“Where is Mary?”
“Downstairs in your own parlor, my lady. She’s fine, not ill at all. I sent her down in Charlotte’s care, soon as I realized what was happening. Charlotte’s a good girl.”
Charlotte, thought Lady Mary, is a feather-brained fifteen-year-old. But at least she is already pockmarked.
The nurse began to cry.
“Hush,” said Lady Mary, crossing the room and giving the woman her hand. The woman did love young Mary, and had been with her since her birth. But it was hard not to notice that none of this would be happening if she hadn’t so adamantly refused to be inoculated while in Constantinople. Inoculated while in Constantinople. The full force of those words jolted her through her brain.
The nurse had been saying something in between sobs. Lady Mary couldn’t make it out. “It will be all right,” she said absently, patting the woman’s hand.
Within half an hour, the nurse was bundled up and packed off to a certain house in Swallow Street, down in Piccadilly, where the servants of the aristocracy were sent to suffer through smallpox with kind care, at a safe distance. Footmen had been sent scurrying through the streets with notes inquiring after the availability of suitable short-term nursemaids. And her own carriage had clattered away in search of Mr. Charles Maitland, with orders not to return without him.
Two hours later, Mr. Maitland was shown into a sitting room that resembled a pleasure palace straight out of the Arabian Nights.
Sitting cross-legged on an ottoman behind a jewel-encrusted coffee set, Lady Mary was resplendent in her flowing Turkish costume, the thin rose damask embroidered with silver flowers and the jeweled cloth-of-gold rustling and clinking softly as she moved.
He bowed low, in the ostentatious manner of the Turkish court. “You must have a djinn at your mercy, my lady,” he said as he straightened. “How else you could have transported such an exquisite corner of Constantinople to Covent Garden, I cannot begin to think.”
“I admire the art and the poetry of the Ottomans,” said Lady Mary with a smile as she poured out the thick coffee. “And I like to think I can offer some poor shadow of their grace in entertaining,” she added, handing him the tiny cup.
He raised the sweet steaming brew to his lips.
“But I fear that in the matter of Turkish medicine I must beg your help,” she added.
He froze, and his eyes met her gaze over the rim of the cup.
“I want you to inoculate little Mary,” she said.
He set the cup down with a click. “I am honored, Lady Mary, by your trust,” he said, stalling.
“Today,” she said, leaning forward.
“In such matters, my lady, it does not pay to be hasty.”
“In the matter of the smallpox,” she countered, “it does not pay to hesitate. In any case, you have had three years to mull over the results of inoculating my son.”
“The season is too cold,” he objected. “In Constantinople, they operate in a warm season.”
“Here, it is a smallpox season,” said Lady Mary, never taking her eyes from him. “Mary’s nurse erupted this morning.”
He had of course, surmised what she wanted. Had surmised several months ago that she might want it. If anything, he was surprised the request had taken this long. He knew her well enough to know that when she set her mind to something, she did not take no for an answer. He knew he was not going to win this contest. Nor did he want to, really. He had seen the experiment work with his own eyes; even a remote possibility that it might work here in Britain made it valuable. But he wished to proceed with caution.
He also wished to make certain demands, though perhaps it would be better to say that he wished to put certain protections into place. For this was not Constantinople, though she seemed to want him to think it was. They were in the heart of London. And she was not asking him just to be a witness, as he had been in Turkey, where he’d merely stepped in to clean up a barbarous operation he had not begun. She was asking him to be the sole operator.
He was less sanguine about the outcome than she was. He had no wish to be charged with the murder of the granddaughter of a duke, and the daughter of an ambassador. It was paramount that he not work in secret. But how was he going to convince Lady Mary?
Let her win a lesser battle, said the voice of instinct. He cleared his throat. “It is not your son I am concerned about, it is your daughter. She must be prepared.”
“She’s strong as a horse,” said Lady Mary, waving that notion off. “Her diet is clean and her exercise regular. I will not have you draining her blood and calling it useful.”
He bowed. “Very well,” he conceded.
Her eyes narrowed. “You want something else. What is it?”
Really, she was unnervingly perceptive. As smoothly as possible, he came out with it. “For you, my lady, this operation offers great personal benefit, in exchange for grave personal risk, as you well know. I hope, however, that you will consider sharing that benefit. Will you allow me to choose two physicians to witness the operation, in order to contribute to its credit and reputation, as well as to consult on the health and safety of your daughter?”
She sprang to her feet, her eyes flashing. “Certainly not,” she exclaimed. “Under no circumstances will my daughter be exhibited to curious crowds like a carnival monkey.”
He knew she had no high opinion of physicians, but still, the force of her refusal took him aback. Another, less patient man might have lost his grip on his own patience, and tried to argue with her, but Mr. Maitland knew her better than that. He called her bluff. “Then, my lady,” he said, rising after her, “I must regretfully decline your kind offer to make use of my services.”
Before she could recover, he had bowed and departed.
Three days later, she summoned him back again. The nurse’s case was not going at all well, and fear was thickening her blood by the hour.
This time, he was shown into a proper English room; in the guise of a proper English lady, Lady Mary was standing by a window, with her back to him. “Two,” she said imperiously, as he walked into the room.
He bowed. “Three,” he countered. There was no need for either of them to specify that it was the number of physician witnesses they were discussing.
“Last time it was two,” she said, glancing over her shoulder.
“Now it is three,” he said.
She turned away again. “One at a time.”
“I agree.”
“And I will be present throughout.” She whirled around. “I will not have physicians corrupting the operation out of sheer malicious rancor, for fear its success will dry up their revenues, along with the town’s pocks.”
He let her outburst skid by him. “You will find the city and the nation grateful, my lady. Now if you will excuse me, I will make the necessary preparations.”
“No preparations,” she snapped. “No prior bloodletting, no purges, no vomits. As I said, she’s strong as a young horse.”
“Yes, my lady. But that is not the sort of preparation I meant.” It had been, of course, but it would not do to let her yet realize it. He liked her on the defensive. “I must acquire some promising matter.”
“How hard can it be to scrape pus from a pock in London?” she cried. “Why haven’t you already done so?”
“With all due respect, my lady, I was not sure we would come to an agreement. Now that we have, I am sure you do not want me to be quite so cavalier in this matter as you suggest. I must find a suitably clean subject, with no other history of disease, at just the right stage of a light, distinct smallpox. You do not want to shield Miss Wortley from smallpox, only to give her the great pox, or a consumption.”
Lady Mary sighed, tapping one foot impatiently. He saw her thinking furiously. “Be quick, then,” was all she said in the end.
As it turned out, he had one week’s preparation for himself, and his three witnesses, but only after the fact: they were engaged to see Mary as soon as the rash came out, and no
t a moment before. And he won no preparation for the girl at all, though he kept lobbying for it right up until the last moment.
Lady Mary held her daughter on her lap right through the procedure, kissing the top of her fair downy hair, and singing her favorite songs. The girl wriggled a bit, but not badly: Mr. Maitland was deft and swift, and she had known his voice all her life.
The little girl liked him. To her, he was tall as the clouds and almost as gentle, with a funny way of talking. His r’s were furry. Or bumpy. She couldn’t decide which. Mamma said he sounded that way because he was from a place called Scotland. Considering this mystery, she sat grave and wide-eyed, only turning away and screwed her eyes shut when he drew out his lancet. She knew he was trying to be kind, so she tried to be brave. But as she felt a prick in each arm, one tear squeezed from each eye and trickled down her cheeks.
The incisions opened and wept early, growing day by day. Two, three, four, five. On the sixth day, Lady Mary was so restless, she snapped at Cook, reduced the new nurse to tears, and sent old Jenkins, the coachman, fleeing for his life, all within five minutes. Directly, she locked herself in her bedchamber lest she transform into a full-blown dragoness. The sixth day spilled into the seventh, and still no fever appeared. Flushes crept across Mary’s porcelain skin, sometimes alarmingly bright, but they were accompanied by no hint of heat. The count of days increased to eight and then nine. On the morning of the tenth day, Lady Mary began to fear that she would begin throwing things.
That afternoon, bells pealed all over the city: the Princess of Wales had given birth to a son. Wine flowed in streets crowded with dancing and cheering.
Late that night, the new nurse appeared at Lady Mary’s door, frightened out of her wits. The child had grown warm, though still not hot. She was restless and fretful, though, and crying out for her old nurse, or her mamma. Lady Mary, for once, was glad to indulge the child.
The fever was not so high as to be terrifying. Nonetheless, it was a smallpox fever, and rising. She sent for old Mr. Brown, the ancient apothecary who had apparently been serving the neighborhood since the last visit of Caesar.
He was none too pleased to be hauled out of bed at midnight, though his way across the square had been well lit by celebratory bonfires and cheered on by happily drunk crowds. He was horrified to discover that the child had been given the smallpox.
He turned reproachful eyes upon Lady Mary. “There is nothing to be done now, my lady, but let Madam Nature take her course. If she behaves, the fever will go off of its own accord by morning.”
Somehow, Lady Mary ground out thanks as the man left, and settled down in the nursery rocking chair to wait. To her mind, Madam Nature did not deserve much in the way of trust.
PART TWO
Boston
1
ZABDIEL AND JERUSHA
Muddy River, west of Boston, in New England
1695
ZABDIEL Boylston flattened himself across his horse’s back, sunlight flitting like butterflies, like bright bats through the gloom as his body rolled with the rhythm of the beating hooves. He ducked and bobbed, sweeping aside the claws of trees that tried to rake him from the horse. Was it a book he had been holding only a moment ago in the clearing, when the buck had appeared at the far edge, pale and silent as a curl of the mists that sometimes wound through the forest? No—it was blue steel, the pistol that his father had carried through battles against the Indians. Far ahead, he caught another glimpse of the deer, heard it crashing through the brush—heard, so he thought, the gasp of its breath and the thump of its trumpeting heart.
They burst into a sun-shot clearing, and his quarry crumpled into the grass, though he could not remember having taken a shot. He dismounted at a run and then pulled up short. The body at his feet was not a buck, but his father.
Zabdiel clenched the knife in his hand, turning it over and over. As he stood there, his father’s leg began to swell, turned black and green; a sweet stench of rotting slid upward. What was he to do?
In his hand, the blade frizzled and stretched into a saw.
Papa? He heard his voice say. Papa, I must take it off. At that, his father quite calmly turned over and sat up. Sadly, he shook his head. Too late, my boy, he said, heaving himself to a stand. Too timid, too slow, too late. Then he turned and limped into the trees.
Zabdiel started, felt the ooze of sweat dampening skin on fire, the salt stinging cracked and swollen sores, the wetness failing to touch the thirst lodged like thick, fetid swamp-mud in his throat. His eyes would not open, so he groped blindly for memory. He was not in the woods that pressed around the thinly settled fields of Muddy River, which in any case had thickened, grown orderly, renamed itself Brookline. He had been dreaming, or caught in the net of delirium more likely, judging by the heat pluming within his body. He listened, and heard the ring and clop of streets. A bit farther off, a wet slapping, snap of canvas, creak of wood, and seabirds calling. Wharves.
He remembered: he was in Boston, a north-south strip of town on a peninsula anchored to the mainland by no more than a ribbon of sandy marsh known as the Neck, which disappeared altogether in high seas. A north-south strip of town perched tiptoe between the Atlantic and the high three-peaked hill of the Tremount, like a lady marooned on a stepping-stone in a puddle, holding her skirts out of reach of the wild land behind her and water lapping all around. Having edged as far eastward as she could without getting wet, she peered coyly, anxiously, toward England and home.
He was in Boston, in a year of the smallpox, 1702. Which meant his father was dead. Had been dead a long time. Seven years.
Back in the summer of 1695, Zabdiel had been only fifteen. After shadowing his surgeon father since he could walk, working beside him as an apprentice for a few years, he had been chafing to enter Harvard that autumn when disaster had struck. Had it been the fall of a tree, the poisoned prick of a buzzing snake, the swipe of a scythe? The kick of a horse, crush of an iron-clad wheel, slip of a plow? On a farm, there were a thousand things that could hurl death at even a careful man, even a man as wise in the ways of medicine as Thomas Boylston, gentleman farmer, horse breeder, and surgeon. A thousand things that his son, still a novice, could neither fight nor fix.
Zabdiel’s mind had wrapped his father’s death in shadow, but could not keep guilt from smoldering through. It had never occurred to anyone else to blame him, but the fifteen-year-old heart still wrapped small and furious somewhere inside his twenty-two-year-old soul would not relinquish that death to the inscrutable decrees of Providence, as the church told him he should. If only he had been faster, better, more daring, the youth grated at his adult self, his father would still be alive. He had worked, ever since, to pluck every splinter of hesitancy from his soul.
After Dr. Boylston’s death, Zabdiel’s dream of college fast dwindled to dust. His elder brothers Edward and Richard were tradesmen with their own families to worry about—Edward a tailor in Boston and Richard a cordwainer, or shoemaker and leatherworker, across the estuary in Charlestown. Peter, already promised in marriage, had walked into the yoke and the pride of the family farm—or estate, as he insisted on calling it. It was heavy enough for the three adult brothers to shoulder responsibility for their mother, six sisters, and his two little brothers, Dudley, who was eight, and Tommy, only two. The money to send Zabdiel to college suddenly seemed extravagant, impossible.
Still, their father had clearly intended to establish his middle son in the profession of medicine. To honor that intention as well as Zabdiel’s obvious aptitude, the family had pooled the money for him to complete his apprenticeship with their father’s colleague, Dr. John Cutler, surgeon of Boston.
So Zabdiel had left the fields, woods, and secret glades, the streams and rivers, the horses, his mother, his sisters and little brothers—the hardest good-bye had been Tommy—had traveled north, letting Cambridge and college recede to his left, to arrive among the clamor and crowds of Boston. Under the meticulous Dutch eyes of Dr. Cutler, he had
learned anatomy and advanced surgery—which mostly meant cutting things off. He had learned to mix medicines and measure dosages of febrifuges to cool fevers and cordials to heat cold, sluggish blood. He had learned phlebotomy, or bloodletting, had learned how and when to blister, to administer enemas, purges, vomits, and diuretics.
In New England, doctors were expected to master all three branches of the art, to be physician (or diagnostic theorist), surgeon, and apothecary all in one, and he had duly learned all the skills that would make him a real doctor in the eyes of his neighbors. Useful, in their way, he admitted. But to his mind—and the not infrequent exasperation of Dr. Cutler—he had already learned most of what was really useful from his father.
Four short lessons: Do as little as possible. Be clean. When surgery is absolutely necessary—be decisive, precise, and lightning quick. Above all, take knowledge wherever you find it. By which his father had meant pay attention to the Indians. Those who are left.
Long before, Thomas Boylston had gone over the sea to England, to be apprenticed in the apothecary shop of a relative in London: where, by law and long tradition, physicians, surgeons, and apothecaries kept rigidly separate. He had learned many things about mixing medicines, but many more about the dangers of blindly accepting the dictums of books—and of tradition. Upon his return, his neighbors had insisted on believing that he carried hidden somewhere about his person the trophy of an M.D. from Oxford. He tried disabusing them of this conviction, but they would not be budged; every cure rooted it more firmly in their minds.
To Zabdiel, though, he acknowledged a rather different source for much of his physic: the Narragansett, the Wampanoag, the last tattered remnants of the Pequod, the Massachusetts, the Cohasset. People his neighbors thought of as savage killers—and God knew, they could be, when pressed to it—but Thomas Boylston, chirurgeon of Muddy River, preferred to know them as skilled healers.