If Una had been distracted before, now she could hardly think straight. Every person she passed in the halls of Bellevue was a potential suspect.
“We don’t even know that it was murder,” Dru reminded her that evening in the library. While the other trainees sat beside the hearth talking of acrobats and snake charmers and sword swallowers, here they were whispering about a killer whom Una still had no proof existed. “Mr. Dupin says we mustn’t—”
“I know, I know,” Una leaned back in her chair and freed her hair from its bun. “We mustn’t lose sight of the matter as a whole and jump to conclusions.” Thanks to Dru, she could practically recite the whole damned story now.
Dru yawned and rested her head on the open textbook that lay between them on the table. Between Una’s distraction and Dru’s malaise, they managed only a few pages’ worth of study. “Tomorrow, we must find a way to get the pathologist’s report.”
“Leave that to me,” Una said. She didn’t relish returning to the morgue alone, but the heist would be easier to manage on her own. Swiping a set of keys left out in plain view was one thing. Stealing a report tucked away God-only-knows where in the vilest part of the hospital was something else entirely.
* * *
The next morning, Una left the nurses’ home early, slipping out before breakfast and heading straight to the morgue. She snuck past the keeper, who was busy stacking coffins, and into the back room. It was dark and cold inside. Several bodies lay beneath showers of water awaiting autopsy. The plink, plink, plink set Una’s nerves on edge. She rummaged through drawers and cupboards but found nothing.
With the room slowly filling with daylight and the morning din growing from outside, Una at last stumbled upon a leather-bound sheaf of papers
carelessly tucked between specimen jars. They weren’t the pathologist’s official reports but sketches and scribbled notes on recent cases. Before Una could read through them, approaching footfalls sounded in the hall. She flipped through the pages, glancing only at the date. Luckily, the day of Deidre’s murder was seared into her mind. She snatched several pages, all inscribed with the same date, and stuffed them beneath the waistband of her apron.
Una hid behind the door as it swung open. Several men shuffled in. She listened to the clap of their shoes and the echo of their voices—a trick Marm Blei had taught her—to judge when they weren’t looking, then slipped around the door and out of the room unseen.
The papers beneath her apron rustled as she walked in a brisk but measured pace from the morgue, arriving on her ward just in time to begin her morning duties. Una was happy to find the patient with the gunshot wound had much improved. He lay nestled amid pillows and sandbags, half-sitting, half-side-lying, so that neither his back nor his bandage- wrapped hand bore any weight. In his good hand, he held a copy of the Daily Post. Beside his bed sat a half-eaten bowl of oatmeal. Perhaps Edwin’s careful dressing of the wound had helped.
Una cleared away his breakfast dishes, turned the page of the paper for him, and got to work tidying the ward before Nurse Hatfield made her rounds. She managed to secure the stolen notes from the morgue more snuggly beneath her apron so they wouldn’t make noise or fall out as she cleaned. Evening seemed an interminably long time away when she and Dru could sit down and study them.
Shortly after noon, however, a new patient arrived from one of the medical wards. Dru accompanied him to relay his condition. She smiled weakly and rubbed her temple before beginning. “Mr. Knauff is a married man, thirty-three years of age, brought here ten days ago after falling from a wagon and fracturing his lower jaw. He is sober of habit with no previous ill-health . . .”
Her report was painfully detailed and precise, and Una only half listened, waiting for the second-year to disappear into the medicine closet so Una could show Dru the papers.
“. . . this morning during rounds, Dr. Lawson decided it necessary to encase Mr. Knauff’s jaw in a plaster of Paris splint to promote further healing. He conferred with Dr. Pingry, and they agreed to transfer the
patient to the care of the surgical department as such a procedure would necessitate the use of ether. Mr. Knauff’s bowel evacuations have been regular, and this morning his urine output measured—”
“I have it,” Una interrupted once the second-year was finally out of sight. “Have what?”
“Notes from the morgue.” She pulled the papers from beneath her apron.
Dru snatched them, her expression brightening. “What do they say?”
“I haven’t had a chance to read them yet. It’s not the pathologist’s official report but notations he makes during the examination, I think.”
Dru moved closer to the window and fanned the pages out between her hands. “He probably uses these afterward when he writes out his official findings.”
Una stood beside her and stared down at the sheets of crumpled paper. It unsettled her to think that Deidre and the other patients she’d seen in the morgue that day had been reduced to a few crude sketches and scribbled notes.
“Could this be her?” Dru pointed to an entry that began: Female, white, mid-twenties. But a few lines down it read, fetus in utero estimated eight months’ gestation.
“No, that’s not her.”
Dru continued to scan the pages, turning them front to back and squinting at the pathologist’s sloppy writing. “Here.”
Una leaned closer. It was another entry of a woman matching Deidre’s description. Further on it read: Fixed lividity visible on the neck and back. Patchy in appearance. Regular in shape and symmetrical in prominence anteriorly and posteriorly. “That’s her. It has to be. What do you make of it?”
“Hmm . . .” Dru said, rubbing her temple again. She sat down on an unoccupied bed beside the window. “We’ll have to consult Dr. Thomas’s guide to postmortem examinations and morbid anatomy tonight. Lividity usually becomes fully fixed eight to ten hours after death. But I thought I remember reading it could take longer—up to a full day sometimes—in particularly cold environments.”
“Why does that matter?”
“Before it is fixed, when you press on an area of the body colored by lividity it will blanch. A bruise will not. It’s possible the pathologist
miscalculated the time of death or failed to consider the temperature when making his assessment, thereby confusing bruising around her neck for fixed lividity. Even more interesting—” Dru stopped and winced, gripping the bedsheets.
“Are you all right?” Una asked, sitting beside her.
Dru flashed a thin-lipped smile. “Yes, quite. What was I saying?” “Even more interesting . . .”
“Yes, even more interesting is the pathologist’s description of her fingernails. Several were broken and ragged. He attributes it to her . . .” Dru picked up the paper and read, “‘Her likely habitude of slatternliness and intoxication.’ But what if—”
“Nurse Lewis, what are you still doing here?”
Una and Dru rose hastily at the sound of the second-year’s voice. “I . . . I . . .”
“She was just finishing telling me about Mr. Knob.” “Knauff,” Dru whispered.
“Knauff.”
The second-year shook her head. “Well, I’m sure her other patients are long since in want of her attentions.”
As Dru hurried off, Una surreptitiously shoved the papers back beneath her apron and returned to her duties. She helped the second-year prepare afternoon medicines between calls for bedpans and extra blankets and cups of water. Several patients had fomentations that needed rewarming and dressings that needed changing. Una stayed so busy she hardly noticed Dr. Allen arrive a few hours later. He lingered over the newly arrived patient’s bed before calling to her to fetch supplies for the splinting procedure. His thin, nasally voice barely reached her across the ward, and she realized that in her more than three months at the hospital, she’d hardly ever heard him speak.
Una finished mixing the mustard and linseed poultice she’d been making for another patient, then hurried to the storeroom. She grabbed the necessary supplies along with a basin of water to mix with the plaster and shuffled over to where Dr. Allen was waiting.
He pulled a towel from her arms before she had a chance to lay down the supplies and began shaping it into a cone for the ether.
“Where’s Dr. Pingry?” she asked.
“Are you questioning my ability to perform such a simple procedure on my own?”
“No, of course not,” Una said, surprised by the edge in his voice. She couldn’t tell whether it was nerves or long-suppressed ego.
“Good, now hand me some cotton.”
Dr. Allen swiped a few pages of newsprint from a nearby patient’s nightstand and rolled it into a cone. He lined the inside with the towel he’d plucked from Una’s arms, and stuffed it with cotton.
“Now lie still and breathe deeply,” he said to the patient and placed the cone over his nose and mouth. Just as he was about to administer the first drops of ether, Una noticed a smudge of what looked like mutton stew across the patient’s shirt. Had Dru mentioned when his last meal was? Una suddenly wished she’d listened better.
“You didn’t eat any dinner today, did you, Mr. Knauff?” Una asked. Mr. Knauff said something that was lost inside the cone.
“The patient hasn’t been fasting?” Dr. Allen said.
“I’m not sure. I don’t remember what the nurse from the medical ward said. If she said.”
“You might have mentioned this earlier.”
And you might try being less of an ass, she thought. “I’m sorry, Dr.
Allen, I only just realized.”
He glowered at her with the same pinched-lip contempt Dr. Pingry often fixed on her and the other trainees. “Carry on mixing the plaster.”
“But we can’t. The risk of—” “The risks are minimal.”
Was that true? She wished she’d paid better attention during Dr. Clarkson’s lecture on the fundamentals of anesthesia or hadn’t skipped out on Nurse Smith’s demonstration last week about the care of surgical patients. It was a simple procedure, after all.
“Are you sure?”
“Forgive me, nurse, I don’t think I heard right. Surely you’re not questioning me. Perhaps I should call down Superintendent Perkins, and you can explain your disobedience to her.”
Una opened her mouth then closed it again. She suspected Dr. Allen’s insistence that they carry on had more to do with his fear of Dr. Pingry than anything else, but to say so would land her in Miss Perkins’s office for sure
and from there the streets. She grabbed the jar of plaster powder and sifted it into the bowl of water. Dr. Allen smirked and administered the ether.
The procedure lasted only fifteen minutes. Once Mr. Knauff was asleep, Una assisted Dr. Allen in constructing a simple plaster splint that wound around the patient’s jaw and up over the crown of his head. They worked in silence. When they were finished, Dr. Allen wiped his hands, listed off his orders—nothing by mouth for four hours, then thin liquids as tolerated, aromatic spirits of ammonia if the patient woke nauseous—and walked away.
Una cleared the supplies and tidied up around the bedside, frequently checking Mr. Knauff’s vital signs. As expected, his breathing grew shallower, and he ceased snoring. His pulse slowed, and color returned to his cheeks. Soon he would awaken, talk boisterously until the intoxicating effects of the ether fully wore off, then fall into a natural sleep.
She began a mental list of all the tasks she had yet to complete that afternoon. Leeches had been ordered for two patients, cupping for another, and a purgative enema on yet another. But at least the busyness would keep her mind from wandering to thoughts of Deidre’s death and the pathologist’s notes still tucked beneath her apron.
Half an hour after the procedure, when Una was just about to leave Mr. Knauff’s bedside and fetch the jar of leeches, she noticed a wheezing sound. She leaned closer to him and listened. His breaths, once soft and easy, had grown high-pitched and piercing. She shouted for the second-year, who hurried over, chastising Una for raising her voice until she heard Mr. Knauff’s noisy inhales. Her face slackened.
“I’ll fetch help.”
Soon Dr. Allen, Dr. Pingry, and Nurse Hatfield were crowded around the bed. Mr. Knauff’s breathing had grown louder and more ragged. His lips were no longer pink but dusky purple. The plaster cast had already set and had to be cut away with scissors before Dr. Pingry could pry open Mr. Knauff’s mouth and look inside. When he could find nothing blocking the throat, he hollered at Una to fetch a scalpel and cut a hole in Mr. Knauff’s neck. A tube was inserted into his windpipe. Una and the others waited and listened. Mr. Knauff drew in a tremulous breath. Then another. Then he ceased to breathe at all.
Dr. Pingry ordered artificial respirations, and for the next twenty minutes
—though it seemed like far longer—Una, Nurse Hatfield, and Dr. Allen
took turns folding Mr. Knauff’s forearms over his chest, pressing down, then unfolding his arms and extending them over his head. When at last Dr. Pingry declared their efforts fruitless, Mr. Knauff’s face was blue. His eyes had never opened from the ether-induced sleep.
* * *
Una sat on the steps outside of Miss Perkins’s office, gnawing on the soft skin around her nails. At first, she’d felt a sort of numb disbelief at Mr. Knauff’s death as if she and the doctors and poor Mr. Knauff were all part of some waxwork tableau like those at the Eden Musée. But as she’d washed and wrapped the body for transport to the morgue, a quiet grief settled beneath her ribs. She should have listened better to Dru’s report. Should have insisted they postpone the procedure.
Nurse Hatfield had come to her shortly after the body was carried away and told her to report to the third floor. “Superintendent Perkins is meeting with Dr. Pingry and Dr. Allen now,” she said, not bothering to restrain her smugness. “She’ll call you in to plead your case after.”
Plead her case? Nurse Hatfield made it sound like Una were on trial.
Now, listening to the soft murmur of the physicians’ voices from within Miss Perkins’s office, Una felt sick and jittery. She tasted blood and realized she’d chewed her cuticles raw like a trapped rat gnawing off its own tail. When the door opened, and Superintendent Perkins waved her in, Una stood slowly, not trusting her legs.
Dr. Pingry and Dr. Allen passed her on their way out. Dr. Pingry looked annoyed as if meeting with the superintendent had been but one more bother in his already irksome day. Dr. Allen’s countenance was more grave, his gray eyes refusing to meet her own.
Miss Perkins did not offer a chair, and Una didn’t presume to sit, even though her feet ached and her head was light with hunger. “I’m told a patient on your ward died unexpectedly today.”
“Yes, ma’am.”
“Dr. Pingry speculates it was due to asphyxia caused by an accumulation of mucus in the trachea during his inhalation of ether.”
Una wasn’t sure what to say, so she remained silent.
“He further speculates that for such a thing to occur in an otherwise healthy patient, food was likely ingested prior to the administration of the
ether.”
“I told—”
“Dr. Pingry will deal with Dr. Allen and censure him as he sees fit. For his part, Dr. Allen claims he was unaware of the patient’s condition prior to giving the ether, and I am in no position to question his statement. I am, however, in a position to determine what went wrong with his nursing care.”
Una’s mouth was as dry as tinder, but she resisted the urge to smack her lips or swallow, lest she appear guilty. “I did not feed Mr. Knauff anything.”
“So he had not eaten?”
Una’s mind scrambled for an answer.
“I trust you understand how serious this is, Miss Kelly. I expect nothing less than complete and honest disclosure.”
Una nodded, wishing she’d had a chance to talk to Dru and get their story straight before being summoned here to answer to Miss Perkins. “He may have eaten before he arrived on the ward.”
“But surely that information would have been relayed to you when he arrived by the transferring nurse.”
“I . . .” Her tongue was so sticky it was hard to form the words. “I don’t remember being told whether the patient had eaten or not, but I assumed, as he was being transferred for surgery, that he’d been made to fast that morning.”
“You don’t remember being told, or you were not told?” When Una didn’t answer, Miss Perkins reached for her pen. “I’m afraid I have no choice then, but to—”
“Wasn’t told. I wasn’t told.”
“I see. And from whom did you receive this deficient report?”
Una looked down. She opened her mouth, closed it again, then finally forced herself to spit out, “Nurse Lewis.”
