“MacKenzie,” he said, with a short jerk of the head in acknowledgment. “Did ye say Mrs. Fraser is wanting Malva? Why?” He frowned as well, the two Christies looking exactly like a pair of barn owls contemplating a questionable mouse. “Only that wee Aidan McCallum’s taken badly, and she’d be glad of Malva’s help. I’ll go and find her.”
Christie’s frown deepened, and he opened his mouth to speak, but Roger had already turned, hurrying into the trees before either of them could stop him.
He found her fairly quickly, though every moment spent searching seemed an eternity. How long did it take an appendix to burst? She was knee-deep in the stream, skirts kirtled high and her rush basket floating beside her, tethered by an apron string. She didn’t hear him at first, deafened by the flow of the water. When he called her name more loudly, her head jerked up in alarm, and she raised the rush knife, gripped tightly in her hand.
The look of alarm faded when she saw who it was, though she kept a wary eye on him—and a good grip on the knife, he saw. His summons was received with a flash of interest.
“The ether? Really, she’s going to cut him?” she asked eagerly, wading toward him.
“Yes. Come on; I’ve already told your father Mrs. Fraser needs you. We needn’t stop.”
Her face changed at that.
“Ye told him?” Her brow creased for a moment. Then she bit her lip and shook her head.
“I can’t,” she said, raising her voice above the sound of the stream.
“Yes, ye can,” he said, as encouragingly as possible, and stretched out a hand to help her. “Come on; I’ll give ye a hand with your things.”
She shook her head more decidedly, pink lower lip poking out a bit.
“No. My father—he’ll no have it.” She glanced in the direction of the cabin, and he turned to look, but it was all right; neither Allan nor Tom had followed him. Yet.
He kicked off his shoes and stepped into the icy creek, the stones rolling, hard and slippery under his feet. Malva’s eyes widened and her mouth fell open as he bent and grabbed her basket, ripped it from her apron string, and tossed it onto the bank. Then he took the knife from her hand, thrust it through his belt, grabbed her round the waist, and picking her up, splashed ashore with her, disregarding the kicking and squealing.
“You’re coming with me,” he said, grunting as he set her down. “Ye want to walk, or do I carry you?”
He thought she seemed more intrigued than horrified at this proposal, but she shook her head again, backing away from him.
“I can’t—truly! He’ll—he’ll beat me if he finds out I’ve been meddling wi’ the ether.”
That checked him momentarily. Would he? Perhaps. But Aidan’s life was at stake.
“He won’t find out, then,” he said. “Or if he does, I’ll see to it that he does ye no harm. Come, for God’s sake—there’s no time to be wasting!”
Her small pink mouth compressed itself in stubbornness. No time for scruples, then. He leaned down to bring his face close to hers and stared her in the eye.
“You’ll come,” he said, fists curling, “or I tell your father and your brother about you and Bobby Higgins. Say what ye like about me—I don’t care. But if ye think your father would beat you for helping Mrs. Fraser, what’s he likely to do if he hears ye’ve been snogging Bobby?”
He didn’t know what the eighteenth-century equivalent of snogging was, but plainly she understood him. And if she’d been anywhere near his own size, she would have knocked him down, if he read the dangerous light in those big gray eyes correctly.
But she wasn’t, and after an instant’s consideration, she bent, dried her legs on her skirts, and shuffled hurriedly into her sandals.
“Leave it,” she said briefly, seeing him stoop for the basket. “And give me back my knife.”
It might have been simply an urge to keep some influence over her until she was safely in the surgery—surely he wasn’t afraid of her. He put a hand to the knife at his belt, though, and said, “Later. When it’s done.”
She didn’t bother arguing, but scampered up the bank ahead of him and headed for the Big House, the soles of her sandals flapping against her bare heels.
I HAD MY FINGERS on the brachial pulse in Aidan’s armpit, counting. His skin was very hot to the touch, maybe a temperature of 101, 102. The pulse was strong, though rapid . . . slowing as he went further under. I could feel Malva counting under her breath, so many drops of ether, so long a pause before the next . . . I lost my own count of the pulse, but it didn’t matter; I was taking it into myself, feeling my own pulse begin to beat in the same rhythm, and it was normal, steady.
He was breathing well. The little abdomen rose and fell slightly under my hand, and I could feel the muscles relaxing by the moment, everything except the tense, distended belly, the visible ribs arching high above it as he breathed. I had the sudden illusion that I could push my hand straight through the wall of his abdomen and touch the swollen appendix, could see it in my mind, throbbing malignantly in the dark security of its sealed world. Time, then.
Mrs. McCallum made a small sound when I took up the scalpel, a louder one when I pressed it down into the pale flesh, still gleaming wet with the alcohol I’d swabbed it with, like a fish’s belly yielding to the gutting knife.
The skin parted easily, blood welling in that odd, magical way, seeming to appear from nowhere. He had almost no fat beneath it; the muscles were right there, dark red, resilient to the touch. There were other people in the room; I felt them vaguely. I had no attention to spare, though. Every sense I had was focused on the small body under my hands. Someone stood at my shoulder, though—Bree?
“Give me a retractor—yes, that thing.” Yes, it was Bree; a long-fingered hand, wet with disinfectant, picked up the claw-shaped thing and put it in my waiting left hand. I missed the services of a good surgical nurse, but we’d manage.
“Hold that, just there.” I nosed the blade between the muscle fibers, splitting them easily, and then pinched up the thick soft gleam of the peritoneum, lifted it and sliced it.
His innards were very warm, sucking wet around two probing fingers. Soft squish of intestine, small half-firm lumps of matter felt through their walls, the brush of bone against my knuckle—he was so small, there wasn’t much room to feel around. I had my eyes closed, concentrating on touch alone. The cecum had to be right under my fingers, that was the curve of the large intestine I could feel, inert but live, like a sleeping snake. Behind? Below? I probed carefully, opened my eyes, and peered closely into the wound. He wasn’t bleeding badly, but the wound was still awash. Ought I take the time to cauterize the small bleeders? I glanced at Malva; she was frowning in concentration, her lips moving silently, counting—and she had one hand on the pulse in his neck, keeping track.
“Cautery iron—a small one.” A moment’s pause; with the flammability of ether in mind, I had doused the hearth and put the brazier across the hall, in Jamie’s study. Bree was quick, though; I had it in my hand in seconds. A wisp of smoke rose from his belly and the sizzle of seared flesh struck into the thick warm smell of blood. I glanced up to hand the iron back to Bree, and saw Mrs. McCallum’s face, all eyes, staring.
I blotted away the blood with a handful of lint, looked again—my fingers were still holding what I thought . . . all right.
“All right,” I said out loud, triumphant. “Got you!” Very carefully, I hooked a finger under the curve of the cecum and pulled a section of it up through the wound, the inflamed appendix sticking out from it like an angry fat worm, purple with inflammation.
“Ligature.”
I had it now. I could see the membrane down the side of the appendix and the blood vessels feeding it. Those had to be tied off first; then I could tie off the appendix itself and cut it away. Difficult only because of the small size, but no real problem . . .
The room was so still, I could hear the tiny hisses and pops from the charcoal in the brazier across the hall. Sweat was running down behind my ears, between my br**sts, and I became dimly aware that my teeth were sunk in my lower lip.
“Forceps.” I pulled the purse-string stitch tight, and taking the forceps, poked the tied-off stump of the appendix neatly up into the cecum. I pressed this firmly back into his belly and took a breath.
“How long, Malva?”
“A bit more than ten minutes, ma’am. He’s all right.” She took her eyes off the ether mask long enough to dart a quick smile at me, then took up the dropping bottle, lips resuming her silent count.
Closing up was quick. I painted the sutured wound with a thick layer of honey, wrapped a bandage tightly round his body, tucked warm blankets over him and breathed.
“Take off the mask,” I said to Malva, straightening up. She made no reply, and I looked at her. She had raised the mask, was holding it in both hands before her, like a shield. But she wasn’t watching Aidan anymore; her eyes were fixed on her father, standing rigid in the doorway.
TOM CHRISTIE looked back and forth from the small naked body on the table to his daughter. She took an uncertain step back, still clutching the ether mask. His head twisted, piercing me with a fierce gray look.
“What’s to do here?” he demanded. “What are ye doing to that child?”
“Saving his life,” I replied tartly. I was still vibrating from the intensity of the surgery, and in no mood for rannygazoo. “Did you want something?”
Christie’s thin lips pressed tight, but before he could reply, his son, Allan, pushed his way past into the room, and reaching his sister in a couple of strides, grabbed her by the wrist.
“Come away, ye wee gomerel,” he said roughly, jerking at her. “Ye’ve no business here.”
“Let go of her.” Roger spoke sharply, and took hold of Allan’s shoulder, to pull him away. Allan whirled on his heel and punched Roger in the stomach, short and sharp. Roger made a hollow crowing noise, but didn’t crumple. Instead, he slugged Allan Christie in the jaw. Allan reeled backward, knocking over the little table of instruments—blades and retractors clattered over the floor in a swash of falling metal, and the jar of catgut ligatures in alcohol smashed on the boards, spraying glass and liquid everywhere.
A soft thump from the floor made me look down. Amy McCallum, overcome by ether fumes and emotion, had passed out.
I hadn’t time to do anything about that; Allan bounced back with a wild swing, Roger ducked, caught the rush of the younger Christie’s body, and the two of them staggered backward, hit the sill, and fell out of the open window, entangled.
Tom Christie made a low growling noise and hurried toward the window. Malva, seizing her chance, ran out the door; I heard her footsteps pattering hastily down the hall toward the kitchen—and, presumably, the back door.
“What on earth . . . ?” Bree said, looking at me.
“Don’t look at me,” I said, shaking my head. “I have no idea.” Which was true; I did, however, have a sinking feeling that my involving Malva in the operation had a lot to do with it. Tom Christie and I had reached something like rapprochement, following my operation on his hand—but that didn’t mean he had altered his views on the ungodliness of ether.