The Moon by Night (39 page)

As Cheney had given the orders, she and Shiloh had removed the wedged pillows from behind Mrs. Green and laid her down flat. Quickly Shiloh moved up behind her head, and Dr. Varick moved the surgical supply table up by him. Shiloh placed one hand underneath her neck, then tilted her head sharply upward, supporting her neck securely. He started to say something, but Dr. Varick quickly put a thick roll of gauze in position so that Shiloh could slide it underneath her neck. “Good,” he murmured.

He leaned close over her, then placed the heel of his hands on her temples. Feeling carefully, he located the apex of the angle of her jaw, placed his fingers just behind it, then pushed open her mouth with his thumbs. He looked up at Cheney, who was listening to her chest. “Okay, Doc, she's still breathing, but it's very shallow, with maybe a ten- to fifteen-second apnea.”

Cheney nodded. She listened for a moment longer, then moved so that she, too, was leaning close over the woman's face. She pulled one eyelid up. Cheney's and Shiloh's eyes met. “Pinpoint pupils,” Cheney said calmly. “Note it in the file, please, Dr. Varick, along with the time.”

Kitty and Timothy returned and began packing her lower extremities with warm blankets and hot bricks wrapped in damp rags.

“Dr. Varick, massage her hands until they feel warm.” Cheney took Rebecca Green by the shoulders and, leaning over, called loudly, “Mrs. Green! Mrs. Green, wake up!” She shook her firmly and called several times.

“How long has it been since the atropine injection?” she asked Dr. Varick.

He kept rubbing Mrs. Green's hands and feet. “It was at 4:32, Dr. Duvall. It's been six minutes.”

Cheney's and Shiloh's gazes met over the woman's face again. Now it was so white, the skin stretched over it so unnaturally, that she looked like a poorly done wax figure. “I'll check for bowel signs again,” Cheney said in a low voice.

Shiloh nodded.

Cheney placed her stethoscope over Mrs. Green's midsection again—her skin was icy and clammy—and made a small signal for silence.

In the quiet the woman's breathing was the only sound. She inhaled very lightly for one or two seconds, then a long hesitation, and then a very faint exhalation.

Cheney couldn't hear bowel sounds anymore.

Finally she rose. “All right, let's get her turned on her side again, please. Kitty, change out the blanket, and then you may go on back onto the ward. Timothy, you've done very well. Go on back to the ward now.”

Dr. Varick said in a low voice, “May I stay, Dr. Duvall?”

“Yes, of course,” Cheney answered. “You and I are her physicians. We have to stay.”

Shiloh was gently positioning her back on her side. “I'm not her physician, but I'd like to stay, Doc. Can I?”

“Yes. You may not be her physician, Shiloh, but you were her comforter,” Cheney said quietly. “In surgery, and even now, I think she knows you're here. Please do stay.”

They made their patient comfortable. Cheney and Dr. Varick stood on one side of the bed behind her. On the other side of her deathbed Shiloh stood holding her hand. He said quietly, “Don't be afraid, Mrs. Green. We're here, and we'll stay with you. We're praying for you, so don't be afraid.”

In eight minutes she took her last breath.

Shiloh whispered, “Stop, traveler.”

Precisely at 8:00
A.M.
Monday Dr. Marcus Pettijohn and Dr. Duncan Gilder came breezing through the emergency doors of the hospital, laughing. “And so her shoe flew up through the air like an artillery shot, and we were amazed at how high she could kick—” Dr. Pettijohn abruptly stopped talking when they reached the nurses' station, for he saw Cheney and her haggard face.

Dr. Gilder looked abashed, but then he saw his friend Stephen Varick standing behind Cheney at the filing cabinet, and Stephen looked so exhausted that Duncan wondered if he might have contracted the influenza. “What's wrong?” he blurted out. Stephen frowned darkly and cut his eyes toward Cheney's back.

Dr. Pettijohn asked with surprise, “Dr. Duvall, what are you doing here at this hour? Was there some emergency?”

Wearily Cheney answered, “There certainly was. All weekend long, it seemed. Dr. Batson came down with influenza on Friday night, so Dr. Varick and I have been here all weekend. We tried to get in touch with you, Dr. Pettijohn, to ask you to help out. But we couldn't contact anyone at the address you gave us.”

“Oh, dear, what a coil,” he said with evident deep regret. “I left early Friday because I had to move this weekend. I told Nurse Flagg. Did she forget? My landlord suddenly doubled my rent last week. I believe he's planning on building attached flats behind to make those horrible tenements. Anyway, I decided to move out into a hotel until I can find another suitable place to live. I am so sorry, Dr. Duvall.” As he spoke, he could see her indignation fade.

She nodded. “I see. Yes, I suppose Mrs. Flagg did forget, but then again, I'm not certain anyone even thought to ask her on Friday about your whereabouts for the weekend because we didn't know until late Friday night that Dr. Batson was ill. At any rate, Dr. Pettijohn, we would certainly appreciate it if you would leave word on the weekends if you will be available in case of emergency, and where you will be.”

“Certainly,” he agreed.

Cheney waited, and he just smiled at her pleasantly. Finally she ventured, “So you have moved into a hotel, Dr. Pettijohn?”

“Yes, temporarily.”

“And would you mind telling me which one? In case we need to contact you,” Cheney finally said with some discomfort, wondering how the man always managed to unsettle her.

“I'm at the Corinthian,” he answered after a moment's pause. “I'll be there, as I said, until I can find a suitable house.”

“Thank you,” Cheney murmured.

“Dr. Duvall, since Dr. Batson is ill, who is going to take the midnight shift?” Dr. Pettijohn asked politely.

“I-I suppose I'll just stay over until Dr. Batson is recovered,” Cheney said vaguely. She was so tired she hadn't actually thought about the late shifts during the week.

Dr. Gilder, who had looked hangdog guilty ever since they had come through the door, blurted out, “I'll stay and work, Dr. Duvall. Stevie and I can bunk up in the lounge and do twelve-and-twelves. Classes are out, you know, for the holidays.”

Cheney said thoughtfully, “That's very kind of you, Dr. Gilder. And any other time I believe that the two of you, along with Dr. White, of course, could certainly handle anything that comes along. But since we have this awful flu going around, and since we have Mrs. Brownlee and Mr. Reese with very serious cases of septic sore throat, I believe that one of the staff physicians should be here at all times. Dr. Buchanan was here for most of the weekend, but he does have so many other commitments that it's impossible for him to take an entire shift.”

Dr. Pettijohn had been looking at the occupancy charts, the floor plans showing which rooms were occupied and by whom. “Only ten patients, Dr. Duvall, that's not such a heavy case load—Oh, wait a minute—” He looked up, his normally guarded eyes shadowed even more cautiously. “Mrs. Green?”

Cheney shook her head, and the gesture clearly illustrated her frustration and her exhaustion. “She died yesterday.”

Dr. Pettijohn looked upset. Cheney thought it was because he was saddened at the loss of a patient, but actually it was because it occurred to him that Victoria Buchanan may not be coming to the hospital quite as often now that her servant had died. Seeing Cheney's sudden look of understanding and compassion as she watched him, he said softly, “I'm so sorry to hear that. She was so young. I assume Mr. Green was extremely upset. I hope he didn't cause you any problem, Dr. Duvall?”

Cheney answered, “It devastated him so that he was just crushed and made no difficulties at all. He wouldn't let us do an autopsy, which was disappointing but not really a surprise.”

Dr. Pettijohn nodded. Then with the air of the man who can solve any problem, he said, “I have a plan, then, Dr. Duvall. I can see that you are exhausted, and now I understand why. Normally you seem to handle on-call weekends easily, but losing a patient, particularly a young person, is debilitating. Now, I assume that you would prefer not to simply trade out next weekend, which I know is your on-call, because that would upset the schedule. And I know that you and Mr. Irons-Winslow were looking forward to having both Christmas weekend and New Year's weekend off.”

“Well, that is true, Dr. Pettijohn,” Cheney said tentatively. “Dr. Buchanan and I planned to take turns relieving you and Dr. Batson on those weekends, but we have, of course, made many plans for the holidays. I did hate to change the weekend on-call schedule around.”

“I understand completely,” he said lightly. “Besides, it's only fair for the families to have some vacation time, while us bachelors tough it out with the poor patients who have the misfortune to be ill during the holidays. Anyway, Dr. Duvall, I propose that you take off today and tomorrow and don't come back until your regular evening shift on Wednesday. I'll keep all three of the interns here, with three eight-hour shifts for them, and I'll stay here also. It'll be a little difficult with all of us here to rest in the doctors' sitting room, but it can be done.”

Cheney looked surprised. “Why…why, that is exceedingly kind of you, Dr. Pettijohn. Would that be all right with you two?”

“Sure, Dr. Duvall,” Dr. Gilder said, “I feel bad that I wasn't here to help out this weekend. You could've sent for me, Stevie,” he finished reproachfully.

“I know, Duncan,” Dr. Varick said, “but Dr. Duvall and I didn't really get beat up till yesterday when Mrs. Green died. And that happened so fast, it wouldn't have helped to call anybody. Besides, Mr. Irons-Winslow was here, and he's great. Like having an extra doctor. A really good one—er—begging your pardon, Dr. Duvall.”

With a touch of amusement she said, “It doesn't offend me, Dr. Varick. I know he's good. So can you stay and help out? If you would, I would certainly not worry as much, taking off for two days.” With emphasis she added, “I have great confidence in you, Dr. Varick. You did exceptionally well this weekend.”

His thin cheeks flushed, and he pushed his glasses up on his nose. “Thank you very much, Dr. Duvall. Of course I'll stay.”

“Good.” Cheney turned back to Dr. Pettijohn. “I'm going to take you up on your offer, Dr. Pettijohn. I admit I can hardly keep my eyes open, and I think I'm as tired as I've ever been. I have one condition, however.”

With sudden wariness he asked, “Yes? And what would that be?”

“I insist that you use the flat above the office instead of trying to grab naps here,” Cheney said firmly. “I just got it stocked with some food and firewood this weekend, and it really helped to have a place to rest quietly and soundly, even if only for an hour or two. It's so much better than catching snatches of naps in the doctors' sitting room.”

Dr. Pettijohn's blue eyes sparkled.
That's how Batson got in the clique,
he thought with satisfaction.
He was just a nobody tagging along with Dr. Buchanan, like me, but they let him bunk upstairs in that flat, and the next thing he knew, he was their partner and was buying his own house. I'll bet I can get in the roses with Buchanan and even Miss Hoi-polloi Duvall a lot faster than that moron Batson did. Now this is the beginning of a very fine new plan, for my new life!

“That's exceedingly generous of you, Dr. Duvall. I accept.”

****

By eleven-thirty that night Dr. Marcus Pettijohn's enthusiasm was considerably diminished. The morning had been busy because, instead of a few patients with assorted injuries and in different stages of recovery from illnesses, he had five patients in the throes of the most infectious and febrile stages of influenza and two patients with septic sore throat, a serious illness. Mrs. Brownlee and his own patient William Reese and all of the flu patients had required constant monitoring, and Marcus had been obliged to use his luncheon and dinner hours to sit with Mevrouw de Sille to earn his expensive personal consultation fee.

And the dispensary had been as busy as a hornet's nest, with an endless stream of women and children and old people, most of them with influenza. The hours for the dispensary were supposed to be from noon until six, but people had kept coming in until almost eight o'clock. Then it had started sleeting, and three accident victims had come in to emergency. One was an elderly man named Withers who had fallen and broken his hip. Marcus had admitted him, simply giving him heroic doses of laudanum until Dr. Buchanan could deal with him in the morning.

The other accident victims were a couple named Bloom whose farm cart had overturned. They both had bruises and minor cuts to be stitched up. The Blooms were still in beds in the clinic's cubicles, for there were no cabs or hacks available during the ice storm. Marcus had told them that they could stay until morning.

He came out of the couple's cubicle and saw Carlie coming down the hallway with an armload of firewood. Carlie was good about keeping all of the fires stoked, just as he was good about keeping the supply closets and carts stocked. Marcus thought with some impatience,
Just one attendant at night, and he's an idiot. And when one doctor gets sick, it throws everyone into a spin. We're definitely understaffed, and I'm going to talk to Victoria about it. Maybe if I put it to her right, she would see that Buchanan doesn't need to be chief physician—that it needs to be someone who can at least work a regular shift, someone who doesn't have other outside distractions…someone like me
.

“Carlie, where's Dr. Varick?” he asked, following the boy to the stove to huddle by it a moment and warm his hands.