The Serpent's Shadow (31 page)

And all those preparations would be in vain if that poor girl's appendix was not intact.

“Bring her in,” Maya instructed, when her hands were just short of raw. O‘Reilly and the nurse went to fetch the girl, and Maya saw to the laying out of her surgical instruments on the tray beside the wooden table.

O‘Reilly carried the girl in his arms into the antechamber, wrapped in a clean sheet. She was in too much pain to walk, and in any case, Maya didn't want her to do anything that might stress that appendix. He put the patient down on the narrow table, giving her a reassuring smile before placing the prepared mask over her mouth and nose and pouring the anesthetic on it.

When she was asleep, they wheeled her into the operating theater and lifted her onto the immovable table. Maya adjusted the sheet she'd been wrapped in to expose as little as possible of anything other than the surgical site, then wiped the site itself clean with carbolic solution. Some physicians not only operated on patients while clothed in their street clothes, but on patients who were
also
still in their street clothes, and as unwashed as they had come in. This girl had been stripped and bathed by the nurses in the outer room, then wrapped in a sheet that, like the aprons, was boiled and bleached and kept wrapped in sterile paper until use. The plain, deal table had an inclined plane at one end to elevate the girl's head, and was covered with a piece of brown oilcloth. Once again, Maya's rules held sway here today; the oilcloth was new and had been wiped down with carbolic before being placed on the table.

As usual, the theater was full—there was a reason why it was called a “theater.” The actual amount of floor space devoted to the operation was small in comparison with the tiers of stand-places rising for four rows, at an angle of sixty degrees, so that those standing in each tier could have an unobstructed view of the operation below. The students' entrance was at the top tier, and a metal rail on which to lean ran at the edge of each tier. It was the students' business to attend every operation he (or rarely, she) possibly could, so even Maya's operations were fully attended, and she was by no means a famous surgeon.

Today, however, there seemed to be more visitors than students. The usual hum of voices contained was louder, and there were finer coats in the audience than was normal.

But Maya didn't bother to examine her audience, not when there was far more pressing business at hand. The quicker she could operate, the less blood the girl would lose; next to infection, it was blood loss that carried off the largest number of patients after an otherwise successful procedure. But by the same token, she had to be as careful as she was quick. Being too hasty could mean she would slice through major vessels, or worse.

She adjusted the box full of sawdust under the table with her foot, nudging it to the place where she judged that the blood from the surgery was likeliest to begin dripping. Then, with a glance at O‘Reilly and a nod to her dressers, Maya went to work.

She had planned this operation carefully in her mind as she and the patient were in preparation. The position and size of the uterus meant that nothing was straightforward. She took her scalpel and made her incision.

Almost immediately a cry arose from the tiers of “Heads! Heads!” since her own head and body obscured the small incision she had made. She ignored the cry, concentrating on making her cut so that she did not cut across any major vessels. Blood began to trickle down the girl's hip, onto the oilcloth, to drip into the pan of sawdust beneath the table.

Maya did not get the benefit of having as many dressers and attendants as she wanted; there was no one vying for the honor of holding her instruments or otherwise helping with the operation. There was no one to sponge the sweat from her forehead; hence the strip of toweling. She was not going to go through all the work of sterilizing patient and surface only to have it all ruined by sweat dropping into the open incision and contaminating the site.

She nodded at O‘Reilly, who put the ether mask aside and sprayed carbolic over the incision and her hands. He would do this all through the operation, for as long as there was an open wound. The clamor of “Heads!” continued; she continued to ignore it.

“I can't believe it!” drawled a loud and obnoxiously familiar voice. “She's not taking the uterus!”

Maya kept herself from jerking around to stare at Simon Parkening in anger and disbelief only by a supreme act of will. That same will kept her hands steady as derisive shouts arose from other lungs. The voices were uniformly unfamiliar, so that was why the theater was so full! Parkening had packed it with his own cronies with the purpose of disturbing the operation!

“Steady, Doctor,” came O‘Reilly's low voice, as a bleat of “Stupid cow!” was aimed at her from the tiers above. “This is aimed at me, not at you.”

“I will be damned,” she replied through gritted teeth, “if I let a pack of piddling puppies interfere with my work!”

But of course it was going to interfere, if only by disturbing her helpers. Twice Maya had to raise her voice to be heard by her dressers over the boos, hisses, and catcalls coming down from above. Her hands started to shake, and she had to stop to steady herself as her impotent anger overwhelmed her own control.

“Now you see why females should never be surgeons!” Simon mocked. “Sentimental! She's going to kill her patient with sentiment over a fetus! By God, they shouldn't be allowed to practice medicine at all! They haven't the nerve for it! Just look at the puny little incision she's made! Is she afraid of a little blood?”

A burst of laughter followed.

“Not that it would make any difference, one Irish bitch more or less in the world to pour out litters of whelps every year,” Simon continued with an air of casual glee. “They breed like flies anyway.”

Maya actually heard O‘Reilly's teeth grinding.

“Steady, Doctor,” she told him.

But that last comment seemed to have gone a bit far, even for Parkening's friends. The catcalls died down, and there was an uneasy note to the muttering. “I say—” someone objected weakly. “Out of order, old man.”

Maya had her hands full—literally. She was trying to locate the appendix by feel, through an incision too small for the pregnant uterus to bulge through. There were whispers of “What's she doing?” that she ignored completely, deciding at last to trust to instinct—and a little magic. She willed the thing to come into her fingers, concentrating a trickle of power into her hands, thinking of the diseased organ as an enemy that was trying to escape her.
It's there, somewhere ... hot, diseased ... like the polluted soil outside my house.

She sensed it now, a swollen malevolence lurking beneath her fingers. Concentrating all her will on it, the hecklers and the theater receded to a mere whisper of annoyance in the background, inconsequential as the buzzing of a fly on a windowpane. She used her anger as power, poured it into her questing fingers.
Into my hands, damn you.

Then, suddenly, she got a tip of her finger on it. It felt so hot it seemed to burn her hand, but she twisted her fingers after it, caught it, and slid it carefully into view in the center of the incision.

Triumph! At last she had the damned thing! And it
hadn't
burst, though its inflamed, swollen condition warned that it could, at any moment. She secured it with her left hand and held out her right.

“Clamp,” she muttered; for a miracle, her dresser heard her, and the clamp slapped into her outstretched hand.

Within moments, the offending organ resided in the tray of sawdust at the foot of the table, and she was in the process of suturing the incision shut while O‘Reilly madly sprayed the last of the carbolic over hands, incision, and anything else that happened to fall in his path.

Done!
She stepped back from the table; her dressers swabbed up the last of the blood with sponges, and covered the incision with clean sticking plaster. A wave of exhaustion threatened; she drove it back and turned to gaze up at the theater full of now-silent onlookers.

She was still so angry that her vision was blurred. She couldn't make out faces—but she sensed Simon Parkening to her left, and deliberately focused her attention slightly to the
right,
away from him, as if he was of no consequence to her.

“I direct the attention of you gentlemen to the plaques upon the wall, behind me there,” she said, in a voice that dripped ice and scorn. “I assume, that since you who are medical students are all
learned
gentlemen, your Latin and Greek will extend to reading and understanding them. And in case your eyesight is faulty, I will tell you that the first reads,
Miseratione non Mercede
while the second is the Oath of Hippocrates. I suggest that you might benefit by taking them both to heart.” She paused, while utter silence fell over the group. “And for those of you who were not capable of conning your Latin and Greek at University, I will translate the first, which means,
From compassion, not for gain.
I would take that to remind us that even those who cannot
pay
are to be treated here as equal to those whose deaths would make a stir in the world. As for the second—” Her gaze swept the room, blindly. “I think you will find an injunction both to
do no harm
and to respect the wishes of the patient. For the rest, I suggest you apply to someone who has made the effort to learn the language of our legendary forefather.”

That said, she nodded to the dressers, who transferred the still-unconscious girl to the wheeled stretcher, and walked to the basin to wash her bloody hands and arms.

There's a couple in your eye, Parkening
—
and you can't claim I singled you out either.

There was not a single sound except for retreating footsteps echoing hollowly on the risers, as she washed, rinsed, and dried her hands, then took off the apron and dropped it on the floor to be collected and washed. Nor did she again turn to look at the retreating students. Her anger sustained and kept her head erect and her spine straight as she walked into the antechamber and shut the door.

Her patient was already gone, taken back to the ward. Hopefully, she would not start an infection. Hopefully, she would not have a miscarriage. Hopefully, the incision would be healed by the time she went into labor.

Hope, essentially, was all she had—but Maya had at least bought her that hope.

She sat down on the chair in the antechamber, drained, as one of the scrubwomen came in to fetch the soiled linen, take away the blood-soaked sawdust tray, and scrub down the table and floor—hopefully (there it was again!), in that order, and not the reverse. The old woman left the door open; there was no other sound now but her, shuffling about, picking up what had been dropped, cleaning, blithely ignoring the fact that it was human blood that soaked everything. Then again, the old woman probably cleaned this chamber many times a day, and had for years. By now, she probably never even noticed. Maya pulled off the band of toweling around her head, braced her elbows on her knees, and buried her face in her hands—not in despair, but in a white-hot rage.

Damn him! Damn him! Why
and
how
had Simon Parkening got in? The last she heard, his uncle had banished him from the hospital! Maybe the heckling had been originally intended for Doctor O‘Reilly, but most of it had been aimed at her.

I'll lodge a complaint with Doctor Clayton-Smythe!
That was her initial thought, but what good would that do? As angry as she was, she still knew that she was only here on sufferance, and if she complained about something that Clayton-Smythe would regard as trivial—which he
would,
since a certain amount of criticism and heckling was expected of students to a very junior surgeon—that sufferance might well end.
Especially
since the target of her complaints was his nephew, who was evidently back in his uncle's good graces.

Yes, she had successfully completed a difficult and delicate operation. But it was not one which would have met with the Director's full approval; Clayton-Smythe would have been in agreement with those who would have wielded the scalpel ruthlessly and with a callous lack of compassion for the girl's own wishes.

Maya's rage built yet again, and her hands clenched on the band of toweling she held against her forehead, when the outer door swung open, and another pair of hands seized her wrists.

She looked up into Amelia's face; her friend dropped her wrists and stepped back a pace involuntarily.

“I just saw O‘Reilly, and I came here at once to congratulate you....” She faltered. “Good heavens, Maya, you look as if you wish to kill something!”

“I do,” she replied, from between clenched teeth. And in a few terse sentences she related what had happened
off
the operating table.

Amelia's face went red, then white, and her own fists clenched. “So Simon Parkening, who
failed
every course he read for at Oxford, is now to be allowed to dictate what a competent physician and surgeon should do?” she hissed. “What next? Is he going to get his uncle to rescind your license to practice?”

“He can't do that,” Maya began, but Amelia interrupted her, shaking her head.

“He
can,
and you have no recourse! Don't you know that if they wish to, these
men
can have laws passed to take away our very right to practice at all?” Her eyes were stormy, and her jaw set stubbornly.

Unfortunately, Maya knew very well that they could—which was one very good reason why she would not lodge a complaint against Parkening's behavior with his uncle. Her anger made her stomach roil.

“Listen,” Amelia continued, seizing her hands again. “I also came to ask you if you would march in the suffrage parade today. Oh, I know you've always said no before, but don't you see why we need people like you, who are doctors and educated, to stand with us? Do you know why we're marching?”