Chapter 3

S imon knew he had got off to a bad start with Isobel – mistaking her for the matron, talking about the studies he hoped to conduct, and now, looking down at the boy in front of him, he felt entirely out of his depth. At medical school, he had encountered the occasional patient, but always in the company of superior doctors and physicians. Only the most serious cases were treated in the hospital, and whilst Simon had observed obscure diseases and remarkable injuries, his experience with ordinary people was somewhat limited. The boy’s request to touch his face had surprised him, even as it was surely not unreasonable for a blind child to want to do so.

“Ah, yes, certainly,” Simon said, kneeling in front of the boy, whom Isobel had introduced as Timothy.

He was a pale-looking child, gaunt and malnourished. He needed feeding – his arms were thin, and cheeks pinched. He was wearing ragged clothes and a flat cap pulled down over his forehead, the very image of poverty. Simon took the boy’s hands in his and guided them to his face.

“There, now, Timothy. You know what the doctor looks like, don’t you?” Isobel said, and Timothy nodded.

Isobel was entirely at ease with the idea of blindness – or so it seemed. Simon had heard much about her father, Henry, the Duke of Crawshaw. He was famously blind and had overcome many obstacles in carrying out the duties of his inheritance. There were many who believed a blind man could not hold such an office, but the Duke of Crawshaw had proved them wrong, and Simon hoped to have the opportunity to meet him, even as he knew he had not made the best of first impressions.

“I can see you now,” Timothy said, and Simon smiled.

“May I examine you? Then I can tell you what’s wrong,” he said, and the boy nodded.

Simon knew the procedure for an examination well enough – he had read about it in a dozen textbooks, and seen it performed several times. He began by holding Timothy’s hand in his, testing the joints, before examining the glands around the neck, opening the eyes, checking the mouth, and performing a dozen other observations, being careful and methodical in his procedure. Isobel stood at his side, waiting expectantly.

“And your diagnosis,” she said, as Simon straightened himself up.

“Ah, well…it’s hard to tell, you see,” Simon said, scratching his head.

“Aren’t you going to ask him how he feels?” Isobel said.

Simon blushed. He had been so deliberate and thorough in his examination, he had neglected to ask the patient what was wrong with him.

“Yes…certainly. Can you tell me, Timothy?” he asked.

Timothy pointed to his stomach, lifting his shirt to reveal a number of small marks across his lower abdomen. He scratched at them and sniffed.

“I’d say it’s obvious,” Isobel said, and Simon nodded.

“Ah…yes, chicken pox,” he said, feeling foolish for not having realized.

He had not thought to lift the child’s undershirt, examining him instead with thoughts of injury or poverty as the cause of his ill-feeling. But the diagnosis was clear, and Simon knew he had to act fast to prevent the infection spreading to the other children.

“He’ll have to be isolated from the other children. We don’t want an outbreak in the school. If one gets it, they could all get it,” Isobel said.

She stooped down and took Timothy’s hands in hers. The child looked worried, and Simon wanted to offer reassurance, even as this was the first time he had encountered such an outbreak – though he had read about the disease in some detail.

“You’ll itch for a few days, Timothy. But bed rest and hot soup will see you through,” Simon said.

“Yes, don’t worry, Timothy. You’ll be quite all right. We’ll have the matron put you to bed away from the other children. I’ll come and sit with you,” Isobel said.

As she stooped down, Simon noticed a set of marks on the exposed skin above the collar of her dress. They were the same scars Timothy would have, and Simon realized Isobel, too, had suffered the infection at some point in her childhood. He, too, had been afflicted, recalling two weeks spent in isolation from his sister, who had cried every day until they had been reunited.

“It hurts,” Timothy said, sniffing, as Isobel took him in her arms.

“But you must try not to scratch. It only makes it worse. Come now, I’ll bathe the spots with chamomile lotion, and you can have a hot cup of tea and some soup,” she said.

Simon was impressed by Isobel’s kindness towards the child, and now he followed her upstairs to the dormitories, where she instructed the matron to prepare a sickroom for the boy and bring him hot tea and soup. Simon himself felt somewhat redundant. He had played no actual part in the diagnosis, and his suggested treatment would have been the same as Isobel had already decided on.

“Perhaps I should check the other children,” he said, and Isobel nodded.

“Yes, you could do. I’ll have to write to Ernest and tell him. Poor Timothy…and on his first day. Our first day,” Isobel said.

The matron now took charge of Timothy, and he was placed in a single room off the dormitory, where he could be isolated from the other children. Simon tried to make himself useful, suggesting a tonic he had read about in a medical journal, and instructing the matron on how best to apply it. Isobel stood listening in silence, and Simon wondered what she really thought of him.

It’s one thing reading about it… he thought to himself, for he was beginning to feel entirely inadequate to his calling, and a fool for not having recognized what was so obvious in Timothy’s condition.

Most children contracted chicken pox at one time or another. It was a rite of passage, in many ways, and the first thing a doctor should think of when examining a poorly child.

“Are you going to look at the other children?” Isobel asked, raising her eyebrows, as Simon stood at the end of Timothy’s bed.

“Ah…yes, I will do,” he said, turning to leave the room.

“Thank you,” Timothy said, and Simon smiled.

“You’re very welcome, Timothy. I’ll check on you later. You’ll be quite all right, I promise,” he said, stepping out into the empty dormitory.

Simon hoped he did not have an epidemic on his hands and making his way downstairs – followed by Isobel – he summoned the children, one by one, for examination. To his relief, none of them showed signs of the chicken pox, though Simon knew he could not afford to be complacent.

“Timothy could be the first one to show,” Isobel said, after they had examined the last child.

“Yes, we’ll check them all again tomorrow, and keep Timothy in isolation for the next week. I’m sorry you’ve been burdened with this on your first day in charge,” Simon said, as Isobel led him into her study off the hallway.

“My brother entrusted me with the running of the school. I’ll do whatever’s necessary whilst he’s away,” Isobel replied.

Simon could not help but admire her practicality. Lord Crawshaw was fortunate in his sister, and Simon could not help but think of Evie, wondering if she, too, would have grown up with the same strength of character and determination as Isobel. Simon admired her, even as he found her somewhat intimidating. The medical world was the preserve of men. Women would act as nurses, midwives, too, but the upper echelons of society demanded the presence of physicians, of men – even in childbirth – and Simon’s medical training had been conducted on that understanding. He was not used to dealing with the fairer sex, not in matters of business, nor on a personal level.

“And I’ll do all I can to help you, too,” Simon assured her.

She nodded, shuffling some papers on the desk, and now she looked up at him, her eyes narrowing.

“Why did you come here? To Lancaster, I mean,” she asked.

Simon faltered. He had no intention of revealing the truth of his background. He did not want to be treated any differently because of his rank and title. He and Isobel were of the same privilege – the son and daughter of dukes – and yet, in his position now, Simon was nothing more than a member of the middle classes, a man of utility, working for a living.

“I…well, I’d always wanted a country practice, you see. I wasn’t interested in surgery, and I’m not a military man, either. I wanted to come somewhere where I’d see medicine in all its fullness – from broken ankles to chicken pox,” Simon replied.

Isobel smiled.

“And is it as you hoped?” she asked.

Simon paused, not knowing quite what to say. He had left London in high spirits, not returning to Burleigh House, but coming at once to Lancaster, hoping to roll up his sleeves and begin his work. But his failure to recognize even the most obvious of alignments, and his encounter with the eminently more practical Isobel, had made him question the abilities he had believed himself to be possessed of.

“I’m sure I’ll get used to it,” he replied, reminding himself he had only been the parish’s resident physician for a few hours.

His new life would take time to grow accustomed to, and it was inevitable he should make one or two mistakes along the way.

“And what of your background? What made you decide to become a doctor?” she asked.

Simon faltered. He was not ready to reveal the truth. He did not want to reveal the truth. His past – his shame over Evie, his guilt – was not something he readily talked about. At Bart’s, Simon would tell his fellow students he was the son of a merchant from the north, and none of them knew of his rank or title.

“I suppose I wanted to help others. I’d always admired the work of physicians – the possibility of curing the incurable, the discovery of new treatments, the expansion of knowledge. I want to do something worthwhile. I want to help people,” he said, and Isobel nodded.

“As do most physicians, one would hope,” she said, and Simon agreed.

She seemed satisfied with his answer, even as Simon was curious to know more about her. But given his apparent place in the social order, and the inequality of their perceived rank, he felt he could not ask her the questions he desired to know the answers to – was she married? What were her hopes and ambitions? What did she think of her brother and his intentions for the school? Instead, Simon limited himself to the more perfunctory and practical.

“How often will you require my services? Shall I visit the school each day?” he asked.

“It’s up to you. You’ll have other patients to see, I’m sure. But my brother specifically requested your attachment to the school, and you’ve already mentioned your interest in making a study of the children,” Isobel replied.

Simon felt foolish for having spoken in such terms. He did not want Isobel to think he was merely interested in the children as a point of study. He wanted to do his best by them, and Simon had already made up his mind to check on Timothy that very evening. He wanted to prove his worth, even as he knew he had not made a good first impression.

“Ah, yes…well, all in good time. But I should be going now. I’ve taken up enough of your time, Lady Isobel,” he said, rising to his feet.

Isobel did the same, ushering him out of the study into the hallway. She held out her hand to him and smiled.

“Until we meet again – soon, I’m sure,” she said, and Simon nodded, taking her hand in his, and returning her smile.

“I’ll return this evening to check on Timothy, and tomorrow to make another examination of the children,” he said, wanting to appear practical in his intentions.

She nodded, showing him to the door, and Simon thanked her again, not wanting to leave on a sour note.

“I’m sure you’ll find your place amongst us, Doctor Wilkinson,” she said.

“Please, Simon, if you will,” he said, and Isobel nodded.

“Simon…well, good day. I’ve got a lot to do. The school won’t run itself,” she said, opening the door for him.

“Good day to you,” Simon replied, clattering down the steps and glancing back at her with a smile.

She stood for a moment to watch him go. He had no carriage waiting for him – having told the driver of the horse and trap he had arrived in to return to his own business – and now he turned, waving to her from the dower house gate. She nodded, and Simon felt foolish for his display of overfamiliarity.

“You’re just a doctor,” he reminded himself, as he set off along the road through the estate.

As he walked, Simon thought back to what had been his first proper encounter with a patient. He had failed spectacularly in his diagnosis, but had tried his best in the aftermath, and now he thought through the various treatments for chicken pox, wondering if he had missed anything. He was so absorbed in his thoughts, he hardly noticed the sound of a carriage behind him, but as it passed, a shout came from the compartment, and the carriage slowed.

“You must be the new doctor,” a voice behind him said, and Simon turned to find a young man smiling at him from the open carriage window.

He was handsomely dressed with an aristocratic look about him, and Simon nodded, removing his hat as a mark of respect.

“Simon Wilkinson,” he said, and the young man leaned out of the carriage to shake Simon by the hand.

“Maximilian Oakley – this is my father’s estate,” the man said, and Simon gave a curt bow, realizing he was in the presence of the heir.

“It’s a pleasure to meet you, sir,” he replied, and Maximilian grinned.

“I’m usually in rude health, myself. But my wife’s just given birth to twins. She’s a delicate creature at the moment, though usually strong as an ox. Perhaps you’d call on her in the coming days? We live on the estate. Just ask someone for directions. I presume you’ve met Isobel by now?” he said, and Simon nodded.

“I’d be glad to, my Lord. And yes, I’ve just come from the school,” Simon replied.

Maximilian smiled.

“She’s quite formidable, isn’t she?” he said, and Simon blushed.

“Lady Isobel knows her mind, my Lord,” he said, wondering if he was being tested in his opinions.

Simon was all too aware of entering a new district, with its gossip, intrigues, and scandals. He had inhabited the world of the aristocracy long enough to know it was imperative to be cautious in proffering one’s opinions.

“She certainly does. Her brother’s married to my wife’s closest friend. They’ve gone off on a grand tour of the continent. Lily’s terribly jealous, but I can’t spare the time. I’ve got responsibilities on the estate. Really, I’m somewhat surprised Ernest went, given the opening of the school and so forth,” Maximilian continued.

Simon wondered if this, too, was a further test, and he merely nodded.

“I’m sure his Lordship knows his mind,” he said, and Maximilian nodded.

“I’m sure he does. Well…good day to you, Doctor. And don’t forget to call in on my wife on your rounds,” he said, signaling for the drive to go on.

Simon watched him go, hoping he had shown more shrewdness in his dealings with this second aristocrat than with the first. But as he made his way back to his lodgings, Simon could only hope he would find his place in this new and unfamiliar setting, knowing he still had a lot to learn, and a lot to prove.

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