here was frost on the ground as Raven accompanied Simpson along Princes Street, the paving stones slippery underfoot, a glowering sky above promising snow. Adding a further element of hazard was Glen the hound, which seemed determined to entangle him in the coils of its lead as it looped and slalomed before its master.
They were late, or in growing jeopardy of being so, and what was particularly annoying was that Raven had no enthusiasm for reaching his destination. He was being excused from assisting at this afternoon’s lectures because Professor Syme was carrying out surgical procedures and Simpson felt Raven should take the opportunity to observe. Having once studied under Syme, Raven had not wanted for such opportunities and lacked any desire to seize another, but he knew not to question the professor’s will in such matters.
They were proceeding on foot rather than enjoying the speed and comfort of the brougham because, since Simpson’s emergence from his great depression, George Keith had been prevailing upon him with typical evangelism regarding the benefits of simple diet, fresh air and exercise. Simpson had listened with much patience and consideration before ultimately deciding that two out of three would have to suffice. ‘I agree with much of George’s thinking,’ he had told Raven, ‘but I draw the line at there being any benefit to culinary asceticism sufficient to offset the impact on one’s soul. I am of the opinion that we should live to eat, not merely eat to live.’
Spoken like one used to Mrs Lyndsay’s cooking rather than Mrs Cherry’s, Raven mused.
Simpson walked for the most part at a brisk pace, barrelling along the pavement with a redoubtable energy that Raven was relieved to see fully restored. However, their progress was slower than it ought to have been due to the fact that Simpson knew simply everybody. With most people there was time for merely a nod and a greeting, but with others there were longer courtesies to be observed, particularly as Simpson had been in confinement and there was catching up to do.
As they passed Kennington & Jenner’s store, the professor stopped once more, he and a fellow pedestrian having recognised one another with mutual surprise and delight.
‘I would not have known you, sir,’ Simpson told him. ‘You are considerably changed since our student days.’
‘I will take that as a compliment,’ the man replied.
‘Will Raven, this is Mr David Waldie,’ Simpson said warmly, and they shook hands, Waldie’s encased in fine leather gloves against the cold. He was a slight man about the same age as the professor, mid-thirties, and peering through spectacles as though Raven was under his microscope.
‘Are you currently residing in Edinburgh?’ Simpson asked. ‘I had thought that you moved away some time ago.’
‘I am visiting relatives. I live and work in Liverpool these days, as a chemist for the Liverpool Apothecaries Company.’
‘I know the city well,’ the professor replied. ‘My wife hails from there.’
Having heard that Waldie worked as a chemist, Simpson was not long in turning the conversation to his great quest, explaining the work that had been done with ether and his search for an improved alternative.
‘In all your chemical endeavours, have you encountered anything that might exhibit comparable properties?’
Simpson was truly indefatigable in the search for his Holy Grail, but Raven feared his efforts were ultimately going to prove as fruitless as every knight before him. He was beginning to think that ether might prove as good as it got, and far from being the first in a series of ever-improving anaesthetic agents, it would turn out to be an anomaly, the mirage promising water in the desert.
‘There is something called perchloride of formyle,’ Waldie said.
‘The name is not familiar. What is it?’
‘A component of chloric ether cordial, a popular remedy in Liverpool for the management of asthma and the relief of chronic cough. The vapour of this cordial has been tried as an anaesthetic on several occasions but was unsuccessful. Nonetheless, I think it may have potential.’
Simpson’s features were alert, and Glen, sensing his master’s interest, was looking up at Waldie with eagerness as though he might throw the dog some meat.
‘Why?’
‘The lack of success with the cordial is unsurprising as the amount of the perchloride in it is small – the patients would have been in effect breathing only the vapour of alcohol. I have devised a method of manufacture that produces a pure form of the chemical, which is then dissolved in rectified spirit. It is this pure form that I think may be of interest to you. On my return to Liverpool I would be more than happy to send you a sample.’
‘I would be much obliged to you, sir.’
One more thing to sniff after a future dinner, Raven thought.
‘A serendipitous encounter?’ he asked as they resumed their progress.
‘Och, you never know,’ Simpson replied, sounding less enthusiastic than he had during the conversation. ‘I have to investigate every avenue, but if I remember Waldie, he is as apt to blow up his own laboratory as to come up with something ingenious.’
They did not make it as far as West Register Street before Simpson encountered another acquaintance, this time Professor Alison. At this point, Raven was compelled to make his apologies. ‘I will need to take my leave and walk on, sir. Professor Syme deplores late-comers.’
As he deplores most things, Raven thought, hurrying towards the North Bridge.
Raven broke into a run to make up time, though he was conscious this might make him conspicuous. It spoke of his enduring terror of Syme that he was more afraid of incurring his wrath than of increasing the risk of being spotted by Flint’s men.
His thoughts turned to his most recent sighting of them, on his way back from Rock House. In truth, his thoughts had turned to it frequently in the days since, but only because of what his evasive action had precipitated. That briefest frisson between him and Sarah, a glimpse of tantalising possibilities. Raven’s instincts warned him that less trouble awaited down the path leading to the Weasel and Gargantua. Nonetheless, his mind kept returning to the moment, and wondering whether hers did too.
As he walked into the courtyard at the university, Raven became aware of an unmistakable smell of oranges – or bergamot, as Beattie had corrected him – and a moment later the man himself fell into step alongside. A cold breeze was blowing in from the east, from which Raven’s care-worn jacket was offering scant protection. His companion, by contrast, was swathed in a flowing greatcoat that made him appear to glide along the cobbles. It made him appear taller too, while Raven’s lack of a similar garment caused him to shrink into himself.
Though Beattie had visited Queen Street a number of times since the death of Mrs Graseby, Raven had not found himself alone with him and had therefore enjoyed no opportunity to discuss it – or indeed anything else. The estrangement saddened him. He had felt they were on the verge of a valuable friendship, but knew now that this dreadful thing would always be between them – unless this was another lesson he needed to learn: that such professional tragedies were part of the job. He therefore wasted no time in broaching the subject.
‘I have been meaning to enquire, was there any manner of investigation following what happened at Danube Street?’
Beattie wore a burdened expression as he replied: ‘She died under her doctor, so I was able to handle the formalities. However, the smell of ether hung about the place for a long time afterwards, raising curiosity among the staff. They were too ignorant to ask the right questions, but one’s concern is always who they might have mentioned it to.’
This was not the stuff of Raven’s dread fears, but nor was it entirely reassuring.
‘I am sure I didn’t overdose her. She must have had an unforeseen reaction.’
‘Possibly. What is without doubt is that my patient died as a result of your anaesthetic, though why that was, we may never know. Which is why I have endeavoured to ensure that you do not find yourself accused.’
‘And thus I am indebted to you, John. Whatever I can do to repay you, please let me know.’
Beattie gave him a sincere nod. ‘I will hold you to that. In the meantime, I am sure you must be aware of my interest in Miss Grindlay, so if Dr Simpson or anyone else in the household should ask about my character, I assume I can rely upon you to speak generously?’
Raven stopped his tongue before offering the assurance Beattie sought, recalling his discussion with Sarah. He owed Beattie a debt, but felt compelled by an instinctive loyalty towards the household that had taken him in.
‘If you can guarantee that your affections are genuine and that Miss Grindlay is the sole object of them.’
Beattie stopped and shot him a piercing look, a volatile mixture of shock, dismay, insult and outrage. Raven had never seen such fury in his face before, which was usually a picture of concentration or composure.
‘I do not mean to offend,’ he attempted to explain. ‘It is merely that—’
‘You have such a low opinion of Miss Grindlay that you cannot believe I would be drawn to her?’
‘Quite the opposite. We are all of us at Queen Street protective of Mina, so the household would not forgive it if I were party to an advance that proved –’ he sought for the word ‘– insincere.’
Beattie opened his mouth to retort, then appeared to think better of what he was going to say. That familiar composure fell over his face like a mask covering his anger.
‘Do you recall how I told you that true sorrow would grant you perspective?’
‘Indeed,’ Raven answered humbly.
‘It does not merely apply to medicine. I was once betrothed, to a young woman who lit up the world like the morning sun. You would have no difficulty in imagining my intentions towards her sincere. She was the love of my life, as she would have been the love of anyone’s. But she died the day before we were to be married. She was thrown from her horse.’
Raven felt half Beattie’s height. The man’s life had been ripped apart, not once, with the deaths of his parents, but twice, and here he was, questioning his motives.
‘I am so terribly sorry. What was her name?’
Beattie took a while to answer, as though he had to think about it. Clearly he was bracing himself for the pain of saying the word.
‘Julia. Her name was Julia. After her death, I could not imagine a future with anyone else. I saw small aspects of her in every woman who ever showed an interest in me, and that brought me only pain. That was until Mina. Mina is the first woman I have truly seen for herself, because when I look at her I am not searching for Julia.’
Raven and Beattie resumed their march past the main Infirmary building towards the new surgical hospital in High School Yards, where they followed a large group of gentlemen making their way towards the operating theatre. It seemed half the doctors in the city would be present to observe. Syme would love that.
‘I imagine it will be full today,’ said a familiar and unwelcome voice. ‘Novel operations always draw a crowd.’
Raven turned to see James Duncan inviting himself into their company. Perfect.
‘Have you seen Syme operate before?’ Duncan asked.
‘Indeed,’ Beattie replied.
Raven said nothing. He had seen Syme operate many times, but had no desire to share this information with either of this pair, for fear of where the conversation might lead.
‘One could argue that he is the best surgeon in the country,’ Duncan ventured.
Raven certainly had little doubt that Syme himself would agree.
‘Did you know that he was the first in Scotland to perform an amputation through the hip joint?’
‘I did,’ Raven replied, suppressing a note of irritation. He disliked the way Duncan presumed upon his ignorance. As though one could be a medical student in Edinburgh and be unaware of such a thing. ‘The patient died though,’ he added.
‘Not for several weeks after the operation, which matters little enough.’
‘I’d wager it mattered to the patient. Anyway, I don’t think Dr Simpson would agree with you regarding Syme’s pre-eminence.’
‘Probably not,’ Duncan admitted. ‘I gather there is a considerable degree of animosity between them. I am told they nearly came to blows on the stairs outside a patient’s bedroom.’
‘Why?’ asked Beattie, his face lit up with delighted curiosity.
‘I believe Syme wrote an article in a professional journal in which he criticised Dr Simpson’s management of a case.’
‘I see,’ said Raven, though he truly didn’t. The senior men of medicine all seemed to indulge in this sort of behaviour. Criticising one’s colleagues in the pages of a publication was not generally regarded as grounds for fisticuffs, so there had to be more to it.
The operating theatre was indeed already packed by the time they made their way inside. They found some seats at the back, where the view of the operating table was obscured by an undulating sea of headwear, a situation Raven was not inclined to complain about. Then above the low murmur of the crowd, someone shouted ‘Hats! Hats!’ and in a seemingly synchronous movement, all obstructing millinery was removed. Duncan leaned forward eagerly, while Beattie settled back into his seat and folded his arms in a relaxed attitude, as though it were a playhouse they were attending. Alongside them Raven felt stiff with a growing unease about what was to come.
A few minutes later the door at the back of the theatre opened and all conversation ceased. The first to enter was the instrument clerk, a small man in a large apron, who made a final check of the well-stocked table under the window. The door then opened again and Professor Syme entered, followed by Henry, who was his house surgeon.
Raven was always a little surprised by the professor’s meek appearance. This leviathan of surgical practice was a small, thin man with a severe, unsmiling face. He was rather grey – eyes, hair and clothing – and his voice was muffled and lacking in power. He had neither the energy and flamboyance attributed to Liston nor the reputed oratory talents of Knox. In fact, there was something altogether miserable about Professor Syme, and Raven would have doubted the many stories of his voluble ill temper had he not experienced such displays first-hand. Despite this, he was reputed to induce a profound loyalty in those who worked closely with him. Perhaps beneath his sullen exterior lurked a magnanimous and caring individual, but Raven had encountered no evidence to support this notion and plenty to refute it.
Syme had demonstrated an open disdain towards Raven during the brief period he studied surgery under him, the roots of which he attributed to one unfortunate incident in this very theatre. It happened during a warm afternoon in August, shortly after Raven began attending the university. The room had been as crowded as it was today, but also stiflingly hot, and Raven was feeling light-headed even before the operation began. He recalled how the smell of putrefaction from the patient’s diseased limb filled his nose and his throat, as though he might choke on it, then the grinding of the knife cutting through bone, combined with the horrifying screams of the patient, caused him to feel sick. He had tried to rush from the room, but his way was barred by spectators, too intent upon the spectacle to notice his urgent need to get past. Thus delayed, he had vomited as he neared the door, in full view of Syme, thereby marking him in the Professor of Surgery’s sharp and unforgiving eyes. Syme had thereafter treated him like a cur, singling him out for ridicule any time he needed to make a point to Raven’s peers.
He particularly recalled the laughter and mockery of Syme’s surgical dressers. Raven recognised some of the same men standing in the theatre now, lengths of cat-gut spilling from their pockets in readiness to be handed to the surgeon. Before that, they would be required for more brutal purpose.
Syme took a seat on a plain chair to the left of the operating table, bobbed his head to the assembled dignitaries in the front row and then signalled for the first case to be brought in.
‘It has been said that he wastes not a word, nor a drop of blood,’ Duncan whispered in admiration.
The four dressers carried in the patient upon a wicker basket, a rough red blanket pulled about him and his face buried in its folds. When he raised his head, Raven was appalled to recognise the man he had confronted over beating his wife.
Gallagher looked about himself apprehensively, taking in the large congregation of strangers who had gathered to witness his operation. He was initially reluctant to let go of the blanket, gripping it in his good hand and causing a ripple of laughter amongst the audience. This was quickly silenced by a reproving look from the still-seated professor.
Raven too could find no levity in the situation. The mirth from the gallery called to mind the words of Simpson regarding this tendency among medical men to make light of suffering: They jest of scars only because they never felt a wound.
Raven’s hand went automatically to his cheek. He had felt that wound all right, but he was feeling something deeper now: guilt and shame.
Syme rose, and with his back to the patient addressed the room.
‘This man has a putrid inflammation of the right hand,’ he said, pulling back the blanket to reveal the offending appendage, which was grossly swollen and horribly discoloured. The smell of rotting flesh, synonymous with the surgical wards of the hospital, wafted all the way to the back row. Those in the audience less inured to the odour quickly sought out handkerchiefs in an attempt to blot out the olfactory assault. To Raven’s nostrils it smelled all the worse for his part in it.
‘It is obvious,’ continued the professor, ‘that amputation is required.’
Gallagher gestured at Syme with his good hand. ‘I beg you, sir, is there no other way? For I am a joiner, and without my hand, my wife and I shall be for the poorhouse.’
‘If I do not amputate, you will be for the grave, and what of your poor wife then?’
Gallagher offered no response other than a look of fear and confusion. The man was right, though. He would lose his livelihood: had done the moment Raven goaded him into punching that wall. Through his vainglorious actions, Raven had condemned Mrs Gallagher to penury, driven more by his need to punish her husband than to offer her genuine help.
Syme continued to describe the procedure to the audience, oblivious to the anxiety of the patient who was being roughly coaxed from his basket. Raven had more than once witnessed those in Gallagher’s position yelling and sobbing in a panic of fear, trying to escape the hefty assistants as they were hauled to the operating theatre like it was the gallows. Gallagher said nothing as one of the dressers held up the diseased limb.
‘The forearm ought to be amputated by making two equal flaps from before and behind,’ said Syme, pointing out to the audience where he intended to make his incisions. ‘The arm should be held in the middle state of pronation and supination in order to relax the muscles equally and facilitate the operation. The hand may be removed at the wrist joint but the larger stump thus obtained is not found to facilitate the adaptation or increase the utility of an artificial hand, and the large articular surface which remains, though it may not materially delay a cure, must always cause a deformity.’
Raven wondered at the professor’s insensitivity. Without doubt the patient was fortunate such an eminent surgeon was to perform his operation and thereby save his life, but surely it was a form of torture to describe within his hearing the mutilation that was about to occur. His mind was taken back to George Heriot’s school, where a singularly vicious mathematics master administered the strap if one’s marks did not meet his standards. Raven was a dedicated and eager pupil, but he unavoidably fell short on occasion and condemned himself to be beaten. What he recalled more than the pain was the ritual with which it was delivered. The master produced the dreaded tawse and laid it on Raven’s desk, forcing him to contemplate it for the duration of the lesson, before finally delivering his thrashing at the end. To this day, Raven still harboured murderous thoughts towards the man.
While the professor was speaking, the patient had been strapped down to the table and the four surgical dressers had positioned themselves around him to provide additional physical restraint if required. It was at this point that Raven remembered Henry saying that Syme had given up on ether, finding it unreliable, not fit for purpose. This operation would be performed without it.
Raven felt suddenly sick, his guilt compounded further by his knowledge of the horror that was about to unfold. It was impossible to predict which patients would submit to their fate meekly and which would struggle; sometimes the frailest-looking specimen would find remarkable strength and attempt to withdraw the limb just as the surgeon’s blade descended for the first cut. Gallagher seemed of the more submissive sort, weeping quietly and then whimpering when the professor was handed his knife.
An assistant grabbed the patient’s arm just above the elbow, holding it steady. Syme began immediately, cutting through flesh with absolute certainty and precision, undistracted by Gallagher’s screams. Raven was both awed and horrified by this, for he felt the anguish of every cry, and had he been holding the knife, such screams would surely have stayed his hand. He failed to understand how surgeons could work as they did, insensitive to the pain that they inflicted, speed their only clemency. It was this more than anything that had told Raven he had no future in it, and which led him to seek another field.
The professor himself was silent in his task, gesturing to the instrument clerk for what he required. Raven felt sweat run down between his shoulder blades and realised he was holding his breath. Alongside him, Beattie and Duncan watched with detached fascination, evidently troubled by no such emotional responses. They might as well have been watching Mrs Lyndsay carve a joint of ham.
Within minutes the gangrenous hand was slung into a sawdust-filled box at the end of the table, spurting vessels were quickly tied, the edges of the wound stitched together and a dressing applied to the stump.
An animalistic keening emanated from Gallagher, his eyes shuttling incredulously between the box of sawdust and the stump where his hand used to be.
One of the surgical assistants quickly wiped the blood that had collected on the operating table. Another threw fresh sawdust onto the floor, covering the majority of the blood spatter and lumps of tissue as though hiding the evidence of what had just occurred.
Raven understood now why Simpson had all but insisted he attend, why his mentor was relentless in his quest for that Holy Grail, and why he would never again complain about sniffing strange potions.