“Nurse Pritchard, I shouldn’t think you prone to such ridiculous bouts of female hysteria.” Dr. Fowler was a rather jowly man for one so thin. The extra skin drooped from his cheeks, punctuating his supercilious frown. “The diagnosis is typhus. Every medical professional who’s cared for Lord Trenwyth from India to here has agreed that this is a textbook case.”
That was assuming Trenwyth actually traveled from India and not Bulgaria or Constantinople like the evidence might suggest.
“So you didn’t make the initial diagnosis yourself?” Imogen pressed.
“Careful, Nurse Pritchard, you are on dangerous ground.” Displeasure snapped from eyes also afflicted with loose skin.
“I wouldn’t dream of meaning any disrespect, Dr. Fowler,” Imogen began, “but I believe I’ve made a strong case for septicemia. If you’d only witnessed how His Grace reacted when I touched his wrist—”
“The poor man had his hand hacked off,” Fowler interrupted impatiently. “Or sawed off, judging by the sight of it, of course it still causes him pain.”
“Yes, but his pain seemed rather extreme and—”
“Is the site swollen, Nurse Pritchard?” He regarded her with such obvious disdain, she could have been a rodent in need of extermination.
“Not that I can tell, but it’s so poorly healed that—”
“Is it visibly quite red or extraordinarily warm to the touch?”
“His entire body is quite warm to the touch.” She’d not actually been hysterical when he’d accused her of it, but Imogen could now hear the desperation creeping into her voice.
“But the wound is not red, is it? There is no abscess or evident swelling.”
She didn’t want to cede the point, but she dare not lie. “If you’d only take a moment to come with me so that I can show you, I might be able to better express—”
“You’re treating me as though I didn’t examine the wound for myself.” The director put undue emphasis on the word. “Are you insinuating that I have been somehow derelict in my assessment?”
“I would never presume, but could we not at least perform a procedure to fix the damaged wrist and create a smoother limb? Then we’d know for certain, and if I’m mistaken, then at least His Grace lives more comfortably.”
“Nonsense! I cannot in good conscience submit such an ailing patient to the risks of the surgical theater,” he blustered. “I’d lose all credibility, and the ability to practice medicine. No, no, dear girl. Besides, the aesthetics of what’s left of Trenwyth’s arm are the least of his problems. He’ll likely not live long enough to notice—”
Impassioned, Imogen slapped her hands on his grand mahogany desk and splayed them open, leaning low over his seated form. “He cannot be allowed to die, Dr. Fowler. It is our duty to do all that we can. To explore every angle and at least consider alternate diagnoses and treatment. What if I’m right? Isn’t it at least worth looking again?”
“I believe I know what is going on here,” Dr. Fowler said after regarding her for an uncomfortably long time. He rose from his desk, and Imogen had to stop herself from taking a step back. She stood to face him, like David squaring off with Goliath. Only without a slingshot. Or an army. Or any real expertise.
Bugger.
“I understand our beloved Majesty tasked you with Trenwyth’s survival. She is an imposing and powerful woman, but even she cannot control the course of disease. The duke is in God’s hands now. The odds of him enduring this illness are insignificant at best.” Fowler crossed his extravagant office to open the door, dismissing her entirely. “Don’t take this so hard, my dear. Your concern and enthusiasm do you credit, and I promise there will be no reprisal on you should the duke expire. Your job is to keep him clean and comfortable, and to leave the diagnoses to the doctors.”
Imogen didn’t trust herself to move. Her entire body shook with equal measures of fear and rage. She abhorred conflict, was petrified of it. But worse than that, she despised ignorant, egotistical men who’d rather see someone die than have their opinions questioned by someone of inferior rank.
By a woman.
God’s hands, indeed. Cole was in their hands, in her hands, and they should be doing everything they could. How did Dr. Fowler not comprehend that?
“Good day, Nurse Pritchard.”
Imogen fled the room, not trusting herself to reply.
By the time she found Dr. Longhurst in the laboratory, her lungs fought for every breath impeded by her corset and a band of desperation.
“You have to do something, or he’s going to die!” she demanded.
“Nurse Pritchard?” Longhurst blinked at her from behind goggles that turned his dark green eyes positively owlish with astonishment and caused his unruly chocolate curls to gather comically high on his crown. “Say what?”
“Col—His Grace, I believe his affliction is septicemia, not typhus. I think his wrist is infected and making him ill and that no one has noticed until now.”
Carefully, as though handling something volatile, Longhurst set the beaker he’d been inspecting on one of the many workbenches strewn about the room. Imogen navigated them like a maze.
“I watched Dr. Fowler change the dressing, myself.” His eyes moved behind the goggles as though scrutinizing the exact same thing in his memory. “No abscess. No evidence of infection or putridity. No vein discoloration. Though … presence of abnormal discomfort for a wound not entirely recent.” His gaze snapped to her, assessing her with clinical precision. “Explain your theory.”
She’d have to keep this brief to retain his attention. “As you know, I’ve survived typhus, I’m intimately familiar with its symptoms. There’s almost always a very painful rash. It feels as though your chest is full of cotton, and you want to cough and cough, but you expel nothing. And then there’s … digestive complaints, which are unpleasant and embarrassing, to say the least.”
“You don’t have to explain the disease to me, Pritchard. I’ve noted it enough.” Impatiently, Longhurst threw the cuffs of his shirtsleeves and began to roll them to the elbow. “I have a great deal of work to do.”
Terrified that she might be bashing up against the wall of another masculine ego, she hurried on. “My point is, Trenwyth has exhibited only one of these symptoms, and only a little. He’s wheezing more than coughing. It’s just not the same. If it were just the absence of the rash, or that he had the rash but not the cough, then I would assume it was just an abnormal manifestation of the disease. But the absence of both symptoms?”
He considered it a moment, nodded curtly, and removed his goggles. “So, why septicemia?”
“You, yourself, noted the pain in his arm. His fever is spiking ever higher, and he’s having an increasingly difficult time breathing. His pulse is both quickening and weakening, almost to a flutter. William said he hasn’t used the necessary once. All these symptoms point to a terrible infection.”
Longhurst hurried to the door on long legs. “I’ll examine Trenwyth again. If all is as you noted, we’ll inform Dr. Fowler and prepare the surgical theater.”
“I already told Dr. Fowler. He won’t hear of it.” Imogen seized his arm. “I fear, Dr. Longhurst, that if you take this to him, we’ll both be reprimanded. And worse, he’ll forbid us to treat the duke.”
“Fowler,” Longhurst spat, as though the name disgusted him. “How a man that stupid was chosen to run such a facility boggles the mind. The blowhard can raise funds, but is utter shit at practicing medicine.” He flicked her a conciliatory look from behind lashes long and thick for a man. “Excuse my vulgarity.”
“I agree.” Imogen sighed out a breath of relief. “Will you help Trenwyth? I think you’re his only hope.”
“I’m more chemist than surgeon. This isn’t really my purview.” He glanced about the laboratory, indecision disturbing the tranquility of his features. “If I performed an unauthorized procedure, I could lose my position.”
“And if you don’t, a man could lose his life!” Imogen cried.
For the first time since she’d known him, Longhurst’s eyes altered from sharp to soft as they alighted on her face. “You are right to remind me of that,” he conceded. “Come, let us see to your patient.”
When she was a young girl, Imogen’s family had a cat named Iris, who’d given birth to a litter of kittens. One of the kittens, Icarus, had taken a particular shine to her and followed her everywhere, going so far as to join her in the bath. At night, it would curl up on her chest and Imogen would hold perfectly still, marveling at the speed of the tiny sleeping animal’s breaths. Once, she’d even attempted to mimic the short motions of the creature’s chest, and found it impossible to maintain.
Now, hovering over Longhurst as he examined Trenwyth, Imogen despaired to note that the duke’s breath was every bit as fast and shallow as Icarus’s had been long ago. This time, when Longhurst palpated the wrist, Cole’s body jerked and spasmed, but only a raw sound escaped. It was as though he couldn’t produce the air for a scream any longer.
Time was running out, she thought with despair.
Longhurst looked up at her, his eyes as serious as she’d ever seen them. “Prepare the anesthesia and surgical kit,” he ordered hoarsely. “And hope that it is not too late.”