The next category was gastrointestinal. Several cases of colic, diarrhea, and worms among the infants and children. Two deaths. The columns grew. Ian pushed away from the desk in frustration. Too many children were dying.
His uncle had taught him the importance of meticulous record keeping. Although many times the number of fatalities was discouraging, Ian knew in the long run the only way to convince officials of the need for decent living conditions was to show them hard numbers.
At least more and more parents were bringing in their sick children. When he’d first opened the dispensary, the only children he’d seen were the ones on his visits to people’s homes. The people were used to hospitals and physicians refusing to treat children, claiming they were too hard to diagnose. He had found the opposite true. By paying close attention, he had found that many times their symptoms were actually more evident than in their adult counterparts.
He continued to record the day’s cases. Surgical treatments included ten broken bones set; eleven bruises; two head injuries; five tumors, of which three were untreatable, the other two possibly operable; six toothaches, with two ending in extraction; four leg ulcers; two abscesses.
He had scheduled one amputation tomorrow. A man had smashed his hand in a doorway, and now gangrene had set in and the arm begun to turn black. Even though amputation was always used as a last resort, in this case there was no help for it, if the patient’s life was to be spared.
He finished recording the day’s patient histories, scattered some pounce over the writing and dusted it off. He eased the kinks in his shoulders as he placed the pen back in the standish.
Taking a few moments to massage the back of his neck, he found his thoughts straying once again to Mrs. Neville.
Over the past few days since meeting her, her pretty face kept floating into his thoughts at odd moments of the day. No, not pretty, he corrected himself. Beautiful. She was the most exquisitely formed creature he’d ever beheld. Each time she looked at him, he was startled afresh by her silvery eyes, her delicate features, her golden hair.
Her figure was slim and dainty. Everything was pleasing to the eye. Even when tired and disheveled after assisting him, she still managed to look fresh and appealing.
He rubbed a hand over his jaw, knowing he had to get his thoughts under control. It did no good daydreaming about an actress. She might look pure and innocent, but he knew how deceptive the image was. Actresses were little better than prostitutes he reminded himself for the countless time.
But try as he might, he couldn’t seem to block her image from his mind.
Thankfully, he hadn’t run into her since the street riot, although he’d been to check on Miss Simms a few times. He’d had to stifle the sense of disappointment, for he knew she visited because Miss Simms waxed eloquent over how kind and generous “Eleanor” had been to her, coming to see her each day. It seemed most of her visits were reserved for late evening after a show or early afternoon before she went to the theater.
“Halloa!” a voice called from the doorway.
Ian looked up to see his friend’s tall frame leaning against the doorway.
“You looked so deep in thought I was afraid to disturb you, lest you be on the verge of discovering a new surgical technique that might aid all of humanity.”
Ian made an effort to chuckle. “Nothing of the kind. I’ve just finished up with the records for today. Come in, Henry, don’t stand there.”
Lord Cumberland eased away from the doorpost and maneuvered himself over to a chair in the cramped room that passed for an office. He sank down with a contented sigh as if the few moments standing had tired him out.
“Too many hours spent doing nothing?” Ian teased, eyeing Henry’s evening clothes. He was about Ian’s age with short-cropped hair cut in the latest fashion.
Henry grinned back shamelessly. “Doing nothing is an art form. Didn’t Byron say that? If he didn’t, he ought to have.”
“I keep telling you to find a useful occupation.”
Henry sighed. “And I keep telling you if you’ll only let me introduce you into society, I’d have a Herculean job on my hands.” He rubbed his hands together. “It would offer me just the challenge I need since the battlefield.”
Ian closed the ledger and set it aside, refusing to rise to the familiar bait. He leaned back in his chair. “So, what brings you to these humble surroundings this evening?”
“I come to invite you to a gathering of intellectuals, artists, and the pink of the ton.”
Ian yawned, used to these invitations, which he invariably turned down. It was a game between them by now, he supposed. “Let me guess. It’s being held at the home of the Duchess of Longworth, and she’s simply dying to meet a lowborn surgeon from St. Thomas’s.”
Henry snorted. “Lowborn, indeed. My wealthy and titled friends and acquaintances would love nothing better than to listen to an eminent surgeon who has not only trained on the battlefield but has been to Paris and brought back the latest techniques. They are agog at the thought of all those postmortems performed at the great teaching hospitals. I keep telling you, anatomy and pathology are all the rage. Bring some of your wax models and let the layman understand the mysteries of the human anatomy.”
When Ian said nothing, Henry continued. “There’ll be quite a crowd. It’s being held at Somerset House. You’ve never been there. We can cross over the new Waterloo Bridge. You’ll see the house in all its splendor, its colonnaded facade lit up over the Thames.
“It’s a rare opportunity. I wouldn’t be surprised if Prinny himself showed up. Come on, old boy, you know you’ll never get the funds you need for your children’s hospital if you refuse to go where the money is.”
“I doubt I’ll make much of an impression if I stand among them to lecture. They’d be bored silly.”
“Don’t be totty-headed! You know yours are some of the most popular lectures at St. Thomas’s.”
Ian was tempted, more than he’d ever been. After two years back from the Continent, he was finally willing to concede that public awareness had to be raised to the overcrowded condition of the poor if change was to come to the city.
“By the by, I read your article in the Medical Journal,” Henry remarked. “You might not think so, but many of these aristos read such journals. This is your opportunity to be among them, answer their questions, let them see you not as a fanatic, but as the dedicated surgeon you are.”
They argued good-naturedly for a while longer. Finally Ian rose with another yawn. “I’m sorry, but not this evening. Perhaps another time. I still have some work to do at home before I turn in.”
Henry stood as well, his look eager. “You mean that? I shall stop pestering you if you give me your word you’ll accompany me the next time I invite you to a social event.”
Ian looked at Henry a moment. What did he have to lose, anyway? Another evening’s work? But what might he gain? He gave Henry a brief nod. “Very well. The next time I’ll go wherever you say.”
Henry clapped him on the back. “That’s the way, old man. You won’t regret it. After all, I’m building your reputation each time I’m among the ton.”
Ian extinguished the lamps and locked the dispensary behind him. He felt for his watch and once again remembered it was gone. It must be near nine in the evening.
He bid Henry good-night, refusing his offer of a ride. He lived only a few doors down.
His neighborhood was one of the most gin-soaked in the city. Prostitutes and men headed in or out of the taverns. Many would end up in the roundhouse by evening’s end. Some children called out to Ian and waved.
He returned their waves. “Time for you to head home to bed,”