The Moon by Night

by Lynn Morris

  “Dev, how could this happen?” Cheney asked with distress. “Please don’t tell me you think she contracted it here.”

  Puerperal fever, or as it was commonly called, childbed fever, was a deadly infection that was rampant in the days before a brilliant young doctor named Ignaz Semmelweis discovered that simply scrubbing the hands thoroughly prevented doctors from transmitting the deadly infection to mothers when they examined them. Since his studies and the publication of Joseph Lister’s carbolic acid antisepsis program, childbed fever was virtually never seen in hospitals that followed the protocols. It had gone from being a very common, usually fatal, infection to an extremely rare affliction among postpartum women who received hospital care. Even hospitals and physicians who still did not adhere to Lister’s full carbolic acid antisepsis program had learned to scrub with the antiseptic before examining pregnant or postpartum women.

  Dev answered evenly, “She is a prostitute, she drinks heavily, her personal habits are careless. She didn’t have any infectious symptoms when she checked in, Cheney, but it’s entirely possible that she was developing some sort of septic condition unrelated to the pregnancy. We’ll know more when—” He stopped abruptly.

  “I know, Dev, and don’t think you’re being cold-blooded when you say it,” Cheney said quietly. “We’ll know more when we do the autopsy. I can tell already, just from what you’ve told me, that she very likely will die. How is the amputee?”

  “She seems to be doing as well as can be expected considering her general debilitation from the life she’s led,” Dev answered cautiously. “But she is very close to Miss Cranmer. She’s an older woman and seems to have sort of adopted her. So it is difficult to judge how Miss Cranmer’s illness, and the baby’s ultimate prognosis, will affect Miss Jones. At any rate, Cheney, I wanted to talk to you about your patient Cornelius Melbourne.”

  Cheney sat up straighter, a move that betrayed her tension. “I know. I saw on the chart that you moved him to a private room. What is it, Dev?”

  He reached over and took her hand. It was cold, and he rubbed it lightly between his. “I want you to examine him, Cheney, because it’s very possible I’m wrong. You are his physician, and you have a better understanding of his condition than do I. But I have been monitoring him closely, and I believe he has contracted tetanus.”

  Cheney’s face paled with shock, and she gripped Dev’s hands convulsively. Then she rose and paced to the window, staring out at the bleak winter scene. There was no sign of life in the colorless ground and gray sky and spiky skeletons of the trees, but it did have a spare, stark beauty of its own.

  “What stage?” she asked in a tight voice.

  “He just started complaining of feeling tightness in his jaw and of his mouth feeling sore from gritting his teeth. He said it was much like when your teeth chatter when you have a high fever, but he didn’t feel feverish. He just kept gritting his teeth, he said, without meaning to.”

  “Oh, Lord have mercy on his soul,” Cheney whispered in a raw voice. She turned around and now her face, so bright and glowing before, was a mask of sadness and even despair.

  “Oh, Dev, I tried so hard to clean out that wound! I swear, Lawana and I took long minutes that were so tense because he was so gravely injured, but still I insisted that we take the time to check and double-check! I couldn’t see anything below the level of the dermis, not a speck!”

  He rose and went to her, taking her by the shoulders and looking down into her anguished eyes. “Cheney, you know better than this. You said yourself that he was covered in mud. I’m not at all surprised, by the nature of the wound and the conditions of the accident, that he contracted tetanus. You did everything humanly possible to protect him, but sometimes, in spite of our utmost care, patients can still be afflicted with such terrible things as erysipelas and septicemia and pyemia.”

  “Why? Why did it have to be tetanus?” Cheney said bitterly. “The highest fatality rate of any disease, except hydrophobia. He’s young; he’s strong; he could have fought off almost anything else!” She jerked away from him and turned back to the window. With an awkward movement she brushed her hand against her face. Dev stood silently behind her, just waiting. After long moments she took a handkerchief out of her coverall pocket, scrubbed her face with it, and turned around. “I’m ready now. I know that you’re right, Dev, but I’m going to examine him thoroughly.”

  “Of course, Cheney. I might be wrong. I’ve been wrong before.”

  “Oh? And when was this?” she said with rough amusement. “Never mind, Dev, I was just teasing you. Anyway, I would like to ask you two favors.”

  “Anything.”

  “Would you please come in with me when I talk to him? You make patients feel very secure, and he’s going to need all the help he can get.”

  “Of course, if you think it’s best, Cheney.”

  “I do. And now, would you please pray with me before I go to work? I’m still a little frayed about the edges.”

  He took her hand again. “I surely will. But, Cheney, is Shiloh here? Would you like me to go get him?”

  She started to answer, then hesitated, her brow furrowed. Finally she said in a low voice, “No, not right now. It’s too complicated to explain to him quickly.”

  “All right, then. Let’s go to the chapel, Cheney. I try to remember to go in there and say a prayer whenever I come in, but I usually am so taken up with ‘the cares of this world,’ you might say, that I forget,” he finished lightly as they left.

  “‘The cares of this world,’” she murmured sadly. “‘These are they which are sown among thorns….’ That’s not us, Dev. And I pray to God that it won’t be Cornelius Melbourne’s fate either.”

  They prayed for each other and for their patients. Even as she prayed, that chattering irreverent voice inside her head went on and on about how she was neglecting her Christian walk because she wasn’t praying and studying the Bible with Shiloh every day, as they had promised each other. And the reason she wasn’t doing that was because she was so busy that she was neglecting both Shiloh and the Lord. And particularly she didn’t press Shiloh to pray with her because she felt horribly guilty about never mentioning Cornelius Melbourne to him.

  Even as Cheney prayed aloud, these thoughts and a heavy burden of guilt weighted her down. But she realized that she must put them aside for now, because she had a grave responsibility to Cornelius Melbourne, and she was going to need the Lord’s help to bear this burden.

  Silently she promised the Lord that as soon as she could, she would make everything right, and she humbly asked that He give her, as it were, a dispensation until she could sort out her own sins and shortcomings.

  Such is His grace, she thought gratefully as she and Dev finished praying. I know He walks with me, right now and forever.

  Cheney rose and steeled herself. “When I finish my examination, I’ll come find you.”

  “I’ll be on the men’s ward,” Dev said, patting her shoulder. “I’ll stay close.”

  Impulsively Cheney threw her arms around him and kissed him on the cheek. “You’re the best brother anyone could ever have,” she whispered. “Thank you, Dev. For everything.”

  “You’re very welcome, Sister,” he said warmly.

  They went to the men’s ward. Dev went into Mr. Riordan’s cubicle, while Cheney went down to the private rooms. With a light knock, she opened the door and went straight to the bedside. “Good afternoon, Mr. Melbourne. Are you comfortable in your new room?”

  His jaw was clenched, Cheney saw with a sinking heart. Full lockjaw had not yet set in, but then she saw that he was unlocking the cramping muscles of his mouth by sheer strength.

  “’Bout time my doctor showed up,” he managed to joke. “Thought maybe you’d forgotten me.”

  “Never,” she said lightly, knowing that she spoke solid truth. “Dr. Buchanan tells me you’re not feeling well. I’m going to examine you, and then we’ll talk. All right?”

  “You’re the
doctor, ma’am.” His jaw clenched up again with an audible click.

  Still, Cheney made a thorough examination. His vital signs were fair. His wound was healing cleanly. Yet it was plain that one of the deadliest poisons known to man was well on its way to killing him. By some devilish mechanism that no one understood, this disease made every voluntary muscle in the body go into spasm, until they were irretrievably locked, inflicting horrific pain on the victim. The muscles of the face were affected first, and once the spasms began, the jaw quickly and completely locked closed. For the unfortunate patients who had a strong constitution, it could take days for them to die, languishing away slowly, starving, dying of thirst, with terrible spasms in every part of their body. Cheney had never had to give this prognosis to a patient. All the time she was examining him, Cheney prayed earnestly.

  He made no sound, said no word. She saw that his calves were already beginning to have slight spasms. She straightened and smiled at him. “I’m going to call in Dr. Buchanan, and we’re going to explain what’s happening to you.”

  He nodded, then closed his eyes and sighed.

  She stepped outside, and Dev was waiting. They went in and Cheney sat on the side of the bed and held Melbourne’s hand. Dev stood close.

  “Mr. Melbourne, you have contracted tetanus,” she said calmly, looking him right in the eyes.

  He had dark eyes that could dance with merriment, as Cheney had seen, and thick curly lashes that women would envy. Now they filled with tears, and he nodded. “I know. I knew.”

  “I’m sorry,” she said softly.

  “I am too,” he sighed, a deep, painful inhalation. “I’ve heard of it. I know I’m going to die. But I don’t know…how long. And…how, exactly?”

  Cheney glanced up at Dev. She didn’t trust herself to speak.

  “We don’t know how long either, Mr. Melbourne. It depends on many things.” Dev searched the young man’s face intently.

  Melbourne nodded. “It’s bad, isn’t it? But you have to tell me.”

  “All right,” Dev said evenly. “Your jaws are already in spasm, which is always the initial symptom. The onset of spasms in your other voluntary muscles will come quickly. And probably by the morning your jaws will be locked shut. You won’t be able to eat, and you will only be able to drink—liquids trickled into your mouth through your teeth—for a day, perhaps two. After that the spasms will be so severe that you won’t be able to control your swallowing reflex.”

  “Don’t guess I’ll be lucky enough to suffocate, though, huh?” he joked weakly. Cheney stifled a sob and turned her head away from him. It reminded her of how he had joked about being her first patient with a spike sticking out of his chest. Hot tears rolled down her face. He squeezed her hand lightly but kept talking to Dev. “Okay, Dr. Buchanan…is it…I mean, I already hurt….”

  “It is a very painful condition,” Dev said.

  “Can you help me? Do anything to help the pain?”

  “Yes, we can. We can give you morphine injections, Mr. Melbourne. They won’t stop the muscle cramps, but if we give you a high enough dosage, you will fall into a very deep sleep. You must understand that once we start giving you the injections, it will be necessary to give them often enough to keep you in what is close to a coma state. For if you wake up, it may be impossible to give you a dosage strong enough to overcome the pain and put you to sleep again.”

  “I see,” he said, staring into an endless distance. “I assume that you would prefer to start this course before I-I’m—”

  “Before you’re in extremis, yes. It’s much easier to induce this sleep state before your brain is fighting severe pain. In other words, it’s better to take preemptive action, Mr. Melbourne.”

  “You’re telling me that I need to say my good-byes soon,” he said, gripping Cheney’s hand harder. She clung to him, her face still averted.

  “Yes,” Dev said simply.

  There was a long heavy silence in the room. The only sounds were Cheney’s sorrow-laden breathing and the muffled sounds of a busy hospital outside the thick door. The world, and all the cares of it, seemed far away.

  Finally Melbourne said quietly, “Dr. Duvall, you prayed with me before, when I thought I was going to die, but instead you were a witness of my new life. I’m so glad Jesus saved me then, because now I’m not frightened. I know that a blessed and joyful eternal life is waiting for me. Will you pray with me again, dear Dr. Duvall, and be my witness again? Pray that I will have no fear and I’ll know no pain?”

  Cheney still wept, but her voice was strong, and she turned to him and smiled through her tears. “I’ll pray with you and be your witness, until we meet again, Mr. Melbourne. ‘Even so, come, Lord Jesus’!”

  ****

  After she and Dev prayed with Cornelius Melbourne, they sat with him until his parents came in. Cheney talked to them, giving them the grim prognosis, and then left them with their stricken son.

  She went back to work, reflecting on the frailty of man and the razor-thin edge of time that humans are allotted to live on the earth. And with deep reflections on such important eternal matters, as always her thoughts turned to Shiloh. I’ve got to share this with him somehow. How did it happen that I never mentioned this man to him?

  “Oh, by the way, Dr. Duvall,” Melbourne had said when Cheney was leaving, “I think we’ve known each other long enough to get on a first-name basis. Well, maybe not, but I’m all for pushing it a little. Would you call me Neil? Not Cornelius or Corny, please. I’ve still never forgiven my mother. Guess I’d better hurry up and do that now.”

  “Of course, Neil,” Cheney had said, “and you may call me Cheney.”

  “Beautiful name,” he murmured, closing his eyes with weariness, “for a beautiful lady.”

  Where was I—oh yes. Shiloh. I can’t remember now exactly why I didn’t want to talk to him about Mr.—about Neil. And now our lives have gotten so entangled that it feels like I’m deliberately hiding something from my husband! And I’m not! How on earth did I ever get myself into this…this…web? You remember, that tangled one you weave when first you practice to deceive?

  Oh, fie on Sir Walter Scott!

  I’m telling Shiloh all about Neil Melbourne first chance I get!

  But that was not so easy.

  Cleve was still sick, so Cheney and Dev were still trying to cover the midnight shifts. Dr. Pettijohn offered on Wednesday to stay the night, but he had been at the hospital for the previous two-and-a-half days. Cheney stayed until two o’clock Thursday morning, and then Dev came in, made a round, and slept at the office. By the time Cheney got home, she was so exhausted and drained that she could hardly even say good-night to Shiloh, much less explain all about Neil Melbourne. She slept late, got up, and rushed to the hospital barely on time for her two o’clock afternoon shift. Dr. Pettijohn offered to stay again, but Cheney thought he looked rather strained and pale. She wondered if he, too, might be getting ill. She didn’t like to question him, however, so she simply said that she and Dev would handle the night shifts. She stayed all night Thursday night because they began Neil Melbourne’s last sleep at midnight. He just winked at her. He couldn’t talk anymore, for his jaw was locked.

  “Until we meet again, friend, know that I am your faithful witness,” she said, then gave him his injection and sat by his side with his parents, talking to them until they were able to go to sleep in the room next to Neil’s, which the hospital had offered for their use until Neil died. Cheney didn’t think it would be very long, which added a new urgency to her determination to talk to Shiloh about all that Neil had meant to her. And, though she knew that Neil was in a semiconscious state, she wanted Shiloh to meet him before he died. She thought Shiloh would understand.

  But Thursday night slipped away. Cheney didn’t get home until almost four o’clock Friday morning. When she got up at noon, Shiloh was gone.

  “He told me to give you his most abject apologies, madam,” Jauncy said as he and Sketes served her breakfast. �
�He had various errands and obligations in the city—or, as I believe you term it, downtown,” he pronounced carefully. “He also said that he would, with your permission, come to the hospital later this evening. I believe he wishes to have dinner with you, madam, although he made no specific reference as to time.”

  “Thank you, Jauncy,” she said, hiding her amusement. “If you should see my husband before I do, please give him my deepest regards and tell him that I accept his dinner invitation with pleasure.”

  Twenty-three

  The Time Was Past; Her Course Was Set

  While Cheney was listening to Jauncy relay Shiloh’s message in such an elegant manner, Manon Fortier Pettijohn was listening to a message that was nowhere near as elegant but was equally clear. Though she couldn’t understand the words, she understood the message perfectly.

  “Hey, Miz Pettijohn! I knows you’re in there, Miz Pettijohn!” Grimes yelled, banging on the door. “And I knows something don’t smell right, ’cause I ain’t seen Mr. Pettijohn comin’ or goin’ all week long! Now I knows he gets paid today, and he gen’ly gives you the rent money for next week. I’m going to give you this evening, but I’ll be here first thing in the mornin’ to collect. You hear me, Miz Pettijohn? First thing in the mornin’!” With a final thud on the door he went to number 21 and started banging on that door.

  Manon pressed her fingers to her eyes. Grimes’s coming was, she had found to her dull surprise, not nearly as bad as the anticipation of his visit. She had known, and dreaded, all week long that he would come to collect the rent.

  She had not seen her husband in a week.

  The only money she had left was a single dollar—it was torn almost in half, so Marcus had tossed it on his bedside stand—and fourteen cents in change that Solange had found on the floor of his bedroom.