Where the Light Enters

by Sara Donati

Genres: Historical Fiction; Sagas; Victorian Romance

Synopsis

From the international bestselling author of The Gilded Hour comes Sara Donati's enthralling epic about two trailblazing female doctors in nineteenth-century New York

Obstetrician Dr. Sophie Savard returns home to the achingly familiar rhythms of Manhattan in the early spring of 1884 to rebuild her life after the death of her husband. With the help of Dr. Anna Savard, her dearest friend, cousin, and fellow physician she plans to continue her work aiding the disadvantaged women society would rather forget.

As Sophie sets out to construct a new life for herself, Anna's husband, Detective Sergeant Jack Mezzanotte calls on them both to consult on two new cases: the wife of a prominent banker has disappeared into thin air, and the corpse of a young woman is found with baffling wounds that suggest a killer is on the loose. In New York it seems that the advancement of women has brought out the worst in some men. Unable to ignore the plight of New York's less fortunate, these intrepid cousins draw on all resources to protect their patients.

Release date: September 10, 2019

Publisher: Berkley

Print pages: 672

Sample

***This excerpt is from an advance uncorrected copy proof***

Copyright © 2019 Sara Donati

Chapter 1

Later, when people asked about her travels, Sophie would put it simply: the trip to Europe as a bride was hazy in her memory, but she would never forget the voyage home as a widow.

To travel from an alpine village some six thousand feet above sea level to a port on the Mediterranean was not a simple undertaking in winter with so many of the mountain passes closed, but it went without incident: first by sleigh down mountainsides on narrow, winding roads to the river valley, then by rail from Chur to Zürich where she spent the night in the Hotel Widder. On the second morning she traveled by rail to Lucerne, where she took a room at the Schweizerhof Hotel. It was small but elegant, with a comfortable bed in which she found no rest.

When the train left the station early the next day she studied the city, awash in snow flurries, swaddled in low clouds that hid the lake from view and robbed Lucerne of its charms. She could not find any way to feel about the city or the country. She could not feel much at all.

The conductor took her ticket, looked at her papers, and asked about her final destination in a ponderous, old-fashioned English. Finally he inspected Pip with a censorious eye.

“A dog that size won’t be any protection for a lady traveling alone.”

As was quickly becoming her habit, Sophie decided not to engage in the conversation and so the conductor left her in peace, on her own in a first-class compartment that would seat four passengers. It was terribly wasteful, and still she was pleased with the soft leather of the seats, the blankets and linen pillow provided for her comfort, and the solitude. With Pip on her lap she fell asleep and missed the entire journey along narrow mountain valleys and finally through a new rail tunnel that burrowed under the Saint-Gotthard alps, leaving winter behind. She woke in a sunny landscape lush with spring and awash in color.

Soon there was a new, far more talkative conductor who looked at her papers, named three cousins who had immigrated to New York City to see if she might be acquainted with them, and then launched into a lecture on the Swiss canton of Ticino, all in a stumbling but enthusiastic English: this was the River Ticino running alongside the train tracks, there was the mountain Madone, here the village Biasca, and there—he threw out a hand as elegantly as any stage actor—the house built in 1659 where his own mother was born seventy-two years ago.

In time he went away and left her to wonder about the names of the villages and mountains and rivers, about houses of stone that looked as if they might have been standing there a thousand years. Cap would have dragged her off the train to explore this landscape that seemed not a product of nature, but of a painter’s imagination: bright blue lakes bracketed by mountain cliffs rising straight to the sky, palm and cypress trees against stucco painted in the colors of candied almonds: pale green and butter yellow, powder blue and pink. Above it all the glaciers caught up the sunlight to cast it out again.

The conductor came back to tell her that they were about to cross Lake Lugano on a true marvel of modern engineering: a railroad bridge. On the other side was Chiasso and the Italian border.

For the first time in days Sophie realized she was truly hungry. She made her way to the dining car, where a somber waiter put a plate of scraps and a meaty bone down for Pip and brought Sophie one course after another, until she could eat no more. Then she dozed all the way to Genoa. The talkative conductor came once, spirited Pip away to see to his business, and brought him back full of compliments for such a personable, well-behaved animal.

With the help of first the station-master and then a hired carriage, Sophie made her way through Genoa. In the train station she had thought only of a hotel room and privacy, but now the city had her attention.

A busy seaport on the Mediterranean, yes, that was obvious. But the city seemed to be carved out of alabaster, glowing in the sunshine that wrapped itself around bell towers and columns and domed palaces, elaborate fountains and sculptures of saints and warriors. Everywhere she looked was white marble.

The effect was magnified because Genoa was hemmed in by steep hillsides all cloaked in dark cypress and evergreen, interrupted by villas—more white marble—with terraced gardens where brighter colors demanded attention.

After such a long time on a train she was struck most by the air, the stinging smell of the salt sea undercut by the advent of a spring in furious blossom: almond trees, acacia, oleander, magnolias so dense with flowers that the scent hung in the air, almost visible. Petals floated on a gusting breeze: waxy white, deep scarlet, frothing pink, crisp blue. Cap had given her instructions about this trip: Don’t forget to look around yourself. Anticipating her mind-set and what she would need.

There was such an abundance of fruit trees: she recognized apple and pear and lemon, but there were just as many that were foreign to her. Trees with leathery dark green leaves and masses of bright yellow fruit, astounding so early in the spring. Cap would have known the name. She could seek out a gardener to ask, but the very idea exhausted her.

The carriage stopped on a wide, open plaza with a fountain at its center. Out in the fresh air she took a moment to stand in the sun while Pip capered around her, delighted to be free of a moving box.

“Signora.” The driver bowed from the waist. “La Piazza de Ferrari, ecco il Hotel del Mar.”

Three men appeared in the doorway. She thought they must be hotel guests and found instead that this was the hotel director and his two assistants, come to welcome her. Signore Alfonso Doria—as he introduced himself—greeted her in English, very correct and dignified while one of his assistants paid the driver.

“We had a telegram from your colleague, Dr. Zängerle,” Doria said, and bowed again, very low. “Please come, all is prepared for you and your”—he paused to look at Pip, his expression both startled and puzzled—“dog.”

The entire staff of the Hotel del Mar seemed to have nothing better to do than to make sure that she, her luggage, and her odd little dog were settled comfortably in a suite of rooms with windows that looked out over the harbor and the Mediterranean beyond.

As soon as she was alone Sophie collapsed on the bed. Pip hopped up to claim a pillow for himself and she caught him before he could put his very dusty paws on a crisp white linen slip edged with lace. When she had found a shawl and covered the pillow, he settled there with an affronted grumble.

She had wondered if it would be difficult to travel with a dog but soon realized what an asset he was. Pip was irresistible; people stopped in surprise to study this sturdy little dog not quite so big as a loaf of bread with a silky brindled coat and big ears out of proportion to his head, ears that pivoted like sails in the wind, as if they knew nothing of the dog they were attached to. A feathery tail curled over his back, arching from side to side like a metronome when he was curious. As he seemed to always be.

Strangers asked questions about his bloodlines that could not be answered. They laughed at tricks he did without prompting, searched their pockets for things to feed him: a piece of a biscuit, a bit of jerky, a half apple, all of which he accepted with good manners and quiet enthusiasm. He was above all things well behaved; he walked at her left heel no matter how diverting the scenery. An insolently staring cat left him quivering with excitement, but he held his place beside her.

Best of all, Pip drew attention to himself and away from her, a creature just as curious. Sophie Savard Verhoeven was an American, not quite twenty-nine years old, by her clothing and luggage both very well-to-do and in mourning. Her posture and bearing spoke of good breeding and education, but her complexion and features were as confounding as Pip’s outsized ears and tail like a flag.

Sophie felt eyes on her always, people trying to put a name to the color of her skin and eyes, to reconcile the curve of her lower lip and the texture of her hair.

On her first full day in Genoa she got ready to run errands and found that Signore Doria had left word asking her to see him before she set out.

When she was shown into his office he came from around his desk, all smiles and compliments and an offer: he wanted her to have not one, but two escorts for the day.

“A lady traveling alone,” he said. “Who will carry your packages? Who will protect you if the need arises? And our Ligurian dialect is especially difficult when you are negotiating prices. You are at the mercy of unscrupulous shopkeepers without someone to guide you.”

Pip was looking back and forth between them, his tail wagging double time. Clearly he saw nothing odd about this, and so Sophie went out into the city with a lady’s maid and a servant, both gray-haired, both of them in uniform, rigorously groomed and very unwilling to look her in the eye. By the time they had reached the shipping line booking office Pip had done his job: he made them laugh, and in laughing, they relaxed.

She booked passage to New York on the Cassandra and with that act convinced herself that she was, indeed, going home.

But not empty handed. For the next few hours she wandered through narrow twisting lanes—called caruggi, her companions told her, to be avoided after dark—and over piazzas surrounded by cathedrals and palaces. Children splashed in fountains under the watchful eyes of mothers; vendors offered bouquets of flowers, roasted chestnuts, candied orange peel, biscuits flavored with anise. The smells of roasting coffee beans and baking bread made Sophie wish she had spent more time with breakfast.

With the help of her companions she bought gifts to take home with her: a crate of small oranges with thin loose peels, a large block of nougat bristling with pistachio nuts, jars of lemons preserved in olive oil, olives in brine, a round of hard cheese, braids of garlic, marzipan, candied fruit. Bolts of figured silk in jade and marigold and lapis, a tablecloth of weighty double damask with matching napkins. Leather journals with marbled endpapers. A set of carved ivory hair combs. A doll of boiled wool with soft pink cheeks, real human hair in braids around its head, dressed in colorful shawls and skirts. Skeins of silk embroidery thread and a clever roll of purple velvet embroidered with white violets, lined with felt, and populated by sewing and embroidery needles of every size along with a thread scissors with an ivory handle carved to resemble a stork.

She made the last stop of the day at a saddler’s, where Pip was measured for a harness and leash in a strong but soft leather. This did not please him in the least, but neither would he sail overboard in a high wind.

That evening she wrote a letter and telegrams, put the words into writing and rendered them permanent, and wept herself to sleep.

On her last day she read and ate and slept. She repacked her luggage with clothes fresh from the hotel laundry, bathed Pip and then to restore his good mood, took him out and let him chase seagulls on the docks.

When she finally boarded the Cassandra, Sophie was feeling more like herself than she had in months. She was a little sad to leave Genoa before she had seen the inside of a single palace or walked in any gardens, but most of all she was thankful to Signore Doria and his staff, who had made it possible for her to do as she pleased.

And still she woke in the night in a panic, listening for Cap’s labored breathing. In the echoing silence she wept a little more, and waited for sleep to claim her again.

“Promise,” Cap had whispered to her with the last of his breath. “Promise me.”

She had promised, and so she rose and ate without appetite, bathed and dressed without looking in the mirror, and went on, making a life for herself without him.

The seas were rough for much of the time, but that turned out to suit her: she had a strong stomach and poor weather meant she often had the deck to herself. She took her meals in her cabin, went out into the fresh air with Pip three or four times a day, and dozed the rest of the time away with a book on her lap. In a small notebook she wrote questions for Cap and tried to imagine his answers.

What is the world without you in it?

Midmorning, just two days out of New York, a lot of sudden movement on deck made Sophie go out to see what the trouble might be. She found herself in a crowd of curious passengers, all staring at the sight of some thirty people clinging to the side of a dead whale.

But no. It took some seconds to make sense of it: not a whale, but a capsized steamer almost completely submerged. The survivors huddled together in the middle of an expanse of wood that was barely afloat, waves washing over them so that they tilted one way and then another. Sophie was fairly new to sea travel and ships, but even she could see that the Cassandra had happened across this disaster almost too late.

The crew had already hauled four of the survivors aboard, men who looked like they had fought and lost a battle. Clothes in tatters, shoeless, salt-encrusted, terribly sunburned, they reminded her of the poor who lived on the streets in winter: dehydrated, near-starved, and so racked by exposure that sanity was frayed to the point of unraveling. Almost every one of them was injured: seeping head wounds, inflamed eyes, lacerations, a crooked arm immobilized by clothing torn into bloody rags, exhaustion.

Many of the Cassandra’s passengers went to work alongside the crew, as eager to help as they were to hear the whole of the story. As each survivor was hoisted off the wreck he was swaddled like an infant in blankets and hurried off to the main dining hall, the largest room on the ship.

Sophie had started to believe that there were no women or children among the survivors when she saw a young couple being helped aboard. The woman looked close to collapse and her companion was only slightly better off. Sophie followed them into the dining hall and then, turning, snatched at a cabin boy who was rushing by.

“I’m in saloon number three. On the floor next to the writing desk you’ll find a doctor’s bag, quite heavy. Bring it to me as fast as you can, without delay.”

She thought of Pip, who would be whining with worry, and called the cabin boy back.

“You know my dog, Pip?”

“Everybody knows Pip,” the boy said. “He does tricks.”

“Yes, he does. There’s a marrow bone on a covered plate on the dining table, please give him that before you leave.”

To his credit the boy loped off in the right direction without pausing to challenge or debate her request.

Neither of the survivors spoke to her, but they didn’t turn her away, either, and Sophie took that as permission to do what she could for them. Another cabin boy came by with a pitcher of clean drinking water, and she stopped him.

“Glasses?”

He jerked his head toward a side table.

“Bring me two, immediately.”

This time there was hesitation, and Sophie found herself falling into old habits. She straightened to her full height and looked at him as she would have looked at a student who failed to understand the simplest of concepts out of nothing more than laziness. He went to fetch the drinking glasses.

Sophie was more worried about the young woman. The young man was sunburned to the point of blisters erupting on his face, but his companion’s coloring had a different source. She put her hand on the back of the young woman’s head to help her take some water, and almost jerked away in surprise. Her skin was very hot and utterly dry to the touch.

She winced when Sophie spoke to her, turning her face away.

“Ma tête,” she murmured. “Mal à la tête.”

A dreadful combination of symptoms, but Sophie did as she had been trained: she let nothing of her concern show on her face as she turned to offer water to the young man. Now that she could study them up close she saw the resemblance, and decided they were not a couple, but brother and sister.

“More.” He reached for the glass, but she held it away.

“Slowly,” she said. “In a minute you can have another sip. Otherwise you’ll bring it all up and it will do you no good. Can you tell me your names?”

It had grown very warm in the dining hall, but his teeth began to chatter and his voice came rough and broken.

“Charles Belmain.”

“And is this your—?”

“Sister. Catherine.”

“Mademoiselle Belmain?”

“Madame Bellegarde. She is a—” His voice was very hoarse, and he paused to swallow. “A widow.”

“I see. I am Dr. Savard.”

She waited for him to take this in. After a long moment, he blinked and then nodded.

When she had given them each a few more sips of water, the cabin boy came up with her medical bag.

Sophie was aware, in some small part of her mind, that she was waking up. Things she hadn’t thought about in many months came back in a great flood. The contents of her Gladstone bag, and the fact that she could find anything in it blindfolded; the way her mind observed and cataloged symptoms with little conscious thought. When she put her hand on Catherine Bellegarde’s brow, she knew with certainty that if she had the means to measure her fever it would be at least 103 degrees.

It was as if she had put down her profession at some point since leaving home, and now picked it up as easily as a scarf once believed to be lost but then found, when all hope was lost, in the very drawer where it was meant to be.

The stethoscope told her what she anticipated: both of these young people were in poor condition, but the girl was far worse off. In addition to her headache, her heart was racing, her respiration was very fast and shallow, and she was drifting in and out of consciousness. She moaned and tried to turn, as if that would be enough to escape the pain.

Sophie palpated the lymph nodes under the jaw and folded the blanket away to examine her abdomen. It was then she realized that the girl—she could be no more than eighteen—was far gone with child.

Gently Sophie traced the taut line of her belly, cupped the curve of a skull, the bulge of a knee that suddenly flexed and withdrew, like a fish darting away to safer, deeper waters. The baby was alive, and no more than a month from term. She saw no evidence of contractions, but that might change at any moment; the terrible shock and stress of the shipwreck would be more than enough to send anyone into premature labor.

To Charles Belmain she said, “Has she been sick to her stomach?”

The question confused him, and Sophie repeated it in French.

“Yes,” he said. “Most of us were, the last three days. But we had so little to eat. At sunrise we got a handful of rice and a single swallow of water and nothing more.”

“Has she been disoriented, speaking of odd things?”

His expression cleared. “Yes. She’s been calling me by her husband’s name.” Something odd in his expression, but this was not the time to pursue family politics.

“Complaints of pain?”

“Since earlier today, that too. A terrible headache, she says she can hardly stand it. She had some protection from the sun—a tray I held over her head—but still, the heat was too much.”

All the symptoms of heatstroke, a disastrous diagnosis in the current situation. Sophie stood up and looked over the room until she found the captain, who was talking to the ship’s physician.

To Charles Belmain she said, “Keep giving her sips of water, and take sips yourself. But just sips. I’ll be right back.”

On her way across the dining hall Sophie scanned the survivors where they lay, attended by crew members and a few intrepid passengers. They were all male and none seemed to be suffering from heatstroke. She was glad of it, because the one thing she must have would be in short supply.

The captain turned toward her as she approached, a deep crease furrowing his brow.

“Mrs. Verhoeven,” he said, his tone quite short. “You needn’t concern yourself—”

He was trying to dismiss her, but Sophie had a lot of experience with people who thought she could be shooed away.

“You have no reason to know this,” she interrupted him. “But I am a fully trained and qualified physician, registered at the New York City Board of Health. Professionally I use my maiden name, Dr. Savard.” Briefly she asked herself when she had made this decision, and decided it didn’t matter; it felt right.

“Captain, you have one female survivor”—she glanced over her shoulder toward the corner where Charles Belmain and his sister sat propped against the wall—“and she is in the last weeks of her pregnancy. She also has heatstroke, which may be fatal. How much ice do you have on board?”

Fifteen minutes later she was back in her cabin cutting the disoriented young woman out of her ragged clothes and then moving her into the hip bath lined with a sheet she took from her own bed. She spread a second sheet over the girl’s swollen form and as she was tucking a rolled towel beneath her neck, there was a knock at the door.

She called to Mr. Belmain, who sat in the next room of the cabin suite drinking a bowl of broth. “That will be the ice. It needs to be chopped into pieces. Would you, please?”

It was a lot to ask of him, but she knew that some kind of activity would help him maintain his calm through what was to come.

Sophie was in constant motion for the next hour. Using a syringe without a needle she dribbled cool water into Catherine Bellegarde’s mouth and massaged her throat when she was slow to swallow, pausing only to scoop more ice into the bath, to wipe the girl’s face, to take her pulse and check her pupils. As if she understood that Sophie needed some encouragement, Catherine Bellegarde finally raised a hand to touch Sophie’s damp wrist.

“Madame Bellegarde,” she said in a calm, even voice. “Catherine. I am Sophie Savard, a physician. The survivors of the Cairo have been rescued, and now you’re on board the Cassandra. You are safe. Your brother is safe.” She repeated herself in French, and got in reply only a grimace. The girl touched her own head.

“You have a headache, I know. I have medicine for you. But you are very dehydrated and you must keep taking water while I get the medicine ready. Here’s a clean cloth for you to suck on, can you do that?”

“My baby?”

“You feel it kicking, yes?”

Catherine Bellegarde smiled with lips that were puffy and cracked. Sophie smiled too.

Pip, who was clearly worried, settled himself on the bed where he could watch the patient, as vigilant as the best of nurses.

By noon the next day Sophie was beginning to believe that Catherine Bellegarde might revive and recover. Her temperature was close to normal, and her heartbeat had steadied. She had taken a pint of water and a pint of beef broth, and she was perspiring freely.

But her headache, never quite conquered, reasserted itself and then came roaring back. Sophie was helping her take a weak dose of laudanum when she realized the girl’s eyelids had begun to swell. As had her hands. With a sense of dread she turned to get the small basin she had been using as a bedpan—a urine sample would tell her some things, even without a laboratory in which to test it—when Catherine Bellegarde began to seize.

Pip came to his feet and gave a fretful yip as she thrashed, looking to Sophie with something like accusation.

Now you really are imagining things, Sophie told herself, but she understood well enough: the accusation came from her own mind, where this new set of symptoms were adding up to something terrible.

Over the next hours as she tended her patient she took note of what was happening, and knew the truth even before a second and then a third seizure.

In the morning she sought out the ship’s doctor for a consultation. Dr. Conway listened to the case history and her poor prognosis, stroking his beard and shaking his head.

“Have you told the brother?”

“No,” Sophie said. “But I will have to speak of it if there’s no improvement by this evening.”

“If you would like me to examine her, just send word with one of the cabin boys.” He paused. “I’m very glad for her sake that you happened to be on board. I’ve had my hands full with the rest of the survivors.”

“Deaths?”

He nodded. “One. Exposure and a weak heart. Three amputations, as well. But it’s amazing that they survived, any of them.”

Sophie wanted to get back to her patient, but her curiosity about the wreck made her pause. “What exactly happened?”

He puffed out his cheeks and let his breath go with a pop. “According to the quartermaster, they got caught up in a nor’easter. Treacherous. A swell like a mountain—so he said, and he’s twenty years a sailor—struck her starboard and took the whole ship over. She might have righted herself, but the hold was full of cattle and every one of them was thrown to the port side when the swell hit. So that’s how they stayed, the cattle thrashing and bawling. The captain put half the crew on the pumps and set the other half to dragging the cattle out of the hold, one by one, up a deck slanted like a roof, you have to imagine it, and then forcing them overboard. One of the sailors got hooked on a horn that tore his arm up. I had to amputate at the elbow.

“Took a day and a night to empty the hold, and the whole time she was sinking, inch by inch. Then they waited another two days to be rescued, in blinding sun. You saw how much was left. The miracle is that we came across them when we did.”

Sophie went back to her cabin thinking of Catherine Bellegarde, who had such a short time left to live. In these few hours of their acquaintance, the young woman had reminded Sophie that she had a profession and—though she disliked the word—what amounted to a calling. She could no more pretend not to be a doctor than she could convince herself that she wasn’t female. This thought was in her mind still when she opened the door and saw Charles Belmain bent over his sister, trying to hold her down while she convulsed. Pip put back his head and howled.

Elise sent the cabin boy running. Dr. Conroy, no longer young and made in the shape of a barrel, was breathing hard when he reached the cabin.

Sophie said, “Sudden-onset cortical blindness and there’s pitting edema on her face and chest. No avoiding the diagnosis anymore.”

He bowed his head. “Eclampsia.”

“Yes. But the baby is still alive, and I might be able to save it.”

He was a physician and understood what she hadn’t said out loud: Catherine Bellegarde was as good as gone. Eclampsia was always fatal, even in the most controlled situation and best-equipped hospital surrounded by specialists; there was nothing to be done for her. It was unlikely that the child would live, but there was at least a small chance.

Charles Belmain was standing near the door, his color very bad. Sophie walked to him, took him by the arm, and forced him to sit down before he fainted.

“Mr. Belmain. Your sister has eclampsia, I’m very sorry to say. There’s nothing we can do for her, but I will try my best to save her child.”

When he glanced up Sophie had the sense that he hadn’t really heard her.

“Let me do what I can to save her child,” Sophie repeated.

Belmain blinked and looked down at his feet. When he looked up again, there were tears in his eyes. “You said she had coup de chaleur. Heatstroke.”

“She did have heatstroke, but it was masking another problem. Eclampsia.”

“What is it?”

“Éclampsie. Probablement à la suite de l’hypertension artérielle. Arterial blood pressure has something to do with it, but I can’t tell you any more than that. As far as medical science has come, the reason some women develop these symptoms are not understood.”

“And you have seen this before?”

“I’ve seen at least fifteen cases.”

“How many of them recover