Naught but Butchers

By Diane Morris

Nottingham. 1817. The body-snatcher John Macreadie has been banished to this northern outpost to find fodder for Ben Crouch's resurrection business. Macreadie and his young assistant, Jack Pegg, dip up the town's newly dead at night and ship the bodies north. Edinburgh's surgeons are every bit as ravenous as London's.
The assistant surgeon James Hammond feels like a foreigner in this small, northern hospital, mainly because he hails from London, where he trained under some of England’s most innovative surgeons. As in London, he performs dissections of newly deceased patients whenever possible. Dissections are scorned by several hospital Board members and the families of some patients. For them, dissections are nothing more than butchering the dead, but Hammond is undeterred, for he believes that only by studying anatomy through dissecting will the science of surgery advance.
When Hammond undertakes a daring procedure, his superior, Augustus Killmaster, begins to resent his assistant surgeon's looks, his training, and his confidence. Killmaster and his friend, Walter Ewebank, plot to get rid of the young, southern upstart. After Killmaster nicks himself during a dissection, Hammond briefly becomes notorious. He never imagined that his drive to understand human anatomy through dissection would spark such shocking repercussions.

• Language: English
• Publisher: Diane Morris
• Release date: Jun 28, 2022
• ISBN: 9781941033111

Diane Morris

Diane H. Morris took up historical fiction after a career as a nutritionist. Her first novel, "Rosings Park," was written to appease Jane Austen's character Anne de Bourgh, who pestered the author for twenty years. She next wrote "Cousin Anne," a novella that examines Anne’s youthful relationship with both her cousin Mr. Darcy and the beguiling rogue George Wickham. These novels sparked her interest in body-snatching, surgery, and medicine during Jane Austen’s day and led her to write the Surgeon’s Duty series. When she’s not writing and researching, she enjoys traveling with her husband (before COVID, of course); meeting friends for coffee; reading mysteries, bestsellers, and the occasional Regency romance; and playing her digital piano (quite badly, but with pleasure).

Book preview

Volume 1 — January 1817

Chapter 1

What brought you here?

M’ legs, said James Hammond, squinting at his companion in the candlelight. William Fitchby was broad shouldered and big as a bull, with a face framed by shortish, unruly hair. Hammond could never decide on its color: not quite red, not truly auburn. It depended upon the angle of the light, which observation, he supposed, might apply to much of the natural world.

Fitchby laughed. No, you dolt. I mean: Why did you move to Nottingham?

It was not a question Hammond wished to consider in depth. He took a long draught of warmish ale. M’ landlady tossed me out.

Fitchby poured a thimbleful of dark ale into his guest’s tankard. Why do I find that hard to believe?

As to that, I cannot say. It ’appens to be the truth. Despite being nearly three sheets in the wind, Hammond was struck with a surprising insight: Fitchby was his only friend in town.

You were working at one of the country’s most prestigious hospitals.

St. Thomas’s. I was training there.

You had a small but growing private practice. You had friends. Yet you left London, the only home you’ve ever known, for a northern county you probably couldn’t find on a map.

You wound me, Fitchby, for I daresay I could find it if I had to.

Nottingham, Nottinghamshire. His new home.

The Gold Hart Inn had been his residence for seven weeks—a lifetime since he finished his surgical training and closed his London practice. Soon he would move to permanent lodgings in St. Peter’s Square, where he would at last enjoy the privacy of his own sitting room and bedchamber. His mother’s antique writing table had arrived, along with his surgical books and other household goods. All would be delivered to his rooms on Saturday.

Hope was his guiding light, for there had been days when he thought he must give up this venture or go mad.

Of course, there were wagers on the success of his northern experiment. Most of his colleagues bet that he would decline Dr. Josiah Cubben’s invitation to work as an assistant surgeon at the Nottingham General Hospital. Others wagered that he would leave London but not endure the north’s inhospitable clime for more than three months. Only Hugh Arkwright, the treasurer of St. Thomas’s Hospital, where Hammond had spent a year studying surgery, bet he would remain in Nottingham longer. Arkwright had encouraged him to accept the hospital position and had even penned a brief letter, received a month ago, wishing him well and urging him to apply himself with diligence and goodwill. Hammond felt a surge of admiration and something very like affection for the man.

St. Thomas’s Hospital, he said, dredging up both pleasant and painful memories. It seems worlds away. I studied there for a year under Benjamin Travers—an excellent man and a gifted surgeon. We had long discussions about the anatomy of the eye, which was a source of fascination for both him and Dr. Chandler. He barked a laugh, remembering a conversation. Mr. Travers is writing a book on the eye and its diseases and once asked me whether I thought he should include a discussion of eyebrows.

Fitchby smiled. Did you agree it was important?

I did. I felt compelled to do so, for I could tell he was keen to include it.

What about your friends? Do you write them of your adventures here in the north?

Not often. Keen to turn the conversation, Hammond asked, Are you from these parts?

Aye. I was born and raised on a farm to the west of town. I’ve never traveled farther than Derby.

Hammond studied Fitchby’s face as if reading runes. We are not so different. I had never traveled north of London until I began working at the General. He downed the last of his ale and collected a candle. He stood unsteadily, gathering his wits. I’m for m’ bed. You are good company, Fitchby.

Fitchby watched his guest lurch toward the stairs. A reserved young man. Earnest. Handsome. He’ll stir a few hearts. He grinned while he righted the chairs and prepared for bed.

Hammond climbed the narrow stairs to his room. It was a slow and methodical process requiring his muddled brain to mind his feet. He was uncommonly disguised, having imbibed at least two tankards too many of dark ale while he and Fitchby sat talking in the inn’s tavern. Halfway up the staircase, he laid one hand against the plastered wall to steady himself.

You fool. Tomorrow will be a misery.

A familiar adage came to mind. He mumbled the words while he rested his head against the wall: In time of prosperity, friends ’ll be plenty; in time of trouble, not one in twenty.

He felt the truth of it. He was living through a great misfortune, which explained why he had made no friends at the hospital. ’Tis true! he shouted up the stairway, nearly dousing his candle.

He steadied himself and watched the flame subside. Did he have any friends?

His brain reeled from the alcoholic insult. Yes, his fellow student Gregory Campbell. Good man. But not Doyle. Not Franklin Doyle. Not anymore.

With an old man’s weariness, he continued climbing until he reached the landing.

When he entered his hotel room his eyes skimmed the dark as if Doyle—not a phantom, but the man made flesh—stood smirking, ready to attack.

Hammond’s rational mind knew the shadows held no terrors, but his feral brain feared otherwise. He heard Doyle’s voice: The beast has been tamed.

I am the beast, Hammond reminded himself. I am the mischief-maker, the monster, the one who killed Henrietta.

I killed her!

For several seconds he felt an awful horror. Then reason took hold.

Before the candle guttered out, he stripped off his clothes and pulled a blanket about his shoulders. He lurched to the window, pushed back the heavy drapes, and opened the casement window. The cold night air stank of kitchen waste. The town clock tolled a single bell.

The inn stood quiet as a derelict house. No tread cracked the hall floor. No door slammed. The other guests were all abed, their brains lulled by gentle dreams or roused by reflections on the morrow’s business. In the crisp light of a crescent moon, the yard behind the inn looked barren except for one mongrel dog snuffling the fence posts. The half-starved creature peed against a post, scratched his feet in the dirt with a satisfying snort, and slunk off through the tall grass, his nose worrying the ground.

From off in the distance the sounds of raucous shrieks crossed the rooftops. Patrons of the taverns nearby in Angel Row and Wheeler Gate had at last decided to take themselves home to bed. As their shouts faded into the distance the night settled like a drowsy cat.

Compared with the boisterous bustle of London, which never ceased in its industry and entertainment, the town seemed a rustic village in England’s island empire.

He had told Fitchby the truth: his London life seemed as remote as the moon. He would probably never again discuss anatomy with Benjamin Travers. He might never again enjoy a dinner of pork chops and porter with his friend Gregory Campbell, now working in his father’s Manchester surgical practice. He might never again wrangle with Hugh Arkwright.

It pained him to realize that these comrades might all disappear from his life, much as his servant, Sam Fry, and his dresser, Dick Spink, had done.

Memories of his former London life made him bad-tempered.

Painful scenes of Franklin Doyle and Henrietta Lavelle also bedeviled him. Many men, himself included, had admired the lovely Henrietta, but Doyle had won her heart. The couple had secured Dr. Lavelle’s blessing and intended to speak their vows within weeks of announcing their engagement, until a tragic carriage accident shattered their future. In the aftermath of Henrietta’s death—by my own hands, by my own incompetence and, yes, arrogance (he winced at the awful truth)—Henrietta was lost forever and his friendship with Doyle destroyed. Within weeks of her funeral Doyle had departed for the continent with Dr. Lavelle’s son George.

I killed her!

His pain lay in trying to accept that whenever he tried picturing Henrietta’s honey-colored hair and warm smile, he instead summoned a horrible image of her greenish body lying on Matthew Braidlake’s filthy dissecting table. Maggots feasted on her flesh. They engorged themselves, bent only on fattening their bulbous bodies until they grew wings, becoming frisky, obnoxious flies.

Only he and Campbell knew that resurrection men had raided the Chertsey burial ground. Henrietta had lain in hallowed ground for little more than two days when the fiends snuck into the old cemetery, bashed her coffin, ripped her body from its resting place, and stripped her of clothing. Bound with rope and stashed in a gunny-bag, her corpse had been transported to London and delivered to the dissecting room at St. Bartholomew’s Hospital.

Even now, eight months later, Hammond felt wretched on recalling that night. Visions swirled: her protruding eyes, her bloated body, her frigid breasts, never again alive to inspire a man’s lust or suckle an infant.

A tornado of questions and suppositions roared through his head. Should he have halted the dissection? Why had he not done so? If he had confessed to knowing the subject lying on the autopsy table, Braidlake would have quit the dissection out of respect for a colleague. But was it so simple? Braidlake might have appeared to respect his wishes but proceeded with the dissection later that evening or within the next day or two.

Worse, if he had prevented the awful dissection by persuading Braidlake to relinquish her body into his care, there remained a tortuous problem: What would he do with it? He could not reinter it in the Church of St. Peter’s graveyard in Chertsey where her family lived, for any fresh disturbance of her grave would bring unwanted attention. He might arrange to bury it in London, but the reburied body could be dug up again and sold to any anatomist. Then, too, if he had stopped Braidlake’s dissection and claimed the body himself, word would circulate that someone had discovered a friend’s body on a dissecting table. It was a rare occurrence, but it sometimes happened.

The problem was that whenever a friend’s or family member’s body had been dug up and sold to an anatomist, the news spread through the medical community like a ruthless contagion. He could not risk Henrietta’s father, a well-known London physician, hearing of it.

The events of that night still haunted him. His mind churned with images of Henrietta’s lifeless form, her once rosy skin stained with death’s mottled blush. As he had stared at her frigid face, he became paralyzed with a sudden grief that robbed him of breath. Did he have the stomach to stay for the dissection or should he go? A decision must be made within seconds. On hearing Braidlake’s gleeful surprise at discovering that his subject was pregnant, Hammond had fled. Out on the street, he devoured the night air, his mind numb from shock.

A truth tortured every memory: in the hands of a resurrectionist Henrietta was nothing more than a thing, a commodity to be stolen, a prize pulled from a coffin and sold to the highest bidder. In the hands of an anatomist or a surgeon, she was a creature to be scored, sectioned, and thoroughly butchered.

There is a fact universally admitted by those who dissect the dead: the cadaver is not a person; it is an object. The anatomist gives it a lofty name: subject—an unremarkable word denoting the rotting husk of the dead. He uses the word to preserve his sanity while he debases a once living person with a well-honed knife.

Hammond vowed to carry the secrets of Henrietta’s defilement and pregnancy to his grave. He relied on his friend Campbell to do likewise.

I killed her!

Much had been lost this past year.

A heart shattered by grief and guilt is the least of the punishments I deserve, he thought. He collapsed on the bed, his brain befuddled by ale.

Sunrise would bring a fresh round of bad luck.

Chapter 2

Hammond stood at the foot of a patient’s bed, observing his three colleagues.

Heaven help me if this be my future.

On his left, Mr. Augustus Killmaster, the General Hospital’s senior surgeon and chief apothecary, scowled down at his patient as if he resented the man’s condition. How are you this morning, Mr. Pardoe?

Fair to middling.

John Pardoe was two-and-thirty years of age and had been admitted in December. He arrived at the General with extreme pain in the region of his liver after being struck in the abdomen by a cart’s shaft. He continued to endure general weakness and frequent bouts of vomiting. His urine remained high-colored.

Your abdomen is still quite swollen, said Killmaster. One might almost expect you to deliver a full-grown infant any day.

Dr. Henry Baker, one of the hospital’s honorary physicians, glanced at Killmaster across the bed and felt sheepish at the silly remark. He must be uncomfortable, Baker said, as if stating the obvious might prevent the patient from taking offense.

The other person present was Killmaster’s young dresser, Severus Jubb, an oddly named boy who appeared to be about thirteen years of age. His longish face and lank hair made him look poorly nourished, although his black wool coat was of sufficient quality to indicate that he was not destitute. Hammond had no very good impression of him, for he looked perennially bored and was lackadaisical in his duties. He was as different from Sam Fry and Dick Spink as dirt is from butter.

As the discussion continued Hammond stood mute. He had not asked a single question on this case and hardly more than two or three dozen all told since becoming the assistant surgeon. The reason was simple: he believed himself to be more a servant than a colleague. Indeed, he felt towed along behind his colleagues like a buoy buckled to a boat.

Neither superior sought his opinion.

Everything about this daily ritual differed from what he had been accustomed to at St. Thomas’s Hospital. There, the pupils, dressers, and medical officers were not only encouraged, but expected, to ask questions as they moved through the wards. Differences of opinion were freely expressed, nearly always in polite tones since the alert patient heard every word. The discussions among the eight or ten medical men and their students, all gathered around the patient’s bedside, were sometimes lengthy and fractious but always illuminating. He had worked with some of the most eminent surgeons in England: Blizard, Cooper, Travers, and both Clines, father and son. He had received the best possible training on English soil.

Yet here, in this rural hospital, he wondered whether his having lived in London since birth was a barrier to being accepted as a colleague. Or was it his youth? Might it be both?

He chafed at not being included in the discussion. Should he be more assertive? Would his status change for the worse if he stated his opinion, whether it had been asked for or not? He doubted it. What he most wanted was to make suggestions and spark a discussion, but he feared his effort would not be welcomed.

Killmaster’s gravelly voice intruded. Our shy puppy here might have an opinion on the case. What advice do you give regarding Mr. Pardoe’s treatment?

Hammond nearly uttered a nasty retort at the insult, but a glance at the patient’s face reminded him of his purpose: to relieve pain and restore health. His duty was to the patient. Pardoe deserved a proper response, especially as he looked haggard from constant pain and daily vomiting. The man was emaciated because he could not keep simple foods on his stomach. His eyes had shrunk in his head. His skin stretched taut as a drum across his cheeks. He wore the classical look of a person near death.

In London, Hammond had seen a similar look on patients dying from starvation due to either unrelenting bowel evacuations or a debilitating illness like cancer that robbed the patient of nourishment. In Pardoe’s case, his abdomen had swollen considerably while his strength declined. He was wasting away and in danger of dying from his injury. None of the traditional approaches had worked.

Little will be achieved by continuing the abdominal fomentations and purging clysters, Hammond said, for neither has achieved the desired result. I believe the low diet of beef broth and milk-potage should be maintained, along with the calomel, opium, and blood-letting. These may make Mr. Pardoe comfortable. He smiled to reassure the patient. Since he appears to have dropsy, it would be wise to tap him now.

He wondered whether he was undergoing some type of test, since neither Killmaster nor Baker had suggested it.

Killmaster gave him a sharp look. Tap him. Like a barrel of beer, you mean? He cackled at his little joke. Or does he have drum belly?

Not drum belly, sir. His abdomen is full of fluid, not air.

Hammond was certain of his diagnosis, for earlier that morning, before rounds began, he placed an ear to Pardoe’s belly while giving it a good thump; the action created a fluctuation that could be heard traveling through the man’s bloated belly. He was confident that Killmaster knew this diagnosis was correct.

Do you not think tapping will precipitate a permanent disability? Killmaster asked, the question a gauntlet hurled at Hammond’s feet. This man must work for his living. Would you rob him of a full recovery?

Hammond measured his words. I would choose the course that is expedient and relatively safe, and that might save his life.

Dr. Baker, stroking his beard, said, Is there a precedent for tapping in such a case? He wore a look of weary displeasure.

Yes, sir, there is. I recall seeing an article several years ago—published in 1812 or 1813, I believe—describing a similar case. Tapping was undertaken over a period of several weeks to remove what the surgeon called ‘pure bile.’ The result was a favorable outcome.

He had nearly said complete cure, for that had been the outcome reported in the article. He must not be overly confident this morning.

Killmaster huffed. I daresay you have an encyclopedic memory and can recall every detail of the case with alacrity. Even so, I would remind you that we prefer simple, proven approaches when dealing with our patients rather than those more brazen procedures undertaken by our southern colleagues. We will not risk being accused of experimenting on our patients. He stabbed Pardoe’s belly in various places.

Pardoe winced with each poke.

Dr. Baker eyed the new surgeon and then asked: What was the diagnosis in the case?

A leakage of bile into the abdominal cavity resulting from a rupture of the gall-bladder or liver. The particulars of the published case are remarkably similar to Mr. Pardoe's symptoms.

Hammond wondered: What must Pardoe think, lying abed, helpless and in severe pain, while forced to listen to his medical keepers dispute each other’s judgment?

Regardless, said Killmaster, leaving off his torture, I cannot support such an undertaking. We shall continue with the opium and low diet. The abdominal blister should remain for another day or two. It may yet relieve his pain and diminish the collected fluid.

Hammond yielded to instinct. Sir, Mr. Pardoe is extremely jaundiced. His stools are white, and the pain and swelling in his abdomen are severe. His condition suggests a leakage of fluid into the abdomen that requires immediate treatment.

There was a danger in being so forthright. If he convinced his colleagues to tap the patient’s abdomen and Pardoe died, then his reputation might never recover. But if they did not intervene, the man would surely die within a few days because he was starved of nourishment. Pardoe could not live much longer if the leakage continued.

You are prepared to undertake tapping in a case where the patient’s symptoms are not typical of dropsy? Killmaster looked prepared to battle. The accepted treatment for dropsy involves extracting any excess fluid by applying a blister to the skin or prompting vomiting. Both approaches have been tried here with no effect. This is not a typical case that requires tapping.

The medical men knew the case was peculiar. It was not a case of dropsy of the belly arising from a tumor; nor was it a case of dropsy of the flesh brought on by gout or heavy drinking."

The discussion stalled. The entire ward held its breath, as if expecting blows.

Dr. Baker intervened. Let us retreat to the hall to discuss our approach. He could not ignore his duty, despite the threat to his equanimity. Hospital rules required a physician’s approval before a surgeon could undertake an amputation or other capital operation. Puncturing the abdomen to remove fluid in a case resembling dropsy was not a capital operation, in his opinion, but he should be careful in reaching a decision in this case, should there be trouble later.

Out of the patient’s hearing, Hammond described the case he had read. The procedure was minimally invasive, although several extractions had been required over a period of three or four weeks to relieve the swelling. I believe the more fluid we extract, the more comfortable Mr. Pardoe will be. If his case follows the published one, he will recover. Perhaps we might explain what we propose to Mr. Pardoe and leave him to sleep on it. If he is prepared to risk the procedure, then so should we be.

Hammond stood firm under his colleagues’ scrutiny.

Here was precisely the situation Dr. Baker most dreaded. Unbeknown to Killmaster, he had supported the hiring of an assistant surgeon. His friend could not long continue to perform surgical procedures safely, a situation recognized by all who worked with him. Hammond or some other worthy surgeon must succeed, such that when Killmaster retired the assistant surgeon was prepared to assume the senior surgeon’s duties.

Baker felt squeezed by pincers. It was disturbing to suspect that Killmaster ignored Hammond’s opinions and perhaps refused his expertise. Most board members would be displeased to learn of the assistant surgeon’s situation if this were true. On the other hand, Killmaster deserved his support as a friend. In a conciliatory tone, he said, Given the procedure’s simplicity, I believe it should be tried. Tapping is a minor intervention, and the case has every appearance of dropsy.

Very well, said Killmaster, miffed to have his decision overturned. We shall ask Mr. Pardoe whether he is prepared to put his life in danger on the basis of a case study published several years ago in some new and obscure medical journal.

Killmaster followed through on his threat, for a more muddled presentation could not be imagined, to Hammond’s way of thinking. Worse, Killmaster’s demeanor displayed his doubt of the procedure’s success.

Pardoe listened while Killmaster cobbled a description of a procedure he had seldom undertaken himself.

Are you willing to submit to our plan?

Pardoe ignored Killmaster’s question and shifted his gaze to Hammond. Sir, how would you rate the likelihood of the operation succeeding?

Very good, I believe.

Pardoe addressed Killmaster: You may proceed.

Let us do so now. Killmaster called for the porter to move Pardoe to the operating theatre, an odd room that also served as a chapel for anxious patients and their families. Jubb, fetch my instrument case.

Baker said, I should like to observe.

You are most welcome to attend. Come. We shall invite everybody and his brother. Killmaster turned on his heels and strode from the room. Hammond and Baker, trading quick glances, scurried behind.

When the ward door closed behind them, Killmaster marched down the hall with surprising speed, as if filled with a new-found purpose. He led his colleagues down a flight of stairs and entered the apothecary’s domain, where Thomas Quaint, the hospital’s assistant apothecary, stood browsing his day-book.

Quaint startled at his superior’s order: I need a large bowl. Mr. Hammond wishes to experiment on one of our patients.

Quaint shoved the day-book into a cabinet and gave his colleagues an odd look. Realizing the request was not made in jest, he did as ordered.

You truly intend to conduct an experiment? asked Quaint.

Yes, replied Killmaster, bustling out of the room, a bowl tucked under one arm.

Remaining behind, Hammond said: I need a small container of vinegar—a jar will do—and several dressings of different sizes. Also, a long bandage.

Supplies in hand, Hammond fetched his own instrument case and joined his colleagues in the hospital’s odd operating theatre. Pardoe looked pale and a little wary.

Position him sitting up, Killmaster ordered Jubb. Meanwhile he opened his instrument case and retrieved his trocar. Designed for the purpose of drawing fluid from a cavity, the instrument consisted of a metal shaft with a handle on one end and a sharp-edged point on the other. The shaft was designed to slide through an outer sleeve called a cannula.

When all was ready, Killmaster poked Mr. Pardoe’s abdomen in several places with his finger. He next placed his hand on the skin above the pubic area and prepared to insert the trocar.

Hammond cried, Sir!

Killmaster looked up, annoyed.

I believe you would have more success if you tapped the abdomen closer to the umbilicus.

Do you? You believe me ignorant? I have been tapping patients since you were in leading strings. Killmaster did not flinch at the lie.

Hammond dared not repeat the words that flashed through his mind: Yes, you are ignorant, and your methods are both outdated and life threatening.

His silence seemed to shimmer in the air. Nobody moved. He must say something! Would you allow me to perform the procedure? I should like to practice my surgical skills. It would have been more honest to remind Killmaster that since his arrival at the General he had not yet been allowed to use them.

Jubb found humor in the scene, silently betting that his master would not relent.

Very well. Show us your London talents. Killmaster held out his trocar.

Thank you, but I prefer to use my own. Hammond retrieved his trocar, laid it on a linen dressing, and exchanged places with his superior. He first took up the long bandage and wrapped it once around Pardoe’s lower abdomen below the navel. He gave one end to Jubb and the other to the porter, asking them not to pull on it yet, and adjusted the bowl positioned between the patient’s legs. He dipped a small dressing in the vinegar and used it to wipe the skin around the umbilicus and remove any dirt. He then picked up his trocar.

He paused. To someone not acquainted with his style, he must seem reluctant to proceed. In truth, he hesitated because he liked to gauge the heft of the instrument, especially this particular trocar, for it was new. It should feel balanced. It must feel as one with his hand. The trocar was sharp, of that he was certain, for he was forever whetting, cleaning, and oiling his tools. Also, he liked to take a moment to focus his eye on the best place in which to apply the instrument. For surgeons, the eye always guided the hand. He smothered any thought of Henrietta’s grievous outcome, ignored the dull headache derived from late-night drinking, and concentrated on the present procedure.

Has your courage deserted you? quipped Killmaster.

Hammond ignored the comment.

He gave Pardoe a reassuring look, positioned the trocar roughly an inch below the navel, and pushed it into the flesh at an angle until it met no resistance. Disregarding Pardoe’s hiss, he carefully withdrew the stylet. For several seconds nothing happened, but then fluid flowed freely into the bowl.

"Pull gently on