Where the Light Enters: Excerpt 3

About this excerpt:  Elise is in medical school, on rotation at the New Amsterdam Charity Hospital; Sally Fontaine is a classmate and friend. Dr. McClure is the physician they are assigned to for the rotation.


Children's Ward, ca 1880
Children’s Ward, ca 1880

Early the next day Elise learned from Sally Fontaine that Tadeusz Kozlow had died in the night. It was not unexpected, and it was far from the first patient Elise had lost, but it was still a failure. She was thinking about him and wondering if the family had been told when Sally reminded her that they had to hurry if they didn’t want to be late for rounds.

“I’ve been thinking,” Sally said. “We just have to survive McClure until Monday, and I’ve got a plan.”

“A plan?”

“Today I’m going to stay out of her line of sight, and every time she looks in my direction, I’ll be writing furiously in my notebook. She doesn’t like it when you look her in the eye, have you noticed? So I won’t. That way I might just avoid the worst of her moods.”

When rounds were half over Elise decided the simplest plans were often best, because thus far she had been following Sally’s example, and both of them had been spared Dr. McClure’s temper. Just as that thought came into her head a nurse stepped into the hall with a swaddled, very quiet newborn on her arm.

Dr. McClure’s attention fixed on the infant. She asked a question Elise didn’t quite hear just as Sally whispered in her ear.

“Poor thing. Maybe the mother died.”

That was entirely possible. The mother might be dead or sick unto death; she might have refused to look at or acknowledge the child. But Sally had never been a nurse or worked in a charity hospital, and none of this was obvious to her. Now she pulled Elise away a little and asked for an explanation, one Elise gave to her in a few short sentences. And still, too many, because when she looked up, Dr. McClure was watching her.

“Miss Mercier,” she said. “Take this infant to the nursery and evaluate. Bring me your notes with a diagnosis, prognosis and treatment plan within the hour.”

Sally’s expression was contrite. Under her breath she whispered, “Oops. Sorry.”

“Never mind,” Elise said to her, and managed a small smile. “It could be worse. As you may soon find out.”

 

On her way to the nursery Elise studied the tiny face, as round and white as an underdone griddle cake, with eyelids of a bruised blue. In happier circumstances a newborn would be assigned to a wet nurse who would take her home. The city paid a small sum every week as compensation until the child died or reached six months of age. At that point it was sent on to one of the church-run asylums or in the worst case scenario, to the infant asylum on Randall’s Island.

If the Catholics claimed her, they would baptize her and name her for – whose feast day was it? St. Agnes of Montepulciano? St. Mary Clopas? Whatever name was she given, she would be fed and kept warm and clean and made aware of her humble origins. The nuns would teach her the Stations of the Cross and the catechism she would recite every day; she would learn to read and write and do sums, to sew and clean and cook and how to care for infants and linens. If she showed any inclination she would be groomed for the convent. Things would be much the same if one of the Protestant asylums took the baby in: a regimented but safe childhood. A warm place to sleep and a full belly was more than most orphans could count on in this city. Some met far worse fates.

As soon as Elise unwrapped the newborn in the nursery she knew that this little girl would never need a wet nurse or an asylum. It was not so much the low birth weight, but the way she breathed, snuffling through congested sinuses as though she had caught a head cold in the womb. Elise palpated her abdomen, and found what she feared: both liver and spleen were enlarged.

One of the student nurses had come close to watch Elise examine the baby. In a whisper she asked a question that took Elise by surprise.

“Chinese?”

Elise glanced at her. “Are you referring to the yellow cast of her skin?”

The student nodded.

“There are other reasons for the skin to take on such a color. Have you not studied the liver?”

An awareness came over the long, thin face. “Jaundice?”

“Yes. Even healthy newborns sometimes have jaundice. The liver is slow to begin its work. But in this case―”

Very gently Elise unfurled one clenched fist, and the student drew in a startled breath at the sight of watery blisters on the palms.

“How does a newborn get blisters?”

“They’re called bullae of pemphigus. A symptom of congenital syphilis. They will be on the bottom of her feet as well.”

The student was very young and new to medicine, and thus unable to hide her shock.

“There’s a chapter on congenital syphilis in the Prendergast text,” Elise told her. “It will be helpful to you.”

Because the girl asked thoughtful questions, Elise went on to point out other signs: the telltale coppery brown rash that covered the baby’s chin and vulva, and most significantly: her nose looked as though someone had pressed a finger to the bridge and flattened it.

“Sometimes the symptoms don’t show themselves for weeks or months,” Elise said. “This is an extreme case.”

The unnamed little girl began to twist and mewl and stutter a weak wail. Her heartbeat was less than steady, and her fontanel pulsed erratically. Worst of all, she had very little suck reflex. A newborn who wouldn’t suckle couldn’t live. It wouldn’t take an hour to write up the case for Dr. McClure; it would hardly take ten minutes, because there was nothing to be done.

A nurse Elise knew well came over and looked briefly at the baby. Margit Troy was highly skilled, compassionate and still pragmatic, exactly the right person to take responsibility for this infant. Elise should have been relieved to hand the little girl over to her, but she hesitated.

As was the case with the best nurses, Margit was very good at hearing what was not said: Elise wasn’t ready to give up the infant. So they worked together, bathing the baby and putting ointment on her rashes. They wrapped her hands and feet in loose layers of gauze saturated with more ointment, and swaddled her firmly.

The student nurse was desperate to be of help. “She’ll need feeding. Should I get a wet nurse?”

“No,” Elise said. “She is almost certainly contagious and it wouldn’t be right to risk the health of a wet nurse.”

In the end Elise sat down to see if the little girl would take a few ounces of warmed sugar water from a bottle with a rubber nipple, putting her cheek to a skull as fragile as porcelain. The baby swallowed feebly once, twice, and then began to cough, a startling sound from so small a creature.

Elise turned the little girl on her side and held her while the cough deepened. She caught the first sprays of blood with a towel and in no more than ten seconds, it was over.

Her shift was near its end by the time she finished writing out her notes and then the death certificate for Dr. McClure’s signature. Unnamed female newborn, Caucasian. As she had been taught to do, she left the cause of death blank, but attached another sheet of paper with proposed wording: pulmonary hemorrhage following from congenital syphilis.

There would be a price to pay not obeying Dr. McClure’s orders, but Elise found it hard to worry about that. In a few years she would probably have forgot whatever task Dr. McClure thought up, but for the rest of her life she would remember the first two patients assigned to her, because she had been unable to do anything for them, and both had died.

When the church bells at St. Mark’s in the Bowery tolled six o’clock Elise gathered her things. On her way down the stairs she could only hope not to come face to face with Dr. McClure. Instead she ran into Margery Inwood, who was almost as bad.

Margery was an able nurse but a terrible gossip. Working with her in the wards had meant constant dodging of inappropriate and intrusive questions about the Savards and their personal lives. Anna’s marriage to an Italian detective was an enduring topic of interest, or had been until the newspapers exploded with news of Sophie’s engagement to Cap Verhoeven. Margery had cut out headlines to show to Elise. Mulatto Doctress to Marry Dying Knickerbocker was the headline that had most tested Elise’s temper, but she had managed to remain calm.

“So,” Margery said now. “How are you liking medical school?”

“I like it,” Elise said, summoning a smile. “When I have time to sit and consider, I like it.”

“I’ve heard Dr. Morrison say that anybody who needs to sleep more than five hours a night should forget about studying medicine.”

“That just about fits my experience,” Elise admitted. “How are things with you?”

Margery ignored the question and leaned forward to put a warm, damp hand on Elise’s wrist.

“Tell me,” Margery said. “Is it true that Dr. Sophie came back to the city in order to start a medical school for negro girls?”

Elise pulled away in surprise. “Where did you hear that?”

“It’s common knowledge.”

“If that were the case you wouldn’t be asking me,” Elise said. “Really, Margery. You should know better. She isn’t starting a medical school. She’s setting up a scholarship fund.”

Margery wrinkled her nose in disagreement. “What I heard―”

The door that opened onto the ground floor opened. The man standing there was a stranger to Elise, but Margery Troy recognized him, because she paled at the sight of his unhappy expression. “Nurse Inwood, what is the delay?”

“Sorry, Dr. Martindale. I’m on my way.” And she took off up the stairs at a tear. Elise had never seen her move so fast.

Dr. Martindale, as she had called the man who still stood in the open doorway, stood watching her until she disappeared. Then his expression cleared and he shook his head, but his gaze was fixed on Elise. She saw curiosity there, but nothing of ill humor.

He said, “I think you must be Candidate Mercier. Don’t look so alarmed, it’s the color of your hair that gives you away.”

Elise’s thoughts jerked in one direction: who is talking about my hair? To another: who is this man?

Before she could think of something reasonable to say he was coming toward her, his hand outstretched. “Gib Martindale.”

He stood two full steps below her, and still Elise had to look up, just slightly, to meet his gaze as she shook the offered hand. He knew that he was being rude; he should have waited for her to make this gesture. But social niceties often gave way to more pressing considerations in medical settings.

“Elise Mercier. Somebody told you about my hair?”

He ducked his head, as if to draw her attention to his own thick mop, unfashionably short and almost exactly the same deep auburn as her own. “Actually, I asked. I caught sight of you on rounds – condolences, by the way, on being stuck with McClure – and I asked. You look so much like my wife, which is why I noticed you, but once I asked I got all the stories – good stories, complimentary. You needn’t worry.”

Elise drew in a breath. “That’s good to know. Thank you. I think.”

“Oh but it’s true,” he said. “You’re very highly valued for your—”

“Miss Mercier,” Nurse Troy called down the stairwell.

Elise turned and had to crane her neck to see up as far as the third floor “Yes?”

“Could you come back to the ward, please? We have an issue. I need your help.”

“It was a pleasure to meet you,” Elise said, which was true and not true; this Dr. Martindale had agitated her for no good reason except that he was friendly and complimentary and tall and – she glanced once more at him before turning to run up the stairs – very handsome. He was watching her with eyes that might have been grey or blue, his smile wide enough to show off a lot of very white teeth, with a chipped canine on his left.

He straightened and saluted her. “My pleasure entirely. Next time I hope we’ll be able to talk at more length.”

 

There were eleven newborns on the ward, and Elise had examined each of them before she left and made chart notes. On her way back up the stairs she went over the cases in her mind. Three might survive long enough to go home with a wet nurse. Five were simply too small and weak to live. The rest were the real challenge: a case of mild hydrocephaly, one of esophageal atresia, and one of severe spina bifida. What she might do for any of them was limited, but she considered the possibilities and then stopped short at the sight of a stranger standing in the nursery, as out of place in this ward as a bull.

He wore a sailor’s long pea-coat and stood legs splayed and tensed, as though he were on a pitching deck. Even if he had been dressed like a clerk or farm worker, anyone would recognize him as a sailor. His clubbed dark hair and beard were streaked with salt or sun, and his face and hands were deeply tanned.

“This is Mr. Bellegarde,” Nurse Troy said, unable to keep the unease out of her voice. “He is asking about his son, who was born here on the seventh of April, a week ago.”

“Can you tell me where to find my son?” His tone was curt to the point of accusation. “If you can’t, who can?”

Angry husbands and fathers were nothing out of the ordinary at the New Amsterdam, Elise reminded herself. Many of them had less cause than Mr. Bellegarde, whose name she remembered perfectly. His wife had been brought to the New Amsterdam by Sophie, on the day she returned to the city. And she had died of eclampsia a few minutes before her child was delivered.

He hadn’t asked about his wife, so he must know that much. She said, “Mr. Bellegarde, I can tell you that your son will have been sent home with a wet nurse, and he’ll be there still.”

“And the name and address of the wet nurse?”

“Let’s go to the records office, we can find out there.” His expression didn’t soften at all. Instead he made an abrupt sweeping motion with one arm, as though Elise were a child dawdling on her way to do her chores.

She set off, very aware of him right behind her.


end excerpt

Excerpt 1: Sophie’s letter home

Excerpt 2: Article from the New York Times regarding the Russo orphans

Where the Light Enters: Excerpt 2

January 1, 1884

Dear Auntie, Dear every one of you,

The Swiss greet each other on New Year’s Eve with this saying: ‘Rutscht gut rein ins neue Jahr!’ If I understand correctly this means ‘I wish you a good slide into the New Year,’ which I suppose makes sense, given the snow and the mountains and the amount of Schnapps consumed during New Year’s Eve celebrations.  For some reason no one can explain, pigs are considered good luck at the New Year, and thus this small offering in India ink rather than pink marzipan.

Aunt Quinlan is not, I trust, sliding anywhere, but sitting snug in the parlor wrapped in the blue shawl that brings out the color of her eyes, with the rest of you gathered all around. How we would like to be there with you to wish you good health and happiness in this new year 1884. With all my heart I wish those things for you.

Cap was especially sad to miss Mrs. Lee’s traditional New Year’s Eve turkey dinner. Apparently that particular bird is unknown in the Alps. But do not fear: we are served good food in abundance. Mrs. Fink is not quite so talented as Mrs. Lee, but still we are eating regularly and very well.

All is calm just now, as Cap is napping. Pip is tucked up against Cap’s shoulder with his nose pressed against the pulse point just below the left ear, an attentive little dog with the instincts of a nurse. This means that I have a short while to write without pauses for cross examination.

Do you remember how Cap told us he wouldn’t miss practicing law? As it turns out, he could only make that claim because he knew he would still have me to practice on. Whatever I write, to whomever I am writing, if I don’t send it off to the post before he realizes what I am up to, he insists that I read every sentence to him. His contribution to my letters consists of suggestions for alternate phrasing and, on occasion, challenges to my reasoning, memory or grammar. More than once I have been tempted to throw the ink pot at his head (this seems to be a family tradition, established by Aunt Quinlan shortly before her first marriage when she hit Uncle Ballentyne in the forehead with some kind of pot, if I remember the story correctly). Fortunately Cap always stops just short of inciting me to violence. And then he finds some way to make me laugh.

We might have known that a stay in a sanatorium, no matter how secluded and hemmed in by alpine glaciers, would not put an end to his curiosity. Even the mycobacterium tuberculosis bacillus has not accomplished so much. He is still working his way through the clinic’s medical library and every publication that deals, however peripherally, with diseases of the lung. At this point I believe he knows as much about tuberculosis as I do. Luckily Dr. Zängerle is better informed than I.

If Cap is not strong enough on a given day to hold a book, I am pressed into reading aloud. Even when he can read and write for himself, my assistance is required for interrogation on medical terminology (though that happens less often as his studies progress). This often involves forays into Latin and Greek etymology and anatomical texts and illustrations. His lungs are failing but his mind is as acute as ever.

Your letter dated December 9th arrived this morning, taken down so diligently by Mrs. Lee in her careful script. Today we also had a letter from Conrad about the custody hearing. The news is distressing, to say the least. If only I had something useful to say or contribute beyond the letters I write. Until there is some decision from the court I will assume that things will take a reasonable and just end, and the children will stay on Waverly Place with Anna and Jack, where they belong.

I’m sorry to say that my weekly report on Cap’s condition is also not what I would hope. A few days ago his right lung collapsed. In an otherwise healthy person, a collapsed lung will often right itself in time, with bed rest and breathing exercises. In advanced pulmonary tuberculosis it is quite common, far more critical, and rarely resolved. In Cap’s case the collapse was not fatal because Dr. Zängerle was so quick. With Dr. Messmer’s assistance he inserted a drainage tube between Cap’s ribs and into the pleura, with the end result that his lung did re-inflate. The tube remains in place despite the fact that there are serious complications that could arise from this artificial opening, but as you are aware, medical science is an exercise in constant juggling of risks and benefits.

What all this means, as I think you will know, is that he is not improving. I can admit to you that I never believed that alpine air and fortified nutrition would reverse the damage to his lungs, but I did hope that it would slow the progress of the disease. As it may have done. In any case, I am where I belong, here with him. He will leave me too soon, but until that day I will make the most of every moment.

Cap is stirring. It is a relief when he is able to fall into a deep sleep; for that short time he looks more like the boy I first met when I came to Waverly Place almost twenty years ago. He was so alive, I could never have imagined him like this. Now I must close this letter before he demands that I read it to him.

With all my love and affection your devoted niece, cousin, auntie and friend  

Sophie

 

Post Script: We have had a letter from Margaret, who is in Greece with her boys. Travel does seem to suit her very well.  There was also a long letter from Lucy, with news of her latest adventures.

Post Script for Mrs. Lee:  The sight of your handwriting on an envelope gives us both such pleasure. Most of all we look forward to the small notes and observations you provide in the margins. It is almost like hearing your voice, which might be the thing I miss most. Please give our love to Mr. Lee and your family.

And for Lia: To answer the question added to the end of Auntie Q’s last letter, yes, the housekeeper’s name really is Hannelore Fink. In German ‘fink’ doesn’t mean the same thing that it does in English.

Where the Light Enters: Excerpt 2

THE NEW YORK TIMES
JANUARY 13, 1884

A CHILD’S TRUTH

Sources close to the investigation and hearing on the custody of the Russo orphans provided transcripts of some of the testimony taken in Judge Sutherland’s chambers. In particular the interview with Rosa, the eldest of the Russo children, provides background and context which has been otherwise missing from the public exchanges. A verbatim excerpt from the transcript of Mr. Falcone’s questioning of the orphan Rosa Russo follows.


Mr. Falcone: Miss Russo, please tell Judge Sutherland about your trip to Staten Island with your current guardians.

Rosa Russo:  We went to find Vittorio, my baby brother. Mr. Lee drove us to the ferry, then we took a train and then a horse and carriage. But Vittorio was gone when we got there.

Mr. Falcone: The weather was very bad, isn’t that right? And you and your little sister were soaked to the skin and got colds.

Rosa Russo: What does that have to do with anything? We went to find Vittorio, because the bad priest took him and wouldn’t give him back.

Mr. Falcone: Miss Russo, Father McKinnawae dedicates his life to the care of orphaned children in danger. It is disrespectful to refer to him as anything but Father McKinnawae. Do you understand?

Rosa Russo: I understand that he took our brother and wouldn’t give him back.

Mr. Falcone: Did Father McKinnawae tell you that he had your brother in his care, that he had arranged an adoption?

Rosa Russo: People who do bad things don’t like to admit what they do.

Mr. Falcone: So I take that to mean that Father McKinnawae never told you he had placed your brother with an adoptive family.

Rosa Russo: You know what you need to do? You need to make him swear on the Bible and then ask him. Judge Sutherland could you please do that, make the priest swear on the Bible and then answer a question? Because his lawyer is asking me a question that only the bad priest himself can answer.

Judge Sutherland: Rosa, I see the logic of your suggestion, but for right now please answer Mr. Falcone’s questions to the best of your ability.

Rosa Russo: Yes sir. I will try.

Mr. Falcone: Now, once again. Did Father McKinnawae tell you that he placed your brother with a new family?

Rosa Russo: The bad priest never answers questions. He just asks them.

Mr. Falcone: Miss Russo, I understand that you are distraught but I will ask you to remember your manners. Let’s try this from a different direction. Why are you so sure that Father McKinnawae placed your brother with an adoptive family? Who told you this?

Rosa Russo: Nobody.

Mr. Falcone: But you must have got the idea from someplace. From someone. Was it Dr. Savard who told you this?

Rosa Russo: You can learn things without being told. You learn things by watching and listening. And reading.

Mr. Falcone: Is it possible that you overheard something about your brother Vittorio that you misunderstood, or was simply incorrect?

Rosa Russo: No. That is not possible.

Mr. Falcone: Are you familiar with the idea of ‘wishful thinking’ when you desire something so much, you imagine it to be true?

Rosa Russo: I’m supposed to be polite and respect you, but you want to trick me. It’s not fair that you try to get me to say something that will make Auntie Anna look bad when she did nothing but good things. When we came to Roses she didn’t send us away. She gave us a big bed to sleep in with warm covers, and good clothes, and lots to eat, and hot water and soap for baths and Auntie Quinlan who speaks Italian and Auntie Sophie who knows lots of stories and Auntie Margaret knows about corsets and manners and who taught me to read. And Mr. Lee and Mrs. Lee who feed us and teach us about gardens and who took us to church even when I didn’t want to go. All the bad priest did was take my brother and give him to a family and refuse to give him back to us. Make the bad priest swear on the Bible and ask him where Vittorio is, and see then who is good and who is bad. And also, that priest doesn’t like Uncle Jack because Nonna is Jewish and she is the best person in the world –

Mr. Falcone: Judge Sutherland –

Judge Sutherland: Let her finish.

Rosa Russo: Thank you. And he doesn’t like Auntie Anna because she thinks free* but most of all because she doesn’t obey him. He doesn’t like anybody who isn’t exactly like him and who doesn’t obey his rules. But I’m not like him and I don’t want to be like him. I just wanted my brother back, my baby brother who I was there when he was born and I gave mama sips of water and did what the levatrice — the midwife — said. And I promised mama when she was dying I would take care of my brothers and my sister, but the nuns lost my brothers, and all I wanted was to find them again. And now I don’t want to answer any more questions. Not until the bad priest answers some of my questions first.

Judge Sutherland: I think we’ll end the questioning for the day right here.


We at The New York Times read this transcript with great interest and some curiosity. Young Miss Russo raises a pertinent issue, and in fact records indicate that Father McKinnawae was questioned about the fate of the infant Vittorio Russo. When Mr. Belmont, attorney for the Mezzanotte-Savard family, asked whether or not the priest had any knowledge of the infant’s fate or whereabouts, Father McKinnawae declined to answer.

Editor’s Note: We believe that Miss Russo was referring to the fact that Dr. Savard is a proponent of Freethought, the philosophy espoused by Robert G. Ingersoll, “The Great Agnostic”.