The Art of Dying Read online

‘Such as?’

  ‘Elizabeth Rigby, Catherine Crowe. Women who supported themselves through writing. Forthright in their opinions. I remember Mrs Crowe scandalised Hans Christian Andersen by inhaling ether after dinner one night.’

  ‘Were they not mothers too? I know that your Mrs Wollstonecraft was.’

  ‘Mrs Crowe had a son, I think. And no husband because she left him. He was a brute, apparently.’

  ‘Unconventional indeed,’ he said, though his mind was clearly racing. He paused for a moment, then said: ‘If you have help with the child, you could continue to study. I am not alone in thinking that a broad education is necessary for women if they are to be properly equipped for raising their offspring.’

  ‘But surely a broad education should be put to greater use, beyond the home? If the intellectual faculties of women are equal to that of men, should they not be encouraged to do more than merely oversee the education of their children?’

  ‘Of course. I only meant that not everyone objects to female self-improvement.’

  He spoke softer now, begging her candour.

  ‘If you could do anything, what would you do?’

  ‘I don’t know.’

  ‘I think that you do.’

  ‘If I were entirely free to choose? If my gender was no impediment?’

  She paused as though contemplating the question, but he was right. She already knew the answer.

  ‘I would like to be in Will Raven’s position: a doctor working alongside Professor Simpson.’ Then she sighed. ‘But such a thing is impossible.’

  ‘And yet you work alongside the professor now.’

  ‘It’s not the same.’

  ‘No. But it is a start.’

  She got up and started straightening the blanket on the bed.

  ‘Dr Simpson says that a woman has obtained a medical degree in America. Perhaps I should go there.’

  She thought he would dismiss the notion as fanciful. Instead Archie said: ‘Perhaps you should. If you have the means and there is nothing to keep you here.’

  She found his sincerity arresting. It was something that hadn’t occurred to her before, not a circumstance that she had entertained, yet he truly believed it a possible course of action. Her head spun. To travel beyond the narrow confines of Edinburgh!

  She thought of Mrs Glassford’s words: You are young yet. You do not know what your life will become. It cheered her to imagine other possible lives beyond what was about to happen. Her immediate future seemed to portend little but difficulty, loss and pain. But perhaps there would be better days to come.

  She looked at Archie and felt guilty for contemplating life without him. But this kind of introspection brought with it other unanswerable questions. Would Archie be suggesting these things if he were well? It would be highly irregular for a medical man with any social pretensions, however modest, to allow his wife to work. Would he have married her if not facing a life-threatening illness? Such thoughts threatened her very sanity.

  As she stood up, she glanced out of the window, and the sight of the grey November streets jolted her back into the coldest reality. She saw all these musings for what they truly were: the consoling fantasies of a dying man. This was a city where his fellow doctors were conspiring to do down no less a man than James Young Simpson. What chance had a woman of ever taking them on?

  ‘Eat your breakfast, Dr Banks,’ she commanded, indicating that the conversation was at an end.

  THIRTY-THREE

  r Johnstone entered the room with the look of a man unmoored. He seemed uncomfortable in the heart of his own house, a disoriented look in his eye as though his surroundings were strange to him. Raven recognised it. This was someone to whom familiar spaces no longer made sense. A vital part of the equation by which he understood the world was missing, and now nothing added up.

  Raven could not help but think of Sarah and what lay in her near future.

  But perhaps these were not so easily compared. Dr Johnstone and his wife had been married for more than twenty years. Sarah and Archie had been married but a matter of weeks. When he learned that, he had wondered whether he ought to have returned from his travels sooner, but he couldn’t fool himself into thinking that would have made a difference. The time to change something was before he left, and back then he had been too concerned with what people thought.

  Too meek. Too cowardly.

  Perhaps weeks or decades made no odds in matters of the heart. Perhaps he merely wanted to tell himself Sarah and Archie’s love was a lesser thing. He ought to admit to himself that it was surely otherwise. They were happy together, despite knowing they would not be together long.

  Was it different if you knew in advance that your spouse’s life was limited? Did that make it easier to prepare yourself for his loss? Or did that make it more painful, seeing him every morning, perhaps looking upon him for a joyful moment before remembering?

  Dr Johnstone carried with him a glass of whisky but did not offer one to his visitor. Raven didn’t interpret it as impolite; more that it had slipped his mind that he ought to. Perhaps his wife had been the one who played host in such times.

  ‘The housekeeper told me your name, but I have quite forgotten it.’

  ‘I am Dr Will Raven. I am Dr Simpson’s new assistant.’

  Dr Johnstone nodded, briefly closing his eyes. ‘Of course you are.’

  His tone was irritable, on the cusp of annoyance. Raven inferred that he had little margin for error before he might be shown the door.

  Dr Johnstone strode purposefully across the room, proceeding past him to the sideboard. He produced from it several newspapers and journals, which he slapped down deliberately hard to emphasise their collective heft.

  He was telling Raven there was no need for him to state his business. He was also telling him precisely how welcome he was.

  ‘My wife’s death has become a mere football kicked around in a game between men who ought to know better.’

  Raven spoke softly. ‘Believe me, Dr Johnstone, sir, there is nobody who regrets that more than Dr Simpson.’

  Johnstone opened one of the journals and stabbed a finger at the page.

  ‘I’m sure that … Professor Miller and Professor Henderson were they here would profess their regret too.’

  ‘Not with any sincerity. While I have no doubt that they would profess regret, I believe there is an unseemly alacrity with which they have seized upon your wife’s demise. They are men who have various grudges against Dr Simpson. You are right that it has become a game, but one which Dr Simpson has been too courteous to play. Which is why I am taking it upon myself, unbeknownst to him, to ascertain the truth of the matter and hopefully put an end to it.’

  Dr Johnstone fixed him with a sour look.

  ‘You are not the first. There was a woman here recently, asking the same thing.’

  ‘Mrs Banks,’ Raven stated, to confirm they were working together. It felt like a retrospective attempt to confer some credentials upon her, as he could now well imagine how she must have been received.

  ‘Yes, though I didn’t see the point. These are complex medical matters, so how could she have understood them? In truth I was relieved to learn that Dr Simpson didn’t send her, as it would have shown a level of disrespect I would consider beneath him.’

  Raven was surprised by the strength of his urge to correct Dr Johnstone on Sarah’s knowledge and capabilities, and felt disloyal that he chose to suppress it. However, he was trying to get the man to open up, and ruled it an occasion when discretion was the better part of valour.

  ‘Mrs Banks and I have elsewhere discovered that some of the claims made in these letters are baseless. What we don’t have is a first-hand account, which is what may be necessary for this issue to be … laid to rest.’

  Raven had searched momentarily for a different phrase, before judging these words the most effective.

  Dr Johnstone sipped from his whisky, eyes glazed, almost as though he had forgotten Raven was presen
t. Then he seemed to come back into the moment.

  ‘I have worked in this city a long time. I know the game they are playing,’ he said. His voice was low, tinged with weariness and not a little anger. ‘Every time they write about this, they make it sound worse, and I know they will wring it out for every last drop it might shed. The reason I have not written to the papers already is out of concern that my own testimony would not be credited by these individuals. I have nothing but gratitude for Dr Simpson’s kind attention, and like him it was my intention to maintain a dignified silence, but nonetheless putting my account on record might be the only way to draw a line under it.’

  When he eyed Raven again, his expression was softer.

  ‘I confess, the other reason I have been reluctant is that my involvement was limited. I entrusted my wife’s care to Dr Simpson and to the nurse I employed.’

  Raven thought of the disdain with which Dr Johnstone had just referred to Sarah and to women’s grasp of medical matters. He couldn’t see how this sat with him handing the care of his wife to a nurse when he was a doctor himself.

  These reflections must have been more legible upon his face than he intended, for Dr Johnstone looked at him with an expression that was challenging yet sincere, and said: ‘You are asking yourself why I delegated such duties to a nurse when I am a medical man.’

  Raven thought it unwise to deny it, and best to say nothing.

  ‘You are not long qualified, are you, Dr Raven?’

  ‘No, sir.’

  ‘And nor, I would wager, have you children or a wife.’

  ‘No, I have neither.’

  ‘When you do, pray that you are never required to treat them. It is not done. One’s judgment is utterly askew, confused at every turn by emotion. Every doctor encounters a sense of helplessness on occasion, an absolute impotence as circumstances overtake one’s knowledge and ability. Now imagine the magnitude of that helplessness when it is with regard to the health, to the life, of the one you love the most.’

  Raven nodded solemnly, acknowledging his understanding.

  ‘I have no regrets over employing a nurse, and certainly not this nurse. She was a caring and diligent woman, and she was with my wife to the last. She, in fact, is the one you ought to speak to. She will remember more clearly because I did not see a patient. I only saw Dorothy.’

  ‘What was the nurse’s name?’

  ‘Mary Dempster.’

  ‘Do you have her address?’

  Dr Johnstone turned briefly to the sideboard as though it might be written down.

  ‘Actually, no. I advertised for help in the newspaper. There were two respondents and I chose her because she came with excellent references and had worked on the surgical wards of the Royal Infirmary.’

  Dr Johnstone finished off his whisky and seemed far away once again. His subsequent words told Raven where his thoughts had taken him, and it couldn’t have been a pleasant journey.

  ‘What I can say is that the amount of blood Dorothy lost never made me uneasy. Considerably more was lost when Syme performed a similar procedure two years ago. Nor was there significant bleeding when Simpson removed the lint plug he had put in place at the time of surgery. The nurse will be able to corroborate that.

  ‘Dorothy seemed to be recovering after the operation, but then deteriorated over the coming days. I am not convinced this ailment was entirely related to the surgery, though perhaps that hindered her strength to fight it off. She was tormented: delirious, grasping at phantoms, her breathing shallow. It was as though she had fever, but her temperature was not elevated. She was at times unrousable, as though narcotised, and yet her pupils were normal in size. An odd combination. I do not think that I have seen it before.’

  Raven felt something course through him as he realised that he had, only a few days ago. Dr Johnstone was describing the same symptoms George Porteous exhibited before he died.

  He recalled Greta Porteous’s fear that she might develop the same disease, because their mother had died shortly before George fell ill. He had missed it at the time, but he now understood that her mother’s symptoms must have been similar for Greta to be so concerned.

  Raven had previously thought that had Dr Simpson been present at the Porteous house, he would have known what to do. Now it appeared Simpson had been confronted with the same symptoms here and been equally confounded.

  As Raven was shown to the door and bade his farewell, he had to suppress his excitement. He had deduced that in their eagerness to go after their enemy, these supposedly great medical men had missed the true significance here. There appeared to be a new, previously undiagnosed disease at large: one that spread rapidly and killed within days. It potentially represented a danger as large as cholera or typhoid. And no one had laid claim to its discovery.

  Rather than the blackening of Simpson’s name, this could be the making of his own.

  Raven’s Malady.

  He liked the sound of that.

  THIRTY-FOUR

  eputation and renown: these are precious things, are they not? More so than anything else you own, for nothing is harder to replace. They are a currency, as surely as the money in your pocket. But just like money, they are not the value they represent: they are mere tokens, promissory notes. Reputation is a guarantor of your character, but not the truth of it. Like any other currency, it can be forged.

  I learned a painful but valuable lesson at the hands of Joyce Meechan, when she lied about me. It is important to be in control of what people believe of you, especially those who have power over you. That is why I endeavoured thereafter always to please the Reverend Gillies. Witness how my obedience was demonstrated in his private office.

  He was playing host to Mrs Josephine Kirkwood, a benefactor of the institution, and her friend, a woman I only heard referred to as ‘Olivia’. Formal introductions were not a courtesy extended to the likes of me. The purpose of the visit was to allow Olivia to see the good work undertaken at the Institute in the hope of her becoming a donor like Mrs Kirkwood.

  Mrs Kirkwood enjoyed a reputation as a woman of great charity. You may judge for yourself whether that was her true nature.

  I stood silent and still, with my hands clasped in front of me and my head bowed. I noted that Mrs Kirkwood was in her stockings, her boots sitting upon the floor next to the desk that dominated the room.

  ‘You will see demonstrated the civilising effects of our methods,’ the Reverend said. ‘Mary, come forth and write for us from Hebrews, chapter thirteen, verse seventeen.’

  Obey them that have the rule over you, I wrote in my best hand, and submit yourselves: for they watch for your souls, as they that must give account, that they may do it with joy, and not with grief: for that is unprofitable for you.

  Olivia watched with interest, while Mrs Kirkwood beamed with satisfaction.

  ‘Mary here was brought to us by her destitute father,’ Mrs Kirkwood said, ‘making one of the few wise and selfless decisions of his life. He was the worst of drunkards, with an erratic and volatile nature. What you see here is proof that, in our care, even the worst of that which is inherited can be overcome.’

  I put down the pen and stepped back from the desk.

  ‘Now, lace my boot for me,’ Mrs Kirkwood said.

  I knelt down, took Mrs Kirkwood’s right foot and eased it into the corresponding boot, patiently and delicately threading the laces through the eyelets and tying a neat bow. While I was about this business, Mrs Kirkwood placed her left heel upon my back, as though it were a footstool.

  Olivia laughed, incredulous. ‘Josephine, a compliant nature is desirable, but allow the girl her dignity.’

  ‘You misunderstand, Olivia. A certain indignity is good for her. Humility is a vital part of what is imparted here, and thus soothes the more savage instincts that only cause conflict within the self. Knowing one’s role and accepting one’s place is the only path to peace for all of us.’

  It was to prove an appropriate introduction, for Olivi
a overcame her reservations, and was to have her foot upon my back for several years thereafter.

  THIRTY-FIVE

  aven found himself standing in another alley, but on this occasion felt no threat bar that posed by the rubbish heap emitting an unmerciful variety of noxious odours. His companion was being discreetly sick, if such a thing were possible, but it was daylight and no strong drink had been taken.

  He handed Sarah his handkerchief and she wiped her mouth. Raven wondered how she planned to explain this sudden illness: would she attempt a lie, or would she come clean, confirming what he already suspected?

  ‘Are you all right?’ he asked.

  ‘I am fine.’ Her reply was emphatic, defensive.

  ‘Emesis is not usually a sign of good health,’ he said gently, offering her the chance to explain.

  She ignored this, refusing to be drawn. He decided not to push her; it would be better that she tell him in her own time. But why was she keeping it from him? He was a doctor after all, a man-midwife no less, and so unlikely to miss the signs. Was it the pregnancy itself or the fact that she was refusing to confide in him that bothered him more? In truth he could not say. He missed how they used to be, how open they were with each other. He could not expect otherwise now that she was married and carrying another man’s child. A child she would probably have to raise alone. Another thing she would not talk about.

  They emerged from the alleyway onto Broughton Street. At the end of the morning clinic, Sarah had seemed unusually quiet and Raven suggested that she accompany him. He had a visit to make and thought some air might do her good. He realised it would also provide a chance for them to talk, there being little opportunity for uninterrupted conversation during working hours at Queen Street. She readily agreed, which had surprised him.

  As they walked, they resumed the discussion which had been abruptly curtailed by Sarah’s sudden need to void the contents of her stomach.

  ‘Have you heard anything more about the missing money?’ he asked.

  ‘No. Have you?’