A Deadly Fortune Page 4

  The boat bumped to a stop against the pylons, and the ferryman appeared beside him and tossed a loop of rope over the one nearest the boat.

  “This’ll be your stop.” He gestured to Andrew’s medical bag and the large carton of books beside it. “I’m sorry I can’t help with those,” he said, not sounding sorry at all. “But I’ve a schedule to keep.”

  Andrew cast one last discouraged look past the dock, then bent to lift his things over the side. “I’m not sure where to go.”

  “The Octagon. Straight up the path there and to the left.” The man pointed. “If you hit the lighthouse, you’ve gone too far.”

  Minutes later, Andrew was alone on the dock, the chuff of the ferry fading as it steamed back across the river. He sighed, then hoisted the box onto one shoulder and, taking his medical bag in his free hand, stepped onto the island.

  The walk was not a long one, but the wind off the river was freezing. Andrew’s ears and fingers were stinging with cold by the time he spotted his destination ahead. The building was rough-quarried gray stone, darkened by the rainy weather. Two straight wings spread out at right angles from the central building the ferryman had called the Octagon. It was indeed angled, with a high-domed roof. A wide paved walk and double staircase led to the entrance. Tall windows arranged on top of one another gave the appearance of glass columns. As he reached the doors, they swung open to reveal a stern-faced, balding man with a pair of spectacles perched atop a hawklike nose.

  “You must be Dr. Cavanaugh.”

  “Yes.” Clumsy with the cold, Andrew attempted to maneuver the box so he might offer his hand.

  “I’m Simon Harcourt, asylum superintendent and head physician. Welcome.” Harcourt motioned to a passing orderly with an acne-scarred face. “Russo, take Dr. Cavanaugh’s things up to Dr. Blounton’s—” He cut himself off. “To the small office on the third floor,” he finished. Harcourt turned back to Andrew. “I’m sorry there was no one there to meet you with the wagon. We’re dreadfully shorthanded.”

  Andrew’s first sight of the inside of the Octagon brought him to a standstill, his mouth dropping open with surprise. Harcourt paused, apparently accustomed to the reaction.

  “Unexpected, isn’t it?”

  “Very,” Andrew replied. Unexpected was hardly the word. It felt inappropriate to call such a place exquisite, but it was the only word that came to mind. The ceiling rose above him all the way to the top of the dome. Wide, gleaming staircases spiraled through the rotunda to open balconies on each floor. Ferns stood on small tables against the walls, and a burnished wood door along the wall to his right stood open to reveal a comfortably appointed parlor. Other doors, most of them closed, lined the gently curved walls. After a moment, Andrew collected himself and turned back to his host.

  “My apologies.”

  “It’s a common enough reaction.” A smile softened Harcourt’s harsh features. “Come, I’ll point out the essentials on the way to your office. It’s a bit small, I’m afraid. Once you’ve settled in, we can have a more detailed tour. I’ve also arranged a luncheon, where you can meet the other doctors. They’re the ones you’ll be working with the most. I see some patients, but I am much preoccupied with administration. Come.”

  Harcourt narrated as they walked. “Here on the first floor, there are parlors and receiving rooms for visitors and official guests, as well as the staff dining rooms. There are entrances to the patient wings on each floor.”

  He opened a polished wood door to reveal a short vestibule with another door at the other end. In contrast, that one was heavy steel, with a barred, square viewing port and a formidable-looking lock.

  “We have over twelve hundred patients, all women, of course,” Harcourt went on. “The men were moved to a facility on Wards Island several years ago. We have a staff of sixty-five—mostly orderlies and nurses. There are three resident doctors, in addition to myself.”

  “So few? That seems inadequate for the need.”

  “Oh, it is,” Harcourt replied. “It’s far too great a load for the staff we have. We leave most of the routine care to the nurses, and even they’re stretched thin. The asylum was never intended for so many patients. There are only four physicians’ apartments—hence my inability to offer you living quarters along with the job.” They started up the stairs.

  “Technically, we’re not even budgeted for a fifth physician. I’ve scraped together the salary out of discretionary funds. You’re fortunate to have some independent means.” He glanced at the fine wool of Andrew’s suit.

  “Yes,” Andrew said, uncomfortably reminded of the falsehood he’d told during his interview. In fact, thanks to his recent estrangement from his family, he had nothing but his own savings to supplement the admittedly tiny salary. But Harcourt had seemed somewhat suspicious of his willingness to accept such a paltry figure, and Andrew had been desperate to get the job, so he’d tossed off a line about income from a family trust.

  Andrew changed the subject. “What about my predecessor? Where did he go after his time here?”

  Harcourt blanched. “Unfortunately, the position became vacant due to the death of the previous occupant.”

  “Oh dear. I’m sorry to hear that.”

  “Thank you—it was a shock and terribly sad.”

  Harcourt continued as they passed the second floor. “We have a central administrative office here. There is also a small medical library and private doctors’ parlor, both of which you are, obviously, welcome to use. Resident physicians’ apartments are here on the third level—as is the office we have set aside for you. I hope it will be adequate.”

  As he finished, Harcourt opened a door down the hall from the stairs and stepped inside. Andrew followed. His bag and carton of books sat on a battered desk beside the narrow window.

  “I had it cleared out for you,” Harcourt said, tugging at one of the drawers. It opened halfway, then stuck. He shoved it closed with a screech. Both men winced at the sound.

  “I can see about finding you a different desk, if you like.”

  “I’m sure this one will be fine,” Andrew assured him. Behind it sat a wheeled wooden office chair. A second chair and a long table were the only other furnishings.

  There was another door opposite the desk. It led to a narrow room with shelves and wooden cabinets lining the wall. Stacks of files covered every surface, and a folding cot sat in the corner. Andrew looked back at Harcourt, a question on his face.

  “Records storage,” Harcourt explained. “The patient wings are so crowded we’ve had to find space wherever we can. Current patients’ files are in the treatment wings, but the older records are more scattered.”

  “And that?” Andrew gestured to the far end of the room, where a metal ladder, bolted to the wall, terminated beneath a hatch in the ceiling.

  Harcourt leaned around him. “Ah, yes. An access hatch for the roof. There are several on this floor. The dome is impressive, but it requires an impractical level of maintenance.” He checked his watch. “I believe lunch will be waiting, if you are ready?”

  The meal was served in a pleasant dining room on the first floor. Two other men were already seated at the long table when Andrew and Harcourt arrived. The elder of the two, a wizened man with ink-stained cuffs, paid them no mind, his attention fixed on the notebook before him as he scratched away with a pen. The other, perhaps in his forties, with a stocky build and gingery side whiskers, stood as they entered.

  “Dr. Tyree,” Harcourt said. “Please, sit. This is Dr. Andrew Cavanaugh.”

  Andrew leaned across the table to shake the man’s hand.

  “Welcome,” Tyree said as he retook his seat. “William Tyree.” He indicated the man seated to his left. “This is Dr. Donald Lawrence.” Tyree tapped him on the shoulder. “Lawrence, would you join us for a moment, please? The new doctor is here.”

  Lawrence looked up with an absent expression, his fine white hair floating around his head like dandelion fluff. “Hmm?” He focused on Andrew, t
hen started. “Oh, yes, pardon me. Welcome. Dr. Donald Lawrence.” He shook Andrew’s hand, then seemed to forget him, turning back to his notes.

  “You’ll have to pardon Lawrence,” Tyree said with a sigh. “He lives on a different plane than we mortals. You watch, if we don’t stay after him, he’ll forget to eat. Myself, though, I’m hungry. Where’s Klafft?”

  “Right here,” said a new voice. A spare, nattily dressed man with smooth silver hair stood in the doorway, an edge of irritation in his patrician features. He entered and took the seat to Andrew’s left. “Dr. Roger Klafft.” He shook Andrew’s hand with starchy formality.

  A silent young man in a threadbare suit had entered behind him. He took up a position against the wall behind Klafft’s chair. No one introduced him.

  “Well,” Harcourt said. “Now that we’re all here, let’s eat.”

  The food was plain but good—roasted chicken, potatoes, peas. There were fresh rolls and butter on the table, along with a wedge of cheese and a dish of preserves.

  Harcourt spoke as they began to fill their plates. “I thought this would be an excellent opportunity for all of you to meet Dr. Cavanaugh and help him prepare for his work.”

  Klafft lowered his fork. “What work is that, precisely, if I may ask? You were an internist in Philadelphia, were you not?”

  “Yes.” Andrew paused to pass a platter to Tyree, who nodded his thanks. “I grew up there. After college in Boston, I returned home for medical school. Once I finished, I was invited to join an established practice.”

  “Why did you leave? I would have thought that a fine prospect for a young physician.”

  “It was. But after my…” Andrew stumbled, then cleared his throat. “Due to some personal circumstances, I became interested in diseases of the mind, specifically as they manifest in women.”

  Personal circumstances. What a pallid way of describing the abrupt upending of his entire life. His father had been furious when Andrew announced he was leaving. His mother had sobbed and begged him not to go. Ending his engagement had been far less difficult than it should have been, if he were honest with himself. Cecilia had been angry but far from heartbroken. She’d been more concerned with the embarrassment than with the loss of the relationship itself. Everything is arranged! Have you even stopped to consider how humiliating this will be for me?

  She’d rebounded quickly. It hadn’t taken long before all of Philadelphia society knew she’d thrown him over for unspecified but clearly just reasons. Between that and his obvious schism with his family, by the time he left, most of his acquaintance had started pretending not to see him in public.

  He didn’t care. He’d wanted out. Out of the engagement, out of the city, out of the constricted little life he’d been so busily building for himself. He’d begun making plans to leave even before the funeral—had been willing to go anywhere to get away. He’d even considered going abroad.

  “I saw the advertisement for the position here,” Andrew explained. “It seemed the perfect way to gain experience with the kinds of cases I wished to study.”

  “And what are those, precisely?” Klafft asked.

  “All mental disorders are fascinating, but my particular focus is the phenomenon of dementia praecox. I hope to produce the first American monograph on the topic. There are some recent clinical reports out of Prague, but—”

  “Oh!” Lawrence looked up from his writing. “Have you read Pick’s work? I’ve been quite interested, but my German is dreadful. I was unable to get the details of the cases he reported. You must tell me all about them.” He turned to a new page in his notebook, pen poised, and looked up at Andrew, intent. “I understand he views it as a form of hebephrenia. How does his classification differ—”

  “Please, Lawrence, not now,” Tyree interjected. He reached for another roll and looked at Andrew. “He’ll have you reciting the entire contents of those reports if you let him. He’ll fill a notebook, the rest of us won’t get another word in, and you’ll not get another bite of your lunch.”

  “But his theories are fascinating,” the older man protested. “Why, an identification and classification of various forms of dementia praecox would revolutionize our understanding—”

  “What rubbish,” Klafft snorted and set down his fork.

  Andrew looked at him, surprised. “How so? I found the concept quite logical. Categorizing symptoms may help us understand the causes of various forms of insanity and might even help us learn how to treat them more effectively.”

  Klafft made a derisive noise. “Far better to classify them by the source of their problems.”

  “What do you mean?”

  “Inebriates, hysterics, syphilitics, and malingerers,” Klafft replied, counting them off on his fingers. “Nearly every patient here is one of those. Oh, there are some cases of congenital insanity, I’ll grant you, but most of the insane are victims of nothing but their own bad choices and innate low instincts. As for treatment—”

  “Roger has a somewhat more, let us say, old-fashioned approach to psychiatry, as you may perceive,” Tyree interjected.

  “Must I remind you, yet again—”

  Tyree sighed. “Yes, I know. I do beg your pardon, Dr. Klafft.”

  Andrew looked between them.

  “I prefer a certain degree of formality,” Klafft explained stiffly. “I do not think it appropriate to be overly familiar with one’s colleagues.”

  There was a moment of silence after this pronouncement. Harcourt cleared his throat. “Dr. Tyree, I wonder if you might be willing to let Dr. Cavanaugh accompany you this afternoon? I have a mountain of paperwork waiting, and there’s still so much of the facility he hasn’t seen. I’d rather not leave him to wander without a guide on his first day.”

  “Of course. I’d be delighted.”

  After a dessert of apple tart with cream, Andrew followed Tyree up to the second floor. A gangly young man in his twenties sat behind a desk inside the doorway. He brightened as he saw them and stood, nodding to Tyree, then turned to Andrew.

  “You must be Dr. Cavanaugh. Herbert Winslow,” he said, extending his hand.

  “Winslow is our head clerk,” Tyree said. “He’s really the one who keeps the place running. You should have seen what a shambles it was before he got here. You’ll probably find him a great help to your research—he’s a genius at tracking down misplaced paperwork and such.”

  The young man waved away the praise as he settled back into his chair. “It only seems that way because you always misplace your paperwork in the same places, and I just happen to know where they are.” He turned to Andrew. “I am, however, at your service, should you need anything.”

  “Dr. Cavanaugh will be joining me on afternoon rounds,” Tyree said. “Where are we headed?”

  “Wards one and three.” Winslow handed him a sheet of paper. “And the reconciliation was yesterday, so this should be accurate.”

  Before Tyree could respond, a metallic clamor split the air. Andrew started at the sound, and Winslow leapt to his feet with an apologetic grimace. “The telephone,” he explained, hurrying toward an alcove on the wall.

  Tyree looked at Andrew with a sympathetic grin. “Awful racket, isn’t it? We’ve had the thing for over a year, and I’m still not used to that noise. No denying it’s useful—when it’s working properly,” he added, as Winslow’s raised voice carried across the room. “There are days when the connection is dreadful.” Tyree turned his back on the young man’s technological struggles.

  “What is the reconciliation?”

  “Winslow’s Sisyphean attempt to impose order on chaos.” Tyree rummaged in a drawer and came up with a battered clipboard. He attached the page Winslow had given him. “Patients get moved from ward to ward, but the transfers aren’t always reflected on the ward lists. Each patient has a file as well, which is meant to be kept in the ward with her, but you can imagine how frequently those go astray. So once a week, there’s an audit of sorts. A head count and roll call in ea
ch ward. Then the lists get updated and the files moved. Winslow instituted it not long after he arrived. It’s made a world of difference.” He tucked the clipboard beneath his arm.

  “Now, if you’re ready, we can get started. We have wards one and three. The malingerers and the hysterics, as Klafft would have it,” he said, with a sardonic glance at Andrew, who smiled.

  “So the patients are separated by diagnosis?”

  “Oh, nothing so formal. We do our best to keep the violent away from potential victims. We try to identify the patients who can safely be released.” He sighed. “And Klafft is correct that a great many of the residents here are inebriates of one kind or another. Or, yes, former prostitutes. It’s not at all uncommon for women to split their time between the city streets and the asylum. Many of them have nowhere else to go.”

  Andrew followed Tyree out of the office and back toward the staircase.

  “The asylum opened in 1839. It was the first city asylum in the country. Before that, there had been only state and private institutions.” He gestured to Andrew to take the stairs down ahead of him.

  “The ferryman mentioned a lighthouse. Where is that?” Andrew asked.

  “On the northernmost point of the island. Supposedly built by an asylum inmate, although that was before my time. Before any of us, actually, even Lawrence, and god knows he’s been here an age. Twenty years or more, at least. He likely couldn’t tell you exactly himself. Brilliant mind, in his day, but I’m afraid he’s grown increasingly, ah, abstracted, I suppose, is the proper word for it.”

  “And yet he’s still caring for patients?” Andrew asked.

  Tyree caught his meaning. “Yes. He’s not incompetent, merely eccentric. More eccentric,” he corrected himself. “I’d guess he was always a bit of an odd duck. Although, really, we all are, to some extent. One has to be, to work here for very long.”