The Art of Dying Read online

  No doubt you have seen paintings depicting Hell, and recoiled at the snarling, twisted features of the demons torturing the forsaken. How much more frightening it is to understand that a true demon has a kindly face.

  When I look at such paintings, I see only representations of evil and cruelty as though they were entities in their own right. They say nothing of where such evil and cruelty comes from. For this I know: every true demon was once a child, one that knew fear and suffering.

  Every true demon learned cruelty and evil at the hands of another.

  SEVEN

  he ticking of the clock was the only sound as Raven sat in an armchair beside the fire in Dr Simpson’s study, feeling uncomfortably alone. He could not remember the house ever being this quiet. It felt bereft, shorn not only of familiar presences, but of much more besides. Nothing here was as he had imagined it would be, but it was not mere absence that was accentuating his feeling of isolation.

  Sarah was married.

  He heard the housemaid’s words over and over in his head: She is no longer Miss Fisher, sir. She is now Mrs Banks. What she had conveyed was instantly understood and yet somehow incomprehensible.

  Jarvis had shown him to his new quarters, helping him heft his trunk up the stairs. The butler had observed that Raven looked ‘less like a vagrant than when you first darkened our door’. It was hardly the most generous of compliments, but it was as warm a welcome as he had received, the place seeming comparatively deserted.

  Raven’s new accommodations were larger and finer than the room he had been given as the doctor’s apprentice. However, part of him wished for the reassurance of its familiarity, or perhaps he merely wished for other things to be the same.

  Raven had busied himself by unpacking his things, though he had halted each time he heard the front door open downstairs, waiting for the accompanying boom of Dr Simpson’s voice. Thus far it had not been forthcoming. His new window offered a view of Queen Street Gardens, and he had gazed out each time he heard hooves, hoping to spy the approach of the professor’s brougham.

  Eventually he had come down the stairs and asked Jarvis when the professor might be due home.

  ‘Any minute,’ the butler assured him, ushering Raven into Dr Simpson’s study. Raven recognised the tone. It was the same one Jarvis used in addressing patients and other visitors when they made a similar enquiry. ‘Any minute’ turned into almost an hour, and Raven was beginning to feel sleepy, lulled into somnolence by the ticking clock, when the sound of a carriage pulling up outside roused him. He got to his feet as he heard the front door open, and moments later Dr Simpson burst in, instantly filling the house with his presence.

  ‘Will Raven! What a pleasure it is to see you again. And just in time too. We have an interesting patient to see. A young woman with troublesome abdominal distension.’

  Raven stood and smiled, relieved that some things had not changed. He was reminded of his first day at Queen Street, when not so much as a cup of tea had been offered before he was hurried into a carriage and driven off with the professor to see a pressing maternity case.

  Dr Simpson appeared to be much as Raven remembered him. There was some more grey in his hair perhaps, and a little thickening around the waist, but otherwise the same: the permanent sense of urgency, an air of perpetual motion.

  ‘How are you? How is Henry?’

  Raven’s mind suddenly ambushed him by conjuring images of blood upon his hands and spilling in rivulets around the course of his knife. He first saw Henry’s leg, cut open that he might remove the ball fired by the masked assailant, but, more unsettlingly, that image gave way to the incision he had made not an hour before.

  He had not lied to Gabriela. He had chased the men into the alley believing them cowards who would run when confronted with the prospect of a real fight. In that regard his judgment had been sound, but a coward will still fight if he believes he has the advantage. In the dark of the alley Raven saw the man with the pistol raise his weapon a second time. He had indeed reloaded quickly, or perhaps he had a second pistol. Either way, he had straightened his arm and aimed point-blank at Raven’s head.

  Raven had reacted without a thought, his blade an extension of his hand, of his mind. The Liston knife opened the man’s throat like it was opening a letter, but it was a letter from which devastating news poured forth.

  At the very mention of Henry’s name, he instantly felt shame and regret. Why otherwise would he have concealed what happened from him, and from Gabriela? He knew his actions had been driven by sheer instinct, near-involuntary reflex, and that the only choice had been to take a life or surrender his own. But none of that made it easier to live with the memory of what he had seen, what he had wrought.

  And what of that instinct? The thought of that troubled him as much as the guilt: what it said about his nature. What he feared he had inherited from his father.

  You have the devil in you, his mother had often said, and though she spoke with humour and affection, he could not help but wonder if it was a way for her to express her own fears for what he had been born with.

  Perhaps the hardest thing was that there was nobody he could talk to about it. Standing here now in the professor’s study, he donned a neutral expression and concealed his feelings.

  ‘My travelling companion decided to extend his stay in Berlin.’

  ‘A city I have yet to see. Chance would be a fine thing. Always so much to be done.’ The professor looked around for somewhere free of clutter to place his bag. He moved a pile of papers from his desk to a chair and seemed sad for a moment. ‘I hunger for a book and thirst for the time to read it,’ he said.

  Raven had so much he wished to tell the professor. There were names to conjure with, institutions of vast renown, techniques and procedures that he was sure would fascinate his ever-curious mind, but there was to be no such opportunity, as almost immediately the doctor began discussing the details of the patient they were about to see. It was frustrating and yet oddly reassuring. This part, at least, was like coming home.

  ‘A widow of more than a year. Her husband was an army surgeon who succumbed to an infectious fever within days of their arrival in India, leaving the poor woman to make her own way home. She now looks as if she is in the advanced stages of pregnancy and, with the husband having been dead for longer than the period of a normal gestation, a certain amount of embarrassment has resulted from her condition. What do you think of that, Dr Raven?’

  Raven felt a slight inward glow at being addressed by his hard-won title, but this quickly left him as he sought to make an intelligent reply to the professor’s query. He thought for a moment. Her apparent condition was bound to prove highly injurious to the widow’s good name, but her reputation might well prove the least of this woman’s worries.

  ‘She might actually be with child,’ he suggested. This answer directly questioned the woman’s virtue but there was no room for drawing-room decorum when discussing medical matters.

  ‘Sometimes the most straightforward explanation is the correct one,’ the professor agreed. ‘It may, of course, be a phantom pregnancy – I have encountered one before – but on that occasion the patient fervently believed she was carrying a child, whereas this lady insists that pregnancy is not a possibility, in spite of her appearance.’

  There was a knock at the study door; at the threshold stood two women, both of whom presented a disconcerting sight in their different ways. One was the patient, introduced as Mrs Elizabeth Glassford, but Raven found his eye drawn to the other.

  Sarah escorted Mrs Glassford through the study door, a supportive hand upon her arm. A cursory visual assessment revealed only that she looked well. Her hair was swept upwards into a loose bun and she wore no cap. She was wearing a plain gown, neat and well fitted – a far remove from the servants’ garb he had become accustomed to seeing her in.

  Was he imagining it, or did she carry herself differently? He could not stop thinking of the implications, of knowing what she had
now experienced. So often he had thought back to the small intimacies they had shared, and the nights he had lain in this house, troubled by the attendant dangers should they share more. Now she had shared all, with someone he knew not, a face he could not even picture. He was not sure if this was a consolation or a further torment.

  His staring, he was sure, would have become prolonged and awkward had his professional attention not been drawn to the patient. Mrs Glassford walked with the gait of one far advanced in years, although she could not have been much more than thirty. As she moved slowly across the room, she supported the sides of her protuberant abdomen with her hands. In contrast to the swelling of her belly, the rest of her seemed excessively thin, as if whatever was growing in her abdomen was leeching all nourishment from every other part of her. The effort of her short walk had rendered her profoundly breathless. Raven knew immediately that this was not a pregnancy, real or imagined.

  Sarah helped the woman onto the examination couch, as Raven had seen her do with countless patients before. She then pulled across the screen that shielded the couch from the rest of the room and assisted in loosening the patient’s clothing. Raven could hear her making encouraging remarks to the woman, though he doubted she would have any misapprehensions about the likely prognosis. He remembered that she always had a good diagnostic eye despite her lack of formal training.

  Raven went behind the screen, with its incongruous embroidered panels depicting chrysanthemums and peacocks, and proceeded with his examination. He was unsurprised by what he found. The skin of the abdomen was stretched tight, the umbilicus protuberant. Fluctuation was easily discernible, suggesting a large volume of fluid contained within. There was also gross swelling of both legs and of the lower abdominal wall. Where he had pressed on the abdomen, an imprint of his hand remained. The diagnosis was obvious.

  ‘Well?’ asked Simpson as Raven emerged, his eyebrows raised. Sarah had gone behind the screen again and grunts of effort could be heard as the two women attempted to squeeze the patient’s misshapen body back into her clothes.

  ‘I think this is a case of ovarian dropsy.’

  ‘I agree,’ the professor replied. ‘How should we proceed?’

  ‘Abdominal binding, mercurials and diuretics,’ Raven said, confident of his answer and yet despairing of its likely effectiveness.

  ‘That is certainly what many would advocate,’ said the professor. ‘However, given the degree of distension and her breathlessness, I think we must remove some of the abdominal fluid directly. We will ask her to return tomorrow for tapping.’

  Raven felt a familiar thrill at the prospect of performing such a procedure, an excitement tempered only slightly by the inevitable discomfort that the patient would have to endure – to say nothing of the fact that this was likely palliation rather than cure. Yet doing something was so much more appealing than doing nothing. To Raven’s mind, in desperate circumstances, action trumped passivity.

  This train of thought prompted the resurgence of an unpleasant memory, a case he had seen while in Paris of a young woman felled in her prime. She had collapsed suddenly, without warning, and an examination revealed evidence of concealed bleeding. There was some debate about the likely diagnosis and possible interventions, whether anything could or should be done. Wise old heads had counselled caution, holding back their younger counterparts. Prevarication had proven fatal and the post-mortem had confirmed what had been suspected: a belly full of blood as a result of a ruptured tubal pregnancy.

  In the aftermath there were voices raised in recrimination, a wringing of hands by some, a shrugging of shoulders by others. Vague promises were made about lessons being learned, which was of small comfort to the young man left bereft by the loss of his wife.

  Raven was still undecided as to whether it had been prudence or cowardice that had held them back from attempting some form of surgical treatment, although frequently he felt that the scales of his judgment were tipping towards the latter. Surely a heroic failure was better than sitting idly by letting nature take its course. A slim chance of success still represented the possibility of survival.

  It was always better to do something rather than nothing.

  Always.

  EIGHT

  arah escorted Mrs Glassford to the waiting room to allow her to catch her breath, though in truth she was as much in need of relief as the patient. The moment she became aware of Raven’s presence in the room, she had felt a tension in the air that reminded her of those rare clammy summer nights just before a thunderstorm broke.

  They had been at close quarters and yet unable to communicate. Sarah had felt at once both a powerful need to talk to Raven and a profound gratitude that the circumstances precluded it. In her time here, she had observed that there was much human congress that could be avoided through protocol, decorum and the practical demands of duty. Sometimes it was a frustration, sometimes a relief, and occasionally both at once.

  ‘Would you like some tea?’ she asked, thinking that in her current state Mrs Glassford was unlikely to be able to make the short trip home.

  ‘Tea would be most welcome.’

  Sarah returned a short time later to find Mrs Glassford already significantly improved. She watched as Sarah poured the tea, a frown creasing her brow.

  ‘What is your position here? If you don’t mind my asking.’

  Sarah smiled. ‘My role is rather unconventional. I help with the patients and administer chloroform on occasion.’

  ‘And do the patients find this arrangement acceptable?’

  Sarah stopped smiling. ‘I’m unaware of any complaints.’

  ‘That is refreshing. Some would have us believe that making ourselves useful will bring about the end of civilisation as we know it.’

  Mrs Glassford leaned forward and placed a bony hand on top of Sarah’s.

  ‘I have long thought that there should be more to life for a woman than being a wife and mother.’

  ‘But you were married,’ Sarah observed.

  ‘Yes. I had thought that it would be an adventure. He was in the army and we were going to live in India. I wished to see the world and experience other cultures. But it wasn’t to be. He died shortly after we arrived, and I was forced to return. If you want to make God laugh, tell him your plans. Though I suppose it could have been worse.’

  ‘Worse? How so.’

  ‘In India there is a tradition that the widow throws herself onto her husband’s funeral pyre.’

  Sarah made no reply as she struggled to take in what Mrs Glassford had just said. It brought to mind the burning of witches and martyrs and she decided she must have misheard or misunderstood.

  ‘The widow is immolated alongside her dead husband?’ she asked.

  ‘Yes. It is known as suttee.’

  ‘And would I be right in assuming there is no tradition of the reciprocal?’

  Mrs Glassford managed a smile, despite her obvious discomfort. ‘A curious oversight.’

  She drained her cup and with some effort got up from her chair. ‘Thank you for the tea. I shall return to my home and rest in preparation for tomorrow.’ As she reached the door she turned. ‘Perhaps we can talk more when I return.’

  Sarah hoped that would be the case.

  NINE

  inner that evening was initially a quiet affair: just Raven, the doctor and Mrs Simpson. Raven hoped that now he would be able to discuss his recent experiences and impress upon the professor how much he had progressed. During the afternoon’s consultation, he had become conscious of their adopting familiar roles, of the master and his apprentice. He knew he still had much to learn from Dr Simpson, but nonetheless felt a need to establish his credentials as a medical practitioner in his own right.

  He would have to wait, however. As soon as they were seated, discussion immediately turned to household matters. The nursery nurse had sought advice on how best to treat young Jamie’s skin complaint, which had flared up again. Jamie was almost three years old. When last Raven
saw him, he was barely weaned.

  ‘I have asked that his bed be stripped, the sheets boiled, and the mattress aired,’ Mrs Simpson said.

  ‘Is she still rubbing the skin with olive oil? That should help,’ Dr Simpson suggested. Raven imagined this would primarily make the child more difficult to apprehend if he was wont to run about the house as his older brothers did.

  Jarvis entered bearing a decanter and two glasses on a silver tray. Raven, who had been hoping for a drop of the doctor’s claret, was disappointed to see that the liquid in the decanter was translucent.

  ‘Ah,’ said Dr Simpson, rubbing his hands as Jarvis poured. ‘My special champagne.’

  Raven was now intrigued as he accepted a glass of the effervescent beverage. He noticed that Mrs Simpson was not partaking and briefly wondered why.

  ‘What is special about it?’ Raven asked as he took a sip.

  ‘It is carbonated water with some chloroform added to it,’ Simpson said.

  If Raven had not already swallowed his mouthful of ‘special champagne’ it would have been sprayed across the table. He put his glass down and looked at Simpson hoping this was some kind of joke.

  ‘Chloroform?’ he asked.

  ‘Yes. It livens up the dreariest of dinner parties – not that this should be interpreted as a comment on present company.’

  Raven dabbed his mouth with a napkin and pushed his glass further from him. ‘If it’s all the same, I think I’ll stick to wine. I have learned altogether too much respect for your special champagne’s active ingredient.’

  Simpson put his own glass on the tray and indicated to Jarvis that he would like it removed just as the dining-room door opened and dinner arrived. As the various dishes were placed on the table, Raven felt a pang of disappointment over who was serving them, or more specifically who was not. He watched the young girl who had answered the door as she made her way round the table, and it brought home to him once again what had so dramatically and irrevocably changed in his time away. He tried to imagine Sarah sitting at her own table with her husband, but he could not bring the image to mind. Even the attempt caused him to feel a distinct ache in his chest.