The Doctor's Discretion

by EE Ottoman

  What were you thinking?

  That Doctor William Blackwood was very pretty. His wide dark brown eyes had looked flecked with amber in the firelight, his lips had been wet and oh so inviting. He’d made stifled little noises when Augustus had sucked him, although, otherwise, he hadn’t seemed inexperienced. It had been good, exactly what Augustus wanted and needed, right up until the point when Blackwood offered to suck him off in return.

  That, though, had been out of the question.

  Oh, but what if it hadn’t been, if he could have said yes? Blackwood would have gone to his knees on his parlor floor. Or maybe Augustus would have lain in front of the fire, Blackwood kneeling over him, long, clever fingers undoing his trousers, pulling back the fall. Blackwood would touch him, sure of what he was doing and how Augustus wanted it, would rub and stroke him to hardness before bending to take him into his mouth.

  Augustus reached down, pulled up his nightshirt enough to touch himself while he imagined it. Blackwood’s beautiful eyes, and his mouth.

  He wanted to see Blackwood naked, spread out, panting and coming undone under Augustus. What would Blackwood look like when he was being fucked, or afterwards, all boneless and sated?

  His hand on his cock was slow and lazy, the pleasure building. He spread his legs farther, let himself get lost in the easy pleasure of his own touch, wished it was Blackwell’s.

  After he spent, he lay in bed for a few more minutes, letting his heart slow, and then got up and put on his dressing gown.

  He lit the fire and put a kettle of water on for coffee.

  While the water heated, he washed in the frigid water of his pitcher and set about dressing.

  He had three suits in his wardrobe: two good ones and one he’d had when he’d been discharged from the Navy. That last one was worn almost to tatters, but the other two were respectable enough. He’d seen Blackwood eyeing his coat the day before. He was particularly proud of that one, a beautiful blue-green shade. Originally, when he’d seen the cloth at the shop where he’d had the coat made, he’d assumed it would be expensive, but the women who owned it had told him it had been the end of the dye batch and pointed out some flaws in the coloring that Augustus couldn’t even see. He suspected there hadn’t actually been anything wrong with the cloth, and the discount she gave him had been for his military service, but he hadn’t argued with her.

  The fact was he loved the coat and the color. When he’d been younger, he’d chosen clothes that were as aggressively male as he could find —coats that made him look larger and his shoulders broader. As he got older, though, it felt more and more like he was coming into himself, giving himself permission to be a person rather than just a man.

  He slid his waistcoat on and did up the buttons one-handed. Over the last year or so, he’d become proficient at that, even if it took him a little longer than an able man.

  The water had boiled by the time he was done, and he poured it into his coffee press and let it steep.

  He had one more item he needed to put on, but he was loath to do it before it was really necessary. The wooden hand lay on his writing desk where he’d tossed it almost the moment he’d walked through the door the last time he’d had to wear the accursed thing.

  Augustus picked it up. It was heavy, the wood itself covered in a worn leather glove he didn’t bother taking off anymore. From the wrist socket dangled a complicated assortment of buckles and straps.

  Just looking at it made the muscles in his arm ache and the stump of his wrist twinge. It was a clumsy dead weight at the end of his arm, existing for no other reason than to get in his way and allow others to forget he only had one hand.

  He debated leaving it off today or, better yet, tossing it into the fire.

  The one time he’d not worn it to the hospital, though, Doctor Cooke had looked like he tasted something bitter every time he and Augustus were in the same room. It was slightly odd for a doctor to have such a distaste for a physical condition like Augustus’, but Doctor Cooke had made it clear that the patients were the ones allowed to have physical afflictions not the doctors.

  “All my staff must be competent, not just in practice but in appearance,” he’d told Augustus, his gaze pointedly fixed on the empty cuff of Augustus’ sleeve. “After all, we have a reputation to maintain.”

  Well, if New York Hospital turns you away, there is always Bellevue to fall back on.

  Augustus smiled thinly at that thought as he sat at the desk and rolled up his sleeve.

  He held the hand steady, slotted it over his wrist, and started doing up the straps using his teeth. When the thing was on, he rolled his sleeve back down, did up the cuff, and headed back into the bedroom to wrestle on his coat.

  Maybe the idea of going to Bellevue wasn’t all that preposterous. The institution might be part penitentiary, part lunatic asylum, and in very small part a hospital, but he could potentially be the director there, the lead physician. Not under constant scrutiny and control as he was at New York Hospital. He might even be able to enact some much-needed reform and abolish Bellevue’s reputation for neglect, cruelty, and filth.

  The post he held at New York Hospital was supposed to be his foot in the door, a prestigious position that would allow him to teach at Columbia or become lead physician at one of the new hospitals that were being planned. It had taken every piece of political leverage he had, every story of his heroics in war, and a good word from Columbia faculty and military officers alike to secure this position. A physician’s position at New York Hospital was one of the highest honors a young doctor could have, after all. If only he could stomach the pretension and being looked down on by the older doctors just a little longer, he’d be able to get a better job or at least one that suited him more.

  He glanced out the window. There was enough pale light outside that he could see the road and sidewalk were white with the night’s accumulation of snow.

  It was going to be an unpleasant walk to work. Given the ice that probably lay under the snow, they were bound to see injuries from at least a few carriage accidents before the day was done.

  When he’d finished his coffee, he bundled up in greatcoat, boots, hat, scarf, and glove, and headed out into the cold.

  The snow was not as deep as it had looked from inside his room, Augustus discovered as he trudged down the sidewalk. He’d been right about the ice though. The rain and sleet they’d had yesterday had frozen underneath the lighter snowfall.

  Catching an omnibus might be faster, but he didn’t trust anything with wheels in this weather, not until the roads had been cleared a little bit and ash and charcoal laid down over the ice.

  New York Hospital lay behind a high stone wall and iron gate. The hospital was also stone, a two-story building in the shape of an H, with a large cross rising from the cupola at the highest point of the roof. There was also the much newer asylum for the insane, set some distance from the hospital but still on its grounds. Within the walls, between the gate and the hospital, was an expanse of land turned into a gentle rolling garden, that was cut through by a tree-lined drive leading up to the front entrance.

  Doctor Cooke often liked to talk about the pastoral calm the park encouraged, away from the noise and filth of the city. Augustus could see how the park was soothing for patients and lifted their spirits, especially those who had to stay for long periods of time. The drive was made of cobbles however, which were difficult to walk on when covered in ice and snow. He almost turned his ankle on one, swore, and limped the rest of the way.

  It was warm inside as always. The fireplace and stoves were well tended through the day and night to assure the hospital was never excessively chill. The drapes had been thrown back from the high windows, letting in the morning light.

  The servants, nurses, medical students, and live-in surgeon, physician, and apothecary were already all at work as the hospital got ready for the morning.

  Augustus stamped the snow from his boots and handed off his hat, greatcoat, and outer thi
ngs to a maid.

  “Good morning, Doctor Hill. There’s coffee and fruit bread laid out in the library if you want something before seeing your patients,” Doctor Walker, their house physician, called to him as Augustus made to pass him in the hall.

  “Really?” Augustus slowed, and Walker smiled.

  “Really. I had the kitchen make extra this morning. I suspected there would be a few of us who could use something to eat after having to walk here in this weather.”

  “Thank you.” Augustus glanced up and down the hall to see how many of his fellow physicians had made it in so far this morning.

  Walker took a step closer to him and lowered his voice. “None of the senior physicians are in yet, if that’s what you’re wondering.”

  “Maybe it will be just us junior men today.” Augustus kept his voice as low. Augustus’ thirtieth birthday was a good ways behind him, and Walker’s was fast approaching, but still, they were youths compared to the hospital’s other physicians and some of the surgeons.

  “Maybe it will. Although Doctor Cooke might also make an appearance. You know how he likes to keep us on our toes.” Walker gave Augustus’ shoulder a small squeeze and stepped around him, heading down the hall towards the women’s ward.

  Augustus let himself into the library and poured a cup of coffee.

  There was a knock on the door, and one of the nurses, Nurse Nelson, ducked into the room.

  “I need to speak with you, Doctor Hill.”

  “Of course.” Augustus waved her into the room. She came in, leaving the door open behind her.

  “Mr. Hartley passed away last night. I thought you should know.”

  Augustus closed his eyes for a moment and took a long steadying breath. “Thank you. I’ll want to see the body of course, after I’ve done my morning rounds.”

  Nurse Nelson nodded. “I’ll make sure he’s prepared for you.”

  “Also, if you would be there to assist me, I would appreciate it.”

  At that, she looked surprised. “Wouldn’t you prefer one of the students to assist you?”

  He should choose one of the students; it would be a good learning experience for them, but Nurse Nelson could probably use the experience more. After all, unlike the male students, she could receive no formal education or training in medicine. Nursing staff entered the hospital’s employ with the same level of training as the maids and relied on the guidance of older nurses and observing doctors to learn the skills they needed for the job. It was one of the reasons why Augustus tended to spend more time working with the nursing staff than the actual students. He smiled at Nurse Nelson instead.

  “I would prefer you, nurse, if that’s all right.”

  She hesitated for a moment and nodded again. “I would be happy to assist you. Send one of the other nurses for me after you have carried out your rounds.”

  “Thank you. Is there anything else?”

  “Doctor Cooke brought a new patient here yesterday. She’s in one of the lying-in rooms upstairs while the doctor decides whether or not to have her housed at the asylum.”

  Augustus raised his eyebrows and took another sip of coffee. He was not overly interested in Doctor Cooke’s patients, as all his duties were conducted in the main hospital.

  “They’re saying the patient has the body of a woman but was living life as a man. She was found out, arrested, and brought here.”

  Augustus felt his entire body go cold and numb.

  Nurse Nelson’s tone lowered, and she took a step closer. “They’re saying the patient might be a hermaphrodite in body as well as in inclination. If that’s true, it would be the first case in the United States. The students are very excited. They’re saying all the senior physicians will be assembled to witness the first examination once the weather permits. There are, even now, physicians traveling from Philadelphia and Washington to examine the patient themselves.”

  Augustus forced his lips to move. “What is the patient’s condition?”

  Nurse Nelson stared at him as though she was unsure what exactly he was asking. “I don’t understand.”

  “This is a hospital.” Each word grated in his mouth like shards of broken glass. “Is she ill or injured in some way?”

  “Not to my knowledge.” Nurse Nelson was frowning now. “The patient was brought here for confinement while the state decides whether to press charges.”

  Augustus drew a long breath and let it out carefully. “Thank you for telling me about this. I’ll send for you when I’m ready to examine Mr. Hartley’s body.”

  She gave him a small curtsey and stepped out into the hall once again.

  As soon as the door shut behind her, Augustus doubled over into the nearest chair. His hand was shaking so hard he feared he would drop the cup, but he managed to set it on the table before reaching up to cover his face.

  A sound very near a sob tried to force its way out, but he clenched his teeth against it. This was a public space where anyone could interrupt him at any moment. He did not have the luxury of falling apart here.

  Forcing himself up, he managed to get out of the library, down the hall, and through the back doors into the gardens.

  The frozen air bit at his skin, ice cracking under his feet, as he took several halting steps down the path and then stood. He took several long breaths until his chest burned, his eyes watering with the cold.

  Finally, he straightened up and turned back towards the hospital.

  Once inside the back entryway, he made sure his clothing was set to rights and brushed his fingers through his hair.

  Then, as fortified as he could be, he started for the east wing to begin his morning rounds.

  ~*~

  This was a mistake.

  Augustus stood in the dimly lit hall and stared at the door.

  He shouldn’t be here. He should turn around, go back downstairs, find Nurse Nelson, and conduct an autopsy on Mr. Hartley’s body.

  This wasn’t his patient, and he wasn’t sure he wanted to go in there anyway.

  He took out his key ring, slipped his copy of the master key into the lock before he could fully talk himself out of it, and opened the door.

  A figure sat on the bed, face turned away from the door, looking towards the window. They had pale, white-blond hair cut close to their head, and were clothed in one of the plain gray dresses the nurses wore.

  They turned from their view of the window as Augustus stepped into the room.

  Once in, Augustus found he wasn’t sure what to say. The patient stayed silent as well, waiting for him to make the first move.

  Augustus cleared his throat.

  “Good morning, let me introduce myself. I’m Doctor Hill.”

  “Moss.” Their chin went up, spine straightening as if the word was a challenge. A glove cast down at the beginning of a duel. “Henri Moss.” Their voice rolled smoothly around the words, giving them a slightly accented touch.

  They stared at each other, and Augustus’ gaze dropped first.

  What could he say? I’m sorry my colleagues will paw over you like you’re some kind of animal for them to dissect and display. I’m sorry you’ll be kept here for the rest of your life while I walk free.

  “Do you need anything?” he managed, and looked back up in time to see Moss’ lips curl into a small bitter smile.

  “I don’t think I need anything from you, Doctor.”

  “I’m sorry,” Augustus said and backed out of the room.

  He stopped in the hall and stared at the door. Part of him wanted to go back in and take Moss away to...somewhere.

  But where? Could he get them both out of the hospital without being seen? If they were seen, Cooke would certainly send soldiers after both of them, and then what? Moss had been ordered here by the state, and Cooke was unlikely to give him up without a fight. Even if Augustus could get Moss out of the hospital unseen, get him out of the city maybe, or put him on a boat for England or France, then what would he do?

  He didn’t have money to
give Moss, and surely all of Moss’ own finances would have been taken. He could think of no one he could go to for help with this.

  Augustus closed his eyes and, not for the first time, wished he were still in the service. He could have gone to Raymond or Fitzroy with this and known they’d support him, no matter what the price. Both were far from here, though, aboard ships sailing around the coast of Africa.

  He only had acquaintances here in the city, men he could speak to but not necessarily trust.

  And there would also be an investigation. Cooke would make sure of it, probably with charges of kidnapping if Augustus was caught. Would he be able to withstand that?

  If a magistrate or the army were to start an investigation into his past, how quickly would they find him out?

  It would take a word, a single rumor, one fact that didn’t fit for him to be the one locked in a lying-in room. He could destroy others too, people who had known and people who hadn’t.

  His hand, holding the key, dropped to his side.

  The safest thing, perhaps the only safe thing, to do right now was to lock the door back up and go downstairs to conduct his autopsy.

  Slowly, his hand rose again. He fitted the key into the lock, turned it, and then headed back down the hall towards the stairs.

  ~*~

  William had spent the day writing on the history of blood transfusion. It would be an article or maybe even a pamphlet when he was done, and he thought it was coming together quite well.

  Two years ago while visiting Paris, he’d read about the case of Jean-Baptiste Denis, a physician charged with murder after attempting to transfuse calf’s blood into a madman. The concept of transfusing animal blood into a human body had sparked his interest, something, something that had, to his knowledge, never been successfully done. Given the nature of the experiments that had been conducted on the subject during the last hundred and fifty years, William was inclined to agree with Doctor Leacock’s theory that only human blood could be safely transfused into a human patient.

  Perhaps he would be able to see Doctor Blundell lecture on his use of blood transfusions to treat postpartum hemorrhage the next time he was in London.