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Jonas wasn’t sure whether Miss Charingford would be taken aback by the other woman’s very visible pregnancy or pleased by it—he never could guess how women would react.

But Lydia greeted Mrs. Hall as she greeted everyone—with a warm, happy smile, with bright conversation and compliments.

“I do love these curtains,” Lydia said earnestly. “They are both functional and quite pretty. Never tell me you made them yourself?”

Jonas had never been able to manage that sort of small conversation. The labyrinthine rules attached to kind words usually left him bemused. And Miss Charingford was so
good
at it. He could have watched her make people smile for hours.

When he saw Mrs. Hall, he didn’t see a woman who made curtains. She wasn’t slender to his eye. She was undernourished. On her skinny frame, the pregnant bump of her belly sat like a grotesque lump.

There was a disease that was peculiar to women, and Mrs. Hall had it. It wasn’t a disease that came from exposure to contagion. It didn’t have a name. It was a sickness that took years to come on, and it crept up so gradually that people rarely noticed what was happening. It ravaged the rich and the poor alike—although, as with all illness, it landed most heavily on the poor.

Miss Charingford moved from Mrs. Hall to her children, never once looking at Jonas. She hadn’t looked at him at all since her outburst.

Not that it mattered now; he had work to do. Jonas set about seeing to his patient.

“I lost another tooth,” Mrs. Hall said quietly. “I lost it two nights ago.”

Her skin was dry and scaly to the touch; she had dark bags under her eyes. Her children gathered around Lydia in a group. From Miss Charingford’s basket, she’d taken a mass of wool stockings, which she distributed.

“Good of you, to bring her by,” Mrs. Hall said. “Once was, I’d not take charity. Now…” She shrugged, as if to say she’d take anything she could get.

“Your heart rate is acceptable,” he said, letting go of her wrist. “Just acceptable. There’s a little fluid in your lungs. I think that so long as you have a chance to rest and recover, you should not suffer too much in the next month.”

She nodded at this. “I’ve done eight already,” she said. “I do know how it’s done, Doctor.”

“It is not the childbirth itself that worries me.”

He didn’t know the name of the disease she had, but he knew its symptoms. A man who wouldn’t breed his mare two seasons in a row for fear of causing her an injury would be at his wife within weeks of childbirth. He’d plant his seed in a field that had not lain fallow for years, and like an overproduced field, the wife inevitably failed. Her back stooped. Her skin changed. Her eyes yellowed. Teeth fell out; bones that were once strong would snap at the smallest slip on icy pavement. Carrying a child was hard on a woman’s body, and eight children, delivered ten months after one another, left a woman no room to recover.

Every time he tried to make the argument, though, he found that women disliked being compared to mares and fields, no matter how apt the analogy was.

As for the men—a fallow field, apparently, said nothing about a man’s virility. But a wife who bore child after child formed a living, walking boast, one that he could parade in front of his compatriots.
Look at me! I’m a man!

“The stuff that babes are made of comes from your own body, Mrs. Hall.” He straightened and put away his stethoscope. “If the babe needs the material of bones, it comes from you. If it needs the material of skin, it comes from you. There’s a reason you’re losing your teeth, Mrs. Hall.”

She looked away.

“You need to take a rest from bearing children. This babe likely won’t kill you. The next one might.”

Mrs. Hall glanced over at Lydia, now handing out oranges to the children. She lowered her voice. “And how am I to feed them all if I take a rest? I know they might not look like much to the likes of you, but they’re precious to me.” Her tone caught.

“How are you to feed them all if you perish?” he countered. “It is not a question of
if,
Mrs. Hall. It will happen. You’re scarcely getting enough to eat. At some point, a child will come, and the act of producing it will exceed your strength. If you want to live, if you want to stay healthy for your little ones, you must stop bearing children.”

Lydia could hear what he was saying, even though she didn’t look in his direction. When Mrs. Hall had said that her children were precious to her, she’d smiled and looked down. But when Jonas spoke, her chin went up a few notches, and her grin turned into a show of teeth.

“What else am I to do?” Mrs. Hall said.

“No excuses,” he said. “There is a way.”

And he leaned in and told her.

“I
DON’T THINK YOU’RE TRYING VERY HARD,”
Lydia said to Doctor Grantham as they left. “In fact, I don’t think you’re trying at all. She has a loving family and beautiful children. Did you notice that she had shoes for them
all?”
They’d been lined up in a row by the door, clean, if worn. “That takes a great deal of love. While I am sure that matters are difficult for her, with her husband deceased and her so recently pregnant…”

“Miss Charingford.” Grantham was shaking his head and looking down, a little smile on his face. “Her husband passed away five years ago.”

“Oh.” She swallowed. “Dear. Will not the man who got her in that situation marry her, though?” She knew as she said it, though, that she’d just made herself look naïve again. Unmarried for five years? There must have been four children under that age in the house. If the man who was getting her with child hadn’t married her yet, he was unlikely to do so now.

But Grantham didn’t point out these obvious facts. He looked over at her and said, quite deliberately, “It’s likely that she doesn’t know who he is.”

Lydia fell silent. That would imply that there were…a good number of men. “But she does honest work. She takes in laundry and mends and…”

“She doesn’t walk the streets, if that’s what you mean. And I have no doubt that with eight children, she is on her feet working as long as she can, as hard as she can, every day.”

It made Lydia’s back ache simply thinking about it. “I suppose,” she finally said, “that she deserves…comfort, too. No matter what has happened to her.”

Grantham gave a snort. “Comfort? Miss Charingford, you know precisely what is going on, even if you won’t say it aloud.”

Lydia felt her cheeks flush.

“Mrs. Hall is on her feet every minute she can work during the day, and when she can no longer stand, she works on her back. It’s a common enough arrangement in tenement halls such as these. Likely she has ten or twelve men who visit her on a regular basis, who help to make up the difference in her expenses. The men can’t afford a wife and a family; she can’t afford not to have a husband.”

Lydia was silent a moment longer. She thought of those shoes lined up, the curtains in the window. The note in the woman’s voice as she said her children were precious to her.

Lydia now knew precisely how she valued them.

She thought of Grantham, leaning in at the end of the visit and whispering, and she felt a hot curl of anger.

“When you whispered to her, were you warning her of the danger of moral decay?”

She could still remember Parwine’s gaze on her as he predicted damnation and death.

But Doctor Grantham simply rolled his eyes. “Tell me, Miss Charingford. Do I look like a rector?”

She glanced at him. The rector had floppy sideburns and always smelled of cabbage. Grantham’s collar was white underneath a black cravat, but there the resemblance ended. He wore dark brown, which set off the dark color of his eyes. He was clean shaven, and he smelled faintly of bay rum. He looked… Very well, he looked handsome. Not that she cared about that.

She looked away and didn’t answer.

“I’m a doctor; it is not my job to look to anyone’s soul, but to see to their physical wellbeing. I told her that she should be using a French letter or one of the new capotes made from vulcanized rubber. Failing that, I suggested that she consider being fitted with a Dutch cap. The expense would be considerable for her, but not compared with the cost of a child.”

Lydia turned to stare at him. “What are those things?”

“Prophylactics.”

He tilted his head to look at her and must have seen the puzzled look on her face.

“For the prevention of pregnancy and, in the case of the former two, social disease,” he spelled out. “The French letter goes over a man’s penis and prevents the transmission of sperm; the Dutch cap over a woman’s cervix. Neither is perfect, but they’re certainly better than nothing.”

The images that brought to mind… Lydia could scarcely breathe, imagining a sheath of rubber being fitted over a man’s… Her cheeks flamed. “I am certain that this is not a proper subject of conversation between an unmarried lady and a gentleman.”

He rolled his eyes again. “Tell me, Miss Charingford. Do I look like an etiquette advisor?”

“Not in the slightest.”

“I’m not a virgin. Neither are you. And even if you were, there’s no need for either of us to be missish about the matter. If a woman is old enough to push a ten-pound child through her birth canal, she can hear words like ‘penis’ and ‘cervix.’ These are medical terms, Miss Charingford, not obscenities.”

He spoke in such a straightforward way, as if the penis and the cervix were parts of the body no more objectionable than fingers or toes, as if enrobing them in rubber were as simple as donning gloves. He didn’t speak of what one would do after that particular glove were put on.

Lydia licked her lips and refused to look at him. “Have you used any of them?”

He didn’t laugh at that highly improper question. “French letters, quite regularly. While I was in medical school, I had an arrangement with a widow who missed sexual intercourse, but didn’t want a husband.”

She couldn’t believe that she’d asked. She couldn’t believe that he’d answered. She really didn’t want to think about the fact that Doctor Grantham was male, in possession of the standard male parts. That made her feel odd inside. Odd, and aware of her own body in a way that made her uncomfortable.

“French letters dull the sensation somewhat,” he said. “If I were married, I’d ask my wife if she would consider being fitted for a Dutch cap. But that won’t prevent social diseases like gonorrhea and syphilis.” He looked at her directly, as if daring her to become flustered at the words he used.

“I really…” The protest seemed a formality, something she had to say. “I don’t think that I should be having this conversation with you.”

She was certain she shouldn’t be. He’d just told her about his illicit arrangement with a willing widow. Men didn’t tell women these things. And yet he hadn’t boasted about the conquest. He’d stated it as a fact, as if sexual intercourse was just another thing that people did, one that had medical implications.

She blinked and shook her head furiously.

But his jaw had squared, and he turned to her. “When should I have this conversation with you, Miss Charingford? Do I wait until you’re married and your body is already falling apart with the strain of carrying your seventh child in as many years? Should I wait until a fifteen-year-old girl catches pregnant because she was seduced by an older man?”

She couldn’t breathe. “Don’t, Grantham. Don’t you dare talk about that.”

“Why, because you might get angry again?” He set his bag down and turned to her deliberately. “I would rather infuriate you by telling you that sperm causes pregnancy and that there are methods to help prevent its transmission. The truth is a
gift,
Miss Charingford, and this conversation is a damn sight better than telling you you’re going to die as a slut, and then poisoning you in hopes that you lose the babe.”

He
was
furious, so furious that it took her a moment to comprehend what he’d said.

“Poisoning me?” she echoed.

“I told you earlier I thought you were angry with me. You should be angry. I could never tell if Parwine prescribed that remedy because he was ignorant, because he was trying to induce a miscarriage, or because he wanted you dead.”

She couldn’t breathe. She couldn’t think at all. “I told you. I don’t want to talk of that. I wish you’d forget it. I have.”

“Tell me, Miss Charingford, before you miscarried, did you feel confused and faint? Were you dizzy? Was your skin more flushed than it usually was?”

“How did you know?” she breathed. “How did you know I miscarried?”

“A good guess. Prussic acid is also known as hydrogen cyanide, and it is one of the deadliest poisons known to man. Of course, the difference between a poison and a cure is the dose, but… At the level Parwine suggested? It wasn’t a cure.”

Lydia stared straight ahead, her eyes feeling dry as a desert. Her whole body seemed in agony remembering those cramps that had come. She shook her head, but the denial didn’t help.

“So, no,” he continued, “I won’t forget that day. I held my tongue because Parwine was older and he knew better. I held my tongue because he had told me to keep quiet, and I thought that agreement more important than your wellbeing. And I have regretted it. I regretted it every day of my medical training. I regret it every day that I practice. I regret it now more deeply than you could imagine. I should have spoken at the time, and to hell with what Parwine told me beforehand. It shouldn’t have mattered that he was the elder, and I was the young pup following him about. I wanted to be a doctor. The rule is that I should do no harm, not that I should do what is considered proper.”

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