“Now, moving on to the pericardium,” Henry continues when his students nod blankly. “You will note this is not the pericardium of a healthy person. This albuminous film”he rubs his fingers together, working it into a lather”I’ve never seen before. And these little bruises, here, are not normal. I would imagine they are factors of the disease.”
“Aren’t we at risk for contagion, standing here breathing in the miasma?” asks Bietler nervously.
Henry shrugs. “It’s all in your attitude, boys. If you are weak and panicky, you will become sick; if strong and resolute, almost nothing can touch you.”
The four students take a step back anyway, and Henry has a good deal more light.
“This woman has no fat around her pericardium, I see,” he says, prodding it with his scalpel. “Notice how the membrane is attached to the diaphragm below, and the thoracic fascia above. The left lung is excavated to fit the heart. Here you can see the external layers of the aorta, the vena cava, and the pulmonary artery.”
Mazby can’t help himself, and reaches for his notebook. The four boys look almost professional in their chocolate brown shalloon aprons and tied-on sleeves. Their deep pockets are filled with scalpels and hooks and other dissecting equipment, which they are all itching to use. Enough talk, they are thinking, let us cut. But Henry is not about to let them mangle this body. This hard-won woman is more than an anatomy lesson; she is Jack Crawford and Isabella Hazzard and all of those he supposes will die after her. She is a study in a new disease.
“I am just going to make a longitudinal incision here, like this,” he says, “and expose the heart.”
Sunk deep inside the chest cavity, the muscle inside is firmly contracted in its left compartments, slightly less so on the right. The right auricle and ventricle are both filled with dark, clotted blood, while the heart in its entirety is rigid and deep red. A cholera heart.
The heavy curtains in the library billow as a cold current of air slides across the room. Henry watches his breath wreathe over the old woman’s open chest, while across from him, Coombs’s eyes disappear behind fogged glasses.
“Here it is, my boys,” says Henry, stepping back from the body for effect. “Cut out an eye, and you will live. Injure the brain, and while intelligence may flee, function continues. You might destroy nerves and tissue and bone and fat, but puncture this organ, interfere with the working of this most primordial piece of man, and all life will cease. Look here,” he says, pointing to the clenched left auricle and ventricle that speed blood to the rest of the body. “You will almost always find the left chambers contracted in a cadaver, because the last impulse of the dying body is to infuse itself with blood. The heart reaches out to the extremities. It dies fighting.”
Henry stares down at the organ that has been the singular fascination of his life. He has learned a hundred reasons why the heart should stop beating a mortal wound, strangling fat, a blockage in the arteriesbut he cannot conceive of a single reason why it should start. The fetal heart emerges first from chaos, bringing with it brain, lungs, bonebut by what celestial magic does it call itself into being? If only a doctor were like a geologist, who every day finds another ancient species impressed in stone; if only Henry might lay a bit of clay over a dying heart and take a fossil of the soul, surely he could find the secret of the first heartbeat impressed upon the last.
“Except for its sunken position and the clotting, which must be due to the disease,” he forces himself to go on, “this is a structurally normal organ. We might expect to find considerable fat deposits between the muscle fibers and the serous layer, but fortunately for us, this woman’s heart is emaciated. You’ll notice it is vaguely conical in shape, with its base looking upward, backward, and to the right side of the body, its apex facing forward, down, and to the left, resting on the diaphragm. Now, descending into the upper right auricle, here, is the vena cava. …”
He hears himself explain the principle vesselsaorta, pulmonary artery, vena cava decendensyet handling this normal heart only turns his mind toward the aberration at Mill Street. He has been thinking of that child nonstop since he saw Gustine’s dress hanging above that horrible one-eyed creature who follows her everywherethere could be no two such alike dresses, certainly no two such alike old women in the impoverished East End. Why did she not tell him she lived in that house? What reason would she have for not admitting her proximity to that child? It is beyond puzzlingit is downright deceitful, when she knows how interested he is in studying it. Stop, he thinks. You are becoming greedy. Concentrate on the body at hand.
“… And the pulmonary artery, here,” he continues mechanically, “speeds blood to the lungs, where it undergoes a chemical process that changes it from a dark to a florid color. This clean blood comes back into the left auricle and ventricle, from whence it is pumped through the aorta to be distributed to all parts of the body. Now, the walls of the left ventricle are about three times as thick as those of the right”
Henry is interrupted by a soft knock on the door. He looks up angrily. What is wrong with Williams? He knows not to disturb him when his students are here.
“It’s me, Henry,” a clear voice announces. “I am sorry to disrupt your lesson.”
Henry and his four students look up to see a young woman neatly turned out in a brick red poplin dress. She stands in the doorway, pale with resolution, for she has never been allowed inside her fiance’s inner sanctum, and trembles now at her own audacity.
“My God, Audrey, what are you doing here?” Henry yelps. His students, blushing to the roots of their hair, instinctively shift to block the naked body from view. The blood-spattered doctor flings down his scalpel and comes around from behind the table.
She swiftly throws up her hand to stop him. “I am here only for a moment, and it is to see your students.” She shifts her focus to the four boys standing shamefacedly before the corpse, looking at the sawdust-strewn floor, at the bookshelves, anywhere but at her. From the pretty silk reticule she carries, Audrey draws forth a quill pen, a little pot of ink, and a crisp piece of parchment. Careful schoolgirl handwriting covers the top quarter of the page, but the rest has been left blankexcept for a single name, in the same hand, written beside the number i.
“I have never met any of you before,” she says, as though she’d been practicing the speech. “But you mustn’t think of me as an excitable girl, to be disturbed by the realities of medicine. Think of me instead as a woman who shares her future husband’s belief in his workno, who even more than shares: as someone who honors it above all other professions.”
But if Audrey’s heart honors her fiance’s profession, her nose rebels against it. The gassy, gamy scent of flesh is so strong in the room that she is forced to lift her handkerchief to her nose or risk having her gorge rise in her throat.
“I have begun a petition to be circulated around the town,” she continues. “My own name is first, and I thought Dr. Chiver’s students might appreciate having their names affixed next.”
“Audrey,” Henry demands roughly. “What on earth are you talking about?”
She lifts her head proudly and turns to him with shining eyes.
“Like the intellectuals you spoke of in Dublin, I have begun a body donation drive. I plan to secure you and the doctors of Sunderland as many donated bodies as you need so that we might end, once and for all, that unholy practice of body-snatching. My own name, willing my body for dissection, is first.”
Bietler can’t help himself: he lets out a strangled nervous bleat.
“What are you talking about?” Henry shouts. “Have you gone mad?”
“I am doing it for you,” Audrey says uncertainly. “There are rumours on the street todayI heard them doing my charity workthat another body has been taken in the East End. Every doctor in Sunderland is under suspicion. If people will only donate”
“People won’t donate, Audrey.” Henry is so embarrassed by her behaviour, he is beside himself. “And it is certainly not a suitable cause for you to espouse. You are a woman; it is inappropriate for you to even know of such things.”
“But I do know,” she replies heatedly, forgetting for a moment the presence of his students. “And it does affect me if my husband is forced into immorality because of other men’s superstition.”
Henry steps from behind the table, determined to lead her out of the room. He is stopped by a vehement, high-pitched voice.
“I will sign.”
They are all startled at Andrew Mazby’s declaration. The student’s face is mottled and his lips tremble. How can I disappoint this brave young woman? he thinks, his admiration overcoming, for a moment, his fear of Henry’s displeasure. She is ready to sacrifice her own body for the man she respects most in this world; why should she expect any less of me? He moves to take the paper and pen she holds out, and in doing so exposes to Audrey’s view the sunken-jawed face of the naked cadaver.
“You are dissecting a woman, I see,” she says bravely, stepping past Mazby to observe the open body on the table. “Oh.”
“Audrey, come with me outside,” Henry commands.
“All the more reason for my petition,” Audrey says, taking a long, woeful look at the body on the table. “Oh, Henry, then you won’t have to cut up women you were sent to help.”
Stung by her words, he turns away and says nothing.
“Thank you, Mr. Mazby.” Audrey nods grimly at the young man as he signs his name. “Mr. Bietler? Mr. Coombs? Mr. Grose? My fiance has spoken so often of you, I feel I might, without offense, solicit your help. Will you not, in the interests of your own profession, publicly donate your bodies for dissection?”
Why doesn’t he thrust this meddling female out of the room, Grose thinks, as he sullenly takes the pen and scrawls his name under Mazby’s. Bietler is equally angry at being shamed into signing away his remains. His family has a mausoleum at St. Peter’s, where the Venerable Bede was laid to rest, an old and established vault into which every Bietler for the last two centuries has been interred. His father is going to kill him when he finds out. Coombs is the only one who signs blithely, completely convinced that with the speed of modern medicine, a cure for death will surely be discovered before it is his time to go.
Audrey nods to the boys and takes up her pen and paper. She throws one last unhappy look Henry’s way, but he does not turn around.
“Let us hope that by example, we will lead this age out of darkness,” she says simply, and pulls the door behind her as she goes. Henry waits a long few seconds before he slams his fist on the table and runs out behind her.
“Audrey! Wait!”
She is at the bottom of the stairs, being helped into her cloak by Williams. His manservant throws the frantic doctor a sly, self-satisfied look, and Henry vows to dismiss him before the day is done. Williams quickly withdraws into the parlour, leaving the two alone in the sunny foyer.
“Henry, how could you?” Audrey sobs, her brave front crumbling at the sight of him. “I promised that woman I was sending help.”
“I went to honour your promise,” he insists, wanting to take her hands, but conscious of the blood and gore upon his own. “She was already dead when I got there. She died of the cholera, darling; there was nothing I could have done.”
“But you didn’t have to steal her in the middle of the night. You didn’t have to make her naked body an object of curiosity for young men.”
“Audrey, you cannot have it both ways.” Henry is so very tired, and he does not want to argue with this weeping woman before him. “You cannot sign away your own body and expect men not to look at it. It is what doctors do. This woman was dead, she had no more use for her body, she was a danger to others in her house, for she very well might have been infectious. Why should she not serve our purposes? Why should something devoid of life not teach us how to save the lives of others?”
Audrey has stopped crying and looks now merely miserable. She cannot articulate what bothered her so greatly in seeing Fos upon her fiance’s table. Perhaps it was her position, prone and so very vulnerable, just as Audrey had last seen her, glowing in her straw. Maybe it was finding a roomful of men standing over a woman’s naked body, and feeling that their wicked thoughts had immediately transferred themselves to her when she walked in. But more than anything else, Audrey is certain this is all her responsibility. If she had never mentioned the glowing woman and the extraordinary child to Henry, this poor creature would not be here today. She would not be hanging open with her breasts under her armpits and her legs spread apart. She would not have been cruelly snatched from her coffin, if Audrey is to believe the rumours she heard this morning. It is all her fault.
“Did you do it, Henry?” she asks at last. “Did you take her yourself?”
He does not know what to say. He has never lied to her, but then she has never asked a question that warranted anything other than the truth. She places her hand over his heart and looks pleadingly into his eyes.
“I don’t want to get you dirty,” he says, pulling away from her.
“Just tell me you don’t do this yourself,” she insists.
“I have someone,” he compromises on a half-truth, “who knows the neighbourhoods.”
His fiancee lets out a long sigh, relieved that at least he is not the monster. He is only doing what must be done until the laws might be changed; she knew that when she agreed to become his wife. “After my petition has circulated,” she says, fitting her head into the hollow of his chest, “you will be able to dismiss that depraved man.”
He cannot imagine what his darling might think if she knew that the “depraved man” who helps him secure his bodies is, in fact, a woman, younger even than herself.
“Don’t be distressed, dearest,” he murmurs into her hair. “That creature on the table is helping us understand the workings of cholera. In finding her, you may have saved any number of lives.”
But Audrey’s conscience is not so easily assuaged as her fiance’s. She steps back and tugs on her black kid gloves, lifts her cottage bonnet off the peg by the door and secures it under her chin. She kisses Henry on his unshaven cheek.