A few disclaimers on this one:
1. The association between cancer and smoking wouldn't have been prevelant in society at the time of this story. In my brief research, there had been some rumblings within anti-tobacco socities and medical circles that sought to prove cigarettes were in fact harmful at that time, but most of these groups directed their focus on juvenile smoking. They also conflated a lot of real physical consequences (like cancer) with weird ones (like deafness and moral & mental "inefficencies") that ultimately made a lot of people disregard their work.
So, chances were Dr. Clarkson, as country doctor, would not have had the astuteness to have read and agreed with these anti-tobacco societies. More than likely, the average person wouldn't know any of the diseases linked to smoking, but they might have known it wasn't the greatest thing in the world. I'd like to imagine people would have connected the health problems of the pea soup industrialised London with the smoke inhaled by cigarettes... but, who knows!
Therefore, just so ya know, this story lives in a slight AU world of a slightly more intelligent physicians. This AU-disclaimer now contractually covers me for when I randomly put in tvs and flying saucers without explanation.
2. The "wise man" Thomas quotes is Mark Twain.
3. And anyone who can spot the poorly constructed and very weak reference to The Twelfth Night wins brownies.
Chapter 2
The one where Thomas pretends he isn't ill and Doctor Clarkson begs to differ.
It had been a busy day in Downton, though not for any particular reason over another; it was a large estate with many cogs and wheels whirring together to maintain its grand operation, and more times than nought the downstairs staff became frantic with the burden of its collective duties. Thomas supposed that, now as the abbey's first ever under-butler, he should be concerned with the efficiency of the staff beyond just how it would affect his own workload; however, two things stopped him from losing his hat and conducting weekly staff meetings extolling the merits of synergy.
One was that Carson would never stand for that sort of nonsense from him, as Mr. Carson felt he was still the only "actual" butler employed at Downton, who had a "responsibility" to demonstrate "the moral compass" for the others, and he didn't need Thomas' idea of "management" to help him with his duties as such – duties Mr. Carson reminded the younger man that had been fulfilled for several decades now without anyone's assistance. Thomas would have liked to have reminded Mr. Carson that it was under Lord Grantham's express instruction that he was there to offer his assistance in the first place but wisely chose not to.
The butler would rather concentrate his time on individual cases, offering sound tutelage and support when a person's work required it. While Thomas mostly agreed with this method, he remembered his own experience under Carson's focused guidance and recalled more of the older man's disappointed sighs and sharp tongue than anything else. But then again, not everyone could be like Alfred and butter Mr. Carson up until he was ready to fall over himself to help find a sodding soup spoon. Nevertheless, Thomas was smart enough to recognise this technique had its failings. He would bide his time before suggesting an alternative.
The second reason that stopped Thomas from opening his mouth, loathed as he was to admit, was due to anxiety. Although the dark event that almost cost him his place at the abbey occurred months and months ago, he still felt as though it was ever present in everyone's minds. It certainly was on his mind most nights, to such an extent that he had begun to refer to it ominously as The Foolish Night. He found himself walking on egg shells most days when dealing with the staff in personal regards, with the exception of Mrs. Hughes, Anna, and – much to his chagrin – Mr. Bates.
Thomas took pride in his work, however, and projected to his subordinates what he knew to be a smooth confidence and a quick wit. He had a keen eye for detail and expected others to emulate his standards – a trait that Thomas knew had silently rankled Mr. Carson for years, in spite of it being one of the reasons why Downton ran as smoothly as it did. Perhaps he was a little reserved and sullen most days, but this was because Thomas was convinced the others were saying things about him behind his back. Much to his dismay, he knew that it included dear Jimmy. Sure, Thomas may have indulged in some pretty entertaining slander when he was younger, but that was different. In any case, Thomas avowed to keep clear of any controversy.
Additionally, Thomas supposed he did enjoy seeing everyone running about the place like chickens without their heads, but that would be a third reason and then he would have to revise his whole list. Until further notice, it would remain a secret footnote to the whole affair.
But presently, he could be counted among the headless fowl, and he found he did not care for it. Since his promotion to under-butler, his hectic days had increased twice-fold. Thomas knew this was partly because no-one quite knew what an under-butler was expected to do and so he had become the catch-all for odd-jobs. Yes, he now shadowed Mr. Carson in some of the butler's tasks; inventory of the pantry and dining room were dreadfully boring, but Thomas thought he could learn to live with working in the wine cellar, despite Carson's misgivings. He also supervised many of the duties of the footmen, Alfred and Jimmy, despite their own set of misgivings. Until Carson finally croaked it, however, it would seem Thomas was destined to be a glorified footman.
It was on such an occasion that Thomas was exercising such footmanly duties that he found himself running up the stairs with a tray of silver for which to set the table, while Alfred followed close behind him. By the time he reached the top of the stairs, he had to stop to catch his breath. The reprieve also let his heart calm itself from its erratic beating against his chest.
Behind him, he could hear Alfred barely caught his footing before redirecting himself and avoiding a collision with the winded man.
"Uh –," Alfred cleared his throat, "are you alright there, Mr. Barrow?"
Thomas was not sure which concerned him most: the fact that Alfred seemed to be exhibiting real concern for his well being, or the fact that he could only nod in reply. He felt oddly touched, but he would rather be caught dead with his trousers down than admit that to another human being.
"Are you out of breath?" A smirk is clearly evident on the gangly berk.
Thomas' faith in humanity instantly vanished and he scowled. He cleared his throat and let loose a somewhat wet cough.
"It's no matter to you. Some of us don't have abnormally long legs to propel us every which way we please." If Thomas' voice was a little hoarse, he chose to ignore it.
And so what if he was out of breath? He wasn't getting any younger and lived a (mostly) honest and industrious life. He was allowed to get tired once in a while. He lived through a war, for God's sake.
"Let's ensure these arrive at the table before the dinner does, yes?"
To think that the issue had been dropped and forgotten about was a naïve notion on Thomas' part. Needless to say, he was blindsided at dinner when the topic of conversation turned to him.
"Feeling any better, Mr. Barrow?" Alfred asked.
Thomas had a spoonful of stew in his mouth, so he resorted to levelling a dark glare at Alfred instead.
"Are you feeling unwell, Thomas?" Mrs. Hughes asked, ever the compassionate soul.
"Oh it's just that he winded himself going up the stairs this afternoon, is all." Alfred kindly offered in his stead. "He looked like he was ready to faint."
Having swallowed the gelatinous chunk of meat, Thomas affirmed, "I was not, nor am I currently, feeling ill." He set down his spoon carefully next to his bowl and straightened his back. "Thank you for your concern, Alfred, but I need none of it."
Of course, this would have been far more believable if he hadn't concluded his pledge of health with a wracking cough that brought up some mucous reminiscent of the stew's gravy he had just eaten. He hoped no one noticed his wince when he swallowed it back down.
"My, surely you'll tell us there's a horse in the bathtub next," Miss O'Brien said with a tight smile, which sent a titter throughout the table's occupants.
"Now, now. If Thomas believed that his health has compromised his ability to work, then he will discuss this matter with me in private," Mr. Carson said.
Thomas felt suitably put out. Ultimately, he deemed it unnecessary to defend himself against such treacherous people and let Mr. Carson's statement speak for itself. He chose instead to dig his pack of smokes out of his pocket.
At the sight of the cigarette between his lips, Anna drew up her eyebrows.
"Mr. Barrow, do you think it wise to be smoking when you lungs are congested so?" Thomas could tell she was motivated by nothing but genuine concern, judging by her almost hushed volume, but he still had to bite his tongue from telling her where to shove it. If a man couldn't have a cigarette now and again, then what did he have?
"Perhaps it would be best to rest your lungs, Thomas," suggested Mrs. Hughes. "After all, you do smoke quite a bit," she paused here as she dug her spoon into her meal before continuing, "and it can't help your breathing any."
"It doesn't help mine, neither," Jimmy contributed, after which he shared a glance with Ivy who grinned in return. That gorgeous, rat bastard.
At that point, Thomas felt unfairly abused and in protest lit his smoke with a flourish. He made sure to blow the smoke towards Jimmy and his pal. He may be lying low, but he wouldn't be a lying dog begging to be beaten either.
"Oh, but Thomas, think of how better you'd feel!" Cried Daisy. The fact that Thomas refrained from commenting on her use of his Christian name reflected how overwhelmed he was to be under such an assault of supposed concern.
"If you stopped, I mean. You'd quit wheezin' like you do in the mornings, maybe?"
"I– wheezing?!" Thomas exclaimed incredulously, praying to the Gods that his voice hadn't sounded as girlishly high to the others as it did to him. And while he was at it – praying to Gods that didn't exist – he hoped that his eyes hadn't widened in that frenzied panic-ridden way that he knew made him look half-mad.
"It certainly would make my job easier," said one of the scullery maids, as if anyone asked her for her opinion.
At everyone's blank stares, she continued, "Your clothes, Mr. Barrow. They'd be a dream to clean if it weren't for the smell of those things."
It had finally happened.
Thomas' descent into hell was finally complete; he was being criticised by a homely maid whose name he had never bothered to learn. Surely, he had not sinned so much so as to deserve this treatment. Perhaps he should have invested more faith in those Gods – any of them, really. Then conceivably he would have avoided this whole foray where decorum and couth went out the window. And he undoubtedly would have avoided a lot of other choice mishaps along the way.
He was startled out of his morose reflections when the cheeky maid grasped his right hand, cigarette and all.
"And you have nothing to blame but those fags for the state of your fingers," she scolded.
For a brief moment she held his hand aloft, offering the nicotine stained tips to all and sundry to see. Out of the corner of his eye, Thomas saw Carson stiffen. At least he had one ally who thought this insolent behaviour was unacceptable. He ripped his hand out of her clutch as if scandalised, but he merely doubted the maid's commitment to personal hygiene. His fingers may be stained yellow but at least they were clean of the day's dirt; he could not speak the same of hers.
"Excuse me," Thomas replied haughtily, "but I don't recall paying a penny for your thoughts. I don't have a lot of leisure time, and what I choose to do in those spare moments is my own business." Unfortunately at this point Thomas thoughts went to previous spare moments, specifically to that of Jimmy and The Foolish Night. It took all of his will power not to look at the boy. The motion of placing the cigarette between his lips and pulling in a drag of smoke didn't help matters – that is if you were orally fixated, which, well let's not get into it.
"Besides, my father smoked every day of his life," he said to the whole table. Thomas failed to reveal that his father had died at the age of forty a withered and sickly man.
"What was good enough for him is good enough for me." He also failed to mention that he rebelled against his father nearly everyday of his life, for the two never quite met eye-to-eye on what was considered 'good'.
After a beat he added, "Well, I'm sorry to disappoint everybody, but it's just not on." He took one final and deep drag before butting out.
"A wise man once said, "If smoking is not allowed in heaven, I shall not go", and I'm inclined to agree." Thomas said as he straightened his jacket and posture.
"Well, I dare say you'll have to worry about making that decision." Miss O'Brien remarked. Thomas opened his mouth to deliver a scathing reply when Carson rose from his seat.
"And that will be the end of such talk, thank you. Dinner is over and you may all resume your duties. The dinner gong shall be rung in forty minutes time."
That set a flurry of action into motion, as everyone rose from their seats and the kitchen maids began clearing the table of dishes. Thomas sent one last stormy scowl towards Miss O'Brien's smug face before preparing himself for the night's duties.
For a while, it seemed as though Carson had the final word on the subject. Thomas was content to forget that the matter ever existed and continued to smoke without abandon. If there were instances where he coughed loudly or felt fatigued and breathless, he thought nothing of them; it was soon to be winter, and his room had always been draughty; it would be no wonder if he caught something. Nor did anyone else deem it fit to mention his increased wheezing or expectorating. They did, however, exchange knowing glances when he hacked up a lung over tea or when he excused himself to smoke in the solitude of the courtyard.
Only Mrs. Patmore showed any overt signs of frustration (read here, rage) by passive aggressively sighing whenever Thomas coughed, cleared his throat, or smoked. This developed into a near constant exhalation of air from the cook, to which Thomas dismissed as the hysterics typical to a "woman of a certain age".
It wasn't until the Crawleys hosted a dinner party that the issue was addressed again. The guest list included various lords and ladies as well as Violet Crawley and Dr. Clarkson. Thomas was asked to assist in the dinner service, in addition to greeting guests before, and waiting on the guests after, the meal. To Mr. Carson's surprise and delight, Thomas accepted these duties gladly without comment and was representing Downton exceptionally well. Thomas thought it prudent to apply himself in all avenues of his work, including now his attitude. The two men stood at opposite ends of the serving table, each rigid and strong in their posture. They both stood proudly overseeing Alfred and James' progress around the table. They also both pretended not to eavesdrop.
Thomas was doing a far worse job than the butler, as he had to swallow a snigger when the Dowager Countess said something particularly scathing. In doing so, he tickled something in the back of his throat that sent him into a convulsion of wet, wracking coughs. The fit seemed to be doing its best to wrestle the very breath from him. So caught up in trying not to die, Thomas didn't notice the lull in conversation around the table as everyone stared at him. Nor did he see Carson turn an absolute fascinating shade of red, though had he had known he would have been sorry he missed it. In any case, the two men seemed to be sharing rapidly alarming complexions.
When he raggedly found his breath, he straightened his twisted posture and raised his tear soaked eyes to the room. He immediately wished the fit had killed him. The entire room was still, with each of its occupants staring agape at the flustered under-butler. Thomas gulped audibly and smiled thinly.
"Good God, Barrow. Are you alright?" Robert exclaimed. Had Thomas not been so embarrassed, he would have been warmed by Lord Grantham's concern. He would have also relished the gob smacked expressions on each of the ladies' faces.
"Yes, m'lord, thank you. I am so very sorry for the interruption," Thomas croaked.
"Nonsense! That sounded extraordinarily painful. Are you ill?" Robert enquired, the answer to which all of those in attendance wanted to know.
"No, sir. It was just a tickle in my throat." This excuse sounded flat even to Thomas' ears, and he desperately wished everyone would just stop staring and get on with the evening.
"Lord Grantham," Dear God, Doctor Clarkson was speaking now. No, this was spiralling towards the disastrous.
"Would you allow me the time to examine Thomas after dinner?"
He turned to look at the now very flushed Thomas, with his expert eyes evaluating him.
"The sound of that cough concerns me. I guarantee it is more than "just a tickle"."
"Of course, doctor. As long as it is acceptable with Thomas here. I'm sure Carson can spare him for a moment tonight." Robert's suggestion booked no room for argument.
"Certainly, my lord," Carson and Thomas echoed each other.
"Perfect. While the ladies withdraw to the sitting room, you can take a look at Thomas. Is that suitable, Richard?"
The doctor nodded his head as he said, "Yes, thank you."
It was after the arrangements were made that the Dowager remarked it was a blessing that it was finally not one of the dinner guests or a member of the family who made such a spectacle for once. At that, the tension eased and everyone resumed their conversations.
Meanwhile, Thomas spent the rest of the service in a mortified daze, cursing himself for attracting such attention. A genuine fear of Dr. Clarkson's examination was starting to brew deep within Thomas' stomach without him understanding why.
Thomas now found himself sitting next to the doctor in the servant's hall. Luckily due to the time of night, the room was empty save for Mr. Bates, who sat smirking behind a newspaper. Thomas would have bet good money the valet had already read it front to back several times before and was just sitting there to be nosy. There was, at least, a small mercy in that Miss O'Brien was missing despite having nothing to do as a lady's maid during the final meal of the day. Thomas didn't dare think of how she would spin this in her web of spite and lies.
Dr. Clarkson placed his medical bag atop the table before turning to the under-butler, which must have meant he brought that thing everywhere with him like a charm, the prat. Thomas was still eying the black satchel when the doctor spoke.
"Has that cough been ailing you for some time, Thomas?"
As Thomas took a breath to deflect the question, Mr. Bates gave a chuckle over in his corner.
Looking briefly towards the valet's direction, the doctor continued, "Right. Could you please remove your jacket and vest and un-tuck your shirt, Thomas? I'll be listening to your chest now."
The under-butler did as told and contained a gasp when he felt the cold stethoscope against the bare skin of his back. He drew and held great breaths as the doctor instructed, while the doctor in turn concentrated on the sounds issuing from Thomas' chest. Richard was dismayed to hear an obvious crackling produced on every other inhale.
The doctor removed his hand from underneath Thomas' shirt and told him he could put his suit jacket and vest back on before he began his examination of Thomas' eyes, throat, and lymph nodes. He also began to start questioning the younger man in earnest.
"Have you been experiencing any chest pain recently?" Thomas shook his head.
"Have you experienced any shortness of breath? Wheezing?" Here Thomas paused for a moment and questioned the value of telling the truth. He chose to admit to those symptoms.
"And when you cough, do you bring up any sputum, or blood?" The mention of blood alarmed Thomas despite having not found it in any of her handkerchiefs when he spat up. He did, on the other hand, admit to coughing up mucus.
Once again Dr. Clarkson reached into his medical bag and pulled out a thermometer.
"I don't think you have a fever, but I would like to be completely sure," he said as he placed the device into Thomas' mouth. "Have any of these symptoms woken you up in the night in a cold sweat?" Thomas shook his head.
"I believe you're suffering from some kind of respiratory infection – most likely bronchitis. Bronchitis occurs when there is an inflammation in the bronchial tubes – or the breathing tubes – that connect your throat to your lungs," he altered his language when Thomas narrowed his eyes.
Richard continued evenly, "When these tubes swell, they secrete a fluid, which is what I heard crackling when I listened to your breathing. The swelling would also make it harder to breathe and cause your wheezing and shortness of breath."
The doctor removed the thermometer from Thomas' mouth and looked at the mercury briefly.
"Elevated, but not altogether unusual," he reported. "Usually a respiratory-tract infection is accompanied with nasal congestion as well, so don't be alarmed if these symptoms arise later on."
Thomas cleared his throat and asked, "So, what does this mean exactly?" His own brief medical training focused more on warfare triage, so he was ignorant of infections and their prognosis.
"Well, since I think we caught this relatively early on, I don't think you'll have to worry about any long-term damage. Bronchitis can be a progressive illness. Had this become a chronic infection, your symptoms would have increased over time until your airways were so narrow that your lungs would struggle to process the air you took in to oxygenate the blood." Thomas was vaguely familiar with this process of the body.
"It may also have damaged the alveoli and lesson their capacity, or it could have developed into something even more serious, such as emphysema. In either case, left untreated you probably would have experienced respiratory failure."
At Thomas' look of distress, Richard asserted, "But that won't be the case, I assure you. As I said, we caught it early enough."
Thomas was annoyed that he was informed of the worst case scenario before being told that it didn't actually apply to him. He didn't want to die. Especially not by a wheezing that Daisy of all people warned him of. He would never live it down.
"I'm sorry if I've alarmed you, Thomas, but I just wanted to impart on you the severity of what your infection can become if left untreated. With just a bit of bed rest, a regiment of herbal tonics, and a few changes to your routine, I think you'll be back to being perfectly healthy within a week." Dr. Clarkson smiled as he concluded his prediction.
"I will write you a prescription for potassium nitrate, but in the meantime, if you wanted you could apply a small dose of clove oil to the skin of your chest, or make a tea of cinnamon and honey." The doctor began to pile his instruments back into his bag.
"I suggest you go to your room to rest for the remainder of the evening, and stay abed tomorrow as well. It's really up to you and Lord Grantham how much time you can miss if you care to rest any longer than that, but I recommend taking it easy in your duties for the next week."
He took a hold of his satchel and instructed, "Of course remember to keep drinking fluids and get plenty of fresh air."
He turned to go and was almost out the door when he stopped to turn around, "Oh– Only– I remember from the war, you used to smoke? You're not still in the habit, are you, Thomas?"
Thomas mutely nodded his head, his quick mind already making connections that were making him uncomfortable.
A deep frown creased Richard's forehead and he returned to the table. He said firmly, "In no uncertain terms are you to continue smoking. How ever many years of inhaling that smoke most probably damaged your airways and made you more susceptible to this infection. To carry on would be dangerous to your health, and those grim predictions I spoke of earlier would more than likely come to pass."
"I've even begun to read reports from America that link smoking to lung cancer; Prolonged smoking, coupled with your infection, could very well lead to arrhythmia and even cardiac arrest, in addition to cancer of the lung."
Drawing himself up to leave again, the doctor continued, "I'm sorry, Thomas but you'll have stop smoking from here on in. You may feel a little ill for the first day or so after stopping but it's unavoidable. Try a liquorice or a chamomile tea if you feel particularly out of sorts."
Thomas felt absolutely gutted. He didn't even savour that last cigarette he had before the dinner service. In fact, he remembered that he threw it to the ground with at least one hearty puff left in it. And he still had a pack of at least seven begging to be smoked.
The doctor hung back at the door and stated, "I suggest the next time you experience any discomfort, please do send for me rather than making a spectacle of yourself at dinner. I'll inform Lord Grantham of your diagnosis."
Thomas mentally suggested that the good doctor go take a long walk off a short pier, but managed to utter a quick thanks out loud before the doctor left the servants' quarters. He sat there for a moment with his shirt and vest still in disarray underneath his jacket. Thomas felt just as jumbled as his clothing surely looked. A heavy dread settled over him when he thought about the pack of smokes sitting in his jacket pocket, burning a hole straight through to his heart.
"Doctor's orders, eh?" Mr. Bates said with a smile.
And the night just got worse.