“Thank you.” His voice sounded so uncharacteristically warm she glanced up at him in surprise. His eyes betrayed nothing, and she couldn’t tell what he wanted. Which reminded her of their first conversation since his return.
“You came to me to tell me something. You said we needed to talk. Is now a good time?”
Mark took a bite of sausage before answering. He adjusted his seating in the chair. “Just...family-related matters. I didn’t know that you kept in contact with my mother so much. You already know most of what I was going to tell you, I think.”
Ellen frowned.“What family matters?”
“Matthew cannot have children anymore.” Mark hesitated, clearly trying to find the right wording. “So if he dies before me, I shall inherit the barony. I shall become Lord Cottesloe.”
Ellen blinked. “I hadn’t thought of that. I’m told it was a serious accident.”
Mark paused again. “So when I become Lord Cottesloe, hopefully three or so decades from now, you shall be Lady Cottesloe.”
Ellen laughed. “My parents shall be thrilled. I’ll be aristocracy after all, even if it does take forty years to get there. And since you have four younger brothers, I suppose the title will be passed down the line as we die.”
He gave a weak smile.
The tension between them had eased, and Ellen didn’t know what to think.
“How are the twins doing?” Mark asked. He had just given her the perfect escape from whatever had been growing between them for the last moment.
Ellen nodded. “Still alive, thank goodness. I’m still worried. They’re having cyanotic attacks, but so far we’ve caught all of them and can jostle them back into breathing before they turn blue. The chances of them catching a fever or pneumonia or something else are so high. I do my best to get them from premature to healthy newborn, but infant mortality rate is still around fifteen percent—and higher among the working class—even among healthy, full-term, well-fed infants.”
Mark hummed. “Is the poverty that bad?”
Ellen shot him a look. “I imagine life as a sailor isn’t pretty if you aren’t on the officer track. Think about all the men who worked and lived in the hold of your ship. Now imagine women and children and babies in similar conditions. But with less food.”
Mark grimaced. “I see.”
Ellen sighed, thinking of everyone and everything she’d seen yesterday. The Patel twins were growing slowly but steadily, thanks to their parents’ patience with teaching them how to swallow and suck. They also had a supportive family, which made all the difference in whether the twins would get the attention they needed to learn to eat and survive. Besides the tedium of holding two babies for three hours, ready to thump them awake if they decided to stop breathing (it had happened three times, twice with the elder and once with the younger), it had been her easiest stop of the day.
A neighbor of the Patels had requested Ellen’s help with breastfeeding, but she'd demurred. Ellen’s expertise was in premature babies and only one type of pregnancy complication. She’d never breastfed, never planned on breastfeeding, and wasn’t a midwife. So Ellen had rattled off the names of some women she knew worked at local hospitals or the Nightingale Training School.
Most of her appointments had gone smoothly, though the Baggins baby looked like he was developing whooping cough. Ellen had tried to convince the father to take the baby to Amelia to get it looked at, but he didn’t trust lady doctors. Mrs. Bagginslooked worried but tried to downplay the issue since it was clear she wouldn’t get far with her husband. After spending far too much time trying to reason with Mr. Baggins, Ellen suggested taking the child to the Hospital for Sick Children where there were only male doctors. She’d even repeated the address on Great Ormond Street multiple times, but to no avail.
Elke Heinrich, the motherless babe, wasn’t gaining weight but she also wasn’t losing, so Ellen told the baby’s grandmother to keep doing what she was doing. She wished she'd more training, equipment and funding to try all the ideas coming out of France and Belgium, but she tried to remind herself she was making some difference, and saving some babies was better than saving none. Sometimes she even believed it.
“There was one visit yesterday that went on far longer than I’d intended,” Ellen said. She didn’t know what made her say it, save that sitting there in silence with Mark was dreadfully awkward and she didn’t want to discuss anything personal with him.
He looked up at her expectantly.
“I saw this woman. She has a scrawny four-month-old girl who I’ve been watching carefully for malnutrition. Well, worse malnutrition than usual for their neighborhood.” Ellen sighed. “I found out she’s pregnant again.”
Mark cocked his head, as though waiting for the punchline.
“Her husband refuses to stay off of her.” Ellen ignored the choking noise Mark made. “She’s had fourteen pregnancies in ten years. Only eight of those resulted in live births, and only four of those children lived past their first birthday. Well, hopefully it will be four, once the baby starts eating better. If they can afford the goat milk.
“These past three years it seems she gets pregnant every few months, miscarries, then is immediately pregnant again. Opal, the baby, is her first live birth for the past four pregnancies. This woman is literally wasting away before my eyes. The pregnancies just take and take and take from her body, sucking all the nutrients out of her, and she doesn’t eat enough or restenough to build her body back up between pregnancies. It’s not right.”
“What’s the solution?”
Ellen rubbed her face. “More food. Cleaner water. Her husband to stop drinking his wages away. Contraceptive sponges or rubber sheaths if she could afford it. Maybe even a feminine hygiene pill that will end this pregnancy. Her milk’s drying up because of the pregnancy, and she could end up with either a miscarriage or a dead baby. Or both.” Ellen gauged Mark’s reaction. “I think one of the quickest solutions would be a dead husband. He’d finally leave her alone.”
“There are teas that prevent conception? Or end pregnancies?” Mark sounded intrigued. “You know about these things?”
“Yes.” Ellen’s lips curled. “Women have been using herbal teas since time immemorial. Well, perhaps not the upper classes.” She snickered. “Can you imagine my mother learning I know these things? I’m hardly supposed to know what sex is, as a proper lady. She’d faint dead away.”
Mark laughed, and it made her belly flip and twist.