City of Dreams (55 page)

The fellow almost stretched on top of the child, tried to pin her body to the cot with his meager weight. He pressed both her hands against the canvas covering. For a moment the girl stopped squirming, using all her energy to suck in air.

The end was coming fast.

Luke bent toward her again and laid the blade of the scalpel along her throat. The child opened her mouth a little, as if she wanted to scream. Her eyes remained open, staring up at him, begging for mercy. He angled the blade toward the slight indentation between the throat and the clavicle. That’s what the first Lucas Turner had written, after he performed the tracheotomy that saved the life of Judith Bayard, Stuyvesant’s wife.

Tilting the Scalpel slightly downward, go behind the uppermost tip of the Sternum and open the Trachea by the Width of no more than a little Finger, and that at the precise point where the Windpipe leaves the Larynx and descends toward the Bronchia. And do so in such a Careful manner as to avoid Severing the major Arteries which exist in that Exact vicinity.

Jesus. Almost seventy years ago. And the first Lucas Turner didn’t have proper Edinburgh training. Do it, Luke told himself. She’s all but gone anyway. Look how much quieter she is. And how her eyes are starting to glaze over.

He stretched the skin taut with his left hand, drew one long breath, then cut with his right. The very instant the skin parted, the child threw off the man holding her down and lurched up in the bed. The scalpel in Luke’s hand traveled a full three inches across her throat, slitting it from the middle of her neck to the lobe of her left ear.

The first blood came in a spurt, catching the old man in the face and Luke in the chest. Then it pumped out, streaming over Luke’s hands and drenching the bed coverings in a sea of red.

Behind him the girl’s mother began to make soft and frightened weeping sounds. His regular patients, the rich folks he saw in their homes and sometimes in the office of his house on Ann Street, screamed when someone died. The crippled crone mewled like a wounded cat. “She’s dead, ain’t she? My girl’s dead and you killed her.”

Luke put his bloody hand on the child’s heart and felt nothing. God, he was exhausted, almost didn’t have the strength to answer. “Yes, she’s dead. The throat distemper killed her. I tried, but …” He shrugged. And did not think about the way his hand had trembled at the moment he made the incision.

“She was all but gone,” Luke told his father. “I tried using Great-Great-Grandfather Lucas’s technique, but it was too late.” His twice-great-uncle, really. But the entire Turner family kept up the fiction of the adoption being the only tie. The Devreys as well.

Christopher wasn’t sure that simply because the girl was dying she deserved to be hurried along by having her throat slit, but he nodded and considered the job at hand. An anatomy. The dead child lay on the table in the little room set aside for the purpose. Dissecting the corpses of those who died in the poorhouse had turned out to be a bonus of his job. It was wonderful to have all these cadavers to examine with no relatives in a position to argue against the practice, and the churches not particularly interested when only the poorest of the poor were involved. The opportunity to learn was priceless. Still, sometimes he was troubled by how the dead came to be lying on this table. “From what you say, the girl was indeed likely to die whether or not you cut. But if you—”

“I was right to try, Papa. There wasn’t time to send for you. And the tracheotomy might have saved her.”

“Yes, it might.” Christopher bent closer, examined the wound. It was caked in dried blood. “But as I recall, Lucas’s journal says an opening the quarter part of an inch. You’ve given this one a gash a good bit wider.”

“An accident. She jerked upward and my hand slipped.”

“Were the ropes not tight enough?”

“I didn’t tie her. There was a man. The warden assigned him. He was supposed to—”

Christopher turned his head and looked over his shoulder into his son’s face. “If you are to practice surgery in my hospital,” he said softly, his eyes flat and showing no emotion, “you must prepare your patients in advance. And your hands, Luke, must never slip.”

“I didn’t mean exactly that. About the slipping. Actually, now I think about it, my hand was remarkably steady. And I’m not a surgeon. I’m a physician.”

“Ah yes, how could I forget. Dr. Luke Turner, trained in Edinburgh. Where they instruct you in the benign use of the knife. Or so I’m told.”

“We learn a bit, yes. Not much,” Luke admitted. “Nothing like the things Great-Great-Grandfather Lucas wrote about. Or what you do.”

“No.” Christopher was still looking at the gash in the dead girl’s throat. “It appears they didn’t teach you quite so much detail. And what of anatomies, Luke? Did you watch many of those?”

“Never.” Luke swallowed hard, unable to take his eyes from the scalpel his father held. As a boy he hadn’t enjoyed spying on the operations performed in the front room of Hall Place. Not like Jennet. His sister always had her nose pressed to a crack in the door when Christopher cut. Luke had wanted to be a physician for as long as he could remember, but never a surgeon. Only lately had it come upon him that he was somehow less than Papa and Lucas were, because he didn’t work miracles with a scalpel. There were damned few miracles to be done with calomel and cupping. At least so it seemed now that he’d started a practice of his own. “I heard there were occasional anatomies performed at the University,” he said. “But it wasn’t easy getting cadavers. And we weren’t required to attend.”

“No. Well, you’re not required to attend this one either,” Christopher said mildly. “But I should think it would be wise if you did. Might help you in your benign use of the knife.”

Luke forced himself to be attentive.

The scalpel seemed an extension of Christopher’s hand, moving with direction and purpose. There was no sign of trembling. Christopher made a lengthwise cut from beneath the chin to the middle of the chest in one swift motion, cutting through skin and the fatty tissue. Finally, he made four shorter crosswise cuts that allowed him to peel back the flesh on either side like the wrappings of a package. “Good. Now we can see what we’re about. Note the condition of the esophagus, Luke. It is a bit inflamed, is it not? Redder than it should be.”

“If you say so.”

“I do. Definitely inflamed. And these white spots.” Christopher flicked his probe lightly along the exposed organ. “Quite a few of them, aren’t there? And they aren’t like the pus-filled lesions of a normally bad sore throat. Come closer, lad. Take a good look.”

Luke bent toward the girl lying on the table with her throat opened. There was no blood now. “Yes, I see. Tissue redder than normal. With white spots.”

“Tough white spots,” Christopher amended.

“Yes. Hard lesions.”

“Exactly. Now we open the esophagus—carefully, so as not to damage the tissue.” Again the scalpel went its delicate way, cutting just so far and no farther, an artist’s touch that revealed the inner lining of the passageway. “Ah,” Christopher breathed softly. “What have we here? Something interesting, wouldn’t you say?”

“I … I’m not sure. What are we looking at?”

“This white lining in the esophagus, going as far as”—Christopher slid the scalpel downward, his perfect touch parting only the outer layer of tissue—“down the trachea and beyond. Appears to continue to where the windpipe divides and enters both lungs. Get a probe, Luke. On the table beside you. Now, lift that white part out. Very gently, mind you. We don’t want it to tear.”

Luke’s hand shook. He could see it, so his father must as well. The trembling prevented him from getting hold of the thing he was supposed to remove from the child’s throat. Looked like a piece of the caul fat the butcher used to wrap patties of chopped meat. Whitish-gray and marked with indentations. “Is it some kind of pox?”

“No, nothing of the sort. There, you almost have it. Slide the probe around to the right and lift.”

In the end it was Christopher who had to remove the thing, while Luke held the tissue of the esophagus apart with two additional probes.

“There. It’s free.” Christopher held the tough membrane up to the window. It was late afternoon; there was not much light, but the remarkable shape was evident. “It’s a perfect cast of the inside of the esophagus and the trachea.”

“And you’ve never seen it before?”

“Never. This is no benign lining placed in the throat by the Maker, lad. This is the thing that’s choking them.”

“Choking who?”

“The children who die by losing their breath,
angina suffocativa.
This is the bladder, a false membrane that grows inside their windpipe and cuts off all their air.”

“But how does it get there?”

“Luke, if I knew the answer to that I’d be God Almighty. I’m just a poor surgeon. Not a fancy Edinburgh-trained doctor like you are.”

The younger man had the grace to flush.

The room beneath the fancy bordello over by Hudson’s River was windowless, carved out of an earthen cellar. The five-foot ceiling and half-height door made it a place where no normal man could stand upright. Being a scant thirty-six inches from the top of his head to his heels, Jan Brinker entered without difficulty. He crossed the threshold, then stood in the doorway squinting.

The gloom was lit by a single candle and the reddish glow that came from a small iron brazier containing a few glowing coals. A gray-blue haze thickened the air. The smoke came from the pipe Solomon DaSilva held between his teeth. Brinker pulled the edge of his coat over his nose and his mouth.
“Jesu Cristo,”
he muttered into the cloth. “This place be worse than Hades.”

He hadn’t meant the words to be heard, but DaSilva looked up. “How do you know, Jan? Have you visited? I’m told you’re a little devil, but I thought that was women’s gossip.”

DaSilva was sitting behind a rough wooden table. Its surface was entirely covered by money, mostly coins, but some bills as well. He was separating the proceeds of his various enterprises into neat piles.

Three years earlier, in 1734, the Council had issued paper money in the equivalent of twelve thousand pounds sterling. Without the security of gold or silver backing, the flood of money led to high interest rates, which contributed to inflation. That worsened the economic downturn brought on by the cheap Pennsylvania flour the Caribbean sugar planters preferred to the finer New York product. Paper money was a curse. DaSilva accepted it because he had to, but like every man of business in America he much preferred hard currency, wherever it came from.

The coins in front of him were of every denomination and represented nearly every realm under heaven. Many were gold, polished by the number of hands that had greedily clutched at them. Even in the smoky half-light of the little room, the gold shimmered.

Jan Brinker continued to breathe into the shabby fabric of his coat, but above the threadbare homespun his glance was fixed on the table. His eyes were dark and filled with longing. They were a man’s eyes, no matter his height.

DaSilva went on making neat, six-high stacks of the heavy Spanish coins known as pieces of eight, each containing a full ounce of silver, worth the equivalent of the much lighter Dutch gold
daalder.
“Sit down, Jan Brinker. I’m almost done here.”

There was no place to sit. Maybe the Jew meant he should squat on the floor. Won’t. Not no
Jesu Cristo
animal …

Brinker looked around, straining to see in the dim light of the coals and the single candle. There was a three-legged stool tipped over and pushed into a corner. The dwarf got it, dragged it closer, and turned it upright. When at last he hoisted himself into position on the seat, his feet didn’t reach the ground.

DaSilva went on counting. Brinker kept staring. Once or twice he licked his lips. So much money … Finally he cleared his throat. “I was told you be wanting me, Mijnheer DaSilva. It be the truth, no?”

“Yes, of course it’s the truth. How else would you have found me here, Jan Brinker?” When DaSilva brought Jennet to this grand house on the west side of Manhattan he’d told her it was the best bordello in the city. Every man in New York knew as much. But damned few had ever found their way to the cellar where Solomon DaSilva counted his wealth. “Is there any way you’d have got here if I didn’t send for you, Dutchman?”