Wondering where the attendants were—there were chamber pots to be emptied as well, and water pitchers to be filled—Hannah left the ward and went down the stairs.
Earlier, just before dawn, Neal had taken Hannah home in his own carriage, worried what people would think if they saw her leaving his apartment at such an improper hour. Hannah hadn't minded. They were engaged to be married, and she was blissfully in love. After kissing Neal good-bye, she had watched him drive off, wishing she could stay with him. But she was needed at the hospital, and Neal needed to pack his photography wagon for his trip to the Cave of the Hands. He had said he would come by her home at noon, to say good-bye.
Hannah looked into the noisy men's ward, where the beds were filled with patients recovering from injuries, gunshot and knife wounds, amputations and lung ailments—all being cared for by wives, mothers and daughters who clustered around the beds of their menfolk with food, pillows and words of encouragement. She recognized old Dr. Kennedy bandaging a patient's head. While Dr. Soames and Dr. Iverson were the only two permanent doctors on staff, various Melbourne physicians and surgeons enjoyed privileges at the eighty-bed facility, and Hannah was acquainted with many of them.
Finding no attendants, she went to Dr. Iverson's office. It opened off the main lobby and was filled with bookcases, anatomical charts, a skeleton on a stand, desk and chair, and a tall, glass-fronted cabinet displaying instruments, rolls of bandages, bottles and jars of ointments and medicines. On the other side of the office was a door which Hannah knew led to a small chamber that held a cot and a washbasin. Dr. Iverson sometimes slept there when he had a critical patient and he did not want to make the trip home to his house in the northern suburbs.
The door opened and he came out. Dressed in his usual meticulous frock coat and starched shirt, Sir Marcus carried a stethoscope and had a worried look on his face. "Miss Conroy, what can I do for you?" Night before last, when he and Miss Conroy had left the gala at Addison's, Dr. Iverson had found himself enjoying the young lady's company in the carriage. They had spoken of medical matters—she had astounded him with her knowledge in that field—and when they visited the patients in the female ward, Miss Conroy had comported herself in such a professional manner that he had thought she was as good as any man.
"I cannot find any ward attendants, doctor."
"I know," he said. "They've run off."
"Run off?"
"Mrs. Chapelle has come down with childbed fever. The attendants ran away in fear."
"Mrs. Chapelle! But she came in with a broken foot. Dr. Iverson, how are the non-maternity cases becoming infected?"
"I do not know, Miss Conroy, and the situation has suddenly gotten worse. Dr. Soames is exhibiting the signs and symptoms of the contagion."
Hannah stared at him. "That's not possible," she whispered.
"Come with me."
Hannah was shocked to find Dr. Soames lying on the cot in his shirt and trousers, shoes removed, coat and hat hung on the nearby rack. His eyes were closed, his faced flushed and feverish.
"I have given him a sedative," Iverson said quietly. "We shall let him sleep."
They stepped out, closing the door. "Dr. Iverson, how can Dr. Soames have a woman's disease? Childbed fever is an infection of the uterus."
"I don't know." He rubbed his forehead. "I cannot, of course, be certain that it is childbed fever. It might be something else entirely. But with two more non-maternity patients contracting the illness, Miss Conroy, I think it best that we keep Dr. Soames here for now."
Iverson strode to the wall of books and perused the titles. "I believe we have an emergency on our hands, and I must get to the bottom of it as soon as possible or the situation will turn into something dire. I pray that the answer is somewhere in these texts."
But Hannah had another idea.
45
S
HE POINTED TO A SPOT ON NEAL'S MAP AND SAID, "HERE IS Brookdale Farm."
They were standing on the front steps of her residence off Collins Street, a red brick building with a shiny brass plaque beside the front door that said, Hannah Conroy, Licensed Midwife and Health Practitioner. It was noon, and Neal had come to say good-bye.
He noted the spot, halfway between Melbourne and the Bendigo goldfields, then folded the map into his pocket. "I will be sure to stop and take a look around." The warm breeze stirred an errant strand of Hannah's hair. Neal reached up and gently swept it behind her ear.
Hannah felt her chest tighten. Neal's touch, his nearness, the details of his face filled her with immense desire. But they were standing in broad daylight on a busy street. She struggled to maintain decorum. "If you encounter Mr. Samson Jones, the land agent, please remind him that I am anxious to sign an agreement with Mr. Swanswick as soon as possible."
Neal was going on the trip alone, traveling with his photographic equipment in a one-horse wagon, with a spare horse tethered to the back. He had said he did not know how long he would be gone, and Hannah could not help thinking that this was how it was going to be when they were married, the many farewells with Neal heading into the unknown.
"I will," he said quietly, looking into her eyes. Although Neal was eager to be on his way and exploring the Cave of the Hands, and although Hannah was anxious to get back to the hospital, neither could move, neither could be the first to say, "Good-bye." After all this time, Hannah thinking Neal dead, Neal desperately searching for Hannah—finding each other at last to spend the night making love and making plans, it was time for their paths to separate once again.
But there was more. Hannah had returned from her morning at the hospital with alarming news. A deadly contagion had broken out and was spreading unchecked. Even one of the doctors had been stricken. Neal wanted to stay. What if Hannah fell ill? But she insisted he go, reach the Cave of Hands before the gold hunters did.
Hannah, too, was thinking of the hospital and the terrible danger that lurked there. She was filled with a sense of dark foreboding. An unstoppable and fatal illness in Melbourne, and now Neal was leaving her once again. But she did not let him see the anxiety that had her in a grip, did not confess her fear over their unknown future.
Neal reached behind his neck and untied a leather knot that rested there. He had had a small hole drilled in the top of the stone talisman Jallara had given him, to suspend it at the end of slender leather thong. He removed it now and placed it over Hannah's head, tying the thong at the nape of her neck so that the stone lay on the lace collar of her gown, at the hollow of her throat.
"Powerful magic," he said. "It will protect you as you follow your songline." He kissed her, holding her tight, whispering a blessing in her ear, then he climbed into the wagon and guided the horse into the street.
Hannah watched him go. It took all her willpower not to call him back.
Hurrying inside her house, she wrote two hasty notes to Alice and Blanche, with whom she had a luncheon engagement. "Please forgive me but I cannot make our appointment today. There is an emergency at the hospital. The ward attendants became frightened of an outbreak of contagion and have left. Dr. Iverson will need my help. I do not know when I shall next be free. The situation is becoming dire."
Asking Mrs. Sparrow to see that the notes were delivered, Hannah donned her bonnet and light cape, picked up her leather medical bag and a satchel holding personal items, and, informing her housekeeper that she might not be back for a day or two, struck off in the direction of Victoria Hospital, her heart tight in her chest.
46
L
EAVING HER CAPE AND BONNET AND PERSONAL BAG IN THE downstairs cloakroom, Hannah went first to the women's ward to check on Nellie Turner.
The bed was empty and had been stripped to its mattress.
Hannah looked down the length of the ward, which was now broken up by chlorine-soaked sheets hanging between beds, and saw two more vacancies—both had been maternity cases.
She found Dr. Iverson in the men's ward, where he was bent over an older g
entleman who was coughing violently. To the white-haired wife who sat beside the bed, Sir Marcus said, "Continue to give him the tea, as strong as he can take it. We must break up that congestion."
When Iverson saw Hannah, he folded the stethoscope into his trouser pocket and escorted her away from the ward.
"Nellie Turner—" Hannah began.
"I am sorry, Miss Conroy. She passed away an hour ago."
"And the other two?"
"They have succumbed as well."
Hannah noticed new shadows under his eyes. He was also without his usual dignified frock coat, but stood in shirtsleeves and suspenders, which surprised Hannah. "And how is Dr. Soames?"
"About the same. I sent for his wife. She is with him right now, while the children are in the care of their nanny." Dr. Iverson glanced down at Hannah's throat and noticed the engraved stone that lay there—definitely primitive and curiously out of place, he thought—then he looked at Hannah and added, "I have not said anything to Mrs. Soames about childbed fever as I am praying that it is a mild influenza or a bronchial condition."
"Have any of the ward attendants returned?"
"I am afraid not. And, Miss Conroy, there are three more non-maternity cases. But Dr. Kennedy has gone for help. The problem, of course, is with the visitors. They don't understand the concept of infection and antisepsis. The confounded women keep opening the windows, causing the bad air to circulate."
"Dr. Iverson, may we speak privately in your office? There is something I must show you."
They crossed the lobby where visitors came and went bearing blankets and food baskets. It was an unpretentious entry, with a tile floor and unadorned walls, a few chairs for outpatients. Dr. Iverson had not come to Australia to get rich, but to realize a dream: to create a modern, progressive hospital that would become a model institution to be imitated around the world. This was something he could not have done in England, where he felt that the old ways were too entrenched for a man of vision. His first task when he had established himself in Melbourne had been to call a public meeting in which to lay the groundwork for a charitably-operated hospital. Funds were raised from among prominent businessmen and wealthy landowners—Blanche Sinclair had been particularly generous—a building site was purchased on the corner of Elizabeth and Bourke Streets, and in March of 1846, the foundation stone was laid for Victoria Hospital.
Many speeches were made that day, in a grand and pompous ceremony for which all the citizens turned out, and Sir Marcus Iverson's words received a deafening cheer when he said, "From this day forward, hospitals will no longer be institutions where the sick go to die, but where they go to get well."
He wished his late wife were there to see the institution he had created in this new land. Blueprints of Victoria Hospital showed future expansions, innovations—a laboratory for research, even a children's wing, which was already under construction. On the grounds surrounding the main building, flower beds were being planted, and a handsome pavilion was planned for the benefit of convalescing patients.
All going according to plan, Dr. Iverson thought as they entered his office. But everything was now threatened by this mysterious and unstoppable contagion.
"Dr. Iverson," Hannah said when they entered his office, "I believe I know the cause of the contagion, and therefore a way to prevent it from spreading further."
He listened with interest as she told him her father's story, concluding with, "He found this microbiote in a sample of my mother's blood. He believes it is what causes childbed fever." Hannah opened her father's portfolio and arranged his notes on the desk for Sir Marcus to see.
Iverson picked up the pencil sketch of what looked like twined strands of berries. He read the label underneath, streptococcus, and thought it an apt name, as it was Greek for "twisted chains of spheres." He was also intrigued by the idea of microscopically analyzing a patient's blood to determine a diagnosis. He had never heard of such a practice. "Are you suggesting we follow your father's example by examining blood?" Dr. Iverson was proud of the wood and brass microscope he displayed in his office. Although he found little use for it, he thought the instrument lent a progressive air to the surroundings.
"I suggest we give it a try," Hannah said.
They went upstairs to the women's ward where they discreetly collected specimens from the childbed fever patients. Returning to his office, Hannah demonstrated a remarkable aptitude for handling a microscope, placing each glass slide, adjusting the focus, moving the mirror until it caught the light. She examined each piece, and then stepped aside for Dr. Iverson to take a look.
The streptococcus microbiote was evident in all samples of the infected patients, and absent in specimens taken from patients who did not have childbed fever.
"Remarkable," he murmured. Then he straightened with a thoughtful frown. Saying nothing to Hannah, he selected a clean slide from the box, pricked his finger and allowed a small drop to fall onto the glass. Adjusting the eyepiece and reflective mirror, he examined his own sample and nodded, satisfied. "The microbiote is not evident in my own blood. I had to be certain. And so the question is, how did the microbe get into these people's blood streams? Was it breathed in from the air? If so, why aren't others infected? What made these particular people susceptible? Or if the germ is, as you say, Miss Conroy, transported—"
He stopped, and Hannah guessed by the way he suddenly glanced at the door to the small sleeping room, he had remembered Dr. Soames.
With a grave tone, Dr. Iverson said, "This will confirm it for us," and he selected a fresh slide and disappeared briefly into the room. When he emerged, saying something over his shoulder to Mrs. Soames, and returned to the microscope, Hannah felt her stomach tighten.
She held her breath as Dr. Iverson placed the glass under the lens, made adjustments and then took a long silent look at his young colleague's blood.
Dr. Iverson closed his eyes and straightened. "The streptococcus is evident."
The moment stretched as neither spoke, and street sounds drifted in through the open window. From the women's floor above came the sound of a concertina. Visitors entertaining a bedridden loved one.
Finally, the rigid-backed and dignified Sir Marcus released a ragged sigh and said, "And you say your father's iodine formula kills these microbiotes?"
"On human hands and objects," Hannah replied, thinking of poor Mrs. Soames holding vigil at the bedside of a husband who, unbeknownst to her, had not long to live. "Unfortunately," she added as she watched a large, noisy family climb the stairs to the female ward, a big yellow dog following them, "the iodine only prevents the spread of the contagion. It is not a cure. And we still do not know the source. How did Nellie Turner become infected in the first place? Until we have the answer to that, I fear that fresh cases will continue to break out."
"We will proceed one step at a time," Marcus Iverson said resolutely, rubbing his stubbled jaw. "I will see that basins of the iodine-water are placed at both entrances to the female ward, and will instruct physicians to periodically rinse their hands in the solution."
But Hannah was thinking of the visitors and how to keep them from spreading the contagion. It would be impossible to tell every individual to wash his or her hands, especially if they visited more than one patient as many often did. Written signs would be of little help as most of these people were illiterate.
And yet Dr. Iverson couldn't bar them from the hospital, for who would then take care of the patients?
As Blanche's carriage neared the hospital, she felt the familiar symptoms—tight stomach, damp palms, dry mouth and racing pulse. At her side, her best friend Martha Barlow-Smith was unaware of the panic that had suddenly gripped Blanche.
The two women rode through the afternoon sunshine as if on a casual Sunday outing instead of an errand of mercy and urgency. In the carriage ahead, Alice rode with her companion, Margaret Lawrence, and when they drew to a halt in front of the hospital, Alice and Margaret stepped to the wooden sidewalk, carrying hampers of
food and clothing. But when Blanche's carriage pulled up, and Martha collected her things and stepped down to the street, Blanche could not move. She looked up at the double doors of the institution's entrance and froze in fear. Martha gave her a questioning look. This visit was Blanche's idea. As soon as she had received Hannah's note about the hospital attendants running off, she had known they must go to Hannah's aid. "Are you coming, dear?" Mrs. Barlow-Smith asked.
"Yes, please go on ahead—" The breath stopped in Blanche's lungs.
Staring at the formidable entrance of bluestone and tall wooden doors inlaid with lead-paned windows, Blanche thought: It's just a building. But horrific visions flashed in her mind, random, rapid-fire, non-cohesive. She had been seven years old at the time and had accompanied her mother to a hospital in London on an errand of charity, bringing food and clothing to patients who had no one to take care of them. In the crowded lobby, young Blanche had somehow gotten separated from her mother, and had ended up wandering hallways searching for her, stumbling upon terrible sights of which her child's mind had no comprehension—emaciated bodies, too much blood, corpses—until her own screams had joined those of the afflicted. She remembered someone picking her up and then her mother's arms were around her. Blanche had tried through the years to wash the poison from her mind, but that day came back in full force now as she looked up at Marcus Iverson's precious hospital.
I cannot do this.
And then, as she watched Alice and Margaret and Martha boldly mount the steps with their parcels for the needy, Blanche thought: I am never going to know what I am truly capable of doing until I overcome my fears.
Stiffening her spine, she drew in a steadying breath and stepped down from the carriage. With great effort she followed the others up the steps, one at a time, praying for courage, praying that she would not faint. When she reached the top, and her friends went through the doors, Blanche became rooted to the spot and could not follow.
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