While She Sleeps

While She Sleeps

The cavernous ceilings of Veyrcrest Academy’s School of Medicine were no match for the pungent smell of ether that bloomed in the surgical room as Helena uncorked the amber bottle.

“It’s been proven quite safe in the past year,” she reassured the anxious woman, a laundress from Veyrcrest’s washroom, sitting upright on the wooden operating table with the sleeve of her bodice rolled up, “and this way you won’t have to feel the pain.” Helena said this with confidence, despite the butterflies fluttering in her own gut.

Professor Sallow set down his notes and pushed the lower sash up two inches further on the tall casement window, allowing the salt air coming off the sea below to compete with the sickly sweet smell of ether that overtook the room.

He huffed through his nostrils, pushed a hand through his coiffed, salt-and-pepper hair, and pulled out his pocket watch. To him, this procedure was routine, and the patient simply an exciting opportunity to experiment with the latest medical innovation: anesthesia. 

That was where his interest lay. It wasn’t uncommon for him to remember extraordinary cases from fifteen years ago in astonishing detail while having completely forgotten the patient’s name. 

Of course, he wants them to survive and the procedures to go well (swimmingly, in fact, because anything less than that would mar his stellar reputation as an avant-garde physician). He just doesn't necessarily care about them.

“I canna lose me arm,” Mrs. Tait whispered, pleading with her eyes. “How’ll I wring the wash?”

The question wasn’t about the chore itself, but the wages that came along with it, and the family of six at home that relied on it.

Helena placed the cork into the neck of the bottle loosely, just enough to trap the volatile spirit before turning to the patient’s swollen arm.

The nearly three-inch forearm gash from a washboard had fiery red skin expanding up towards the elbow and down to the wrist. The surrounding flesh was noticeably hot.

“Professor Sallow is very good,” Helena said, hesitating, not wanting to make any promises she couldn’t keep.

She pressed gently around an edge where the wound looked greenish and a thick yellow discharge emerged. 

Mrs. Tait sucked in air, her eyes darting away and landing on the amber bottle waiting on the tray.

“What’ll it feel like?” Mrs. Tait asked.

A perfectly reasonable question, but Helena was caught off guard. That was the same question her little sister had weakly asked a decade ago. 

Death was at the door, and even the best available medicine money could buy couldn’t save her sister. So Helena had vowed to stay as close as humanly possible to whatever medical innovation came next.

Never again would she stand helplessly beside a bed watching somebody she loved die.

Professor Sallow’s matter-of-fact response snapped Helena back to the examination. “While ether will prevent you from feeling pain during the procedure, it will be quite uncomfortable before and after the administration of it. We will need to use these.” He gestured to the leather straps with big steel buckles attached to the bed.

A fresh wave of terror flooded Mrs. Tait’s eyes.

Professor Sallow had lectured on the suffocating feeling of the ether, and how patients would thrash or rip the mask of the inhaler from their face during the “excitement” phase, just before drifting off.

“It’s much better than being awake,” Helena consoled her. “And I’ll be here the whole time.”

“Young lady, may I remind you my selection for the assistantship must be before the board by five o’clock. What is your recommendation?”

Helena felt that flutter again.

Her four years at Veyrcrest would end at commencement the next day, when she would receive her diploma and one student would be selected for Professor Sallow’s assistantship, a coveted opportunity to remain at the forefront of medicine.

“There is severe inflammation with suppuration that requires immediate drainage and removal of unhealthy tissue, but…” She flicked her eyes to Mrs. Tait. “I see no present evidence that the limb is beyond saving.”

“Are you certain? How do you know the bone is not affected?,” he challenged.

Helena didn’t want to overstate what she could know beyond the visual examination: “Once the wound is opened and drained, we can exclude the bone’s involvement, but as of now, I’ve found no evidence.”

He squinted. “Would your recommendation be the same were the patient not sitting there?”

Her thoughts strayed again to her sister and the brutal honesty the physician had delivered to their parents: “She’ll be dead by morning.”

Helena nodded. Butterflies.

Professor Sallow’s bedside and classroom manner had proven to be abysmal throughout Helena’s time at Veyrcrest. He’d been only marginally kinder to Helena than the rest of the all-male student body in the medical department. 

Women had attended Veyrcrest for decades, but the School of Medicine? She was the actual first.

His mistreatment was likely instigated initially by her (if she were honest), in just the third week of her first year. She hadn’t yet learned the survival skill of letting Professor Sallow be wrong gracefully—because, like all humans, he was occasionally.

With eighteen students watching, and while discussing one of Sallow’s own published case studies, Helena noticed that the dosage recorded in his conclusion didn’t match the dosage in his clinical notes. She asked about the discrepancy in front of the class, assuming it was intentional.

The professor could tolerate Helena's intelligence. He could even take pride in having trained an unconventionally capable student. What he could not tolerate was Helena being right when he was wrong, and bringing it to the whole hall’s attention.

Helena made it even worse by trying to rescue him: “Perhaps this was a transcription error, Professor...”

He never used her name again. Only “young lady,” after that.

And while the male students would give their answer and be met with “adequate” (practically a compliment coming from Professor Sallow), any answer from Helena warranted further interrogation: “Why?” “On what evidence?” “And if that fails?”

The professor stood in silence. 

Helena interpreted that as approving her recommendation and poured an ounce of ether into the brass-and-glass inhaler, a new medical apparatus he had gone to considerable trouble to acquire (and his latest pride and joy). 

Glass clinked as Helena recorked the bottle and set it on the instrument tray, sealing the inhaler and double-checking the tools she’d laid out: scalpel, probe, forceps, rolls of bandages, needles and silk thread, bone saw… She breathed out, praying it wouldn’t come to that.

Helena encouraged the laundress to lie back, and gently buckled her wrists into the ominous restraining straps.

“All is prepared, sir.”

The professor moved around the wooden table to the side closest the infected arm, which was nearer the window to give better light. He rolled his sleeves methodically and donned a linen apron to protect his waistcoat.

With the anesthesia and the tray of instruments ready, Helena gave one final reassuring smile and lifted the inhaler, positioning the mouthpiece. The glass turned hazy with condensation as the rubber hose pulled ether into Mrs. Tait’s lungs.

She coughed sharply, then retched as her body took over. She arched her back off the table and let out the unsettling “ether shriek” Professor Sallow had warned of in class.  

Helena’s heart raced as she struggled to keep the mouthpiece in place.

Mrs. Tait kicked at the wooden table with such ferocity, Helena thought it might crack. She looked to the wounded arm, being rubbed and pulled against the strap, hoping it wouldn't make the injury worse. 

Minutes of struggle passed like a lifetime before her protests slurred and her breaths became ragged. With eyes rolled upward, the patient's body went limp.

Helena pressed a thumb to her wrist, feeling that consistent drum of life.

With Mrs. Tait still, Helena anticipated Professor Sallow’s first step. She picked up the metal probe from the instrument tray and extended it to him. 

He leaned in closer to the inanimate face, studying, then lightly brushed a finger along the lashes of Mrs. Tait's partially opened eyelids. She didn’t move.

The corner of his mouth twitched into what Helena guessed was the hint of a smile.

He took the probe and pushed at the edge of the open wound aggressively, exploring pockets in a way that would have been excruciating were the patient awake, but there was no movement from Mrs. Tait.

The professor passed the probe back to Helena, keeping his open hand extended. She filled it with a scalpel.

A familiar animation overtook him; the unmistakable thrill of having some new corner of medicine before him.

He made an incision. Creamy yellow discharge mixed with blood oozed down the arm. Helena dabbed it with a folded rag, then watched as Professor Sallow artfully cut away compromised tissue for nine precious, uninterrupted minutes.

Without ether, physicians prioritized speed above all other skills. Crudely amputating a limb might take just a minute or two, rushed by both the patient’s endurance and the assistant’s ability to hold them down.

But ether afforded the luxury of silence, stillness, time. The professor could carve flesh away carefully, rather than quickly.

They worked in silence, Professor Sallow shaving away gray slough with the concentration and talent of a sculptor revealing a figure beneath a block of marble, Helena anticipating instruments and cycling through bloodied cloths.

An almost imperceptible clench of Mrs. Tait’s jaw caught Helena’s eye. She watched for another sign, willing the ether to keep its grip. 

A low moan emerged from Mrs. Tait’s lips. Her head tilted, and the arm Professor Sallow was working on jerked.

He shifted back on his heel. “We must administer more ether.”

Helena moved quickly, picking up the inhaler and repositioning the mask, but even in her mostly unconscious state, Mrs. Tait's body writhed at the sensation. She struggled against the straps and momentarily cried out, her eyes finding Helena’s with perfect lucidity.

Helena knew that terrifying flash of sudden consciousness.

Just a fortnight prior, she’d awakened lying amongst the sinister-looking holly bushes in the campus arboretum, their sharp, glossy leaves poking into her skin with red berries, like eyes, watching her from above. 

She had been ambushed by the other medical students on her way back to the dormitories from a late-night study session at the library.

They held a sponge of ether so tightly over her mouth, she thought she'd swallow the sponge itself as she choked her way into delirium.

Apart from the ether “prank,” there seemed to have been no other foul play. She was shaken, but fully clothed and otherwise unharmed (save for the shallow holly scratches).

The attack hadn’t come from nowhere. 

When she first arrived at Veyrcrest, she was simply a novelty. Over the years, she regularly found specimens—a cat's spleen, a goat's eye, a human toe—in various states of decomposition, anywhere from her book bag to her bed pillows.

By fourth year, all the students in the School of Medicine could see she was beating them academically. The abuse reached a fever pitch when the assistantship was announced.

Mrs. Tait’s movements slowed, and her body went limp. Helena relaxed along with her, placing the inhaler back on the tray. 

Professor Sallow resumed his procedure, removing the last of the sickly flesh, while Helena continued clearing the custard-like matter that crept out as he manipulated the wound's edge. 

Helena read his next move, took the scalpel, and handed him the forceps and probe from earlier.

He widened the opening and dipped inside, probing the margins for anything he missed. Sufficiently cleaned, it was time to investigate the cavity at its rawest depths.

While the professor's attention turned to the question of the bone, Helena’s ear snagged on a hitch in Mrs. Tait’s rhythmic breathing; silence lingered where that next ragged breath should have been. 

Helena reached for Mrs. Tait’s wrist, eyeing her pale face. The cadence was hard to locate at first, and once Helena found it, it was entirely too fast. 

A gust of ocean wind from the open window caused a nearby oil lamp to flicker, casting a contrasting warmth across Mrs. Tait’s pallid skin and lips that appeared slightly blue along the edges.

Another pause in her breathing followed before a wet gasp emerged. Mrs. Tait’s eyelids fluttered. 

“She must stay under; I've yet to exclude the bone’s involvement,” Professor Sallow said with a quick glance at the patient.

“Professor, her pulse is rapid, and exceedingly weak.”

“We have reached the most diagnostically valuable portion of the procedure, young lady.” His tone remained clinically calm. “And, might I add, the most painful.”

He returned to his work, guiding the blunt-tipped rod further in and listening for the click of metal as it hit bone. Mrs. Tait’s fingers curled.

Helena knew he would need time to feel for any grittiness or softening along the exposed length. A minute, perhaps two, and then they could dress the arm. 

The bluish cast at the edges of Mrs. Tait’s lips appeared to deepen. Her chest rose again, but barely.

Professor Sallow maneuvered the probe down the bone. The laundress’s arm bucked against the restraint, forcing him to withdraw the instrument.

His eyes cut toward the inhaler, then settled expectantly on Helena. “If there is necrosis left undiscovered, the consequence will be far worse than a lost limb.”

“I fear another administration may suppress her breathing altogether,” Helena pushed back, despite the mounting irritation in his eyes.

“Fear has no place in medicine,” he quickly rebutted. “What do you propose instead?”

“We must let her wake.” 

Mrs. Tait moaned. She could fully wake in seconds.

He felt Mrs. Tait’s pulse himself. “Concerning…” he said, looking longingly at the bottle of ether, “but not prohibitive.”

He gripped the patient’s arm, bringing the probe back toward it. “We discard the very advantage that permits me to examine properly… and subject her to the pain instead? An unexpectedly callous recommendation, young lady.” 

Helena held his gaze. “I do, sir.” 

“Your refusal to cooperate will be remembered when I make my recommendation to the board.”

Slowly, she picked up the ether. Smugness tugged at Professor Sallows' lips, and eagerness was in his eyes.

She rotated the amber bottle as she rotated the decision in her mind, then set it back down with a defiant clink, the sound pulling Mrs. Tait fully from oblivion. She howled in pain, crunching her body forward against the pull of the restraints.

“Mrs. Tait…” Helena said firmly, trying to control her frenzied movements, “You must remain still. We’re nearly finished” 

Mrs. Tait was weak, exhausted from the week-long fever and the physical struggle and pain of the day’s events. 

“You're in a fragile state, Mrs. Tait. We must finish without ether.” 

The woman settled, fear in her eyes, but color returning slightly to her face. 

“Hold her firmly then, young lady.”

Helena knew finishing the examination and suturing the wound would be a struggle, yet pain is temporary. Death was permanent.

Mrs. Tait screamed as the probe met bone, but Sallow worked quickly.

“No necrosis,” he finally said.

Helena exhaled as he dressed the arm, the limb still very much attached. He then checked his pocket watch, gathered his notes, and left without another word.

─── ❧ ───

Helena sat stiffly as the final names of her colleagues were called and they crossed the stage to collect their diplomas. She fingered the gold ribbon tying her own diploma shut, certain it was the last accomplishment she would experience on the grounds of Veyrcrest.

“And now, for the highly anticipated announcement of Professor Sallow’s assistantship,” said the Dean. “Will you join me on stage, sir?”

Professor Sallow stepped forward, and Helena waited to hear one of her colleagues’ names.

“Medicine often requires decisions to be made quickly and with delicacy. Innovation may expand what is possible, but it cannot make those decisions for us.”

Something about his expression unsettled Helena. She had never seen him look anything less than certain.

“Which is why I have selected Miss Helena Harcourt.” A murmur moved through the medical students behind her.

“Her judgment during her final demonstration, her pursuit of education, and her resolve under considerable opposition will make her an asset to Veyrcrest and to her patients.”