“Is that why you asked about contraception?” I asked, waving a greeting as we passed the MacRaes’ campsite. “You were worried about having more children, in case . . .”

“Oh. No. I mean—I hadn’t even thought about venereal disease until you mentioned syphilis, and then it just struck me as a horrible realization—that he might have—” She stopped and cleared her throat. “Er, no. I just wanted to know.”

A slippery patch of trail put paid to the conversation at that point, but not to my speculations.

It wasn’t that a young bride’s mind might not turn lightly to thoughts of contraception—but under the circumstances . . . what was it? I wondered. Fear for herself, or for a new baby? Childbirth could be dangerous, of course—and anyone who had seen the attendees at my surgery or heard the women’s conversations round the campfires in the evening could be in no doubt as to the dangers to infants and children; it was the rare family that had not lost at least one infant to fever, morbid sore throat, or “the squitters”—uncontrolled diarrhea. Many women had lost three, four, or more babies. I remembered Abel MacLennan’s story, and a small shiver ran down my spine.

Still, Brianna was very healthy, and while we did lack important things like antibiotics and sophisticated medical facilities, I had told her not to underestimate the power of simple hygiene and good nutrition.

No, I thought, watching the strong curve of her back as she lifted the heavy equipment over an entangling root that hunched across the trail. It wasn’t that. She might have reason to be concerned, but she wasn’t basically a fearful person.

Roger? On the face of it, it would seem that the best thing to do was to become pregnant again quickly, with a child that was definitely Roger’s. That would certainly help to cement their new marriage. On the other hand . . . what if she did? Roger would be more than pleased—but what about Jemmy?

Roger had sworn a blood oath, taking Jemmy as his own. But human nature was human nature, and while I was sure that Roger would never abandon or neglect Jemmy, it was quite possible that he would feel differently—and obviously differently—for a child he knew was his. Would Bree risk that?

On due consideration, I rather thought she was wise to wait—if she could. Give Roger time to feel a close bond with Jemmy, before complicating the family situation with another child. Yes, very sensible—and Bree was an eminently sensible person.

It wasn’t until we had arrived, finally, at the clearing where the morning surgeries were held that another possibility occurred to me.

“Can we be helpin’ ye at all, Missus Fraser?”

Two of the younger Chisholm boys hurried forward to help, relieving me and Brianna of our heavy loads, and without being told, started in at once to unfold tables, fetch clean water, kindle a fire, and generally make themselves useful. They were no more than eight and ten, and watching them work, I realized afresh that in this time, a lad of twelve or fourteen could be essentially a grown man.

Brianna knew that, too. She would never leave Jemmy, I knew—not while he needed her. But . . . later? What might happen when he left her?

I opened my chest and began slowly to lay out the necessary supplies for the morning’s work: scissors, probe, forceps, alcohol, scalpel, bandages, tooth pliers, suture needles, ointments, salves, washes, purges . . .

Brianna was twenty-three. She might be no more than in her mid-thirties by the time Jem was fully independent. And if he no longer needed her care—she and Roger might possibly go back. Back to her own time, to safety—to the interrupted life that had been hers by birth.

But only if she had no further children, whose helplessness would keep her here.

“Good morn to ye, ma’am.” A short, middle-aged gentleman stood before me, the morning’s first patient. He was bristling with a week’s worth of whiskers, but noticeably pallid round the gills, with a clammy look and bloodshot eyes so raw with smoke and whisky that his malady was instantly discernible. Hangover was endemic at the morning surgery.

“I’ve a wee gripin’ in my guts, ma’am,” he said, swallowing unhappily. “Would ye have anything like to settle ’em, maybe?”

“Just the thing,” I assured him, reaching for a cup. “Raw egg and a bit of ipecac. Have you a good vomit, and you’ll be a new man.”

THE SURGERY was held at the edge of the big clearing at the foot of the hill, where the great fire of the Gathering burned at night. The damp air smelled of soot and the acrid scent of wet ashes, but the blackened patch of earth—some ten feet across, at least—was already disappearing under a crisscross of fresh branches and kindling. They’d have a time starting it tonight, I thought, if the drizzle kept up.

The gentleman with the hangover disposed of, there was a short lull, and I was able to give my attention to Murray MacLeod, who had set up shop a short distance away.

Murray had gotten an early start, I saw; the ground by his feet was dark, the scattered ashes sodden and squishy with blood. He had an early patient in hand, too—a stout gentleman whose red, spongy nose and flabby jowls gave testimony to a life of alcoholic excess. He had the man stripped to his shirt despite the rain and cold, sleeve turned up and tourniquet in place, the bleeding bowl held across the patient’s knees.

I was a good ten feet from the stool where Murray plied his trade, but could see the man’s eyes, yellow as mustard even in the dim morning light.

“Liver disease,” I said to Brianna, taking no particular pains to lower my voice. “You can see the jaundice from here, can’t you?”

“Bilious humors,” MacLeod said loudly, snapping open his fleam. “An excess of the humors, clear as day.” Small, dark, and neat in his dress, Murray was not personally impressive, but he was opinionated.

“Cirrhosis due to drink, I daresay,” I said, coming closer and looking the patient over dispassionately.

“An impaction of the bile, owing to an imbalance of the phlegm!” Murray glowered at me, clearly thinking I intended to steal his thunder, if not his patient.

I ignored him and bent down to examine the patient, who looked alarmed at my scrutiny.

“You have a hard mass just under the ribs on the right, don’t you?” I said, kindly. “Your piss is dark, and when you shit, it’s black and bloody, am I right?”

The man nodded, mouth hanging open. We were beginning to attract attention.

“Mo-therr.” Brianna was standing behind me. She gave Murray a nod and bent to mutter in my ear. “What can you do for cirrhosis, Mother? Nothing!”

I stopped, biting my lip. She was right. In my urge to show off by making the diagnosis—and keep Murray from using his stained, rusty-looking fleam on the man—I had overlooked the minor point that I had no alternative treatment to offer.

The patient was glancing back and forth between us, plainly uneasy. With an effort, I smiled at him, and nodded to Murray.

“Mr. MacLeod has the right of it,” I said, forcing the words past my teeth. “Liver disease, surely—caused by an excess of humors.” I supposed one could consider alcohol a humor, after all; the folk drinking Jamie’s whisky last night had evidently found it hilarious.

Murray’s face had been tense with suspicion; at my capitulation, it went quite comically blank with astonishment. Stepping in front of me, Brianna seized advantage of the moment.

“There’s a charm,” she said, smiling charmingly at him. “It . . . er . . . sharpens the blade, and eases the flow of the humors. Let me show you.” Before he could tighten his grip, she snatched the fleam from his hand and turned to our small surgery fire, where a pot of water hung steaming from a tripod.

“In the name of Michael, wielder of swords, defender of souls,” she intoned. I trusted that taking the name of St. Michael in vain was not actual blasphemy—or if it was, that Michael would not object in a good cause. The men laying the fire had stopped to watch, as had a few people coming to the surgery.

She raised the fleam and made a large, slow sign of the cross with it, looking from side to side, to be sure she had the attention of all the onlookers. She did; they were agog. Towering over most of the gawkers, blue eyes narrowed in concentration, she reminded me strongly of Jamie in some of his more bravura performances. I could only hope she was as good at it as he was.

“Bless this blade, for the healing of your servant,” she said, casting her eyes up to heaven, and holding the fleam above the fire in the manner of a priest offering the Eucharist. Bubbles were rising through the water, but it hadn’t quite reached the boil.

“Bless its edge, for the drawing of blood, for the spilling of blood, for the . . . er . . . the letting of poison from the body of your most humble petitioner. Bless the blade . . . bless the blade . . . bless the blade in the hand of your humble servant. . . . Thanks be to God for the brightness of the metal.” Thanks be to God for the repetitious nature of Gaelic prayers, I thought cynically.

Thanks be to God, the water was boiling. She lowered the short, curved blade to the surface of the water, glowered significantly at the crowd, and declaimed, “Let the cleansing of the waters from the side of our Lord Jesus be upon this blade!”

She plunged the metal into the water and held it until the steam rising over the wooden casing reddened her fingers. She lifted the fleam and transferred it hastily to her other hand, raising it into the air as she surreptitiously waggled the scalded hand behind her.

“May the blessing of Michael, defender from demons, be on this blade and on the hand of its wielder, to the health of the body, to the health of the soul. Amen!”

She stepped forward and presented the fleam ceremoniously to Murray, handle first. Murray, no fool, gave me a look in which keen suspicion was mingled with a reluctant appreciation for my daughter’s theatrical abilities.

“Don’t touch the blade,” I said, smiling graciously. “It will break the charm. Oh—and you repeat the charm, each time you use the blade. It has to be done with the water boiling, mind.”

“Mmphm,” he said, but took the fleam carefully by the handle. With a short nod to Brianna, he turned away to his patient, and I to mine—a young girl with nettle rash. Brianna followed, wiping her hands on her skirt and looking pleased with herself. I heard the patient’s soft grunt behind me, and the ringing patter of blood running into the metal bowl.

I felt rather guilty about MacLeod’s patient, but Brianna had been quite right; there was absolutely nothing I could do for him under the circumstances. Careful long-term nursing, coupled with excellent nutrition and a complete abstinence from alcohol, might prolong his life; the chances of the first two were low, the third, nonexistent.

Brianna had brilliantly saved him from a potentially nasty blood infection—and seized the opportunity to provide a similar protection for all MacLeod’s future patients—but I couldn’t help a nagging sense of guilt that I could not do more myself. Still, the first medical principle I had learned as a nurse on the battlefields of France still held: treat the patient in front of you.