He briefly met her eyes. Again he swiftly debated, then said, “It’s like this. Ryder has the constitution of an ox and the heart of a lion. With an injury like this, the former is a great help, but the latter . . . might not be such a boon.”
She frowned. “How so?”
“His heart would have been beating hard in the alley—in reaction to being attacked, in anger and in defense, in fighting for his life. And his heart is very strong. That’s why he lost so much blood so quickly.” Sanderson glanced at her and this time held her gaze. “Frankly, if you hadn’t reached him and done what you did—pressed your hands there and kept them there—he would almost certainly have died, have bled out, within minutes.”
She took a moment to absorb that, then let her frown deepen. “But he didn’t die, so—”
“He didn’t die because the pressure from your hands slowed the blood enough for the worst internal cuts to clot.” Sanderson glanced down at Ryder. “That’s good—but until I see what it was that was cut, and whether it requires sewing to stay closed permanently or not, we won’t know if, when he wakes and moves, some bad cut won’t open up again. If I sew him up without checking and some major internal cut opens again, he could very easily bleed to death before he or anyone else realizes what’s happening.”
“Because the bleeding will then be on the inside?”
“Exactly.” Sanderson glanced at the corridor; multiple pairs of footsteps were heading their way. He looked at her again, again caught her eyes. “Washing away the clotted blood enough to see what was cut carries its own dangers—he might start bleeding heavily again. But I can’t risk not checking, and if you’re willing to help me by holding the wound open—I’ll show you how—then I’ll have a better chance of doing the job without starting a fresh round of bleeding.” He glanced at Ryder’s face. “Which, truth be told, he really can’t afford.”
“Of course I’ll help.” Mary added for good measure, “I wasn’t about to leave him to your tender mercies, anyway.”
Sanderson smiled; the expression lifted the weariness from his face, revealing a rakishly handsome man beneath. “Looks like Ryder has at least the two of us on his side.”
As the door opened to admit Mrs. Perkins, Pemberly, and Collier, between them bearing two steaming kettles and an assortment of metal basins, bowls, and a pile of clean cloths, Mary murmured, “If it counts in any way, from all I can see he has everyone in this house on his side.”
Sanderson dipped his head in acknowledgment, then set about organizing his surgery.
Mary had never assisted in any medical procedure before. It was painstaking, back-breaking work. In addition to her, all three of Ryder’s staff remained in the room throughout, holding lamps as required, replenishing hot water, handing Sanderson fresh cloths.
Eventually Sanderson, his bent head blocking Mary’s view of the wound, murmured, “He always had the devil’s own luck.” He briefly shifted to glance up at Mary, then went back to his task. “I’d hardly dared hope, but the only cut I can see is to his liver, and while that’s more than enough to account for all the blood he lost, it will heal and take care of itself—I don’t need to disturb it by trying to stitch it.”
Mary had no idea how to interpret that. “Does that mean he’ll be all right once he wakes?”
“As not one of the major vessels has even been nicked, then . . . yes.” Slowly Sanderson straightened, eyes closing as he eased his back, which had to be aching even more than Mary’s. Opening his eyes, he met her gaze and smiled faintly, albeit tiredly. “Once I sew him back up, the skin and inner layers will eventually seal, and that will be it—at least as far as more bleeding goes. However,” he continued, sobering significantly, “before we get too relieved, let me hasten to add that he still has to survive the shock of losing so much blood.”
Mary narrowed her eyes. “What does that mean? Specifically, what does that mean for someone with the constitution of an ox?”
“It means,” Sanderson said, bending to dab again, “that I sew him up, and then we wait. If he wakes, we can proceed from there with more confidence, but whether he wakes . . . I regret to inform you that that is still in question.”
The relief in the room abruptly faded.
Sanderson finished his inspection, cleansed the wound’s surrounds, then plied his needle. Mary watched, quite literally unable not to.
At last all was done, the wound rebandaged and the covers tucked around Ryder again. While washing his hands, Sanderson gave orders for the fire to be lit and the room to be allowed to warm. “But not to the point of being a hothouse. Just normal, reasonable warmth.” He glanced at the assembled staff. “Do not allow him to overheat. That won’t help.”
“Yes, Doctor,” the three chorused.
Finally, Sanderson returned to the bed. He checked Ryder’s pulse, then looked across the bed at Mary, once again seated in the straight-backed chair on the bed’s other side. “His heartbeat’s still steady, but barely the right side of thready, much too weak. His pulse is unusually slow. I wish I could give us all better hope, but the truth is it’s still touch and go.” He drew a tight breath, then said, “I expect we’ll know by morning, when he wakes.”
Her gaze on Ryder’s face, Mary nodded, understanding that Sanderson meant if he wakes. Without looking up, she said, “I’ll stay. Until he wakes.”
If Ryder was going to die, she couldn’t let him die alone.
Sanderson studied her silently for several moments; she could feel his gaze but didn’t meet it, then from the corner of her eye she saw him incline his head. “I have an accouchement to attend—the boy has already come to call me. I’ll return as soon as I can, but that will most likely be late morning. Regardless, if there’s any change for the worse, send word—I’ll leave my direction with Pemberly.”
She nodded in farewell. Thanking Sanderson wasn’t her place, and more, thanking him would be an insult to the devotion he so clearly felt toward Ryder.
With murmurs to the others, Sanderson left.
His mention of the wider world had reminded Mary that it was still there; John and Peter would be waiting downstairs, and Hudson and the staff in Upper Brook Street would soon start worrying about where they all were. Looking up, she said, “Pemberly—if you would fetch paper, pen, and ink, I should like to write a note for my coachman to take to my home.”
“Of course, miss. Right away.”
Before Pemberly could depart, Collier volunteered, “His lordship’s traveling writing case is in the dressing room next door, miss—if that would do?”