Leicester, September 1857

“In her condition,” Doctor Parwine was saying from the other side of the room, “she must particularly beware foul miasmas.”

The atmosphere in the room was neither foul nor miasmic, Jonas Grantham thought, only gloomy and tense. The girl—and, unfortunately, she was a girl, no matter the situation she’d found herself in—sat stiffly on a chair across the room. Her hair was dark and unbound; her figure showed no sign of the changes that would shortly come to her. She didn’t cry, although Jonas supposed that most girls in her situation would weep. She simply stared straight ahead, hands folded. Maybe she didn’t understand what had happened to her.

He’d seen her a time or two before. He remembered her playing with the other girls just a few years ago, rolling a hoop down the street and shrieking with laughter, ribbons trailing after her.

She still looked more child than woman, but there was no hint of laughter about her now.

“Foul miasmas,” the girl’s mother breathed. “What are foul miasmas?”

“Miasmas,” Parwine intoned, “are the cause of all disease, and are particularly noxious to…” He glanced down at the girl, and then narrowed his eyes. “To expecting mothers,” he finished. “There are a number of miasmas which one must avoid. There is the idio-kino miasma, produced by…”

Jonas Grantham barely restrained himself from a roll of the eyes. In a matter of weeks, he was due to start his course of medical instruction at King’s College in London. He’d beat out students with pedigrees from Oxford and Cambridge to win a prized three-year Warneford scholarship. He was itching for the first lecture—scheduled for the first of October at eight p.m., a mere six days and seven hours from this moment—and ignoramuses like Parwine made his hands itch all the more.

Truly, miasmas? In this modern day and age? The theory of miasmas had been conclusively disproven three years past. Only benighted fools still spouted that gibberish. But Jonas had asked to spend time with Doctor Parwine. He had an agreement in place to take over the man’s practice as soon as he’d finished his education. Parwine had been most specific: He could come along, see how things were managed, but as an untutored (the older man’s words) youth, he was expected to keep silent. So here Jonas stood, listening to an old man ramble on about miasmas.

“Finally,” Parwine was saying, “there is the perkoino miasma, the cause of yellow fever—but surely you will not expose your daughter to that.”

Her parents exchanged glances. “No, doctor, of course not. But what is to be done?”

The last weeks following the man about had not been totally useless. Jonas had learned a great deal about how not to be a physician from Parwine. The doctor maundered on and on with medical terminology that none of his patients understood, all of it supposition that had been rejected by scientific men within the last decades. It took all of Jonas’s self-control—never excellent under ideal circumstances—to keep his mouth shut. He kept telling himself to respect his elders, and so far he’d managed. Barely.

Parwine frowned. “For the prevention of nausea and vomiting, which is so often associated with this delicate condition, I suggest a solution of lettuce water and prussic acid. Take it liberally and there shall be no ill symptoms. I shall leave a direction for such with the apothecary.”

Jonas straightened from his post against the wall and took a step forward, before he checked himself.

He had started reading the medical texts for his course of study, had already begun to commit compounds and cures to memory. Prussic acid was a poison. Some suggested it in minute quantities for the headache; others as a palliative for cancerous growths. But for a pregnant woman? He couldn’t remember reading any such thing. Still, it could exist. And there was that old dictum, that the difference between a cure and a poison was the dose. He bit his lip.

“But, Doctor,” the father repeated, “what is to be done with my daughter? She is…she is only fifteen.”

Parwine looked the girl up and down. “What do you think?” he finally said, in his quiet, gentle voice. “Treat her with Christian kindness. Now that you know what she is, quietly put her away.”

The wife gasped and burst into tears. The girl’s father gripped the seat, his knuckles whitening. “No,” he said in denial.

The only one who didn’t respond was the girl herself.

“I’ve seen it a hundred times,” Parwine said with a shake of his head. “Once a girl is ruined, her life is over. Even if you can conceal the truth of her unfortunate state from those around her, the girl is worth nothing. Her life will follow one of two paths. If she acquires no moral sense, she will continue on in her sluttish ways, a burden of humiliation on all who know her. One of the moral diseases will shortly find her, and she will perish in ignominy.”

“No.” Her father’s hand fell on the girl’s shoulder. “No,” he repeated, this time with greater certainty. “That’s not going to happen to my little girl.”

“Then accept the other path your daughter could tread. If there is any hint of goodness in her, her shame will consume her. She will never be loved; she will go into a decline. Likely she will die early and thus expiate her sin. There is nothing to be done at this juncture except to recognize the truth. Your daughter is already dead. It is only a matter of time until the condition manifests itself.” Parwine gave the man a nod. “I can only treat the symptoms of this disease,” he intoned. “There’s nothing to be done about the cause—moral decay.”

The father pulled a handkerchief from his pocket and dabbed angrily at his eyes. The only dry-eyed one among them was the girl. She stared across the room almost defiantly.

God damn that superstition. Jonas damned himself, too, for agreeing to keep silent as a condition of these visits. He hadn’t chosen to become a doctor so that he could foretell the death of children. He’d been seduced by the stories—the stories of John Snow saving hundreds of lives by careful observation, of men who noticed the world around them and cared and thought, men who set aside irrationality in favor of cures supported by statistical research.

Parwine gathered up his things and motioned for Jonas to follow.

I have seen no scientific study that suggests that life is foreshortened by moral decay, he imagined himself saying to her father as he crossed the room to the exit.

Or maybe this: Don’t take the prussic acid. Whatever you do, don’t take the prussic acid.

Perhaps he might whisper a single phrase: Don’t believe a word he said.

But he’d given the man his word. Besides—he told himself—he knew his place. He was scarcely twenty-one, hadn’t even had his first lecture in medicine. He was not at the point where he should be publicly contradicting a man more than three times his age. Besides, what did he know? A little book learning was all he had. Maybe he was wrong. Maybe Parwine’s experience meant he did know better.

All that was rubbish, and he knew it. As he left, her eyes fell on him. He didn’t even know the girl’s name, but his guilt made him see accusation in her gaze. You could help me.

Superstition, that—nobody could read thoughts from a single glance. It was his own conscience that he saw reflected in her eyes. But he didn’t say anything. He didn’t speak because he was young. He didn’t speak because he doubted his memory of the pharmacopeia. And most thorny of all, Jonas kept his silence because Parwine had offered him his practice once he graduated.

It was the last reason he remembered in the weeks that followed when he queried one of the instructing physicians about the recommended dosage for prussic acid. Almost nothing, the man told him. And for pregnant women? Never.

For years afterward, Jonas dreamed of her eyes—those harsh, cold, accusing depths. He could have helped her.

When he finally graduated, he swore the oath of Hippocrates on Apollo the healer. But it was her face he saw when he spoke, her eyes that bored into his when he promised to do no harm.

* * *

Five years later

The most unreasonable notion Jonas ever had—the nonsensical fixed point of his adult life—started from an excess of rationality. And yet at the time when it happened, everything he did made perfect sense.

He first heard the name “Lydia Charingford” on a brilliant summer day nearly five years after he’d made the rounds with Parwine. He discovered it, not because he recognized her, but because he didn’t. He liked the look of her, so he asked his friend who she was after service one Sunday.

“Would you like an introduction?” Toford asked, a knowing look in his eye.

“It depends,” he responded. “I’m trying to decide whether I favor round numbers or complete information.”

Toford frowned. “For God’s sake, Grantham, use English. What the devil do you mean by that?”

They were standing in a corner of the churchyard, looking over the crowd. It was a fine day at the end of summer, and all the ladies were wearing their loveliest—and their lightest—gowns. The young ladies had been casting welcoming glances his way throughout the rector’s lengthy sermon. Jonas was young, handsome, and—with Parwine now retired—in possession of an excellent income.

Those curious, hopeful glances had made him feel very nice indeed. The breeze was refreshing, the sun was warm, and the ladies were all vying to make a good impression on him. It was a damned good time to be a man.

He was watching the ladies in return. No point in pretending he wasn’t; he intended to take a wife and had only to choose her. But Toford was still staring at him in confusion.

“I mean,” Jonas told him, “that during the service, I made a rank-ordered list of the ten prettiest young ladies in Leicester. I intend to speak with every one of them.”

Toford nodded thoughtfully. “Good plan, Grantham, good plan. I did much the same thing last year, and see how it served me.”

Mrs. Toford had teeth that were far too large. She wouldn’t have ranked anywhere on Jonas’s list. Jonas managed a polite murmur of approval.

“Ten, though,” Toford continued. “Ten’s a lot of women to speak with. You’re tall. You’re respectable. Why not limit yourself to three, maybe five? It’s hard enough work, trying to see if one woman will suit you. My head hurts just thinking of the effort.”

Jonas waved this off. “Yes, well. I have demanding tastes. What if number one snorts when she laughs? What if number six is untidy? What if number eight doesn’t like me?”

“Doesn’t like you?” Toford’s brows rose. “Grantham, I think you have it all wrong.” He looked around and then lowered his voice to just above a whisper. “See here,” he said. “We’re men. We don’t have to marry. These girls, here? They’ve seen their sisters, their friends placed firmly on the shelf. They know their prospects if they don’t catch a man. It’s not their place to like or not like. It’s their place to marry any way they can, and it’s ours to choose.”

“Be that as it may. One never knows what a woman might find off-putting. I’d rather cast my net broadly than miss altogether. And, as it happens, I have a few defects in my character.”

For instance, he was fairly certain that his list of local beauties, arranged by degree of physical attractiveness, was not something that members of the opposite sex would find particularly compelling. Also, he had decided it would be best not to mention his main reason for wanting to marry—that he thought it expedient to procure a regular source of sexual intercourse without risking syphilis.

“Defects?” Toford squinted at him. “Huh. Strange, irrational creatures, women are. Miss Charingford is what number on your list?”

There was the problem. “Eleven. Well, ten, sometimes—but only some of the time. Miss Perrod is usually ten. But at some angles, in some lighting…” He shrugged. “You see my conundrum. If I want to talk to the ten loveliest young ladies, I might need to include Miss Charingford. But if I do, I’ll have eleven, not ten. Both results make my hands itch.” He rubbed them together, but it didn’t help. That unpleasant sensation he felt in the palms of his hands was an illusion, a mere echo of that same itch somewhere in his brain.

“Maybe,” Toford said, “maybe you should talk to her—not for the list, mind you, but just as a way of seeing her up close. Evaluating whether she should be included or not.”

“Ah,” he said in relief. “Good thinking.”

Which was how he found himself walking around a park a few days later, with Miss Lydia Charingford on his arm, wondering how quickly he could extricate himself from the conversation. Closer examination revealed that she was number eleven. Most definitely eleven, with those freckles that he hadn’t noticed from a distance and that too-wide smile. Furthermore, she fussed with the ribbons of her gown and responded to his conversational overtures in monosyllables.

“This is fine weather for September,” he tried.

“Is it?” She stared straight ahead, her mouth pinched in a way that could have sunk her to twelve.

“Yes,” he replied. “It is.”

They walked on in blighted silence.

“Much has changed in Leicester since my absence,” he tried again. “That’s a new façade on the hat emporium, is it not?”

She didn’t even look in the direction that he pointed. “Is it?” she asked.

Her terse responses brought out the devil in him. He’d not been lying when he said he had a few defects in his personality. He turned to her and spoke with no effort at politeness. “Did you know that before I spoke this sentence, you had uttered twenty percent of the words in the conversation? Now we are much closer to ten percent. It won’t do, Miss Charingford. It won’t do.”

Beside him, she tilted her head. “Won’t it?”

He clenched a fist, annoyed beyond measure. He’d used up his rather limited store of polite conversation already, and she wasn’t even trying. In fact, she was looking up at him resentfully.

“I think it will do,” she said. “I think it will do very well. I know what you are thinking, Doctor Grantham. You’re thinking that I’m easy prey.”

“I’m thinking that?” He wrinkled his nose.

She looked about, as if to verify that nobody was nearby. “That because you know of my faults, of what has happened to me, that I’ll be susceptible to your blackmail and flattery.”

“Blackmail!” he repeated in surprise.

“I don’t care what you think of my moral decay,” she hissed. “I am still alive, and I intend to remain so. I refuse to be ruined. If you try anything, you’ll be sorry.”

It was the look on her face that sparked his recognition—that defiant, accusing glare directed at him once more. It made him catch his breath, remembering the girl from five years ago. He’d worried about her after he left. Every time he’d seen an unwed mother or a prostitute in those intervening years, he’d wondered what horror his silence had brought to her.

The answer, apparently, was…nothing. Holding his tongue hadn’t had any consequence. Because she was here, accepted by all. She’d not only survived, she’d managed to do so with her reputation intact.

And she was glaring at him. “So stop measuring me for your bed, Grantham,” she told him. “You aren’t going to have me.”

He stared at her, collecting his confused feelings. He hadn’t recognized her, but she’d recognized him—the difference between fifteen and twenty, apparently, being far greater than the difference between twenty-one and twenty-six. She was being uncivil to him on purpose. She thought—oh, God—she thought he was trying to—

“Rest easy, Miss Charingford,” he said. “I wasn’t attempting to seduce you. I had come to no conclusions about your virtue. I was only talking to you because you were the eleventh prettiest young lady in Leicester.”

Faint dots of pink appeared on her cheeks. “Oh?” There was a dangerous tone to her voice now. “Eleven, am I?”

“That is—I mean—” He looked away. “Shite. I didn’t mean to say that.”

She didn’t gasp at that obscenity. “Work your way on to number twelve,” she snapped. “Number eleven wants nothing more to do with you.”

She lifted her nose in the air—the eleventh prettiest nose in the entire town—and stalked away. He watched her go, his insides a total muddle.

She’d lived. She’d survived. Her reputation hadn’t suffered. She crossed the park to another woman who had been waiting for her on a bench. Their heads bent together under their hats, black hair touching tawny honey, and then they laughed.

He’d never seen anything so vibrant, so full of life.

“Shite,” he breathed again.

Her laughter seemed like a complete repudiation of the superstitions of the last century. It was a great light cast on the dark miasmas of the last century of medicine.

Live, Miss Charingford. Live.

She linked arms with her friend—a young lady who hadn’t ranked at all—and strolled away.

He felt as if he’d been hit straight on with a cannon blast. One of the defects in his personality was a taste for the perverse. Being told he couldn’t have something only made him want it more. And at the moment, he wanted. He wanted her very badly.

Toford came up behind him. “Well? What number is she?”

“Eleven,” he answered.

“Not on the list, then.” Toford shrugged.

“No.” He still couldn’t take his eyes off her. “No, she is. This list goes to eleven.”

It was a lie. He knew it was a lie even as he said it. His rational mind, usually so predominant, kicked up a protest. He had hoped to establish his household within the next few months. And he had really been looking forward to securing that source of safe, regular sexual intercourse. There were literally dozens of women who would be willing to provide it—pretty ones, who actually smiled at him in encouragement instead of accusing him of seduction.

Miss Charingford didn’t even want to talk to him. It made no sense to consider her.

But it was too late. Miss Lydia Charingford wasn’t just on the list.

She was the list, and he hoped God would have mercy on his soul.