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an irregular heartbeat—which in turn makes diagnosis and treatment of such dangerous conditions faster. When an illness affects the lungs, without swift intervention a patient can quickly develop pleurisy or pneumonia. That stethoscope you are holding has saved a few lives here in Retford in the two years I have been using it.’ In fact, it was Joe’s most essential piece of equipment aside from his spectacles. Without those, he couldn’t read a damn thing or see anything close up. ‘I have been experimenting with it with expectant mothers. During the first stage of confinement it is also possible to hear the heartbeats of a foetus.’ Was it appropriate to discuss such things with a gently bred young woman? Probably not, yet her eyes lit up and he reminded himself she had read Laennec.

      ‘How can you be sure you are simply not hearing the mother’s heart?’

      ‘Because I can clearly hear both, beating in tandem. The mother’s is louder, as one would expect with an adult, fully grown heart, and the babe’s is softer and beats much more rapidly. I was staggered at how fast it was at first, but it is a wonderful thing to hear.’

      ‘Rapid heartbeats? How fascinating. To hear life at such an early stage of development. Is the instrument easy to use?’

      ‘I’m sure young Tom here won’t mind you listening to his chest. Why don’t you give it a go and see for yourself?’

      There was no hesitation this time. No wariness. Lady Isabella placed the end on the boy’s sternum, ever so slightly left without having to be told the human heart did not sit dead central, and rested her ear against the other end. Within seconds she was smiling again. ‘My goodness! Why, I can hear it as clear as a bell.’ Then she giggled, a delicious, warm sound which did odd things to his own heartbeat and made him feel uncharacteristically vain. Joe found himself unhooking his spectacles from his ears and stuffing them into his pocket and quashed the urge to neaten his unruly hair. ‘I can also hear your tummy gurgling, young man. There are so many noises going on inside your body it is like an orchestra is playing a symphony with your organs.’

      A symphony of organs. What an apt description. ‘Listen again while Tom takes a deep breath. Can you hear any wheezing in his lungs?’

      She bent her head again and listened intently for almost half a minute before standing up. ‘You are right. There is no congestion in his lungs. The only sounds of laboured breathing I hear clearly come from the swelling in his throat.’ Anticipating his next move, she handed him the tongue depressor on the nightstand so he could get a better look inside the boy’s mouth at the source of the trouble, then went to fetch the candle to shine light on the right spot. Just as she had said, the offending tonsils were quite nasty, but he had seen far worse. ‘Will you have to remove his tonsils, Doctor?’

      Little Tom’s eyes widened and Joe winked at him and shook his head. ‘Only if they keep causing problems. In my experience, this is a stage many children go through and grow out of. I am of the belief, if one is born with an organ, then it serves a greater purpose remaining in the body unless it proves to be absolutely necessary to remove it. For the time being, Tom’s tonsils can stay put.’

      The boy yawned and she was all concern again. ‘It’s time for your medicine and then it’s back to sleep for you, I think.’

      ‘Indeed. A good night’s sleep works wonders, young Master Tom. That and more of Lady Isabella’s tonsil-taming tea.’

      She stood and began to limp towards the door to fetch it and Joe remembered she had been injured. ‘I can see to that. You should be at home, resting your ankle. Is your carriage waiting for you or would you like me to send for it?’ He didn’t dare offer to drive her home after the last time.

      ‘No, thank you, Dr Warriner. I shall stay till morning. I have already sent word to my family not to expect me home until then. The carriage is returning for me at six when Mrs Giles arrives.’ A servant chose that exact moment to return with his pot of coffee, which she glared at with blatant disapproval. ‘Coffee at midnight? Is that wise? If anyone needs rest, it is probably you, not I. You have a great many other patients to attend to tomorrow, including Tom, whilst I can sleep all day if I wish to. I believe your bed will do you more good than coffee will tonight. I can hold the fort here—as you have already plainly seen—and if the danger is passed, you might as well get some well-earned rest. A good night’s sleep works wonders, after all.’

      As there was no arguing with his own good advice, he did exactly as she suggested.

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