“Tomorrow morning at ten,” Thomas said, again feeling the surge of excitement, mixed with a trace of foreboding. He had sent home a widow the first time he’d tried the procedure. Deaton was strong, the injury was a closed fracture, and the growing inflammation could be managed.
“I shall need perhaps eight pieces,” Thomas said, drawing Bertha to one side. “But I don’t know how long. He thought for a moment, visualizing the bones of the man’s lower leg.
“I shall make a list of a variety of sizes, and Lindeman can fashion them all.”
“Out of…”
“The silver that Alvi used last time was ideal,” he said. “I’m sure there are more forks to be had.”
“Gert James is going to run out of patience with you, Doctor.”
“I’ll deal with her. Will you find Alvi? I’ll give her the list.”
Deaton watched Bertha Auerbach leave the ward. He sighed, and his voice dropped to a whisper. “This is going to be one of them things that either cures me or kills me? Is that about right?”
Thomas reflected for a moment. “I’m confident. That’s the best I can do.”
“That’s something, I guess. How many others you done like this?”
Deaton’s gray eyes assessed the young physician, waiting.
“None yet,” Thomas said.
“Figured that, too,” Deaton said. “I heard about Larry Beautard.” He held out his hand, and Thomas wheeled forward to take it. The man’s grip was damp from slight fever. “Proud to be the first,” he said.
Chapter Forty-nine
The more Thomas pored through the various volumes in Dr. John Haines’ medical library, the more he felt the conflict of excitement and apprehension. With a messy compound fracture such as Howard Deaton’s, every author chose amputation. The newest text in the library, written in 1876, showed only maps of the most expedient incisions for the knife and saw.
He found himself racking his memory, trying to recall the advice from the first edition of Dr. John Roberts’ Modern Surgery, a text that he now so sorely regretted losing with his steamer trunk. He had read of attempts in Europe to join bones artificially, to “assist nature,” as Roberts would say, when the very muscles, tendons, and ligaments surrounding those bones proved to be the enemy, pulling the fragments out of alignment.
He considered wiring Roberts at the university with a list of questions, but he knew that from three thousand miles away, the physician would be loath to recommend specifics without being able to examine the patient himself. Still, something might be gained, some little shred of advice to guide him.
With that in mind, Thomas set about writing a concise outline of his needs for Carter Birch, Port McKinney’s telegraph operator. With any luck, some answer might be promptly received from Pennsylvania.
So intense was his concentration that when the knock came on the door jamb of the office, he bolted upright, letting out a cry as pain stabbed his ribs and hip.
“Didn’t mean to set you off,” the assistant constable said as Thomas settled back in the chair.
“My God, man, I didn’t hear you come in.”
“I’ll be a little more clumpy next time,” George Aldrich said. His eyes settled on the dog, who had not bothered to lift his head. “Not much of a watchdog.”
“That’s what he does, as a matter of fact,” Thomas said, holding his ribs. “He watches. He seems to know who his friends are. Right now his best friend is morphine.”
“You cut him up pretty bad?”
“His leg was badly abscessed. It appears that someone shot him. I removed the ball.” He stretched carefully.
“That don’t surprise me. Half the town he’s either bit or tried to. Riggs let fly at him once. I know that.”
“The same sort of ball that was recovered from Kittrick’s brain,” Thomas said. “Riggs admitted it.”
“So there you are.”
Thomas glanced at the clock and saw that it was approaching six.
“Interesting thing,” Aldrich said, and without invitation settled carefully in the straight-backed chair on the other side of the desk. He bent far to one side and Thomas heard the jingle of metal. The constable pulled out what appeared to be half a dozen enormous spikes, square in cross section, polished off on one end, tapering on the other. He reached out and placed them on the desk in front of Thomas. From another pocket he pulled yet another, this one of the same general proportions, but badly mangled.
“Railroad spikes,” the constable said, seeing the question in Thomas’ expression. “Except the flanges have been ground off.”
“So…,” the young physician said.
“And so this one here we took out of the log that broke Mr. Schmidt’s saw—and killed two good men.”
Thomas picked it up, feeling the heft of it. Nearly cut in half, the iron spike had bent and split.
“That saw blade is fifty-four feet long,” Aldrich said. “A good foot wide. Only one like it in these parts. Schmidt tells me that when the saw’s wound up, that blade is traveling a hundred miles an hour.”
“Amazing,” Thomas said.
“Meant to cut wood, you know. Now, you put iron in the way…”
“You mean someone drove one of these spikes into the log? Why would they do that?”
“To wreck the saw,” Aldrich said calmly. “Shuts down the mill. Costs Schmidt maybe more than he’s got.”
“Wouldn’t someone at the mill see it done? Good heavens, man, sledging one of those things into a log would take some effort, not to mention making a good deal of noise in the process.”
“That it would. Unless done on the stump, out in the timber. Nobody to see or hear.” He reached out and laid his hand on the six new iron spikes.
Thomas sat silently, staring at the spikes, not sure what he was supposed to say, or why the constable was confiding in him. “The obvious question is why,” he said after a moment. “And who.”
“The why is easy. There’s a hundred reasons why somebody might hold a grudge against Mr. Schmidt. Anybody who runs a big operation has his share of enemies. Bound to, you betcha.”
Thomas nodded at the pile of altered spikes. “Since you have these unused spikes in your possession, it would appear you also know the who.”
“I found these in the Kittrick brothers’ cabin.”
“Really?”
“Yep.”
“But it was my understanding that Kittrick worked for Schmidt. Both brothers did, I thought.”
“Did.” Aldrich spun the mangled piece of iron in his fingers thoughtfully.
“Not long ago,” Thomas said, and Aldrich looked up at him. “I mean, it couldn’t have been long ago when that was pounded into the tree. There’s no significant rust on the fresh iron, where the head was ground.”
“Nope, there isn’t.” Aldrich frowned. “So, I come to ask you about last night.”
“However I can be of assistance,” Thomas said. Aldrich dropped the spike on the table and crossed his legs, folding his hands in his lap.
“Kittrick came to see you. That’s what you were telling me.”
“He did. He warned me to remain silent about the knife and the circumstances of the boy’s murder.”
“And then he left.”
“Yes. It’s my understanding that he went upstairs to see Mr. Riggs. Mrs. Unger heard them talking upstairs when she went to his door.”
Aldrich frowned at his folded hands. “I’m just wondering why Kittrick would do that.”
“Mrs. Unger reported that the two were engaged in conversation. Not an argument. You might ask her if she recollects differently now. Riggs claims that Kittrick threatened him as well as me. That he feared for his life.”
Aldrich grunted something and made a wry face. “‘Claims,’ you say. You don’t believe him?”
“I don’t kn
ow what to think, sir. All I know is that Kittrick was a ruffian, that he threatened me, and then went upstairs. Moments later, he was dead.”
“Any number of ways it could have happened,” Aldrich mused. “Hard to say now. Nobody saw. Well, except Riggs. Still,” and he uncrossed his legs and stretched the left one, massaging his knee.
“Still?”
“I wonder why you shoot a man in the back of the head just when he’s leaving. That’s a puzzle.”
“Maybe it’s how Riggs claims. Afraid Kittrick would return, he saw an opportunity, and took it.”
“Goddamn good thing he didn’t miss,” Aldrich said. “Otherwise Kittrick might have taken that little peashooter away from him and shoved it up his ass.” He smiled at the image. “Then you’d really have work to do, eh?”
The front door chimed, and Thomas turned to see Alvi enter, carrying a large tray.
“I have to be going,” Aldrich said, and stood, tipping the narrow brim of his hat as Alvi entered. At the same time, he scooped up the spikes and dropped them into his coat pocket. “Ma’am, whatever you have there smells mighty fine.”
“You’re welcome to stay. There’s plenty,” Alvi said. She set the tray on the desk. Prince lifted his head like an old drunk, his neck muscles sedated to flab. His thick, ratty tail rapped the floor a time or two.
Aldrich grinned, and switched an index finger back and forth between doctor and dog. “You feed him the same thing?”
“As a matter of fact, I do…except the dog doesn’t get the peach cobbler.”
Aldrich nodded, and once more turned to Thomas. “You think on all this,” he said.
“I wish I could be of more help,” Thomas said.
“Pleasant evening to you both now.” The constable nodded at them again and left the office.
“Bertha told me that you needed more silver pins,” Alvi said. “I gave your list to Lindeman, but the only silver we have at the moment is my mother’s dinnerware, Doctor.”
“I will replace it.”
An eyebrow drifted up. “I wasn’t concerned with that, particularly. A service for twelve leaves plenty of spare dessert forks.” She smiled and removed the towel from the tray. Prince groaned pathetically, but didn’t move. “I hope you don’t mind stew again. This is elk. A couple weeks ago, one of the hunters south of here paid off a bill to Father with a hindquarter. Gert canned most of it.”
“It smells wonderful.” His eyes widened at the pan of muffins. Alvi retrieved the dog’s enameled dish and deftly selected out several large chunks of savory meat, along with two small potatoes and several carrots.
Approaching the dog, she paused. “You’re probably too sorry for yourself to eat a bite, aren’t you?” The dog’s tail flailed twice, and his jaw dropped open an inch, a long drool of saliva stretching to the floor. Alvi set down the pan, and the dog turned his head sideways without rising, reaching for the food with an impressively long tongue. In an instant, every scrap had vanished.
“If I can get him on his feet, we’ll go outside for a few minutes,” she said.
“Have you had a chance to talk with your father?”
“No. Perhaps at dinner. Perhaps we’ll both take an evening stroll down here. It’s really quite beautiful outside.”
“I hadn’t noticed,” Thomas said. “Is there someone who can take a telegram to Mr. Birch for me?”
“I’ll be happy to oblige,” Alvi said. He handed her the carefully worded message that he had composed to John Roberts in Philadelphia, and she folded it up twice without looking at it. “May I send Horace down for you this evening if Father isn’t up to the walk? I’m sure he’d like to talk with you.”
Thomas grimaced. “I can’t, Alvi. Deaton is in a bad way, and no one else is here. He can’t be left alone.”
She nodded philosophically. “I’ll see what Father says.”
They both turned at the sound of a carriage sliding to a halt in front of the clinic, and in a moment the door burst open. Horace James took no notice of the mud flinging from his boots as he hastened across the waiting room. Prince huffed a short grunt, but otherwise remained silent.
“Needja ta home,” he said. “Gert went upstairs to fetch your father for dinner and can’t rouse him.”
Chapter Fifty
When they reached 101 Lincoln, Alvi raced on ahead, carrying Thomas’ bulky medical bag. She plunged up the stairs to the second floor where her father kept his bedroom and a private study, and Thomas had managed only three stairsteps before she reappeared and descended to meet him, a sudden, desperate hug telling all.
Alvi released him. “I don’t think there’s anything you can do,” she whispered, and blinked back tears. Her eyes searched his as if she expected him to say, “I know just the cure.” The twelve stairsteps were narrow, but he crutched up quickly, back against the wall. Alvi followed, a hand offering balance.
Dr. John Haines sat in a rocker by the window. The late afternoon light flowed in over his shoulder, illuminating the book in his lap. Nothing was out of place, no brandy tumbler knocked over to stain the carpet, no spectacles dropped in his lap—simply an old man deep in a comfortable nap.
For Thomas, the absence of struggle erased any vestige of hope. The older man’s head had sunk to his chest, but his hands remained on the book, two fingers of his right hand still curled around the corner of a page, as if poised to turn it just as the flood of bursting blood vessels somewhere deep in his brain eclipsed his thoughts.
Thomas leaned his crutches against the wall and bent over as far as he could, one hand grasping the back of the chair while he manipulated the stethoscope. A pulse so faint as to barely disturb the great arteries in the old man’s neck could be felt with a gentle fingertip. Haines’ eyes were half-lidded, jaw slack, skin unresponsive and ashen gray. Lifting first one eyelid and then the other, Thomas saw that the pupils were dramatically unequal and unresponsive.
“Let’s get him onto the bed,” Thomas said. Gert James stood by the end of the bed, hands clasped at her bosom, face set in anguish. Alvi had stepped over to her, and stood with both hands on the older woman’s shoulders. “Alvi,” Thomas prompted, “can we do that?”
“I’ll fetch Horace,” she said, and enfolded Gert in another hug before leaving the room.
“I came up to fetch him for dinner when he didn’t answer my call,” Gert whispered. “I knocked, but…” She shook her head in misery. “He never closes the door unless he’s ill.”
“He might have known,” Thomas said, more to himself than to the others. The heavy Universal Medical Advisor was open to the page featuring the engraving of the massive clinic, left thumb marking the spot. He took the book gently and placed it on the dresser. Haines’ fingers never moved.
“Had you spoken to him this afternoon?”
Gert shook her head. I heard him come in sometime—I don’t remember just when. He said he wasn’t feeling well. She pulled in a sniff and touched the end of her nose with her hankie. “He said he would take a little nap before dinner.”
Heavy boots clattered on the stairway, and Alvi and Horace James reappeared, this time with Zachary Riggs in tow.
“Oh, my,” Riggs said gently. As he advanced into the room, he reached out and squeezed Alvi’s left arm in sympathy. “What may I do to assist?” he asked Thomas.
“I need to have him on the bed,” the young man replied. That took but a moment, and Alvi began unlacing her father’s black boots.
“A bit on his left side,” Thomas directed, trying to turn Haines somewhat. “The stertor is from his tongue falling back.” He looked up at Alvi. “Several pillows to keep his head up, if you please. We must make his breathing as easy as possible.”
“Some venesection to lower the pulse tension?” Riggs asked.
“No,” Thomas snapped. “He has virtually no pulse tension, Zachary. He needs to lose no more bl
ood.”
“Stimulant, then.”
“Yes.” He bent down close, smelling the patient’s breath. “I’d like to see some calomel, if he’ll swallow. Relaxing the bowels is only going to help. And Alvi, first some ammonia, to see if there’s any response at all. We may be able to support the pulse with digitalis. I think that’s the order of things.”
“Brandy?” Riggs asked.
“No. He’s had enough brandy.” Thomas held up three fingers. “Ammonia, then digitalis, then calomel. We’ll see where that puts us.” He pushed himself upright. “Let’s see no restrictions from clothing. That should be first.”
A few moments later, any slight optimism prompted by their activity vanished. The pungent ammonia held directly under Haines’ nose produced no reaction. The patient’s bowels had released without aid of any drug, and it was Alvi who set about both preserving some small sense of modesty for the patient while at the same time removing the soiled linens and clothing. To that, Zachary Riggs reacted by backing toward the door.
“I think I’m only in the way,” he said apologetically.
“I need nurse Auerbach,” Thomas said before Riggs could disappear. “Zachary, will you do that?”
“You want her here, you mean?”
“No, at the clinic. We have a patient in the ward who shouldn’t be left alone. Would you ask her to return to the clinic and remain as long as necessary?”
“Of course. I’ll see to it, Thomas.” Riggs took on the confident, officious tone that suited him so well. “Do what you can here.” He left the room so quickly that he nearly ran over Horace, himself seeking a way to exit graciously.
In a few moments, it became abundantly clear to Thomas that there was nothing to be done, other than to keep the patient comfortable.
When he placed a small amount of digitalis extract on the back of Haines’ tongue, the swallow reflex was feeble. He tried a tablespoon of brandy as well, and most of the liquor simply ran out of the corner of Haines’ mouth, staining the pillowcase.
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