An Echo in the Bone (Page 89)

An Echo in the Bone (Outlander #7)(89)
Author: Diana Gabaldon

The new influx has made things busier, of course. Most of the new recruits are reasonably healthy, for a wonder, but there are the usual minor accidents, cases of venereal disease, and summer ague—enough that Major Thacher—he’s the chief medical officer—has taken to turning a blind eye when I surreptitiously bind up a wound, though he draws the line at allowing me access to sharp instruments. Fortunately, I have a small knife with which to lance boils.

I am also growing very short of useful herbs, since Ian’s defection. He used to bring me things from his foraging expeditions, but it really isn’t safe to venture out of the fort save in large bodies. Two men who went out hunting a few days ago were found murdered and scalped.

While my medical kit thus remains a little sparse, I have as some compensation acquired a ghoul. This is a Mrs. Raven from New Hampshire, whose husband is a militia officer. She’s relatively young, in her thirties, but has never had children and thus has a lot of emotional energy to expend. She battens on the sick and dying, though I’m sure she considers herself to be sympathetic in the extreme. She revels in ghastly detail, which, while mildly repulsive in itself, does make her a competent aide, since she can be counted on not to faint while I set a compound fracture or amputate (quickly, before Major Thacher or his henchman, Lieutenant Stactoe, notices) a gangrenous digit, for fear of missing something. Granted, she does wail and carry on a bit, and is much given to clutching her rather flat chest and allowing her eyes to bulge while describing these adventures to other people afterward (she nearly prostrated herself from hyperventilation when they brought in the men who were scalped), but one takes what one can get in the way of help.

At the other end of the scale in terms of medical competence, though, the new influx of recruits has brought with it a young Quaker doctor named Denzell Hunter and his sister, Rachel. I haven’t yet spoken to him personally, but from what I see, Dr. Hunter really is a doctor, and seems even to have some vague notion of germ theory, owing to his having trained with John Hunter, one of the great men of medicine (on the chance that Roger will be reading this, I will refrain from telling you the manner in which John Hunter discovered how gonorrhea is transmitted—well, no, actually I won’t: he stabbed himself in the penis with a lancet covered in pus from an infected victim and was deeply gratified with the results, according to Denny Hunter, who recounted this interesting incident to your father while bandaging his thumb, which got squashed between two rolling logs—don’t worry, it isn’t broken; just badly bruised). I’d love to see how Mrs. Raven would take this story, but I suppose propriety would prevent young Dr. Hunter telling her.

You are, of course, minding the children’s vaccination schedule.

With all my love,


BRIANNA HAD CLOSED the book, but her hand kept returning involuntarily to the cover, as though she wished to open it again, in case it might say something different.

“What’s twenty-three days past June eighteenth?” She should be able to reckon that—she could do things like that in her head—but nervousness had deprived her of the ability to compute.

“Thirty days hath September,” Roger chanted quickly under his breath, rolling up his eyes to the ceiling, “April, June—right, June’s got thirty days, so twelve days from the eighteenth to the thirtieth, and ten more makes it the tenth of July.”

“Oh, dear Lord.”

She’d read it three times, looking again wouldn’t make a difference; still, she opened the book once more, to the page with John Burgoyne’s portrait. A handsome man—“And doesn’t he just know it, too!” she said aloud, making Roger frown at her in consternation—as painted by Sir Joshua Reynolds, he was in uniform, his hand resting on the hilt of his sword, standing against a dramatic backdrop of gathering storm clouds. And there it was on the next page, plain in black and white.

On the sixth of July, General Burgoyne attacked Fort Ticonderoga with a force of some 8,000 regulars, plus several German regiments under the Baron von Riedesel, and a number of Indians.

WILLIAM FOUND General Burgoyne and his army somewhat more easily than the Hunters had discovered General Washington’s whereabouts. On the other hand, General Burgoyne was making no attempt to hide.

It was a lavish camp, by army standards. Neatly arranged rows of white canvas tents covered three fields and ran off into the woods. Making his way to the commander’s tent to report, he spotted a pile of empty wine bottles near the general’s tent that rose nearly to his knee. As he had not heard that the general was a notable souse, he assumed this largesse to be the result of an open-handed hospitality and a liking for company. A good sign in a commander, he thought.

A yawning servant was picking off the remnants of the lead seals, tossing the metal into a can, presumably to be melted for bullets. He gave William a sleepy, inquiring eye.

“I’ve come to report to General Burgoyne,” William said, drawing himself up. The servant’s eye traveled slowly up the length of his body, lingering with vague curiosity on his face and making him doubt the thoroughness of his morning shave.

“Dinner party with the brigadier and Colonel St. Leger last night,” the servant said at last, and belched slightly. “Come back this afternoon. Meanwhile”—he stood slowly, wincing as though the movement hurt his head, and pointed—“the mess tent’s over there.”


Fort Ticonderoga

June 22, 1777

MUCH TO MY surprise, I found Captain Stebbings sitting up. White-faced, bathed in sweat, and swaying like a pendulum—but upright. Mr. Dick hovered over him, clucking with the tender anxiety of a hen with one chick.

“I see you’re feeling better, Captain,” I said, smiling at him. “Have you on your feet any day now, won’t we?”

“Been… on my feet,” he wheezed. “Think I might die.”


“Him be walking!” Mr. Dick assured me, torn between pride and dismay. “On my arm, but him walk, sure!”

I was on my knees, listening to lungs and heart through the wooden stethoscope Jamie had made for me. A pulse fit for an eight-cylinder race car, and a good bit of gurgling and wheezing, but nothing horribly alarming.

“Congratulations, Captain Stebbings!” I said, lowering the stethoscope and smiling at him. He still looked dreadful, but his breathing was beginning to slow. “You probably won’t die today. What brought on this burst of ambition?”

“My… bosun,” he managed, before a fit of coughing intervened.

“Joe Ormiston,” Mr. Dick clarified, with a nod in my direction. “Him foot stink. The captain go see him.”

“Mr. Ormiston. His foot stinks?” That sounded all sorts of alarm bells. For a wound in this particular setting to smell so notably as to draw attention was a very bad indication. I rose to my feet but was detained by Stebbings, who had taken a firm grip of my skirt.

“You—” he said, laboring for air. “You take care of him.”

He bared stained teeth at me in a grin.

“ ’S an order,” he wheezed. “Ma’am.”

“Aye, aye, Cap’n,” I said tartly, and made off for the hospital building, where the majority of the sick and wounded were housed.

“Mrs. Fraser! What’s amiss?” The eager cry came from Mrs. Raven, who was coming out of the commissary as I passed. She was tall and lean, with dark hair that perpetually straggled out from under her cap, which it was doing at the moment.

“I don’t know yet,” I said briefly, not stopping. “But it might be serious.”

“Oh!” she said, barely refraining from adding, “Goody!” Tucking her basket under her arm, she fell in beside me, firmly set to Do Good.

Invalid British prisoners were housed alongside the American sick in a long stone building lit by narrow, glassless windows and either freezing or stifling, depending on the weather. It was presently hot and humid outdoors—it was mid-afternoon—and entering the building was like being struck in the face with a hot, wet towel. A dirty hot, wet towel.

It wasn’t hard to find Mr. Ormiston; there was a knot of men standing round his cot. Lieutentant Stactoe was among them—that was bad—arguing with little Dr. Hunter—that was good—with a couple of other surgeons trying to put in their own opinions.

I knew without looking what they were arguing about; clearly Mr. Ormiston’s foot had taken a turn for the worse, and they intended to amputate it. In all probability, they were right. The argument would likely be about where to amputate, or who was to do it.

Mrs. Raven hung back, nervous at sight of the surgeons.

“Do you really think …” she began, but I paid her no attention. There are times for thinking, but this wasn’t one of them. Only action, and fast, decisive action at that, would serve. I took in a lungful of the thick air and stepped forward.

“Good afternoon, Dr. Hunter,” I said, elbowing my way between the two militia surgeons and smiling at the young Quaker doctor. “Lieutenant Stactoe,” I added as an afterthought, not to be overtly rude. I knelt beside the patient’s cot, wiped my sweaty hand on my skirt, and took his.

“How are you, Mr. Ormiston? Captain Stebbings has sent me to take care of your foot.”

“He what?” Lieutenant Stactoe began, in a peeved sort of voice. “Really, Mrs. Fraser, what can you possibly—”

“That’s good, ma’am,” Mr. Ormiston interrupted. “The captain said as how he’d send you; I was just a-telling these gentlemen here as they needn’t be concerned, as I was sure you’d know the best way to do it.”

And I’m sure they were pleased to hear that, I thought, but smiled at him and squeezed his hand. His pulse was fast and a little light, but regular. His hand, though, was very hot, and I wasn’t even faintly surprised to see the reddish streaks of septicemia rising up his leg from the mangled foot.

They had unwrapped the foot, and Mr. Dick had unquestionably been right: him stank.

“Oh, my God,” said Mrs. Raven behind me, in complete sincerity.

Gangrene had set in; if the smell and tissue crepitation were not enough, the toes had begun to blacken already. I didn’t waste time in being angry at Stactoe; given the original condition of the foot, and the treatment available, I might not have been able to save it, either. And the fact that gangrene was so clearly present was actually a help; there couldn’t be any question that amputation was necessary. But in that case, I wondered, why were they arguing?

“I take it you agree that amputation is necessary, Mrs. Fraser?” the lieutenant said, with sarcastic courtesy. “As the patient’s physician?” He had his instruments already laid out on cloth, I saw. Decently kept; not disgustingly filthy—but plainly not sterilized.

“Certainly,” I said mildly. “I’m very sorry about it, Mr. Ormiston, but he’s right. And you will feel much better with it off. Mrs. Raven, will you go and bring me a pan of boiling water?” I turned to Denzell Hunter, who, I saw, was holding Mr. Ormiston’s other hand, plainly counting his pulse.

“Do you not agree, Dr. Hunter?”

“I do, yes,” he said mildly. “We are in disagreement regarding the degree of amputation required, not its necessity. What is the boiling water for, Friend… Fraser, he said?”

“Claire,” I said briefly. “Sterilization of the instruments. To prevent postoperative infection. As much as possible,” I added honestly. Stactoe made a very disrespectful noise at this, but I ignored it. “What do you recommend, Dr. Hunter?”

“Denzell,” he said, with a fleeting smile. “Friend Stactoe wishes to amputate below the knee—”

“Of course I do!” Stactoe said, furious. “I wish to preserve the knee joint, and there is no need to do it higher!”

“Oddly enough, I’m inclined to agree with you,” I told him, but turned back to Denzell Hunter. “But you don’t?”

He shook his head and pushed his spectacles up the bridge of his nose.

“We must do a mid-femoral amputation. The man has a popliteal aneurysm. That means—”

“I know what it means.” I did, and was already feeling behind Mr. Ormiston’s knee. He emitted a high-pitched giggle, stopped abruptly, and went red in the face with embarrassment. I smiled at him.

“Sorry, Mr. Ormiston,” I said. “I won’t tickle you again.”

I wouldn’t need to. I could feel the aneurysm plainly; it throbbed gently against my fingers, a big, hard swelling right in the hollow of the joint. He must have had it for some time; a wonder it hadn’t burst during the sea battle or the arduous portage to Ticonderoga. In a modern operating room, it might be possible to do the lesser amputation and repair the aneurysm—but not here.

“You’re right, Friend Denzell,” I said, straightening up. “As soon as Mrs. Raven brings the hot water, we’ll—” But the men weren’t listening to me. They were staring at something behind me, and I turned to see Guinea Dick, stripped to a breechclout because of the heat and glistening with sweat, all his tattoos on display, advancing upon us with a black glass bottle held ceremoniously between his hands.

“Him captain send you grog, Joe,” he said to Mr. Ormiston.

“Well, God bless the captain for a good un!” Mr. Ormiston said in heartfelt thanks. He took the bottle of rum, drew the cork with his teeth, and began to swallow with a single-minded determination.

Sloshing and splashing heralded Mrs. Raven’s return with the water. Nearly every fire had a kettle on; finding boiling water was no difficulty. She had, bless her, also brought a bucket of cold water so that I could wash my hands without burning myself.

I took one of the short-bladed, brutal amputation knives, preparing to plunge it into the hot water, only to have it snatched from my hand by an outraged Lieutenant Stactoe.