This Duchess of Mine(64)

“The Duke of Villiers and the Duke of Beaumont. Two dukes are here to consult with you.”

Dr. Chalus hummed, deep in his throat, and finally looked up. His eyes were bloodshot and tired, and for the first time, Elijah felt a bit of hope. The doctor looked like a man working as hard to cure hearts as he himself was to cure the ills of English governance.

“Your Graces,” he said, looking singularly unimpressed by their presence in his office. “What can I do for you?”

By fifteen minutes later, though, it was clear that Chalus was having no more luck solving heart problems than Elijah had had in the House of Lords. “Your heart is beating irregularly,” he said. “I can hear it clearly. At the moment it is quite fast.”

“What can you do for it?” Elijah asked, already knowing the answer. The doctor’s eyes were far too sympathetic for his liking.

“I have had small successes here and there,” he told them. “I am working on a medicine that will force urination when a patient has dropsy. I believe the swelling we call dropsy indicates the heart is about to give out. But your ankles are quite normal.”

Elijah nodded.

“From the sound of your heart, you may have a spasmodic defect, something wrong on the right side. Which is unusual: generally one hears problems with the left side. That may explain…”

Dr. Chalus’s voice died away and he looked as if he were listening to an argument only he could hear.

Villiers cleared his throat.

The doctor shook himself. “Your heartbeat is tumultuous, but you are perplexingly free of some of the symptoms I would expect. Perhaps a structural defect on the right side would explain why you are not suffering from dropsy. I would love to know…”

“How could you determine it?” Elijah asked.

Chalus shook his head. “I can’t.”

“Then how do you gain your knowledge?”

“Through autopsy of the dead,” the doctor said, backing away to his desk. “And for the most part, those patients who are wealthy enough to realize that they should see me are not inclined to allow me to examine their bodies after death.”

Elijah nodded. He had no such inclination himself.

“You have no idea how frustrating the study of medicine can be. The only bodies I am able to examine are those of criminals. And when a man has been hanged, it is readily obvious why and how he died. That is not helpful in the study of hearts. You’d be surprised,” he said, turning to include Villiers in the conversation, “how infrequently criminals suffer from dropsy.”

“I can imagine,” Villiers said.

“There is nothing that can be done,” Elijah stated. He felt a remote airiness in his head, though it was nothing he hadn’t surmised himself.

Dr. Chalus was sympathetic enough. “I don’t have anything to offer you that isn’t, frankly, a palliative. I am currently having some success by inducing my patients to inhale a vapor infused with fungi, or mushrooms. But as I say, I am trying to find a cure for dropsy, and you show no signs of that.”

“Surely you are not the only physician studying hearts?” Villiers said briskly. “Who are your colleagues? Who else is experimenting with such medicines?”

“Darwin, of course,” Chalus said. “Erasmus Darwin. But frankly, I consider him a fool, and his recent publications have been rather weak. There’s a fellow that we’re considering admitting to the Royal Society. He’s had some luck, I believe…” He went over to his desk and began rummaging about the great sheaves of paper.

Elijah wasn’t even listening. Villiers was right. He had to prepare his estate. He should summon his solicitor tonight.

“How much time do I have?” he asked abruptly.

The doctor paused. “You present an unusual case, Your Grace.”

“Surely you can give me some sort of estimation.”

“You are fainting, you said, for short periods of time. Immediately upon vigorous exercise?”

Elijah shook his head.

“He was in a fistfight at Vauxhall last night and seemed in the pink of health afterwards,” Villiers said. “But I found him unconscious, sitting in a chair one afternoon.”

“I was tired,” Elijah said. “Tired. If I’m very, very tired, and I sit down…”

“You’re rather lucky,” Dr. Chalus said. “Most patients can’t tolerate vigorous exercise and you seem to be the opposite. How often does this occur?”

“I have these episodes perhaps once a week. More so if I am deeply exhausted.”

“I recommend avoiding exhaustion, though I’m sure that has occurred to you as well.”