The Art of Dying

by Ambrose Parry

  ‘Mrs Banks is not here,’ Mrs Sullivan replied, in a tone that suggested he had better be on his way. Raven wondered if perhaps she didn’t recognise him from his recent visit. The alternative suggested that Sarah had not been generous in her accounts of him afterwards.

  ‘Who is it, Mrs Sullivan?’ called out a male voice behind her. Archie.

  ‘It’s Dr Raven from Queen Street.’

  Evidently, she did know who he was.

  ‘Do show him in.’

  Raven was about to decline but the door was opened wide and he was ushered inside. He didn’t particularly want to speak to Sarah’s husband and certainly not without her present to moderate.

  He was shown into the parlour, where Archie was already seated in an armchair by the fire.

  ‘Do sit down, Will.’

  He seemed open and friendly, as though they had known each other for some time. Raven was wary. He perched himself on the edge of a chair, hoping to give the impression that he was not at liberty to stay for any length of time.

  He looked at the man sitting opposite: really looked, searching for confirmation of his suspicions. Archie was indeed thin, perhaps thinner than the last time Raven had seen him, but he couldn’t be sure. He was pale but not uncommonly so. Raven had to admit that this was hardly conclusive evidence, but he felt intuitively that this man was far from well. Or did he merely wish that it was so?

  ‘I am so glad that you called by,’ Archie said. ‘We haven’t really had much of a chance to talk.’

  Raven had been hoping that this was a state of affairs that might long endure. His instinct was to imagine that there was nothing they had in common to talk about, but if he were being honest, his reluctance derived from the opposite being true. They were both men of medicine, for one thing. But primarily the thing – or rather the person – they had in common was now Archie’s wife.

  ‘Sarah has told me so much about you,’ he said cheerily. ‘It seems you two had quite the adventure together, once upon a time. A secret alliance engaged in subterfuge and hazardous enterprises.’

  Raven swallowed, wondering just how much Sarah had told Archie about their time together. Had it been anyone else, he could have been assured that common discretion protected his confidence, but this was Sarah. Little about her was common, and that included her relationship with her new husband.

  ‘How did you two encounter each other?’ Raven asked, eager to shift the focus of discussion. He was also impatiently curious.

  ‘I was visiting the professor,’ Archie said. ‘I first crossed paths with James when we were both students here in Edinburgh. He was several years my senior, but we got on well and have kept up a regular correspondence since.’

  Raven wondered if the visit being alluded to was as a colleague or as a patient but felt it would be impertinent to ask.

  ‘When I arrived here from Perth in the summer, I left my card at Queen Street and then took a room at the Royal Hotel. I had only just begun to unpack my portmanteau when Dr Simpson appeared at my door in the company of Mr Gibb, the proprietor. He said that I must come and stay at Queen Street as his guest.

  ‘Of course I protested, but he would not hear of my remaining at the hotel. I suggested Mr Gibb might have something to say in the matter, as I had planned to stay in his establishment for a week, but the hotelier simply smiled and shook his head. “We here in Edinburgh do rather much as the professor says,” he told me. And so, within the hour I found myself comfortably ensconced at Queen Street. There I remained for some time – longer than I had originally intended – and there I met Sarah.’

  ‘You live in Perth?’

  ‘I had my practice there.’

  Raven noted the past tense. He would not be returning, and nor had there been any talk of him setting up a practice elsewhere.

  Archie paused for a moment and looked at Raven before continuing.

  ‘I came to Edinburgh to consult with colleagues about a medical problem. I have an ulcer on my tongue and came to seek advice and treatment.’

  ‘I see,’ Raven said. He knew now that his theory was about to be confirmed, but felt no satisfaction about being proven correct in his deduction.

  ‘There have been a number of rather painful procedures performed in an attempt to rid me of it, but thus far they have only been partially successful. I met with Professor Syme again yesterday and he is recommending further surgery, a more extensive operation than before. Because such an operation comes with an attendant risk of considerable blood loss, the proposed procedure would have to be performed without the benefit of anaesthesia.’

  Archie laughed, then added: ‘I am of a mind to respectfully decline.’

  Raven was unsure how to respond to this. One question was imperative, however.

  ‘Does Sarah know?’

  ‘Yes, of course. How could I have kept it from her? After all, it was her intellect and curiosity that attracted me to her in the first place. Was it the same for you?’

  Raven was beginning to feel uncomfortable about just how much this man, this relative stranger, seemed to know about him. He was quite unprepared to be as open as Archie had been with him. Perhaps it was easier for Archie because he had greater worries. Or perhaps it was simply easier for him because he had been the one who married her.

  He shifted in his seat. Archie seemed to sense his awkwardness and smiled at him benignly.

  ‘If it’s any consolation, I think one of the things that attracted her to me was that I reminded her of you.’

  Raven got to his feet.

  ‘I am not sure this conversation is entirely appropriate, or that Sarah would like us to be having it. I think that I had better leave.’

  ‘Oh, don’t be daft,’ Archie replied. ‘Sarah and I have no secrets from each other.’

  ‘If you truly knew her, you would not be so sure of that.’

  Raven had meant it to unsettle Archie, but it made him laugh instead.

  ‘One of the great benefits of my condition is that I can be honest without fear of the consequences.’

  Raven remained on his feet.

  ‘Then you will indulge me if I am equally candid,’ he said.

  ‘Fire at will.’

  ‘If you are as ill as you are implying, why did you marry her? Do you love her, or did you merely need someone who would be obliged to take care of you? She was a housemaid after all and is well used to hard labour.’

  ‘Neither of us would be having this conversation had she been merely a housemaid,’ Archie replied. ‘But I suspect you think that I have taken advantage of her good nature. I don’t suppose I can blame you for that.’

  He got up from his chair and moved towards a cabinet in the corner of the room, from which he removed a decanter and two glasses. He poured a measure of what turned out to be rather good brandy into both and offered Raven a glass.

  ‘I know that this is difficult for you, but I would like for us to be friends.’

  Raven took the drink and sat down again, thinking to test Archie’s new-found enthusiasm for honest conversation.

  ‘Did she know how serious your illness was when she agreed to marry you?’

  ‘That a cure is unlikely? Yes, she did.’

  ‘And do you think that is perhaps why she agreed to marry you?’

  ‘You think it was unfair of me to ask? I long pondered that question myself. There was a growing mutual affection between us. Plenty of people get married without that.’

  ‘But in the circumstances, it would have been hard for her to refuse.’

  ‘If you know her as well as you claim, then you will also know that she would not be forced into something against her will or better judgment. I have not deceived her in any way and there are a great many benefits for her in marrying me.’

  ‘Guaranteed loss and pain do not seem like much of a benefit to me,’ Raven muttered, downing the rest of his brandy in one gulp. The burn in his gullet felt good. Counter irritation.

  ‘I have given her statu
s,’ Archie said, ignoring Raven’s surly comment. ‘Should the worst happen – when the worst happens – she will inherit my money, and with it certain freedoms and opportunities. Believe me, Will, I have her best interests at heart.’

  Raven sat quietly for a moment as the truth of what Archie had said began to seep into his irritable mind. He knew his ire was being misdirected. He was angry with himself more than Archie. There was little point in resenting Archie or Sarah for seizing something he had lacked the fortitude to pursue himself.

  ‘I have endured quite enough of the pompous prigs of my profession,’ Archie said. ‘And though I will surely not live to see it, my sense of mischief is tickled by the thought of their outrage on the day that a woman intrudes upon their so fiercely guarded domain. If any woman could, it would be Sarah.’

  Raven was unsure exactly what was meant by this. Was Sarah planning some kind of battle with the medical profession in Edinburgh? If so, was her defence of Simpson imagined as a shot across the bows? He thought the notion fanciful but that didn’t stop him worrying about his potential role in it.

  ‘Don’t you have any other relatives?’ Raven asked. ‘Surely they would contest such a bequest?’

  ‘I have nobody else to leave the money to. No blood relatives. Or at least, none that I’ll live to see.’

  Archie’s expression was curious. It seemed wistful and yet there was something proud, satisfied in it. Raven was about to disregard this last statement, thinking it a throwaway remark, when he realised what Archie meant.

  If he did die, he would be leaving Sarah with more than his money. His legacy was going to be greater than that. Archie was under the impression that his wife was with child.

  TWENTY-NINE

  arah was replenishing the dressings drawer when Dr Simpson entered the consulting room carrying a sheaf of papers. He had just returned from his trip to Lanarkshire and had barely crossed the threshold before throwing himself into more work.

  ‘Ah, Sarah. I am currently in the process of writing up some notes for the Monthly Journal on the analogy between puerperal fever and surgical fever, and I thought that Archie might like to take a look at them?’

  ‘Thank you, Dr Simpson. I think that he would like that very much. Although I may have to read them to him. He is so easily fatigued these days.’

  ‘Then you must tell me what you think.’

  ‘Me?’

  ‘Yes. Why not? You have read half of the contents of my library; you have tackled Gregory and Christison. Surely something I have written would not be beyond your comprehension.’

  Sarah took the papers he held out to her.

  ‘Thank you,’ she said again, and wondered if he meant it. Did he really consider her opinion to be worthy of note? She had indeed read many of the books in Dr Simpson’s library and, she thought, understood them, but often doubted she would ever be able to put the knowledge she was acquiring to any use. In such times she consoled herself with the adage that self-improvement was its own reward.

  ‘You know the phrenologists say that examination of the skull reveals women to be the intellectual equals of men,’ the professor said. He had a twinkle in his eye that Sarah had come to recognise: he was trying to provoke an argument, but Sarah had been over this course too many times before to be riled. She was also well versed in his opinions on this particular strain of quackery.

  ‘I don’t need a phrenologist to tell me that,’ she said, smiling.

  ‘You know I have never subscribed to the notion that women are in any way the weaker sex. I have been surrounded by remarkable women my whole life, and as Professor of Midwifery I know that women can withstand pain and distress as well as any man.’

  ‘I fear that there are few men who would agree with you.’

  ‘I think that Archie would.’

  ‘Yes,’ she smiled again. ‘Archie would.’

  ‘Did you know that when Her Majesty the Queen was born, she was delivered by a woman?’

  ‘A midwife?’

  ‘No. A physician.’

  Sarah stopped what she was doing. He had her full attention now.

  ‘When Queen Victoria’s mother travelled from Bavaria to England in 1819, she brought her own doctor with her: Charlotte Siebold, who had received her doctorate in obstetrics from Giessen University two years before.’

  Sarah was so excited by the notion Dr Simpson had just introduced that she had to seek clarification.

  ‘The birth of our queen was managed by a female physician?’

  ‘Yes. And then she promptly returned to Coburg where, if you can believe this, she delivered Prince Albert.’

  There was only one aspect of this remarkable tale that held Sarah’s attention.

  ‘So, it is possible for a woman to study medicine in Germany?’

  ‘I think Madame Siebold was an exceptional case. Both parents practiced midwifery and taught her all that they knew.’

  ‘Is there anywhere in the world where a woman may study as she chooses?’

  ‘On my last visit to London I met Dr Elizabeth Blackwell. Have you heard of her?’

  Sarah shook her head.

  ‘She recently qualified at Geneva Medical College in New York. She was on her way to Paris to further her studies there. I invited her to visit us here in Edinburgh.’

  ‘Will she come?’

  ‘She said that she hoped to, one day.’

  ‘I should very much like to meet her. I did not know that a woman could go to medical school in America.’

  ‘Well, yes, but it is not commonplace there either. Dr Blackwell is the first, something of a pioneer. She caused quite a stir among the medical brethren of the capital when she arrived there, but I think she is seen as something of a curiosity rather than as any kind of threat. Medical men can be very proprietorial. They do not like intrusions upon their professional territory. I suspect attitudes will harden should more women attempt to follow her example.’

  ‘Do you think that it will ever be possible for a woman to study at the university here, in Edinburgh?’

  Dr Simpson frowned.

  ‘Despite being a leader in many fields, I doubt Edinburgh University will blaze a trail in this matter,’ he said. ‘Certainly not the Medical School. Knowing my brother professors as I do, I think it unlikely in my lifetime.’

  Sarah felt her shoulders sag. Dr Simpson could usually be relied upon for his optimism no matter the subject being discussed. His doubts about this could not be readily dismissed.

  ‘Things will change,’ he said. ‘There are few obstacles that will not disappear before determined industry.’

  He smiled at her, but she noticed that, unusually, it did not reach his eyes.

  THIRTY

  thick fog had settled itself on the streets of the New Town as Raven and Sarah made their way along Queen Street. It was brutally cold, so they walked quickly, heads down. They had shared few words since leaving No. 52, Sarah rebuffing his conversational gambits with brief, terse answers.

  Eventually, she spoke.

  ‘What made you change your mind about helping me?’

  There was an edge of accusation to it. He could tell she was still annoyed that he had refused her in the first place.

  ‘It occurred to me that although Dr Simpson can be disorganised, he is not dishonest, and he is certainly not incompetent.’

  ‘That is surely not news to you.’

  ‘No, but it was brought home to me by a case I was asked to see recently. Unusual symptoms that I could not explain. Deep stupor preceded by delirium and twitching. I’ve never come across anything quite like it. The patient’s usual practitioner, a Dr Fowler, was an old-fashioned type, determined to bleed and purge. He seemed more concerned about his leeches than the fate of the patient.’

  ‘His leeches?’

  ‘Yes, they all fell off and died shortly after they were applied. It seems he was quite attached to them, if you will.’

  Raven paused, inviting her to share the joke. She did n
ot look amused.

  ‘I mean he had had them for a long time,’ he explained. ‘Given his adherence to the doctrine of depletion and blood-letting, the things probably succumbed due to exhaustion.’ There was still no hint of a smile from Sarah and so he abandoned his attempts at humour and continued with the unadorned facts of the case.

  ‘I had no idea what to suggest and the patient died shortly after I saw him. By the time I was involved it was probably too late to make a difference, but I still felt a terrible sense of defeat. Dr Fowler implied that I had been obstructive and was clearly trying to blame me for the outcome. It occurred to me that it is easy to make enemies in this town, and it troubles me that the death of a patient often becomes a battleground rather than an opportunity to learn.’

  Sarah made no reply and they walked on in silence. Raven had thought that his change of heart would begin to melt the frostiness that had developed between them, but it appeared that a thaw might be slow in coming.

  ‘How is Archie?’ he enquired, and instantly regretted it. He didn’t know how much her husband might have told Sarah about their conversation.

  ‘Why do you ask?’

  She sounded defensive. Perhaps she was merely wary of his suspicions, what he might have picked up on, being a medical man.

  ‘Polite enquiry.’

  Sarah seemed to realise she was being unnecessarily brusque.

  ‘He is well,’ she told him, her tone more even. ‘And what about you? Aside from a few dead leeches, are you glad to be back in Edinburgh?’

  ‘In some ways I am.’

  He smiled at her, but her eyes were fixed ahead. She did not turn to look at him as he spoke.

  ‘I feel I learned a great deal abroad,’ he continued, ‘but in practical terms, little seems to have changed with regard to my duties. I have yet to make headway in establishing myself as an independent practitioner. Working with someone as esteemed as Dr Simpson, it is tantalising to see the rewards that are still so far out of my reach. For instance, a lady from Brighton has been sending letters begging for a consultation. The professor always refuses, saying that she is not ill and that he has told her as much. Yesterday she sent a telegram offering a fee of a thousand pounds. A thousand pounds! And still he refuses to consider it.’