Author's Note: I've decided to up the rating to a T for this chapter, just to be safe.There will be a surgical procedure, but nothing too descriptive - I think.
It wasn't long until the door opened and Mr. Buxton entered. There was no way he would be kept from his son's sickroom during the current crisis. The sight of William resting against a mound of pillows, fighting to draw each labored breath caused his father's step to falter, but only for a moment. He quickly regained his composure and turned to Mrs. Hargrave.
"I am afraid I have bad news. The doctor was called to a breech birth with mortal danger to mother and child, and it will likely take several hours until he returns." He stepped up to the bed and looked down at his suffering son. "Will he last that long?"
"I doubt it, sir." The housekeeper quickly repeated what she had told Erminia earlier.
Mr. Buxton nodded. "You seem to have intimate knowledge of this condition and of the procedure to treat it. Are you prepared to operate on him yourself if need be?"
A worried frown appeared on Mrs. Hargrave's face. "I have only assisted but never undertaken this measure myself. It is a very delicate task, and I'm not sure I am qualified to..."
"I have complete faith in you. It appears fate has brought you and your medical knowledge to us for just this occasion. William's life may be lying in your hands."
The housekeeper stood up straighter. "Alright, sir, if there is no alternative. But these cases are never clear cut, he may very well be able to hold out long enough, or the birth could go faster than anticipated. I sincerely hope that I won't..."
She was interrupted by William, who was shaken by a violent coughing fit which left his lips flecked with red. Erminia quickly jumped to his side, supporting him when further coughs racked his body. When it was finally over she lowered his head back against the pillows and noticed to her surprise that his eyes were open.
"William! Can you hear me? Do you need anything? Tell me how I can help!" she urged him. She could hear the other two hurrying over to join her, but William's gaze had found hers and she refused to step aside and break the connection. His lips were moving but he obviously had trouble speaking.
"Can't... breathe..." he finally manged before another cough tore from him. He wrapped his good arm around his chest and locked eyes with hers again before he whispered, "Hurts..."
" I know, darling, you must be in terrible pain, and we have something to give you for it, don't we, Mrs Hargrave?"
Erminia turned to the housekeeper, but the older woman slowly shook her head. "I'm afraid we can't risk it. Look, his lips are already turning blue. Giving him Laudanum may stop his breathing altogether." She bit her lip. "He's coughing up blood, so now I know that it's fluid in his lung which is obstructing his air. Which in a way is good news. The procedure to drain it is somewhat less delicate than releasing trapped air. And I don't think we should wait much longer."
Erminia was horrified. "But you said you'd have to operate, and now he's conscious, how..."
"That will do, Erminia." Mr. Buxton resolutely pushed her aside and sat down on the edge of William's bed. "Son, I've always been truthful with you, so listen carefully. Your life is in danger, but Mrs. Hargrave here knows the procedure that can save you. It will be invasive and painful, but Erminia and I will be with you every step of the way. Do you understand me?"
William's eyes looked enormous in his sunken face, but in spite of the terror that lurked in them he nodded.
"Good boy." Mr. Buxton quickly wrapped his hand around his son's arm and gave it a comforting squeeze. Then he turned to Mrs. Hargrave. "What do you require?"
"A sharp knife with a slender blade and a funnel with a long, narrow spout. Both of them need to be put in a pot of water and boiled for at least ten minutes. Bring them here still in the pot with the hot water along with some strong alcohol, a stack of towels, a bucket or pan and some fishing line. I have a needle right here."
Erminia couldn't suppress a whimper at the gruesome list, but caught herself immediately. She knew William would be frantic with apprehension already, and she did not want to add to his terror. Mr. Buxton nodded grimly and left to fetch the required materials. Erminia quickly took his seat by William's side and grasped his hand in hers.
"Everything will be alright. And as soon as you're healed, we will take the horses on a long ride to that pond in the forest you love so much; and we'll bring a picnic, and catch butterflies and have a lovely day, won't we?" She was quite proud of herself that there was barely a tremor in her voice, when it was all she could do not to break down and bawl her eyes out. She was rewarded with a ghost of a smile from William and a weak twitch of his fingers as he tried to return her firm grip.
Mrs. Hargrave had watched the exchange with a heavy heart. Widowed early in life, her marriage had never been blessed with children. But she could not deny that William brought out her motherly instincts. She hated to interrupt the young man's tender moment with his cousin, but there was work to do.
"I will need your help, Miss," she said.
"Of course." Erminia gave William what she hoped was an encouraging smile and rose from her seat. "What can I do?"
"For a start, we need to remove the bandage around his chest in preparation for the operation," Mrs. Hargrave explained to Erminia. "I prefer to cut it rather than unwind it, and since it's so tight the best place is along the dip of the spine. So we need to roll him over on his side - slowly and carefully, and without putting too much pressure on his broken ribs."
Working in tandem the two women managed the maneuver without too much trauma for the patient. Using a pair of slender sewing scissors the housekeeper cut through the material and tried to peel it back. One side came away without problems, but the other half covered the gash the broken rib had made, and the caked blood had stuck the linen to the wound. Mrs. Hargrave used a cloth and the water from her tea kettle to soak the material so it would release its hold on the young man's skin, while Erminia sat on the other side of the bed, running her fingers through William's hair and talking to him in a low voice to try and take his mind off the situation.
When the housekeeper was finally able to remove the bandage from the wound bits of scab came off as well, and she frowned when she realized that the blood that began to seep out was mixed with pus. It was unusual for such an injury to show signs of infection so quickly, but it would explain William's fever. At least there was no bone sticking out, the rib had obviously retreated back into the chest cavity, and she could only hope that the other end had found its way back to its original position as well.
For a moment Mrs. Hargrave debated whether to clean and disinfect the wound, but decided against it. She knew only too well what an ordeal William would be facing soon, and she did not want to add even more pain to it. In his weakened condition he could quite easily go into shock and then he would not be able to withstand the operation. She was counting on him to lose consciousness at some point - praying for it to be sooner rather than later - so there would be an opportunity afterwards to treat the infected area without him being aware of it. For the time being she took a folded piece of cloth, doused it with more water from the kettle and covered the wound with it. William gave a low hiss at the contact, but recovered quickly enough.
They had barely removed the bandages and settled William on his back again when the door opened and Mr. Buxton appeared, a basket with supplies over his arm. He was followed by a scullery maid who was carrying a steaming pot. She quickly set it down on the bedside table and almost ran from the room, stifling a sob. Obviously she wasn't the only one with a soft spot for young Master William, Mrs. Hargrave thought.
She liberally washed her hands with the alcohol before fishing the knife from the still hot water. After pouring more alcohol over the blade she pulled the funnel from the pot and set it with the big opening facing down on a freshly ironed kitchen towel within easy reach.
William was watching her preparations with growing apprehension. The blade of the knife looked wicked, and the thought that it would soon be cutting into him should have made him panic. But the constant struggle for breath had exhausted him, and he was beginning to feel light-headed from lack of oxygen, so he did not have enough energy for such a strong emotion. He only hoped that Mrs. Hargrave would not hesitate, and that it would be over quickly. If only he could tell her there was no need for her to be considerate, and that she should just go for it, but he didn't have enough breath to spare. As if she'd felt his gaze, the housekeeper turned to look at him. Her stern face softened for a moment, and she gave him a quick nod as if she'd read the unspoken plea in his eyes. William nodded back at her as a signal that he was ready. Then he closed his eyes and gritted his teeth, steeling himself for what was to come.
He heard Mrs. Hargrave's instructions to his father and Erminia. "I will require you both on the other side of the bed, holding him still. Don't be afraid to sit on his legs if need be. He can cause himself irreparable damage if he tries to pull away from the knife, so no matter what happens, hold tight."
Her two assistants nodded solemnly, then they took their positions. William felt four sets of hands pinning him against the mattress. His already labored breathing became ragged as he waited for the first cut. When it came it was a searing pain in his side, and his mouth opened as if for a scream; but all his oxygen-starved lungs could manage was a strangled groan.
There was no reprieve, the blinding agony went on and on. At one point the knife seemed to meet some obstacle, and the additional pressure when the tip tried to force itself through sent shockwaves of pain through his chest and belly. In spite of Mrs. Hargrave's warning words and his earlier resolution not to pull away his instincts took over, trying to escape the sharp blade piercing his side. But his waning strength was no match for the four hands which gripped him, and try as he might they would not let him move an inch. Tears of pain and frustration started to seep from under his tightly closed eyelids, when with a jolt the knife pushed through the barrier, and the torment suddenly ceased. One final stinging slide told him the blade had been withdrawn, and he was able to relax slightly, the pain now at a manageable level.
Wiiliam's chest was heaving and his hearbeat was hammering in his ears; he realized there were voices talking but he could not understand any of the words. Then a cool hand came to rest on his feverish forehead, and he leaned into the touch, grateful for its comfort. After a while he managed to open his eyes, and saw that it was Erminia by his side. She was as white as a sheet, and her wide eyes were terrified although she tried her best to smile at him.
He knew he couldn't speak, but his lips managed to form the silent question, "... over?" His cousin bit her lip, then she shook her head. "Almost," she promised, then she wrapped her arms around his shoulders again, and William knew he should prepare himself for further unpleasantness. But he could not have anticipated that what was to come would be infinitely worse than the cutting part. His eyes flew open when a blunt object started to press into the canal the knife had carved before. It felt as if somebody was trying to force the white hot barrel of a shotgun between his ribs. This time a ragged scream was torn from him, and he bucked and writhed like a madman under the restraining hands, until finally merciful darkness took him away from this hell.