And here he is in Act V of his life, a tragic end for a tragic hero. His performance must’ve stunk, for he sees he’s driven the entire audience away, all except one man, who slouches in the second row with his great wide head in his hands.
The younger player leans over him and places a cool tube of glass under his tongue. Jack falls asleep again, and when he wakes the bit of glass is being removed and the player is shaking his head.
“Eighty-four degrees,” Henry says. “And the external temperature has dropped to seventy.”
“Let’s get him in the bath,” sighs Doctor Clanny.
“Jack,” Henry says, clasping the old man beneath the shoulders. “We are going to lift you now. Can you grab hold?”
“May I go home?” the old hero croaks, and his breath is icy against Henry’s cheek.
“Not quite yet.”
“He wants to go home! Did you hear him?” The lone audience member leaps up from the second row. How long are they going to keep him in this fiendish operating theatre? Hung round with skeletons and pictures of skeletons—it’s enough to drive a perfectly healthy man to his grave, much less poor liquor-soaked Jack Crawford. “He asked to go home!”
“Not yet,” says Clanny over his shoulder. “He’s still too ill.”
They have been working on Jack Crawford for a good eight hours now, trying first to restore his circulation and then to ease his stomach spasms. His symptoms were most severe the first few hours, when the old hero was convulsing at a clocked rate of once every ten minutes. Nothing Henry had ever seen had prepared him for this disease, and its progress has been almost unbearable to watch. In great heaving waves the old hero would vomit basinfuls of gruely white flocculent matter, the color of soap in hard water. Sometimes he would collapse back into sleep, sometimes the purging would start anew. Over the course of his convulsions it became less violent and more pathetic, just a helpless oozing of white jellylike pus from the buttocks. His uncle collected it in a pan and when they sniffed it for clues, neither could come up with a word to describe it. “Fusty” was the closest Henry got. It had the distilled aroma of every dilapidated back lane lodging house he had ever visited, a damp, mildewy smell, as if the man were spoiling from the inside out.
But the tetanus spasms were what finally drove them to banish Robert Cooley (as they learned Bob, formerly Fustian, was more properly called) to the benches of the operating theatre. They were horrible to behold. Like panicked mice running the length of his body, the contractions would start at the sick man’s toes and race up the legs to his groin; would start in his fingertips and flee down the arms to his chest. Faster and faster they’d try to outrun each other until poor Jack Crawford became one anguished, protracted spasm, jackknifing across the operating table, only the top of his head and his heels touching the surface. Clanny and Henry would fall on him, trying to hold him in place, while his friend, Robert Cooley, screamed every profanity known to workingmen. Henry’s own calves would start to cramp in sympathy—he could feel the long muscles charley-horsing into knots as he watched his uncle pour medicine down Jack Crawford’s constricted throat. You are poisoning him! Robert Cooley banged the table. What are you giving him? Laudanum and brandy, you misbegotten creature. Now go sit down, you are tormenting this patient.
Jack Crawford is now in the third and usually final phase of the disease, what the doctors who first studied cholera in India termed “the cold blue stage.” Henry had read of it, but never thought it would manifest itself so literally. The disease has pummeled Jack’s face, leaving it a bruised black-and-blue; the old hero’s hands have gone from a freckled white to a deep indigo; his feet have turned blue as if stained with woad. With no fluid to keep it plump, his skin has shriveled and his dry eyes have receded into his head. The constant spasms have so contorted his back and spine that he has become like a hunched old man. It is the most horrible aspect of the disease. Cholera has aged Jack Crawford forty years in a few short hours and turned him into his own grandfather before their very eyes.
“Here we go,” says Clanny, gently lowering the sick man into the steaming tub of water. If they can only get his temperature up, he may have a chance. But Clanny and Henry barely have him an inch into the bath before he cries out pathetically.
“It’s torture!” Jack Crawford wheezes.
“Acid! You’re putting my mate in a vat of acid!” Robert Cooley leaps up and crashes over a row of benches to get at the doctors. “It’s his bones you want, isn’t it? You only care about his bones!”
“Damn it, man!” Henry roars, struggling to support Jack’s dead weight above the surface of the water. “You saw us fill this tub with that very kettle. You saw me pour a pot of tea from it not even an hour ago and drink it. Your friend cries out because he is so cold, even tepid water will feel like a thousand degrees to him. We need to elevate his body temperature or he will certainly die.”
Robert Cooley looks uncertain, but, unwilling to test the acid water on his own beefy forearm, he sits sullenly back down.
The doctors ease England’s whimpering hero of Camperdown farther into the bath and set his arms on either side of the tub to keep his head from going under. We can leave him in for fifteen or twenty minutes, Clanny says. Let’s rest ourselves by the fire.
Henry shovels a few more coals onto the brazier and pulls a hard, cane-backed chair next to his uncle’s. Robert Cooley sits all alone in the shadowy operating theatre, where many a surgeon-to-be has dozed through lectures on the palmaris brevis of the hand or the thirty pairs of nerves that originate in the backbone’s dorsal medulla. The man looks like he could use some sleep, but Henry knows that, for fear of having a plaster slapped across his nose and mouth, Cooley won’t shut an eye. It’s strange. Henry has practically grown up in rooms like this, has never thought of an operating theatre as a fearful place, but he can see how to a simple man like Robert, a suspicious man, this auditorium must appear a house of horrors. Is he more frightened of floating fetuses in specimen jars arranged neatly on bookcases, Henry wonders, or of the human skeletons, dark brown and oily-looking, suspended by delicate cords of silk? The paneled walls are decorated with prints by the master dissector/illustrator Albinus, of bug-eyed muscle men flexing their exposed tendons in front of felled Corinthian columns, of animated skeletons (front and back view) posed before grazing rhinoceroses. Henry has always looked at them and seen the Lesser sciatic notch, the Occipitalis, the Flexor Hallucis Longus, isolated muscle and bone he would have to identify on a test. Seen through Robert Cooley’s eyes, though, the engravings are rather macabre—all these flayed reanimated carcasses cavorting through Arcadia. No wonder he’s afraid to go to sleep.
Henry reaches out for the ceramic cup of tea he left on the hearth after their last break. The handle has stayed hot next to the fire, but the liquid inside is cold. Having worked two solid days on the corpse Gustine procured for him, and now staying up all night with Jack Crawford, he is on the point of collapse. It is hard to keep from shaking as he drinks his cold tea.
“We need to alert the Board in London,” Clanny says, leaning back in his chair with his eyes closed. “I would imagine they’ll lock us down even tighter.”
All summer the debate over Quarantine had raged. The merchants and landowners led by Lord Londonderry argued against it—self-servingly saying that a suspension of trade could only further bankrupt the poor and drive them more rapidly to their deaths. Clanny and a good number of the other doctors, backed by the London Board of Health and thus His Majesty, claimed it was their only protection. They’d all read the numbers in the newspaper: thirty thousand dead in Cairo in twenty-four hours, five hundred cases a day in Saint Petersburg, anti–doctor poison riots in Hungary, Paris, and Berlin. Cholera morbus must not be allowed into the realm. This was a disease to enrage the people, to bring down governments, and with Reform Riots already flaring in Nottingham and Bristol, His Majesty decided it in the country’s best interest to quarantine all incoming vessels.
“
What do you think they’ll do?” asks Henry. His uncle shakes his head.
“Did you read the latest Sanitary Code? ‘It may be necessary to draw troops around infected areas, so as to utterly exclude the inhabitants from all intercourse with the rest of the country.’”
“Londonderry will never stand for it. He needs to sell his coal.”
“Then let him take responsibility for the pestilence.”
Clanny stretches his long legs toward the fire. “Do you remember back in August when Dr. Dixon called me in to look at that keelman Robert Henry? We thought he had the summer diarrhea, but twenty hours later, he died of it. And earlier this month, that girl … what was her name—Hazzard? Only twelve years old and dead after twelve hours. I think the cholera has been here since the summer. I think it’s been moving among us for months.
“For that matter, who knows how many of them have died without our even knowing it?” Clanny continues. “They don’t trust us, so they don’t send for us. Our behaviour is as responsible for the spread of this disease as anything else.”
Henry looks over at Robert Cooley, sitting watchfully in the second row. Why would they trust us? We bully them, confuse them, experiment on their kidney stones in hospitals no respectable person would consider entering. We dig up their bodies, steal them from their parlours, hire desperate men to murder them while they sleep. It is a wretched business being a doctor, thinks Henry. But what else are we to do?
“I have a theory,” Clanny interrupts his meditations. “On why they turn blue.”
“What is it?”
“Too much carbon in the bloodstream.” Clanny sits up when his nephew doesn’t answer. “Think about it. Blood changes from bright red to blue when carbon swallows all the oxygen. All summer and into the autumn it was so humid—now it is cold, but still damp. Atmospheric pressure forces the free carbon back into the body where it cannot be properly expelled. It’s why we are so languid and unnerved in July and August.”
“So you think it is atmospheric rather than contagious?” Henry asks, slightly confused by his uncle’s theorizing.
“I’m not saying it’s not contagious. But it may not be imported. The atmosphere in Sunderland could be responsible for its generation; men could be responsible for its spread.”
“I don’t know, Uncle.”
“I don’t know either,” says Clanny, “but I’m certain of one thing. I’m going to sleep with the doors and windows cracked at least an inch until this passes over.”
Henry smiles at the old man and puts his feet up on the bags of bran they have warming before the fire. Clanny likes to blame everything from gout to broken collarbones on the weather. Henry’s seen the long, cramped lists he keeps in his office here in the Infirmary, pages and pages filled with discourses on climate—Saturday, the 15th: much lightning, wind from the WSW. Sunday, the 16th: cloudy and mild. Henry would not deny carbon might well play a part—it’s as good a hypothesis as any other—but he can’t help feeling it’s exactly the sort of ungrounded, theoretical guess a doctor of Clanny’s sort would make. He and his uncle were trained so very differently, after all. Clanny, studying to become a high-paid physician, took most of his education from books. He read the classics, observed in hospital wards, studied his materia medica to prescribe pills. If he took any anatomy at all, it consisted of sitting once or twice in a lecture hall while a demonstrator held up a brain and pointed to the medulla oblongata. Henry, coming up fifteen years behind him, took a radically different course of study. He knew he would never make as much money training as a surgeon, but he couldn’t help feeling anatomy was the way of the future. You would not expect to know how a clock works merely from studying its face; you would need to open its door, examine the complex interaction of springs and gears, observe how, in the telling of time, it releases its tightly wound tension. But you might take a million clocks apart and have no one weep for them. Taking apart a poor man was another matter.
“Mr. Cooley?” Henry turns around in his chair. “Would you like to join us by the fire?”
Mr. Cooley looks up startled. Neither of them have said a word but to yell at him for the past eight hours. Why the sudden pleasantry?
“I’d like to sit with my friend,” he says at last.
“You may stand by the tub,” Clanny consents. “But don’t say a word that might disturb him.”
The awkward man in his fustian jacket and too tight knee breeches struggles down from the observation benches and walks over to his friend. Jack’s naked body is dim under the water, but thin—as thin as Starvation himself. If Bob hadn’t come in here with them, he would’ve sworn the sawbones had swapped his mate for this horrible old man in the tub. His skin is wrinkled and an awful mottled color; his hands, dangling over the edge, are turned in on the wrist and clenched into claws. His eyes are closed, but his lids are so weirdly sunk, you might see the very hollowness of the sockets like them that’s on the skeletons hanging about this awful place. Aw, Jack. First Reg taken from old Mag Scurr’s down on the Quay, and now you. Who’s left for a man to lift a pint with?
“There’s no need to cry, Mr. Cooley,” Clanny says, coming over. “You must stay optimistic. Doctors are always optimistic; it’s why we rarely catch the diseases we treat.”
The old doctor slips a thin tube of glass under Jack’s tongue and studies his pocket watch. At the prescribed time, he removes the glass and squints at it.
“It’s barely come up five degrees,” he announces sadly. “And he’s chilled the water. Let’s get him under the bags.”
“Mr. Cooley.” Henry taps the woebegone friend on the shoulder. “You may be of help by ferrying those sacks of bran from in front of the fire. When we lay your friend on the table, place them immediately on top of him.”
The doctors reach into the tub and lift the slippery eel of a hero out and back onto the table. Obedient Robert carefully covers him with hot bags of bran, while Henry retrieves the rest and builds a steaming barricade around him. Working beneath the bags, the doctors bind Jack’s still twitching calf muscles with clean white handkerchiefs and apply a mustard poultice to his chest. Like shall cure like, says Clanny, feeding him his hourly dose of ipecacuanha in brandy to induce vomiting and expel the poison more quickly.
“It’s time to bleed him again,” he says. “Maybe there will be some change.”
The tiny lancets they used to prick him stick like feeding metal mosquitoes in the tabletop. Henry tugs one out and prepares to make a small incision in the vein that runs from the left leg to the abdomen. As blood-letting is one of medicine’s most powerful remedies, and hemorrhage one of its worst calamities, this important art must be exactingly executed. A patient should be bled to the point of fainting syncope without accidentally being brought to dissolution. He must never be bled in a horizontal position, but always upright, for as long as the head remains above the heart, fainting will occur before cardiac failure, and thus alert the surgeon that enough blood has been taken. Take too little blood and nothing is gained; take too much and the patient sinks even unto death.
While his uncle arranges the warm bran sacks to support the head, Henry feels about for the vein. He cuts sure and deep, holding the cup to catch the spurting fountain of red. But to Henry’s astonishment, where he’d expected warm blood to gush, only a black trickle weeps from the cut. The blood that does flow from the vein wanders in two streams, side by side. One, dark as treacle, is thick and tenacious; the other, bright and of thinner consistence, runs along with greater velocity. Henry has never seen anything like it
“Take these off!” Jack Crawford startles them all by suddenly lashing out at the hot bran bags that cover him. He kicks so hard, Henry’s lancet flies through the air and clatters across the wooden floor. What strange turn is this? The hero of Camperdown, only moments ago in a complete state of collapse, is struggling off the table, trying to get to his feet. He is striking out at Henry, at Clanny, who rushes over to calm him. “I feel fine,” Jack rasps. “Is there n
othing to eat in this bloody place?”
“Jack!” Robert Cooley pushes the old doctor aside and gathers his friend in his arms. “Ach, God, I knew you’d get better.”
“Help me home,” the old man begs.
“This is a trick of the disease,” Clanny declares, trying to draw the patient back onto the table; but Robert Cooley has gotten his shoulder under his friend’s armpit and is pulling him toward the door.
“You tried, you bloody burker,” shouts Robert, supporting the weak-kneed hero. “You tried to kill him. But he is too strong.”
“Look at his eyes,” Clanny shouts back. “Look at his tongue.”
The corneas of Jack Crawford’s dry eyes are albumin-dull and cloudy, it is true, and the red vessels frizzing out from the iris are engorged with blood. The veins terminate abruptly, having no network, just a tangle of crazed dead ends. When Clanny grasps his chin and forces his mouth open, the old hero’s tongue is woolly with white fur. Still, would a dying man cry out for a pork chop as Jack does now? Would he bellow for a pint of beer? Robert will not risk it.