“A fracture such as you describe is a serious matter,” I admitted.
“Lord Gilbert knows this. That is why he will have you attend Lady Joan and no other.”
“And Lady Joan; what does she say?”
“She agrees, and bids you hasten to her.”
“I will. I will gather instruments and remedies and meet you at the marshalsea. Oh…tell the boy I’ll not take Bruce. The journey to Goodrich will be too hard for the old fellow.”
I left Sir John stuffing the last of his rabbit pie into his mouth. Cicily busied herself gathering loaves and two legs of mutton, placing them in a sack.
I would need, in addition to my instruments, salves for healing, potions for relief of pain, and splints and plaster to stabilize the fracture. Egg albumin I could have at Goodrich, other items I must take with me: hemp, willow bark, groundsel, lady’s mantle, lettuce, and moneywort would suffice. I stuffed small sacks of each into a leather pouch, along with my implements and a pair of new gloves, wrapped my cloak about me and trotted to the stables.
Castle Goodrich was more than fifty miles from Bampton, but I knew the pain Lady Joan endured and so was determined to be at my destination before evening of the next day. My seat was improving after all my autumn travel, and Sir John and his squire were accustomed to long hours in the saddle. We pushed our horses as hard as we dared and found shelter for the night at St Peter’s Abbey in Gloucester. By the sixth hour of the next day, a Sunday, we skirted the Forest of Dean.
Lord Gilbert’s castle of Goodrich is built higher and so is more imposing than his residence at Bampton. One enters Goodrich through a gate on the east side in the wall of the barbican, then one must cross the moat, which is cut into the rock of the castle’s foundation, on a stone and timber bridge.
We had barely swung from our horses in the barbican when Lord Gilbert hallowed a greeting from atop the gatehouse. Sir John led me across the moat, and Lord Gilbert met me under the raised portcullis, having plunged down the gatehouse stairway.
“How does Lady Joan?” I asked.
Lord Gilbert’s face darkened. “Not well. She writhes the night in pain, I am told, and will eat little. Come…see for yourself. She is resting by the fire.”
He led me to a small, comfortable, tapestry-hung chamber in the southeast tower. A great blaze warmed and illuminated the room, which was otherwise quite dark, for it was a room low in the tower and so lit only by one narrow, glazed window.
Lady Joan sat between the window and the fire, attended by two maids. I saw in silhouette that her head was thrown back against her chair. Around her neck and right arm a sling of white linen glowed in the firelight. She turned her head as Lord Gilbert closed the door.
“I am sorry,” Lady Joan whispered, “to cause you inconvenience. I would have been content with the surgeon from Gloucester, but my brother would have only you.”
“To speak truthfully,” I replied, “I decided two days past to visit your brother here at my earliest opportunity. I have news of Margaret Smith and the death of Sir Robert Mallory. But first I will deal with your injury.”
I turned to Lord Gilbert, who had overheard my words to Lady Joan; he returned my gaze with one uplifted eyebrow. How does he do that, I wondered?
I drew the sling back from Lady Joan’s injured wrist and unwrapped the bandage wrapped tightly around it. I was prepared for what I might find, but was not pleased to discover the premonition correct.
The broken bone no longer protruded from the wound, but only because the flesh was purpled and swollen. A mixture of blood and pus stained the bandage as I lifted it from the skin, and Lady Joan drew breath sharply as the removal of the bandage left her hand temporarily unsupported.
“’Tis an evil wound,” Lord Gilbert remarked. “I’ve seen few worse in battle.”
I agreed with him absentmindedly while I considered what course I would follow to restore the shattered limb.
“I know,” Lord Gilbert spoke again. “You will need wine.”
“Aye, that is so, and candles. I must see my work.”
“You can set the break?” Lady Joan asked.
I did not know whether I should speak the truth or temporize. I decided on truth. “You have a severe injury. I mean to give you an agent to reduce your suffering and cause drowsiness, but when I attempt to put the break in place you will feel great pain.”
Lady Joan nodded, but said nothing.
“It has been four days since you fell from your horse?” I asked. She nodded again.
“A fracture will mend most readily if it is dealt with immediately after the injury. When setting the break is delayed, as in your case, it may be that the bones will refuse to knit, or do so imperfectly.” I saw an expression of alarm creep across her face, so I quickly added, “but four days is not so long as to cause serious trouble, I think.”
“Imperfectly?” she asked. “What do you mean?”
“The break remains fragile, and easily broken again.”
Lady Joan was silent for a moment, then finally spoke again. “And is it possible the break will not join at all?” She cut to the heart of my worry quickly.
“It is…possible…but not likely, I think. You are young and should mend completely.” I did not wish to speak of the unsavory potential of such an eventuality.
I ended the conversation and turned to a closer inspection of the injury. I was pleased to see that the swelling and discoloration did not extend past the heel of Lady Joan’s hand. I feared the outcome if I found red and purple streaks lacing her palm and fingers. I conducted this examination with as little manipulation of the hand as possible, yet could not prevent inflicting some hurt. Lady Joan winced, and drew a sharp breath, but was otherwise silent. While I worked I heard Lord Gilbert send a serving girl for wine and candles.
“You bear the discomfort well, m’lady,” I complimented her.
“’Tis a feature of my sex,” she replied with more humor than I could have displayed in the circumstance. “God gave women greater endurance for affliction than men, so we might tolerate bearing children…don’t you agree, Master Hugh?”
“Perhaps so you might tolerate the deeds of men, as well,” I observed.
“Just so. You speak truth, Master Hugh.” I was pleased to hear mirth in her voice.
The servant arrived with wine, and I prepared a draught. I added to the wine ground hemp seeds and root, as I had done for Henry atte Bridge, a pinch of willow, and also added powdered lettuce to bring sleep for Lady Joan when my task was done.
I waited near an hour until I saw her eyes blink to focus and occasionally close, then breathed a prayer for God’s guidance and set to my work. Lord Gilbert and Sir John peered over my shoulder as I bathed the oozing wound with wine. Some surgeons might object to close observation of their labor, but I do not. I do good work. I do not care if others wish to observe as I do it.
The swelling of Lady Joan’s wrist caused me some difficulty in finding the ends of the fractured bones. I had hoped that only one of the bones of her forearm was broken, but was disappointed to discover that both had been shattered in the fall. Through the injured flesh I sought to position the breaks so that they butted against each other. There would be no healing if I could not do this.
Lady Joan was placid for most of this work. Only when I succeeded in placing bone against bone did she shudder and gasp. I cannot tell if the draught or her nature made her calm. Probably both. Whatever the cause, her tranquility made my task easier.
When the bones were aligned to my satisfaction, I washed the broken skin in wine once more, then stitched closed the wound. You will know I prefer to leave such a wound open to heal, but this I could not do, for a splint was necessary so as to immobilize the wrist until the break should knit. I decided against applying egg albumin to draw pus from the wound. Instead I packed the wrist with moneywort, then wrapped a linen bandage about the sutures.
All that remained was to fix splints about Lady Joan’s arm, wrap these in layers of linen strips, then coat the fabric with moistened plaster. Lady Joan had been awake for the procedure to that time, but fell to a restless sleep as I coated the linen with plaster. This was the first use I had made of hemp and lettuce together. I was pleased to see the combination work so well, and determined to use it again when need arose.
