City of Dreams (31 page)

“We shall need more help than this old one can provide,” Christopher said brusquely, not looking at Hetje when he spoke. “Tell me whom else to summon. Younger and stronger.”

Red Bess lay on her back, her hair spread out on the white linen pillowslip, her eyes half closed. “Hetje will do,” she murmured sleepily. “I can’t …” The words trailed away. A small smile played about her lips.

Christopher himself had instructed her to take as much laudanum as she was sure wouldn’t kill her a few minutes before his arrival, and to drink a couple of tots of rum after that. But he was sure he’d also told her he would need a couple of young slaves to help. “Cousin Bess, listen to me, I told—”

“I birthed her,” Hetje said. “And her brother and all her children. Hetje be a good slave. Do whatever the master says.”

She was looking at him with the same intent gaze he had noticed the night of the slave uprising. Something about this old black woman made his skin prickle, but that wasn’t why he was disturbed by her presence. “You can stay if your mistress said you could. But I need a couple of young helpers with strong arms and stronger backs.”

“And strong stomachs,” Hetje said bluntly. “Nobody gonna come. Every one of them be afraid. They say you be a torturer.”

“It doesn’t matter what they say.” Recalcitrant blacks who would not obey without argument seemed to Christopher a great deal more trouble than they were worth. Far better to hire them out if they had useful skills, or sell them on if they did not. He glanced at Bess. Magnificent to be able to sleep before going under the knife, and in his experience, a degree of relaxation impossible to achieve with strong drink alone. He’d seldom seen the benefits of laudanum so clearly demonstrated; but she was of little use to him at the moment.

He’d promised he wouldn’t tie her down. “That’s the one thing I can’t bear the thought of,” she’d confided, “being roped into place like a mule on a tether.”

“I would not consider it,” he’d told her. “It isn’t seemly.” Being tied to the bed was all right for patients in the hospital, but not acceptable for a decent woman being treated in her own home. Unfortunately she had not left him with many options.

“The mistress gave instructions that everyone was to do exactly as I say,” Christopher lied. “Now, go get two of your strongest young house slaves. And if you’re not back in ten seconds I’ll have you whipped for gross disobedience.”

Hetje looked at him. She seemed not in the least impressed with his claims to authority, and certainly not frightened by his threats, but after a few moments she grunted and left the room. She returned in under a minute, accompanied by two younger women.

One hung back, hovering by the door with her hand pressed over her mouth, her dark eyes wide with fear. The other went immediately to the bed and looked down at her mistress. “She be fine.” The mutterings were aimed more in Hetje’s direction than Christopher’s. “Amba make strong medicine.”

“Amba,” Christopher murmured. “Yes, of course, I thought I recognized you. I remember from the day of the bur— Good God, Bess bought you, did she?”

“Amba make strong medicine. Mistress Bess not die.”

“I hope not,” Christopher said. He swung around to face the other girl, the one still cowering near the door. “You, what’s your name?”

“Cuffy, master.”

“Very well, Cuffy, come here.”

The girl approached. She was maybe fourteen and looked plenty strong. “You’ll do, Cuffy. Position yourself there at the bottom of the bed and get a good, steady grip on your mistress’s legs. I don’t want her to kick and thrash about, do you understand? If she does it could be very dangerous for her. I need her to stay still. Come on, girl, say something. Do you or don’t you understand?”

The girl nodded and moved to where she could get a solid hold on Bess’s ankles. “Good. Now, you.” Christopher turned to face Amba. “You’ll have to steady the top part of her body. Her head and her shoulders mustn’t move. Is that clear?”

Amba sprang onto the bed. Christopher made a move toward her, but Hetje was there before him. She stretched out both hands, grabbed Amba’s arm, and began to yank. “You get off that bed, girl. You be altogether too familiar. I be telling you how it got to be. You don’t—”

Bess opened her eyes. “Hello, Amba,” she murmured, then drifted off again. The young woman meanwhile had shaken off Hetje’s grip and hitched up the skirt of her gingham frock. Christopher could see the sleek ebony thighs, muscles taut beneath the skin. Amba set Bess’s head on her lap and leaned forward, supporting the older woman’s shoulders on those muscular thighs, twining her young black arms around Bess’s old white ones. “This be what you want?”

“You supposed to say ‘master,’” Hetje railed. “I been telling you that right along. And you can’t—”

Christopher held up a restraining hand. “Yes, that’s fine,” he told Amba. Then, to Hetje, “It’s all right. Let her do it in that fashion. It will work very well, and I don’t think your mistress minds.”

Bess was sleeping again, still smiling.

“Hetje be a good slave,” Hetje grumbled. “Know better than—”

“It’s all right,” Christopher said again. “All of you are to stay exactly where you are. The pair of you”—he glanced at Cuffy positioned by Bess’s ankles, and at Amba cradling her torso—“remember that your job is to hold your mistress absolutely still. Hetje, you will stay right where you are and get me anything I ask for. Instantly, do you understand? With no grumbling and no questions. And the three of you remember this: whatever you see—or hear—never doubt for one moment that I am doing exactly the right thing for your mistress. Exactly what she wanted. Now, let us begin.”

Christopher drew a chair up to the right side of the bed, sat down, and folded back the coverlet. Following his instructions, Bess had put herself to bed naked above the waist. Her huge breasts hung slack to either side. Christopher lifted the one on the right and gently prodded the tumor. It was only three days since she’d come to him at Hall Place and exposed the growth, but it seemed larger. Still slick and smooth and rock-hard, however. And even in her dreamy, half-sleeping state, when he palpated the protruding mass she gave a little gasp of discomfort.

He moved his fingers up to the armpit. This time he counted four tight knobs, or knots, as Lucas had called them.
When the
Scirrhus
is attended by Knots in the Arm-pit, no service can be done by Amputation unless the Knots be taken away as well, for there is no sort of dependence to be laid on their subsiding by the discharge of the Wound of the Breast.

He was sweating. Christopher had to stop to wipe his face with one of the cloths that had been laid beside the bed in preparation for his needs. “Have you told them what you intend?” he’d asked the day after Bess’s first visit, when she came back to tell him of her decision. “Tamsyn and her husband, do they know?”

“They do not.”

“Bess, I don’t think—”

“You are not to tell me how to run my life, Christopher Turner.” She’d looked straight at him in that way she had. “You are to prevent my losing it. Zachary Craddock and my daughter will know soon enough what I have done. Either they will come to bury me, or to drink a toast to my restored health.”

“Cousin Bess, I have to tell you, I can give no guarantees.”

“I ask none. Only your best efforts.”

The possibility of extirpating these Knots, without wounding the great Vessels, is very much questioned by Surgeons; but I have done it when they have not laid backwards and deep.

A manual examination gave him a fair certainty that they were upstanding, not lying backward, but he wouldn’t know how deep they were until he cut. Christopher opened his instrument case.

In extirpating the
Scirrhus,
if it be small, a longitudinal Incision will dilate sufficiently for the Operation, if large, an oval piece of Skin must be cut through first, the size of which is to be proportioned to that of the Tumour.

He had sharpened every one of his scalpels before he left the house that morning. Jane had watched him perform the ritual. “You seem more than usually agitated,” she’d said. “You must not fear this surgery, my dearest. You are well up to the doing of the thing.”

“Thank you for your confidence. Though I rather think if I told you I was to cut off the head of a man and put it on a pussycat, you’d tell me I was ‘well up to the doing of the thing.’”

“Indeed, because you are. Though I can’t think why anyone would want to perform so strange an alteration. Pussycats are on the whole much nicer than men. With some exceptions, of course.” She’d come close to him then, and lifted her face for his kiss, and he’d bestowed it, and patted her distended tummy and put the knives back in their case and brought them here. And now it was time to see if he was, as his adoring wife insisted, well up to the doing of the thing.

He selected the long, curved scalpel. To be sure there were no filings clinging to it from the recent honing, he wiped it across the fabric of his breeches. Then he leaned forward.
In taking off the whole Breast the Skin may be very much preserved by making the Wound of it a great deal less than the Basis of the Breast, which must be carefully cleared away from the Pectoral Muscle.

The first cut made her moan, but nothing like as loudly as she would have if only rum had been administered. Christopher heard Cuffy moan as well. “You there,” he said without lifting his head or turning around, “Cuffy. Don’t you dare move or I’ll see you’re caged and whipped, and whatever else I can think of on the day.” He glanced up at Amba. She was looking not at him but at Bess, and she hadn’t budged.

The shallow cut he’d made was oozing blood. “Give me one of those cloths,” Christopher murmured. Hetje held it out. He took it, swabbed at the red puddle on Bess’s white skin, then gave it back to her. “You saw what I just did. Can you do that, Hetje? Move in a little closer beside me and keep mopping up the blood whenever it comes. Even if there’s quite a lot of it. Just sop it up. I need to see what I’m doing. Have you got that?”

“Hetje be a good slave. Do whatever the master say.”

“Right. Fine. Then do it.” He was conscious of her looking over his shoulder when he selected a second scalpel. This one was broader, more triangular in shape. Christopher used his left hand to spread the wound he’d made, then inserted the blade between the pectoral muscle and the fatty breast tissue and, working inside the skin, began separating the two.

Bess screamed again. Louder this time, longer, and she was trying to jerk away from the knife. Behind him Christopher heard Cuffy sob, but she held steady. Amba had still not moved so much as an inch. Bess continued to scream, and to try and arch her back, but the black girl who cradled her upper body did not allow her to pull out of Christopher’s reach.

He worked from right to left, away from the tumor.
It is Imperative not to pierce the Tumour itself, for great Harm can come to the Patient if the evil in the thing is spread throughout the Body. Indeed, a decent Practitioner can easily follow this Advice because, all these
Scirrhuses
being enlarged Glands, are encompassed with their proper Membranes, which make them quite distinct from the neighboring Parts, and easily separable.

The left side of the breast was free of the rib cage. Christopher eased the knife between the skin and the muscle and loosened the top half of the breast from its covering.

The screams were much louder now, and she’d opened her eyes. Bess was staring at him, and yelling so that it seemed everyone in New York must hear. Blood was flooding the wound. “Hetje! Come, do as I told you. Mop it up!”

The old woman reached across his hand with the wadded cloth and began swabbing at the flow. Christopher waited until she’d gone some way to reducing the inundation. It gave him a few seconds to make up his mind.

It was still entirely possible he would have to sew up the wound and declare the operation a failure.
In cases where the Tumour adheres to the subjacent Muscle and that Muscle to the Ribs, the Operation is impracticable.

He was almost entirely certain that was not Bess’s case. On her second visit, when she said she wanted him to take off her breast, he’d examined her again. The growth had seemed to him then entirely free of the parts beneath it, a creature of only her offending pappe, as she called it. However, if he was wrong, he had shortened her life rather than preserved it. Worse, he had put her through this agony for no reason whatever.

She was screaming steadily now, all her strength seeming to go into that one sustained screech of torment that patients uttered toward the end of a surgery, when all their courage and endurance were exhausted. And he was only just begun.

There was, however, a slightly different quality to these shrieks. They seemed to issue almost as an involuntary reaction. Bess’s eyes were open and looking at him, but they did not accuse; they seemed filled with a dreamy indifference. Christopher was an expert on the screams of surgery, and he’d neither seen nor heard anything quite like this before.