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Charlie suffered through three hours—three hours!—with Emily’s modiste. Despite her assurances that new dresses were unnecessary, Emily had insisted.


“Let me do this for you, sister,” she’d pleaded. “It gives me great joy.”


As it seemed there was little enough of that in Emily’s life, Charlie had relented.


Emily’s taste ran toward stylish gowns of little substance, unlike Charlie’s own serviceable attire. Indeed, few of the evening dresses Emily selected for her had a sufficient amount of coverage in the bodice, so Charlie had insisted on a fichu if Emily expected her to wear them in company.


“Oh, stuff, Charlie! This is the style,” she’d told her. “I assure you, you’ll be no less covered than any other young lady.”


“That may be, sister, but I’d like a fichu, please.” Why a lady would purchase a gown that necessitated the expense of yet another garment to fill in the gaps made little sense to her, but she’d never been one for fashion like her sisters.


Emily had grumbled but eventually agreed, and the modiste added three fichus to their order.


So it was that they returned to Russell Square with no less than twelve boxes containing ready-made dresses, stockings, gloves, bonnets, shawls, spencers, and fichus. There were more custom pieces on the way, and Charlie’s head spun at the extravagance.


“Are you certain Colonel Watson won’t mind the expense?” she asked as they removed their gloves and retired to the drawing room. “It seems terribly excessive.”


“Of course he doesn’t mind,” Emily said. “He knows how much I adore spending my husband’s money.” Charlie thought Colonel Watson must be quite flush indeed, and a very indulgent husband to allow his wife such latitude with his purse.

“What time do we ride in the park?” Charlie asked, checking the clock on the mantle.


“I should think five o’clock will be perfect. Everyone will be there then.”


“Then I should like to go to . . . the lending library,” Charlie said. By way of Barts, although she kept that bit to herself. If she left now, she’d arrive in plenty of time for today’s lecture.


“Fine, if you must. Would you like company?”


“Oh, no, there’s no need. I know the lending library is not to your taste, and I’m sure you must have other things you’d like to do.”


“Very well, but be sure to take one of the maids. Agnes, perhaps. And you might as well look lovely while you’re there. Wear the blue dress, Charlie. It looks so nice on you.”


Charlie hadn’t thought to change her gown—she was only going to the hospital, after all—but she gave in to please her sister.


The dress was quite pretty, she admitted. In a printed blue muslin a shade darker than her eyes, it provided a soft, tempering effect to her red hair. She pulled on an ivory spencer and grabbed a chipped straw bonnet before hurrying down the stairs.


Agnes trailed her on the short walk to Barts, never more than five steps behind, never less. For one unaccustomed to having a servant shadowing her movements, the maid’s presence was awkward.

After a few wrong turns, she finally reached the hospital's expansive square complex. She’d long made a habit of arriving early to every appointment, so she had ample time to fully appreciate the sight before her.


The broad wing on the north side of the square, with its impressive arch and statue of Henry VIII, appeared to be the main entrance. Additional wings on the remaining three sides completed the square around a spacious central green.

She’d read the history of St. Bartholomew’s Hospital in her father’s library and was curious to see the painted murals on the main wing’s grand staircase, but she was even more eager to find the lecture hall.

“Favored Techniques in Wound Dressing” the advert in the Times had said. She crossed the green and advanced toward the north wing, Agnes trailing a precise five steps behind her.


As it turned out, no one was inclined to provide her with direction to the lecture hall. Each person she stopped shrugged and hurried on their way, giving her and the maid skeptical glances.


She blew a stray curl from her forehead and began methodically checking each corridor of each wing. At this rate, the lecture would be long over before she found the hall, no matter that she’d arrived well in advance of the advertised time.


Finally, as she passed the pathology department, she spied a group of young men gathered before a set of double doors. They looked as though they were waiting . . . for a lecture to begin.


She hurried forward and peered through the throng into the room beyond. It was arranged as a small auditorium, with raised semicircular seating around a central lecture stage. She’d found it!


“Pardon me,” she said to the gentleman nearest her. “May I pass, please?”


Two men turned and looked at her. “Are you lost, miss?” the first one asked.


“This is the lecture on wound dressing, is it not?”


They looked at each other hesitantly, then the others around them, before nodding.


“Then no, I’m not lost. If you’ll let me through, please.”


An older silver-haired gentleman stepped forward, blocking her way. “I’m sorry, miss. There must be some confusion. Allow me to see you back to the entrance.”


“I’m here for the lecture,” Charlie protested, ignoring the titters of the young men—boys, really—that surrounded them. Truly, you’d think they’d never seen a lady before. “The Times said it’s open to the public.”


“It is,” Mr. Silver Hair said. “To the male public. I’m afraid it’s not appropriate for”—he eyed her skeptically—“ladies.” As Charlie’s heart rate increased, so too did the blasted warm flush creeping up her throat. She willed it down but suspected she wasn’t successful. One never was with involuntary biological responses, much as one might wish otherwise.


She felt, rather than saw, Agnes shrinking into the wall covering behind her. Charlie drew a breath, then tucked a curl behind her ear. “With all due respect, sir, I’m fair certain all of you”—she looked at the gaggle of men—“had mothers who dressed your wounds when you were children. And I’m fair certain every one of them was female, so there’s nothing inappropriate about it.” They chuckled, then sobered when Mr. Silver Hair narrowed his eyes at them. As one, they turned and entered the lecture hall, closing the door behind them and leaving her firmly outside.



Julian was surprised to see men still milling about the entrance to the lecture hall. He was running late, as usual, and expected everyone would have been seated by now. But as the crowd near the doors shifted, he realized the source of the delay: a lady.


She was tall for a woman, with curly red hair—hard to miss, really. As he drew closer, a sense of familiarity teased him. He was certain he knew her from somewhere.


He listened to Dr. Fletcher inform her the lecture was not open to ladies, then he heard her crisp tones as she told him what she thought of that. Recognition furrowed his brow on hearing her voice. She turned to the side, and he caught more of her profile, which only confirmed what her voice had told him. Mr. Grace’s bluestocking daughter.


He’d spent the summer of his twenty-first year with the kindly surgeon in Little Tarrington . . . Torrington? Tarlington. Little Tarlington. That was it.


Miss Grace had been attractive in an earthy, wholesome sort of way, and he’d never been immune to a pretty face. She’d accompanied them on all her father’s rounds, asking questions and answering her father’s queries like any medical student.


At first, Julian had discounted her, enjoying the novelty of her presence as he suspected any healthy male would have. But once he realized she successfully answered more of her father’s questions than he did, he’d started paying more attention.


His collar grew tight as he recalled how often he’d shown to poor advantage before Mr. Grace, coming up short against Miss Grace’s freakishly accurate memory. She was brilliant, he recalled, a fact of which she was well aware.


But, as irritating as she was, she was Mr. Grace’s daughter, and he’d learned much at the man’s side. He sighed, knowing he couldn’t turn away now no matter how tempting the thought.


“Dr. Fletcher,” he said, catching the older man’s attention. “Miss Grace is with me.” He assumed she was still Miss Grace, as no husband in his right mind would allow a wife to attend a lecture at Barts.


She stared at him, and Julian resisted the urge to loosen his collar. Did she recall him? How lowering if she did not. She opened her mouth, no doubt to dispute his words, then snapped it shut and narrowed her eyes. She did remember him then, it would seem.

“Dr. Grey.” Fletcher nodded in greeting then pressed his lips together. “But . . . she’s a female.”

“She’s my assistant.” Julian gave a slight shrug. “Highly irregular, I know, but she keeps my notes organized,” he said. And although he would probably regret it, he added, “I can vouch for her.”


Dr. Fletcher sucked on his teeth and looked from Miss Grace to Julian and back again. It was quite comical, truth be told. Finally, the older man gave a short, terse nod and opened the door for them to precede him.


Miss Grace motioned to her maid to await her at the end of the hall, then she swept in. All the seats were taken save two in the center of the top row.


The polite thing for the gentlemen to do—the only proper thing—would have been to move to the center and allow them the seats on the end. But they remained stubbornly seated, obliging Julian and Miss Grace to navigate knees and feet to the center of the row.

It was abominably rude for the gentlemen to remain seated in the presence of a lady, and Julian glared at them as he passed. If Miss Grace noticed the slight, she gave no indication. Finally, she took her seat next to a pale blond man with broad sideburns, and Julian settled next to her.


“Your assistant?” she asked in a sharp whisper once they were seated. Her affront was obvious.


“You’re welcome,” he said.


She pressed her lips together and shifted her bonnet in her lap. “Thank you,” she whispered, though it was clear the words pained her. Then, after some moments had passed, she added graciously, “It’s a pleasure to see you again, Dr. Grey.”


He nodded, and they sat in silence as the lecture began. Julian surveyed the attendees, searching for new faces he could approach about the position at Heloise Manor.


There. He recognized a gentleman on the front row: Mr. Thomas Williston, if he wasn’t mistaken. A young surgeon who’d recently arrived from Edinburgh. He was green but had achieved high marks from what Julian had heard. He’d read some of the man's papers and found them to be well-founded and of sound argument. He’d approach him after the lecture. With his plan decided, he settled back to listen to Dr. Fletcher.



Charlie watched Dr. Grey from the corner of her eye. Why he’d jumped to her defense she didn’t know, but she wouldn’t question her good fortune. She was here, in the lecture hall of Barts, and she reveled in the experience. How many women could say such a thing? How many men had such an experience? She couldn’t recall ever having a better day.


That was, until Dr. Fletcher misspoke about the proper application of pressure when caring for a wound. She frowned, waiting for someone to correct him. When no one did, she shifted in her seat and moved to stand, but Dr. Grey placed a warm hand over hers and shook his head slightly.


“But he’s incorrect,” she whispered to him loudly.


“Yes,” he agreed. “But he’s only too eager to toss you out, and me along with you. So be quiet if you wish to stay,” he urged.


She shook his hand off. The heat where he’d held her lingered, and she tried unsuccessfully to wipe it away on her skirt.


One of the students asked a question about the best type of material to wrap a wound, and Fletcher answered. Incorrectly, yet again. Charlie opened her mouth, and Dr. Grey shook his head again. She clamped her mouth shut and glared at him. “He’s giving them the wrong instruction,” she protested on a whisper. “Evidence has shown that the wound needs to breathe.”


“Shh,” the blond student next to her hissed. She glared at him, then turned back to Dr. Grey.


“Shh,” he said.


She settled back in her seat and faced forward, but the words on her tongue wouldn’t be silenced. She couldn’t allow the man’s inaccuracies to go unchallenged. She stood. “Dr. Fletcher.”

Dr. Fletcher’s head came up at her words, but he continued droning on about infection. From the corner of her eye, she saw Dr. Grey wipe a hand over his face. “Dr. Fletcher,” she said again, more loudly.


Finally, Fletcher stopped and looked at her. He sucked on his teeth for a moment before saying, “Yes, Miss Grace?”


“Your instruction to wrap the wound tightly . . . Evidence has shown greater results with a looser dressing.”


“Miss Grace,” Dr. Fletcher began with a twist of his lips. “A tighter dressing is beneficial to prevent bad humors from infecting the wound.” The room murmured their agreement.


“Yes, but—”


“Dr. Grey. Please ask your assistant to refrain from comment.”


Dr. Grey reached a hand to hers and tugged her back to her seat. She went quietly, if not willingly.


When the lecture ended, Dr. Grey whispered to her, “Please wait here, Miss Grace. I need to speak with Mr. Williston for a moment, and then I shall escort you out.”


“Thank you for your assistance, Dr. Grey,” she said. “But your escort is unnecessary. I can see myself out.”

His jaw tightened, but he merely nodded. “As you wish, Miss Grace. Good day.”

She watched him navigate the crowded room and approach a young man of about twenty years. She turned away and gathered her bonnet to leave. As excited as she’d been to attend the day’s lecture, it had been a tremendous disappointment. She should head back to Russell Square as Emily had Plans for them to go driving in the park. But as she passed Dr. Grey and Mr. Williston, she couldn’t help overhearing bits of their conversation.


“—seeking a surgeon for twenty residents at Heloise Manor. The wage is good, and the work will be rewarding.”

“I thank ye for considerin’ me, Dr. Grey. I’ll give it some thought. Can I let ye know in a few days?”

“Yes, although our need is rather immediate. Please do let me know soon.”

Mr. Williston nodded and placed his hat on his head before moving to exit.

“You’re looking for a surgeon?” Charlie asked at Dr. Grey’s shoulder.

He startled and turned toward her. “I thought you were going to see yourself out.”

“Pish,” she said. “I heard you talking to Mr. Williston. You’re looking for a surgeon,” she repeated.


“Yes. Do you know any?” He steered her toward the exit and held the door for her. She sailed through, and Agnes jumped up from where she’d been sitting on a bench at the end of the corridor.


“Let me do it,” Charlie said. The more she thought about it, the more the idea appealed. Meaningful occupation would make London more bearable. She could remain in London indefinitely if she had something worthwhile with which to fill her days.


Dr. Grey looked at her and laughed, then sobered when she remained silent. “No.”

“No? Why not? You know the quality of my work so you can have no argument there. I could even serve in the position on a trial basis while you decide.”

“No,” he said again, this time more firmly. “For one thing, you’re not licensed. I’m looking for a licensed surgeon.”

She chewed her nail. “Yes, I can see your dilemma, but I’m as good as licensed. All but degreed, even. I’ve studied all the same texts. I even wrote a thesis for the Medical College at Edinburgh.”

He stopped walking and turned to her. “You wrote a thesis for a curriculum you didn’t attend? For a degree for which you’re not eligible?”

She nodded. “Yes. You can read it if you would like. The Merits of Uniting the Complementary Disciplines of Medicine and Surgery.”

He stared at her for a moment, then nodded once. “A controversial subject, to be sure, but one on which we would find accord. I’ve long thought the divide between the two disciplines is detrimental for patients, which is why I studied both.”


She looked at him with surprise, both at his admission and his agreement. A physician who was also a surgeon was . . . unusual. Not unheard of, but not the normal way of things, either.


He resumed walking, and they exited the building into the April afternoon. Mindful of her freckles and her mother’s frequent admonitions about the sun, Charlie hurried to don her bonnet, tying the ribbons haphazardly.

“You said for one thing. What’s the other thing?”


He slanted her a look from the corner of his eye. “You have to ask?”


“What other objection do you have? Speak plainly, Dr. Grey.”


“You—you’re a woman,” he said. Rather unnecessarily, she thought.




“What do you mean, And? Isn’t that enough?”


“I fail to see how the fact is relevant, as long as I’m qualified. And you know from the summer you worked with my father that I’m more qualified than many of the men in that lecture hall. Most of them,” she muttered.


They’d reached the front of the central green and stood next to the street. A boy approached leading a horse, and Dr. Grey pulled a coin from his waistcoat pocket. He tipped his hat to her and gave a short bow. “Miss Grace, it’s been a pleasure seeing you again, but this is where we part. Please give my warmest regards to your father.”


She nodded, her brow wrinkled, as she watched him ride away.



Excerpt © 2021 by K. Lyn Smith.

The Physician's Dilemma is available in paperback and eBook formats.

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