Leah and her father had argued long and loud about outfitting an operating theater in the surgery. Edward Mundy claimed to scorn the fancy, big-city ways of modern medicine. In truth, what he scorned was spending money on anything but himself. Leah rarely won an argument with her father, but when it came to her profession, she found strength in her passion for healing.

      In the end, she had prevailed and was rewarded with a tiny but innovative theater adjacent to the main suite. It was nothing so grand as the busy hospital theaters where she had learned her brutal craft in Denver and Omaha, but it was an impressive facility for a small island town.

      She religiously followed the antiseptic methods of Dr. Lister of Great Britain. Lister had proven beyond a doubt that sterilizing the operating theater reduced the risk of infection. Penny Lake had written to say that all the surgeons of Johns Hopkins were using rubber gloves during surgery. Leah willingly embraced the technique.

      Her assistant, Sophie Whitebear, had returned from Port Townsend. With quiet competence, she sprayed the chamber with carbolic acid solution until a fine mist hung in the air. Everything—their gowns, their hair, their sleeping patient, the instruments, the walls and the floors—grew damp and acrid-smelling.

      When all was in readiness—the light in place, the patient draped, the dressings and instruments at hand—Leah closed her eyes and said a quick prayer. She had done this many times, had probed dozens of bodies in search of bullets or gallstones or bleeding tumors, but each time, she was overwhelmed with the enormity of invading the sanctity of the human body.

      Dear God, please guide my hand in this. Please….

      Holding her breath and her nerves perfectly steady, she began.

      Three

      There wasn’t a goddamned thing he could do.

      Like a caged beast, Jackson prowled the surgery. His gaze kept cutting to the enameled white door. Beyond that door, in a room lit so brightly his eyes hurt, Carrie lay bleeding. He might have looked his last at her as they brought her into the strange, foul-smelling chamber. She might never awaken again. He might never again see the color of her eyes, hear the sound of her voice, feel her hand grasping his.

      Bitter guilt seared his throat. From the time they were children in the orphanage, he had promised Carrie he’d look out for her. But the deadly bleeding was a shadow enemy. He couldn’t beat it in a fistfight or run away from it. He had to put all his faith in an ill-tempered lady doctor who clearly had no respect for him and not a whole lot of compassion for Carrie.

      Fear had become a familiar companion to Jackson. His life had been, for the most part, a series of horrifying incidents, from the moment his mother had abandoned him on a stoop in Chicago to the moment he’d fled Texas with a man’s blood on his hands. But this fear was sharper and colder than anything he’d ever felt.

      He hated being in this position. Helpless. Without choices. Powerless to do anything. God, how long was this thing going to take? he wondered.

      Grim silence shrouded the surgery. The lady doctor and her assistant weren’t saying a word. Carrie was under ether, blessedly senseless, thank God. The only sound came from a wood-cased mantel clock. The incessant ticking pounded out a hammer rhythm to Jackson’s anxiety, seized his mind and wouldn’t let go.

      Gritting his teeth, he forced himself to stop pacing. The outer office was snug and painfully neat with apothecary jars lining one wall and shelf after shelf of textbooks. Above a woodstove hung a picture of a misty green-and-gold island with palm trees nodding over a calm bay. For a moment, Jackson stared at it.

      Paradise. He could almost smell the perfume of exotic flowers, hear the call of colorful birds. He wondered if such a place actually existed.

      Hungry for a distraction, he moved into the tiny inner office. Ah. Here, at least, was a bit of evidence that Dr. Leah Mundy actually had a life. That she was not some clockwork female sawbones who snapped out orders and intimidated people into getting better. Several diplomas lined one wall. Jackson had never actually seen one up close before, and he was fascinated by the scrolling script that spelled out high honors and important degrees.

      She had attended institutions that sounded both imposing and exotic—Great Western, Beauchamps Elysées, Loxtercamp Hospital. She had read books such as Delafield & Pudden’s Pathology and Osteology of the Mammalia. Tucked between the medical tomes was one slim volume. He had to tilt his head to read the title: Ships that Pass in the Night: A Tragic Love Story by Beatrice Harraden.

      An educated woman. Jackson was fairly certain he had never met one before.

      He picked up a framed tintype of Leah and a bewhiskered gentleman. Jackson squinted at the image. A father. He had no idea what it felt like to have one; he’d been told he was sired by a Nordic lumberjack at a Chicago brothel.

      He’d never allowed himself to care about not having a father. But he could tell from the expression on Leah Mundy’s face in the picture that she cared very much. Her hand gripped his arm. Her other hand held a rolled certificate—one of the diplomas on the wall? The bearded man exuded a chilly hauteur while Leah beamed with the eagerness of a pup.

      Something had happened since then to beat her down. She was smart as a seasoned cardsharp. When she did her doctoring, she exuded competence and control. But she’d lost that bright sparkle in her eye. What happened to you, Leah Mundy? he wondered.

      Was it the death of her father, or had something else soured her spirits? Whatever it was, it had turned her from a smiling, eager young woman into a somber, authoritative physician whose only pleasure seemed to be in work.

      Was that what made Leah Mundy unique? What made her seem so very sharp, so special, so competent?

      Or was it that she held Carrie’s life in her hands?

      With a muttered oath, he started pacing again. Carrie. For years she had been his quest, his purpose; sometimes she was his only reason for getting up in the morning.

      She had been no more than nine years old when he’d first laid eyes on her. He recalled the moment vividly, because it was the first time in his life that he’d dared to believe angels were real. Even standing in the dingy foyer of the Chicago orphan asylum, Carrie seemed to transcend the squalor, her eyes fixed on some point far beyond the busy roomful of orphans and wardens.

      She reminded Jackson of a painting he’d once seen in church—a pilgrim filled with the quiet ecstasy of her first sight of God. The other children whispered that Carrie—as beautiful and delicate as a moth—was strangely empty, that she had no soul.

      He knew he was the only one who could protect her. He had endured hell in her defense: bloodied nose, broken finger, twisted arm. The rewards were sparing, but he cherished them all the more for their scarcity. She’d smile or squeeze his hand or whisper that she loved him—just often enough to make him believe her. And with just enough sincerity to make him believe she knew how to love.

      He glanced again at the surgery door. He tried to think of Carrie having a kid, but his imagination wouldn’t cooperate. She wouldn’t know the first thing about babies. Ever since that accident back at St. I’s when an infant in Carrie’s ward had died and she’d been sent in disgrace to the isolation room, she’d never spoken of babies, never looked at one, never held one.

      Then one day, Carrie had disappeared from the orphanage. He remembered waiting for her outside the girls’ ward as he always did, the corridor stinking of piss and borax. But she hadn’t come out. Brother Anthony had informed Jackson—cuffing him on the ear for the impertinence of asking—that Carrie had been adopted.