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Patient Confidentiality

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I.
Being Mr. Maturin’s personal physician was an exercise in patience and persistence. Though the patient had a genuine weakness of limb and a certain anaemia that required careful attention, he was clearly a hysteric and hypochondriac, prone to strange whims. When he’d introduced the subject of having a nurse to assist in my care of him, at first I’d welcomed the idea—but then he’d had such peculiar and unfitting conditions laid out that I couldn’t help questioning his judgment. Yet Mr. Maturin was obstinate to the point of intractability on the matter, and I could not help but yield to his wishes.His choice of companion, however, was perhaps the most peculiar and unfitting thing about the whole affair. For all that he’d rejected the others, I could never understand why he’d chosen this one to be his companion. He had no medical experience—none whatsoever. But in the end, it was not my money spent. The lad was frankly unsuitable as a nurse, but if he kept my employer in good spirits, there was not much to be done. He was here to stay.Still, I had my concerns. On discovering from my butcher that the lad was a former felon, I’d promptly returned to the flat on Earl’s Court to inform my employer. I’d found them in his room as expected, with the dim lighting I’d prescribed, though the lad was seated by the window with the newspaper pulled up to his face, presumably squinting to read the print by the crack of light that squeezed out from the blind. I asked for a word alone with my patient, and he hurriedly stomped out with a mumbled word.“BAH, turn down the light, you bloody fool! Are you trying to make me blind as well as feeble?” snarled Mr. Maturin, throwing up his hands to cover his face as I’d tried to illuminate the room more with his bedside lamp. I obliged, but then immediately told him in a whisper what I had learned. He was silent—I assumed in shock. I assured him that I would turn the blackguard out myself, that I would call for the police if we discovered anything missing.Then, the unthinkable: my poor invalid merely chuckled. It was my turn to sit in stunned silence.“You think I didn’t know that myself, doctor?” he said. “And what of it? You can’t walk without stubbing your toe meeting some fellow or other who comes from a line of guests of Her Majesty’s Care where I’m from. Why should I give a fig for it here, eh?” At my lack of reply, he added, “Don’t you worry your head, doctor, he’s an honest villain, if a villain at all, not to mention a gentleman. A man’s gotta have some dark to make the light all the better in him.”“All the same…” I began, but he interrupted me with a hacking cough, and I was forced to quit my line of argument in favour of checking his condition. He was warm to the touch, with a slightly elevated pulse, and to my alarm, I noticed his mouth seemed somewhat swollen. “You appear to have a fever,” I murmured, “let’s hope it’s not a flu, or something worse.”He fell back into a vicious coughing fit, and I rushed off to fetch him cool water and damp cloths.
***
“The newspaper was inspired, Bunny, but you should take care to hold it the correct side up next time,” Raffles teased me with a slow smile. I chose not to reply to that.
II.
It rained for forty days and forty nights, or so it seemed to our unfortunate lot, stuck indoors as we were. Though one might think it would serve to make little difference to my invalid, seeing as he rarely could venture out as it was, it made him more irascible than ever; he complained of congested sinuses, aching limbs, and an inability to sleep. I prescribed hot water bottles, weak but hot tea, baths, but he whinged that it was hot enough as it was being summer with all the windows closed up against the rain.Even his companion could do little to cheer him, and his mood was nearly as black as Mr. Maturin’s. As it was, we rarely said much to each other outside of the usual niceties, but he even forwent these customs in favour of a sullen silence, keeping watch over his suffering charge like some malevolent gargoyle, only leaving to fetch some whim or another of his master’s out in the rain.One particularly nasty evening found me in my consulting-room running an inventory of my supplies. It was dull work, but necessary all the same to requisition any that were falling short. The tediousness of the task combined with the fantastical weather drew my imagination to eerie wanderings. Of late, my fiancée had taken to reading Stoker’s novel aloud for us when I visited her, and as the rain chattered against the panes I felt akin to Harker in his imprisonment in the Count’s castle. I fancied if I looked outside I might see the Count himself slithering headfirst down the red brick wall to hunt in the night for his grewsome, squalling prey. An inexplicable chill swept through me, and I drank from the tumbler that I’d set out earlier. Looking into the small shaving mirror by the washbasin, I half-expected to feel the Count’s poisonous breath on my neck…a prickling of teeth…
CLASH!
It came from upstairs, loud as thunder, and I nearly jumped out of my skin.Shaking the grotesque images from my head, I rushed out of my consulting-room to the stairs and heard a second crash just as I reached my patient’s door. I knocked urgently and demanded entry.“Don’t come in!” squawked the lad.The devil I wasn’t! I opened the door regardless, but he was there to block my entry.“What’s happened?” I demanded.“There’s glass on the floor. Please, I-I can sweep it up myself,” he said.“Why are you wet, man?!” I said, just noticing that he was soaked to the skin, his hair dripping.“I, uh, I-I’m afraid he threw the water pitcher too, and it got me. Please, it’s all right, I can—”I attempted to get past him into the pitch-black room, but still he blocked my way. “Mr. Maturin, are you well?” I called, fearing to find him insensible or with his throat slit—for all that Mr. Maturin trusted the lad, I had not forgotten his felonious history.“Stop your clucking, Theobald, you damn ass, and clear off,” Mr. Maturin growled from the shadows of his bed. I breathed a sigh of relief.“He-He was just having a nightmare,” said the lad.“And I just about got the ghoul ‘tween the eyes with my lamp that’s all over the floor,” Mr. Maturin said. “You ever met a bushranger, doctor? Got me one time when I was on my way to Yea, but I showed ‘em!” He cackled hoarsely. “But damn if they don’t try to haunt me still!”My racing heart had steadied, and my anxiety was replaced with annoyance at the needless disturbance. “Well then, if you have no further need for me,” I said, and dismissed myself back downstairs. In my consulting-room I refilled my tumbler, deciding I had had enough excitement for one night.
***
“You could have been more careful, Bunny,” Raffles snapped after we heard the door to Theobald’s consulting-room close once more. He pulled the silver serving-platter out from under its rushed hiding place beneath the bed and ran his hands over it, checking for dents. “Of all the ones to drop, you knew this was my favourite of tonight’s haul.”“I could have been more careful? You could have hit me with that lamp!” I retorted. After fumbling in the dark for the matches, I struck one and lit a candle, then picked glass shards from the floor. My handkerchief soaked up spilled oil.“Nonsense, Bunny, you know I have remarkable aim. I ensured it was at least five feet away from you.”“Did you have to throw it at all?”“If I hadn’t, Theobald would’ve wondered what it was he heard,” Raffles replied. I couldn’t help but admit he had a point, nor could I help admiring his characteristic resourcefulness. He sighed. “Slippery fingers aside, that was some quick thinking on your part, Bunny, well done.”“You think so?” I said, a warm burst of pride swimming through me.“Like you’d stolen into my mind and plucked the idea right from it. Though it’s a good thing he didn’t think to question why you were still wearing your overcoat, otherwise we might have been in trouble there.” He threw back the blankets from his bed and shook his head at the muddy, wet mess his soaked trousers had made of the sheets. “I suppose I’ll be kipping with you tonight.”“With me?”He raised his eyebrows. “What’s the matter?”“My bed’s smaller than yours, A.J. I don’t know how we’d fit.”He laughed in that bright way that never failed to cheer me even on our darkest nights. “My dear rabbit, if I can cramp myself up and spend a lonely day in that old silver chest of mine, I can spend a night cramped up with you—and the latter’s hardly a hardship,” he added, with a glimmer of mischief in his eyes.
III.
My darling Ernestina has the joy of commanding her own home now, and I couldn’t be happier. Her father had been a difficult man to win over, protective as he was of his four daughters and vast fortune, but when he’d taken me aside following the nuptials to congratulate me, he’d revealed a surprise: an offer to pay for our honeymoon to Switzerland. We’d taken it. Ernestina had loved the peaceful serenity of the mountains, and I’d had the chance to learn from their health spas while enjoying the scenery.But now we were back in London, settling into our new life together. The first thing I did of course was return to Earl’s Court to see how my invalid had fared during my absence. To my surprise, he looked as though he’d gained a few pounds, and I cast a suspicious eye at the plates his attendant was hurriedly trying to clear out of my vision. They had the mark of gravy upon them, and the smell of fried onions lingered in the air.“Have you been maintaining Mr. Maturin’s diet as I prescribed?” I asked his attendant.“Of course,” he replied.“Because it is essential that Mr. Maturin not overtax his system—heavy foods will make his digestion suffer, and everything is a delicate balance in a case such as his,” I said.“Of course,” he repeated, with a noticeable note of impatience.“Aw, leave him alone,” my invalid piped up, “And quit talking like I’m not here. Now, are you here to be my doctor or my dear departed mum?—God rest her soul.” I sighed, pulled up the chair by his bedside, and started to take his pulse. “Go get me a paper, would ya,” he growled to his assistant, who simply sighed, then did as he was told.His pulse was steady. I clucked my tongue and started to take his blood pressure.“So what’s it to be today, then?” he drawled. “Leeches?”“Most amusing, Mr. Maturin,” I said dryly. His blood pressure was a little high, but nothing that would be concerning in an ordinary man. I sighed. “It’s just as I feared.”“Yeah? What is it, then?”“Cardiovascular stema.”“Sounds serious.”“Oh, it is, Mr. Maturin, it most certainly is. But we’ll get you fixed right up, don’t you worry.”
***
“Oh, hell,” Raffles groaned, stumbling out of bed for the third time that night into the bathroom.“Again?” I mumbled. My suspicions were confirmed as I heard him retching into the toilet. Sighing, I shuffled out of my own bed in the corner to help hold back his hair, but by the time I reached him, the worst of it seemed to have passed. He waved my hands away tiredly.He spat viciously into the toilet and sniffled. “Guh. Not to worry, Bunny,” he said, sounding like his throat had been scraped over with a rusted rake, “Not much left for me to offer the thing at this rate. It’s already got the steak and kidney pie.”Seeing him like this was a puncture to my heart—just that afternoon he’d been dazzling, laughing, and cheerful, content with a week’s worth of hearty eating and fresh air, and then that devil of a doctor had returned and reduced him to this. “My dear A.J.,” I said feelingly, rubbing a hand across his shoulders.He groaned again. “Hang on, it wants my dignity.” And he turned his head back down.Afterwards, I’d wiped his mouth with a damp washcloth and helped him, weak and shivering, back to his bed, then I fetched him a fresh glass of water and insisted that he sip some of it. He did so without complaint.I disliked the idea of going back to my own bed. We’d long since established that it was safer if we didn’t share unless certain circumstances deemed it necessary—a habit and precaution we’d taken while Dr Theobald had still slept in the rooms downstairs—but I’d become spoilt for it during the week the doctor was away. Tonight Raffles had insisted on the separation out of some misguided gallantry, hoping that his getting up in the night wouldn’t wake me if I was in another bed. But it was quite useless for either of us to sleep; him, tormented by the nausea of taking nonsense medications, and me by worry.I was about to put myself on the other side of his bed no matter what he said, when he grasped my hand and looked at me with exhaustion. “Oh, Bunny,” he said with a sigh, “you may as well climb in with me after all.”“I thought you’d never say so,” I said, and he smiled weakly.I curled up against him, trying in vain to seep some of my warmth and comfort into his clammy form. He rested his chin on my head, and the sour stench of his breath wafted down to me. I held him tighter.“You’ll have to make it back to your own bed before dawn, I’m afraid,” he murmured. “The doctor will be back early to check on me.”I muttered a curse. Raffles shook once in the semblance of a laugh.But I was in no mood for mirth. I could hear the pattering of his heart as it tried to keep up with all that was being done to him, when just a day ago it had been so steady and strong. How he could accept this ruining of his body with such willingness was beyond me—and for what? To maintain this disguise in a city that would condemn him on sight if they knew who he was, so that he had to skulk around it on the rooftops at night like some mangy tomcat? My Raffles, who’d always been as carefree and breezy as a spring lark, cooped up like a wilting bird in a glass cage…“Is it worth—” I began, then cut myself off tightly.But he was awake. “Bunny?”“Why are you doing all this, A.J.?” I whispered, unable to keep the emotion from my voice. “This whole farce with the doctor, coming back to London. You’re ruining yourself and bored to death! This isn’t like you, A.J., and you know it. You’re miserable here. You could be anywhere—you should be anywhere but here. You could be happy somewhere on the continent, and—”“You think I’m not happy here?” he replied.“Of course not!” I snapped. “How could you be?”“Oh, Bunny,” he sighed, and he stroked my head with his thin fingers as I tried—and failed—to keep a few stray tears from staining his nightshirt. “Bunny, Bunny…I forget you, sometimes, how well you know me.”I stifled a sob. “I feel like I don’t know you at all,” I admitted. It was a truth I’d had to face numerous times in all the years I’d known him, and it always struck me with a stark, wretched coldness whenever it surfaced.“But you do, my rabbit, you do, you know me better than anyone in this world,” he murmured, still stroking my hair soothingly. “And…you’re right, Bunny, that this isn’t my idea of paradise.”“Then you should leave,” I said miserably. “You should leave, and be happy.”He sighed. “Oh, Bunny…” he said again, pressing his mouth silently to the top of my head for a moment. His hand drifted to the back of my neck and simply rested there like an anchor’s weight, and I felt my emotions steady from the height they’d climbed.“Paradise doesn’t come easy to men like us,” he said at last. “I learned that after I jumped off that steamship in the Mediterranean. It’ll come and…when you least expect it, it’ll go. You have to make Paradise wherever you can, Bunny—you can’t expect to just find it, waiting for you. You have to build it yourself. Do you understand?”“But why here?” I asked quietly. For once, I was afraid to meet his eyes in the darkness of our room, so I kept my cheek pressed over his chest, listening intently to the secrets of his heartbeat.“Is it really that hard to guess even one reason, Bunny?” he said, and I could hear the smile in his voice.I smiled back into his nightshirt. “You don’t mean that.”“I mean every bit of it,” he said, and to my surprise, gentle fingers were tilting my chin up to face him. Even in the darkness, I could see the sparkle of his eyes as they caught the dim gaslight chinking through the crooked blinds. “The mind is its own place, Bunny, and in itself can make a heav’n of hell. With a bit of practice, you’ll be able to see it too.”For all that he’d been through, his form had not yet lost all his original brightness, nor yet, I think, could it ever completely diminish. But here we were, in that quiet chamber that reeked of sickness and antiseptic, and it was far from Paradise. But to me, and to him, I think, it was home—if not forever, then for now, and that was enough.
IV.
That woman was back again. It had started about two weeks ago, when the forceful Jacques Saillard had barged her way in at breakfast with neither a chaperone nor a calling card, demanding to see Mr. Maturin. She was not a blood relation, that much was self-evident, and by my observations, she didn’t appear to be an in-law either. Most irksome of all, she made herself continuously underfoot: she called on Mr. Maturin multiple times a day, refusing to leave his side, insisting on feeding him herself with meals she brought against my dietary guidelines, and haranguing me constantly on the state of his health and treatment as if she fancied herself the better physician.It was plain as day she was driving the poor man to exhaustion; as I carried in his tray of medications and tea, he was paler even than ivory, with grewsome, heavy bags residing under his eyes. She was clutching his hand like an unyielding vulture grasping the bony limb of its carrion, heedless of my entrance. I cleared my throat.When she failed to acknowledge my presence, I added, “Madam, it is time for me to administer Mr. Maturin’s medication. If you would…”“I can do it,” she said, the line of her brow adamant.It was not the first time she had attempted to commandeer his care from me. “Madam, I must insist—”“Let him do it, please,” Mr. Maturin said, giving her an indulgent look. “It’s what I pay him to do.”She turned back to him in an instant, her dark eyes suddenly bright. “But would you not prefer a gentler touch? Darling, but you’re so frail…I dread to think of what could happen if I were to leave your side. How could I leave when you look so poorly?”He shook his head and smiled. “It’s not for so long—and I can look forward to seeing you again, can’t I?”She pursed her lips, then nodded. “I’ll come back with your favourite bisque and cassoulet.”“Madam, I really must insist—” I started again, but the intractable woman was already brushing past me to the door, the single-minded focus in her expression dismissing the presence of all other men in her eyes excepting that of my patient. My expertise did not delve deeply in the field of psychoanalysis, but in my professional opinion, it would not be outside the realm of plausibility if she were to be diagnosed with some sort of hysteric mania. At the sound of the street door shutting behind her, I shook my head and turned back to my patient.“Mr. Maturin, is there nothing you can do to—”I jumped. The bed was empty, the covers thrown back, and my invalid was standing at the window, parting the slats of the blinds with two fingers. I hadn’t even heard him move.“Mr. Maturin!”“It’s no use, doctor,” he said, and I blinked again in surprise. Gone was the raspy colonial drawl I had become accustomed to; in its place was a crisp, masterful public-school accent. Even the way he stood at the window was changed—the habitual hunch of an elderly, frail man replaced with the straight spine of an athlete. In short, an entirely new man was standing before me.“Whatever I might do or say to her will not drive that woman off,” he continued, disregarding my shock, “She has the heart of an artist and her blood runs hot—that combination shall be my undoing, I think.” At last, he turned to face me, and though he still wore the same face as my invalid, his eyes glittered with a greater cunning than I could ever recall seeing before. “That’s where you come in, Theobald.”He sauntered to a painting hung on the wall and reached behind it, pulling out a pack of cigarettes. As he retrieved one, he glanced over to me. “Come now, Theobald, don’t act so shocked! You knew as well as I did that I wasn’t ill.” He smiled. “Unless that seal on your medical papers is less genuine than I thought, in which case you must have a rather respectable forger.”I felt as though I needed to sit down, so I did. I ended up on his attendant’s cot in the corner, whom I just realized was absent. Maturin struck a match and lit his cigarette, watching me carefully as I stared back at him.He wasn’t mistaken: I knew from the start the man was a hypochondriac, but I had assumed—I had believed that he was still an elderly, feeble man of no consequence whose temper frequently surpassed his reason. However, the figure I was looking at now was evidently in full control of both his mental and physical faculties.“Who are you?” I asked at last, when I had regained my capacity for speech.“Is that important?” he replied.“Well, you are clearly not who you are pretending to be,” I said, suddenly feeling a flood of righteous anger surge through me. I stood to my feet again. “Just what kind of charade are you trying to pull here? Are you trying to swindle that unfortunate woman? Is she some wealthy widow you intend to prey on?”He barked a laugh. “No, no! My good chap, it’s rather the opposite—she’s the one trying to ensnare me. By Jove, she’s making my life utterly unbearable! Even you can see that.” He smoked for a moment contemplatively. “She’s foreshortened my life here considerably. I see no reason why we shouldn’t hurry that along.”I blanched. “W-What do you mean, sir?”He smiled. “To ‘undertake a thing like death to chide away this shame.’ It’s an act I’ve played before, so I should have no trouble recreating it—with your help.” He strode forward and clapped my shoulder as if we were the oldest of school chums. “What do you say, doctor? Care to play the Friar Laurence to my Juliet? There’s a good thousand quid in it for you if you keep your mouth shut afterwards.”“A thou—” I heaved a breath and raised a hand to my mouth. “Sir…did-did I hear you correctly?”“I should think a thousand pounds would be more than enough to keep you and your lady wife comfortable. You could even set up a new practice in better digs than this,” he said.My head was reeling. With a thousand pounds, my wife and I could relocate to a home within her father’s prestigious neighbourhood, I could set up a new practice, buy Ernestina new dresses and that pearl necklace she so wanted, go on holiday in Paris, Vienna…How could I refuse?“What about the lad?” I asked sometime later, after he had explained at length the steps of his plan.“Don’t you worry about him,” he replied breezily. “We’ll simply dismiss him. Well—he’ll swallow it down easier if we tell him it was your idea, but I’ll break the news to him myself.”And that was that. In the end, it was much simpler than I had at first believed it would be; the lady bought the act, as did Maturin’s former attendant, and with a thousand pounds of cash in my pockets, I signed away my first patient’s death certificate with an easy conscience.
***
“Well, what do you think, old chap?” I asked, turning to face my oldest friend freshly risen from his newest grave. The weak autumn sun was pale on his skin, and his prematurely grey head seemed a perfect fit for the orange foliage surrounding us.He was smiling. How good it was to see that smile again, after all those weeks of suffocating confinement—and to know, for once and for all, that he was as near to freedom as a wiser Icarus might have been to the Sun. “You tell me, my rabbit,” he said. “What does it look like to you?”I laughed—and when was it, the last time I had truly laughed? It felt like it’d been centuries.“My dear A.J.,” I said, “compared to Wormwood Scrubs, I think it’s as close to Eden as the Thames could ever take us!”

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