* * *
Bella had read the book from cover to cover. Two of the children had drifted off to sleep by the time she quietly closed the book. The third, a usually boisterous lad by the name of Tom, stared listlessly at the ceiling. His cheeks were almost scarlet. Earlier, he had complained about a bit of a sore throat and had a slight cough. Now he was glassy eyed and still. Despite promising her father and the matron she would confine herself to the chair, something about the look of the boy did not sit right. She limped towards his cot and laid a hand on his brow. His skin was on fire.
She hobbled across the ward to pour a bowl of cool water and dunked a clean square of linen into it. After placing it across Tom’s fevered brow, Bella quickly found a maid and told her to summon the physician. All her reading told her the rapid onset of a high temperature did not bode well and signalled something nasty.
Back at his bedside, she sat and used the cold flannel to cool the boy’s skin. ‘The doctor is on his way, Tom. Are you in any pain?’
‘My throat.’ His voice was so hoarse he winced as he whispered and frightened tears gathered in the corners of his eyes.
‘Let me see.’ His mouth was so swollen that seeing was impossible. Remembering the spare medical tools Dr Warriner kept in the cabinet, Bella rummaged through them and returned with the ivory tongue depressor she had seen him use before. ‘Say ah, Tom.’
The boy did as instructed, with some difficulty, but Bella saw the swollen and infected tonsils. To her untrained eyes they appeared very infected indeed, which suggested quinsy. The high temperature and general malaise confirmed the diagnosis. The poor lad must be in agony and his rapid fever was a worry.
‘Dr Warriner is attending a birth, my lady.’ The matron, Mrs Giles, scurried in, looking flustered. ‘His housekeeper says he might be gone many hours, but she will send him with all haste as soon as he returns.’
‘Then send for Dr Bentley!’ Bella did not want to wait hours. Hours of high fever killed children.
The matron shook her head. ‘Dr Bentley won’t come here.’
‘If it is a matter of money, Mrs Giles, tell him I will pay him personally.’
‘It’s not the money, my lady...it’s the family. Dr Bentley will not come here because it is owned by a Warriner.’
Bella had never heard anything so ridiculous in her life. ‘The man is a physician, is he not? As such, his first duty is to attend to those who need him. Send for him immediately.’ Petty feuds had no place in an emergency.
Just a few short minutes later, word came that Dr Bentley would not be attending the foundling home, now or at any time in the future and no amount of money would sway him. ‘I’m sorry, my lady, but the old prejudices still run deep in Retford. I’m sure Dr Warriner will be here presently.’
Such an outrage beggared belief and at some point she fully intended to give the silly man a piece of her mind, but in the meantime Tom was burning up. ‘Can you brew some willow bark tea, Mrs Giles?’ That was known to help reduce a fever. ‘And some ice.’ Common sense told her cooling the boy’s skin might help, just as it had her hot, swollen ankle. Then Bella remembered her conversation with the doctor in his office. Honey fights infection... If it worked externally, then there was a chance it might work internally as well. She called at the woman’s retreating back. ‘And bring me a jar of honey, Mrs Giles!’
A few minutes later, she helped the boy to sit and carefully spooned the warm, hastily mixed willow bark and honey concoction into his mouth. He really didn’t want to swallow, so she tilted his head back to allow the liquid to trickle over those inflamed tonsils and into his stomach.
Mrs Giles moved the other boys to another room at Bella’s insistence and all the windows in the sunny infirmary were thrown open and the blankets stripped from the bed to allow the linen parcels of ice she had made to rest against his limbs, torso and head. Despite her best efforts, the boy’s temperature remained dangerously high. The willow bark alone was not going to be enough. What else could she use? Feverfew—wasn’t that known to have a calming effect on inflammation? And she had recently read a very enlightening paper on the benefits of echinacea flower...
‘Mrs Giles, send somebody immediately to Dr Warriner’s surgery and ask his housekeeper to send us the following things.’ Bella listed all the herbs she could think of which might be of use: yarrow root, black elder berries, chamomile, ginger, more white willow, much more honey. In the absence of a proper physician, Bella was all little Tom had.
* * *
It was almost midnight when Joe finally made it to the infirmary. The twins he had just delivered had been most uncooperative. The first had been breech and the second baby had the cord wrapped around his neck. It had been a difficult and dangerous birth and he was supremely grateful he had been called early enough to be able to save the mother and both of her babies. Now he was practically dead on his feet and had already called for a large pot of coffee to sharpen his wits ready for his next emergency. He only hoped the child’s fever was manageable and that the hours of delay had not been catastrophic. Dealing mostly with the many poor of the parish, Joe was often spread too thin and, because of his innate need to rescue, felt personally responsible for every failure—especially the children. Today, three of them had needed him and he prayed he was not too late for the third.
The ward was dim as he walked in. A single candle burned in one corner of the room and he could just about make out the outline of a napping nurse resting in the chair beside the sleeping boy’s bed, her head buried in the scrunched-up pillow which had been propped behind her and her legs tucked under her skirts. He crept to the opposite side of the bed and rested his palm on the boy’s forehead. He was warm, but not burning. A good sign. Fortunately, this nurse had not closed up the room or had a roaring fire burning in the grate. No matter how many times he told Mrs Giles heat was the worst thing to use to treat a fever, the old matron was set in her ways and always reverted to it in an emergency. It was all she knew.
This nurse was obviously more intelligent. Tom was covered in only a thin cotton sheet, the fireplace was stone-cold and the lace curtains billowed in the gentle summer breeze coming through the wide-open windows. Joe placed his bag on the edge of the bed and the movement woke up the sleeping woman with a start. Her terrified eyes were round in the darkness.
‘I didn’t mean to frighten you.’
‘Dr Warriner!’
He knew that voice. ‘Lady Isabella?’ To find her still here, at a sick child’s bedside so late at night, was a huge surprise. ‘What are you doing here?’
‘I wanted to stay with Tom...just in case his fever returned.’ She had hastily stood and was in the process of lighting a lamp close to the bed. ‘His temperature was so high earlier I was worried about him.’ As usual, she was already backing away towards the open doorway, her posture stiff. He could see her chest rising and falling rapidly almost as if she was in the midst of a panic, but her features were composed, if slightly strained.
‘Is he having any difficulty breathing?’
She took a step forward and gazed down at the sleeping child and shook her head. ‘Not so far—thank goodness.’ In the lamplight, he could see her hairstyle had collapsed on one side. One slippery coil of dark hair hung down against her cheek almost to her waist. The rest of that side of her head charmingly resembled a bird’s nest. Rumpled and groggy with sleep, she appeared younger and much softer than usual. Instead of their usual wariness, those soulful dark eyes were now filled only with concern for the little boy. ‘The fever came on so suddenly.’
‘His temperature is not unduly high now.’
Almost as if she didn’t believe him, her own palm brushed against the boy’s brow and she exhaled in relief. ‘I mixed willow bark with feverfew, echinacea and chamomile in a tea to fight the fever and have been feeding him it every two hours since midday. I didn’t know what else to do.’
Joe took in the scene, the open windows, the ice, the cool cloths draped over the
boy’s arms and head. The child’s distinct lack of a nightgown. ‘I think you did everything I would have done. You have managed the symptoms perfectly.’
‘Not all of them. He’s wheezing and his tonsils are badly infected and he is in a great deal of pain. I mixed a generous dollop of honey in with the tea because I recalled you said it had healing properties against infection. I have no idea if it has actually made a difference, but it seemed to help.’
She really had thought of everything. ‘The warmth of the tea will have soothed them and the honey will help to fight the infection. As for the pain, I think you have alleviated a great deal with your quick thinking—he is sleeping very soundly. I doubt he would be so deep in the arms of Morpheus if he were still in the grip of pain. I was expecting to walk into a crisis, but thanks to you, it was deftly avoided... Well done.’
She smiled at him shyly but then brushed the compliment away. ‘I can assure you, it was merely borne out of necessity. When we learned you might not return for hours, I sent for Dr Bentley and the fool refused to come.’ The flash of annoyance had her scowling. ‘And the man has the cheek to call himself a physician!’
‘Dr Bentley is quite particular about who he treats.’ People with no money to pay him for his services up front, for example, were callously ignored. Joe hated that, yet at the same time he was strangely grateful for the fellow’s ambivalence. Had Bentley been a good doctor who treated first and sought payment after, then nobody in his Retford practice would have given Joe a chance. His willingness to treat all comers and to accept whatever payment in kind the families could afford had granted him a level of acceptance he would never have enjoyed otherwise. Of course, it also meant he was given all manner of things he had no use for—like the ornate lady’s hair comb which had been sent to his surgery only yesterday by an elderly patient who was as fit as a fiddle but imagined she suffered from everything. Nothing he could use to pay the wages of an assistant to help him with his growing workload.
‘Doctors have no place being selective in their choice of patients. Ignoring a sick child is nothing short of cruelty. In fact, it is criminal!’
‘I keep trying to appeal to his better nature.’ Joe refrained from saying what he truly thought. Dr Bentley was motivated by money rather than the need to heal. Meanwhile the poverty-stricken people suffered unnecessarily from his neglect. However, knowing what he did about Dr Bentley’s archaic and draconian practices, he supposed it was just as well he was not more charitable. His antiquated methods rarely worked and often made things worse. If Joe ever found himself bleeding to death in the middle of the road, the very last person he would call was Dr Bentley, as he’d probably end up dead.
‘I am not sure that man has a better nature. I didn’t take to him when I first met him and respect him less now. It is a wonder that he is still condoned by the locals when his attitude towards the sick is so appalling.’
‘Dr Bentley has been practising medicine here for as long as I can remember. People are unwaveringly loyal to him after so many years of service.’ And, of course, it helped he did not have the unfortunate surname of Warriner.
‘Service?’ She was so outraged she forgot to whisper. ‘Leaving a sick child to potentially die is hardly service!’ Her fierceness amused him and reminded Joe of the way he had seen Dr Bentley glare at her as he left her the other day. Lady Isabella clearly hid a bit of a temper beneath her usually silent, suspicious exterior. It made her forget to be silent and it was nice not to be on the receiving end of her disdain for once. The noise roused their patient and he whimpered slightly. The change in her was instantaneous. ‘Oh, I’m sorry, Tom.’ Her hand brushed his hair affectionately. ‘Dr Warriner is here. He is delighted to see you getting better. Would you like something to drink?’
The boy nodded and she began to fuss over him, so different from the uptight and dour woman he had always assumed her to be. To be still here because a foundling was sick and to be treating him as if she genuinely cared about him was...well, frankly nothing short of admirable and not at all what he would have expected of her. She stepped aside while Joe did his own examination of the boy, watching with barely disguised interest from her preferred spot nearest the door as he took his stethoscope out of his bag and used it to listen to Tom’s chest. ‘His lungs are clear. The wheezing is in his throat, not his chest.’
‘You can tell such things just from listening?’
‘Yes, indeed. With this wonderful instrument I can hear all manner of things I couldn’t before.’
‘Is that Laennec’s stethoscope?’ She took two steps forward. At her apparent fascination with the instrument he passed it to her to examine. She took another step forward, took it eagerly and scrutinised both ends of the wooden tube whilst holding it as if it were as precious as the Holy Grail. ‘I read his paper last year but have never seen one used before.’
She kept surprising him. ‘You read his Treatise on the Diagnosis of the Diseases of the Lungs and Heart?’
‘I didn’t understand all of it,’ she said, holding his stethoscope like a telescope and peering through the hole, ‘but his claims that different diseases caused the chest cavity to sound different was intriguing.’ Lady Isabella was the first person he had ever met who had read the great Dr Laennec’s work, a surprising choice of reading matter for a young lady, yet one which proved she had more than a working knowledge of all things scientific if she had read that weighty academic essay.
‘I had one made to Laennec’s exact design as soon as he began to publish his successes. He has used it to great effect when diagnosing the treatment of consumption. I have heard of a few other physicians who have started to use a stethoscope rather than rely on just their own ears—but it is still a relatively new invention. Everyone who tries it, swears by it. It’s amazing how clearly one can hear congestion in the lungs, or an irregular heartbeat—which in turn makes diagnosis and treatment of such dangerous conditions faster. When an illness affects the lungs, without swift intervention a patient can quickly develop pleurisy or pneumonia. That stethoscope you are holding has saved a few lives here in Retford in the two years I have been using it.’ In fact, it was Joe’s most essential piece of equipment aside from his spectacles. Without those, he couldn’t read a damn thing or see anything close up. ‘I have been experimenting with it with expectant mothers. During the first stage of confinement it is also possible to hear the heartbeats of a foetus.’ Was it appropriate to discuss such things with a gently bred young woman? Probably not, yet her eyes lit up and he reminded himself she had read Laennec.
‘How can you be sure you are simply not hearing the mother’s heart?’
‘Because I can clearly hear both, beating in tandem. The mother’s is louder, as one would expect with an adult, fully grown heart, and the babe’s is softer and beats much more rapidly. I was staggered at how fast it was at first, but it is a wonderful thing to hear.’
‘Rapid heartbeats? How fascinating. To hear life at such an early stage of development. Is the instrument easy to use?’
‘I’m sure young Tom here won’t mind you listening to his chest. Why don’t you give it a go and see for yourself?’
There was no hesitation this time. No wariness. Lady Isabella placed the end on the boy’s sternum, ever so slightly left without having to be told the human heart did not sit dead central, and rested her ear against the other end. Within seconds she was smiling again. ‘My goodness! Why, I can hear it as clear as a bell.’ Then she giggled, a delicious, warm sound which did odd things to his own heartbeat and made him feel uncharacteristically vain. Joe found himself unhooking his spectacles from his ears and stuffing them into his pocket and quashed the urge to neaten his unruly hair. ‘I can also hear your tummy gurgling, young man. There are so many noises going on inside your body it is like an orchestra is playing a symphony with your organs.’
A symphony of organs. What an apt description. ‘Listen again while Tom takes a deep breath. Can you hear any wheezing in his lungs?’
She bent her head again and listened intently for almost half a minute before standing up. ‘You are right. There is no congestion in his lungs. The only sounds of laboured breathing I hear clearly come from the swelling in his throat.’ Anticipating his next move, she handed him the tongue depressor on the nightstand so he could get a better look inside the boy’s mouth at the source of the trouble, then went to fetch the candle to shine light on the right spot. Just as she had said, the offending tonsils were quite nasty, but he had seen far worse. ‘Will you have to remove his tonsils, Doctor?’
Little Tom’s eyes widened and Joe winked at him and shook his head. ‘Only if they keep causing problems. In my experience, this is a stage many children go through and grow out of. I am of the belief, if one is born with an organ, then it serves a greater purpose remaining in the body unless it proves to be absolutely necessary to remove it. For the time being, Tom’s tonsils can stay put.’
A Warriner to Tempt Her Page 4