"Jon, I'll be there in the operating room. Half a dozen of us will be there."
"Fine, fine. In your germy frock coats. No, thank you. I'm sorry about Hortense. But call Harrington, Humphrey, as you should have called him in the beginning."
Dr. Bedloe seemed about to burst into tears. "I—I thought about that. He refuses."
"Good for Phil. Look, I'll say a prayer for Hortense, if I can remember who to, but not for me, Humphrey."
He shook his head and turned away, then caught young Robert's eyes. He stared and said with disgust, "Oh, not you, too!"
"I'll be there," said Robert. "I'll help."
"You and your pretty little red mustache!" Jonathan regarded him with contempt. "Let me warn you: Never clean up after the hacks. Or try to. After it's too late, the hacks will sing, 'He did it, he did it!' They never forgive us for having a decent medical education. Come on."
"Please, Jon," said Dr. Bedloe.
"What more can this stinking town say about me? Just that I murdered Hortense. Bob? Coming? We're going over to St. Hilda's."
CHAPTER NINE
Jonathan and Robert arrived at St. Hilda's after a fast ride through the town. They had not spoken, though Jonathan had given Robert many a grim and accusatory glance, as if all this were the younger man's fault, and as if Robert had forced him into this dangerous situation. But Robert smiled under his mustache. They went at once to the luxurious suite of young Hortense Nolan, and there Jonathan found Dr. Emil Schaefer sitting beside the bed of Hortense, who was whining painfully and protesting, while the doctor gently and lovingly urged her to eat "just a little, dear. This good broth. This dainty piece of chicken, this hot buttered muffin. You must keep up your strength."
Jonathan walked in, almost running, swept the spoon from the doctor's hand, and lifted the filled and steaming tray and hurled it furiously against the wall with a resounding crash. "God damn it!" he exclaimed. "Are you trying to kill the girl? Out, out. I want a conference with all of you." Dr. Schaefer, a short and rosy man with a bald head and a thick gray beard, stared at him as at a mad dog, and he rose slowly, his blue eyes blank and staring. Dr. Bedloe, who had followed on Jonathan's heels, looked with dismay at the ruins of the "nourishing lunch" but said as easily as he could, "Emil, I called Jon Ferrier—he's used to these things—and we'd like to consult with you."
"You called this—this—" Dr. Schaefer stammered.
"Emil, she's my niece. There are some modern things, you know—"
The fair fat face of Dr. Schaefer turned very white. "If he touches her, then I must leave the case, Bedloe."
"Louis Hedler has also asked Jon," said Dr. Bedloe, in terror of Jonathan's refusal. "Please, Emil."
"On second thought," said Jonathan, "I want him here. I want to ask him some questions. I also want those two last-year interns, Moe Abrams and Jed Collins, who've been suffering enough under the hacks. I also want Louis. Go and get them, Humphrey." He spoke to the Chief-of-Staff of the Friends' as if he were a lackey. "I won't even look at the girl until you're all here. And you might tell Moe and Jed to bring their notebooks. This is not only for their information but for my own protection."
His dark lean face was very pale and his black eyes flashed at Dr. Bedloe threateningly. Dr. Schaefer took out his handkerchief and wiped the sweat from his face and his hands. Jonathan took one step toward him, seized the handkerchief, stared at the elderly man and then at his hands, then threw the handkerchief into his face. "So, you have a cold, have you? And you've been examining her—how many times today, you criminal fool? With germ-laden hands?"
"I won't stand this!" said Dr. Schaefer. "I won't bear these insults from a jackanapes, an incompetent, who even bungled—"
"Emil, for God's sake!" cried Dr. Bedloe in an agonized voice.
"Deliberately," added Dr. Schaefer, who appeared on the verge of a stroke.
"Never mind him, Humphrey," said Jonathan. "Go and get those people. Let him stand here and blubber. He'll have enough to do to answer questions later."
He pushed his hands into his pockets as if he were sheathing daggers. Does he have to be so violent? Robert asked of himself, then he moved slowly to the fine brass bed and looked down at the young girl there.
Hortense Nolan lay high on a bolster and pillows and sheets of the best and softest linen, and it was evident to Robert that she was almost moribund with sepsis. She was so slender and small and young that she appeared to be hardly more than twelve years of age, and her mass of red hair was in strong contrast to the ashen pallor of her little face. It flowed over her pillows like a flag of danger and fell over her panting breast. Her eyes were half open and sunken in gray pits; their color was clouded by a glaucous film. Her nostrils
were pale and pinched, her lips faintly purple. She was delicately made, with the slightest of arms, the daintiest of hands. The latter were pulling restlessly and aimlessly at the bed linen, and Robert felt sick and frightened. Her breath was slow yet noisy in the suddenly silent room. But Jonathan would not look at her; he stood at the windows and stared out, while Dr. Schaefer pressed his fat back hard against the wall near the door.
Two nurses came in and hurried to the bed. Jonathan said without turning, "Don't go near that bed or touch that girl!"
The nurses gaped at him, and both their fresh-colored faces hardened with surprise and knowing significance. They turned as one to Dr. Schaefer and spoke to him obsequiously, "Doctor, Mrs. Nolan's parents and her husband are outside and wish to see Mrs. Nolan."
"Yes, yes," said the overwhelmed man. "Of course. Send them in."
"No," said Jonathan. "If they come in, I go—out. And I won't come back."
But the nurses only awaited Dr. Schaefer's orders, smiling contemptuously, ignoring Jonathan. Dr. Schaefer hesitated. His effort to come to a decision turned his plump face scarlet. He looked at Jonathan's back with hate. "I—we—we are having a consultation," he said to the nurses. One of them, the older, stepped back in astonishment. "With Doctor—Ferrier?"
"With Dr. Ferrier," said Dr. Schaefer. The young women gaped again. They turned their heads slowly and regarded Jonathan at the window. Their astonishment grew immense. "Please leave," said Dr. Schaefer in a choked voice. The girls flurried from the room, their long white skirts rustling. They could not wait to report this incredible scene to their sisters. Robert could hear their fluting and agitated voices retreating down the hall. Silence entered the room again, except for the anguished breathing of the dying girl, who appeared to be totally unaware of the men in the room, the broad sunlight of afternoon and the corridor noises and the soft wind lifting the frilled curtains at the windows. She had sunken into that profound detachment and distance which is the anteroom of death. But Jonathan did not look at her; Robert saw his pale and sallow cheek, the hard jutting of his cheekbones and jaw, the tensity of his whole body, as if he were on the point of losing control of himself.
The door swung open and Dr. Hedler, accompanied by Dr. Bedloe and the two young interns, entered hurriedly. "Jon!" cried Louis Hedler. "It was good of you to—ah—attend this consultation! Very good!"
Jonathan turned slowly from the window, but he looked at the interns while he replied, "I want this understood: I came under pressure. My common sense told me to refuse. I came against my will, and because I'm a damned sentimentalist and have a soft heart for young victims of obdurate and medieval old hacks who never heard of Semmelweis and Lister, and who continue to murder at their will. I came to expose you, as the American Medical Association wants you exposed. I want to rid hospitals of you. That's too much to expect, of course, but time will take care of you."
"Jon," said Louis Hedler, "can't we save these insults for later? Hortense is almost in extremis."
But Jonathan continued to look at the interns. "Moe Abrams," he said. "It was your co-religionist, Ignaz Semmelweis, who, in 1847, isolated the cause of puerperal fever in postpartum females. Lack of asepsis, and coming from dissection rooms to maternity wards with the
blood of the dead on 'medical' hands. His chief, Johann Klein, drove him from his native land, Hungary, with calumny and hatred, out of his vanity and his contempt for 'modern methods.' He almost drove Semmelweis mad. And then there was Joseph Lister. But he was also laughed at.
"Both these pioneers are still derided by the diploma-mill hacks we have with us today."
"Jon," said Dr. Hedler.
"Louis," said Jonathan, "you and Schaefer here, and Bedloe, too, have no right even to treat dogs. I know I'd never let you touch my boxer, Monty. You'd probably kill him."
The two interns smiled fleetingly at each other and then with admiration at Jonathan.
"I," said Jonathan, "wouldn't permit you to treat me for a first-degree burn." He pointed to the bed. "Yet, you have probably killed little Hortense here." He moved to the bed and regarded the interns with gravity. "Boys," he went on, "I want you to take voluminous notes here. I'll ask my questions slowly so you can take them down. I want you to put down the replies, too."
"Unethical!" cried Dr. Schaefer and looked imploringly at his friends, Louis Hedler and Humphrey Bedloe. But they uneasily avoided his eyes. "Am I on trial here?"
"Yes. You are and all the rest with you," said Jonathan. He opened his bag and drew a chair to the bedside and for the first time gave all his attention to Hortense. He studied her with absolute concentration, leaning forward over her but not touching her. Then he said, "Fetch a nurse with a hypodermic of 15 mg/cc of morphine, at once."
"Morphine!" cried Dr. Schaefer. "When she can hardly breathe!"
"Louis," said Jonathan, not lifting his head.
Dr. Hedler hesitated, then rang the bell for a nurse and, when she appeared, hurriedly gave her the order.
"He will kill her," said Dr. Schaefer in a low and desperate tone. Jonathan glanced at the interns. "Morphine reduces peristalsis, as you know, among other things. This is a case not only of puerperal fever but of extensive peritonitis." Now he began to examine the girl. She moaned feebly. He threw aside the sheets. Then he uttered the foulest oath Robert had ever heard. "A filthy tampon!" he said. "A dirty, filthy tampon! What for? To reduce bleeding? Look at it!" and he held the object up high in the air. "Filled with what our friends here would call 'salutary pus!' Or something. When in hell did her bleeding stop, Emil?"
Dr. Schaefer despairingly noted that the interns were busily scribbling. "Until yesterday morning—she bled quite a little. That's why I ordered the tampon."
The nurse came in with the hypodermic of morphine and handed it with a disdainful flourish to Jonathan, who deftly injected the fluid into Hortense's arm. She moaned faintly. The nurse, smirking, retreated to the door but stood there. She would have such funny news for the other girls! Robert saw the smirk, and his old conviction of the "goodness" of human nature was strongly shaken again. What had Jonathan said? "Man is not good, he is intrinsically malicious and evil and desires only a bad fate for his brother." Well. It seemed there was much truth in it. Too much truth for one's peace of mind.
Jonathan threw the yellowed tampon on a tray and extended it to the interns. He said, as they looked at it with horror, "Now, Emil. Did you sew up lacerations?"
"I did." Dr. Schaefer's eyes burned with humiliation and his pallor increased.
"After the high forceps? Yes. And did you sterilize the forceps? No. Did you use modern methods of asepsis on your hands? No. Rubber gloves? No. Boys, you have all this?"
Young Dr. Abrams said with portentous solemnity, "Yes, Doctor."
"Good. Now, Emil. Were you certain that all the placenta was delivered?"
Dr. Schaefer moved heavily against the wall. "I believe it was. It—appeared so."
Jonathan pounced on him. "You 'believe it was!' Aren't you sure—Doctor?"
Dr. Schaefer spoke in a loud and rapid voice. "I've delivered thousands—thousands—I ought to know!"
"How many died—Doctor? Of hemorrhage? Of puerperal fever? Of extensive peritonitis?"
"I am not compelled to answer that! I will not!"
"No," said Jonathan. "The Fifth Amendment protects you from self-incrimination. So—we have here a distinct possibility of remnants of the placenta being retained, which in itself would cause all this damage. Moreover, an ominous situation is that the normal discharge has been inhibited, and pus has taken its place." He looked at Dr. Hedler. "I want an operating room prepared at once."
Dr. Hedler nodded to the nurse and she flurried out, bursting with news.
Jonathan continued "to examine Hortense, speaking slowly. He held the chart in his hand and checked it with his examination, nodding at times. "Tachycardia. Vomiting. Rigidity of the abdomen. You will notice, Dr. Abrams and Dr. Collins, that I do not do a vaginal examination. The patient has had six such today alone. With dirty hands."
"I will not—!" began Dr. Schaefer, turning wildly to his colleagues.
Now Dr. Bedloe looked at him with bitterness. "Shut up, Emil," he said.
Jonathan continued. "Fever of 104° since last night. Violent sepsis. Let us hope to God there is no embolism, too, somewhere." He examined the drugged girl's small white legs minutely. "Not yet, at least as far as I can tell."
Dr. Bedloe said, "A hysterectomy?"
"I don't know. Yet. I find an abscess here, adjacent to the uterus. Extensive peritonitis. Fulminating. Let us hope to God the abscess is walled off! Now, no one shall be admitted to the operating room without complete asepsis, gowns, masks, caps, rubber gloves. You, Dr. Schaefer, must not be admitted at all. Your 'cold' has helped spread the infection."
"My patient! How can I know what you will do to her— you young quack?"
Jonathan stood up and stared at him with disgust. "Quack? I? Look in the mirror, Emil. If I save this girl—which I doubt I can—it will be no kudos to you. It will be in spite of you."
Dr. Schaefer spread out his hands to his colleagues. "Louis! Humphrey! You know what happened! To his wife. You'll let that happen to Hortense?"
Robert did not blame Jonathan for what he did then. Jonathan walked quickly to Dr. Schaefer and struck him savagely across the face. The loud crack seemed to explode the quiet of the room. Dr. Schaefer staggered back and put his hand to his cheek. Everyone stood mute and unmoving, and aghast, except for the young interns who regarded their boots demurely.
Dr. Schaefer said, "I'll have you arrested for assault and battery!"
Jonathan said, "And I'll have you sued for deliberate malpractice, caused by your ignorance and stupidity and your unfitness even to enter a hospital room. If this girl dies, Emil, as sure as God I'll tell the husband to institute proceedings against you." He looked at Louis Hedler. "And against this hospital, for permitting this man to use its facilities and in aiding and abetting him." His black eyes seemed on fire.
The stretcher arrived for Hortense; she was snoring heavily under the influence of the morphine. Jonathan did not look at the older doctors. He said to Robert and the interns, "Ready, as soon as possible. With your notebooks."
He shook his head. "Here is Hortense in an open suite in the maternity section! Do you know how dangerous this is? The infection can spread to the other mothers. She must be isolated after her return from the operating room—if she survives the operation, which I doubt. Complete isolation. And no one who attends her must attend anyone else. My God!"
But Jonathan had overlooked something very vital When he entered the sitting room of the suite, he saw gathered there Mr. and Mrs. Horace Kimberley, the parents of Hortense, and her young husband, Jeffrey Nolan. Jonathan said under his breath, "Oh --," another unspeakable word to
Robert. Dr. Schaefer was already talking to the tearful mother, who had flaming hair like her daughter's and was as fat and round as a middle-aged and amiable hen. Her wet eyes were like big bronze coins, and she was fussily dressed in a welter of pink ruffles to her insteps and wore a huge straw hat bending under a burden of great pink roses. Her husband was almost as small, but he was thin and boyish of figure and face and possessed an enormous bla
ck mustache. The husband, Jeffrey Nolan, was a serious young man, all pince-nez, light hair, and clean-shaven nervous face, a very rich young man who had inherited "old" money, which had placed him far above those vulgarians who had just acquired it "through those dirty oil wells."
Louis Hedler and Humphrey Bedloe were disagreeably Startled, and the latter put his hand on Jonathan's arm. But Jonathan pushed it off and advanced on the four with a cold and angry expression. Dr. Schaefer had apparently been talking urgently to the others, and his face was flushed and one cheek was streaked with the crimson of Jonathan's blow. It was Jeffrey Nolan who spoke to Jonathan, while the frantic parents blinked in confusion and fear.
"Hello, Jon," he said, and held out his dry and narrow hand. "What's this I hear? Humphrey called you, is that right? But Dr. Schaefer tells us that Hortense is really getting better— Operation! Jon, she's only nineteen, and the baby died!"
"Now, wait," said Jonathan, ignoring Dr. Schaefer and speaking to the other three. "I have to be blunt because there is practically no time, Jeff, Mrs. Kimberley, Mr. Kimberley. No time. Hortense has what is called puerperal fever, and peritonitis. Please let me finish. Didn't Schaefer tell you that? She needs cleaning out, Jeff, what is called a D&C, dilation and curettage—I don't know yet. The abscess also needs evacuating. Drainage established. I have to do it at once, right now. She's almost in extremis, Jeff, do you understand that? She will be dead in less than twenty-four hours if I don't operate. That's certain."
"I don't agree!" shouted Dr. Schaefer. "She is definitely improving! She has longer periods out of coma! Her heart sounds are better! She just needs nourishment for her strength, and good nursing—!"
"Jon?" said the young husband in a voice as dry as his hand. But his eyes were full of beggary.
"She will die, and very soon, unless I perform that operation," said Jonathan. "That I can promise you with absolute certainty. Jeff, I didn't want to take this on; I wanted Schaefer to suffer from the butchery he is guilty of, and the in- competence and the scorn of what he calls 'modern methods.' Young Harrington refused to be involved with this, for excellent reasons. Jeff, say the word and I'll withdraw. It's no mess of mine."
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