First Comes Scandal

She frowned. He’d noticed she did this when she was in deep thought. He’d also noticed that he found this fascinating. When Georgie thought deeply on something, her face was in constant motion. Her brow might dip, or her eyes would dart from side to side.

She was not a passive thinker, his wife.

Then something occurred to him. “Were you ever bled?” he asked her. “For your breathing illness?”

“Twice,” she told him.

“And did it work?”

She shrugged. “According to the doctor it did.”

Nicholas did not find this reply satisfying. “What was his criteria?”

“For success?”

He nodded.

She looked at him frankly. “I’m not dead.”

“Oh, for heav—”

Georgie cut him off with a shake of her head. “According to my mother, that is the ultimate proof of cure.”

Nicholas smiled, although he didn’t really think this was funny.

“But,” Georgie continued, “I don’t think that the bloodletting had anything to do with my getting better. If anything, it made me feel worse. It was exhausting. And it hurt.”

“The exhaustion is to be expected. The body must work to produce new, healthier blood.”

“—that is more in balance with the other three humors,” she finished.

“That is the thought.”

She frowned, and an odd, growly sound came from the back of her throat. She was impatient, he realized.

“How do we know I wouldn’t have improved without the bloodletting?” she asked. “How do we know I wouldn’t have improved faster?”

“We don’t,” he admitted.

Georgie’s eyes met his and then held them in a piercingly direct manner. “Would you have bled me under the circumstances?”

“I can’t answer that,” he said. “I don’t know all the circumstances. I don’t know how labored your breathing was. Was it shallow, rapid? Did you have a fever? Muscle aches? Rigidity in your spleen?”

He paused for a moment, even though his questions were largely rhetorical. “It is dangerous to dispense medical advice when one does not have all the facts at hand.”

“I’m not sure the doctor had all the facts at hand,” Georgie muttered.

“He certainly had more than I do.”

She dismissed this with a little snort. “But think about it,” she said. “The difficulty was in my breathing. Whatever was wrong with me, it was in my lungs, not my veins.”

“Everything is connected,” he said.

She rolled her eyes. Hard. “You keep answering with platitudes that don’t explain anything.”

“Sadly, medicine is as much an art as a science.”

She wagged her finger at him. “Another platitude.”

“I didn’t mean it as such,” he said. “I swear. I wish we had more proof to guide our practices. I truly do. And I’m not sure I would choose to bleed a patient who was having difficulty breathing. At least not as a first measure.”

“But when someone is having difficulty breathing,” she said quietly, “there may not be time for a second measure.”

A cold shiver passed through Nicholas, the kind one didn’t feel so much as sense. He had never witnessed one of Georgie’s breathing attacks. He’d heard about them over the years, though. He hadn’t given them a lot of thought—it always seemed he found out about them well after the fact, when it was clear that she’d come through with no lasting implications. So he had not realized just how serious they had been.

And besides that, he’d been young. And not medically minded. Certainly not thinking like a doctor.

“Georgie,” he said slowly, his thoughts coalescing as he spoke, “did your doctor ever suggest you might have asthma?”

“Oh yes, of course,” she replied, with a tone and expression that suggested she found his question somewhat silly.

“No, no,” Nicholas said. He had a feeling he understood her reaction. Many doctors—especially those who were not affiliated with a university and thus not as up-to-date on medical progress—used the word “asthma” to describe any sort of breathing malady. He explained this to her, then asked, “Did anyone ever use the term spasmodic or convulsive asthma?”

She thought for a moment, then gave an apologetic shrug. “I don’t know,” she said. “Not to me. Maybe to my parents.”

“It’s a very specific sort of breathing disorder,” Nicholas explained, “one that manifests itself differently in different people.”

“And this makes it difficult to diagnose?”

“Not that so much as difficult to treat. Different people seem to respond to different treatments. The good news is it is rarely fatal.”

“Rarely,” she echoed, her voice flat.

“My late professor—he died just last year—wrote extensively on the subject.”

At that she smiled. “How fortuitous.”

“To be honest,” Nicholas said, “he wrote extensively on almost every topic of medicine. His major life’s work was the arrangement and classification of disease.”

“In a book?” Georgie asked. “I should like to read that.”

He regarded her with some surprise. “You would?”

“Wouldn’t you?”

“I already have done,” he answered. Dr. Cullen’s tome was required reading of every medical student at the University of Edinburgh. Nicholas knew that some of his classmates had skipped the sections they were not interested in, but he had tried his best to give his full attention to the entire work.

Which hadn’t always been easy. Synopsis Nosologiae Methodicae was, in a word, dense.

“Did you find it interesting?” Georgie asked.

“Of course. Well, most of it. I don’t know that there is any doctor who finds every aspect of medicine interesting.”

She nodded thoughtfully. “I think I would enjoy reading it.”

“You probably would. Although you might like a different one of his texts better. It’s less about the classification of diseases and more about how to treat them.”

“Oh, yes, that does sound more interesting. Do you own this book?”

“I do.”

“Is it here or at Scotsby?”

Nicholas glanced at his overflowing bookshelf, and then tipped his head in its direction. “It’s right there.”

She twisted to look, not that she could have possibly known which book he was motioning to. “May I take it back with me? Or will you need it?”

He smiled. “Not between now and when I next see you.”

Her entire face lit with anticipation, and it occurred to Nicholas that she looked far more excited at the process of reading First Lines of the Practice of Physic than any medical student he’d ever seen, himself included.

“Thank you,” she said, before snuggling into the pillow with a sigh. “It will give me something to do while you’re gone.”

“Is it so very dull, then?”

One corner of her mouth turned down—not sad, but a little sheepish. “It shouldn’t be. I have so much to do. But at the same time it feels like there is nothing to do.”