Episode: The Doctor and the Nurse
Chapter: The Mother and the Obstetrician [2/4]
Summary: Rory wanted the Doctor to take a break before he inevitably snapped. A Matron wanted for her children to grow old and strong, at any cost. And a Doctor wanted to save his patients, even if that meant trusting some weird Englishmen. The Master wanted to find enough information about the cracks to bring back Amy and the Doctor. Or the one where some people work, others take a break, and tempers end up snapping all the same.
Rating: T
Warning: Pregnancy and (not graphic) childbirth.
As soon as they are outside and the Doctor locks the TARDIS behind them, a pained scream fills the alley they parked in, making both of them jump and spin around.
There's a shape curled just inside the alley, out of the main street and going ignored by the people walking by, barely sparing a look without slowing down. Rory curses in his head as he and the Doctor rush to the screamer, falling to his knees next to who he now recognizes as a woman – and blanches as the source of her pain becomes very much obvious.
She's pregnant. Very pregnant. So very pregnant that her skirts are stained and she's red and sweaty and huffing—
Rory looks up at the Doctor, slightly panicked, only to be met with the same look on the alien's face.
Right. Alien. Of course.
"Hospital. There has to be a hospital around here, someplace we can take her—"
"No!" the woman shouts, grabbing onto Rory's arm so painfully tight that he winces. "Not the hospital, please! They will kill us there!"
"They will what?" the Doctor and Rory exclaim in unison, startled, before quick footsteps stop next to them.
A man somewhere in his late twenties looks down at them with determination rather than the disgust of the other people in the street, though there's a brief flash of surprise as his eyes land on Rory and the Doctor, in their posh clothes, next to the woman. His brown hair, ear-length and parted to one side, looks slightly disheveled thanks to his run, and his own clothes consist of pale gray pants and a beige vest over a white shirt pulled up to his elbows, with neither coat nor neck cloth in sight.
However, when he looks at the woman again, any doubt or surprise vanish from his face.
"Bring her up to my apartment. It's no maternity ward, but anything is better than a street birth," he orders Rory and the Doctor, before hurrying up to an open door in the main street, the first to their left. "Hurry up! I will prepare everything!"
Rory doesn't hesitate as he helps the woman to her feet, whispering softly to her, and ignores the Doctor's sigh and mutinous grumbling. A moment later, though, he pulls up to the woman's other side to help Rory bring her up.
The stranger has left the door of the apartment on the first floor open, so they make their way inside with only one scare when the woman's weight falls on them halfway up the stairs due to a contraction. A voice calls for them from a door past a humble living room, and they lose no time making their way into the bedroom.
"Put her on the bed," the stranger tells them, just finished washing his hands in a basin that smells faintly of chlorine and lime. "Wash your hands if you wish to assist, leave if you don't. I will not have you loitering around while there's work to be done."
"Right away," Rory answers without hesitation, pulling off his hat, coat and tailcoat, and throwing them on a chair, before rolling up his sleeves and washing his hands while the Doctor helps the woman lie on the bed, grimacing when she crushes his hand with a new scream. "Doctor, are you going to—"
"I'd rather wait outside," the alien cuts before Rory can do something as horrifying as to ask him to assist in childbirth, but the woman's grip doesn't slack, keeping him in place. "Oh, alright! I'll deliver moral support, you do your thing and make this stop," he hisses at Rory, threat clear in his voice but panic in his pale eyes, and so Rory just nods and proceeds to help the stranger, who apparently has far more experience in childbirth than Rory does, with whatever he may need.
The stranger instructs the woman to breathe, and when the Doctor takes over, free hand wiping her forehead before he carefully, almost tenderly, cradles her cheek and rests his forehead against hers, whispering softly, the stranger turns to Rory again.
"Do you have experience in obstetrics?"
"Not in that specific field, no," he answers, and so he's relegated to a supporting role instead, cleaning and handing towels and marveling at the fact the woman no longer screams with each new contraction, instead whimpering softly in time with the Doctor, both their eyes closed, and murmuring 'breath' or 'push' in unison every now and then.
Rory's pretty sure it's only the Doctor's alien mind-tricks that make the birth go as smoothly as it does, though he has to admit that the stranger's calm and knowledge would have got them through even if Rory and the Doctor hadn't been around.
What feels like an eternity later, the cry of a newborn babe fills the room. Rory sighs, relieved and awed and exhausted all at once, but he doesn't have time for more than that before the stranger starts ordering him around once more. Placental delivery, cleanup, checking up on the mother… The stranger leaves Rory in charge when he demonstrates he can take care of that, taking the baby away for the routine care and cleaning, but Rory is so busy with his tasks that he doesn't notice he's been left alone until he has to check on the woman.
"Doctor? Hey, are you alright?" he asks once he realizes the stranger isn't around and the new mother is dead asleep, looking at the alien in concern as he finally pushes away from the woman to sit on the bed, flexing his freed fingers with a grimace.
"Ugh, I never thought I'd give birth again. I had forgotten how much that hurt," he hisses, rubbing his chest with a pained expression that he vanishes with a deep breath, turning his attention to his reddened fingers with something that could be called awe. "Huh. She has a strong grip."
Despite the previous exhaustion weighing him down, Rory finds himself almost jumping to his feet, brain abuzz with a lot of nonsensical static, and lower jaw practically on the floor.
"What do you – again?!" he squeaks an octave higher than his regular voice, and the Doctor looks up at him in confusion, still flexing his fingers. "You said—But you—And she—And you—Give birth?!"
"Oh, that," the Doctor hums once he manages to figure out what has left Rory in this state, completely unbothered. "Just had to do my part to preserve the House. Do my duty as expected for once," he explains with a scowl, no longer flexing his fingers even as he gives them a look, and Rory can only answer with a high-pitched whimper that he's not sure how he's managed to produce. "Re-lax! They didn't trust me to be a good role model, so I only had the one womb-born."
"One womb-born?!"
"Yes, I know! But they put me in charge of a couple batches of loom-borns, before my other duties took precedence."
A couple batches. A batch of cupcakes is six. A batch of cookies is around two dozen. How much is a batch of kids?
Rory makes the high-pitched noise again, refusing to let his brain go further down that path, and earning himself a confused and slightly worried look from the Doctor.
"Are you alright? I'm not sure humans are supposed to sound like that."
"You had—But that's all from a machine, right? You said just one was from a womb, right?" he asks, trying to get a grip on his sanity while a wailing part of his brain keeps shouting alien almost hysterically, as if that would make it all better.
… It should, but Rory is in too big a shock for it to work this time.
"The loom-borns were from a machine. But yes, I had a womb-born too. I was supposed to have more, but by then they had already tested the looms and they implemented them, so they gave me a batch of loom-borns instead," he explains with a shrug, checking the woman's temperature with the back of his hand when she starts to shiver, and getting up to retrieve a blanket from the wardrobe.
"You had a – you have a womb? No, wait, forget that. You must have been a woman then," Rory blurts out before he can stop himself, shaking his head and slowly grabbing onto the calm that had eluded him just a moment ago.
The Doctor scowls.
"Really? Rory, please. I'm a Time Lord. We don't have something as ridiculous as genders, we just happen to have different models of shells that binary species can categorize according to their divisions," he explains in his 'Time Lords are the superior species' tone, completely serious and obviously disappointed in Rory for having forgotten the Doctor is an alien, and that, despite all similarities to humans, he's most definitely not one of them.
Which is something Rory doesn't want to think about, not when discussing this topic, even if any detail of the Doctor's past is interesting – but not in this context!
"Shell? What's a shell?" he asks instead before his brain can fully reboot, but even after that, he realizes it is a good question.
The Doctor looks at him with a deadpan expression.
"You're staring right at it," he says simply before letting out a sigh and sitting more comfortably on the bed, crossing his arms against his chest and tilting his head as if trying to figure out the best way to explain whatever alien concept a 'shell' is supposed to be. "Humans, and most of this universe, are tridimensional creatures. You have width, length and height, and live in a tridimensional environment. You also exist in the fourth dimension, in Time, but you do not have the ability or the dimension to be in that dimension. As thus, you can appreciate a small part of the fourth dimension in the passage of time. But Time Lords are more than that."
"You… have a 'fourth' dimension? Is that how you can tell the time, and stitch it like you did with the Neverwere?" he asks far more calmly, and infinitely more curious now that they are on a safer topic.
Far more confusing, in all likelihood, but definitely more interesting.
"We have a fourth dimension, but we have many more too. Time Lords are one of the few species left in this universe that are multidimensional, not merely tridimensional or tetradimensional or even pentadimensional. Well, I am one of the last few multidimensional creatures in the universe," he corrects himself with a scowl, turning away from Rory and tightening his grip on his arms, still crossed against his chest.
"Why 'multidimensional'? Why not a number? Just how many dimensions do you have?" he asks, both in an attempt to break him out of his oncoming gloom and to once more redirect him to this interesting and useful topic.
If something like a Neverwere occurs again, Rory will need this information to know where to start treating him, especially if the TARDIS is inaccessible once more.
"Do you know how rude that just was?" the Doctor asks with a grimace that is part mocking and part shark grin, so Rory merely shrugs with a not completely insincere grin. "And there's no number because, quite simply, none of your languages have a number for it. No, it's not because it's too 'big'," he adds when he sees Rory's eyes grow wide, the grimace morphing into a genuinely amused smile. "It's simply that it is understood in a way your species cannot comprehend, and so you cannot describe it in a way as simple as any of your numbers. If I were to try… It would be something like 7+1-6x0,3-(-4/2)x9-6/3+(-1,2-10). Don't try to operate that, it's not an equation. It's a sentence. Only, it's written in a language you cannot understand," he explains calmly, though it probably helps that there's comprehension in Rory's face rather than complete lack of understanding.
Of course, what he won't tell the Doctor is that part of that realization comes from the fact he remembers this string of numbers, or a very similar one, from back when the Doctor had been drifting in Cardiff.
Still, in a very twisted way, Rory can make sense of that.
"And where does the shell thing come from then? Is it a disguise?" he asks, eying the Doctor more warily after that.
"No, it's not. The 'shell' is the name we give to the tridimensional part of our selves that tridimensional species can comprehend. What you see right now is about a third of me, but it's not a disguise in any sense of the word. It's like seeing someone with or without clothes. There is a body under the shirt that you just can't see. Then again, I can 'curl up' somewhat, hiding feelers or wrapping dimensions into my tridimensional shell, so that they are protected from multidimensional attacks. Like you would cover your head with your arms if someone tried to punch you."
Rory's head is reeling, but he has to admit that all the comparisons help a lot when it comes to making impossible concepts such as multidimensionality comprehensible, up to an extent.
Still, ouch, my head.
Of course, the stranger comes back in right at that moment, the baby asleep in some kind of basket, bundled in a pale beige cloth.
"How is she?" he asks, carefully depositing the basket on one of the chairs in the room.
"Resting. She had some chills, but everything else is alright. She's a strong woman," Rory reports, relieved to have the more experienced man around despite not having felt his absence as keenly before. "I'm Rory Williams. Thank you for coming to our aid. Not that we know her, we found her just before you found us, but when she refused to go to the hospital…"
"Many do," their benefactor tells them with a scowl, though it doesn't seem to be directed at any of them. "Doctor Ignaz Semmelweis, First Obstetrical Clinic of the Vienna General Hospital. Thank you for your help and cooperation," he introduces himself, shaking Rory's hand, but Rory's brain has gone offline once again, eyes wide and mouth hanging open.
Ignaz Semmelweis, of the Vienna General Hospital. Ignaz Semmelweis, the savior of mothers, the pioneer of antiseptic policy. Ignaz. Semmelweis.
"Are you alright?" he hears Doctor Ignaz Semmelweis ask as if from underwater, part of his muddled brain noticing how the man's eyes narrow as he analyzes Rory, and how the hand he has still tightly wrapped around Ignaz Semmelweis' is starting to sweat.
"Ah, forgive him, Doctor Semmelweis. We've just had a long day. We were planning on spending the last three hours in the opera, not tending to a birth," Rory hears the Doctor say somewhere behind him, but when the alien's cool hand lands on his shoulder, he comes back to his body as if zapped, immediately releasing Semmelweis' hand and taking a step back with a soft blush.
"Yes, right. What he said. Sorry about that," he manages to stutter with a giddy grin that he's pretty sure he's successfully wrangled down into something more adequate. "Wait! Three hours? We missed the opera?" he asks, this time turning to the Doctor, and feels his face fall.
Had it really been that long?
"That's alright. There will be other days," the Doctor answers calmly, patting his shoulder once more before letting his hand fall. "Now, what can you tell us about the hospital? Why do women refuse to go there to give birth?" the Doctor asks Semmelweis, and Rory realizes that this, like back in London with The Lord of the Rings thing, is one of those situations where Rory knows more than the Doctor.
Doctor Ignaz Semmelweis, Hungarian physician of the mid-19th century, was the first to advocate that doctors in obstetric clinics disinfect their hands before treating their patients. While controversial at the time due to his inability to explain why the process was necessary, it all came together with Louis Pasteur's germ theory, some years after his death. Which… they could maybe prevent now. After all, Semmelweis hadn't explained his reasons until years after instilling the practice, answering instead with quite controversial open letters to any who dared doubt him, despite the results that his method was working. He'd been sent to an asylum, and died mere days after being admitted into it.
Semmelweis scowls, ignorant of Rory's thoughts and focused on the Doctor's question instead, but rather than answer them, he gestures for them to take the conversation back to the living room, letting the woman and her baby rest.
"Why would they agree to give birth at the hospital? They still come for the aftercare, it is free after all, but they would rather have a street birth," he finally answers, dropping in an armchair while Rory timidly sits on the couch and the Doctor moves to stand by the window, looking down at the dark street. "The women who give birth at the Clinic risk contracting puerperal fever," he adds, and Rory nods, recalling his lectures, while the Doctor listens attentively, looking at Semmelweis over his shoulder.
The Vienna General Hospital had two obstetrician clinics, both of them free with the condition junior doctors could practice there. One of them, the First, also performed autopsies, while the second was exclusively for the midwives, for birth and aftercare. When Semmelweis worked at the First Obstetrical Clinic, he observed that the Second didn't have a mortality rate as bad as the First, not when it came to puerperal fever, and theorized it was because of the autopsies. So, he proposed washing their hands after the autopsies, before taking care of their living patients, and the mortality rates dropped 90% in less than six months.
Of course, it didn't matter much to his contemporary doctors since he called the germs 'cadaverous particles' and couldn't properly explain how they worked, not until Pasteur, and by then it was too late. But for the rest of the world, this man, far younger than the history books ever pictured him, and as tired as any good doctor striving to help, was a pioneer of modern medicine. Rory doubts the 21st century would be where it is if it hadn't been for someone realizing just how important a simple thing like washing one's hands could be.
"Is it really that big a risk?" Rory asks tentatively, trying to gauge how far into his discovery Semmelweis is, since he did make Rory wash his hands before he could help with the birth.
He hadn't thought twice about it, at the time, but now he can see the significance of it. And, quite frankly, it's taking quite an effort not to hop to his feet and start pacing to try to burn his excitement and nervous energy.
Ignaz. Semmelweis!
"Unfortunately, it is," Semmelweis answers with a tired sigh, once more oblivious as to what is going through Rory's mind, for which he's grateful. "I have been trying to find a solution to it, there must be something we can do, but I haven't made any progress. And now that Professor Kolletschka is dead…"
"Professor Kolletschka?" Rory asks softly, excitement tempered by his confusion, before the metaphorical lightbulb turns on again.
Semmelweis had lost a friend to puerperal fever after an incident during an autopsy, which had helped him figure things out. Or, at least, he thinks there was something like that in the lectures, but he'd been quite distracted that day…
"Professor Jakob Kolletschka, of Forensic Medicine. He helped me put together some information regarding the deceased, but in the end, he was claimed in the same manner," he explains somberly, looking older as he leans back in his armchair, and the Doctor finally turns around to give Rory a considering look, as if aware he knows more than he's telling.
Well, that's what they're here for, isn't it?
"My condolences, Doctor Semmelweis. But surely you could get some help from the Second Obstetrical Clinic to supplement your, uh, your findings?" he comments as casually as he can, trying to be subtle, and sees the Doctor's look turn accusing as he finally realizes what Rory is doing, even if he doesn't have any idea what is his endgame.
Rory would have answered with a sheepish grin and dropped the subject, but Semmelweis chooses that moment to scoff.
"The Second Clinic? What would be the use? Their mortality rate is as high as the First's."
And Rory freezes, eyes wide, before he finally looks away from Semmelweis, morosely glaring at his hands on his lap, to turn pleading eyes on the Doctor.
The alien may not be aware of the details, but Rory's look tells him more than enough.
"It is late and you've had a busy day, Doctor Semmelweis. Thank you once more for your assistance, but if all is well here, then we'll return to our accommodations," the Doctor tells their host calmly, approaching the couch as Rory tentatively gets back to his feet. "Have a good night, Doctor Semmelweis."
"Ah, right, right. Thank you for your assistance, Doctor Williams and Doctor…"
"Sherlock Holmes. And I am not the Doctor," the alien answers, keeping his glare to mere annoyance as he quietly disappears back into the guest bedroom to fetch their hats and coats.
"Isn't he? I thought you had called him Doctor," Semmelweis muses curiously, turning to Rory while the Doctor is away, and Rory grimaces.
"Long story."
He doesn't have time to explain, as the Doctor returns almost as soon as the words are out, and so, coat on once more, they say their goodbyes one last time and leave Semmelweis' apartment.
"Alright, what's the deal with Ignaz Semmelweis and those Obstetrical Clinics?" the Doctor asks as soon as they're back in the TARDIS, coats and top hats hanging from a coat hanger by the door that hadn't been there when they left.
And so, Rory tells him. About the cadaverous particles, and Professor Kolletschka, and the importance of Semmelweis' discovery on modern medicine. And, most important of all, about how he'd arrived to his conclusion.
"A third?" the Doctor repeats, looking away from the screen showing a wall of text next to a picture of, Rory thinks, older Semmelweis.
"Yes. The Second Obstetrical Clinic didn't perform autopsies, so they only had a third of the mortality rate of the First. That was what made him turn his attention to the bodies, and Professor Kolletschka's death only confirmed it," he explains, arms crossed against his chest and foot tapping impatiently on the glass floor.
The Doctor takes a moment for himself, thinking and analyzing options and staring at the screen, before making the information on it vanish with a click.
"Alright. First of all, it isn't February, it's the beginning of May, so we overshot for a bit. We can still go to the opera once we fix this, that's the good news. The bad news is that this won't be the 'relaxing' escapade you wanted," he tells Rory, finger-quoting the word 'relaxing' with a smirk.
"As long as we take a break after, I'll take it," Rory answers with a sigh, too tired to fight the Doctor about who needs to take a break when it clearly isn't Rory.
Stubborn alien.
Rory shakes his head and meets the Doctor's eyes once more.
"So, what do we do about this?"
"Eat, get some rest. This afternoon was exhausting, we've both earned some downtime. I'll get more information on this era, the hospital and Semmelweis himself, and then we can join him for work in the morning. We'll check that Second Clinic, make sure what's going on here isn't completely natural, and deal with the rest as we go," the Doctor answers, and Rory nods gratefully.
"Sounds good. I need a shower."
"… Me too."