“If you keep the brandy down, that should help a little,” he says.
“I wish to God I could piss,” the priest says, “but I can barely squeeze out a drop.”
Anna sits by the bed and reads out Saint Paul’s letters to the Corinthians in her quiet and halting English. As the afternoon moves into evening, the priest’s pain worsens and he starts to moan and gasp. Sumner makes up a warm poultice and finds some paregoric in the medicine chest. He tells Anna to continue giving him brandy and the Dover’s Powder, and to use the paregoric whenever the pain gets worse. During the night, the priest wakes up every hour, his eyes bulging, and howls with pain. Sumner, who is asleep at the table, his head resting on his folded arms, jolts awake each time, his heart pounding, and his own guts twisting in sympathy. He goes over to the bed, kneels, and gives him more brandy to drink. As he sips from the glass, the priest grasps onto Sumner’s arm as if scared he might suddenly leave. The priest’s green eyes are wild and rheumy; his lips are crusted, and his hot breath is foul.
In the morning, when they are out of earshot, Anna asks Sumner whether the priest is going to die.
“He has an abscess inside him here,” Sumner explains, pointing to the right side of his belly just above the groin. “Some inner part has ruptured and his belly is filling up with poison.”
“You will save him though,” she says.
“There’s nothing I can do. It’s impossible.”
“You told me you are an Angakoq.”
“We are a thousand miles or more from any hospital, and I have no medicines to speak of.”
She gives him a disbelieving look. Sumner wonders how old this Anna is — eighteen? thirty? It is difficult to judge. All the Esquimaux women have the same leathery brown skin, the same small dark eyes and quizzical expression. A different man would have taken her to his bed, he thinks, but the priest has tutored her to read the Bible and answer back.
“If you can’t save him, then why are you here?” she asks. “What are you for?”
“I’m here by accident. It doesn’t mean anything.”
“Everyone died except for you. Why did you live?”
“There is no why,” he says.
She glares at him, then shakes her head and goes back to the priest’s bedside. She kneels down and starts to pray.
After a few more hours, the priest begins having violent shivering fits and his skin turns cold and clammy. His pulse is faint and irregular, and his tongue has a large streak of brown along its center. When Anna tries to give him brandy, he throws it up. Sumner watches for a while, then pulls on his new set of furs and steps outside the cabin; it is bitterly cold and only semilight, but he is glad to escape from the sour stench of mortal illness and the priest’s constant, grating howls of complaint. He walks past the igloo and looks out east across the immense desert of sea ice to the faint white parabola of the far horizon. It is noon, but the stars are visible overhead. There is no sign of life or movement anywhere; everything is still and dark and cold. It is as if the end of the world has already happened, he thinks, as if he is the only man left alive on the frigid earth. For several minutes he stands where he is, listening to the shallow wheeze of his own breathing, feeling the red muscle of his heart gently thudding in his chest; then, remembering himself at last, he turns slowly around and goes back inside.
Anna is laying another poultice on the priest’s belly. She gives him a fierce look but he ignores it. He goes to the medicine chest and takes out a large bottle of ether, a wad of lint, and a lancet. He spends a few minutes sharpening the lancet to an edge with a whetstone. Then he clears the remaining books off the table and wipes it clean with a damp rag. He walks over to the bed and looks down at the priest. The elder man’s skin is waxen and damp, and his eyes are filled with pain. Sumner places his hand on his forehead and then peers into his mouth for a moment.
“Your cecum is abscessed,” he tells him, “or possibly ulcerated — the difference is unimportant. If we had any amount of opium in the medicine chest, that would help, but since we have none at all, the best thing to do is make a cut in your belly here to allow the diseased matter to flow out of you.”
“How do you know such things?”
“Because I’m a surgeon.”
Since he is in too much pain to comment or express surprise, the priest merely nods. He closes his eyes a moment to think, then opens them again.
“So you’ve done the thing before?” he asks.
Sumner shakes his head.
“I’ve neither done it myself nor seen it done. I read about it being performed by a man named Hancock in the Charing Cross hospital in London some years ago. On that occasion, the patient lived.”
“We’re a good way from London,” the priest says.
Sumner nods.
“I’ll do all I can in these conditions, but we’ll need a large amount of luck.”
“You do your best,” the priest says, “and I expect the Lord will take care of the remainder.”
Sumner asks Anna to fetch her brother in from the igloo and, when the brother arrives, he tips some of the ether onto the wad of lint and places it over the priest’s nose and mouth. They remove his clothes, then lift his naked, lolling body off the cot and lay it out on the table. Sumner lights an extra candle and places it on the windowsill to illuminate his work. Anna starts praying and rapidly crossing herself, but Sumner interrupts her pieties and instructs her to stand at the end of the table and apply more ether whenever the priest shows any sign of reviving. The brother, who is tall and has a genial, oafish air, is given a metal bucket and a towel, and told to stand by Sumner’s shoulder and stay alert.
He palpates the abdomen again, feeling its lines of hardness and give. He wonders for a moment if he has made a mistake, if this is a hernia or a tumor rather than an abscess, but then reminds himself why that can’t be true. He tests the sharpness of the lancet against his thumb, then presses the blade’s edge down into the priest’s flesh and makes a lateral cut from the top of his hip bone, halfway to the navel. It takes him several attempts to penetrate the layers of sheath, muscle, and fat and get into the abdomen proper. As he presses deeper, blood wells up and he wipes it away with a cloth and continues cutting. As soon as he pierces the cavity wall, a pint or more of foul and flocculent pus, turbid and pinkish gray, squirts unhindered out of the newly made breach, spattering across the table and coating Sumner’s hands and forearms. The roaring stench of excrement and decay instantly fills the cabin. Anna yelps out in horror and her brother drops the metal bucket. Sumner gasps and jolts backwards. The discharge is fibrinous, bloody, and thick as Cornish cream; it pulses out from the narrow opening like the last twitching apogee of a monstrous ejaculation. Sumner, squinting against the reek, curses, spits onto the floor, then, breathing through his mouth, cleans the muck from his hands and arms, and tells the brother to wipe the table down and throw the soiled rags into the stove. The three of them, working together, tip the priest over onto his side to further speed the drainage. He makes a low moan as they move him. Anna, with shaking hands, reapplies the etherized lint to his face until he settles. Sumner presses down on the skin and muscle around the edges of the wound with his fingertips, pushing out as much of the remaining foulness as he can. It is hard to believe that the priest’s body could contain such an abundance of pus. He is not tall, and, stripped naked as he now is, he appears slight, bony, and almost boyish, yet it gurgles out of him like water from a rock. Sumner presses down and the brother wipes up the outflowings. They press and wipe, press and wipe, until eventually the stinking stream slows, then ceases altogether.