Chapter Nine

Dwarfed by the large double windows stretching almost to the ceiling, Cam waited as Mai led Fong Hoy across the surgery.

As usual, Mai’s grandfather rested a hand on her shoulder, following her in his quaint trotting gait. His shoulders bony and stooped, the old man seemed frailer than ever. Yet he radiated calmness, which surprised Cam. Most patients displayed some degree of nervousness when about to undergo any sort of surgical procedure, but the old man appeared to have no qualms whatsoever about the operation.

Such faith was flattering and should have filled Cam with confidence; instead it was unnerving, and it was the surgeon, not the patient, who was riddled with anxiety. Holding out his hands, he saw a slight tremor and flexed them, hoping to settle the near-imperceptible unsteadiness. Beckoning to Mai, he pointed to the chair in front of the window, positioned so that Fong Hoy would sit with his right side to the light.

‘Seat him here if you will, please.’

Mai led her grandfather to the chair and helped him to sit comfortably. She touched his shoulder and smiled — but her hands, tightly clasped as she left the room, betrayed her trepidation.

‘You understand you must remain perfectly still at all times?’ Cam said to Fong Hoy, touching the old man’s arm.

Fong Hoy nodded.

Cam pointed to a chair near the door. ‘Henry, bring that chair over to the side of Fong Hoy, if you will — no, further to the front, if you please. Yes, that’s better. Now, you will sit there and hold the patient’s head firmly. At no stage must you let it go. Do you understand?’

‘Yes.’ Daunted by the responsibility being placed on him, Henry’s reply came out as a croak.

If Cam could have moved his frozen features, he would have smiled at Henry to reassure him. As it was, he could manage only a slight nod in acknowledgement.

‘I will stand here behind Fong Hoy,’ Cam said, beckoning to Poppy. ‘If you would stand beside me as you did when assisting George and me …’

Lacing his fingers together, Cam inhaled deeply, casting his gaze over the tray on the trolley, mentally checking and approving the necessary instruments. A legacy from George Lyndhurst, they had lain untouched since George’s death.

Only the ophthalmoscope — that wonderful tool for looking into the interior of the eye, and for judging the transparency of the crystalline lens, George’s pride and joy — had been used since then. And that had only been a week ago, when Cam had made his preliminary examination of Fong Hoy’s eyes. He’d found a traumatic retinal detachment of the left eye, rendering it beyond any form of treatment.

‘I had bad blow to that eye,’ Fong Hoy had explained.

But the right eye had been cataractous, and, as luck would have it, at the exact stage of ripeness for extraction. Overripeness would have presented the problem of shrivelling and hardening of the cortical substance, reducing the operation’s chances of success. However, the lens had been entirely opaque, the fundus reflecting no red light under ophthalmoscopic examination, and Cam had been satisfied that an operation could be performed with an almost sure degree of success.

At the initial examination, Cam had been impatient at Fong Hoy’s reluctance to remove a silk square he’d been wearing underneath his bun hat. But when the material had slid from the old man’s head Cam had been unable to repress a horrified gasp. Where he would have expected to see a pigtail, there was instead a patch of taut scar tissue, so thin it was almost transparent over the bone at the back of Fong Hoy’s scalp.

‘Good God! What happened to cause a wound like that?’

‘Someone mistake me for Indian and want my scalp, I think. Cut my pigtail too close,’ the old man said in a cynical attempt at humour.

‘When — where did this happen?’ Cam had asked, sickened.

‘In Australia — Lambing Flat. Miners attack the Chinese camp. That’s where I was bashed in eye, too. Lucky not to bleed to death. My son not so lucky … he was killed there.’

Fong Hoy swallowed the bile rising in his throat. Even now, thirteen years later, the stench of his own fear and that of hundreds of brothers was familiar to him. The image of his only son, Fong Soo, lying dead, his head stoved in by a miner’s pick, flashed before him. Fong Soo’s Irish whore, hysterical and screaming as she ran for her life, had left behind their child, Mai, an infant of three. Fong Hoy recalled his own scream of pain as the knife sliced through the thin skin of his scalp, and the numbing wonder as the blood streamed down his neck, staining his shirt … and then the blessed darkness.

 

Cam was grateful for Fong Hoy’s stoic composure: it eliminated the need for anaesthesia. As gently as he could, he placed a thinly padded cushion behind the old man’s head to protect the taut covering of skin. He picked up the Graefe knife. Unbidden, the image of a dying child’s terrified face, pleading for breath, speared his brain … Dryness bit the back of his throat as the demons of doubt returned.

Perhaps the successful extractions he had performed under George’s guidance had been purely a matter of luck? What if the vitreous should prolapse while he was removing the lens? He would have to pass the spoon behind the lens to remove it, perhaps doing more harm than good. Although George had discussed the remedial procedure for such an occurrence, Cam had no actual experience of it.

He stared at the knife in his hand, his gaze fixed on the long, thin blade’s sharp edge, imagining it slipping through his grip, making the wound far too large, causing damage beyond repair. His hand jerked at the irony of the thought. The last time — the only time — he’d caused damage beyond repair had been because he’d made too small an incision. And that had been an entirely different operation. Sweat slicked over his palms.

Sensing the eyes of his small audience on him, Cam replaced the knife on the tray and walked out of the surgery to the verandah. Gulping in deep, steadying breaths, he recalled George’s parting words: Cam, you have a rare touch for ophthalmology. You must not waste your talent and ability in this place.

‘Cam?’

He turned and saw Poppy, eyes clouded with concern. Had she guessed at his panic, his fear of failure?

‘Fong Hoy is waiting for you.’

Her gaze was steady and there was no doubt in her voice. As swiftly as his panic had risen, it subsided.

This time, when he picked up the Graefe knife, his hand was steady and his mind cleared of all thought bar the task ahead. Holding the cutting edge upwards, he inserted it into the sclerotic. George’s words came back to him as clearly as if he were standing beside him.

Inwards now, till you can see the point through the cornea just inside the eye, then advance it across in front of the iris and pupil until its point reaches the spot directly opposite the initial puncture.

Push the point out of the eye and continue with a smooth upward movement so the knife cuts through the junction of cornea and sclera.

As the knife emerged, he tilted it slightly backwards to cut a small flap of conjunctiva for sealing the incision at the end of the operation.

All noise faded from his hearing as he performed an iridectomy. Not too much, now, but don’t leave any in the wound, Cam reminded himself, grasping a fold of iris with fine forceps and cutting it off with scissors.

Next, the capsulotomy. Using a long-handled, tiny, scimitar-shaped needle, he cut a central hole in the front of the lens capsule and deftly proceeded to extract the lens, pushing it out of the eye by stroking the cornea upwards towards the incision with the external pressure of a small rubber spoon. At last, satisfied no cortical masses remained, he allowed himself to relax enough to flex his shoulders, easing an aching tenseness he’d been unaware of, so engrossed had he been in the operation.

Elation bubbled inside him, but a sliver of superstitious caution remained. He was sure the results would be satisfactory, but there was still the risk of suppuration ruining all his good work.

Once the dressings were in place, Cam helped Fong Hoy from his chair, sending Poppy to tell Mai of the operation’s successful outcome. The young Chinese girl appeared in the surgery so quickly he guessed she had been hovering outside the door waiting for news.

Fong Hoy had been the perfect patient. Cam doubted that he would have moved a muscle throughout the entire operation, even without the aid of Henry’s steadying hands. Even so, he still felt it prudent to fasten strips of cloth around his patient’s wrists and secure them to the end of the bed. Von Graefe had always advised it for the first few days, so George had said. Better that small discomfort than to have the surgeon’s work ruined because of the patient unthinkingly rubbing the inevitable irritation caused by the operation.

Mai’s joyful expression altered to consternation as Cam secured the ties around her grandfather’s wrists, but Cam was quick to reassure her. ‘Don’t be alarmed. It’s the normal procedure. Your grandfather’s wound must be protected. There’s bound to be a certain amount of irritation and we must ensure he will not be able to rub his eye.’

‘Thank you. You are a good man, doctor,’ Mai said, smiling with relief.

Giving a curt nod, Cam turned on his heel, anxious for her not to see the dampness misting his own eyes.