“How in the hell did your student not notice he was tugging out this woman’s womb?” Horace growled at Adams.
“I—I was removing the placenta,” Wilkins stammered quietly through pale lips.
“And when it came out attached to the uterus, you continued to pull?” Horace demanded.
“I didn’t…” The terror of being responsible for someone’s demise visibly washed over him. Daniel shivered. Every doctor knew the sensation.
“She needs a hysterectomy. Best to remove it entirely,” Adams said, avoiding conversation about his dresser. “You’ll never get it back in place intact, Horace. And if you did, it would prolapse again. We can ligate it.”
Horace checked the patient’s pulse. “We have more time with the anesthesia. She’s breathing easily. Proceed, Gibson.”
If only he could. Daniel had managed only to prod a few millimeters back into place, but salt was drawing out the bloating fluids, and slowly, slowly, with his finagling, the organ retracted farther inside the birth canal. Horace took a turn when Daniel grew too frustrated, and between the two of them, they finally maneuvered the last bit through the cervix.
Daniel sighed with relief. His shoulders ached with the strain. “Is the patient still stable?” he asked.
“Enjoying a postpartum nap,” Horace said. “Let me finish.”
Daniel ceded his chair to the older man. Only when he turned did he realize how many doctors had crammed into the room.
“You cannot just leave the uterus in place once you return it,” Horace said airily, as if discussing how to prune roses or select a wine for dinner. “The round ligaments are now degraded from pregnancy and injury. Imagine it in a deflated state, vulnerable to prolapse.” Horace taught as he always did—conversationally. Even the seasoned surgeons held their breath as they observed.
“Now that Gibson has returned the organ to its rightful place inside the body, we can proceed. This bottle is filled with warm salinized water. I will invert the bottle and release the fluid, effectively inflating the organ to help it hold its shape and position. This will also help the ovaries to return to their place.”
The room erupted into boisterous applause as Horace proceeded. One student removed his hat and dashed it against his leg in disbelief. A hurrah sounded from the back of the mob, growing as orderlies and other students tried to cram inside to see what they’d missed.
“I’ve never seen uterine polyps contribute to a complete external prolapse,” Adams grumbled over the buzz of excitement.
Horace stood slowly, unrolling his spine and taking care to plant his feet. “Now you have.”
“Where did you learn it?” a student demanded, his young eyes sparking with wonder like train wheels on the rails.
Horace grinned as he rinsed the blood from his hands. “A farmer in Edinburgh.”
“Farmer?” Daniel frowned with contracted eyebrows.
“He learned it from his grandfather. One of their heifers pushed her whole sack out with the calf, and they salted it to shrink it and showed me how to use the bottle. Took us three hours to push that uterus back in.”
Horace surveyed the incredulous doctors. “You never dismiss a good idea, no matter where it comes from—even toothless, illiterate farmers.” He settled a heavy stare on Adams, his soft Scottish brogue more distinct than usual. “We doctors do not have a monopoly on knowledge.”
***
Nora stayed up that night, reading and waiting for Daniel. The clock struck eleven, twelve, then one, before she finally heard the distant groan of the front door. Fifteen minutes passed, but he didn’t come upstairs.
Fine.
Putting on her slippers, she tied herself inside her thickest wrapper and abandoned the warmth of the bed, armed with a flickering candle.
She found him in the library with a book. He looked up in surprise and something else—a mixture, perhaps, of equal parts shame and stubbornness.
Setting aside her candle, Nora took the opposite chair, tucking up her feet to keep them warm.
“I was reading, too,” she said. “Don’t tell me I should have been sleeping. You could also use the rest.”
“I wasn’t going to say that.”
She nodded at the book. “Any good?”
His mouth hitched, then fell as he let out a sigh. “I haven’t understood a word.”
