"Dr. Foster, would you come here please?"
Jed finished counting the man's pulse and set the thick wrist back down. The captain had come through the surgery well, had a good color, and apparently the constitution of an ox. Mary stood a few feet away, beside the bed of a corporal or private, he wasn't sure, the man had been Hale's patient. He walked over briskly until he was next to Mary. He had a varying sense of her size. At times, she seemed tall, firmly imposing, an Amazon or Boudicca rallying her troops and yet when she was near him, he was more impressed by how finely she was built, a dryad away from her woods. And then she would turn her gaze upon him and all degrees were lost, there was only that sense of light—brilliance and heat, a glow, even the play of shadows.
Her hands were clasped before her, an unusual pose; she was unsure then or concerned about something—the patient or his response to her?
"Yes, Nurse Mary? How may I help you?" he asked.
"I hoped, that is, I thought perhaps you might consult on Corporal Bluett's case. I thought your expertise might be of particular relevance," she began, growing less tentative.
"But his physician is Hale, isn't that so? Can he not take care of his own patients now?" Jed blustered a bit. He meant to relent but could not resist the opportunity to take Hale down a peg, even if only with Mary, who he was fairly certain did not esteem Hale highly in any case.
"Dr. Hale has taken care of Corporal Bluett's other injuries, but I feel you might have a more sophisticated assessment of a new problem that has presented itself," she replied. The man in the bed was quiet and Jed saw a bandaged leg ending without the vertical lump of a foot under the bed-clothes. Well, there were worse injuries and Hale had grown nearly competent in extremity amputations with the sheer number he'd had to practice on.
"And what is that, that new problem? And why might I be best suited to consult?" he said, growing curious. Mary was an astute manager and would have a clear and cogent reason she'd asked for his help; he simply enjoyed drawing it out since there was no pressing influx of nearly-dead boys to deal with. He liked to stand by her and talk for minutes, watching the color in her cheeks, the little movements she made, how she held her mouth. He had decided he was not responsible for what he dreamt and these moments beside her were rich fodder; if, in his sleep, that red mouth was soft beneath his, if her hands went to his shoulders lightly, if those dark eyes looked up at him, winsome and charmed by him, from the tumble of his bed, he could not be faulted but he might savor it.
"When he came to us, Corporal Bluett had a grievous injury to his tibia and ankle, gangrene had set in from his foot. Dr. Hale did what he could and it seemed the corporal would do well, was in good spirits when he awoke from the ether. And yet, today, when he woke, he screamed for a half hour," she paused. Something had unsettled her, he saw.
"Do you know why?" he asked. He worked to keep from asking her more questions. He had learned she was quite an efficient clinician and that she often told him more if he asked less.
"He had gone blind," she replied.
"And there is no explanation? No previous injury to his head, no blood from his ears, vomiting?" He understood now why she had asked for him. Even if there was an etiology for the acute onset of blindness, Hale would have little ability to divine it and even less to devise a plan of action. He peered at the man more carefully; there no mark upon his face, no bruising near the eyes or brow, in fact, he appeared to be resting easily.
"No. He had talked and joked with us quite readily yesterday, had all his faculties intact. There is no sign he might have fallen from his bed in the night—his bandages are clean. He has no fever, his breath is good and his pulse steady. He simply cannot see. Dr. Hale gave him a small dose of morphine when he had been screaming a full hour and then he fell into a deep sleep. I thought, perhaps in Paris, you might have had a patient like this? How can it be that he could suddenly go blind?" she said. She was primarily troubled by her question but he admitted to himself that the challenge invigorated him, that the man's suffering caused in him an opposite pleasure, that hunger for understanding and sense that he might make some break-through in medicine, unravel a mystery. A body held so many.
"Well, I must examine him when he awakens, I cannot say anything before that. You were right to call for me, I can't imagine this problem is within Dr. Hale's scope," he said. She was looking down at the man, quite focused, then turned to look at him. He had the feeling he frequently did when they worked together, that she was not merely his assistant but had very likely her own complex thoughts and theories which, even when they were inadequate or mistaken, often served to set him upon a more productive or innovative train of thought. He wondered what it would be like to work with her had she the training devoted to cadets like Mr. Squivers and not only lessons in bandaging and letter-writing.
"I thought so. Shall I call you then, when he awakens? I will try to keep him calm without more morphine, so you may conduct an examination," she replied. He wondered what had troubled her—the man's screams, the disorder, the thought he would refuse her? He would ask.
"Did you think I would say no? That is, did you think I would refuse to treat this man, was that why you were worried?" he asked.
"He was Dr. Hale's patient and I know you have many of your own patients to care for, he is not your responsibility, there must be an end to the work you do," she said, reason after reason he might have said no. She must hear it from him, then.
"Ma—Nurse Mary, I will never say no to you, you have only to ask," he said, clearly, but low, trying to evoke the privacy the exchange merited, as they stood among so many sick men, orderlies in the hall, Matron scowling as she moved through the rooms, somehow crocodilian when she regarded him.
"I-, thank you, I did not want, you don't need," she said, her words hesitant, halting; she had heard what he said and what he meant. He was a little sorry to see her unsettled but he welcomed her to the strange place they were in. He liked to imagine what she was thinking, what questions she would consider and discard, now sure of his response. Her eyes were bright, but not with tears, she began to know her power but he was at ease. He knew she would never act without the sanction of her morals, her honor and he knew she had enveloped him in those, had dragged him there when in the needle's thrall he resisted. He knew her, however, to be intellectually provocative, with strong opinions she would defend with little feminine deference and he wondered what she allowed herself to envision. What limits would she impose on her thoughts? On her fantasy?
"I will come back in a few hours if I do not hear you call first," he said and smiled at her a little, a return to Dr. Foster and his more equable bedside manner.
It was a few hours before he heard the swell of voices from the ward Bluett was in. He had collected a few instruments, nothing as exceptional as von Helmhotz's ophthalmoscope, but they would aid him in the exam. Mary seemed to have soothed the man to cooperation by the time he arrived. He heard her, as gentle as she could be, and knew she would also be stroking the man's hand when he arrived. He was always a little surprised by how easily she was able to take from within herself to give to this man and that; she never seemed to become exhausted or irritable, as he did, and he knew when he was the one in need, she gave to him as well, and yet he could feel the difference, which thrilled and concerned him in equal measure.
"Dr. Foster is here now, Corporal Bluett. He needs to conduct an examination so we may understand your… malady better. I will be beside you," she began.
"Bluett, it's as Nurse Mary says, you just need to do your best and I will be able to make a diagnosis, try to find a treatment for you," Jed said, keeping his tone practical, trying to imply a solution was imminent. He deployed his instruments as he could, asked the man to try and shift his gaze, open and shut his eyes. He took a small candle out and lit it, held it before the man's face. Mary was a powerful tranquilizer and Bluett cooperated fairly calmly. Jed had expected him to grow frustrated and impatient, or acutely anxious, but her hand upon his and the few soft words she uttered, "There now" and "Just so" and "That's right, Corporal Bluett, what a good job!" kept the man compliant.
"Well, Corporal Bluett, I've finished your exam. I'll need to discuss your treatment with Nurse Mary, then she'll return to you. Try to rest now," he said, then gestured to Mary to join him in a small alcove in the corner of the room which provided a modicum of privacy or at least, gave the impression of it. He pushed aside a wooden chair with a broken slat and set his bag of instruments down on the seat.
"What is wrong with him?" Mary asked directly.
"His exam is benign, that is, there is no evidence of any damage to the eye or his optic nerve, his ocular muscles are strong and there is no other overt sign of neurologic injury. I'm sure Hale would say he is a liar and a malingerer, but I see nothing to suggest that; his tone was sincere and his other injuries sufficient to remove him from the War. His blindess has no explanation," he said. He was both frustrated and fascinated by Bluett. Would the ophthalmoscope have revealed more? He thought not.
"But that cannot be so! For he saw and now he does not, something must be wrong or damaged!" she exclaimed.
"He puts me in mind of cases Charcot had, in Paris. Patients with bizarre symptoms, contortions, changes in sensation— though I am not sure if he ever had one who suddenly went completely blind. He called it hysteria," Jed replied, recalling lectures he'd been to in the Paris hospital, the room filled with medical men. Some would dash in between surgeries even, their white coats tiger-striped with blood old and new. The walls were hung with paintings of patients, the entire tenor of the room curiosity, investigation, discovery—the determination of men to use science as scalpel or bludgeon as the situation called for it.
"And was there a cause of this hysteria? Or more importantly, a cure?" she asked.
"The cause is elusive, perhaps some imbalance in the brain, an injury. Sometimes it seemed they had seen something, an accident perhaps, shortly before their symptoms started. A cure, no, no cure. He had a ward for women with similar presentations but the outcomes were not impressive. He had started to explore mesmerism, but who can say what will come of it," he said. He saw from her face she was dissatisfied.
"What will we do for him, then? What shall we tell Corporal Bluett?" she demanded. She was all politeness and form, but still it was clearly a demand. He wished he had something better to tell her.
"The truth—he is blind, we don't know why and there is no cure, no prognosis. We will wait to see what happens while his other injuries heal and then, if his sight hasn't returned, his family will have to care for him. He will not return to battle in any case," he said, the words unadorned and blunt.
"If that is what you mean to say, let me tell him instead. For I think he will surely break to hear it and I would not have him bound to the needle," Mary said. It was unorthodox, what she asked, a nurse to step in the physician's place, but what harm would it do? The man was blind, there was no treatment. He would surely fare better to hear her tell him than from himself, or God forbid, Hale.
"I don't see why not. But I would draw up a syringe and bring it with you. He may not take it well and it is not fair to the others to let him destroy what little peace they may get," he responded. He wanted to say something else to her, something about how he thought she would be kind and perhaps that would ease the sting, or something about how he appreciated how she fought for the men, to get them whatever she thought the best was. He could not think of how to say any of it and her thoughts were already elsewere, with Bluett most likely, so he only nodded to her and took up the bag. There was another ward full of his own patients waiting for him.
The afternoon passed and the evening, then one day and the next. He thought from time to time of the blind man, but before he could find the time to check on his progress or lack thereof, there was another soldier placed before him. He worked, he ate, he slept. If he saw a glimpse of Mary across the room, her fair face, her figure neat in whatever dull dress she wore, he counted it a blessing, as a match struck in the gloom.
It had been three days before he found himself again at Corporal Bluett's bedside. A nun sat next to him, singing a little. There was a clean bandage wound about his head and a small candle guttered in a dish, though it was three o'clock and the sun shone in, quilting the floor with light.
"Corporal Bluett, it is Dr. Foster. How are you faring?" he asked.
"Couldn't ask for much more, sir. Sister here is keeping me company and Dr. Hale says my leg is healing up. I'm doing what Nurse Mary said you told me to, trying to be patient and let my eyes heal up with the ointment and the bandage, I never touch it once she changes the dressing, no sir. She said you had done a great deal for me and I mean to show I appreciate it. I'm doing the exercises you said and I remember you in my prayers every night, sir, every night. We are the lucky ones to have such a doctor as yourself here, Nurse Mary said it and it's true," Bluett ended emphatically. Jed was baffled though—whatever did the man mean, the exercises, an ointment? Still, the man appeared to be of sound mind, his color was good, and there was no evidence he'd needed additional morphine, so he'd improved from the initial consultation.
"Can you tell me how you are finding the exercises?" he asked.
"Well, they were mighty hard the first time I tried, but now I can pretty well make the picture of the farm at home in my head, the herd of cattle, how the fields look this time of year. I've got my wife's face fixed but the easiest is my collie, Geordie. Him I can jus' about see coming right up to me, he's always looking for something to eat, and how he likes to have his ears scratched! Land sakes, that dog! He's a hard worker though and no mistake. So, I jus' make the pictures and practice holding them and then take a little rest. I wait for Nurse Mary to do the other ones, like when you examined me, how I had to move my eyes around," he said. He'd started smiling when he talked about the fields and was positively beaming when he mentioned his dog. Jed looked at Sister Joanna sitting next to the man and she gave him a small smile in acknowledgement, as if to say, yes, it's just as Bluett says.
"If I may?" Jed said, moving forward to remove the bandage and see what else Mary was about.
"Of course, of course. Whatever you want, Dr. Foster," Bluett replied. Jed unwound the bandage from the man's face and looked closely. It appeared Mary had mixed up some herbal concoction, he smelled chamomile and calendula, in a base of lanolin; there was no sign of infection and Bluett opened his eyes easily when directed. Everything looked as it had before, sclera white, the irises grey-blue, pupils dilated but equal and they quickly contracted against the sunlight.
"Bluett, all appears in order," he said. He was reluctant to say more—that the man should continue exercises that seemed pointless, that the ointment would be efficacious, if he suffered from conjunctivitis perhaps. There was still no cause and no cure, no progress save that the man's spirits were up and he did not depend on the needle.
"Well, thank you for your visit then, Dr. Foster," Bluett replied. Jed carefully replaced the useless bandage and made a few parting remarks, then went in search of Mary. He found her in her little kitchen, putting together a tray; somehow she contrived to make the wholemeaf loaf and stewed fruit look appealing, though he knew he'd never eaten such poor food in his life before coming to Mansion House. She was wiping her hands with a rough linen towel when she saw him. He saw the smile start and then she hastily subdued it, steeling herself for some calamity.
"Mary, I just saw Bluett and he said the oddest things—that I'd given him exercises to do and an ointment for his eyes, when you know I never have. Any why is there a candle beside him in the middle of broad daylight? What did you tell him? Certainly not what I told you to!" he ended, having worked himself from puzzlement to a fine state of irritation.
"I told him what he needed to hear! That there was hope, that he might regain his vision," she retorted, her voice slightly raised, her own temper up.
"But it was not the truth, Mary!" he exclaimed.
"It was a truth, one you didn't want to tell him. What chance would he have, hearing you say his illness had no cause and no treatment? Lying in that bed all day and all night in darkness? He was already halfway mad," she replied.
"But what are these exercises then, what have you told him I mean him to do? For you have invoked me to him and I will know what it is you've said," he said.
"You said, these patients of Charcot's, they had had an accident before, and I thought, Bluett has seen such horrors on the battle-field, he was found holding his cousin, the boy was run through with a bayonet- I thought he could not see anymore. I wondered if he was able to turn his mind to something pleasant, something from his past, perhaps it would ease him. I thought if he could remember there were good things to see, perhaps he could risk it again. And if it didn't work, at least he would have spent his energy on hope, thinking about his wife and his farm," she explained.
"And the candle?" he asked.
"It is dark all the time for him now, but if his sight should return, I thought, it might come back at night and what then, if he should be faced with darkness? Would he become blind again? Would that be his only chance? It is little enough, I use the stubs of candle we have left from the officers' table, or sometimes just a wick in some oil, just something so he may see a light. I've asked the nuns to try and sit with him as much as they can, he's easier with someone about. The ointment is something my mother would make to treat sore eyes, I thought it couldn't hurt and it has a soothing smell," she finished.
Was she wrong? He'd seen the case as hopeless, or, at least, the man unlikely to recover, surely an invalid, possibly mad, a morphine addict soon enough. She had taken what he'd told her and fashioned a theory of treatment, one which could hardly harm the man and seemed to be doing him some good. And if his sight should not return, well, she had not promised a cure on his behalf. This was not Paris, there was no other physician to consult, no expert in mesmerism to attempt to seek out the deformity in his brain.
"I should have spoken with you first, I see that now, I should not have said you recommended the exercises, the ointment, when it was all my own doing. He would not have listened to a nurse's suggestions if the doctor said there was no hope. I just know how much faith the men have in you, I knew if he thought it was your order, whatever chance it had to work would be doubled or tripled. But that was the untruth, and I am sorry for it," she said, her eyes downcast. How easily she had acknowledged the fault and how small it truly was! If he had been willing to consider the man and his symptoms, would he have imagined such a solution? He admitted it was unlikely; his approach ran toward the surgical, the procedure, while Mary had shown, many times now, that she saw suffering to be relieved with presence, compassion, an attempt to draw men's wounds together using the resources of their own hearts and mind, or what she might add from her own kindness. And yet, for Bluett, what was there other than what she offered? Even Charcot himself could not have diagnosed more, could not have operated and removed a cataract of the mind. He himself had explained little and forecast nil. Who was the true physician here?
And still she stood before him, waiting to be scolded or chastened further. Perhaps she thought he would simply accept her apology with a quick reminder of her place in the hospital. When she first came to Mansion House, the last was the best she might have hoped for from him. But over the past several months, through battles and illness, Bullen and Lincoln and the ordeal of his withdrawal, he found he no longer knew her place. She was neither mistress nor servant, baroness nor nurse, widow, Yankee, abolitionist. She was only Mary now, by turns forthright and self-effacing, startlingly bright in every way, his heart's desire and as far from him as the North Star.
"You should have been able to ask me and to know I would listen, that is my fault and I am sorry for it. I don't know if your treatment will work, but it is the only chance he has been given and that is better than no chance at all, I think. I only wish, if another similar circumstance arises, I wish you would talk to me more of your theories and plans for the men, for I think you see things that I overlook, or even ignore," he stepped forward and took both her hands in his, beyond bold, an indiscretion he could not resist, "Mary, I wish that we might, together… find our way through these crises."
Her hands were slender and there were calluses on her palms. In his mind's eye, he brought them to his lips, placed kisses at the center, before he dropped them back down and took her sweet face in his hands and pressed his mouth to hers. He did not smile as Bluett did, but he felt the joy of the vision in his mind and it was enough for him to let her hands go. They hung in front of her, still curled as if waiting for his to return to their clasp, but she didn't move. She had shut her eyes and he wondered what she saw within. When she opened them, he asked without thinking, "And what picture have you fixed for yourself, just then, Mary?" He knew what he wished, though he thought she would demur, or tell him a New Hampshire brook, the first snow, anything but the truth.
"Just what is before me," she said, quietly and then picked up the tray and walked from the room, her lashes down so he could not see her dark eyes and the warm, shadowed candor of them. She had trapped and freed him both with her honesty. That night he dreamt months had passed, a letter was received from Bluett, whose sight had slowly come back to him and then all at once, with the harvest. He dreamt he read the letter to Mary as she lay in his arms, her left hand with his grandmother's gold ring held against his heart. She turned up her sweet mouth to be kissed, but first, he pressed his lips against first one closed eye and then the other, and watched the smile curve her mouth, her pink cheeks. The room was lit with a hundred candles, the sun, the moon and a thousand stars.