‘It is obvious,’ continued the professor, ‘that amputation is required.’
Gallagher gestured at Syme with his good hand. ‘I beg you, sir, is there no other way? For I am a joiner, and without my hand, my wife and I shall be for the poorhouse.’
‘If I do not amputate, you will be for the grave, and what of your poor wife then?’
Gallagher offered no response other than a look of fear and confusion. The man was right, though. He would lose his livelihood: had done the moment Raven goaded him into punching that wall. Through his vainglorious actions, Raven had condemned Mrs Gallagher to penury, driven more by his need to punish her husband than to offer her genuine help.
Syme continued to describe the procedure to the audience, oblivious to the anxiety of the patient who was being roughly coaxed from his basket. Raven had more than once witnessed those in Gallagher’s position yelling and sobbing in a panic of fear, trying to escape the hefty assistants as they were hauled to the operating theatre like it was the gallows. Gallagher said nothing as one of the dressers held up the diseased limb.
‘The forearm ought to be amputated by making two equal flaps from before and behind,’ said Syme, pointing out to the audience where he intended to make his incisions. ‘The arm should be held in the middle state of pronation and supination in order to relax the muscles equally and facilitate the operation. The hand may be removed at the wrist joint but the larger stump thus obtained is not found to facilitate the adaptation or increase the utility of an artificial hand, and the large articular surface which remains, though it may not materially delay a cure, must always cause a deformity.’
Raven wondered at the professor’s insensitivity. Without doubt the patient was fortunate such an eminent surgeon was to perform his operation and thereby save his life, but surely it was a form of torture to describe within his hearing the mutilation that was about to occur. His mind was taken back to George Heriot’s school, where a singularly vicious mathematics master administered the strap if one’s marks did not meet his standards. Raven was a dedicated and eager pupil, but he unavoidably fell short on occasion and condemned himself to be beaten. What he recalled more than the pain was the ritual with which it was delivered. The master produced the dreaded tawse and laid it on Raven’s desk, forcing him to contemplate it for the duration of the lesson, before finally delivering his thrashing at the end. To this day, Raven still harboured murderous thoughts towards the man.
While the professor was speaking, the patient had been strapped down to the table and the four surgical dressers had positioned themselves around him to provide additional physical restraint if required. It was at this point that Raven remembered Henry saying that Syme had given up on ether, finding it unreliable, not fit for purpose. This operation would be performed without it.
Raven felt suddenly sick, his guilt compounded further by his knowledge of the horror that was about to unfold. It was impossible to predict which patients would submit to their fate meekly and which would struggle; sometimes the frailest-looking specimen would find remarkable strength and attempt to withdraw the limb just as the surgeon’s blade descended for the first cut. Gallagher seemed of the more submissive sort, weeping quietly and then whimpering when the professor was handed his knife.
An assistant grabbed the patient’s arm just above the elbow, holding it steady. Syme began immediately, cutting through flesh with absolute certainty and precision, undistracted by Gallagher’s screams. Raven was both awed and horrified by this, for he felt the anguish of every cry, and had he been holding the knife, such screams would surely have stayed his hand. He failed to understand how surgeons could work as they did, insensitive to the pain that they inflicted, speed their only clemency. It was this more than anything that had told Raven he had no future in it, and which led him to seek another field.
The professor himself was silent in his task, gesturing to the instrument clerk for what he required. Raven felt sweat run down between his shoulder blades and realised he was holding his breath. Alongside him, Beattie and Duncan watched with detached fascination, evidently troubled by no such emotional responses. They might as well have been watching Mrs Lyndsay carve a joint of ham.
Within minutes the gangrenous hand was slung into a sawdust-filled box at the end of the table, spurting vessels were quickly tied, the edges of the wound stitched together and a dressing applied to the stump.
An animalistic keening emanated from Gallagher, his eyes shuttling incredulously between the box of sawdust and the stump where his hand used to be.
One of the surgical assistants quickly wiped the blood that had collected on the operating table. Another threw fresh sawdust onto the floor, covering the majority of the blood spatter and lumps of tissue as though hiding the evidence of what had just occurred.
Raven understood now why Simpson had all but insisted he attend, why his mentor was relentless in his quest for that Holy Grail, and why he would never again complain about sniffing strange potions.
There had to be a better way than this.
Thirty-Four
Rain was bouncing off the pavements as the brougham drew to a halt close to the Royal Exchange. As George Keith had explained, Simpson did not keep anything so conventional as an appointment book, claiming all such relevant information to be locked safe in his head. Consequently Raven seldom knew their destination much in advance, or what the next case might involve.
He did know there had been a messenger to the house this morning during clinic, resulting in their first stop being an address in Canonmills, where Simpson had delivered a baby using his forceps. It had been an unnecessarily traumatic affair, the household being another contaminated by the Reverend Grissom’s leaflets and therefore ether had not been permitted. Raven’s lingering anger had occupied his mind on the subsequent journey, and he had not thought to enquire as to what was next on Simpson’s mental list.
He looked up at the grimy windows looming above the pavement, wondering what sights and smells awaited inside the ramshackle tenement before him. There was a lodging inn on the ground floor, an establishment he had passed many times, but the unfamiliarity of the building itself made him realise how seldom his gaze was drawn above street level. Gazing up for too long in the Old Town was merely an invitation to pickpockets.
Simpson looked out into the driving rain and waved acknowledgement to a fellow hailing them from a doorway. Raven quickly recognised him as McLevy, the police detective, accompanied by one of his burly assistants.
Simpson turned briefly to Raven, an odd look upon his face. ‘We are here to assist with a police inquiry,’ he said. He seemed rather bemused by this notion, but offered no further detail as to why. ‘It is always advantageous to have the constabulary owing one favours,’ he added.
Raven wondered whether Simpson was waiting for a break in the rain, then observed that McLevy was coming to join them inside the carriage. He clambered in, water running around the brim of his hat even from the journey of a short few yards.
Simpson made introductions. At such moments, most men of station inferred that they could now safely ignore the apprentice, but McLevy looked Raven up and down carefully, as though taking the measure of him.
‘May I pick your brains before we proceed?’ McLevy asked. Though he was looking directly at him, it still took Raven a moment to realise that McLevy meant him and not the professor.
‘By all means,’ Raven replied.
‘You may have heard tell of a scavenger discovering a bairn’s leg in a gutter pipe, not far from here?’
Of course. It had been near the Royal Exchange.
‘I have indeed. And I have heard all manner of gruesome explanations for it. From devil-worshipping child sacrifice to cannibalistic Irish immigrants.’
‘And what do you think to it yourself, Mr Raven?’
‘I would expect the cause to be more prosaic. An unwanted baby, disposed of in a hurried manner suggesting desperation and panic. The act of a person not thinking c
learly.’
‘Aye,’ McLevy said with a nod, causing more rain to run from his hat. ‘The leg was found inside a main pipe, into which pipes from all the nearby dwellings feed as well as Mr White’s inn, wherein several females dwell. There are many females of a higher grade resident hereby, thus I have had to be most delicate in my investigations; perhaps too delicate, hence my lack of success up until now. This inquiry contains an imputation wont to stain a woman’s name forever after.’
Raven noted that such delicacy was only to be extended when the subjects laid claim to a certain level of respectability. He could not imagine the policeman treading so lightly around Evie’s lodgings. Nor did he care for how McLevy used the term ‘females’. He made it sound as though he were talking about some other manner of species; exotic and of interest, no doubt, but somehow beyond the human. Or beneath it.
He wondered how McLevy would get on against Miss Rigby. She was a species apart, for sure, but one beneath nobody.
‘My enquiries have so far borne little fruit, but I recently heard it said that Mr White, the landlord, has been known to impose himself upon some of the young ladies in his employ. There are staff who have bed and board in part lieu of a wage, and that can bring its complications.’
Impose.
Complications.
Raven thought there an obscenity about this politesse.
McLevy led them from the carriage and into the inn. They gathered at the foot of a staircase leading up to the lodging rooms; to their right, next to the kitchen, was a common area in which several young women were about their duties.
White was ill-named for such a red-faced individual. He did not look pleased to see McLevy, but quickly concealed this behind an oily display of obsequiousness.
‘How may I help you on this occasion, Mr McLevy? Did you ever get to the bottom of that unpleasant matter that brought you here before?’
‘That is indeed what brings me back, sir. I need to speak to the female domestics once again.’
White’s eyes narrowed. ‘As I assured you before, it would not have escaped me had one of them been in such a condition. And I would have surely acted upon it, as my house has its pride and reputation to uphold.’
As he spoke, McLevy turned his gaze to the young women, picking out one in particular for his piercing stare. She was sweeping the floor near the back door, keeping her head down just a little too keenly.
‘That one there,’ McLevy announced. ‘I don’t recall seeing her the last time.’
Raven was beginning to suspect he knew why, though he remained unsure what Simpson’s role in all this might be.
‘What is her name?’
‘Mary Brennan,’ White replied.
The girl started at the mere mention. She looked to her landlord in pale fright, though Raven was not sure whether it was him or McLevy she was more afraid of.
‘We would speak with her alone.’
White issued a sigh, then told the other girls to leave the common area.
‘I said we would speak with Mary alone,’ McLevy reiterated with a firm tone, his eyes fixed on White.
The landlord retreated with hesitancy, sending one last look to Mary before the door closed. Raven did not imagine it escaped McLevy’s notice.
Mary Brennan stood before the four of them, clutching a broom as though she might fall down without it. She was trembling.
‘We are investigating the discovery of a bairn’s leg, wrapped in cloth and flushed down a pipe. Do you know anything about this?’
Her eyes searched back and forth along the line, as though seeking an ally.
‘No, sir,’ she replied, her voice feeble. There was a determination there, however: an awareness of the stakes should she crumble.
‘Do you know who this gentleman is?’ McLevy asked.
‘No, sir.’
‘His name is Professor James Young Simpson. Does that name mean anything to you, Mary?’
Her expression was blank, but all the more worried for not knowing the potential significance of this esteemed gentleman’s presence.
‘He is one of the foremost medical men in the city, specialising in the care of pregnant women, and assisting them in their time of labour.’
McLevy then turned to address the professor.
‘Dr Simpson, if you were to examine a young woman such as Mary here, would you be able to ascertain whether she had recently given birth?’
‘Most certainly and unmistakably,’ Simpson replied.
That was all it took. The girl dropped to her knees and broke down in tears, spilling forth a confession there on the floor as though relieved to be finally shedding her burden.
‘God forgive me, I confess that I bore that child, but it was dead when it came into the world. Wild with sorrow and pain, I cut it into pieces and put it into the soil pipe so that nobody would know my shame.’
‘Did anybody know of your condition?’
‘No, sir. I kept it secret for fear I would be cast out onto the street. Mr White insists he keeps a respectable house.’
She looked to the door as she said this. A greater threat lay beyond it than anything she faced inside this room.
‘Whose child was it?’ McLevy asked, though the question struck Raven as redundant.
She hung her head, her hair all but sweeping the floorboards.
‘A wicked man seduced me,’ she answered, not looking one of them in the eye.
McLevy pressed her, but she would not name him.
She did not have to.
McLevy’s assistant helped her to her feet and led her away. She looked hollow-eyed, as though entranced, then a panic enlivened her face. ‘Am I to hang?’ she asked McLevy, terrified.
‘Not if what you told us was true, about the child being still-born. You will only be confined a short while.’
Simpson shook his head sadly as she was led away.
‘It is a tragedy that this young woman should be facing any greater punishment than that which she has already endured,’ he stated.
‘And it sorely compounds the injustice that there should be no consequence for the landlord,’ ventured Raven, struggling to keep bitterness from his voice.
‘I’ll have a stern word,’ McLevy assured him. ‘He’ll understand I have my eye on him, but what more can I do?’
Raven thought of what more he would like to do, then remembered the fate of Mrs Gallagher, in danger of the poorhouse as a consequence of his previous thirst for justice.
McLevy thanked Simpson for his assistance, which had amounted to little more than his august presence, but Raven had to commend the policeman’s cunning in knowing this alone would do the trick.
‘You are most welcome, as always,’ Simpson replied.
‘If I may ever be of assistance, just say the word.’
‘Certainly. But in the meantime, I believe Mr Raven was curious about another case you were looking into.’
Raven looked at him in some surprise, and wondered how conspicuous his interest might have been.
‘Which case would that be?’
‘Rose Campbell,’ Raven replied. ‘She was a housemaid of Mr Sheldrake, the dentist. Her body was pulled from the water at Leith.’
‘Oh, yes. Dr Renfrew, our police surgeon, carried out a full examination of her remains. He concluded that she had drowned.’
‘So he found no trace of poison?’
‘Why would he?’
‘The agonised posture of her body. It is my understanding that it can be a symptom of strychnine.’
Raven was aware of Simpson regarding him with some scrutiny, but had to press on while he had McLevy here before him.
‘As I say,’ continued McLevy, ‘no evidence of poison was found. When the bodies of the drowned are removed from the water their limbs may be contorted, indicating their final struggles, contortions which persist because of the rigidity that follows on after death.’
That may well be true, thought Raven. But Evie did not drown.
‘This was a case of accidental death,’ said McLevy, with a finality that suggested further questions were superfluous. Raven ignored this.
‘Didn’t you previously entertain the notion that she had done away with herself?’
McLevy looked at him with wariness and some surprise.
‘I did indeed, as I was informed she was pregnant, as much as five or six months. But here’s the strangest thing: when the post-mortem was carried out, she did not appear to be with child after all.’
Raven reeled from this, as though the walls around him had moved. ‘Are you sure?’
McLevy allowed himself a grin. ‘Speaking candidly, Dr Renfrew is not the greatest medical mind I have ever encountered, even on the rare occasions he is sober, but I am confident that even he would not have made a mistake about something like that.’
Raven felt numb in his confusion, the world swirling around him as the brougham pulled away, rain hammering upon its roof.
‘You did not hear the answers you were hoping for,’ Simpson observed.
This was to say the least. His belief in a connection between Rose and Evie, about which he had been so certain, now appeared to be groundless. He had no real evidence that either of them had been poisoned, McLevy having provided an adequate explanation for the condition of Rose’s body when he suggested rigor had set in while she was still in the water. Now it transpired that Rose had not been pregnant, and he was forced to own that it had been mere speculation on his part that Evie was with child.
‘I will not intrude to ask why you were so exercised by Miss Campbell’s death, but I will impart a lesson that will serve you well in all your dealings as a doctor.’
Raven looked up, eager for the comfort wisdom might bring.
‘Always remember that the patient is the one with the disease.’
Raven’s expression betrayed that he did not understand.
‘It is easy to become burdened by responsibilities, to become so obsessed with a problem that you lose perspective. Evidence can be confounding, unlikely coincidences do happen, and an over-wrought mind can leap to wrong conclusions. Remember your own good judgment when McLevy asked how you would explain the dead baby’s leg. In that instance, your detachment served you well. People often hypothesise the sensational, and become inexplicably blind to the obvious that is before their very eyes.’
The Way of All Flesh Page 22