Dragonfly in Amber - Diana Gabaldon [113]
“What do you think?” said Mother Hildegarde. I wasn’t at all sure whether she was addressing me or Bouton, but took the benefit of the doubt and explained my observations.
“So, there must be a secondary source of infection,” I concluded, “but I can’t find it. I’m wondering now whether perhaps he has an internal infection that’s not related to the leg wound. A mild appendicitis, or a bladder infection, perhaps, though I don’t find any abdominal tenderness, either.”
Mother Hildegarde nodded. “A possibility, certainly. Bouton!” The dog cocked his head toward his mistress, who jerked an oblong chin in the direction of the patient. “A la bouche, Bouton,” she ordered. With a mincing step, the dog pushed the round black nose that presumably gave him his name into the carter’s face. The man’s eyes, heavy-lidded with fever, sprang open at this intrusion, but a glance at the imposing presence of Mother Hildegarde stopped whatever complaint he might have been forming.
“Open your mouth,” Mother Hildegarde instructed, and such was her force of character that he did so, even though his lips twitched at the nearness of Bouton’s. Dog-kissing plainly wasn’t on his agenda of desirable activities.
“No,” said Mother Hildegarde thoughtfully, watching Bouton. “That isn’t it. Have a look elsewhere, Bouton, but carefully. The man has a broken leg, remember.”
As though he had in fact understood every word, the dog began to sniff curiously at the patient, nosing into his armpits, putting stubby feet on his chest in order to investigate, nudging gently along the crease of the groin. When it came to the injured leg, he stepped carefully over the limb before putting his nose to the surface of the bandages round it.
He returned to the groin area—well, what else, I thought impatiently, he’s a dog, after all—nudged at the top of the thigh, then sat down and barked once, wagging triumphantly.
“There it is,” said Mother Hildegarde, pointing to a small brown scab just below the inguinal crease.
“But that’s almost healed,” I protested. “It isn’t infected.”
“No?” The tall nun placed a hand on the man’s thigh and pressed hard. Her muscular fingers dented the pale, clammy flesh, and the carter screamed like a banshee.
“Ah,” she said in satisfaction, observing the deep prints left by her touch. “A pocket of putrefaction.”
It was; the scab had loosened at one edge, and a thick ooze of yellow pus showed under it. A little probing, with Mother Hildegarde holding the man by leg and shoulder, revealed the problem. A long sliver of wood, flying free of the splintered cartwheel, had driven upward, deep into the thigh. Disregarded because of the apparently insignificant entrance wound, it had gone unnoticed by the patient himself, to whom the whole leg was one giant pain. While the tiny entrance wound had healed cleanly, the deeper wound had festered and formed a pocket of pus around the intrusion, buried in the muscle tissue where no surface symptoms were visible—to human senses, at least.
A little scalpel work to enlarge the entrance wound, a quick grip with a pair of long-nosed forceps, a smooth, forceful pull—and I held up a three-inch sliver of wood, coated with blood and slime.
“Not bad, Bouton,” I said, with a nod of acknowledgment. A long pink tongue lolled happily, and the black nostrils sniffed in my direction.
“Yes, she’s a good one,” said Mother Hildegarde, and this time there was no doubt which of us she was speaking to, Bouton being male. Bouton leaned forward and sniffed politely at my hand, then licked my knuckles once in reciprocal acknowledgment of a fellow professional. I repressed the urge to wipe my hand on my gown.
“Amazing,” I said, meaning it.
“Yes,” said Mother Hildegarde, casually, but with an unmistakable note of pride. “He’s very good at locating tumors beneath the skin, as well. And while I cannot always tell what he finds in the odors of breath and urine, he has a certain tone of bark that indicates unmistakably the presence of a derangement of the stomach.”