I could feel the steps of the process of amputation, echoing in the muscles of my hands and forearms; the tensile severing of skin and muscle, the grate of bone, the snap of tendon, and the slippery, rubbery, blood-squirting vessels, sliding away into the severed flesh like . . . snakes.
I swallowed. No. It wouldn’t come to that. Surely not.
“Ye need fat meat. You’re verra thin, a muirninn,” Jamie said softly, behind me. “Too thin, for a woman breeding.”
I turned round, swearing silently to myself once more. I’d thought so, but had hoped I was wrong. Three babies in four years! And a one-handed husband, who couldn’t manage the man’s work of a homestead and wouldn’t do the “women’s work” of baby-minding and mash-brewing that he could handle.
Marsali made a small sound, half-snort, half-sob.
“How did you know? I havena even told Fergus yet.”
“Ye should—though he kens it already.”
“He told you?”
“No—but I didna think it only the indigestion that troubled him, whilst we were hunting. Now I see ye, I ken what it is that’s weighin’ on him.”
I was biting my tongue hard enough to taste blood. Did the tansy oil and vinegar mixture I’d given her not work? Or the dauco seeds? Or, as I strongly suspected, had she just not bothered to use either one regularly? Well, too late for questions or reproaches. I caught her eye as she glanced up, and managed—I hoped—to look encouraging.
“Och,” she said with a feeble smile. “We’ll manage.”
The leeches were stirring, bodies stretching slowly like animated rubber bands. I turned back the quilt over Jamie’s leg, and pressed the leeches gently onto the swollen flesh near the wound.
“It looks nastier than it is,” I said reassuringly, hearing Marsali’s unguarded gasp at the sight. That was true, but the reality was nasty enough. The slashmarks were crusted black at the edges, but still gaped. Instead of the sealing and granulation of normal healing, they were beginning to erode, the exposed tissues oozing pus. The flesh around the wounds was hugely swollen, black and mottled with sinister reddish streaks.
I bit my lip, frowning as I considered the situation. I didn’t know what kind of snake had bitten him—not that it made much difference, with no antivenin for treatment—but it had plainly had a powerful hemolytic toxin. Tiny blood vessels had ruptured and bled all over his body—internally, as well as externally—and larger ones, near the site of the wound.
The foot and ankle on the injured side were still warm and pink—or rather, red. That was a good sign, insofar as it meant the deeper circulation was intact. The problem was to improve circulation near the wound, enough to prevent a massive die-off and sloughing of tissue. The red streaks bothered me very much indeed, though; they could be only part of the hemorrhagic process, but it was more likely that they were the early signs of septicemia—blood poisoning.
Roger hadn’t told me much of their night on the mountain, but he hadn’t had to; I’d seen men before who’d sat through the dark with death beside them. If Jamie had lived a night and a day since then, chances were he would go on surviving—if I could control the infection. But in what condition?
I hadn’t treated snakebite injuries before, but I’d seen sufficient textbook illustrations. The poisoned tissue would die and rot; Jamie could easily lose most of the muscle of his calf, which would cripple him permanently—or worse, the wound could turn gangrenous.
I stole a look at him under my lashes. He was covered with quilts and so ill he could barely move—and yet the lines of his body were drawn with grace and the promise of strength. I couldn’t bear the thought of mutilating him—and yet I would do it if I must. To cripple Jamie . . . to leave him halt and half-limbed . . . the thought made my stomach clench and sweat break out on my blue-blotched palms.
Would he wish that himself?
I reached for the cup of water by Jamie’s head and drained it myself. I wouldn’t ask him. The choice was his by right—but he was mine, and I had made my choice. I wouldn’t give him up, no matter what I had to do to keep him.
“You’re sure you’re all right, Da?” Marsali had been watching my face. Her eyes darted from me to Jamie and back, looking scared. I hastily tried to rearrange my features into a look of competent assurance.
Jamie had been watching me, too. One corner of his mouth turned up.
“Aye, well, I did think so. Now I’m none so sure, though.”
“What’s the matter? Do you feel worse?” I asked anxiously.
“No, I feel fine,” he assured me—lying through his teeth. “It’s only, when I’ve hurt myself, but it’s all right, ye always scold like a magpie—but if I’m desperate bad, ye’re tender as milk. Now, ye havena called me wicked names or uttered a word of reproach since I came home, Sassenach. Does that mean ye think I’m dyin’?”
One eyebrow rose in irony, but I could see a true hint of worry in his eyes. There were no vipers in Scotland; he couldn’t know what was happening to his leg.
I took a deep breath and laid my hands lightly on his shoulders.
“Bloody man. Stepping on a snake! Couldn’t you have looked where you were going?”
“Not whilst chasing a thousand-weight of meat downhill,” he said, smiling. I felt a tiny relaxation in the muscles under my hands, and repressed the urge to smile back. I glared down at him instead.
“You scared bloody hell out of me!” That at least was sincere.
The eyebrow went up again.
“Maybe ye think I wasna frightened, too?”
“You’re not allowed,” I said firmly. “Only one of us can be scared at a time, and it’s my turn.”
That made him laugh, though the laughter was quickly succeeded by coughing and a shaking chill.
“Fetch me a hot stone for his feet,” I said to Marsali, quickly tucking in the quilts around him. “And fill the teapot with boiling water and bring that, too.”
She darted hastily toward the kitchen. I glanced toward the window, wondering whether Brianna was having any luck in finding maggots. They had no equal in cleaning pustulant wounds without damage to the healthy flesh nearby. If I was to save his leg as well as his life, I needed more help than Saint Bride’s.
Wondering vaguely if there were a patron saint of maggots, I lifted the edge of the quilt and stole a quick look at my other invertebrate assistants. Good; I let out a small sigh of relief. The leeches worked fast; they were already swelling into plumpness, sucking away the blood that was flooding the tissues of his leg from ruptured capillaries. Without that pressure, healthy circulation might be restored in time to keep skin and muscle alive.
I could see his hand clenched on the edge of the table, and could feel the shuddering of his chill through my thighs, pressed against the wood.
I took his head between my hands; the skin of his cheeks was burning hot.
“You are not going to die!” I hissed. “You’re not! I won’t let you!”
“People keep sayin’ that to me,” he muttered, eyes closed and sunken with exhaustion. “Am I not allowed my own opinion?”
“No,” I said. “You’re not. Here, drink this.”
I held the cup of penicillin broth to his lips, steadying it while he drank. He made faces, squinching his eyes shut, but swallowed it obediently enough.
Marsali had brought the teapot, brimful of boiling water. I poured most of it over the waiting herbs, and left them to steep, while I poured him a cup of cold water to wash away the taste of the penicillin.
He swallowed the water, eyes still shut, then lay back on the pillow.
“What is that?” he asked. “It tastes of iron.”
“Water,” I replied. “Everything tastes of iron; your gums are bleeding.” I handed the empty water jug to Marsali and asked her to bring more. “Put honey in it,” I said. “About one part honey to four parts water.”
“Beef tea is what he needs,” she said, pausing to look at him, brow furrowed with concern. “That’s what my Mam did swear by, and her Mam before her. When a body’s lost a deal o’ blood, there’s naught like beef tea.”
I thought Marsali must be seriously worried; she seldom mentioned her mother in my hearing, out of a natural sense of tact. For once, though, bloody Laoghaire was right; beef tea would be an excellent thing—if we happened to have any fresh beef, which we didn’t.
“Honey water,” I said briefly, shooing her out of the room. I went to fetch reinforcements from the leech department, pausing to check on Brianna’s progress through the front window.
She was out by the paddock, barefoot, skirts kilted up above the knee, shaking bits of horse dung from one foot. No luck so far, then. She saw me at the window and waved, then motioned to the ax that stood nearby, then to the edge of the wood. I nodded and waved back; a rotted log might be a possibility.
Jemmy was on the ground nearby, his leading-strings securely tied to the paddock fence. He certainly didn’t need them to help him stay upright, but they did keep him from escaping while his mother was busy. He was industriously engaged in pulling down the remains of a dried gourd-vine that had grown up over the fence, crowing with delight as bits of crumbled leaf and the dried remains of frostbitten gourds showered over his flaming hair. His round face bore a look of determined intent, as he set about the task of getting a gourd the size of his head into his mouth.
A movement caught the corner of my eye; Marsali, bringing up water from the spring, to fill the crusted cauldron. No, she wasn’t showing at all yet—Jamie was right, she was much too thin—but now that I knew, I could see the pallor in her face, and the shadows under her eyes.
Damn. Another glimpse of movement; Bree’s long pale legs, flashing under her kilted skirts in the shadow of the big blue spruce. And was she using the tansy oil? She was still nursing Jemmy, but that was no guarantee, not at his age . . .
I swung around at a sound behind me, to find Jamie climbing slowly back into his nest of quilts, looking like a great crimson sloth, my amputation saw in one hand.
“What the hell are you doing?”
He eased himself down, grimacing, and lay back on the pillow, breathing in long, deep gasps. The folded saw was clasped to his chest.
“I repeat,” I said, standing menacingly over him, hands on my hips, “what the hell . . .”
He opened his eyes and lifted the saw an inch or so.
“No,” he said positively. “I ken what ye’re thinking, Sassenach, and I willna have it.”
I took a deep breath, to keep my voice from quivering.
“You know I wouldn’t, not unless I absolutely had to.”
“No,” he said again, and gave me a familiar look of obstinacy. No surprise at all that he never wondered who Jemmy looked like, I thought with sour amusement.
“You don’t know what may happen—”
“I ken what’s happening to my leg better than you do, Sassenach,” he interrupted, then paused to breathe some more. “I dinna care.”