“Of course.” I poured some water from a carafe into a glass and he drank it down in one gulp. “So Mr. Holmes is summoning me to St. Bart’s?”
He nodded. “T’ meet with ’imself and Detective Inspector Lestrade.”
“He is with Detective Inspector Lestrade? You are certain?”
If Lestrade was involved, some serious game was afoot.
“I’d sooner starve than lie, I would,” the boy said.
Glancing around my empty office and staring down at the page of my daily, which displayed nothing except a luncheon date with my friend Oscar Wilde, I mumbled with a sigh, “I certainly have nothing more pressing.”
“Wha’s tha’, Miss?”
I slammed the appointment book closed. I could not refuse Sherlock, but I wanted to show him that I did not have to drop everything at his beck and call. “I have some appointments and a luncheon engagement. Advise Mr. Holmes that I shall be there by three half. Tell him I shall meet him at the fountain.”
“The wha’, Miss?”
“The fountain at St. Bart’s. He shall know the place.”
“Bu’ ’e wans yer t’ come now. And ’e wans yer t’ read somefink in fis newspaper.” He shoved a copy of The London Daily News into my hands.
“Oh, he does, does he?” I snarled.
The boy nodded.
I glanced at the front page of the paper. There was a follow-up article to one I’d read in the spring that had reported Mr. Thomas Edison’s presentation to the Academy of Sciences about his new carbon telephone. Graham Bell had displayed his version of the device, which could transmit speech, a few years earlier at the U.S. Centennial Exposition in Philadelphia. The exhibition judges, Emperor Dom Pedro II of the Empire of Brazil and Sir William Thompson, an eminent British physicist, took part in the experiments, and the voices of each were recognized by their accents and peculiarities of speech. They recommended Bell’s device to the Committee of Electrical Awards and he won the Gold Medal, but Mr. Edison’s new carbon telephone was a complete novelty. He had made changes in its design after he discovered that certain kinds of carbon are enormously susceptible to changes in conductivity when subjected to different pressures.
When I’d read that article, I thought it was just the kind of thing Sherlock would be keenly interested in, given his experiments with chemicals and different properties of ash, wood, blood and so on. I would have loved to get his opinion. But Sherlock and I were not on speaking terms at that time.
“Does Mr. Holmes want me to read this front page article about Mr. Edison?” I asked.
“Why is yer askin’ sich a ’eap of questions fer?”
“Which one, Rattle?”
“Th’one on page twenty and one, ’e says.”
I put the newspaper on my desk and said, “Do apologize to Mr. Holmes for the delay, but I have things to attend to.”
“Yer sure, Miss?”
“Quite sure.”
The boy grimaced and groaned, “Mr. ’olmes won’ be ’appy, Miss.” Then he said, “Good day to yer,” turned and left.
5
I busied myself for a while, cleaning instruments, and then reading an update in one of Uncle’s medical journals about risk management and surgical intervention in railway and industrial accidents. Railway surgeons had long been regarded with contempt by most physicians. After reading a disparaging article about them, Uncle Ormond said to me, “The level of discourtesy on the part of my colleagues is extremely unkind and entirely uncalled for. We know, Poppy, don’t we, what it is like to treat the victims of a railway accident?”
Oh, yes, I remembered. I still heard their voices in the night.
Uncle and I had been, by default, railway physicians for one horrible night in 1874, a night I would forever remember, one that had spurred in me a deep desire to promote and foster specialties in trauma and emergency medicine. We had treated dozens of injured passengers and railway employees scattered on the tracks that rainy, foggy night after the head-on collision near my home in Norfolk.
Like physicians who worked exclusively for the railway, we were faced with impossible conditions. One brakeman’s hand was crushed between a link-and-pin coupler. He had wrapped an oily rag around his severed hand. Unconscious, he was not found until the next day, his hand dangling, and his shoes and clothing awash in a pool of blood. By the time he was transferred to the nearest hospital, he was unconscious. Though Uncle amputed the hand, the poor soul had contracted gangrene and died a few days later.
But even without a crash, it was not unusual for a railway employee to sustain an injury during the scope of his employment - to have an arm or leg crushed - and he could not expect proper treatment. Such casualties, like the poor boy we could not save, were treated with old rags, oily handkerchiefs, or whatever was lying about, and transported for hours and miles in a chilly, dirty car. Too often, by the time a victim arrived at a hospital, he was grey and unconscious, or without a pulse at all, having bled to death, and his crushed limb was tossed into the rubbish. Sometimes, the patient did not even get to a hospital. More often, operations were performed out in the woods, on the backporch of some filthy house on the wayside, or occasionally in a nearby hotel room. But the rooms were rarely suitably equipped, and the railway were billed outrageously for room charges as well as replacement of bloodstained furnishings.
Railway doctors had no special training; they learned on the job, as they went. No major surgery textbooks would include the unique techniques involved in railway surgery until many years later, and the specialty would not appear in Index Medicus, the major index of medical literature, until 1903. Worse, railway surgeons were socially and professionally isolated, and they often lived a very difficult and austere life compared to their metropolitan counterparts. But, oh, they were innovative. They had to be, for railway and manufacturing facilities presented unique hazards and created
