What Lies Beneath

Chapter 24

London, 1912

Serena was starting to feel as if she would never be free again. She was certainly beginning to think she would never feel well again.

When Dr Martlet next called, she was fretful, complaining about the sores on her face and neck.

‘It’s very distressing. Surely there’s something you can do? I’ve always looked after my complexion so carefully. As a girl they used to say my complexion was as good as Lillie Langtry’s.’

‘I remember how you looked as a girl,’ he said softly.

‘The porcelain look, it was called, and very fashionable. Not that one particularly wanted to be compared to the Langtry hussy, but still…’ Serena frowned. ‘Surely there’s something you can do? It’s only in the very early stages, isn’t it? I know you couldn’t help Julius, but he’d had it for years, only no one knew.’

‘Lady Cadence—’

‘I distinctly recall you saying if you had known, you could have helped him.’

‘Helped, but not cured,’ said Dr Martlet. ‘There’s no cure for syphilis.’

‘Then am I to end like my husband?’ She was aware that fear was making her voice hard and ugly.

‘I shall do everything I can for you.’

‘That,’ said Serena, fighting back mounting dread, ‘does not answer my question.’

‘The disease waxes and wanes,’ said Dr Martlet after a moment. ‘You know that – I explained it. That’s how Sir Julius was able to keep it from everyone. It can be quiescent for months, even years. I’m hopeful that will be the case for you.’

‘So am I,’ said Serena coldly.

‘When it’s at its height there are some remedies that can be tried,’ he said, speaking rather reluctantly. ‘And we can and will do so after the birth.’

The birth… The dark memory rushed back at Serena yet again. Julius’s face, twisted into the mask of a frightening stranger, forcing into her… Then sobbing like a bewildered child ashamed of itself.

‘I should prefer to try the remedies now,’ she said in the same cool voice.

‘It wouldn’t be advisable to try any of the treatments at the moment,’ said Martlet. ‘And the sores will disappear after a time.’

‘Only to return.’

‘Not necessarily. The difficulty is that almost all of the remedies we could try might harm the child.’

Harm the child. The memory clawed at Serena again and this time a dreadful idea etched itself onto her mind like poison.

She said sharply, ‘Dr Martlet, if you will not do what I’m asking, our association must end and I must find a physician prepared to help me.’

Martlet flinched as if he had been dealt a blow. With the air of a man yielding to intolerable pressure, he said, ‘Very well.’

‘You’ll arrange treatment?’

‘Yes. But there are only two possibilities. One is a fairly new drug they say is producing some good results with early syphilis. It’s been developed by a German scientist: Dr Ehrlich. But it contains arsenic, which is poisonous in the wrong quantities.’

‘When I was a girl people occasionally used weak solutions of arsenic to whiten their hands,’ said Serena. ‘So I have no especial fear of it. But I don’t think my husband would want me to take a German drug. He doesn’t trust the Kaiser, you know.’ Despite the extraordinary and macabre circumstances, there were still rules in marriage, and one of them was obedience to a husband’s wishes.

‘I’m not altogether sure I trust the Kaiser either,’ Martlet was saying. ‘To my mind this obsession he has with the idea of German Imperialism clouds his judgement. All those speeches about what he calls a place in the sun for Germany. Still, that doesn’t mean we should doubt Dr Ehrlich’s work.’

‘Oh, no,’ said Serena politely. ‘But I still don’t care for the sound of it. Is there nothing else?’

‘Well,’ said Dr Martlet, with even more reluctance, ‘there is something called the mercury cure.’

‘Mercury doesn’t sound particularly unpleasant. Isn’t it sometimes called quicksilver?’

‘Yes. I’ve never actually administered it – I’ve never even seen it administered – but I will be straight and tell you it’s not pleasant. I think it’s possible to give it by injection, but as far as I know most physicians make use of an infusion box. The box is about so big.’ He described with his hands a squat structure, roughly oblong in shape, to Serena’s eye like an oversized chair. ‘The patient is enclosed inside it for a number of hours and a mercury solution is heated underneath. The mercury turns to vapour so that the fumes are absorbed into the skin and lungs. It’s a little like the principle of inhaling friar’s balsam from a boiling kettle for a bad chest.’

‘I understand.’ Serena did not think this sounded so terrible.

‘Lady Cadence, this is a painful and exhausting treatment,’ said Martlet very earnestly. ‘And I really am concerned about the risk to the child.’

Risk to the child. There it was again, the trickle of acid into her mind, a little stronger this time, a little more insistent. Serena stared at Dr Martlet and thought: but what you don’t know, you stupid man, is that I don’t care about the child. And if this treatment dislodges it before it can even draw breath—

She snapped off this thought before it could develop, but the child had stirred uneasily and a dull pain rippled through Serena’s stomach. She ignored it and said, ‘Please tell me about this mercury treatment. Could it be administered here?’

‘I should think so,’ said Martlet. ‘It would be a bit of an upheaval, but the equipment could be brought by carriage or carter. I’d have to call in a colleague to supervise everything – probably someone from Guy’s. How would you feel about that?’

A strange doctor who would need her to undress, and who would see the ravages of the disease… Who might make one of those painful intrusive examinations to determine the unborn child’s condition… I can’t bear it, thought Serena.

But a moment later, in the remote voice she used for giving orders to Mrs Flagg or Hetty and Dora, she said, ‘I should have no objection. I understand the risks. Please arrange this mercury treatment for me as soon as you can.’

‘Lady Cadence,’ he said, ‘are you sure?’

‘Perfectly sure,’ said Serena and again felt the child move restlessly.

The equipment for the treatment was conveyed to the house a week later.

Gillespie Martlet’s colleague from Guy’s Hospital was a portly gentleman who brought with him the aroma of cigars and claret. With him came his assistant, a youngish man, who carried the contraption up the stairs with Dr Martlet’s help. Dr Martlet suggested Flagg should be called, but Serena could not bear any of the servants to be part of this or to realize what was happening, and she had given them all the afternoon off. Dora had told her Mr Flagg had bought tickets for an afternoon performance at one of the music halls. Serena had said, ‘I hope you have an enjoyable afternoon,’ and had called Flagg to her room to give him a small sum of money. ‘Perhaps you could have afternoon tea somewhere after the music hall,’ she had said, and Flagg had said that was very kind, milady, and they might go along to Lyons Corner House at Marble Arch, which Mrs Flagg always thought very genteel and where the cakes were particularly good.

Dora and Hetty had cleared out a small room on the second floor the previous day. It had been a nursery-maid’s room when Crispian was small and Jamie used to stay with them, but it had been unused for years.

‘The doctors have said a separate room must be set aside for the actual birth,’ said Serena to Dora. ‘I know it’s a good four months away, but since Dr Martlet is bringing a medical gentleman to the house, the room had better be ready for him to see.’ This explanation had seemed to satisfy Dora, and the walls were washed down and the floor thoroughly swept. Flagg, puffing like a grampus, carried in a bedstead, which Hetty made up with clean sheets. There was a marble washstand in the corner with clean towels and soap, and before the servants went off to their music hall Hetty brought a can of hot water, wrapped in flannel to keep it warm.

Serena had been aware of the child stirring all through the morning, almost as if it knew something distressing was ahead, and when the wooden contraption for the treatment was carried in, something at the pit of her stomach clenched in painful spasm. She gasped and bit her lip, but the pain passed and no one seemed to notice. The portly doctor, who was introduced as Mr Josiah Jex, listened to her heart with a stethoscope and looked into her eyes and ears.

‘No dizzy spells, Lady Cadence? No palpitations or swoons? Good. Now then, I believe Martlet is a little concerned about giving this treatment to a lady in your condition, but you seem fairly robust to me. Your pulse rate is a little fast, but I dare say you’re apprehensive about what’s ahead. Very understandable. I’ll make sure the little one is just as healthy before we go any further, though.’ He placed the stethoscope on her stomach to listen to the baby’s heartbeat, then nodded and straightened up.

‘Is it all right?’ said Serena, trying to read his expression.

‘Oh, yes,’ he said, reassuringly. ‘A perfectly good regular heartbeat. I think we can proceed. You understand what we’re going to do, I think? Martlet explained it all?’

‘Yes.’

The wooden box had been set in the centre of the room. Serena hated it at once. It was about the height of her shoulders, roughly square in shape, with a hole at the top where the head of the patient would protrude. At the front was what looked like a hinged flap, with a catch to hold it in place. The whole structure was mounted on small legs so that it stood about eight inches off the floor, and underneath it, on some kind of metal sheet, was a grid like a flattened brazier, with small pieces of charcoal laid out on it.

‘I’ll ask you to undress down to your underthings,’ said Josiah Jex. ‘First we shall paint a mercury solution directly onto the worst affected parts. Rather cold initially, I’m afraid, but I’ll be as gentle as I can.’

The mercury felt cool and not unpleasant against her skin, but when he asked her to lie back on the bed and spread her legs apart, Serena said, ‘Must I?’

‘We do need to treat all the areas,’ said Jex, glancing at the assistant. ‘We’ll be very quick and very gentle, I promise.’

‘We’re very used to treating people,’ added the young assistant. ‘Ladies and gentlemen both.’

They spoke kindly, but Serena thought that of all the humiliations and discomforts she had had to endure, this was the worst yet. To lie on a narrow bed, wearing nothing but a chemise and drawers, while two men moved their hands intimately between her thighs and saw the ravages the disease had inflicted on her skin, was deeply embarrassing and shameful. They both wore thin cotton gloves, but Serena could still feel their hands through the fabric. Josiah Jex’s hands were warm and fleshy, the assistant’s thin and probing. Several times she flinched as they applied the mercury with a small soft brush, but she managed not to resist or cry out. She was thankful that Dr Martlet had waited outside for this part of the treatment; these two men were strangers and she was unlikely to see them again, which made it seem impersonal. But when finally she was allowed to sit up, her whole body felt as if it had been punched.

‘We’ll leave the room for you to undress completely,’ said Jex. ‘Take everything off, please, and then get inside and close the door like this.’ He demonstrated the hinged door at the front, which opened into two parts, the top flap folding down when the subject was seated inside. ‘We’ll give you fifteen minutes then we’ll come back.’

Serena was grateful for this small privacy. She took off the chemise and silk drawers, opened the hinged flap of the wooden structure and forced herself to squeeze inside. It smelled worse than anything she had ever encountered, but she sat on the wooden bench as instructed. There was hardly any space and it was necessary to keep her feet tightly together and to cross her arms over her body. But it was not as uncomfortable as she had feared and the wooden seat had some kind of covering that softened it a little. By now she was strongly conscious of the child’s distress, and of the pain spiking through her lower stomach. But I’m ignoring you, Serena said to it.

The two doctors returned, inspected the box and the grid on which it stood, and at a nod from Jex, the young assistant kneeled down to set light to the charcoals.

‘This is like a fumigation process, if you’re familiar with that,’ said Jex. ‘There’s mercury in a small tank at the bottom of the box – you’ll be resting your feet on it. We’ve lit the charcoal directly underneath and as the heat rises the mercury will vaporize – turn to smoke. The fumes will soak into you and you’ll breathe them in as well. That seems to be burning quite well now,’ he said to the assistant.

‘How long must I be in here?’ asked Serena.

‘Three or four hours, I’m afraid. You won’t be able to open the door because you won’t be able to reach out to the catch, but we’ll stay in earshot, of course.’

‘You won’t remain in the room with me?’

‘I’m afraid we can’t. If we inhaled all the mercury vapour we administer…’ He made a gesture implying it would be harmful. ‘And we’ll have to keep this door closed to prevent it seeping out to the rest of the house. But don’t worry. We’ll look in at intervals to make sure you’re all right.’

‘And to see that the mercury’s staying at the right level of heat,’ said the assistant. ‘But there’s no danger of fire, Lady Cadence. Sometimes we need to add a little more charcoal or mercury halfway through.’

‘We’ll hear you if you call out,’ said Jex. ‘Stay as calm as you can. It’ll soon be over and you’ll quickly recover.’ He nodded to her and the two men went out, closing the door.

The room was very quiet, apart from the occasional sizzling from the charcoal, and several times Serena thought the mercury in the tank spat as it bubbled from the heat. The only other sound in the room was the ticking of the clock, which Jex had moved to the windowledge where Serena could see it.

At first she thought nothing much was going to happen, and that all the talk about pain and exhaustion was purely for the doctors to surround themselves and their remedy with a degree of mystery. The small container of mercury under her feet was certainly warming up, but it was not burningly hot or even particularly uncomfortable. Her skin was starting to tingle where the mercury had been painted on earlier, but that was all. It’s bearable, thought Serena. I’ll get through it. But will the child get through it?

The clock’s hands pointed to two o’clock. Normally she would have just finished her lunch and be drinking a cup of Mrs Flagg’s excellent coffee. She would like some coffee now; Dr Martlet had told her to have only the very lightest of breakfasts and no lunch. She had done as he said, but she was used to a substantial lunch and she felt slightly light-headed.

It was half-past two. The inside of the box was beginning to feel uncomfortably warm and Serena began to fear it would overheat and she would burn. They had said they would come back at intervals, but how long would those intervals be? And if she shouted, would they really hear? The house was large and the doors were heavy and close-fitting. She moved restlessly, trying to get more comfortable, but the box was too small to permit much movement. She managed to get her arms into a slightly different position, and as she did so the mercury fumes finally started to rise. There was a smell like hot tin in her nostrils and a stinging sensation when she breathed in. Serena felt even more light-headed and had the impression of a thin mist forming in front of her eyes. She had no idea if there was actual mist from the hot mercury or if it was just the result of its fumes on an empty stomach clouding her vision. Her skin was starting to feel as if it was being scraped with a knife, but it was still all bearable.

Mr Jex looked round the door just then, asking, was she all right – was she in much pain?

‘Only a little,’ said Serena, relieved to hear her voice came out fairly normally.

‘Sure?’

‘Yes. It’s unpleasant but not unduly so. I can bear it.’

‘Good,’ he said, and went out, closing the door.

But if Serena was bearing it, the child was not. It was churning inside her – the word ‘threshing’ occurred to her – its movements sending ripples of pain across her stomach and spiking down between her legs. She moved again, but the pain was building up into a vicious wave, and she cried out and instinctively tried to hunch over but could not because of the cramped space. This was part of the cost she must pay for curing the repulsive disease Julius had given her. But what about the child? Was the child going to be part of the cost she would pay? Serena, sobbing and moaning, was beyond caring. The mist was partly obscuring her vision again and the stench of hot metal was making her feel sick.

The pain receded and she gasped with relief, sweat running down her face, but now the mercury vapour was soaking into her skin, down and down, as if it was scouring her body, trying to find the core of the disease. Serena moaned, and tried to withstand it, but it reached deeper and deeper, until she had the impression that her very bones were bubbling and seething.

The child was like a hard, heavy lump at the pit of her stomach. It’s dying, she thought. It’s dying or it’s already dead. She had no idea if it was her own pain or something in the mercury vapour that was causing the child’s distress, and she no longer cared. Because you’ll never love it, said her mind. Remember? You’ll never love it and you’ll never even like it. It was perfectly true. She could scarcely even think of the child as human any more. It was as if the thing in her womb was nothing more than a black twisted lump of disease. She shuddered and pushed this nightmarish image away, and she thought she lost consciousness for a time because when the mist cleared slightly the clock was showing a quarter-past three.

The clock’s hands had reached quarter to four when a warm viscous fluid began to seep between her legs, and agony tore mercilessly through her lower body. Tears ran down her face, this time not from the burning pain of the mercury on her skin and within her bones, but because of the little lost life that was leaching away. ‘Forgive me,’ she whispered to it. ‘I know you’re dying, and I’m so sorry…’

Sweat streamed down her face and ran stingingly into her eyes. She gasped and clenched her fists. She would not call for help, she would not… But there was a dreadful pressure between her legs now. The child was thrusting its blind, fumbling way out of her. Serena tried to lean back, tried to widen her legs to ease the brutal pushing, but the box was too narrow and she could not. Blood trickled down her legs and she sobbed with the agony and, finally, with the loss.

‘I don’t want you,’ she said to the child. ‘I never did. But I’m so sorry you’ve got to die before you’re born. I’m so dreadfully sorry…’

The clock had reached half-past four when she began to scream.

Gillespie Martlet and Josiah Jex agreed later that it had been a narrow thing with Lady Cadence. A very unpleasant business indeed, although, as Mr Jex said, she had been most straitly warned of the risk she ran.

‘Certainly she was warned,’ said Dr Martlet, who was rather white around the lips and had discarded his starched high-necked collar halfway through their endeavours to revive their patient and stop the bleeding. Dear God, he had forgotten how much blood a damaged, aborted foetus could bring with it! That was what came of practising medicine from the dignified confines of a Wimpole Street consulting room, of course; you no longer dealt with the voidances and the exudations of the human body. Gillespie Martlet, who for the last two decades had been more accustomed to advising delicate ladies to take care of their fragile constitutions, and to exchanging bluff but deferential pleasantries with corpulent gentlemen about their fondness for rich food, had found the last two hours an appalling experience.

Lady Cadence – Serena, whom he had loved from afar in a perfectly respectful and entirely chaste fashion for more than fifteen years – had screamed like a trapped hare, and when they dragged open the mercury box’s door, she had been seated in a pool of blood and amniotic fluid, writhing and struggling. And the child, the poor half-formed, half-crushed foetus, half in and half out of her body…

Between them, Dr Martlet and Jex had carried her to the narrow bed in the corner of the room, sending the young assistant for hot water and cloths. He had taken so long that Jex had almost gone huffing down the stairs himself, but he had finally returned with a canister of water and towels, gasping his apologies, but explaining that there appeared to be no servants anywhere in the house.

‘No, of course there aren’t,’ said Martlet, remembering. ‘She sent them out for a half-day’s holiday. She didn’t want any of them knowing what was being done to her this afternoon.’

Jex, his hands busy about his patient, grunted that in his experience servants generally knew more about their masters and mistresses than anyone else, and added it was a pity there was not a sensible woman in the house to help them. But they would manage, he said, eyeing the prone figure on the bed.

They did manage, but it was, as they later admitted to one another, a very close-run thing indeed. It took their combined knowledge and Jex’s skill to remove the foetus without damaging Serena Cadence’s uterus. As the forceps, hastily snatched out of Jex’s bag, closed around it and he prepared to withdraw it, there was a nightmare moment when it seemed to squirm and resist.

‘Oh God,’ said Martlet again, recoiling, one hand over his mouth. ‘Jex, it can’t possibly be alive…’

‘Five months, didn’t you say?’

‘Yes, but—’

‘I’ve known them survive at five months,’ said Jex grimly. ‘But this little one hasn’t, and from the look of it, that’s God’s mercy.’

They piled pillows under Serena’s feet to stem the bleeding, but even so, the sheets and the mattress were soaked, and the stench of stale blood quickly filled up the small room. Martlet, feeling slightly sick, reflected that this was something else you lost touch with from a smart consulting room.

Much later, the servants returned, and the sensible maid, Dora, left to sit with her mistress, the three gentlemen sat in the downstairs drawing room.

‘And,’ said Dr Martlet, ‘I think Lady Cadence – and Sir Julius – would permit us a little of their brandy.’ He poured the brandy, his hands still shaking.

‘A very good brandy,’ observed Josiah Jex, swilling it round in its balloon glass to release the ethers. Without looking up, he said, ‘She understood what happened, didn’t she?’

‘That the child was lost? Yes, of course.’

Jex paused, then said, ‘Have you told her she was pregnant with twins and she only aborted one of them?’

‘Not yet,’ said Dr Martlet. ‘But undoubtedly it will be a great comfort to her.’