No Hallowed Ground

By Diane Morris

The year is 1817. Since Augustus Killmaster’s death, James Hammond has grown optimistic about his prospects at the Nottingham General Hospital, but he worries about Walter Ewebank, a prominent board member who grieves for his friend. Since Ewebank unearthed Killmaster’s empty coffin, a maggot has burrowed into his brain and will not let him rest. It feeds his anger; it fuels his discontent and only one action—revenge—will satisfy it. Meanwhile, the youth Jack Pegg continues working with Macreadie to dig up the dead and ship the bodies to Edinburgh. Pegg spends his idle hours watching the foot traffic near St. Peter’s Square. He has come north for a very particular reason and is only waiting for the sign that will change his life. Miss Hannah Freestone has come to realize that she has fallen in love with the handsome James Hammond, but she sees an enormous barrier to her happiness. Can she bury her past and return Hammond's affection or will remain unmarried?

• Language: English
• Publisher: Diane Morris
• Release date: Jul 31, 2022
• ISBN: 9781941033159

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 — April 1817

Chapter 1

With the turning of a calendar page the belief took root that spring had arrived. The pedestrians crowding Nottingham’s sidewalks imagined they felt the sun’s warmth and were not much bothered by the ungovernable weather. They ignored the high clouds dimming the sun’s sparkle and the wind biting their cheeks and instead pitched their smiles at every passing fellow, whether he was an acquaintance or not.

James Hammond, joining the throng, walked the few blocks from his lodgings in St. Peter’s Square to the Nottingham General Hospital and recalled an old proverb: on the first day of April, you may send a fool whither you will. He suspected he was himself a fool this day, for on arriving ahead of the morning rounds his mood remained quite buoyant. Settling in his office—an office he still thought of as belonging to the hospital’s former senior surgeon, Augustus Killmaster, dead now five weeks—he completed the required chores: approving the cook’s order for beef and vegetables, recording donations, reviewing cases.

He was signing his name to a letter when a firm knock was heard. He looked up to see the matron advancing into his office.

Can I help you, ma’am? he asked, taking in her determined air, as if she had a special purpose and nobody would dare thwart her wishes.

Aye, sir. I be a mite irked with Mrs. Gaunt.

Is she ill?

Nay, not in the way yer mean, but she’s become a saucy wench of late, parading ’round like a queen and fergettin’ to air the wards.

"That is a serious oversight," Hammond said.

Keeping the windows open to allow the flow of fresh air was essential to improving the patients’ health, no matter the time of year.

Yesterday, the matron rushed to say, I found her sleeping in an empty bed in the women’s ward. This morning she refused to wash Mr. Ivory’s bedding.

The latter, at least, was understandable, for Ivory’s diarrhea had been nearly impossible to control. Giving the matron a smile, he said: I will interview her myself.

Strangely, he was not discomfited by the matron’s sniff of disapproval.

Although there was much to learn about directing the hospital’s staff and activities, in unexpected moments he realized that he was enjoying himself—a surprising discovery.

When rounds began, he and his dresser, Severus Jubb, moved from bed to bed, changing dressings and cleaning wounds. He applied an astringent to one patient’s tongue to reduce his fever and sent Jubb downstairs to Thomas Quaint’s apothecary laboratory to retrieve a bitter for another’s persistent indigestion. His most challenging patient was a carpenter who had an inflammation in his right eye that was proving difficult to treat. He decided to attach leeches to the man’s temple to make him comfortable and administer eye drops containing opium to relieve pain. After the leeches had their fill, he laid down a cataplasm with a deft hand. Its mashed pulp of roasted apples would help the eye heal.

His final duty was to have a few stern words with Mrs. Gaunt, whose addiction to gin was severe. She did not look in the least mortified on being reprimanded.

After a busy morning, the sunshine invited him outdoors.

I am going for a walk, he told Jubb.

Going fer a walk, sir? Jubb was puzzled by the idea, as if Hammond had announced his resolve to swim the channel. At Wollaton Park?

Wollaton Park was a vast pile of masonry and windows surrounded by sweeps of lawn and stands of grand old trees. It was situated on Nottingham’s west side, not far from the General. The townspeople seldom presumed to trespass on its grounds, as the estate was the seat of Henry Willoughby, 6th Baron Middleton.

Hammond laughed at Jubb’s whimsy. No, I will walk to Mr. Maplebeck’s shop in Long Row to inspect his knives, after which I will examine Mr. Hartley. I won’t be away longer than an hour. While I am gone you will help Quaint.

Maplebeck was a cutler who sold mostly knives, axes, and scissors, along with a small number of surgical instruments. On entering the shop, Hammond studied the saws and gleaming scalpels arranged in a case near the window. Aware of the proprietor’s scrutiny, he introduced himself and asked whether instruments could be shipped from London. Assured it was possible, Hammond ordered an attractor vesica.

Yer are the new senior surgeon at the General, I believe, said Maplebeck.

The interim senior surgeon, yes. Hammond half expected a rude comment. I never thought to find myself occupying a position thrust upon me under such awful circumstances. By all accounts, the hospital ran efficiently under Mr. Killmaster.

He was careful to speak well of his former superior, even though he had not much liked the man. No good would come from expressing his concerns about Killmaster’s bristly character, his erratic dealings with underlings, and his poor organizational skills. Any criticism of Killmaster would only reflect unfavorably on himself.

True. Mr. Killmaster enjoyed an excellent reputation and is much mourned in these parts, said Maplebeck as he settled to writing the order. I am not familiar with this instrument. What is it designed to do?

"I read a description of it in The London Medical and Physical Journal. It’s designed to make the operation of cutting for stone both safer and more precise. This version was developed by Professor Assalini, who was a surgeon to Napoleon during the wars. Several of the professor’s improvements to common instruments are being adopted here in England."

Maplebeck grimaced, not at hearing a lithotomy mentioned—though the cutting operation to remove stones from the bladder was universally dreaded—but on hearing two foreign surnames, one of which belonged to a known monster, a French villain whose penchant for empire building had resulted in the deaths of thousands of British soldiers, including his second son. He did not like hearing the villain’s name spoken anywhere, much less in his shop. Yer have never used the instrument.

Hammond heard a rebuke. True, but I will teach myself how to do so.

Ah, a gambling man, I believe.

Hammond was alert to criticism, especially after Mr. Mackleberry told him that some Nottinghamians believed he had murdered Killmaster in a fit of rage. A more absurd and fantastic notion Hammond could not imagine, but some people would choose to think the worst of him.

"I understand why you might think so, but I am very particular when it comes to treating my patients. I don’t endanger their lives needlessly. In the case of this attractor, I understand its action in principle and believe I can learn to use it with sufficient skill. My first goal, always, is to heal and comfort."

Maplebeck looked unconvinced. Shall I have the instrument delivered to the hospital?

Thank you, yes.

On leaving the shop Hammond chastised himself for offending Maplebeck. Many people cringed to hear Old Boney’s name spoken aloud, especially if a beloved son, brother, husband, or friend had died in the wars. He had not intended to annoy the shopkeeper, but likewise he would not whitewash his opinion.

As he walked toward Hartley’s residence in Beast Market Hill, he tasted the cool April air. Most days he felt like an outsider—the typical Londoner—but he had lived in Nottingham for only five months. It took time to make friends. Hartley might prove to be one of them. He smiled to himself when Hartley’s surgical office and residence came into view.

A knock on Hartley’s apartment door brought a maid, who led him into a comfortable parlor.

Mr. Hammond, said Mrs. Hartley, coming across the room with a wide smile gracing her face. It’s a pleasure to see you this morning. Have you come to examine my husband?

Yes, ma’am, if it’s not an inconvenient time. I also wish to confirm that you are in good health, which I see plain enough.

She laughed. I feel as fit as a fiddle but predict a few vexations before long. You may know that I expect to be confined in May. Her eyes sparkled. Come. Peregrine is working in his study.

She led Hammond down a hall toward the back of the house. I should warn him that he has company. She rapped lightly on the study door. Peregrine, my love, you have a visitor. She gave Hammond a pointed look. I won’t allow you to entertain him too long, for he tires quickly.

Yes, ma’am. I’ll take care.

See that you do. I’ll ask the maid to bring up a pot of tea. With a smile for her husband, she closed the door.

She can sometimes be a tyrant, said Hartley.

I must take your word for it, but even if true, she is a beautiful tyrant. Hammond sat in the chair facing his friend. He searched for nuances. How are you this morning?

Hartley sighed and closed the book lying across his lap. For the past hour, I have been trying to read this discussion on the treatment of inflammation arising from St. Anthony’s fire, but I make little real progress.

Which book is it?

The new one by Copland Hutchison, published last year. Hartley read the title: Some Practical Observations in Surgery: Illustrated by Cases.

Was he a surgeon to the Royal Naval Hospital?

Yes, at Deal. Several of his papers discuss issues related to amputation, which fortunately is not a condition I address very often in my practice. In truth, I have performed only one such procedure on two mangled fingers over the course of my career. Have you performed many?

At St. Thomas’s Hospital, perhaps ten or more, said Hammond, but I always doubted my skill. The best surgeons for amputating are military men. Only think of the number of amputations required during battle, most performed with the roar of cannon fire overhead. I consider myself lucky not to have carried out an amputation since moving here. Hammond thought Hartley looked pale. Are you getting outdoors at all?

I sit in the garden when the weather is agreeable, which is not often these days. What worries me is my lack of stamina. I cannot yet return to my practice and fear my patients will desert me for my more energetic competitors.

It has only been ten days since your attack. Don’t worry about something you cannot control. You are a popular practitioner. Your patients will return to you when you are ready for them. Ah, here is the tea. Allow me to pour.

As he walked back to the hospital, Hammond thought about Hartley’s struggle to recover from being clubbed on the head. On the night of the attack, he had shown numerous symptoms of a severe concussion: ringing in his ears; dilated pupils; giddiness one moment, followed by extreme drowsiness the next. Hammond had dressed a cut above one ear, administered cordials and wine, and applied a blister to his feet. During the next several days, Hartley had remained lethargic, sometimes to the point of stupefaction, but since then his coloring had improved. Everyone hoped for his complete recovery.

The puzzle was why anyone would attack him. Hartley was a kind and decent man who enjoyed his patients’ goodwill and often worked gratis when treating the unfortunates living in Narrow Marsh. Who would attack a respected surgeon?

And what should be made of Hartley’s claim that his attacker called him ‘Hammond’? This intelligence was rather bizarre, for Hammond could think of no one whom he had offended so deeply that the person would resort to violence. That is, no one other than Walter Ewebank, who might still hold him responsible for the death of his friend August Killmaster. But Ewebank was a man of at least sixty years, a Greek scholar, and a respected member of the town’s governing body. He had much to lose if he mugged a fellow citizen.

Still, the assault was troubling, no matter which surgeon had been the intended victim.

He forced himself to quit worrying over his and Hartley’s safety as he entered the men’s ward and took up the self-discipline required of every surgeon.

He and Jubb continued their rounds, first examining two patients: Mr. Vason, who was recovering from surgery to repair a hernia, and the youth of twelve or thirteen who was admitted as an accident patient. The latter had been beaten and suffered from deep bruises on his face, lacerations to one cheek, abrasions, and a fractured bone in his right arm. His limp body had been found on the hospital grounds. Since his admission, he lay abed, unconscious and unnamed.

Hammond felt relief on realizing that he was not Sam Fry. Now that his facial swellings had diminished, Hammond saw that his features were not quite right: his nose was a little too broad and his lips too plump. Sometimes he doubted his memory. Had that truly been Fry at Killmaster’s funeral? There had always been an unspoken pact between them: the youth wished to learn anatomy and surgery; the surgeon promised to teach him. Why had Fry not contacted him?

Being a sensible person, Hammond knew it was foolish to think Fry would search for him. Yet he could not smother thoughts of the boy while he moved through the wards issuing instructions to Jubb and discussing treatment plans with Dr. Baker, the honorary physician on duty.

He had held fast to a dream all these months. He believed Sam Fry did too. With each passing day, his hope of training Fry flickered like a flame starved for air.

Yet the spark did not die.

Chapter 2

The next morning Jubb thought to inquire whether the attractor had been ordered.

Yes, I ordered it yesterday, Hammond replied.

How will yer teach yourself to use an instrument yer have never used before?

I shall find a subject on which to practice. You will assist me in the dissection. Is there a particular body part you wish to study? The heart and lungs? The liver? Muscles? The eye? The brain?—a fascinating organ.

Jubb cringed whenever the topic was mentioned. I am not certain, sir.

All the more reason to join me. The more dissecting you undertake, the clearer will be your path.

Jubb disliked being reminded of how little he knew of anatomy and sent his thanks heavenward that Hammond’s questions about dissecting ceased when they took up their duties in the wards. They moved from bed to bed, with Hammond asking questions and probing tender tissues and calling for this cataplasm or that tonic or a warm bath or leeches. Jubb carried numerous requests to Quaint.

Sir, a chit has arrived, called Jubb as he entered the ward carrying in one hand a myrrh lotion and in the other, a piece of folded stationery, which he waved above his head.

Hammond watched him approach. Some days he despaired of ever teaching his dresser to behave with decorum. Here he came, striding down the length of the ward’s center aisle, grinning like a goose. One would think he had found a twenty-pound bank note hidden behind the gallipots in the apothecary’s laboratory and wished to share his bounty with everybody.

Hammond apologized to his patient, a middle-aged woman with a painful scrofulous ulcer. I shall return shortly, ma’am.

The woman managed a weak smile, as if she had experience dealing with excitable boys.

Join me in the hall, please, Hammond said, taking the chit. He reminded himself that Jubb was only thirteen or fourteen years old, and his tenure under Killmaster had been difficult at best.

I knew yer would want to see it immediately, sir. Jubb appeared pleased with himself.

Thank you. Try to remember that the ward is full of patients who are sick and in pain. We should be careful not to disturb their rest, lest it delay their recovery.

Of course. I had not thought of that.

Just so. Wait while I read the chit. Hammond moved near a tall window where the light was good. He read its few lines and signaled Jubb. Mr. Tate calls me to examine a patient. I shall retrieve my instrument case. Ask Quaint to give you a small jar of vinegar, several large dressings, and half a grain of Turkey opium—not the East-Indian opium, mind you, for its potency is less predictable. I also need a dab of honey. I’ll apply the myrrh lotion now and meet you downstairs in thirty minutes.

Yes, sir! said Jubb, all but saluting as he turned on his heel and hurried again to the apothecary’s sanctuary.

Surgeon and dresser walked to Wheeler Gate, where the chit had directed them to go. Hammond was already familiar with the case’s broad outlines, having been told of it by Thomas Tate, one of the General’s honorary surgeons and a past president of its board.

The patient was one of the mayor’s sons-in-law, a burly man named William Dodd. A maltster by trade, Dodd had long been accustomed to manual work moving casks of beer. About two years ago he discovered a pea-sized swelling on the inside of his right thigh. His family’s doctor advised him to be less energetic at work, which advice Dodd ignored, it being completely impractical. The swelling did not much bother him until this past January, when it began increasing in size and was now grown as big as a pint jar.

Knowing a doctor would be useless, Dodd contacted Peregrine Hartley, whose surgical services had occasionally been needed to treat one of his young sons. Hartley wrote of his regret at being unavailable, for he had not yet returned to practice after receiving a blow to the head in March. He advised Dodd to contact Mr. Hammond.

The mayor’s son-in-law hesitated to call on the General’s new surgeon, for he knew almost nothing about the man, other than hearing his father-in-law speak well of him.

In the end he called for Mr. Tate, who admitted quite honestly that the surgery required was beyond his skills and referred Dodd to Hammond.

And so it happened that on this weekday afternoon, Dodd found himself being introduced to the General Hospital’s interim senior surgeon and his dresser.

Hammond greeted the mayor and Tate, both hovering near Dodd’s bedside, before making a quick study of his patient. May I examine you, Mr. Dodd?

As you wish.

Hammond probed the tumor with his fingers, by which method he determined that it extended from a point about five inches below the crest of the pelvic bone to a point some four inches down the thigh. The swelling felt dense to the touch and appeared to lie quite deep within the thigh muscles. Has it been painful?

Not much, although my leg has taken to swelling in the evening.

Have you experienced changes in your bowel habits or appetite?

None, sir.

Hammond felt a dull pulsation when the tumor was grasped firmly. When pressed, the mass disappeared within the muscle tissue. It appears, Mr. Dodd, that you have an aneurysm that requires surgery. I am prepared to undertake the procedure now if you consent to the operation.

Dodd blanched at the news, not having expected to decide on such short notice. Do I have a choice?

I like to think we have choices in most aspects of our lives, but in this case, I advise you not to delay.

What are the consequences if I choose to forgo surgery?

Your leg will continue to swell. It will also grow cold and heavy because your blood is not flowing properly through it. The skin around the aneurysm will become thin and may turn blue. Eventually, the skin there will crack, allowing blood to seep through and form scabs. At some point you will hemorrhage. I cannot predict when. The first such event is seldom fatal, but a second or third blood loss is invariably deadly.

Dodd barked a nervous laugh. In other words, I have no choice.

Hammond took a few seconds to answer. Surgery is always a gamble, but if I were not confident that this operation would succeed, I would not suggest it.

His words hung in the air, both comforting and coldly forthright.

Very well. Dodd looked at the mayor. Would you agree?

It is a risk, but I believe it must be done. You cannot continue as you are. The mayor did not state his true thought: every aspect of life was a risk. Some gambles succeeded; some did not. His greatest worry was the welfare of his daughter and her children should her husband not survive the procedure.

Hammond began issuing orders. The mayor left to obtain a cordial to steady his son-in-law’s nerves and find two servants to help hold Dodd steady during the operation. Old blankets were also needed. Jubb prepared an electuary by combining a quarter grain of opium with a spot of honey and gave it to Dodd. While Dodd swallowed the electuary and drank the cordial, Hammond wiped the man’s lower abdomen and upper thigh with vinegar. He used this time to consider the operation in greater detail. He must determine the aneurysm’s position and depth and prepare his mind for the expected incisions.

Mrs. Dodd arrived with a tarpaulin and an old quilt, which she tucked underneath her husband’s hip and leg, else the mattress be destroyed by blood. A frown rumpled her forehead and her cheeks had lost their lustre, but a hardy determination could be read in her eyes. She whispered to her husband, kissed his cheek, and gave Hammond a speaking look as she quit the bedchamber.

The mayor wrestled with his nerves.

Hammond suddenly wished he had never met the mayor, had not talked with him about body-snatching and surgical training over tankards of ale, and knew nothing of his congenial character, for he saw terror crouching in the man’s eyes. I believe you will wish to sit with your daughter, sir.

I will remain while you operate and try not to faint.

Hammond nodded his encouragement and directed the mayor, Tate, and the servants to pin Dodd to the bed.

Satisfied that all was ready, he took a deep breath to prepare himself for the screams and pleas that would follow his scalpel’s slice through skin and muscle and surging blood, each nerve alive to pain. This moment was the hardest to conquer in every surgical procedure. There being no point in delaying, he began by making an incision nearly four inches in length beginning at the aneurysm’s margin.

Dodd, now alert to exquisite pain, fought his captors, screaming a stream of expletives of surprising originality. Jubb was forced to grip the leg like a vise. Blood saturated the quilt.

Ignoring his patient’s threats, Hammond next divided and secured several arteries, and then exposed roughly two inches of the tendinous area. Using a pointed bistoury, he expanded the tissue so that the pulsating aneurysm was now discerned. (Dodd moaned but did not faint.) A difficulty was encountered when Hammond tried passing a finger around the artery, but the problem was resolved by pressing the artery down upon the psoas muscle. By keeping his finger upon it, he was able to pass the surgical probe under it and bend the probe upward. Jubb threaded a double ligature through the probe’s eye, after which the instrument was withdrawn and the ligature tied as high as possible.

The observers breathed easier when the aneurysm’s pulsations ceased.

Hammond then tied the lower ligature and pinched the muscles and skin together while he secured the wound with several stitches. Over these he laid down strips of adhesive plaster and passed a roller around the thigh. The limb remained warm to the touch—a healthy sign.

The mayor’s face was white as ashes. Is it done? Will he recover?

It’s done, said Hammond. I believe he will soon stir. Allow him to sleep as much as he wishes this evening and offer some bread and tea later. Before bedtime give him a little opium. Mr. Jubb has prepared a bolus of it.

I’ll check on him tomorrow morning, said Tate, relieved to have the surgery over but knowing that an infection from so daring an intervention was always a danger.

If there is evidence of inflammation tomorrow and you wish assistance, contact me, Hammond said to Tate. I can leave the hospital for a few minutes.

The mayor escorted Hammond downstairs to the foyer. Thank you, he said. I hope you were not offended by William’s rather colorful language.

Hammond grinned. Not at all. He merely said what any one of us would say under the same circumstances.

The mayor laughed. I don’t know how you can remain calm and collected during so bloody a procedure. I could never do it.

In truth, I could never deal with the political scheming and squabbling you are required to deal with every day. It’s good to see you again, sir. Come, Mr. Jubb.

The mayor felt surprisingly hopeful and went to reassure his daughter that the surgery had gone well.

On returning to his son-in-law’s bedchamber, he found Tate staring down at the somnolent patient. I could no more have operated on that aneurysm than I could walk barefoot to China.

I have no means of evaluating his skills. He is good, then?

He is remarkable. I hope Nottingham can hold on to him.

Hammond didn’t think of the operation itself as he and Jubb walked to the hospital. Instead, he questioned Jubb about his understanding of the surgical procedures. It came as no surprise that Jubb had comprehended very little of them.

Chapter 3

William Davis Hursell, 4th Duke of Ashbourne, had been raised to wear his father’s boots. His fastidious, fault-finding pater was imposing in appearance and determined in character. He had been active in parliamentary affairs in the nation’s capital and dabbled in Nottingham’s politics. His heir was expected to do likewise.

Thus, no one had been surprised when the duke won the contest for the leadership of the Nottingham General Hospital’s board. After all, the duke had served as a hospital governor for several years and was familiar with many details related to the running of the General. He was also much admired for his business acumen and generosity. Family. Duty. Faith. Those were the watchwords by which he lived, although not always faithfully. He could not abide fools, no matter their rank, and was sometimes guilty of choosing convenience over constancy, but he daily felt his own consequence.

Standing near the door leading into the hospital’s meeting-room, he smiled and nodded at his fellow members, welcoming them on this, the first meeting of the Board since the election. All of the men were known to him, of course. Here came his comrades, Mr. Tate, the past president, and Dr. Cubben, followed by Dr. Baker (a man whose character was not well known to him) and Mr. Hammond, a young man with ambition. Other members drifted in. The matron captured his attention for several minutes, gushing with pleasure at seeing him occupy a position once held by his dear father. He called on patience to endure her acclaim.

The last to arrive