The Furies (21 page)

‘I'm sorry. I shouldn't have lost my temper,' she said. ‘But I can't bear to see waste. And it would be a waste: you, languishing ineffectively in that camp.'

He shook his head. ‘You have no need to apologise, Sister.' He paused and then came to a quick decision. ‘Look, if anything it should be me apologising to you: because you are absolutely right, both from a moral and practical point-of-view. If you will have me, I would happily work here as an orderly. I would have no problem accepting orders from your doctors or nurses – women or otherwise.'

‘Excellent decision, Captain Bayer.'

‘I've learned it's best not to argue with you, Sister.'

‘Very wise,' she answered as she turned away with a smile.

***

The next day Gabriel began work as an orderly in the fever hospital. As he was now immune to typhus he did not wear the calico typhus clothing, but instead found his old uniform – shirt, trousers, and even his jacket with three silver stars still attached – clean and freshly steamed in a neatly folded pile in the laundry.

It was good to be out of bed, he thought, as he accompanied the nurses on his first ward round. However, it was not easy adjusting to this new role. Not that he considered nursing duties unimportant – indeed, he now knew from personal experience how vital it was for a patient's recovery – but it was strange to watch others make decisions on patients and then have to carry out their instructions. The other Austrian orderlies knew of his rank and offered to do the more menial tasks, but Gabriel declined, telling them he wanted no special treatment, that he would do his share of the work no matter how trivial. But after a whole afternoon spent emptying and rinsing out piss-pots, he realised it would take him some time to get used to his new position.

The prison orderlies had been allocated their own room. Although they were locked in at night, it was warm and dry and they received two good meals a day, heaven compared to the conditions in the prison camp. And it was wonderful to be working with patients again, discussing their symptoms and problems and complications. On the first ward round that morning, Gabriel diagnosed a missed septic arthritis, and by the next day Sylvia and the other nurses were already asking for his opinion whenever Dr Wakefield was unavailable.

On the third morning, as usual, the guard unlocked the door of the prisoners' sleeping quarters. But as Gabriel left the room, he was surprised to find Sylvia waiting for him.

‘I have some good news for you, Captain,' she said. ‘Two of the surgeons at the school hospital have gone down with fever, leaving only one surgeon well enough to operate. Dr Stewart has a full list of cases and needs an experienced assistant. Would you be willing to help?'

‘Help?'

‘Yes.'

‘You mean…in the operating theatre?'

She nodded.

A grin spread across his face. ‘I should be delighted.'

‘Excellent. I've cleared it with the guards. They will escort you there immediately.'

‘Thank you very much, Sister.'

‘Don't let me down,' she replied. ‘It was me who suggested your name.'

Early morning at the school hospital, and Elspeth was already inside one of the converted classroom wards, about to examine a patient due for surgery later that day.

But she was feeling ill at ease.

The previous morning, both Dr Soltau and Dr Chesney had presented with fever and taken to their beds. Later the same day, two ox wagons loaded with eight urgent surgical transfers from the nearby town of Valjevo had rolled into the hospital courtyard. Examining the casualties, Elspeth had seen that several of the transfers were complex and would require the skills of two surgeons. But she was now the only surgeon fit enough to operate. She had gone to the First Reserve Hospital to ask for help from Dr Anitch, but he could spare her no one and had told her she would have to do the best she could and not worry about the outcome. But Elspeth was unhappy with risking lives in this way, and had discussed her problem with Sylvia that evening.

‘But if the cases are complex and you need a trained surgeon,' Sylvia had replied, ‘why not use Captain Bayer? I've watched him on the wards over the past few days: he's hard working and perceptive. He speaks good English as well as German, and he has a smattering of Serbian. What do you have to lose by giving him a try?'

Elspeth had agreed; it seemed like the only sensible choice, although now she wondered if she had made the right decision. Well, she told herself, she would know soon enough.

She heard the door to the ward open and looking up from the patient saw two Serbian guards appear in the doorway, followed a moment later by Gabriel.

It was the first time she had seen him since he had collapsed so spectacularly in the school courtyard almost a month ago. Now, as she watched him walk towards her, Elspeth studied his appearance: a little thinner, perhaps, in his pale blue uniform, his black hair much shorter, of course, but a warm intelligence still perceptible in the silver of his eyes.

‘Captain Bayer,' she said, nodding her head in greeting.

‘Dr Stewart,' he said, bowing in return. ‘It is a pleasure to see you again. The last time we met, I was unfortunately not at my best.'

She smiled. ‘I'm glad to see you've recovered. Has Sister Calthorpe explained my problem?'

‘She has, and I am very sorry to hear about Dr Soltau. I met her only briefly as you know, but she struck me as being extremely nice. How is she doing, may I ask?'

‘She still has a high fever. But there is no rash and this morning she developed a sore throat. There is an exudate covering the back of the pharynx—'

‘Diphtheria, you think?'

‘Yes,' she replied, reassured he had arrived at the same provisional diagnosis as her. ‘It is easy to assume every new case of fever is typhus, but in these conditions it's important to keep an open mind.'

‘I agree. As well as typhus, I saw diphtheria, pneumonia, even meningitis in my camp. Well, I truly hope she recovers.'

His empathy for Dr Soltau was unexpected and warmed her to him. She could see why Sylvia was drawn to him: a confident yet kind manner, the look of someone you could trust. ‘Our lead surgeon, Dr Chesney, has also gone down with bronchitis.'

‘I see.' He nodded. ‘Well, I am honoured to be asked to help and excited at the prospect of operating—'

She saw him flinch as an ear-splitting roar of a motor engine from the courtyard cut off his words.

‘Oh don't worry,' she said, trying to suppress a smile at the startled expression on his face. ‘It's only our electricity generator.'

He straightened up, grinning sheepishly at her. ‘Sorry for being a…how you say…scaredy-cat. Yes?'

She gently laughed and then realised she was looking forward to being in theatre with him. ‘Dr Soltau brought it with us from England. It's a noisy beast, but invaluable for guaranteeing a steady electricity supply for the theatre lights and X-ray machine.'

His eyebrows rose. ‘You
brought
an X-ray machine with you?'

‘Oh yes,' she said pertly. ‘One of our women studied physics and radiology at Cambridge and brought a small device with her. It's been invaluable.'

‘How we could have done with an X-ray machine in our field hospital,' he said, and she saw him shake his head in wonder. For a moment there was a silence as they looked at each other, and then she broke the awkwardness of the moment by pulling her pocket watch out of her jacket and flipping open the lid. ‘Well, they'll be waiting for us in theatre,' she said, closing the lid with a snap. ‘I just need to see one more case. It's the first on our list today and probably the most challenging.'

They crossed to one of the beds and Elspeth began to examine the patient; a Serbian corporal who became breathless with even the gentle effort of sitting forward to remove the top of his gown. His lips and fingers were purple with cyanosis, the skin of his chest scarred and puckered, and via Aurelia, the translator, Elspeth told the soldier there was a collection of pus – an empyema – surrounding his left lung, caused by a shrapnel injury received a few months ago. The X-ray showed a fragment of metal lodged close to his heart she told him, and the pus needed to be drained and the shrapnel removed to prevent a recurrence of the empyema.

***

As she explained all this to the soldier, Gabriel stood by Elspeth's side and studied her with a growing sense of fascination. He had never met a female surgeon before, but now he was spellbound at her confident assessment and correctly proposed solution to the problem. She finished her examination and then led him out of the ward and along a corridor to a main staircase, then up one flight of stairs towards the first floor. As they reached the landing, she started to tell him about another patient on the list.

And as he listened to her enthusiastic analysis of this case, a smile of wonder spread across his face. He felt nothing but admiration for her, and her colleagues. To have travelled all the way to a war zone at such a dangerous time, showed a selfless dedication he had rarely witnessed before. So he was startled when – as they arrived outside the operating theatre – Elspeth stopped talking mid-sentence and suddenly turned towards him.

‘You appear amused, Captain Bayer,' she said, her voice sharp, her hands on her hips, the diamond blue of her eyes alight. ‘Have I said something comical, something you don't agree with?'

‘Oh,' Gabriel said with dismay. ‘No, not at all. Please do not take offence, Dr Stewart. I'm just amazed…amazed that—'

‘Amazed?' He saw that her eyes were now ablaze. ‘And why is that, may I ask?'

Gabriel blinked, then opened and closed his mouth without speaking, eventually finding his tongue. ‘I am sorry, Dr Stewart…my English…is a little rusty. What I wanted to say is that I am amazed at the competence and commitment of all the women in your unit. We have no women doctors in Austria. Yet having been nursed back to health by Sister Calthorpe, and now watching you at work, makes me realise what a valuable asset has been wasted all these years.'

At first she seemed surprised at his reply, and then he saw two spots of scarlet slowly appear on her cheeks. She looked down at her shoes for a moment; then looked up at him from under partly lowered eyelids.

‘I must apologise for my outburst,' she replied. ‘In my country, the majority of men do not respect the abilities of female surgeons. So when I hear the word “amazed”, I am apt to assume it is being used in much the same way as when describing a talking pig, or a cow walking on its hind legs.'

Gabriel gently laughed at the images, relieved she had already forgiven him. ‘You have no need to apologise. I know that what you say is true about the majority of male doctors. But I am not one of them. I can see you understand surgical method.'

‘That's kind of you to say, Captain Bayer, but you haven't actually seen me operate yet.'

‘Well then,' he said with a smile, pushing the theatre door open for her. ‘Show me.'

He followed her inside, into a classroom that had been converted into an operating theatre, the centre of the room dominated by an improvised operating table overhung by several lights mounted on a stand. Elspeth introduced him to three other nurses already in the room: Monica, a fresh-faced scrub nurse, preparing the sutures, scalpels, and other tools of surgery; Aurelia, a VAD, a cheery girl who spoke fluent Serbian and would act as a translator; and Lydia, a pretty but quiet nurse who Gabriel was told would administer the anaesthetic.

As they waited for the patient to be brought in, Elspeth held a roentogram plate up to the light and showed Gabriel the shadow of a large empyema – pus in the cavity surrounding the left lung. She also pointed out a small triangular density, the piece of shrapnel that had caused the empyema. Although the shard of metal was close to the heart, her plan, she told him, was to open the chest, wash out the pus, remove the shrapnel, and leave a drainage tube in place.

‘You mean Bulau drainage?' he said and she nodded. His eyebrows rose. ‘That surprises me. We use Bulau's method in Austria, of course, but I thought the British method for empyema was to resect a portion of the ribs and allow free drainage of the pus?'

She smiled. ‘In Paris we tried Bulau's method of an underwater seal and chest drain and found it much less traumatic. So we are happy to adopt Germanic practice if it's better for our patients—'

She was interrupted by the clatter of the theatre door swinging open. Two orderlies appeared with the Serbian corporal lying on a stretcher, which they hoisted onto the operating table. The soldier's face was tense, his breathing rapid, his eyes wide as he scanned the unfamiliar surroundings. But Gabriel saw the man relax as Elspeth walked over to him and placed her hand on his wrist. She smiled reassuringly at him, and then looked across at Lydia and gave a subtle nod of her head.

As Gabriel washed his hands, Lydia took a gauze mask and held it an inch above the soldier's face, dripping liquid from a bottle labelled ‘Chloroform' onto the mask, while Aurelia – sitting at the soldier's head – whispered gently soothing words of Serbian. Gabriel put on a white cotton gown, a cap, and a muslin veil that covered the lower part of his face. Then he squeezed his hands inside the largest pair of rubber gloves he could find, realising that the women must have smaller hands as even the largest gloves were a tight fit. He heard a change in breathing from the patient as the chloroform took effect and saw Lydia lower the mask tightly over the man's nose and mouth. Now she took another bottle – labelled ether – and dripped liquid from this onto the mask. Gabriel heard the breathing become deeper, slower, more regular. After another minute Lydia pinched the soldier's ear; there was no response. She turned to Elspeth and Gabriel.

‘He's under. You can begin.'

Gabriel stood beside Elspeth as she pulled away the surgical gown to expose the soldier's torso, the scars on the chest wall puckered and red. With Gabriel's help she rolled the man onto his right side and slid a wooden wedge underneath his body; then rolled him back so that his left flank was elevated and exposed. Monica handed Elspeth a small pastry brush and a jar containing a brown liquid.

‘Iodine,' Elspeth said to Gabriel, her voice slightly muffled by the face veil as she painted the chest wall with the solution. ‘Dr Alexander Fleming, one of our microbiologists at St Mary's, has undertaken studies that suggest it is a more effective sterilising agent than carbolic acid.'

She stepped back as Monica covered the wedge and torso with sterile drapes, leaving only the iodine-coated chest wall uncovered. Then Elspeth stepped forward again and pressed her gloved fingers over the scar tissue. She palpated a gap between the ribs. Keeping her fingers in place she looked expectantly up at Gabriel, who already been given a scalpel by Monica; he placed its handle in Elspeth's free hand. Without hesitation she made an incision, a stripe of red appearing as the skin parted beneath the blade's razor edge and tiny hoses of blood began to spurt in the air.

They worked together quickly, efficiently and wordlessly: he clipping the spraying vessels with artery forceps and tying them off with catgut, while she dissected down through the skin and muscle between the ribs. He saw her push a gloved index finger through the chest wall into the pleural cavity: a spout of foul-smelling yellow fluid erupted from the hole. She waited for the flow of pus to stop and then widened the hole with the scalpel. Then she turned to Monica.

‘Tuffier, please.'

Monica handed her a metal device consisting of two wide steel blades separated by a serrated rod, a contraption Gabriel had not seen before. Without explanation Elspeth inserted the blades into the incision and then – using a ratchet which gripped the serrations on the rod – she levered the blades apart, causing the gap between the two ribs to spring open, widening the space into the lung. Gabriel was astonished: it was a novel type of rib separator, a hands-free device the like of which he had never seen before. Now he could see deep inside the lung cavity. He saw Elspeth lock the blades apart using a thumb screw on the rod; then she glanced up at him. Even though the lower part of her face was obscured by muslin, he could tell from the wrinkles around her eyes that she was smiling at him.

‘You haven't seen one of these before, have you?' she said to him.

‘No.'

‘It was invented by Theodore Tuffier in Paris only last year. Monsieur Tuffier was kind enough to lend us one and it proved so invaluable that I knew I had to bring it out here. It's extremely useful, almost like having a third pair of hands.'

His initial surprise at the competency of these women was now surpassed by a feeling of inadequacy, as he realised that many of their innovations – first the iodine, now the Tuffier – were ahead of his own. And he could see that Elspeth was in her element: slipping her slender wrist between the blades of the Tuffier and into the man's chest; pushing the lung aside with her fingertips; squinting along the back of her forearm.