“With my family. It’s a busy time for us. Tomorrow my cousin is getting married and she’ll be sailing for Europe with her new husband right away.”
“Oh, that sounds lovely,” Miss Branson said. “Fireworks and a spring wedding. I wouldn’t know what to do with my excitement.”
“It is exciting,” Anna agreed.
After a long moment Miss Branson said, “I would have liked to see the fireworks.”
“You have a good view of the sky from this window,” Anna said. “You should be able to see them.”
A thoughtful look passed over the older woman’s face. “Maybe,” she said finally. She seemed to rouse herself purposefully. “I have a little savings,” she said. “I’ve written out instructions for the bank, to release those funds to the hospital to pay for my care and—afterward.”
Some people needed to talk about practical matters, unwilling or unable to let go of details. Miss Branson outlined her arrangements for her small apartment and what would become of her things, and Anna listened without interrupting her.
“But really what I wanted to tell you is that I have some lovely hats,” she was saying. “Do you think you might like to have them?”
Startled, Anna marshaled her thoughts, but Miss Branson held up a hand to forestall Anna’s answer. “They are my own work, the best of my work. I started in a milliner’s shop when I was just eight years old. Six days a week, from seven in the morning to seven in the evening. At first I swept floors and at thirty I was the designer. I trained under old Mr. Malcolm and then I worked for his son and finally his grandson. My whole life in that one place. Fifty years in the same shop on the same street.”
“That is a very long time.”
“He’s still alive,” Miss Branson said. Her gaze was far away, but her tone was matter-of-fact. “The first Mr. Malcolm. Ninety-four years old but still spry, the kind of elderly gentleman who seems just as dry and tough as gristle.” She glanced at Anna, who nodded that she understood.
“But terribly absentminded about everything outside his business. Even when I first knew him, Mr. Malcolm could never remember birthdays—not even his own—or anniversaries or invitations, and he mixed up his children, running through all the names until he hit the right one. Jacob-Hans-Jeb or Amity-Ruth-Josie, just like that. They laughed it off, though I think when the children were little there were some hurt feelings, now and then. I didn’t see it at first but as I got older I realized that it wasn’t really comical, how much passed him by. How many small good things in his life went unnoticed.”
She turned her head to watch the activity on the bridge for a moment, and then she picked up her story again. “He was a strict taskmaster, but not mean. Never mean. Gruff but good-hearted, is how I think of him. My own father died young and I felt the lack, so I sometimes pretended that Mr. Malcolm was my father. I think the idea came to me because he always remembered my name, you see. His daughters he couldn’t keep straight, but he knew my name. And that made me think I was a little special.”
Anna was fairly sure that Miss Branson had had no visitors, though she had been admitted to the hospital the previous Saturday.
“I sent word, Monday morning. Paid a messenger to take a note to say that I was here and couldn’t come in. Didn’t hear back but after—after you told me my situation I thought I should write again, but maybe not. They might be closed up for the celebration. They might.”
Anna drew in a deep breath and held it. The simplest of stories, and her heart was beating so fiercely she could feel the pulse in her wrists. A physician had to keep some distance, but once in a while a simple story would catch her unawares, sliding like a needle through a crack in a thimble to embed itself deeply, without warning, in tender flesh.
Miss Branson was looking at Anna with an expression that couldn’t be identified. Not pain or sorrow or regret, and nothing of anger. Anna could not rail against an insensitive and cruel employer in the face of such placid acceptance. She certainly could not disturb the woman’s peaceful state of mind, not now or ever.
“Things never quite turn out the way you imagine, do they,” Miss Branson said, her voice low and almost amused in tone. “You have to pay attention to the moment in your hands, before it’s gone.
“Now, would you have any use for my hats? I don’t like to leave my bills unpaid, and you have looked after me very well.”
• • •
ANNA CHANGED INTO the summer-weight frock she had brought with her, brushed out her hair and put it up again in a loose chignon on the back of her head, changed her shoes, and picked up the straw boater that would protect her from the sun on the river. She regarded herself in the mirror. Margaret was fond of pointing out that Jack had done wonders for Anna’s complexion, making it more of a subtle accusation than a compliment. Anna saw that it was true, her color was high and her skin clear. She wondered if sexual frustration could be as invigorating as sex itself, wondered what Margaret would say to this question. The idea put a smile on her face. She hadn’t been alone with Jack for a very long time, but that would change soon.
It was just after one and he would be waiting downstairs. She was suddenly very impatient to see him, and had to remind herself that it would not fill patients or staff with confidence to see a doctor skipping down the hall. She thought in passing of Maura Kingsolver, the surgeon coming on shift. Fortunately there were no pending surgeries that she had to be informed about. It seemed as if Anna might really get out of the hospital on time.
Jack was talking to Mr. Abernathy in the lobby. He stood with his hands in his pockets, rocking back on his heels, his chin lowered to his chest. A powerfully built man at ease in his own skin, listening closely to an old man’s story. He had been raised in a household that valued stories and the people who told them. It was one part of what made him good at his work.
He was wearing a beautifully cut suit that fit him perfectly. A summer-weight wool of a deep buff color, his jacket was open to reveal a checked vest buttoned over a soft white shirt and a copper-colored silk tie in a loose bow around a standing collar. His sisters’ influence, and one way in which Anna could never compete; she paid little attention to fashion and was satisfied to let her aunt and cousin choose for her. As they had today, because it wouldn’t have occurred to her that the clothes she wore at the hospital were not right for an afternoon on the river. Or not until it was too late to go home and change.
Jack looked up and caught her eye. His whole face came alive as he broke into a smile. He was here for her. That odd and wondrous thought was in her mind still when the wide front doors flew open with a tremendous crash that made Anna jump in place.
An ambulance driver appeared holding up one end of a stretcher, backing through the door carefully. Jack and Mr. Abernathy were there before Anna even realized they were moving, blocking her view while they helped maneuver the stretcher all the way in and then carrying it through to the examination room.
A young woman wrapped in bloody sheets was struggling and writhing to free herself while the ambulance doctor tried to put three fingers to her throat to time her pulse. The driver stood back, arms crossed over his chest, looking studiously bored. To Anna he said, “This one’s asking for a Dr. Savard.” Ambulance drivers were notoriously hard to shock and often simply rude, but Anna had no time to teach him manners.
“You’re in the way,” Anna said. “Step outside.”
• • •
AMBULANCE DOCTORS WERE employees of the police department, generally men newly out of medical college and in need of practical experience. Jack knew most of them at least by sight, but this one he had never met before.
“I’m an intern at Bellevue, Neill Graham. You’re Dr. Savard?”
“I’m one of two Dr. Savards at this hospital. This lady is a stranger to me. She must be my cousin’s patient.”
“You’ll have to do,” said Graham. “She can??
?t wait.”
Anna’s expression cleared, all her questions and confusion leaving her face to be replaced by a focused calm. She looked over her shoulder at Mr. Abernathy. “Is Dr. Kingsolver available?”
“Already in surgery,” he said. “Room two is free.”
Orderlies appeared out of a side door to scoop up the stretcher.
To Neill Graham Anna said, “It’s the first operating room on the right. Please stay with her until I get there, I’ll just be a moment.”
Then she turned to Jack.
“I’m sorry.”
He nodded, adding a half shrug. He understood very well the regret, and knew too that it would last only until she stood in front of her patient. The woman’s condition would drive all other thoughts out of her mind. He said, “I’ll go to the ferry dock to explain.”
“I’m sorry about your day too.”
She was already moving away, but she changed direction and dashed toward him, stopping short to go up on tiptoe and press a kiss to his mouth, a fleeting touch he might have imagined if not for the scent of her skin. Then she was gone, flying down the hall to the operating rooms.
Jack had almost reached the cab waiting for him when another pulled up and a man leapt down before the horses came to a halt. He wore a black wool suit despite the warm weather and a matching bowler pulled down over frizzled red hair.
“Hold on!” the cabby bellowed. “Hold on there, what about my fare?”
The man yelled over his shoulder. “Archer Campbell, postal inspector. You’ll get your fare.”
“I’ll get double my fare if you make me chase you down for it,” the cabby shouted even as the man disappeared into the hospital. “Or I’ll get the police after you, postal inspector or not!”
• • •
WHEN ANNA CAME in, three nurses were already going about the business of preparing the operating room and the patient, who was still struggling despite firm hands and calm words. The nurses talked to her in a studiously attentive but calm tone as they had been taught to do. As Anna herself had once learned when she was a medical student and new to this world that was now her own.
They provided Anna with information without prompting: pulse 150 and thready, temperature 104. Anna was still trying to attach the name Mrs. Campbell to a memory, a patient of Sophie’s she had been worried about—when the woman shouted.
“Dr. Savard!” And again: “Please, Dr. Savard!”
Time was of the essence but a terrified patient could not be ignored. She went to stand beside the operating table.
“I am Dr. Anna Savard. I think you must be a patient of my cousin Sophie’s. I will do my best for you, Mrs. Campbell. Can you tell me about your condition? What exactly was done?” She put a hand on the woman’s abdomen and flinched as she shrieked in pain, curling away from Anna’s touch.
In a whisper she said, “Where is Dr. Savard?”
“She has left the hospital staff and is moving to Europe. Can you tell me what you’ve done?”
The woman shook her head fiercely and turned her face away.
“Mrs. Campbell,” Anna said. “Your situation is dire. You must realize that. I will do everything in my power to help you, but you must prepare yourself. Do you have a message for me to pass on?”
Again the violent shake of the head. Her voice was broken and hoarse, but Anna heard her clearly.
“I want nothing now but an end to it all.”
Anna said, “Nurse Mitchard, please put the patient under as quickly as possible. There is not one second to waste.”
• • •
NO TIME TO waste, and still hygiene could not be forgotten. Anna stood at the sink scrubbing her hands and lower arms furiously, counting out the seconds to herself. Beside her the ambulance doctor held his hands and shirtsleeves both under running water and was watching the blood wash away.
He introduced himself as Neill Graham, an intern from Bellevue.
“What can you tell me?” she asked him.
“She admitted nothing. Profuse hemorrhaging, guarding, pain on rebound, in and out of delirium. I couldn’t examine her properly in the ambulance but by the smell, she’s septic.”
“The husband?”
“Neighbor sent word, I’m guessing he’s on his way.”
“Dr. Savard,” one of the nurses called, a note of panic in her voice. “We’ve got a prolapsed umbilical cord already presenting.”
To Neill Graham Anna said, “Anything else?”
“Just that she wanted to see Dr. Savard.”
“Thank you,” Anna said. “I’ll take it from here.”
“Could I observe?”
Anna paused. He was young, but his demeanor was professional and his interest seemed sincere. “I may need another pair of hands,” she said. “But you’ll have to get rid of that shirt and scrub in properly, nails especially. Don’t spare on the carbolic. Nurse Walker is circulating, she’ll find you a tunic.”
• • •
WHEN ANNA CAME to the operating table, her hands still damp and stinging from the carbolic acid, Mrs. Campbell had already been calmed by the ether. She was strapped to the extended stirrups in the lithotomy position, her knees flexed and canted outward, her legs and torso draped. Instruments newly out of the autoclave were arranged neatly on sterile trays. The nursing staff stood waiting for Anna to begin.
Helen Mitchard sat at Mrs. Campbell’s head monitoring anesthesia. She had already started to give the patient saline injections by means of a cannula, which might make some small difference.
“Status?”
She gave a sharp shake of her head, reaffirming what Anna already knew: it would take a miracle to turn this around.
Anna folded back the draping to reveal fresh dressings that were already soaked with blood and discharge. The effluvia was enough to make her head snap back. Septicemia had an unmistakable smell, but there was also a strong odor of feces. Whoever had operated on this woman had perforated her bowel.
Anna glanced at the nurse beside her. “Nurse—”
“Hawkins,” the young woman supplied.
“I’m going to need a good three gallons of saline to irrigate. And when we’re done here today, I’ll want to talk to you about your grasp of human anatomy.” She picked up a uterine sound that would give her an idea of the extent of the damage. “This is not an umbilical cord, Nurse Hawkins. It’s a loop of lower intestine.”
• • •
JACK STOPPED BY Verhoeven’s house to tell Sophie and Cap that the family party had boarded the ferry and departed as scheduled to cruise the East River. Without Anna.
“Or you,” said Sophie. “There will be some very disappointed cousins.”
They sat him down to eat lunch and talk through changes to the day’s plans.
Cap said, “Bring her back here when she’s free. We’re planning on eating on the terrace in the evening. We have a good view of the new bridge from there.”
Sophie walked Jack to the door. She put her hand on his lower arm, lowering her voice.
“Cap’s been pushing himself far too hard,” Sophie said. “But I really would like you to bring Anna and we’ll eat together. Cap and I will both retire quite early given—”
“Tomorrow.”
She nodded, a little flustered. “So you two will have the terrace to yourselves.” Her expression was completely innocent, but Jack had begun to figure Sophie out, and he saw something like quiet amusement in her eyes. He leaned over and kissed her cheek, felt her start and then relax.
“It’s good that you and Anna found each other,” she said. “I would worry about her while I’m gone, if she didn’t have you.”
• • •
IT WAS PAST three by the time Jack got back to the New Amsterdam, where he found Anna waiting for him in her office. To his gently raised brow she said, ??
?Her blood loss was too severe and the infection too far advanced. She began to convulse and I lost her. Someday when blood transfusions are safe, cases like this one will take a better end.”
Jack sat down across from her, rested his elbow on the arm of the chair and his chin on his palm, and regarded Anna. Her demeanor was resigned, as it must be, he understood, for anyone who practiced medicine.
He said, “Her husband passed me on my way out, earlier.”
Anna closed her eyes. “Yes, I know.”
“Very distraught?”
“Angry, I would say. Confrontational. When I told him she had asked for Dr. Savard by name, he looked at me as if I had been caught in a lie. He said, ‘She has a proper doctor at Women’s Hospital, she has no business in a place like this.’ As if the New Amsterdam were a brothel. I was glad he didn’t ask me about a cause of death. I don’t think he would have liked hearing about an abortion.”
“Has the coroner been notified?”
She stood and stretched. “Yes, Mr. Abernathy took care of it. There will be an autopsy and an inquest, and I’ll have to testify. But not until Monday. Shall we go?”
• • •
IN THE END Anna was glad to have missed the family party on the river. Once Cap and Sophie had sailed, they would spend the afternoon together in the garden with the visitors; for now it suited her to sit on Cap’s terrace in the late afternoon sun with the people she loved best in the world.
Then Sophie surprised her. As soon as Anna started to describe the emergency surgery that had caused the change in plans, her cousin went very still.
“Don’t you remember, Anna? I told you about Mrs. Campbell, you must remember. It was the day you went to Hoboken in my place.”
Jack sat forward, his attention suddenly focused.
Sophie was saying, “Her fourth boy, the oldest barely five, and she was terribly afraid of another pregnancy.”
Anna did recall. “The woman married to the postal inspector.”
“Ah,” Jack said. “I crossed paths with the man when he got to the New Amsterdam.”