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Authors: Elaine Coffman

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Earlier, Duncan suggested they celebrate the coming occasion with a little whisky. Just the family members were present, for tomorrow, when the abbot arrived, the entire Murray clan and members of nearby clans would all be in attendance.

When they were all gathered there, David stood and gave a toast: “To Elisabeth Douglas, for her love and concern for her fellow man, for her desire to open this hospital, and for the persistence she possessed in persuading me that we needed a hospital. And to my sister, Ailis, who stood firm on the common ground of siding with another woman and prevented many an argument by convincing me I was being overly stubborn.”

Elisabeth raised her glass and took one sip, then began to speak to everyone who came forth to congratulate her. And the biggest surprise was the big bear hug she received from Cailean, his green eyes alive with laughter when he admitted he had been terribly pigheaded about the hospital. “'Twould seem I have spent so much time in opposition to everything in the past, that I became quite fond o' the role. 'Tis a good feeling to be on the supportive side for a change,” he said, and everyone laughed.

He looked as if he planned to say more, but at that moment, the door opened and several people burst into the room, following a man carrying a lad who looked to be about sixteen. A woman walked beside them, crying.

Elisabeth was shocked because she never dreamed she would have a patient so soon, and this one did look like he was in excruciating pain. She approached the man and woman. “Is this your son?”

“Aye, he isna well. 'Tis a fever and pain in the stomach.”

“Has he been sick to his stomach or vomiting?”

“Aye, he did once, but no more.”

Elisabeth put her hand on the boy's head. He was burning with fever. “We need to get him on a table so I can examine him,” she said, but she knew he was in horrible pain, and with the fever and vomiting, she was thinking appendicitis. “How old is he?”

“Seventeen years,” the woman said. “He is our oldest son.”

The age was right, for appendicitis was most common among people ten to thirty years old, and it was the cause of more emergency abdominal surgeries than any other illness. She led them into one of the private rooms to shield everything from the growing number of people who were gathering. David and Ailis followed, along with their cousins. A short time later, David called Duncan aside and said something, and Duncan nodded and stood beside the door.

Ailis was looking rather lost, so Elisabeth began to tell her what was going on. “I think it is his appendix, but there are a couple of tests I can do that will confirm it. Do you know what an appendix is?”

“I know that in Latin the word means ‘the part that hangs.'”

“That's very good, Ailis. A human appendix hangs at the end of the large intestine. It is located in the lower right portion of the abdomen. It has no known function. Removal of the appendix doesn't cause any harm to the body's function.”

She looked at the lad, “What is your name?”

“Ian.”

“Well, Ian, I am going to press on your… stomach.” She almost said abdomen but decided to switch to stomach, which was a much older word. “I want you to tell me if you feel any pain.” She tested for rebound tenderness first by placing her hand on his abdomen and pressing, then letting go.

The moment she released her hand, he writhed and said, “I dinna like ye to do that. It hurts.”

“I'm going to do one more test.” It was called Rovsing's sign. She put her hand on his abdomen again, this time on the lower left side of the abdomen. She pressed, then released, and he howled.

“Can you show me where it hurt?”

He pointed to the right side of his abdomen. She told Ailis, “You see I pressed on the left side of his abdomen, and when I released it, he felt pain, but when I asked where, he pointed to the right side. That is another indication of what is wrong with him.”

She turned to David. “He has appendicitis. I'm certain of it.”

When she saw the puzzled look on his face, she took him aside. “Appendicitis is an inflammation of the appendix. Once it occurs, there is no cure, so it is considered a medical emergency. If you get to it soon enough, the sick person recovers without a problem. However, if they do not have it taken care of quickly, the appendix can burst, causing infection and possibly death. It is quite common and anyone can get it, but it occurs most often between the ages of ten and thirty. His appendix has to come out. If it ruptures, it could kill him. I pray it has not ruptured already. Can you explain this to his parents?”

He nodded, and while David spoke with the parents, Elisabeth asked Ailis to go with her, and they moved quickly to the pharmacy where she gathered opium for pain and the instruments she would need to operate. These Ailis placed on a clean cloth on a small table next to the long table where the boy lay. She covered the instruments with another cloth.

“I am going to give you something for pain,” Elisabeth said, “It will make you very sleepy and that is good. While you are asleep, I am going to make a small cut in the lower part of your stomach, about right here,” she said, lightly touching the place. “I will remove your appendix, which is what causes you to feel so bad. I will keep giving you this sleeping medicine after it is over so you can sleep some more.”

She brushed the hair back from his face and smiled at him. “You are a strong, young lad, Ian, and you are healthy. You will be much better when this is over. Are you afraid?”

He shook his head, and she smiled again and patted his hand. She turned to Ailis. “Hand me the opium and alcohol mixture,” she said, as she picked up a spoon to feed him the amount she had calculated for his age, height, and weight.

Once he was asleep, she asked David if he would explain to Ian's parents that it was best to have the door closed to keep her from being distracted. “Tell them Ailis will come out from time to time to tell them how their son is doing. And tell them that Ian will not feel any pain.”

Once he was asleep, Elisabeth used a clean cloth to wash a large area of Ian's stomach with soap and water, then dried it and cleaned it a second time with some of David's whisky. She used a sharp scalpel to cut an incision, pausing from time to time to let Ailis use the clean squares of cloth to blot away the blood. The appendix was a darkish red and highly inflamed, but thankfully, it had not ruptured. She removed it and closed the wound.

She cleaned the area, including the stitches, with alcohol, then lightly applied a mixture of mashed garlic to keep down infection. As she finished, she said to Ailis, “Stay with the lad while I go speak to his parents.”

David and the parents were next to the door, and it looked as if there were even more people gathered than there were before. She smiled at the parents, then said to David, “It was his appendix and it was very close to rupturing. Thankfully, they brought him here just in time. He won't be able to go home for several days, as I will keep him here to make sure there are no signs of infection.” David spoke to them and the woman started to cry. She took Elisabeth's hand and kissed it. Elisabeth smiled and said, “Come, would you like to see your son now?”

They followed her into the room and David stood back to make certain no one else came into the room, as Elisabeth requested. He did not understand why that was necessary, but he did as she said.

“He will sleep for a while due to the medicine I gave him for pain. But as you can see, his color is good, and…” She put her hand on his forehead. “His fever is going down. Both are very good signs.”

“I hope he can come home soon,” the father asked.

“It all depends on how well he does, but he should only stay here for about three days so we can be certain he is free of infection. Then he can go home and return a week later for me to remove the stitches.”

“He will be well then?” the father asked.

“He will be feeling much better, but full recovery usually takes four to six weeks. He is young and strong, and we have no complications, so it could be less.”

When David returned with his cousins, Elisabeth had them take Ian to one of the beds in the ward so she could sleep on the bed next to it. After that was done, David left with the family, while Elisabeth and Ailis cleaned things up. As they worked, she noticed Ailis was on such a high, having taken part in her first surgical operation, and she had a million questions. But, eventually even Ailis began to run out of steam.

“I will be back in the morning and I'll have breakfast sent to ye,” Ailis said. “Should I have anything sent for the lad?”

“No, that would not be wise. I will keep him on liquids for a day at least, just to observe how he does. You might see if the cook can make a clear broth for him from chicken or pheasant. And perhaps some milk.”

Ailis nodded. “I will see ye in the morning.”

Although tired, Elisabeth smiled and said, “Good night, Ailis. I couldn't have done this without you,” and she was rewarded by a beaming smile from Ailis.

Elisabeth checked on Ian again, and carried a ewer of water and a cup and placed it by the bed, in case Ian woke up during the night. He needed to drink a lot of liquids. She washed her face and hands and lay down, too tired to remove her shoes or pull the blanket over herself.

Sometime later, she was awakened by someone tugging at her shoe, and even in the dim light coming through the window, she saw it was David. “What are you doing here? You should be asleep like normal people.”

“I wanted to be certain ye were getting some rest.”

“As you can see, I was.” She sat up and lit a candle, then stood to check on Ian. His brow was cool and his breathing steady. She pushed the long hair back from his face. “Poor lad, I know he was in so much pain. He will be sore for a while, but the pain will not return.”

David came up behind her and wrapped her in his arms. “I wonder if he will ever know just how fortunate a lad he was. I am humbled by yer knowledge, the skill of yer hands, and the learning that took place betwixt yer time and mine.”

“Oh, you have no idea,” she said, turning toward him. “It would be a true wonderment to you, milord.”

“I prefer David coming from yer sweet lips. ‘Milord' sounds too formal.”

“You're an earl! You are formal,” she said, laughing.

He pulled her close and whispered, “Call me David. I love the way you say it.”

“I've never known anyone with so many names.” She started to say something more, but he was looking at her in a way that made her forget what it was.

“You are wonderment to me,” he said, and turned her toward him. His kiss was tender and gentle, and the arms he wrapped around her strong and protective. When the kiss ended, she placed her head against his chest and her arms slipped around him. She had no idea what the future held for her or him, or even if she would remain here at Aisling, which made her think of her ghostly friend and confidant. Once again, Black Douglas was remaining in the background and making himself scarce, which usually meant there were rougher roads ahead. Because of this, she was gripped by uneasiness and a fear of the unknown, although she did not know exactly why.

She had no idea why her mind went off in that direction, other than she was tired and not riding herd on her thoughts. She closed her eyes and listened to the steady sound of David's heart beating and wondered how she would survive being separated from him, if it came to that. She didn't want to leave here. She didn't want to leave him. He was a good man. She had feelings for him, deep ones, but she wasn't certain if that was a deep and intense love that would last a lifetime, and sometimes she worried that this might be moving too fast, and David had yet to say anything more than that he simply desired her.

Still, the thought of being separate from him was like being bound and chained in a solitary room deep in the bowels of some dreadful dungeon. She knew that even then, he would be with her, as was the memory of Ronan, for memories, like history, could never be completely erased.

Chapter 14

Evil enters like a needle

and spreads like an oak tree.

—Ethiopian proverb

Word of the hospital at Aisling spread faster and further than anyone anticipated, and the only thing that saved it from being horribly overcrowded was its location, for the Black Isle was not as accessible as other shires due to its being surrounded by water on three sides: Cromarty Firth to the north, the Beauly Firth to the south, and the Moray Firth to the east, and on the fourth western side, its boundary was delineated by rivers.

Yet, in spite of the marvelous things going on with the hospital, Elisabeth could not shake the cloud of gloom and doom hanging over her head. She thought perhaps it was born of her feeling for David, for she did care for him more and more with each passing day, and he always seemed to be riding in the back of her mind. Usually, that thought was followed by the thought that she had also cared for Ronan, and look what happened to that.

Would David be taken as well?

Perhaps she was doomed… doomed to a life of unfulfilled and hopeless passion, or perhaps she was allowing her mind to wander off in a ridiculous direction when she should be enjoying each and every moment.

She gave herself a mental shake, for she had other things to think about. A new patient had just arrived by the name of Lord Leven, and he had a badly injured leg. Elisabeth had looked at it and told Ailis to ready things for surgery, for she feared the foot was in too bad a condition to save.

She began to gather the seeds for an herbal preparation she was about to make. She needed her wits about her, for what she was about to mix could be lethal if she made the slightest mistake, so the doctor in her took over.

Ailis came into the room. “I ha' everything set up for surgery.”

Elisabeth turned her head and asked, “How is Lord Leven?”

“His wife is with him now, and it calms him, although I do feel sorry for her, puir woman. He isna a verra kind soul, ye ken. Still, it is a terrible thing to know ye are to lose yer leg at such a young age.”

“Yes, it is horrible, but not as horrible as dying from it. If he had only come sooner, I could have saved it, but it's too late. The blood supply to the lower part of the leg and foot is damaged. My fear now is that it may not be possible for the tissues to heal even after I amputate. That is why I am not taking just the foot but part of the leg above it. He does have on his side the fact that he is young and healthy.”

“Aye, he is young and so is Lady Leven, but I fear he will be difficult to deal with, for it willna be easy to accept the loss of even part of his leg.”

“I agree,” Elisabeth said, “but dying is a worse fate.” She glanced back at the seeds awaiting her. “I will mix this now and we can administer it to Lord Leven. It will put him completely under… that is, he will be sound asleep.”

Ailis stepped closer. “What is it that ye are preparing?”

“They are seeds from three poisonous herbs: black henbane, opium poppy, and hemlock.”

“Hemlock! 'Tis what killed Socrates.”

“Yes, it is what killed him, and by dying he made it famous,” Elisabeth said.

“How did ye learn aboot it?”

“I learned about poisons in medical school, but I learned this recipe from the friars at Soutra Aisle. It is mixed by volume of three parts to one part to one part, respectively.”

Ailis had that worried frown of concentration spread across her brow. “How do ye get it doon him?”

“That is why I had you fetch the draught of ale. We will mix the seeds in the ale and have him drink it, and he will fall into a deep sleep.” She did not add that the friars had provided her with an ancient addendum, spoken in Middle English:
And
thanne
men
may
safly
kerven
him
(and then men may safely carve him).

Elisabeth picked up the mixture and followed Ailis out the door. She saw David standing a few feet away, with a pleading look in his eye. He had tried at length when they brought Lord Leven to the hospital to convince her to let Lord Leven be, for he was a hothead and rather arrogant. “Ye may save his life, but he willna thank ye fer it. 'Twould be best if ye let him be.”

Well, she thought, it is too late to turn back now, so she gave David a weak smile and said, “I took an oath to save lives. I cannot let him die knowing there was a chance I could save him.”

“I hope ye dinna come to regret it, lass.”

“So do I,” she said. Then taking a deep breath, she stepped into the surgery room.

The mixture of herbs worked like a charm, and Lord Leven was completely out and wouldn't feel a thing. But, oh, he would upon awakening, so she would keep him on a less potent combination for the next few days to keep him quiet and resting as much as possible.

As far as the operation went, it was highly successful, and over the next few days, she was very relieved that there was no sign of infection, which did occur even in the twenty-first century. Due to the gradual reduction in pain medication, Lord Leven was awake most of the time, and as the medication continued to be reduced, his hostility and criticism escalated. Whenever his wife tried to smooth things over, he would turn on her until the poor woman sat silently at his side, her eyes downcast.

When it came time for him to leave, Elisabeth, Ailis, and David told him good-bye.

When he did not respond, his wife turned to him. “They have saved yer life. Can ye no thank them for it?”

His eyes were wild and his nostrils pinched as he turned on her, and for a moment Elisabeth thought he might strike the poor woman. “It is beyond me to comprehend why you think I should thank them for giving me a future as a cripple.”

“I understand your hurt,” Elisabeth said. “The loss of a limb is a terrible thing, but I had to remove it to save your life. If I had not, you would be dead now.”

Lord Leven's nostrils flared, but he said nothing, before he turned and signaled for his entourage to follow. Moments later, they departed.

When the last of them was gone, Ailis said, “I have never met a more ungrateful person in my life.” She looked at Elisabeth and said, “Dinna feel poorly about what he said. He is an ungrateful, hurtful man.”

“I gave him his life back,” Elisabeth said. “What he does with it is up to him, although I will say he does have a highly developed instinct for being unhappy.”

It had been a long day, and as they walked back to the castle, they forgot about Lord Leven.

Later that evening, after the family had dined, David and Elisabeth played chess in David's study. It was a nice change for her and kept her mind off the unpleasantness with Lord Leven, which did visit her mind from time to time. However, before long, such thoughts took a backseat, for she was really into the game and focused upon it, especially when she began to make an interesting observation, for she had a sneaking suspicion that David was cheating.

“You let me win!” she said.

“Nae, lass, I didna. Ye beat me fairly and with no help from me.”

She crossed her arms in front of herself and said, “David, I have
never
been a good chess player.” Which was true.

“Ye never had a good teacher,” he replied, laughter in his eyes.

“Oh,” she said, laughing. “So you are heaping piles of praise upon yourself now? I had no idea you were so vain.”

He had a mischievous gleam in his eye, as he said, “I take pride in my game, lass, but no' excessively so.”

He laughed and offered her a goblet of red wine that had arrived by ship from France a few weeks ago, and they talked for a while. But before long, he put his glass down and held out his hand. Elisabeth tilted her head to one side and gave him a questioning look. “Come here,” he said, softly. “I just want to hold ye and whisper in that pearly shell of an ear.”

Shivers went over her whenever he waxed poetic like this. What followed was a rush of desire so strong that it left her hoping he would do more than ply her with words whispered in her ear. She smiled, stood, and placed her trembling hand in his, and he pulled her around the small game table and into his arms. She wished things could always be like this with him and that she would always be this happy. He kissed her soundly and long enough that she was ready to make love on the floor, if that was what he wanted, but he bit her earlobe gently and whispered, “Go to yer room and ready yersel' for bed, and I will join ye shortly.”

Her heart pounded so loud that she feared he might hear it, for she knew he wasn't coming to her room for tea.
Am
I
ready
for
this?
Oh
yes, you are so ready…
That was true, and when she stood and walked out of the room with him, she kept repeating in her mind…
When
he
turns
to
go
down
the
other
hallway, do
not
take
off
running, and whatever you do, do not take the stairs two at a time. Remember what Alysandir's sister, Barbara, told you: A lady glides in a smooth, effortless manner, like a swan upon water… not clumsy as a puffin taking off or landing.

She went to her room, thankful her customary bath awaited her, and she undressed quickly and stepped into the warm water, wanting to bathe before it grew cold. Afterward, she dressed for bed, and when she climbed into it, she stretched and found a comfortable position, then sighed, for it had been a very, very long day, both physically and emotionally. That, coupled with the slow-spreading warmth of the wine, overpowered her and she fell sound asleep.

She did not awaken when he opened the door and came into the room, nor did she stir when he removed his clothes and slipped into bed beside her, but when she felt the weight of him on top of her, she stirred and said, “David…” And then she said groggily, still half asleep, “I think I'm too sleepy.”

He chuckled. “Naught to worrit aboot, lass. I ha' a way to open those sleepy, green eyes and make yer soul sing,” he said, and her eyes opened to see his face shadowy above hers. She smiled at him, aware that her heart was now pumping blood furiously to meet the demand that would soon be required of it. She put her arms around him and opened her mouth to say something, but he stopped whatever it was she was going to say with a kiss that made her forget all about talking.

She felt the press of his legs against hers, and she moved them to accommodate him, and he entered her swiftly, pressing himself against her until he could go no further. She felt the heat of each strong, sweeping movement, each rhythmic stroke that her body responded to, until she felt her body no longer belonged to her but completely to him, for she was powerless to stop as she lifted her hips, groaning at the exquisite feeling radiating through her.

Again and again he moved against her, and her body responded on its own, rising up to meet him, her legs encircling his and drawing him closer still. Something wild and wonderful was happening to her, and she felt as if she teetered on the edge of a deep precipice, and if she fell into it, she would never return.

She had never felt such an out-of-control response and she tried to pull away, but he held her fast. She wanted to tell him to stop, that she was going insane and couldn't handle it, but her breathing was running ahead of her thinking, gasping and panting, until her hands curled to grip the bedding beneath her. She wondered if anyone ever died from such exquisite sensation and need.

She felt the sweat-slickened body slide over hers, and her hands went around his back to caress the hardness of his firm buttocks, the skin so smooth, the muscles hard and unrelenting. And then the spasms came, rolling like storm-driven waves, riding high and crashing mightily against the shore, pounding and pounding repeatedly, until she cried out and felt the uncontrolled jerk of her body that seemed to separate itself from her and follow his lead.

“This is where ye belong,” he said, taking her in his arms and rolling to his side, her head resting on his shoulder. He stroked her arm gently, as if he had to be touching her even now. “I find I am even jealous of the sun for looking down upon ye. Ye are in my thoughts constantly. I think aboot making love to ye when I should have my mind on what I am aboot. I am a prisoner of my own desire, and the thought of losing ye sets fire to my mind and stills my heart.”

Her arms went around him and she wanted to tell him she loved him, but something held her back. Uneasiness settled over her and she wondered if Black Douglas was about and if he had bad news to deliver to her. She hugged David with all her might, and she fell asleep holding him tightly, as if by doing so, she could keep the magic of the moment and him in her life forever.

But when she awoke before daybreak the next morning, she saw that David was gone and the place where he had been was cold. She dressed and went to the hospital without breakfast. Since the hospital was once a chapel, there was a small altar room that had not been changed, for both she and Ailis felt it would not be right to do away with it, and besides, the sick and the infirm that entered the hospital would often desire the opportunity to attend to the spiritual side of their healing.

She paused just inside the door and lit a few candles. Although she was Presbyterian (which was not heard of yet) and not Catholic, she knew that to God, it would not matter. She knelt at the altar and prayed for guidance and answers to what troubled her soul, for she should be at her happiest moment after such a night of lovemaking, but something prevented her from feeling the uplifting joy that should follow it.

She prayed for strength and wisdom and guidance that she would make the right decisions, but she no more than said her amen when she had a clouded vision of a great black bird as it flew over the gentle terrain and sloping fields of the Black Isle before it disappeared into the mist that shrouded Mulbuie Ridge, and she knew it was a sign full of portent.

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