“Is there a second choice?” Garrett had asked dully. “Because at the moment, the only thing I’d like to do with cheerful people is push them into the path of an oncoming carriage.”

However, the following morning, Garrett was finally able to feel something other than gloom. It was during an appointment with one of the clinic’s new patients, a watchmaker’s wife named Mrs. Notley, who had given birth eight months earlier and feared she might be with child again. After examining her, Garrett gave her the welcome news that she was not expecting. “None of the various evidences of pregnancy are there,” she told Mrs. Notley. “Although your worry is understandable, it’s not uncommon for a woman’s monthly courses to be irregular while her infant is still nursing.”

Mrs. Notley was overcome with relief. “Praise God,” she exclaimed, dabbing at her eyes with a handkerchief. “My husband and I didn’t know what we were going to do. We have four little ones already, and can’t afford another so soon. We live in constant dread of when the next baby might come.”

“What method of prevention do you use?”

The woman blushed and looked uncomfortable at Garrett’s frankness. “We count the days after my monthly turn.”

“Does your husband practice withdrawal?”

“Oh, no, doctor. Our pastor says it’s a sin for a man to do that outside his wife’s body.”

“Have you considered contraception such as douches or sponges?” Garrett asked.

Mrs. Notley looked aghast. “That’s against Nature.”

A wave of impatience swept over Garrett, but she managed to keep her expression pleasant. “Nature must occasionally be prevented from having its way, or we should have no inventions such as running water or lace-up shoes. As modern women, we need not produce more offspring than we can adequately feed, clothe, and raise to be satisfactory adults. Let me tell you about some safe options that will reduce the chances of unwanted pregnancy.”

“No, thank you.”

Garrett’s brows drew together. “May I ask why not?”

“Our pastor says a large family is a blessing, and we mustn’t refuse gifts from God.”

On any other day, in any other mood, Garrett might have tried to coax her into viewing the issue from a different perspective. Instead, she found herself saying curtly, “I suggest you tell your pastor that it’s none of his business how many children you have, unless he offers to help pay for them. One rather doubts the Good Lord wishes for you and your entire family to end up in the poorhouse.”

Surprised and offended, Mrs. Notley stood from her chair, still clutching the tear-dampened handkerchief. “I should have expected blasphemy from a female doctor,” she snapped, and stormed out of the consultation room.

Garrett lowered her forehead to her desk, stewing in frustration and guilt. “Suffering savior,” she muttered.

Before five minutes had passed, Dr. Havelock came to stand at the doorway. Before he even spoke, Garrett saw from his expression that he’d heard about what had happened.

“I shouldn’t have to remind you that our patients are not mechanical creatures,” he said matter-of-factly. “They come to us with physical and spiritual concerns. You have an obligation to treat their opinions—and feelings—with courtesy.”

“Why is Mrs. Notley’s pastor dispensing medical advice?” Garrett asked defensively. “He should stick to his line of work, and leave me to mine. I don’t go to his church to deliver sermons, do I?”

“A fact for which his congregation is profoundly grateful,” Havelock assured her.

Garrett dropped her gaze and rubbed her face wearily. “My own mother died in childbirth because she didn’t receive adequate medical attention. I would like my female patients to know how to protect and care for themselves. At the very least, they should understand how their own reproductive systems work.”

Havelock’s gravelly voice softened. “As you’re well aware, girls are taught from early childhood that any interest in the workings of their own bodies is shameful. A young woman is praised and admired for her ignorance of sexual matters until her wedding night, when she’s finally introduced to intimacy with pain and confusion. Some of my female patients are so reluctant to discuss their own anatomy that they have to point to an area on a doll to tell me where it hurts. I can scarcely imagine how difficult it must be for a woman to take responsibility for her physical health when she’s always been told she hasn’t the moral or legal right to do so. What I do know is that it is neither up to you, nor me, to judge her. When you speak to a patient like Mrs. Notley, keep in mind that women receive more than enough condescension and arrogance from male doctors—they don’t need it from you as well.”

Humbled and contrite, Garrett mumbled, “I’ll write her a letter of apology.”

“That would be appropriate.” There was a long pause. “You’ve been ill-tempered all week. Whatever your personal problems are, they have no place at work. Go on holiday if necessary.”

Go on holiday? Where in heaven’s name did he think she would go? What was there for her to do?

Havelock regarded her dourly. “In light of your current disposition, I hesitate to mention it . . . but I would like you to accompany me to a soiree at the Home Secretary’s private residence, at the behest of a colleague I’ve known for many years. Dr. George Salter.”

“No, thank you.” Garrett lowered her forehead to the desk again.

“Dr. George Salter,” Havelock repeated. “The name has no significance to you?”

“Not really,” came her muffled voice.

“He was recently appointed as the chief medical officer of the Privy Council. Having learned of the report you’re writing on workhouse conditions, Salter asked me to bring you to the soiree.”

“I would rather set myself on fire.”

“Good God, woman, Salter is an advisor to the queen! He helps to shape public health legislation and administration for the entire British Empire. He would like to include a female perspective on these issues, especially as they pertain to women and children. There’s no woman more qualified than you to provide him with informed opinions and recommendations. It’s the opportunity of a lifetime.”

Garrett knew she should be excited. But the thought of dressing up to attend a formal event and mingle with a crowd of political people filled her with gloom. She raised her head to look at him dully. “I’d rather not meet him on some frivolous occasion. Why can’t I visit his office instead? One can’t exactly project an air of gravitas while prancing through a polka.”

Havelock’s bushy white brows rushed downward. “You have more than enough gravitas. Try for charm instead.”

“One of the reasons I entered the medical profession is so I would never have to be charming.”

“A goal you’ve achieved with great success,” Havelock informed her sourly. “However, I insist that you come with me to the soiree, and try to be amiable.”

“Is Mrs. Havelock coming with us?”

“No, she’s away visiting her sister in Norwich.” He pulled a handkerchief from his pocket and extended it to her.