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April 12, 1861
Beginnings often hark back to a single, crystalline moment, as if it were a precursor for everything that followed. While mighty events unfold with what seems to be an inevitability, sometimes we are left to wonder at the implications of what seems a simple and inconsequential choice.
For Dr. Philip Hancock, that pivotal moment occurred in the back room of an upper-class New Orleans brothel.
For the previous three years, Philip Hancock had lived in a low-ceilinged, poorly lit attic in Boston where he had been attending medical school. In those narrow confines he’d frozen through the bitter winters, only to roast during the brief respite of summer. Nevertheless, he’d completed his studies, and though opportunities had abounded for a physician in bustling Boston, he’d longed for the semiwilderness of northwest Arkansas—the land of his boyhood.
To Doc’s way of thinking, the fastest way home had been by sea on a merchant vessel loaded with textiles. Its next port: New Orleans. He’d only been able to afford a cheap berth, the bottommost hammock on a dark lower deck. Nevertheless, he’d completed the first leg of his journey and emerged in the sultry air of the New Orleans waterfront a free, and almost penniless, physician and surgeon.
As Doc had strolled down the wharves that morning, he had overheard a young boy—an apparent street urchin dressed in rags—calling to one of his friends, “Me? I can’t play today. I gotta find me a doctor for Miss Meg!”
Doc had signaled the boy, asking, “And what service might your Miss Meg require?”
The black-haired urchin had stared suspiciously at Doc’s surgical bag and cocked his head. Defiantly he had propped filth-encrusted hands on his skinny hips—a gesture no doubt mimicked from a much older man—in order to impart an air of importance.
“You can fix a man’s leg?”
“I can fix as much as any physician can,” Doc had replied. “Assuming your Miss Meg is financially solvent.”
The boy’s round and freckled face had puckered as if he were having trouble with the words “financially solvent.”
Eyes still fixed on Doc’s bag, he seemed to come to a decision. “Reckon you can make terms with Miss Meg. Foller me.”
The way had led up cobblestoned streets where old French buildings rose to brood, gray-walled, with intricate wrought-iron balconies opening to cramped second-story rooms.
Miss Meg’s occupied a neighborhood substantially higher in class than the waterfront where the urchin had been prowling.
Nevertheless, Doc had a moment of hesitation as the boy pointed him down a narrow alley, saying, “We gots ta go in the back.”
The boy nodded with serene gravity. “The front door is for gentlemen.” He emphasized “gentlemen” as if Doc might be just another bit of riffraff like himself.
Doc had suppressed a smile, following the urchin past piles of rotting horse manure that left a rainbowlike sheen across puddles of black water. Broken whiskey bottles had been kicked to the side, and the entwined reek of urine and excrement hung pungently in the air. In places, soot-stained white stucco had peeled like scabs from old wounds to expose the underlying brick.
The boy’s discreet knock at a blue plank door had summoned an overweight black woman in her late forties. Dressed in a dark blue cotton smock fronted by a stroud apron stained with grease, she smelled of frying bacon.
“I brought Miss Meg a doctor!” the boy crowed.
“You all’s a doctor?” the cook had demanded suspiciously as she stared Doc up and down. Her round face glistened with a sheen of perspiration. Before he could reply, she added, “Come on in. She be down the hall with Eli.”
Only after passing through the kitchen and entering a velvet-walled hallway had Doc pegged the establishment as a bordello. A rather more sophisticated example of the trade than the shabby cribs a block back from the wharfs, but a house nonetheless.
Even as Doc had stopped short in hesitation, Miss Meg had come rustling down the wallpapered hallway. The woman was dressed in crimson taffeta layered with watered silk, her high-piled hair accenting a patrician forehead, angular cheeks, and pointed jaw. She’d pinned Doc with a hard blue gaze that would have melted iron plate.
“Didn’t expect anyone this quickly. This way!”
Not the sort of woman to deny.
And he did need the money.
Resigned, Doc followed Miss Meg to what appeared to be a cramped closet. Doc could have spit across the room’s long axis. The stale air reeked of unwashed human, the stench of corrupt flesh, and old misery. And now he found himself face-to-face with his patient. A sweating man on the table blinked, swallowed hard. His black eyes darted this way and that but seemed unable to focus.
Eli appeared to be in his late forties, emaciated; his sunken narrow cheeks and knobby chin sported a four-day beard. In the amber light cast by the four oil lamps set on wall sconces, perspiration gleamed on the man’s rounded forehead and around his glassy eyes. He wore only a smudged white shirt. Hairy bare legs protruded from beneath a gray blanket that draped his waist.
“Don’t you touch dat leg! I ain’t one of your girls what can be ordered around like a dog.” He shifted to free his right arm long enough to shake a finger at Doc, the burning sincerity behind his eyes like a fire of the will.
Doc took in the whitewashed, rough-cut walls. A stained plank floor supported the raised table with its hanging leather straps. The stench of rot intensified in the sweltering air. In the lamplight the man’s left leg—swollen, blackened, and stinking—extended beyond the table’s edge.
Miss Meg, or Madam de Elaine, as she’d introduced herself, closed the door behind her to block the view from the small hallway. As news of Doc’s arrival spread, it had filled with women dressed as tarts who craned their necks to see into the confining room.
“What do you think, Doc?” Miss Meg’s voice, softer now, was thick with the rasp of whiskey and cigar smoke.
Doc pushed a lock of dark blond hair off his brow and opened his surgical bag where it rested on the room’s one rickety wooden chair. With the door closed, the air thickened with burned oil and the cloying smell of gangrene. He needed but one look at the grossly swollen foot to see sharp fragments of bone protruding from a black scab that leaked yellow pus.
“Cut dat leg and the world gonna go crazy,” the man insisted as he began shaking his head in violent swings.
“Eli,” she told him, “the only thing crazy in here is you.”
For a woman closing on forty, Madam de Elaine might have passed as ten years younger had Doc not seen her in the light of day. Her makeup had been artfully applied; her thick black locks were curled, piled up, and held in place with diamond-studded tortoiseshell combs. She’d slipped a no-nonsense apron similar to the cook’s over her crimson dress.
Given the stout leather straps and buckles dangling below the table, and the positioning of the four lamps, Doc realized Madam de Elaine was no stranger to ad hoc medical procedures in her back room.
This is not the reason I studied medicine.
He fought down his sudden distaste. This was the sort of place Paw would have frequented. Doc had spent most of his life struggling to outrun his father’s shadow. The flight had taken him all the way to Boston and the finest medical school in the land. Paw, of course, had paid for the schooling, but Philip had always wondered if it had been because of guilt, or as a final slap in the face. Whichever, the son need never emulate his dissipated and morally bankrupt sire.
I am a gentleman surgeon!
“Yes, tell yourself that,” he murmured, pulling out his instruments.
“Tell yourself what?” Miss Meg asked. Her gaze narrowed. “You sure you’re a physician? A mite young, aren’t you?”
“You ain’t touching dis leg,” crazy Eli protested yet again. “Better you all let me die with dis leg. Take it off and nothing gonna be the same ever again. Madness. You all hear? Gonna be madness if’n you cut my leg.”
“Madam de Elaine,” Doc began, opening his bag, “I’m going to need you—”
“In this room? Given what we’re about? Best call me Meg.” She gestured toward the straps. “You want me to buckle him down?”
“Maybe after I’ve administered the anesthetic.”
“Don’t know that I want to pay for chloroform or ether.”
Doc met her hard eyes. “I’m not cutting a man’s leg off while he’s awake.” Then he added, “Meg.”
She winced, nodded. “Very well.”
“Don’t do it! It be your fault!” Eli tried to struggle up from the table, reaching out with an imploring hand.
“Easy, Eli,” Meg told him as she stepped over to the bed and laid a hand on his forehead. “No one’s going to do anything you tell them not to.”
Doc shot her a sidelong glance. The lie had rolled so smoothly off her tongue. But then perhaps such facile prevarication came with her profession. He tried not to imagine all the things that had passed between those shapely rouged lips as he reached for his bottle and cloth.
Eli seemed to relax, dropped back on the table, his cracked and dry lips working. Anxious black eyes jerked back and forth, as though following fevered delusions.
“I seen it in my dreams, ma’am,” Eli whispered. “Clear as you right now. All the world was right while I was dying. Flowers, they growed. Children was a-playing, doing chores. Young people, they’s a-paying court, and young love was a-blooming.” He swallowed hard, Adam’s apple bobbing. “It come out of the darkness, a gleaming silver blade. Then … swish. And it done took my leg.”
“What happened then, Eli?” Meg asked.
“The moment my leg dropped away, the blood started. World went crazy. Shooting, yelling, screaming, and dying. Wasn’t just New Orleans, ma’am. No, it was the whole country. Men and boys, their arms and legs popping off their bodies like ticks off a hot plate. Not just no handful, neither, but by the thousands. Maybe tens of thousands, filling fields with legs and arms and heads popping right off their bodies. Crazy, I tell you. Plumb crazy.”
He stared up at her face, panic-glazed eyes probing hers. “You gotta believe me, ma’am. You promise me you don’t cut my leg.”
She patted him on the bony shoulder. “Nothing’s going to be your fault, Eli. Doc’s here to take a look, that’s all. He’s going to make you well.”
Eli sagged in apparent relief. “Thank you, ma’am. Gotta tell you, I’s plumb scared.”
Doc dosed his cloth, stepped past Meg, and said, “Eli? I need you to smell this cloth. It will make you sleep.”
“Don’t want to smell no—”
“This is an order, Eli,” Meg told him sharply. “You want to stay on here, you gotta get well. Now, pull your weight and smell the cloth.”
Eli blinked, allowing Doc to place the cloth over his nose and mouth.
“Breathe deeply, Eli,” Doc told him. “That’s it. No, don’t struggle. Just breathe.”
Doc waited, finishing his count. Removing the rag, he checked Eli’s breathing and heart.
“You’re good at that, Dr. Hancock. And at so young an age? I wasn’t certain when you knocked on my door.”
He gave her a wistful smile. “I studied medicine and surgery for three years in Boston.” He had observed and assisted on several amputations. This would be the first one he’d attempted on his own. He hoped Madam de Elaine remained blissfully ignorant of his tension.
“Your accent?” she mused. “Arkansas?”
“Very good. You have no idea how hard I have to work to keep the backwoods twang out of my voice.” He rubbed his sweaty hands. Nerves. God, he hated the jitters. Eli’s ravings about chaos hadn’t helped.
Come on, Philip. Buck up. You know what to do.
“Arkansas to Boston to New Orleans? You travel, Doctor.” She bent to retrieve the first of the heavy leather straps, and in moments had competently buckled Eli’s passive body into the restraint.
“I think I inherited the wanderlust from my father. As much as he claimed to love the farm, he loved being away from it even more.”
“He was a surgeon as well?”
A smile thinned his lips. “If he’s anything, he’s a rogue and scoundrel. An irresponsible womanizing freebooter.”
Doc squinted in the lamplight as he palpated Eli’s gangrenous leg. “Do I want to know what you use this table and those straps for?”
“What does it look like?” Meg ripped the blanket from Eli’s hips, leaving him naked from the waist down. Businesslike, she positioned his good right leg to the side and tightened it in a strap.
“I’d say you terminate the occasional pregnancy here.”
“That and dose the girls for the clap when they need it. The straps keep the girls from moving at the wrong moment.” She pinned him with her icy gaze. “I wouldn’t like that to be talked about around town. If that’s going to be a problem for you…”
Laying out his instruments, and hoping his hands wouldn’t shake, Doc replied, “Impecunious young physicians, fresh off the boat, and new in town, should not consider themselves too high-and-mighty.”
Her lips curled in a world-weary smile. “Then I guess we see eye to eye.”
He removed the tourniquet from his bag and unwound the strap. “Not that Paw ever let us develop what he called airs.”
She had bound Eli’s left thigh to the table. “Sounds like an interesting man, this father of yours.”
“Interesting covers a lot of territory.” Doc tied on his apron. “I’m taking it at the knee.”
“Do what you must.”
“You don’t have to watch this.” Doc positioned his tourniquet, taking his time to screw it tight on Eli’s skinny thigh.
“You’re right. I don’t.” She crossed her arms beneath her full breasts and fixed her hard gaze on Eli’s ruined foot and ankle.
Doc picked up his knife, reflexively wiping it on his apron. Don’t think. Just do it.
Doc’s blade traced a deep U in Eli’s skin to create enough excess flap to cover the stump. He shot a sidelong glance at Meg, her blue eyes unflinching, face expressionless. Given other things she’d seen, perhaps an amputation wasn’t among the worst.
How many girls have died on this table?
“Boston?” Meg mused. “What were they saying about secession up there?”
“Some are saying good riddance. Others are calling for troops to ‘put down the rebellion.’ Most, quite honestly, don’t care if the country splits or not. Were it not for the abolitionists and Mr. Lincoln’s rhetoric, my guess is that we’d be allowed to go peacefully. Still might as long as some lunatic doesn’t start shooting at federal forces.”
She spared him an inquisitive look. “And why did you choose Boston?”
“The best medical schools are there.” Doc concentrated as he separated the thick web of ligaments around the knee. Synovial fluid drained like water as he punctured the joint. To his relief, the sepsis hadn’t spread past the calf muscles. “After completing my studies I wanted to come home. The first ship bound for a Southern port was headed to New Orleans. Which brings me to your back room and Eli’s gangrenous leg.”
“Eli lives under the stairs,” she told him. “He’s harmless, mostly. Just moon-touched crazy. Sees things that aren’t there. Carries on conversations with invisible people. But you tell him to clean the floor? He pitches in and cleans and cleans. No letup until it’s spotless. If I tell him to comb the carpets in the salon, or dust the shelves, it’s done. And best of all, he’s never pestering the girls for as much as a yank on his johnson.”
“How did this happen?” Doc indicated the gangrenous lower leg.
“Moving a new cast-iron cookstove into the kitchen. Eli’s not the strongest of men. He was on the downstairs end. Dropped it.” She quickly added, “He wouldn’t countenance the notion of having someone look at it. Didn’t know how bad it really was till we cut his shoe off the next morning. Should have called for a physician then. But he insisted we leave him be. That it would heal.”
“It might not have made any difference, as badly as his foot is crushed.”
She raised an expressive eyebrow. “He kept insisting it was getting better, and I had more important things to do than keep track of his foot.”
Doc’s quick hands cut the last of the ligaments, and he caught the deadweight of the severed limb. He gently lowered it into a bucket placed conveniently beneath the table. One that had no doubt caught many an unwanted fetus.
A muffled bang, as if from a pistol shot, carried from the street. Then another and another. Meg stepped to the door, opened it a crack, and called, “Hattie? Go see what the commotion is about. If it’s a fight, lock our front door.”
The lower leg looked oddly forlorn where it canted in the bucket. “Well, there you go, Eli. The leg’s gone, and the world is just the same as it was before.”
Meg grunted. “I guess I can’t very well order Eli to carry his own leg out, can I?”
“I’ll see to it,” Doc told her as he slipped silk suture over his tenaculum, the surgical hook. He used it to fish the arteries from the surrounding muscle. Sliding the surgical silk down, he carefully used it to ligate each of the major blood vessels.
She pursed her lips as if the notion were just sinking in. “How long until he can work again?”
“Maybe a month if there are no complications. The stump will have to heal. Keep him quiet and immobilized in a well-aired room to prevent the development of noxious effluvia. Expect fever for the next week or so. Dressings will need to be changed until the pus stops draining. It should be clear. You’ll know from the smell if anything goes amiss. At the end of the month, you’ll have to fit him with a prosthesis to—”
“A peg leg.”
Her lips soured. “But he can still work?”
Doc pulled the flap taut and began to suture. “Physically he’ll be a little slower. Expect him to be clumsy for the next six months. It takes a while to learn to balance and move with a prosthesis.”
She turned her thoughtful gaze on him. “That was quickly done. I didn’t know a leg could come off that fast.”
“I grew up on a farm. Butchering pigs, deer, sheep, and cattle. Paw had me learning anatomy from a medical book, cutting up critters and comparing their innards with human internal organs.” He smiled, delighted with himself. She apparently had no idea how nervous he’d been. “There’s not that much difference.”
“You thinking of staying in New Orleans? Having just lost our old physician to the yellow fever, I’d be willing to offer you regular work here, checking the girls, dealing with our … special needs?”
Me? Service a bawdy house? Never again.
He finished his last knot. Bent down. Studied his suture. After wiping his hands on his apron, he slowly began unscrewing the tourniquet. A faint weeping of blood oozed along the incision’s margins. This was the critical moment. Would the ligated arteries hold?
“Let me guess,” Meg said tartly. “Your mother also taught you how to sew?”
“My father, actually. Harnesses, moccasins, and such. Life beyond the frontier taught him the skill, and he swore no son of his would ever be in a position where he couldn’t ‘repair his possibles’ should the need arise.”
Doc made quick work bandaging Eli’s stump.
“Quite the man, this brigand father you so despise. Returning to my query. My girls are in need of a new physician. Young and handsome as you are—”
“I’m honored by your offer,” he lied.
I’ll see myself in hell before I lower myself to working in a brothel!
He’d never so much as set foot in a whorehouse before—and before God and the angels, he’d be damned if he’d ever do so again. That was Paw’s realm, after all.
He began picking caked blood from his fingers, still alert for the sudden rush should one of his ligatures fail. “Hopefully, I’m only going to be in New Orleans long enough to find a boat headed upriver. With the uncertainty of secession, I’d like to see my family again. It’s been more than four years.”
Then he added, “Assuming, that is, that Father’s not home. Which, I must admit, is a high probability given his affinity for being anywhere else.”
She smiled faintly, an amused look on her face. “But Arkansas?”
“Even worse, western Arkansas.” Doc paused at her expression. “And it’s true: as appalling as travel is in Arkansas, the politics are, indeed, even worse. Now, if someone could bring me a pan of water, I’d like to clean my instruments and hands.”
“Of course.” She opened the door, calling to someone out of sight. Then she turned back. “So that’s it? Off to wild Arkansas to become a surgeon? They don’t pay. Not even in Little Rock with its … what? Three thousand people? New Orleans, especially with the secession, will become the most powerful city in the Confederacy. Probably even become the capital as soon as this asinine notion of placing it in Montgomery over in Alabama wears off.”
“I’ve no doubt that you’re right. My dream, Madam de Elaine, is a small surgical practice. One where I can be close to the country. Hunt, fish, raise a family, and perhaps dabble in good-blooded horses.”
He smiled at her as he checked Eli’s pulse and breathing. “If I share anything with Paw, it’s that I need a bit of wilderness. Paw settled in Arkansas, so he says, because it still has mountains and Indians, but with warmer winters and closer access to trade goods.”
She vented a disbelieving sigh. “Well, what will it be then? Cash?” She narrowed her eye into a near wink. “Or could we interest you in a bit of trade? You, being a surgeon and all, should know your way around a female body. I’ll have the girls—”
“Again, no disrespect, but cash would be preferred.” He paused. “If I catch the spring-full rivers just right, I might make it all the way to Little Rock by boat.”
“Very well.” She nodded politely before stepping out. On her heels a young mulatto woman entered and set a pan of water on the rickety chair. Doc began washing the blood off his equipment and hands. He glanced at Eli, slumbering in drugged bliss.
What was it about the insane that they concocted such peculiarities of imagination?
Not my problem. I’m a surgeon. Destined to deal with medicine’s higher and most noble calling.
Out in the hall, a young woman shouted, “It’s war! In Charleston they’re firing on Fort Sumter!”
Doc buckled up his surgical bag and reached down for the bucket with Eli’s leg. He’d need a place to discard it, wishing the brothel had a garden. The outhouse would have to do.
“Hooraw!” another woman shouted in the hallway.
Bag in one hand, bucket in the other, Doc stepped out into the hallway.
“They’re bombarding the Yankees!” one of the more buxom of the belles cried. She was a round-faced blonde, her cheeks rouged. “They’re shouting it in the streets. The South Carolinians are going to war!”
“Get your rest while you can, girls,” a thin black-haired young woman called drolly. “The loyal gentlemen of New Orleans will be primed for celebrating until long after dawn. And very free with their money, if I’m any judge.”
“War in the distance,” a redhead chortled, “profits in hand.”
Doc glanced down at the bucket where the limp leg leaked blood and fluid.
Copyright © 2018 by W. Michael Gear