into a mass of wrinkles. He looked like a sprite or an elf, but he was as gentle as any mother when he examined a frightened child.
With his staff he was neither gentle nor amusing. He ran the hospital like a dictator; where he had no authority he took it anyway, and narrowed his eyes at anyone who would gainsay him. And he did not like Sophie’s news at all.
“You can’t leave,” he said shortly. “You’re the best we have.”
“Thank you for the compliment,” Sophie said. “But I am leaving to get married.” Saying the words out loud made her swallow hard.
The director’s mouth puckered as if he had taken a mouthful of vinegar. “Anybody can get married, Dr. Savard. Few people can do what you do. Your fellow can find someone else to marry, but I can’t find another doctor like you.”
Because Sophie had anticipated this reaction, she had taken the time to write out her resignation in very formal language. Now she put the document on his desk. He jerked away and wrinkled his nose as though she had put a decomposing rat in front of him.
“This is my official resignation letter. Three weeks from today will be my last day on the staff.”
When she left his office her hands were shaking, but otherwise she felt great relief. She had wondered if she would feel regret or even resentment, and found instead a heady joy, a child let out of school for the summer. She so rarely took time away from work, she had forgotten what it felt like to put down the multitude of burdens, small and large, just to breathe. In another day—or even an hour—she would begin to feel guilty, that was inevitable, but she would put it off as long as possible.
In her office she sat down to finish her chart notes and then she took a piece of her own stationery and wrote out the note she had been composing in her head for a day.
Dearest,
Today I handed in my resignation at the Infant Hospital, and tomorrow I will do the same at the New Amsterdam and the Colored Infirmary. On Saturday I will come to call midmorning so that we can talk about Switzerland.
With all my love,
your Sophie
It was her intention to have everything organized and in order before she went to see him. She wouldn’t give him any opportunity to change his mind, or the terms he had offered. Given all he had arranged to force her hand, it would be foolish to underestimate his propensity for forging and then taking advantage of the tiniest of loopholes.
She stopped at the New Amsterdam to check on a patient before heading home for the day, and had just gone into her office when there was a soft knock at door. The student nurse who came in bobbed her head in apology.
“A Mrs. Campbell is here to see you. She says she doesn’t have an appointment.”
It took a moment to place the name, and then it came to her. Mrs. Campbell, four little boys and a postal inspector husband, one of Comstock’s henchmen. Dr. Heath’s patient, but here and asking to see her.
“Thank you, Mrs. Henshaw. Just a postpartum exam. Please send her in.”
Just recently there had been a rash of letters, sent to the house by strangers pleading for medical intervention and contraceptives, and now she wondered if this visit could be coincidence, or if it was just another one of Comstock’s tricks. Those thoughts left her as soon as Mrs. Campbell came in; she was a physician first, and she recognized that this woman was in trouble.
She was very pale, the flesh around her eyes so dark that in the first moment Sophie thought of healing bruises, and then saw just what would be expected when a woman had three small children and a new infant, without household help. Sleeplessness was to be her lot for some time to come. Sleeplessness, and irritability, and perhaps full-blown depression. Mrs. Campbell was a woman taxed to the point of breakdown.
“Dr. Savard. May I speak to you?”
A month before Mrs. Campbell had been rounded, cheek and hip and thigh, and strong. Now her jaw and cheekbones were more prominent, and there was a brittleness to the way she held herself.
Sophie gestured to a chair. “Please.”
The fewer questions she asked at this stage, the sooner a patient would come to the point. Mrs. Campbell started slowly, relating facts about the new baby and the older three, her hands clasped in her lap so hard that her knuckles went white.
“And how are you, how is your health?”
Mrs. Campbell drew in a breath and held it for three heartbeats. “I don’t know,” she said. “I don’t know how I am.”
“Have you seen Dr. Heath since the birth?”
She shook her head, quite sharply.
“Then what can I do for you today?”
The pale face came up suddenly, her gaze fixed on Sophie. “I want you to examine me.”
Rather than ask questions, Sophie went to wash her hands while Mrs. Campbell disrobed behind the privacy screen. Throughout the examination she was quiet and cooperative, staring at the ceiling overhead blankly, hands still wound together.
“You are healing well,” Sophie said. “But you are losing weight, and too quickly. You need four or five small meals throughout the day. Nothing too heavy or spicy. A poached egg and a piece of bread would do, or oatmeal with cream. Meat or fish once a day, but in small amounts. Leeks, collards, spinach, any kind of bean will provide you with the iron you need as a nursing mother.”
The thin mouth contorted and an arm came up to cover her eyes.
“I’m pregnant, aren’t I.”
Sophie had turned away to pick up an instrument, but she looked over her shoulder in surprise.
“Pardon?”
Mrs. Campbell sat up, rough patches of color rising in her cheeks. “I know I am, I can always tell.”
“What makes you think that? Have you missed your menses?”
“I haven’t had a period for four years,” Mrs. Campbell said. “Doesn’t seem to matter, I fall pregnant anyway.”
“I saw no indication of pregnancy,” Sophie said.
“But I could be,” Mrs. Campbell said. “He’s been at me morning and night. I could be. And if not now, then next week.”
Sophie spread out a hand. “It’s not likely, Mrs. Campbell, but it’s possible. In any case, there isn’t any way for me to diagnose a pregnancy at such an early stage.”
“I know what I know.” There were tears in her eyes.
Women often did know very early that they had conceived, but in this case it was hard to say. Mrs. Campbell might still be feeling the aftereffects of pregnancy and birth, or in her anxiety and fear—because she was terribly afraid, without doubt—she could convince herself of something that simply wasn’t true.
But she could be pregnant. Children born ten months apart were not all that unusual.
“Would you like me to write a letter ordering no intimacies for health reasons, until further notice?”
“He wouldn’t credit it,” Mrs. Campbell said, bitterly.
And that was certainly true; Mr. Campbell would ignore what she had to say. The situation was simple and familiar and heartrending, because Sophie had no solutions to offer. She could not even ask if Mrs. Campbell had received the pamphlet she had sent, because she still could not be absolutely sure of the woman’s true purpose.
Mrs. Campbell spoke under her breath, as if giving Sophie permission to ignore her. “I cannot, I cannot have another baby so soon. It will kill me.”
Sophie could simply send the woman on her way with a few carefully chosen platitudes; it would be the safest and soundest thing to do. But it would also be cowardly and worse, a violation of the oath she had taken. She must try, at least, to pass on information the woman could use to help herself.
For a moment she imagined Anthony Comstock standing out in the hall, a smirk on his face, and then she looked at her patient and all other concerns had to be set aside.
“You realize the importance of attention to hygiene while you are still healing?”
Mrs. Campbell’s expression shifted, something of hope there now. “I have heard something about that, but I don’t know where to start.”
“Let me explain to you about the most effective ways to maintain personal hygiene. If you have time?”
“I do,” Mrs. Campbell said. “For this I do have time.”
• • •
AN HOUR LATER as she was getting ready to leave, Janine Campbell paused as if she had something she needed to say but would leave unsaid without encouragement.
“Mrs. Campbell, I can’t promise to have an answer to every question, but I will do what I can for you.”
“If scrupulous attention to personal hygiene is not enough, if I am already pregnant—”
The silence drew out for a long moment.
“Mrs. Campbell,” Sophie said quietly. “I have given you all the information I have to share.”
She closed her eyes for a moment, then opened them, looking resigned.
“But I can come back to see you?”
“Normally I would be happy to have you as a patient,” Sophie said. “But I am just about to leave on a longer journey. I may be gone a year, or possibly more.” Or far less, she added to herself.
It often fell to Sophie to give a patient very bad news. An imminent stillbirth, malignant tumors that could not be excised, a child who would not survive the night. She had seen all manner of grief and sorrow and anger, raging and tears and those who fell away into unconsciousness rather than face tragedy. She was seeing many of those things on Mrs. Campbell’s face along with a cold resignation, and the force of it struck her.
“I have a number of colleagues who would give you excellent care,” Sophie said. “Shall I give you some names? Female physicians, women I went to school with?”
“No,” Janine Campbell said, her voice low and soft and hoarse. “No. I’ll figure something out. But thank you.”
• • •
ANNA GOT TO the hospital at dawn just as a cab pulled up. The door flew open and Sister Mary Augustin jumped down before the cabby could even get off the box. She was so intent on helping Sister Francis Xavier step down safely that she didn’t notice Anna, standing a few feet away.
What Anna saw was that the older nun and the cabby wore almost identical expressions. Crankit, Aunt Quinlan would have called it, a bit of Scots left over from her first marriage.
While Sister Xavier fussed at Mary Augustin, the cabdriver dumped their satchels on the ground and turned to stalk away. Anna called after him.
“Take those inside, please,” she said. “And leave them with the porter.”
He gave her a long and speculative look, which Anna took to mean that he had been paid but not tipped. Nuns might not know about what a working man has coming, his look seemed to say, but you should. Anna produced a quarter dollar from her pocket and held it up; the cabby retrieved the bags with a surly grunt.
“Dr. Savard.” Sister Xavier’s voice was hoarse and brimming with impatience. Anna didn’t expect pleasantries from people in pain, but then again she was glad that Mary Augustin had been sent along as Xavier’s private nurse.
Now she smiled at both of them. “Good morning,” she said. “Come, I’ll show you to your room and you can make yourself comfortable.”
“Comfortable,” sputtered Sister Xavier. “I’m too old for fairy tales, and so are you.”
• • •
MARY AUGUSTIN DID what she could to put her very agitated patient at ease, but by the time Sister Xavier was settled in the bed, all color had drained from her face and her complexion was the texture of candle wax.
It was very wrong, Mary Augustin told herself, to be so happy under these circumstances. To take pleasure in an opportunity that existed only because of Sister Xavier’s pain was something she would have to confess, but absolution required repentance, and that was something she could not manage. She had been hoping for this ever since the day in Hoboken when she learned that women could be doctors and surgeons. She had tried to put that idea—that outrageous, impossible, unattainable idea—out of her head, without success.
There was a soft knock at the door and things began to happen very quickly. Later she would have trouble sorting it all out: nurses and medical students came and went, sometimes, it seemed, with the sole purpose of irritating Sister Xavier, which wasn’t very hard to do anyway. Then Dr. Savard came in pushing a cart full of equipment, trailing two assistants behind her.
Under other circumstances the look on Sister Xavier’s face might have struck her as funny, but it was only later that she could smile about it to herself. Fortunately Dr. Savard didn’t seem put out by the tone of the questions that came her way in such rapid fire. She introduced her assistants as medical students and explained the purpose of the different objects on the rolling cart: the stethoscope made it possible to listen to the heart beating and blood moving—Sister Xavier shot Mary a sharp and questioning look, and she nodded.
“And that?” she pointed to a contraption that was quite odd, with multiple arms and pads and bulbs of India rubber. “There’s a needle in there somewhere, I know it.”
“No needles,” Dr. Savard said calmly. “This is a sphygmomanometer—”
“A what?”
“A sphygmomanometer.” She pulled up the single stool in the room and sat on it. That simple act seemed to make Sister Xavier relax.
“Your heart beats to push blood through your arteries. The blood brings oxygen and nutrition to the cells,” she said in a tone of voice that had nothing schoolmarmish about it. “The force of the pulsing of the blood puts pressure on the walls of those arteries. This machine”—she touched it almost gently—“measures that. Your blood pressure.”
“And why do you need to know about my blood pressure?” Sister Xavier was trying to sound irritated, and failing. Dr. Savard had tapped her cu
riosity and disarmed her completely.
“It’s useful information for a surgeon,” Dr. Savard said. “It will influence the kind and duration of anesthesia we use.”
“Anesthesia?” Sister Xavier grabbed onto the word. “Anesthesia?”
At that moment Dr. Savard seemed to realize the source of Sister Xavier’s agitation.
“Did you think you would be awake for the procedure?” Dr. Savard said. “I should have made clear to you, and I apologize.” She turned to her assistants.
“Bring in one of the gas-ether regulators, please,” she said. “So I can explain the way it works to Sister Xavier.”
13
“SO,” MARONEY SAID, sliding into his desk chair and leaning back with his hands behind his head. “I see you got a private letter this morning.”
Jack let out a whistling breath. “Here,” he said, and tossed it onto Oscar’s desk. “Read it yourself.”
It was the path of least resistance, Jack told himself. Maybe he should have done this weeks ago, and saved himself the henpecking.
“Mezzanotte,” Oscar read aloud, and paused to raise an eyebrow in Jack’s direction before he went on.
Sister Mary Augustin will be here in the hospital for the next three or four days looking after a patient from the convent. Today between one and three would probably be best if you want to talk to her. Ask the porter to send for me, and I’ll arrange it.
“She signed it ‘Savard.’” Oscar looked at the back of the sheet of paper as if he’d find some explanation for such oddness there. “From this it sounds like she doesn’t like you much.”
“She likes me just fine.” Jack’s tone said that he would entertain no more questions in that direction.
Which Maroney ignored. “Is that so? And what about you?”
Jack picked up the newspaper and snapped it open. “I like me fine too.”
“Ass,” Maroney said. “What’s this about a nun?”
“She’ll make it easier to get answers at the Foundling.”