The Bone Garden: A Novel

draw the same conclusions I have, based on the injuries. In fact, it seems pretty clear to me and to Dr. Crouch that? —

— Crouch has already seen it? — asked Grenville.

— Dr. Crouch was on the wards when the body was carried into the hospital. A fortunate circumstance, actually, because he also examined Agnes Poole. He saw, at once, the similarities in the injuries. The peculiar pattern of the cuts. — Pratt looked at Norris. — You would know what I'm talking about, Mr. Marshall. —

Norris stared at him. — The shape of a cross? — he asked softly.

— Yes. Despite the?damage, the pattern is apparent. —

— What damage? — asked Sewall.

— Rats, sir. Perhaps other animals as well. It's clear that the body has been lying there for some time. It's logical to assume that his death coincided with the date of his disappearance. —

It was as if the temperature in the room had suddenly plunged. Though no one said a word, Norris could see stunned realization on all the faces.

— Then you have found him, — Grenville finally said.

Pratt nodded. — The body is Dr. Nathaniel Berry's. He did not flee, as we all believed. He was murdered. —

Twenty-four

The present

JULIA LOOKED UP from Wendell Holmes's letter. — Was Wendell Holmes right, Tom? Did that case of childbed fever have anything to do with Charles's blood poisoning? —

Tom stood at the window, staring out at the sea. The fog had started to lift that morning, and although the sky was still gray, they could finally see the water. Gulls skimmed past a background of silvery clouds. — Yes, — he said quietly. — It was almost certainly related. What he described in his letter barely begins to touch on the horrors of childbed fever. — He sat down at the dining table, across from Julia and Henry, and the light through the window behind him cast his face in gloomy shadow. — In Holmes's era, — said Tom, — it was so common that during epidemics, one of every four new mothers died of it. They died so quickly, hospitals had to cram them two to a coffin. In one maternity ward in Budapest, laboring mothers had a view of the cemetery through the window, and a view of the autopsy room down the hall. No wonder women were terrified of childbirth. They knew that if they went into the hospital to have a baby, there was a good chance they would come out in a coffin. And you know the worst part of all? They were killed by their own doctors. —

— You mean through incompetence? — said Julia.

— Through ignorance. In those days, they had no concept of germ theory. They wore no gloves, so doctors used their bare hands to examine women. They'd perform an autopsy on a corpse that was putrid with disease, then they'd go straight to the maternity ward, with filthy hands. They'd examine patient after patient, spreading infection right down the row of beds. Killing every woman they touched. —

— It never occurred to any of them just to wash their hands? —

— There was one doctor in Vienna who suggested it. He was a Hungarian named Ignaz Semmelweis, who noticed that patients attended by medical students were far more likely to die of childbed fever than those attended by midwives. He knew that the students attended autopsies while the midwives didn't. So he concluded that some form of contagion was being spread from the autopsy room. He advised all his colleagues to wash their hands. —

— It sounds like common sense. —

— But he was ridiculed for it. —

— They didn't follow his advice? —

— They hounded him out of his job. He ended up so depressed, he was committed to a mental institution. Where he cut his finger and suffered blood poisoning. —

— Like Charles Lackaway. —

Tom nodded. — Ironic, isn't it? That's what makes these letters so valuable. This is medical history, straight from the pen of one of the greatest doctors who ever lived. — He looked across the table at Julia. — You do know, don't you? Why Holmes is such a hero in American medicine? —

Julia shook her head.

— Here in the United States, we hadn't heard of Semmelweis and his germ theory. Yet we were dealing with the same epidemics of childbed fever, the same appalling mortality rates. American doctors blamed it on bad air or poor circulation or even something as ridiculous as wounded modesty! Women were dying, and no one in America could figure out why. — He looked down at the letter. — No one, that is, until Oliver Wendell Holmes. —

Twenty-five

1830

SHELTERED IN A NOOK beneath a doorway, blocked from the worst of the wind, Rose gazed across the hospital common, her eyes fixed on Norris's attic window. She had been watching for hours, but now that darkness had fallen, she could no longer distinguish his building from among the rooflines silhouetted against the night sky. Why hadn't he come back? What if he did not return tonight? She hoped for a second night under Norris's roof, for a second chance to see him, to hear his voice. This morning, she'd awakened to find the coins he'd left for her, coins that would keep Meggie warm and fed for another week. In return for his generosity, she'd mended two of his threadbare shirts. Even if she hadn't owed him, she'd have been happy to mend those shirts, just for the pleasure of touching fabric that had brushed his back, fabric that had known the warmth of his skin.

She saw candlelight flicker to life in a window. His window.

She started across the hospital common. This time, he'll be anxious to listen to me, she thought. By now, he'd surely heard the latest news. She eased open the door to his building and peeked inside, then quietly slipped up the two flights of stairs to the attic. At his door she paused, her heart thumping hard. Because of her run up those steps? Or because she was about to see Norris again? She patted her hair, straightened her skirt, feeling foolish even as she did it, because all the effort was for a man who wouldn't give her a second glance. Why would he bother to look at Rose after dancing with all those fine ladies last night?

She'd glimpsed them as they'd left Dr. Grenville's house and stepped into their carriages, those lovely girls with their swishing silk gowns and velvet mantles and fur muffs. She'd watched how carelessly they allowed their hems to drag across the dirty snow, but of course they would not have to wash out the stains. They had not spent hours, as Rose had, bent over needle and thread, sewing in light so poor that her eyes would one day be pinched as permanently as if she had stitched puckers into her own skin. One season's round of parties and dances, and the poor old dress would be retired anyway, to make way for the newest styles, the latest shade of gauze. Lurking in the darkness outside Dr. Grenville's home, Rose had spotted the very gown that she herself had sewn, with the rose-colored silk. It adorned a round-cheeked young miss who had giggled all the way to her carriage. Is that the kind of girl you prefer, Mr. Marshall? Because I cannot compete with that.

She knocked. Stood with back straight and chin raised as she heard his footsteps approach the door. Suddenly he was standing before her, the light spilling from behind him into the gloomy staircase. — There you are! Where have you been? —