Race for the Dying (15 page)

The treatment for each patient was recorded and in a final column, the fees charged. At those rates, Thomas reflected, a new clinic would be long in coming—as would his first paycheck.

“If you have nothing else for me?” Bertha Auerbach asked, and Thomas looked up with a start.

“I'm sorry. No. If you have time to tend to the instruments, I would be grateful.”

“I'll let you know when patients arrive,” she said. “Since it's Monday morning, we might expect Mrs. Cleary promptly.”

“Ah, Mrs. Cleary. Dr. Haines mentioned her.”

“Every Monday morning,” Bertha said. “She begins her week with a visit to the physician.”

“Whether needed or not?”

“As regular as the clock in the waiting room.”

“How interesting. She would be in here, then.” He patted the book.

“Number 21,210.” Her smile was tight, as if she feared that she might burst into laughter.

“My word,” Thomas said, and looked down at the book. He flipped back to the previous Monday, and sure enough, the first entry was

Number 21210, Mrs. Robina Cleary, a 71-year-old woman of impressive stature. Complains of a ringing in the ears. Advised to exercise (again) and to avoid rich foods (again). Accepted Universal Tonic. $2.00.

The week previous, the entry read

Number 21210, Mrs. Robina Cleary. Claims that the spate of hot weather has caused some discomfort. Suggested lighter clothing. Universal Tonic, $2.00.

Thomas paused and looked up. “Is this sort of thing common, Miss Auerbach?”

“Common?”

“We have a number of patients who take up space and time without any specific complaint?”

“I'm sure we do.”

He fanned some of the journal pages. “I had an elderly aunt,” he said. “A wonderful woman whom I loved dearly. As my father would say, Aunt Ethel enjoyed nothing as much as a good ailment. Something to discuss with neighbors. Mrs. Cleary reminds me of her.”

“Be kind, Doctor.”

The comment surprised Thomas. “Of course,” he said, and patted the book. “I'll be prepared.”

Chapter Twenty-five

Doctor?” Thomas Parks looked up with a start. He put a finger on a name in the journal to mark his place. “The constable is here to see you, Doctor,” Bertha said.

Edgar Eastman's towering, broad figure appeared in the office doorway. “There you are,” he said, as if Thomas might have been hiding.

“Come in, come in,” Thomas said, although Eastman already had. The constable closed the door a bit, nodded at Bertha as if accepting her permission, and then shut it the rest of the way. He turned and surveyed the room, in no hurry to engage the young physician in conversation.

“I thought to stop by.” He scanned the spines of books on the top shelf that were at his eye level. He pulled one book partially out, cocking his head to better read the inscription. “You read Latin?”

“Some,” Thomas replied, impressed that the constable recognized the language in the title.

“I don't.”

“I wouldn't think Latin of much value in your line of work.”

Eastman turned and looked at him. “You never know,” he said. “We can't always tell what's going to be of value, can we?”

“I suppose not.”

“I came by to see what you found out.” Eastman turned one of the heavy straight-backed chairs and sat down on it backward, then dug in his pocket, eventually pulling out a large pocket-knife. Sliding it across the polished surface of the desk toward Thomas, he waited while the physician pried out the blade and examined it.

“I have my notes,” Thomas said, and reached for his own medical bag that now rested on the floor beside the desk. He handed the open journal to Eastman.

“As you can see, it would be most difficult to say that this is the knife,” he said. “This blade is more blunt than I would expect, and there is only one.” He folded the knife and ran his finger along the front of the handle near the base of the blade. “This is not as wide as the bruising around the wound.”

“You're sure?”

“Reasonably, yes.”

Eastman turned the page that included Thomas' drawing of the bruise and squinted at it. “This?”

“Yes. The boy was stabbed so hard that the handle of the knife bruised the skin around the entry wound. And in my view, that bruise…that mark…is not consistent with this particular knife.”

“Interesting. And this?” He pointed at another sketch.

“That's the shape of the wound in the posterior wall of the heart.”

“Huh.”

“That's where the blade actually came to rest.”

“So that shape would be fairly accurate?”

“I would say so.”

“And it matches this?” Eastman held up the pocket knife.

“Not at all. As you can see, that blade in your hand is quite rounded, almost blunt. The knife that caused that fatal wound was sharply pointed, an acute shape. As you can see by my notations, the angle of the tip was approximately twenty-five degrees. That's a very pointed blade, sir.”

“Approximately twenty-five degrees.” Eastman grinned, looking ten years younger when he did so. “You're a man of exact science.”

“It's a relatively simple task to measure an incision in tough muscle,” Thomas said.

Eastman opened the knife blade and laid it on top of Thomas' drawing for comparison.

“As you can see,” Thomas said.

“Huh.” The constable refolded the knife, slipped it in his pocket, and pulled out a second one. “And this?”

Much heavier, this knife featured two blades, and as Thomas opened the first, he felt a chill of apprehension. Fully four inches long, sharply pointed, and razor sharp. He knew before he overlaid it on the journal drawing that it would match.

“Now this one.” He looked up at Eastman. “It could match easily.” He laid the blade over the drawing of the heart wound. “If not a match, then an amazing coincidence. Both the wound itself and the bruise on the skin.”

“Well, well,” Eastman said, and accepted the knife back. He opened and closed the knife several times, brow furrowed in thought. Thomas heard voices out in the waiting room, and then sounds as if a herd of elephants were crossing the floor. The door to the examination room closed with a bang, and through the thin wall, he could hear the voices continuing. Eastman ignored the ruckus, and Thomas forced himself to relax, knowing that if he was needed. Bertha would feel free to interrupt.

“You know to whom the knife belongs?” Thomas prompted.

“Yes.”

“I should say both knives,” Thomas amended. “The first is not the murder weapon, I'm sure of that. The second may certainly be. It, or another knife exactly like it.”

Eastman rested his chin on his crossed arms, and for a moment it appeared as if he were going asleep. “All right,” he said after a moment, and it was little more than a murmur. “Irwin Pedersen. You've met him yet?”

Thomas laughed. “I've met very few people, thanks to my circumstances. He's the owner of the knife?”

“No.” Eastman pushed himself upright. He turned the chair carefully, arranging it just so. “Pedersen is the prosecutor who will handle this case. He'll want to talk with you in the next few days.”

“Anything I can do to help,” Thomas said quickly. “I can't imagine the circumstances that led to the boy's death, but if the perpetrator is to be found, then by all means—”

“You may be called to testify.”

“Absolutely,” Thomas said. “Against whom?”

“I have arrested Ward Kittrick,” Eastman said quietly. He glanced at the doorway as if someone might be standing there listening, then looked at Thomas. “Kittrick is brother to Harvey, the man killed last week in the scuffle with Charlie Grimes, one week ago. I took the knife from Ward at the time of his arrest.”

“You don't say. He was after revenge of some sort? I had heard that the man's death was more an unfortunate accident. A drunken brawl.”

“That we'll never know. Ward tells me that he had nothing to do with Charlie's death. He claims that he wasn't in town when it happened…that he was out in the timber. But a dozen others say differently.”

“Well, obviously his knife was in town,” Thomas said.

“Kittrick is lying,” the constable said. “There were no witnesses to the stabbing, and he thinks to get away with it. Your testimony is important, you understand. We can prove he was in town that night, and those drawings can convince a jury.”

“As I said, you have my complete cooperation.”

Eastman moved toward the door, reaching out for the knob. He didn't turn it, but stood there silently for a moment, deep in thought. “You'll keep our discussion to yourself,” he said.

“Of course.”

“Will you make a copy of your drawings for me?”

“Take the journal with you. The drawings and figures are the only things in it at the moment.” He closed the journal and held it out to Eastman. “I hope it helps.” The constable nodded. “The first knife you showed me? Whose was that?”

“My own,” Eastman said. He smiled at the look of surprise on the young physician's face, and opened the office door. Thomas saw that his day had truly begun, and wheeled after the constable.

“Mrs. Cleary.” Eastman greeted a voluminous woman who sat in one of the leather chairs as if she were royalty. “Good morning to you.” Before the woman could respond, Eastman turned away and nodded at a much younger woman who sat with her arm around a ten-year-old child.

Robina Cleary saw Thomas and her face lit up with interest.

“Doctor?” Bertha Auerbach interrupted, her tone sharp and imperious. She held the door of the examination room open. “We'll need to attend to Mr. Doyle immediately,” she said.

“You have a good day, Doctor,” Eastman said. As the huge constable headed toward the door, Mrs. Cleary reached out a hand toward him, her face full of questions. Eastman skillfully ducked around her, nimble as a dancer, and with only a polite touch of his hat brim, left the clinic.

Chapter Twenty-six

Good morning, ma'am.” Thomas greeted Mrs. Cleary heartily, but steered his wheelchair toward the mother and child. At the last minute, he swerved abruptly, halting directly in front of the little girl. He leaned on the arm of the chair and frowned at her, lifting his free eyebrow so the bandage bobbed up and down. He knew he looked comical, and was rewarded with a tiny smile from the child.

“I'll be with you in just a minute, all right?” he asked. “Will you wait for me?”

“Are you…,” the child's mother started.

“Dr. Thomas Parks,” he said, and held out his hand. The woman's grip was bony and listless.

“Is Dr. Haines…”

“He'll be along in a few minutes,” Thomas said. “I've joined the practice, so”—he leaned toward the little girl—”you'll probably see a lot of me. But excuse me for a moment. There's a gentleman who's injured himself.” He reached out and touched the girl's chin, the hot skin feeling like fine silk held in direct sunshine.

“Young man,” Mrs. Cleary called, and the command in her tone was unmistakable. Her hands clasped over the head of her black cane. Thomas flashed a cheerful smile her way. “We'll be with you directly, ma'am,” he said, and before she could reply wheeled to the examination room.

“Sorry,” he said as he closed the door. “But the little girl looks miserable.”

“Doctor, this is Mr. Doyle,” Bertha said. She didn't rise from her position, kneeling with both hands holding a bandage on Mr. Doyle's left leg just above the knee. The fisherman—the smell said he had to be that—was thin to the point of emaciation, his clothing soaking wet. The fingers of one hand were wound in his long, unkempt hair as if he was trying to pull it all out by the roots. “He slipped down on the wharf.” Thomas now recognized the man as one of the fishermen he had greeted when he first disembarked from the
Alice
.

“Mr. Doyle,” Thomas said, and extended his hand. The fisherman hesitated, eyeing the wheeled apparition in front of him. Doyle finally untangled his grip on a shank of hair and took the proffered hand.

“I heard about you,” he gasped. His face was gray and sweaty, eyes wide with pain. “Name's Jimmy. Everybody calls me Jimmy.” The hand strayed back to grab another hank of hair as he sucked in a breath, close to panic.

“Fair enough. Let's have a look.”

Thomas maneuvered his chair with an impatient shake of his head, and Bertha Auerbach saw his exasperation. “Let me move out of the way,” she said. “Mr. Doyle, I want you to lean back. Just relax.”

The moment Bertha released her pad of bandage on Doyle's thigh, a flow of dark, venous blood leaked down his leg. A nasty splinter of wood smelling like a not-so-fresh seaside had skewered the scrawny muscle of Doyle's lower left thigh. He jerked and gasped with pain as Bertha shifted her hands.

“A quarter grain of morphine,” Thomas said, and glanced up at Bertha, accepting the scissors that she handed him. “Mr. Doyle, I'm going to remove your trouser leg, so hold still, if you please. The nurse is going to give you an injection that will ease the pain.”

“I don't need nothin',” Doyle said, but his teeth were clenched so hard that it came out a slur. “You cain't take my leg!”

“Oh, yes, you do need something,” Thomas said congenially. “And I'm only taking your trousers. Your leg will be fine.” He cut the filthy, wet trouser fabric, removing the legging far up on the thigh. He grimaced at the odor. Jimmy Doyle was as much a stranger to the bath as he was to the barber. With the blood slowing, Thomas pulled away the strips of cloth.

“My God, man. How did you do this?”

“Slipped on the wharf,” Doyle said. “Tried to catch myself, but damned if I didn't fall down the piling. Thought I was like to drown.”

“My word.” The fragment of wood that projected from the skin was roughly oval in cross-section, like the heavy blade of a weapon, broken off by the man's weight. Four inches above the knee, the splinter had driven upward, ripping through skin and muscle as it plowed under the flesh of his thigh. The man's own weight had broken the wooden spear free from one of the wharf's pilings, twisting the weapon in the wound in a hideous fashion.

“What's that?” Doyle asked, sounding like a frightened child. He eyed the hypodermic syringe in Bertha Auerbach's hand.

“That will help you forget your troubles, Mr. Doyle,” Thomas said. Ignoring the man's mumbled protestations, they managed to maneuver his right arm sufficiently for Bertha to find a target. Doyle let out a squeal.

“Now, lie back and count the planks in the ceiling,” Thomas said, “or dream about all the fish you're going to catch.”

Doyle mumbled something, but it wouldn't be long before the drug dispersed through his system, dulling all the edges.

“We'll want to wash this entire area with sublimate,” Thomas said. “And shave from here to here.” He touched the leg well above the projecting spur of wood, running his finger down to immediately above the kneecap. “The splinter has been driven into the deep tissues. If we don't excise the entire wound, it will infect with certainty.”

“Ether?” Bertha said quietly.

“Absolutely.” He lowered his voice to a soft whisper. “If I just pull this out and bandage him up, he'll be dead in a week. Wood is host to all kinds of particularly nasty things.” If Doyle heard the pronouncement, he made no sound, off as he was on the soft cloud of morphine.

“Clean, shave, clean,” Thomas said. “I want at least ten minutes for the morphine to work before we start the ether.” He pushed back. “The kit in the sterilizer is finished?”

“Yes.”

“That's good then. Immerse the kit in a pan with beta-naphthyl,” he said.

The bleeding had slowed, and Thomas wheeled so that he could converse with the patient who lay now with a fresh pillow under his head and his lower legs hanging off the end of the table.

“Mr. Doyle, are you feeling some relief?”

“I guess so,” the man murmured. “They call me Jimmy.”

Thomas watched the pulse ticking away in the man's temple. “Did you pull on that splinter after you fell, Jimmy?”

“Couldn't get it out,” Jimmy replied. “Couldn't get old Bob to touch it.”

“Bob is your companion?”

“Yep.”

“He's a smart man. And where is he now?”

The words came slowly, with a slur. “Him and Dennis brought me up here. They went back down to fishin', I suppose.”

“I see. Well, we'll take care of you. You'll be taking some ether, Jimmy. Have you ever done that before?”

“No. Heard of it.”

“It will make the surgery painless for you. You'll wake up, and all will be well. But we want this to go smoothly, so I'm going to ask you to help me a little.” Thomas looked up as the door of the surgery opened. Dr. John Haines hesitated a moment, then closed the door behind him.

“Sir, would you hand me two of those small towels?” Thomas asked, and Haines did so without comment. The younger physician hesitated, loath to defer to the other now that a patient was at hand, now that he had thought through the procedure and was confident of a successful outcome. But Haines lifted both hands palms up, offering that Thomas should continue.

“Jimmy,” Thomas said, turning back to the fisherman, “I'll be putting this over your face, covering it with another small towel over your nose and mouth. I want you to breath easy, just in and out, as deeply as you can without straining.” He folded the cloth and held it so that the patient could see it. “This is nothing but dry cloth,” he said, “and I'm going to ask you to practice the most even, deep breathing that you can.” He gently covered the man's face. One of Doyle's hands flailed, and Thomas could see that the man was holding his breath.

“Just relax back now,” he said. “Breathe deeply. Let's try it. There is no drug yet. Just clean cloth. It can really be quite comfortable. Very peaceful. Think of a sunny, windless day with every fish in the world going for your bait.”

“I'll do this,” Haines whispered. He moved to the other side of the chair, one huge hand resting on Doyle's forehead like a gentle father, the other manipulating the cloth.

“Jimmy,” Haines said, “easy now, in and out. In and out.” Haines turned and snapped his fingers once at Bertha, then pointed at the shelf. She reached for a small brown bottle and handed it to him. “Now Jimmy,” Haines said, “you're doing fine. Just relax back. Don't fight it.”

In another ten minutes, the surgical kit was in an enameled basin at Thomas' elbow. His sleeves rolled to the elbow, his hands still tingling from the scrub in hot water, then the sublimate, and finally a rinse in dilute carbolic acid.

“I think we're set,” he said. “Jimmy, are you comfortable?”

“No,” the voice mumbled.

“Well, I'm not surprised. But we'll have you up and around in no time at all.” Just no time at all, Thomas thought to himself. Haines opened the small bottle and poured a dollop into the cloth, then covering it with the second towel. As deft and quick as he was, the odd, cloying aroma of ether filled the room.

“Now Jimmy, I won't lie to you,” Haines said in the same comfortable tone. “This stuff smells worse than rotting otters. But just relax and let it work.” The moment Haines laid the cloth over Jimmy Doyle's face, Thomas could see the man's body stiffen, and his hands flopped.

“Just relax,” Haines crooned. “Just close your eyes and breathe nice and deeply. There now. That's fine.” Other than the older physician's continued lullaby, the room was silent. In three minutes, Thomas could see Jimmy's body relax, his left hand opening.

In another minute, Haines said, “The conjunctiva, now.”

There was no reaction when Thomas reached across, lifted a corner of the towel, and stroked the corner of Doyle's eye, producing not a flicker. From under the cloth came a regular snore, and Haines nodded his satisfaction.

“Bertha, let's get the rest of the trousers out of our way,” Thomas said. He watched, keeping his hands clear of the contaminated clothing. In a moment, the remains of Jimmy Doyle's trousers hit the floor, along with underclothing so rank it could have walked out of the office by itself. When the patient was draped for some semblance of modesty, Thomas nodded. “If you please,” he said, and he watched as the woman industriously scrubbed the wound, then shaved it, then scrubbed again. Jimmy Doyle snoozed on, unaware.

The wound oozed around the wooden shaft, and as Bertha prepared the site, Thomas sat back, regarding the leg, imagining the damage the wooden spear might have done, planning his incisions. No major arteries had been severed or lacerated, but the wound was both large and filthy.

At last Bertha finished by draping clean towels around the site. Thomas wheeled the chair until he was snug against the patient. He scrutinized the wound. “All right,” he said at last. “The best little bistoury we have.”

Bertha started to reach, and he held up a hand. “You need to wash your hands again, Miss Auerbach. Let me.” She offered the small pan, and he selected the bistoury that appeared new and winked a reflection at him. “We're just going to see what we have,” he murmured. By the time he stopped his first stroke, the incision was nearly a dozen inches long, running along the ridge of swelling above the imbedded wood. For an instant no blood appeared, as if he'd merely scratched the skin with the back of the blade. But then blood welled up along the incision.

“We're after the very tip,” Thomas whispered, and as he manipulated the small, sterile gauze pads from the brass sterilization box, he cursed his clumsy left hand. “You see what I'm doing?” he said, a little louder as Bertha returned to his side.

“Yes,” she replied.

“Then follow along with me. This damn thumb…”

In a moment, as he cut delicately into the muscle, spreading aside the upper layers, the enormous splinter was laid bare, ragged and foul from its years in and out of the tide. Before he asked for it, a hemostat appeared, and he clamped a large torn vein.

“Now the largest forceps we have,” he said. Holding his breath, he retracted as much tissue as he could as she lifted out the splinter. He looked at the wooden dagger for a moment, amazed at its heft. “Let's irrigate this with sublimate and then beta-naphthyl.”

For the better part of half an hour, Thomas worked, until satisfied that the wound was clean down to the very depths reached by the splinter's ragged point and beyond. He sat back with a loud sigh, hip, ribs, and skull pounding.

“Nicely done,” Haines said.

“We're lucky,” Thomas said. “We have silk?”

“Indeed, Doctor,” Bertha said. Again she presented the brass box, and he selected a long coil of black silk that she threaded for him. Haines remained at Doyle's head, minding the effects of the ether, although he had removed the pad for several minutes. Haines did not offer to assist in any other way, but Thomas knew he was being observed—and with a flush of pride now welcomed the opportunity. While many of his classmates had struggled with the intricacies of sutures, especially the finest ones of slip catgut deep in the viscera, Thomas had discovered that his fingers seemed to have minds of their own, judging the tension of the silk against tissue, the roll of the knot under the pad of the finger.

Now, with underlying layers of muscle sutured with gut, he used a neat, continued suture with the silk, applying only enough tension to bring the lips of the wound together. He kept the stitches as close as he would for a facial wound where appearance would matter—here just a matter of pride that this incision would heal to a mere white line down Jimmy Doyle's thigh.

In due course, he reached for one of the cotton sponges soaked in carbolic acid. With gentle strokes away from the incision, he cleaned the wound once more.