Lee - The Ladys Guide to Petticoats and Piracy

I have just taken an overly large bite of iced bun when Callum slices his finger off.

We are in the middle of our usual nightly routine, after the bakery is shut and the lamps along the Cowgate are lit, their syrupy glow creating halos against the twilight. I wash the days dishes and Callum dries. Since I am always finished first, I get to dip into whatever baked goods are left over from the day while I wait for him to count the till. Still on the counter are the three iced buns I have been eyeing all day, the sort Callum piles with sticky, translucent frosting to make up for all the years his father, who had the shop before him, skimped on it. Their domes are beginning to collapse from a long day unpurchased, the cherries that top them slipping down the sides. Fortunately, I have never been a girl overbothered with aesthetics. I would have happily tucked in to buns far uglier than these.

Callum is always a bit of a hand wringer who doesnt enjoy eye contact, but hes jumpier than usual tonight. He stepped on a butter mold this morning, cracking it in half, and burned two trays of brioche. He fumbles every dish I pass him and stares up at the ceiling as I prod the conversation along, his already ruddy cheeks going even redder.

I do not particularly mind being the foremost conversationalist out of the pair of us. Even on his chattiest days, I usually am. Or he lets me be. As he finishes drying the cutlery, I am telling him about the time that has elapsed since the last letter I sent to the Royal Infirmary about my admission to their teaching hospital and the private physician who last week responded to my request to sit in on one of his dissections with a three-word missiveno, thank you.

Maybe I need a different approach, I say, pinching the top off an iced bun and bringing it up to my lips, though I know full well its too large for a single bite.

Callum looks up from the knife hes wiping and cries, Wait, dont eat that! with such vehemence that I startle, and he startles, and the knife pops through the towel and straight through the tip of his finger. Theres a small plop as the severed tip lands in the dishwater.

The blood starts at once, dripping from his hand and into the soapy water, where it blossoms through the suds like poppies bursting from their buds. All the color leaves his face as he stares down at his hand, then says, Oh dear.

It is, I must confess, the most excited I have ever been in Callums presence. I cant remember the last time I was so excited. Here I am with an actual medical emergency and no male physicians to push me out of the way to handle it. With a chunk of his finger missing, Callum is the most interesting he has ever been to me.

I leaf through the mental compendium of medical knowledge I have compiled over years of study, and I land, as I almost always do, on Dr. Alexander Platts Treaties on Human Blood and Its Movement through the Body. In it, he writes that hands are complex instruments: each contains twenty-seven bones, four tendons, three main nerves, two arteries, two major muscle groups, and a complex network of veins that I am still trying to memorize, all wrapped up in tissue and skin and capped with fingernails. There are sensory components and motor functionsaffecting everything from the ability to take a pinch of salt to bending at the elbowthat begin in the hand and run all the way into the arm, any of which can be mucked up by a misplaced knife.

Callum is staring wide-eyed at his finger, still as a rabbit dazed by the snap of a snare and making no attempt to staunch the blood. I snatch the towel from his hand and swaddle the tip of his finger in it, for the priority when dealing with a wound spouting excessive blood is to remind that blood that it will do far more good inside the body than out. It soaks through the cloth almost immediately, leaving my palms red and sticky.

My hands are steady, I notice with a blush of pride, even after the good jolt my heart was given when the actual severing occurred. I have read the books. I have studied anatomical drawings. I once cut open my own foot in a horribly misguided attempt to understand what the blue veins I can see through my skin look like up close. And though comparing books about medicine to the actual practice is like comparing a garden puddle to the ocean, I am as prepared for this as I could possibly be.

This is not how I envisioned attending to my first true medical patient in Edinburghin the backroom of the tiny bakeshop Ive been toiling in to keep myself afloat between failed petition after failed petition to the university and a whole slew of private surgeons, begging for permission to study. But after the year Ive had, Ill take whatever opportunities to put my knowledge into practice that are presented. Gift horses and mouths and all that.

Here, sit down. I guide Callum to the stool behind the counter, where I take coins from his customers, for I can make change faster than Mr. Brown, the second clerk. Hand over your head, I say, for if nothing else, gravity will work in favor of keeping his blood inside his body. He obeys. I then fish the wayward fingertip from the washbasin, coming up with several chunks of slimy dough before I finally find it.

I return to Callum, who still has both hands over his head so that it looks as though hes surrendering. Hes pale as flour, or perhaps that is actually flour dusting his cheeks. Hes not a clean sort. Is it bad? he croaks.

Well, its not good, but it certainly could have been worse. Here, let me have a look. He starts to unwrap the towel, and I qualify, No, lower your arms. I cant look at it all the way up there.

The bleeding has not stopped, but it has slowed enough that I can remove the towel long enough for a look. The finger is less severed than I expected. While he sliced off a good piece of his fingerprint and a wicked crescent of the nail, the bone is untouched. If one must lose a part of ones finger, this is the best that can be hoped for.

I pull the skin on either side of the wound up over it. I have a sewing kit in my bag, as I have three times lost the button from my cloak this winter and grew tired of walking around with the ghastly wind of the Nor Loch flapping its tails. All it takes is three stitchesin a style I learned not from A General System of Surgery but rather from a hideous pillow cover my mother pestered me into embroidering a daft-looking dog uponto hold the flap in place. A few drops of blood still ooze up between the stitches, and I frown down at them. Had they truly been upon a pillowcase, I would have ripped them out and tried again.

But considering how little practice Ive had with sealing an amputationparticularly one so small and delicateand how much it slowed the bleeding, I allow myself a moment of pride before I move on to the second priority of Dr. Platts treaty on wounds of the flesh: holding infection at bay.

Stay here, I say, as though he has any inclination to move. Ill be right back.