He blinked at me. His eyes were heavy, still clouded with fever.
“It didna take much effort, Sassenach,” he said, his voice soft and husky from sleep. “Not dying was harder.”
He made no pretense of not understanding me. In the light of day, I saw clearly what exhaustion and the aftereffects of shock had stopped me seeing the night before. His insistence on his own bed. The open shutters, so he could hear the voices of his family below, his tenants outside. And me beside him. He had, very carefully, and without saying a word to me, decided how and where he wanted to die.
“You thought you were dying when we brought you up here, didn’t you?” I asked. My voice sounded more bewildered than accusing.
It took him a moment to answer, though he didn’t look hesitant. It was more as though he was looking for the proper words.
“Well, I didna ken for sure, no,” he said slowly. “Though I did feel verra ill.” His eyes closed, slowly, as though he were too tired to keep them open. “I still do,” he added, in a detached sort of voice. “Ye needna worry, though—I’ve made my choice.”
“What on earth do you mean by that?”
I groped beneath the covers, and found his wrist. He was warm; hot again, in fact, and with a pulse that was too fast, too shallow. Still, it was so different from the deathly chill I had felt in him the night before that my first reaction was relief.
He took a couple of deep breaths, then turned his head and opened his eyes to look at me.
“I mean I could have died last night.”
He could, certainly—and yet that wasn’t what he meant. He made it sound like a conscious—
“What do you mean you’ve made your choice? You’ve decided not to die, after all?” I tried to speak lightly, but it wasn’t working very well. I remembered all too well that odd sense of timeless stillness that had surrounded us.
“It was verra strange,” he said. “And yet it wasna strange at all.” He sounded faintly surprised.
“I think,” I said carefully, keeping a thumb on his pulse, “you’d better tell me just what happened.”
He actually smiled at that, though the smile was more in his eyes than his lips. Those were dry, and painfully cracked in the corners. I touched his lips with a finger, wanting to go and fetch some soothing ointment for him, some water, some tea—but I put aside the impulse, steeling myself to stay and hear.
“I dinna really know, Sassenach—or rather, I do, but I canna think quite how to say it.” He still looked tired, but his eyes stayed open. They lingered on my face, a vivid blue in the morning light, with an expression almost of curiosity, as though he hadn’t seen me before.
“You are so beautiful,” he said, softly. “So verra beautiful, mo chridhe. ”
My hands were covered with fading blue blotches and overlooked smears of buffalo blood, I could feel my hair clinging in unwashed tangles to my neck, and I could smell everything from the stale-urine odor of dye to the reek of fear-sweat on my body. And yet whatever he saw lit his face as though he were looking at the full moon on a summer night, pure and lovely.
His eyes stayed fixed on my face as he talked, absorbed, moving slightly as they seemed to trace my features.
“I felt verra badly indeed when Arch and Roger Mac brought me up,” he said. “Terribly sick, and my leg and my head both throbbing with each heartbeat, so much that I began to dread the next. And so I would listen to the spaces between. Ye wouldna think it,” he said, sounded vaguely surprised, “but there is a great deal of time between the beats of a heart.”
He had, he said, begun to hope, in those spaces, that the next beat would not come. And slowly, he realized that his heart was indeed slowing—and that the pain was growing remote, something separate from himself.
His skin had grown colder, the fever fading from both body and mind, leaving the latter oddly clear.
“And this is where I canna really say, Sassenach.” He pulled his wrist from my grip in the intensity of his story, and curled his fingers over mine. “But I... saw.”
“Saw what?” And yet I already knew that he couldn’t tell me. Like any doctor, I had seen sick people make up their minds to die—and I knew that look they sometimes had; eyes wide-fixed on something in the distance.
He hesitated, struggling to find words. I thought of something, and jumped in to try to help.
“There was an elderly woman,” I said. “She died in the hospital where I was on staff—all her grown children with her, it was very peaceful.” I looked down, my own eyes fixed on his fingers, still red and slightly swollen, interlaced with my own stained and bloody digits.
“She died—she was dead, I could see her pulse had stopped, she wasn’t breathing. All her children were by her bedside, weeping. And then, quite suddenly, her eyes opened. She wasn’t looking at any of them, but she was seeing something. And she said, quite clearly, ‘Oooh!’ Just like that—thrilled, like a little girl who’s just seen something wonderful. And then she closed her eyes again.” I looked up at him, blinking back tears. “Was it—like that?”
He nodded, speechless, and his hand tightened on mine.
“Something like,” he said, very softly.
He had felt oddly suspended, in a place he could by no means describe, feeling completely at peace—and seeing very clearly.
“It was as if there was a—it wasna a door, exactly, but a passageway of some kind—before me. And I could go through it, if I wanted. And I did want to,” he said, giving me a sideways glance and a shy smile.
He had known what lay behind him, too, and realized that for that moment, he could choose. Go forward—or turn back.
“And that’s when you asked me to touch you?”
“I knew ye were the only thing that could bring me back,” he said simply. “I didna have the strength, myself.”
There was a huge lump in my throat; I couldn’t speak, but squeezed his hand very tight.
“Why?” I asked at last. “Why did you... choose to stay?” My throat was still tight, and my voice was hoarse. He heard it, and his hand tightened on mine; a ghost of his usual firm grip, and yet with the memory of strength within it.
“Because ye need me,” he said, very softly.
“Not because you love me?”
He looked up then, with a shadow of a smile.
“Sassenach... I love ye now, and I will love ye always. Whether I am dead—or you—whether we are together or apart. You know it is true,” he said quietly, and touched my face. “I know it of you, and ye know it of me as well.”
He bent his head then, the bright hair swinging down across his cheek.
“I didna mean only you, Sassenach. I have work still to do. I thought—for a bit—that perhaps it wasna so; that ye all might manage, with Roger Mac and auld Arch, Joseph and the Beardsleys. But there is war coming, and—for my sins—” he grimaced slightly, “I am a chief.”
He shook his head slightly, in resignation.
“God has made me what I am. He has given me the duty—and I must do it, whatever the cost.”
“The cost,” I echoed uneasily, hearing something harsher than resignation in his voice. He looked at me, then glanced, almost off-handed, toward the foot of the bed.
“My leg’s no much worse,” he said, matter-of-factly, “but it’s no better. I think ye’ll have to take it off.”
I SAT IN MY SURGERY, staring out the window, trying to think of another way. There had to be something else I could do. Had to.
He was right; the red streaks were still there. They hadn’t advanced any further, but they were still there, ugly and threatening. The oral and topical penicillin had evidently had some effect on the infection, but not enough. The maggots were dealing nicely with the small abscesses, but they couldn’t affect the underlying bacteremia that was poisoning his blood.
I glanced up at the brown glass bottle; only about a third full. It might help him hold his ground for a little longer, but there wasn’t enough—and it wasn’t likely to have sufficient effect, administered by mouth—to eradicate whatever deadly bacterium was multiplying in his blood.
“Ten thousand to ten million milligrams,” I murmured to myself. Recommended dosage of penicillin for bacteremia or sepsis, according to the Merck Manual, the physician’s basic desk reference. I glanced at Daniel Rawlings’ casebook, then back at the bottle. With no way of telling what concentration of penicillin I had, administration was likely still more efficacious than the combination of snakeroot and garlic Rawlings advised—but not enough to matter, I was afraid.
The amputation saw was still lying on the counter, where he had left it the day before. I’d given him my word—and he’d given it back.
I clenched my hands, a feeling of unutterable frustration washing over me, so strongly as almost to overwhelm my sense of despair. Why, why, why hadn’t I started more penicillin brewing at once? How could I have been so feckless, so careless—so bloody fucking stupid?
Why had I not insisted on going to Charleston, or at least Wilmington, in hopes of finding a glassblower who could make me the barrel and plunger for a hypodermic syringe? Surely I could have improvised something for a needle. All that difficulty, all that experimentation, to get the precious substance in the first place—and now that I desperately needed it...
A tentative movement at the open door made me turn round, struggling to get my face under control. I’d have to tell the household what was happening, and soon. But it would be better to choose my time, and tell them all together.
It was one of the Beardsleys. With their hair grown out and neatly trimmed to the same length by Lizzie, it was increasingly difficult to tell them apart—unless one was close enough to see their thumbs. Once they spoke, of course, it was simple.
“Ma’am?” It was Kezzie.
“Yes?” No doubt I sounded short, but it didn’t matter; Kezzie couldn’t distinguish nuances of speech.
He was carrying a cloth bag. As he came into the room, I saw the bag twitch and change shape, and a small shudder of revulsion came over me. He saw that, and smiled a little.
“This for Himself,” he said, in his loud, slightly flat voice, holding up the bag. “Him—old Aaron—said this works good. A big snake bite you, get you a little ’un, cut his head off, drink his blood.” He thrust out the bag, which I very gingerly accepted, holding it as far away from me as I could. The contents of the sack shifted again, making my skin crawl, and a faint buzzing noise issued through the cloth.
“Thank you,” I said faintly. “I’ll... ah... do something with it. Thank you.”
Keziah beamed and bowed his way out, leaving me in personal custody of a sack containing what appeared to be a small but highly annoyed rattlesnake. I looked round frantically for some place to put it. I didn’t dare throw it out of the window; Jemmy often played in the dooryard near the house.
Finally, I pulled the big clear glass jar of salt over to the edge of the counter, and—holding the bag at arm’s length—used my other hand to dump the salt out on the counter. I dropped the bag into the jar and slammed the lid on it, then rushed to the other side of the room and collapsed on a stool, the backs of my knees sweaty with dread.
I didn’t really mind snakes in theory; in practice, though...
Brianna poked her head through the door.
“Mama? How’s Da this morning?”
“Not all that well.” My face evidently told her just how serious it was, for she came into the room and stood beside me, frowning.
“Really bad?” she asked softly, and I nodded, unable to speak. She let her breath out in a deep sigh.
“Can I help?”
I let out an identical sigh, and made a helpless gesture. I had one vague glimmering of an idea—or rather, the return of an idea I’d had in the back of my mind for some time.
“The only thing I can think of doing is to open the leg—cut down deep through the muscle—and pour what penicillin I have left directly into the wounds. It’s much more effective against bacterial infections if you can inject it, rather than give it orally. Raw penicillin like this”—I nodded at the bottle—“is very unstable in the presence of acid. It’s not likely enough would make it through the stomach to do any good.”
“That’s more or less what Aunt Jenny did, isn’t it? That’s what made that huge scar on his thigh.”
I nodded, wiping my palms unobtrusively over my knees. I didn’t normally suffer from sweaty hands, but the feel of the amputation saw was much too clear in my memory.
“I’d have to do two or three deep cuts. It would likely cripple him permanently—but it might work.” I tried to give her a smile. “I don’t suppose MIT taught you how to engineer a hypodermic syringe, did they?”
“Why didn’t you say so before?” she said calmly. “I don’t know if I can make a syringe, but I’d be really surprised if I can’t figure out something that does the same thing. How long have we got?”
I stared at her, my mouth half open, then shut it with a snap.
“A few hours, at least. I thought if we didn’t get any improvement with the hot poultices, I’d have to either cut or amputate by this evening.”
“Amputate!” All the blood drained out of her face. “You can’t do that!”
“I can—but my God, I don’t want to.” My hands curled hard, denying their skill.
“Let me think, then.” Her face was still pale, but the shock was passing as her mind began to focus. “Oh—where’s Mrs. Bug? I was going to leave Jemmy with her, but—”
“She’s gone? Are you sure she isn’t just out in the hencoop?”
“No, I stopped there when I came up to the house. I didn’t see her anywhere—and the kitchen fire is smoored.”
That was more than odd; Mrs. Bug had come to the house as usual to make breakfast—what could have induced her to leave again? I hoped Arch hadn’t suddenly been taken ill; that would just about put the cocked hat on things.
“Where’s Jemmy, then?” I asked, looking round for him. He didn’t normally go far away from his mother, though he was beginning to wander a bit, as small boys did.
“Lizzie took him upstairs to see Da. I’ll ask her to look after him for a while.”
“Fine. Oh!”
My exclamation made her turn back at the door, eyebrows raised in question.
“Do you think you could take that”—I gestured distastefully at the big glass jar—“outside, darling? Dispose of it somewhere?”
“Sure. What is it?” Curious, she walked over to the jar. The little rattlesnake had crawled out of its bag and was coiled up in a suspicious dark knot; as she extended a hand toward the jar, it lunged, striking at the glass, and Brianna jumped back with a yelp.
“Ifrinn!” she said, and I laughed, in spite of the general stress and worry.
“Where did you get him, and what is he for?” she asked. Recovering from the initial shock, she leaned forward cautiously and tapped lightly on the glass. The snake, who appeared irascible in the extreme, struck the side of the jar with an audible thump, and she jerked her hand away again.
“Kezzie brought him in; Jamie is meant to drink his blood as a cure,” I explained.
She reached out a cautious forefinger, and traced the path of a small droplet of yellowish liquid, sliding down the glass. Two droplets, in fact.
“Look at that! He tried to bite me right through the glass! That’s a really mad snake; I guess he doesn’t think much of the idea.”
He didn’t. He—if it was a he—was coiled again, tiny rattles vibrating in an absolute frenzy of animosity.
“Well, that’s all right,” I said, coming to stand beside her. “I’m sure Jamie wouldn’t think much of the idea, either. He’s rather strongly anti-snake at the moment.”
“Mmphm.” She was still staring at the little snake, a slight frown drawing down her thick red brows. “Did Kezzie say where he got it?”
“I didn’t think to ask. Why?”
“It’s getting cold out—snakes hibernate, don’t they? In dens?”
“Well, Dr. Brickell says they do,” I replied, rather dubiously. The good doctor’s Natural History of North Carolina made entertaining reading, but I took leave to doubt some of his observations, particularly those pertaining to snakes and crocodiles, of whose prowess he appeared to have a rather exaggerated opinion.
She nodded, not taking her eyes off the snake.
“See, the thing is,” she said, sounding rather dreamy, “pit-vipers have beautiful engineering. Their jaws are disarticulated, so they can swallow prey bigger than they are—and their fangs fold back against the roof of their mouth when they aren’t using them.”
“Yes?” I said, giving her a slightly fishy look, which she ignored.
“The fangs are hollow,” she said, and touched a finger to the glass, marking the spot where the venom had soaked into the linen cloth, leaving a small yellowish stain. “They’re connected to a venom sac in the snake’s cheek, and so when they bite down, the cheek muscles squeeze venom out of the sac... and down through the fang into the prey. Just like a—”
“Jesus H. Roosevelt Christ,” I said.
She nodded, finally taking her eyes off the snake in order to look at me.
“I was thinking of trying to do something with a sharpened quill, but this would work lots better—it’s already designed for the job.”
“I see,” I said, feeling a small surge of hope. “But you’ll need a reservoir of some kind...”
“First I need a bigger snake,” she said practically, turning toward the door. “Let me go find Jo or Kezzie, and see if that one did come from a den—and if so, if there are more of them there.”
She set off promptly on this mission, taking the glass jar with her, and leaving me to return to a contemplation of the antibiotic situation with renewed hope. If I was going to be able to inject the solution, it needed to be strained and purified as much as possible.
I would have liked to boil the solution, but didn’t dare to; I didn’t know whether high temperatures would destroy or inactivate raw penicillin—if, in fact, there still was active penicillin in there. The surge of hope I had experienced at Brianna’s idea dimmed somewhat. Having a hypodermic apparatus wouldn’t help, if I had nothing useful to inject.
Restlessly, I moved around the surgery, picking things up and putting them down again.
Steeling myself, I put my hand on the saw again, and closed my eyes, deliberately reliving the movements and sensations, trying also to recapture the sense of otherworldly detachment with which I had killed the buffalo.
Of course, it was Jamie who’d been talking to the otherworld this time. Nice of you to give him the choice, I thought sardonically. I see you aren’t going to make it easy on him, though.
But he wouldn’t have asked for that. I opened my eyes, startled. I didn’t know whether that answer came from my own subconscious, or elsewhere—but there it was in my mind, and I recognized the truth of it.
Jamie was accustomed to make his choice and abide by it, no matter the cost. He saw that living would likely mean the loss of his leg and all that that implied—and had accepted that as the natural price of his decision.
“Well, I don’t bloody accept it!” I said out loud, chin uplifted toward the window. A cedar waxwing swinging on the end of a tree limb gave me a sharp look through his black robber’s mask, decided I was mad but harmless, and went about his business.
I pulled open the cupboard door, threw open the top of my medicine chest, and fetched a sheet of paper, quill, and ink from Jamie’s study.
A jar of dried red wintergreen berries. Extract of pipsissewa. Slippery elm bark. Willow bark, cherry bark, fleabane, yarrow. Penicillin was by far the most effective of the antibiotics available, but it wasn’t the only one. People had been waging war on germs for thousands of years, without any notion what they were fighting. I knew; that was some slight advantage.
I began to make a list of the herbs I had on hand, and under each name, all the uses that I knew for that herb—whether I had ever made such use of it or not. Any herb used to treat a septic condition was a possibility—cleansing lacerations, treating mouth sores, treatment of diarrhea and dysentery... I heard footsteps in the kitchen, and called to Mrs. Bug, wanting her to bring me a kettle of boiling water, so I could set things to steeping at once.
She appeared in the doorway, her cheeks bright pink from the cold and her hair coming down in untidy wisps from under her kerch, a large basket clutched in her arms. Before I could say anything, she came and plunked the basket down on the counter in front of me. Just behind her came her husband, with another basket, and a small open keg, from which came a pungent alcoholic scent. The air around them held a faint ripe smell, like the distant reek of a garbage dump.
“I did hear ye say as how ye’d not enough mold on hand,” she started in, anxious but bright-eyed, “so I said to Arch, I said, we must go round to the houses nearabouts, and see what we can fetch back wi’ us for Mrs. Fraser, for after all, bread does go bad so quick when it’s damp, and the good Lord kens that Mrs. Chisholm is a slattern, for all I’m sure she’s a good heart, and what goings-on there may be at her hearth I’m sure I shouldna like even to think about, but we—”
I wasn’t paying attention, but was staring at the results of the Bugs’ morning raid on the pantries and middens of the Ridge. Crusts of bread, spoilt biscuit, half-rotted squash, bits of pie with the marks of teeth still visible in the pastry... a hodgepodge of gluey orts and decaying fragments—all sprouting molds in patches of velvet-blue and lichen-green, interspersed with warty blobs of pink and yellow and dustings of splotchy white. The keg was half-filled with decaying corn, the resultant murky liquid rimmed with floating islands of blue mold.
“Evan Lindsay’s pigs,” Mr. Bug explained, in a rare burst of loquacity. Both Bugs beamed at me, begrimed with their efforts.
“Thank you,” I said, feeling choked, and not only from the smell. I blinked, eyes watering slightly from the miasma of the corn liquor. “Oh, thank you.”
IT WAS JUST AFTER DARK when I made my way upstairs, carrying my tray of potions and implements, feeling a mixture of excitement and trepidation.
Jamie was propped on his pillows, surrounded by visitors. People had been coming by the house all day to see him and wish him well; a good many of them had simply stayed, and a host of anxious faces turned toward me as I came in, glimmering in the light of the candles.
He looked very ill, flushed and drawn, and I wondered whether I ought to have chased the visitors away. I saw Murdo Lindsay take his hand, though, and squeeze it tight, and realized that the distraction and support of his company through the day was probably much more helpful to him than the rest that he wouldn’t have taken in any case.
“Well, then,” Jamie said, with a good assumption of casualness, “we’re ready, I suppose.” He stretched his legs, flexing his toes hard under the blanket. Given the state of his leg, it must have hurt dreadfully, but I recognized that he was taking what he thought would be the last opportunity to move the limb, and bit the inside of my lip.
“Well, we’re ready to have a go at something,” I said, smiling at him with an attempt at confident reassurance. “And anyone who would like to pray about it, please do.”
A rustle of surprise replaced the air of dread that had been sprung up at my appearance, and I saw Marsali, who was holding a sleeping Joan with one hand, grope hastily in her pocket with the other to pull out her rosary.
There was a rush to clear the bedside table, which was littered with books, papers, candle-stubs, various treats brought up to tempt Jamie’s appetite—all untouched—and, for some unfathomable reason, the fret-board of a dulcimer and a half-tanned groundhog hide. I set down the tray, and Brianna, who had come up with me, stepped forward, her invention carefully held in both hands, like an acolyte presenting bread to a priest.
“What in the name of Christ is that?” Jamie frowned at the object, then up at me.
“It’s sort of a do-it-yourself rattlesnake,” Brianna told him.
Everyone murmured with interest, craning their necks to see—though the interest was diverted almost at once as I turned back the quilt and began to unwrap his leg, to a chorus of shocked murmurs and sympathetic exclamations at sight of it.
Lizzie and Marsali had been faithfully applying fresh, hot onion and flaxseed poultices to it all day, and wisps of steam rose from the wrappings as I put them aside. The flesh of his leg was bright red to the knee, at least in those parts that weren’t black or seeping with pus. We had removed the maggots temporarily, afraid the heat would kill them; they were presently downstairs on a plate in my surgery, happily occupied with some of the nastier bits of the Bugs’ gleanings. If I succeeded in saving the leg, they could help with the tidying-up, later.
I had carefully gone through the detritus bit by bit, examining the blue molds with my microscope, and putting aside everything that could be identified as bearing Penicillium into a large bowl. Over this miscellaneous collection I had poured the fermented corn liquor, allowing the whole to steep during the day—and with luck, to dissolve any actual raw penicillin from the garbage into the alcoholic liquid.
Meanwhile, I had made a selection of those herbs with a reputation for the internal treatment of suppurative conditions, and made a stiff decoction of them, steeped in boiling water for several hours. I poured a cup of this highly aromatic solution, and handed it to Roger, carefully averting my nose.
“Make him drink it,” I said. “All of it,” I added pointedly, fixing Jamie with a look.
Jamie sniffed the proffered cup, and gave me the look back—but obediently sipped, making exaggerated faces for the entertainment of his company, who giggled appreciatively. The mood thus lightened, I proceeded to the main event, turning to take the makeshift hypodermic from Bree.
The Beardsley twins, standing shoulder-to-shoulder in the corner, pressed forward to see, swelling with pride. They had gone out at once at Bree’s request, coming back in mid-afternoon with a fine rattlesnake, nearly three feet long—and fortunately dead, having been cut nearly in half with an ax, so as to preserve the valuable head.
I had dissected out the poison sacs with great caution, detaching the fangs, and then had put Mrs. Bug to the task of rinsing the fangs repeatedly with alcohol, to eradicate any lingering traces of venom.
Bree had taken the oiled silk that had been used to wrap the astrolabe, and stitched part of it into a small tube, gathering one end of this with a draw-stitch, like a purse-string. She had cut a thick segment from a turkey’s wing-quill, softened with hot water, and used this to join the gathered end of the silk tube to the fang. Melted beeswax had sealed the joints of tube, quill, and fang, and been spread carefully along the line of the stitching, to prevent leakage. It was a nice, neat job—but it did look quite like a small, fat snake with one enormous curved fang, and occasioned no little comment from the spectators.
Murdo Lindsay was still holding one of Jamie’s hands. As I motioned to Fergus to hold the candle for me, I saw Jamie reach out the other toward Roger. Roger looked momentarily startled, but grabbed the hand and knelt down by the bed, holding on tight.
I ran my fingers lightly over the leg, selected a good spot, clear of major blood vessels, swabbed it with pure alcohol, and jabbed the fang in, as deeply as I could. There was a gasp from the spectators, and a sharp intake of breath from Jamie, but he didn’t move.
“All right.” I nodded at Brianna, who was standing by with the bottle of strained corn-alcohol. Teeth sunk in her lower lip, she poured carefully, filling the silk tube as I supported it. I folded the open top tightly over, and with thumb and forefinger, firmly pressed downward, forcing the liquid out through the fang and into the tissues of the leg.
Jamie made a small, breathless noise, and both Murdo and Roger leaned inward instinctively, their shoulders pressing against his, holding on.
I didn’t dare go too fast, for fear of cracking the wax seals by exerting too much pressure, though we had a second syringe, made with the other fang, just in case. I worked my way up and down the leg, with Bree refilling the syringe with each injection, and blood rose glistening from the holes as I withdrew the fang, rolling in tiny rivulets down the side of his leg. Without being asked, Lizzie picked up a cloth and blotted it clean, eyes intent on the job.
The room was silent, but I felt everyone’s breath held as I chose a new spot, let out in a sigh as the stab was made—and then the unconscious leaning toward the bed as I squeezed the stinging alcohol deep into the infected tissues. The muscles stood out in knots on Jamie’s forearms, and sweat ran down his face like rain, but neither he, nor Murdo, nor Roger made a sound or moved.
