Blood and Ice

CHAPTER ELEVEN

June 21, 1854, 1:15 a.m.

ELEANOR AMES HAD been employed at the Establishment for Gentlewomen during Illness, located at No. 2 Harley Street, for only less than a year, but it was a sign of Miss Nightingale's confidence in her that she had been appointed the night nurse. Although it meant staying awake until dawn, Eleanor was honored, and pleased, to have that responsibility. And, truth be told, she enjoyed the relative tranquillity of the night hours. Apart from having to administer the occasional medication, or change a soiled poultice, her duties were largely spiritual in nature; some of the patients, restless and distressed at the best of times, became even more so after dark. Their private demons seemed to descend as the night wore on. And it was Eleanor's task to keep these demons at bay.

Already she had looked in on Miss Baillet, a governess who had lost her position in Belgravia after a violent seizure had afflicted her, and Miss Swann, a milliner who was suffering from a high but utterly inexplicable fever. The rest of the night she had simply patrolled the wards, making sure that all was well, and tidying up the dispensary. As superintendent, Miss Nightingale had made it abundantly clear that the hospital was to be spotlessly clean and orderly in every way. She insisted upon fresh air being let into the wards (or as fresh as you could get in London), especially at night; she was equally adamant that all beds be made up daily, fresh linen bandages be applied to every wound, and well-prepared, nutritional food be served at every meal. In many circles, Miss Nightingale's ideas had been greeted with skepticism, or a shrug-even the doctors who cared for the patients seemed to think it all irrelevant, though harmless. Eleanor, however, had come to embrace the Nightingale ideals, and was proud to be among the young women-and at nineteen, she was among the youngest-to have been accepted into the hospital's training program.

Locking up the dispensary (particularly the laudanum, which was much in demand as a sleeping draught by certain patients), she caught a glimpse of herself in the glass of the cabinet. Her dark hair, so tightly pinned under the white bonnet, had begun to come undone, and she had to stop to tuck it under again. If Miss Nightingale came down from her rooms on the top floor and found her night nurse looking disheveled, she would not be pleased. And for all her tender solicitude toward the patients, Miss Nightingale was not someone by whom you wished to be reprimanded.

Eleanor turned down the gas lamp and went out into the hall. She was about to go upstairs and straighten the solarium-Miss Nightingale was a great believer in the restorative power of sunlight- when she happened to glance toward the front door. Through its glass panels, she thought she saw a coach stopping, directly in front of the steps. As she watched, she saw three men stepping down, and, to her surprise, mounting the stairs. Did they not know that visitors were only allowed during the afternoon hours?

Apparently not, because even as she moved to forestall the sound-she did not wish any of the patients to be unnecessarily awakened-she heard the front bell tinkling, and almost at the same moment a fist hammering on the wooden portion of the doors. She saw a muttonchopped face peering in, and heard a voice call out, “Assistance? May we have some assistance?”

Just as the fist was raised again, she unlatched the door and threw it open. A big man with a florid face-the one who had been demanding assistance-looked suddenly abashed, and said, “Please pardon our intrusion, Miss, but we have a companion in need of attention.” That companion, also in a red cavalry uniform, was holding his hand over one arm, while another soldier held him by the elbow, as if to steady him.

“This is a hospital for women,” Eleanor said, “and I'm afraid-”

“We're aware of that,” the florid man said. “But this is in the nature of an emergency, and we did not know where else to turn.”

She could see blood seeping from a wound on the blond soldier, who suddenly looked familiar to her. Why, he was the same man who had stared up at her a few hours earlier, when she had leaned out to close the shutters.

“There is no physician on the premises,” she said. “And there won't be until tomorrow morning.”

The big man looked back at his companions several steps below, as if unsure what they wanted him to do next, and the wounded man said, “My name is Lieutenant Sinclair Copley. I've been injured while helping a woman to ward off an attacker.”

Eleanor vacillated on the front step; what would Miss Nightingale wish her to do? She did not dare to awaken her-after all, wasn't she, Eleanor, the night nurse, in charge?-but she also felt it incumbent upon her to offer a wounded man some help.

“In short,” the lieutenant said, “I've been shot and require someone to attend to the wound.” He had ascended the steps and, in the feeble glow of the streetlamp, he looked imploringly into her eyes. “Could you not at least examine the arm and see if you have some remedy on hand until I can consult a surgeon in the morning? As you see,” he said, removing his hand and revealing the blood-caked sleeve of his uniform, “something must be done to stanch the flow.”

She remained in the doorway, irresolute, until the big fellow, apparently losing heart, said, “Come on, Sinclair, Frenchie. I know an apothecary in the High Street, and he owes me a favor.” He turned his back on Eleanor and clumped down the stairs, but the blond man stayed where he was. Eleanor had the distinct impression, though a blush rose in her cheek for even thinking such things, that he had come here expressly so that she might care for him.

She stood to one side and swung the great door open behind her. “Please be careful to make no noise. The other patients are sleeping.”

She locked the door behind them, then ushered them down the wide and chilly hall-all the windows being left open-and into the receiving suite. It was something of a cross between a parlor and a surgery, with armchairs, tasseled lamps, and a desk in the front room, and in an alcove at the rear a leather-topped examination table, stuffed with horsehair, a white linen screen, and a locked bureau containing medical instruments and a small cache of medicinal supplies.

“I'm Captain Rutherford, by the way,” the big man said, “and this other fine gentleman is Lieutenant Le Maitre, generally known as Frenchie. All of the Seventeenth Lancers.”

“Pleased to make your acquaintance,” Eleanor replied-she could tell from their uniforms and their manner of speaking that they were wellborn men of means-”but I must ask you again to keep your voices low.”

Rutherford nodded, put a finger to his lips in confirmation, and retired to one of the armchairs. He turned up the lamp on the table, adjusted the wick, then pulled out a packet of cigars, offering one to Le Maitre. Striking a lucifer off the bottom of his boot, he lighted the two cheroots and the men sat back contentedly.

“Go to it,” Rutherford whispered, whisking his hand toward Eleanor and the alcove. “We don't want him to die here; the Russians want a shot at him first.”

Frenchie guffawed, then slapped a hand over his mouth.

“Don't mind them,” Sinclair said, softly. “They left their manners in the barracks.” He stepped toward the examining table and began to remove the jacket of his uniform. But the blood had stuck the cloth to the skin, and he winced as he tried to free it. Until that moment, Eleanor had not had a chance to give her full consideration to just what she was doing. She could think of at least three rules she had already broken. But the sight of the lieutenant trying to separate the bloody fabric from the wound suddenly seemed to snap her into the moment. She said, “Stop. Let me do that,” and, hastily unlocking the bureau, took out a pair of tailor's scissors and snipped away at the sleeve until a larger opening allowed her to pull the cloth away from the skin and gently remove the torn jacket.

Which she did not know what to do with.

The lieutenant laughed at her temporary confusion, took it from her hand, and tossed it onto a coatrack behind her, which she had completely forgotten was there. Then he took a seat on the edge of the leather table.

The billowy white linen of his shirt was also torn and bloody but she would not think of having him take off the shirt. Instead, she used the scissors to slice the sleeve open from below his shoulder to above his wrist. It was fine fabric, that she could tell, and she regretted having to cut it. But what disconcerted her more was his steady gaze; while she tried to focus all her attention on revealing the wound, she felt that he was studying her, from her green eyes to the dark brown ringlets of her hair, escaping, yet again, from under the white bonnet. She knew that she had begun to blush again, and though she would have liked to will the blood back down from her cheek, there was nothing she could do.

Once the shirtsleeve had fallen open, she was able to see that the flesh had been torn away, but the bullet did not appear to have penetrated the bone, or even the muscle very deeply. It was hard for her to know, as the hospital never saw wounds of that particular nature, and even when somewhat similar injuries did occur-one elderly lady had been accidentally pierced by a fireplace poker-the surgeon seldom if ever allowed a nurse to assist in any significant way.

“What do you think?” the lieutenant asked her. “Will I live to fight another day?”

Eleanor was not used to being spoken to in such a playful way, much less by a man to whom she was in such close proximity… and whose bloody arm was exposed. An arm that she, in fact, had been the one to expose.

Instead, she briskly turned to the bureau, removed a clean cotton rag and a bottle of carbolic acid, and began to daub at the wound. The blood had largely caked, and it came off in flakes, which she deposited in an enameled basin atop the bureau. As she did so, the wound was gradually more revealed to her, and she could see that the skin had been sufficiently broken that stitches would be required for it to knit properly together again.

“Yes,” she finally said, “you will live, but I hope not to fight again.” She fetched a fresh cloth. “You will need to see a proper surgeon, though.”

“Why?” He glanced down at his arm. “It doesn't look so bad to me.”

“The wound will need to be closed, and that will require stitches-the sooner, the better.”

He smiled, and though she knew he was ducking his head to try to catch her eye, she kept her gaze averted.

“Is tonight too soon?” he said.

“As I've said, at this hour there is no doctor here.”

“I meant you, Miss…?”

“Ames,” she said. “Nurse Eleanor Ames.”

“Can't you do it, Nurse Eleanor Ames?”

Eleanor was nonplussed. No one had ever suggested such a thing. A woman-even if she was a nurse-mending the bullet wound of a soldier, under no one's aegis but her own? She felt her face turn as scarlet as his uniform.

Lieutenant Copley laughed. “It's my arm, and if I believe you can do it, why shouldn't you?”

She glanced up, into his face, and saw a great, gleaming smile, tousled blond hair, and a fine, pale moustache-the kind you might see on a young man determined to make himself look older.

“But I'm only a nurse, and not yet done with my probationary training.”

“Ever sewn a garment?”

“Many times. But this is-”

“And could you do any worse than the regiment's surgeon, whose specialty is pulling teeth? At least, unlike our good Dr. Phillips, you're not drunk.” He touched her hand and said, in a conspiratorial tone, “You're not, are you?”

Despite herself, she had to smile. “No, I'm quite sober.”

“Then good. And we certainly don't want the wound festering all night.” He yanked the sleeve free from his wrist and bunched it up at his shoulder. “Now, what do you say we begin?”

Eleanor was utterly torn between her certainty that she was violating her responsibilities and a desire, growing every second, to do something that, in her heart, she felt that she could do. Regardless of the surgeons’ routine dismissals, she had seen enough of their handiwork-often cursorily done-to know that she could match it. But what would Miss Nightingale say if such a gross breach of medical protocol ever came to light?

As if he'd read her mind, the lieutenant said, “No one will ever know.”

“A Lancer's word is as good as his bond,” Rutherford called out from his chair, and Frenchie immediately gestured for him to lower his voice.

Sinclair waited expectantly, his arm bared, a half smile creasing his lips, and when Eleanor poured some water into the basin and began scrubbing her hands with a bar of lye soap, his smile broadened. He knew he had won.

Rutherford got up from his chair, withdrew a silver flask from under his pelisse, and held it out to Sinclair. When Eleanor saw it, she said, “We do have chloroform, and ether.” Which she was very hesitant about administering; this she had never done, and she feared the consequences of a misapplication.

But Rutherford said, “Pshaw! Brandy's the thing. Enough of it, and I've seen men sleep through a leg being taken off.”

Sinclair took the flask, tipped it toward his benefactor, then took a healthy swig.

“Again,” Rutherford said.

Sinclair did as instructed.

“There you go,” Rutherford said, patting him on the shoulder and turning toward Eleanor. “The patient awaits.”

She turned up the gas lamps in the wall sconces and began to withdraw from the bureau drawers the implements she would need-catgut and a sewing needle-then asked Sinclair to lie back on the table so that she could better see the wound. Her hands were shaking as she threaded the sutures through the needle, and Sinclair put out his own hand, on top of hers, and said, in a calming voice, “Steady.”

She swallowed and nodded twice, then continued, slowly and deliberately. She bent low to study the skin, then decided on a plan of action: She would begin at the bottom of the wound, where the skin was most separated, pinch it together, put the needle through, and then, as if completing a hem, stitch upward. It would take, she estimated, no more than eight to ten stitches… though she knew it would prove quite painful for the lieutenant. She would have to work as speedily as she could.

“Are you ready?” she asked.

He had thrown his other arm behind his head, and was resting as if he were lying on a riverbank in June. “Quite.”

She touched the needle to the skin and hesitated several seconds before she could bring herself to put it through. She felt his muscles flex, saw the arm go taut, but he didn't say a word. She knew that he was loath to appear anything but stoic in front of his companions… or, she suspected, in front of her. She drew the flap of skin from the other side closer, put the needle through that, too, and then, as if holding a pinch of salt between her fingers, held both together as the needle came back in the other direction. She had seen patients, in the midst of painful procedures, often look away, as if focusing on some idyllic, faraway vision, but his eyes, she could tell, were fixed- in that same way-upon her.

She drew the needle through again, and again, and again, and the wound gradually closed, until it was more of a puckered scar running several inches up his arm. When she had finished, she tied off the knot, but rather than biting it off, as she would have done with ordinary thread, she used the tailor's scissors to cut it short. Finally, she glanced up at his face; his forehead was gleaming with sweat, and the smile wavered on his lips, but he had not flinched.

“That should hold,” she said, turning to dispose of the leftover suture. She gently coated the skin with the carbolic acid once more, then took a clean bandage from the bureau and wrapped it tightly around the arm. “You may sit up, if you like.”

He took a deep breath, then, without leaning on his right arm for support, sat up. For a second, due to the effects of the surgery, the brandy, or both, he swayed from one side to the other, and Frenchie and Rutherford quickly stubbed out their cigars and came to steady him.

And that was how Miss Florence Nightingale found them.

She stood like a pillar of rectitude in a long, hooped skirt, with her black hair perfectly and severely parted down the middle, her pale hands crossed in front of her. Her dark eyes, under high uplifted brows, flitted from the soldiers, who appeared no doubt inebriated, to the night nurse, her bonnet askew, her hands wet with water and carbolic acid, then back again. It was as if she were trying to make sense of an elephant in her parlor.

“Nurse Ames,” she said at last, “I expect an explanation.”

Before Eleanor could summon a single word to her parched lips, Rutherford stepped forward, hand extended, and introduced himself as a captain in the 17th Lancers. “My friend here,” he said, gesturing toward Sinclair, “was injured in the act of defending a woman's honor.”

Frenchie put in, “Quite nearby.”

“And we required immediate assistance. Your Miss Ames has rendered it, and in a thoroughly professional manner.”

“That is for me to decide,” Miss Nightingale said, frostily. “And were you gentlemen unaware that this is an institution devoted solely to the care of gentlewomen?”

Rutherford looked over at Frenchie and then Sinclair, as if unsure how to answer that one.

“We were,” Sinclair said, managing to step down onto the floor. “But as my regiment leaves for the east in the morning, we had no time to seek out an alternative.”

Rutherford and Frenchie appeared happy with that improvisation.

And even Miss Nightingale seemed mollified, somewhat. She swept into the alcove, and closely examined the newly stitched wound.

Eleanor was quivering in fear, but when she glanced at Sinclair, he winked at her.

“And are you happy with the result of this… unorthodox procedure?” she said to Sinclair.

“I am.”

She straightened up, and without looking yet at Eleanor, said, “As am I.” She then turned toward Eleanor, and said, “It appears to have been expertly done.”

Eleanor took her first full breath in minutes.

“But we cannot have this sort of thing here. The reputation and public standing of this hospital is in constant review. I will require a full account, in writing, by eight o'clock in the morning, Nurse.”

Eleanor bowed her head in assent.

“And if you gentlemen have now received the care you required, I will have to ask you to leave.”

Rutherford and Frenchie made quick to fetch their cigar butts, and then, with Sinclair slung between them, made their way out into the hall. Miss Nightingale held the front door open for them, with Eleanor hanging back behind. But as they stopped at the bottom of the stairs, Miss Nightingale stepped forward, her long skirts swaying, and said, “Be careful, young men, and come back safe.”

From her limited vantage point, Eleanor could only see Lieutenant Copley, his blond hair shining beneath the streetlamp, his scarlet jacket draped around his shoulders. But he was smiling up at her. She suddenly felt a twinge of concern-quite unexpected, and surprising in its intensity-at the thought of his imminent departure for the battlefront.