‘Well?’ asked Simpson as Raven emerged, his eyebrows raised. Sarah had gone behind the screen again and grunts of effort could be heard as the two women attempted to squeeze the patient’s misshapen body back into her clothes.

‘I think this is a case of ovarian dropsy.’

‘I agree,’ the professor replied. ‘How should we proceed?’

‘Abdominal binding, mercurials and diuretics,’ Raven said, confident of his answer and yet despairing of its likely effectiveness.

‘That is certainly what many would advocate,’ said the professor. ‘However, given the degree of distension and her breathlessness, I think we must remove some of the abdominal fluid directly. We will ask her to return tomorrow for tapping.’

Raven felt a familiar thrill at the prospect of performing such a procedure, an excitement tempered only slightly by the inevitable discomfort that the patient would have to endure – to say nothing of the fact that this was likely palliation rather than cure. Yet doing something was so much more appealing than doing nothing. To Raven’s mind, in desperate circumstances, action trumped passivity.

This train of thought prompted the resurgence of an unpleasant memory, a case he had seen while in Paris of a young woman felled in her prime. She had collapsed suddenly, without warning, and an examination revealed evidence of concealed bleeding. There was some debate about the likely diagnosis and possible interventions, whether anything could or should be done. Wise old heads had counselled caution, holding back their younger counterparts. Prevarication had proven fatal and the post-mortem had confirmed what had been suspected: a belly full of blood as a result of a ruptured tubal pregnancy.

In the aftermath there were voices raised in recrimination, a wringing of hands by some, a shrugging of shoulders by others. Vague promises were made about lessons being learned, which was of small comfort to the young man left bereft by the loss of his wife.

Raven was still undecided as to whether it had been prudence or cowardice that had held them back from attempting some form of surgical treatment, although frequently he felt that the scales of his judgment were tipping towards the latter. Surely a heroic failure was better than sitting idly by letting nature take its course. A slim chance of success still represented the possibility of survival.

It was always better to do something rather than nothing.

Always.

EIGHT

arah escorted Mrs Glassford to the waiting room to allow her to catch her breath, though in truth she was as much in need of relief as the patient. The moment she became aware of Raven’s presence in the room, she had felt a tension in the air that reminded her of those rare clammy summer nights just before a thunderstorm broke.