‘Yes. I’m sure,’ he said, trying to speak with confidence and authority.

‘Is there no other way to help her?’

‘No. But I can’t do this alone. I’m going to need your help.’

Martha hesitated for a few moments then nodded.

‘Tell me what to do.’

‘Go to the kitchen and fetch me hot water, a basin and some towels. I think I have everything else now.’

Martha left the room and Raven began to lay out the instruments that he would need: scalpel, clamp, ligatures, piles of lint, sponges and the chloroform. In Sarah’s depleted state she would not require much of the latter. Her pulse, still rapid, felt a little stronger now that she was in bed, her feet elevated on pillows. She was groaning a little, not fully awake.

Martha returned with a large bowl of water and an empty basin. Raven added chloride of lime to the water, dropped his scalpel in and then washed his hands, almost scalding himself.

‘Christ, Martha, I said hot, not boiling.’

Martha bit her lip but said nothing. She stood silently by the bed awaiting further instructions. Raven proceeded to give the chloroform. As he had expected, only a small amount was required. He rolled up Sarah’s chemise and paused, quickly running through in his mind what he had to do. Most basically, get in there and stop the bleeding. But how different the theory was to the practice.

He took a few deep breaths, forcing himself to think of everything in an abstract way. It was a procedure, a process, a series of steps to be followed: incision from umbilicus to pubis, enter peritoneal cavity, pass ligature around broad ligament and divide it.

Even if he succeeded, he knew he would be criticised for this. It was unjustifiable in the eyes of the profession to perform hazardous experiments, for surely this is what he was about to do. Those who challenged established rules were always harshly dealt with. Only those whose professional stature had been recognised and rewarded could expect a fair hearing. Someone at his stage would be condemned out of hand. He thought of Dr Simpson, the scandal of the bloodstained mattress, the criticism he had endured over nothing but unsubstantiated gossip. This mattress was going to be a thousand times worse. But there was no time to think about such things. His reputation be damned. If he had to choose, then he chose Sarah.

Without further thought, he began. His mind cleared, his focus became preternaturally acute. He opened the abdomen, scooped out a huge amount of clot, filling the basin that Martha had brought him. The source of mischief was easily identified: an ovoid swelling in the left tube, ruptured and full of clot. He clamped and tied the broad ligament, arresting the haemorrhage just as the textbooks suggested it would, and removed the ruptured tube. He worked quickly, knowing that Sarah would be weakened by blood loss.