A/n: Antibiotics were not mass produced until 1944, so at the time of this story, there was no definite treatment for infection "septic" arthritis or septicemia. Some people managed to survive it, but it had a high mortality rate and even today, it can kill quickly. The medicine that John is treated with Neosalvarsan is not a precursor to penicillin, however, at the time, it was one of the only medications with antimicrobial properties that would not certainly kill the patient. It was an arsenic based compound, but in small doses, was an effective treatment for syphilis. It was likely tried "off label" for other conditions as well.

The ride is just starting for the Bates, I'm afraid. Drop me a line and let me know what you think.

Chapter Twenty-Four

The doctors took John for the procedure an hour after he arrived. Anna sat with Mary while Robert went to see the accommodations for the duration of their stay in York. It didn't take very long, but Anna felt it was eons. The doctors told her ever though John was medicated with morphine they would be putting him to sleep with ether so he didn't feel anything or accidentally come awake during the procedure. Anna hated to think of him alone without control of his senses, but the sooner they drained the infection the better it would be for John.

It took just over two hours to clean out the infection. Robert was back before the doctors came to talk to Anna so he stood beside her as he had promised John.

"The infection, we are glad to say, was not as advanced as it could have been. The earlier injury and remaining shrapnel coupled with the loss of cartilage, bone spurs, and bone loss made the condition worse. We are confident we got all the infection from the bone."

Anna smiled, "Then he will be alright? He's going to make it?"

"If we got to the infection before it invaded the rest of his system," the doctor explained. "But now, because it has, he has to recover from the procedure and heal his wound while battling a blood infection. There's no guarantee."

Robert's hand went to the small of Anna's back to support her as she staggered back. "Dr. Clarkson said there's a medication that could work to help him. What is it? Can you give it to him?"

"The medication is called Neosalvarsan," Dr. Reid replied. "It's been highly effective in treating syphilis, but we have had some success with other diseases caused by bacteria. We can give Mr. Bates an injection and support him with IV fluids and other remedies while his body tries to fight off the infection. It is in Mr. Bates' favor he was so healthy before this, but his age works against him. We will do everything we can."

"How did he get this sick?" Mary asked. "He had to have symptoms, his knee looked like it hurt like the devil."

"He probably did," Dr. Reid replied. "Fatigue is a major symptoms, but Dr. Clarkson told us that Mrs. Bates had been recovering from a difficult birth and that Mr. Bates had been working for his lordship, running,the home, and caring for the children, so he likely dismissed it. Given his knee, hip, and lower back are already arthritic, he probably wrote off any pain as well. It wasn't until the fever got hold of him that his body forced him to stop."

Anna shuddered at the thought she had in anyway contributed to this. Robert's touch shifted to her shoulder and he squeezed gently. "It was just Bates being Bates, Anna. Don't be upset with yourself for doing what you needed to for your family. You had no way of knowing it would come to this. You were well for over a month before this happened."

"Papa's right," Mary replied. "Bates wouldn't want you to feel guilty for needing to rest and recover from a cesarean section or anything else. You wouldn't hold him responsible if you fell ill taking care of him, would you?"

Anna shook her head, "Did you…You said he has this in his hip and back? Why was only the knee so swollen?"

"He has osteoarthritis in his hip and back, a loss of cartilage, that is the padding between bones. The cartilage in his knee is gone, there is nothing we can do about that except treat the symptoms, pain and stiffness, and we will get him on a treatment plan for it. His left hip shows loss of bone and cartilage, but not as significant as his right knee, and the lower vertebrae in his back have developed bone spurs with the space between each very narrow. Again, we can't cure these conditions, we can only help him live with them."

Anna shook her head, "He never told me any of this. Did he know any of this?"

"I'm not certain if he…" Dr. Reid realized he had just revealed something that his patient would have rather kept secret.

"Yes," Robert replied. "He knew, but in all fairness to Bates, he found out the night before you went into labor with Elizabeth. I'm sure he would have told you when he was ready."

"But you can help him? As I look back on it now, I can see, my husband was suffering pain, I just ignored it, I thought it was…" Anna licked her lips. "Something else. You can help him?"

"We can," Dr. Reid replied. "Once he's over the infection, we can start him exercising, taking anti inflammation treatments, and temper that with rest. We can ease the symptoms, as I said, but we can't cure him and we can't stop the progression of the condition."

Anna nodded her thanks before requesting she be allowed to sit with John while he came around from the ether. "Many patients have poor reactions to ether, it might be difficult to stomach, Mrs. Bates."

"I'm a mother of three, Doctor, not much can happen that is difficult for me to stomach. May I please sit with my husband and ease him out of it?" Anna replied.

Anna was led down a long corridor to a private recovery room where John lay, still unconscious, from the ether. His right leg was suspended from a large metal frame, supported by a system of pulleys and straps to keep it still and elevated. His knee was cut open and packed with cloth to facilitate the drainage of the infection.

"You can sit on his left side," his nurse told her. "And only his left side. You can come for three hours in the morning, then three hours at night. That is all the hospital will permit. He must rest."

Anna wanted to protest, but she knew she'd not get anywhere. She was nobody in the scheme of the Royal Yorkshire Hospital system. If she wanted to nurse John herself, and she did, as she knew he'd not rest if she wasn't close by, she'd have to involve his lordship. Anna was not one to prey upon the deep friendship between her husband and the Earl of Grantham, because their relationship wasn't that. It was Robert and John that were friends, not Bates and Lord Grantham, but in this case, Anna would throw all that away for Robert's influence.

Anna took John's hand, mindful of the IV line running fluids and heaven knows what else into his body. He still looked so dreadful. If possible, he'd lost even more color in his cheeks, and his hands were cold. Anna leaned over to stroke his forehead and was relieved to feel that he was warm, but no longer burning hot. If whatever the doctors had done helped him even the slightest, Anna would be grateful.

Anna sat beside John for almost the entire time allotted before he started to stir. Anna stood when she heard him moan and felt him squeeze her hand. "John?" Anna whispered, keeping her voice soft and gentle. "Come on, John. Come back to me. I'm right here with you."

The pressure on her hand increased, a sure sign John heard Anna's voice. "That's it, my love. Squeeze my hand and come back to me."

John tried to force his eyes open, Anna was here and she wanted him to wake up. He didn't want to wake up, he felt so sick. There was that smell, that was the last thing he remembered, a sickening sweet smell. It was gone now, but the sickness it induced was still washing over him in painful waves.

John managed to open his eyes after a few minutes of Anna's gentle prodding. Her face was the first thing he saw when he did, she smiled at him with such love and joy, he had to smile back. That smile was short lived.

John took a few deep breaths and swallowed hard before choking out a warning to his wife, "I'm going to be sick."

Anna expected this. She remembered how awful it was to wake up after having Elizabeth and she'd only been under chloroform. She grabbed a basin that was sitting on the table near the side of John's bed, sat on the edge so she could help him sit up, and held it under his mouth.

"Don't fight it, let it come," Anna whispered as John became violently sick from the after effects of the ether.

Anna gently rubbed his back as he lost what little was in his stomach and likely a lot of the fluids he was being pumped full of from the IV bag. When it was over, Anna offered John a cup of water, then held the basin in place so he could rinse his mouth.

"Lie back," Anna urged when it looked like the sickness passed. "Is the pillow alright? Are you comfortable?"

John looked around the large, white room. This didn't look like home nor did it look like the hospital in Downton village. It wreaked of disinfectant and some other odor he couldn't place. It was enough to turn his stomach, again.

When that was finally over John sank back against the pillows Anna had fluffed up to be as supportive as possible. John looked at Anna's face. She looked tired and worried, but she smiled at him. Her eyes held his own, willing him to say something.

"What happened?" he finally managed.

Anna's hand was stroking up and down John's chest as she sat on the edge of his bed. He was breathing slower and deeper now that his fever was down, but not as he should be either. Not yet.

"You've been ill, John. You're in York at Royal Yorkshire. They had to open your knee, you had a terrible infection there. You still have it, but the doctors here have some medicine they can give you now you've woken. Do you remember being ill at all?"

John thought a moment. "I remember…" he paused to catch his breath. It was incredibly hard to talk, he kept feeling short of air. "I remember you were angry with me. I'd lost my temper with Margaret Mary and you were angry at me. I was angry with myself. Elizabeth needed a change, I did that and I felt so…tired and my head ached, my back hurt, and my knee…there was fire in it. I had to lie down, just for a moment…that's all I remember, lying down for a minute."

"That was almost a full day ago," Anna replied. "I woke up and you had a terrible fever. You still have, but it's a bit better now."

"How long will I be here?" John asked. He was already exhausted from talking.

"A few weeks," Anna replied. She saw fear cross John's face. "But don't worry. His lordship secured a boarding house for me and Mrs. Hughes is coming with the children tomorrow. Mrs. Patmore is going to take over for her and Daisy will stay on full time until you're well and we all go home together."

John shook his head "No, I won't have them all put out because of me. I can manage."

John's facial expression and body language betrayed him. He was terrified, but he'd never admit it. "Well, I can't," Anna replied. "I can't manage without you for that long.You promised me I was stuck with you for good and proper well…back at you, Mr. Bates."

Anna leaned over John and placed a gentle kiss on his lips. "Go to sleep, get your strength back. We have so much waiting for us. We've been through worse, and we've been just fine."

John held onto Anna's words as he leaned back and squeezed her hand. It was only minutes before sleep came to take him.