Bone Powder

One flash of the scalpel, and the assistant’s pinkie finger comes off. It tumbles to the floor, landing on sawdust. The assistant recoils and clutches his bleeding hand. He doubles over, clenching his teeth to block a scream.

I don’t know why he bothers. His scream couldn’t be more chilling than the patient’s terrified howl.

The surgeon doesn’t stop. He pushes deeper with his knife into the patient’s upper arm, pink yielding to purple. The knife jams on bone, so he tosses it aside. He brandishes a bone saw, and slides it into the wound.

The assistant has regained his composure, and uses his intact hand to hold the patient’s arm firm. He presses the bleeding stump on his other hand hard into his sternum.

Around the operating table, the students stand and watch, faces slack.

I’m frozen by the upper arm wound, which is blossoming into curling petals of sick yellow fat and blazing incarnadine flesh.

Then there is the grating snore of bone splintering, and my stomach heaves. I bolt from the room, and bury my face in my hands, desperately sucking calmness from stale air. My body turns cold, and my intestines writhe like poisoned snakes.

From within the operating room, the crowd cheers. The surgeon has set a new speed record for transhumeral amputation.

I look up from my hands, and see the students falling backwards through the doorway, unwilling to look away from the surgeon, gabbling congratulations. Taller than the students and pulsing with stern ardor, the surgeon is a sun dragging orbiting planets. His apron is splattered with glistening fresh gore, bright against the sooty crust from hundreds of other operations. He turns the severed arm in his hands with the delicate touch of a conjurer manipulating their crystal orb.

At the back of the pack, the assistant holds his unblemished hand above his head. His fingers pinch his own severed digit, on display as a trophy in this impromptu triumph.

I step aside, and the parade flows past me, not acknowledging my presence. In a few moments, I am alone.

I peek through the operating room door and see two silent nurses dragging the patient off the table onto unsteady feet, shouldering him for the stumble back to his bed. His upper chest and forearm are tightly bound in white bandages. His face is ash, his blood and bile exhausted by the ordeal. But his eyes shimmer. He knows he is alive.

Tomorrow, it will be my turn to operate. I will be asked to wield the knife, and open up the body of a living, screaming patient. I will have to hold him firm as he writhes, and guide a brisk scalpel through the impossible maze of bulging blood vessels.

Just the thought makes my insides contort.

I startle as a hand squeezes my shoulder.

“Joshua my boy, show’s over! The lads are going to swing by the pub to rejoice in that swashbuckling performance we were blessed to witness. Your presence is requested. Nay, required. The Lord Mayor told me so himself. You can’t fight Mansion House.”

“Snodgrass, I’m not sure I should, I’ve got an… appointment. Of a medical nature.”

“One tankard of Genuine Stunning Ale and you can be on your way. In my experience, though, one is rarely enough.”

And so Snodgrass prods me onto the street. As we walk, he prattles about the twists and shocks in a nautical theatrical he witnessed last night at the Old Vic.

I try not to breathe as we travel down the London streets. Nothing can prepare a vicar’s son from Essex for the stench of this city. Leavings of horses, flooding cesspits, and rotting carcasses are scattered like bluebells and primroses… And then there’s the Thames, congealed with waste, and stinking like a forgotten abattoir. As we walk, I see an old woman lean out of an upper window and tip the contents of a chamberpot onto the street.

It’s as though the people who live here don’t know poison air is the root of contagion. I can’t wait for Christmas. The first thing I’ll do when I’m home is find a meadow, lie down, and suck down the clean air.

Finally we reach our tavern, Old Dr. Butler’s Head, the preferred watering hole for those apprenticed in the trade of surgery.

The other students are already huddled at our regular table. Trelawney is setting up dominoes, and flicking them at Griffith. Shaw, the assistant who was partially denuded at today’s surgery, is chattering at an impatient barmaid. Abernathy is slurping an oyster from its shell.

Wisps of tobacco smoke twirl in the air, heavy on the lungs, but healthier than the miasma outside. If I ever become a successful surgeon, I’ll need to take up smoking to prolong my life. The sawdust scattered across the floor makes me think of our operating room.

Snodgrass plants himself next to his friends, and restarts his narrative of last night’s nautical drama from the opening of the velvet curtain. I squeeze in next to him, although there isn’t much room left on the bench. Without speaking, Abernathy pushes the bucket of half-shell oysters on the table towards me. I reach in and pluck one out. I put the shell to my mouth, close my eyes, and suck down the slimy, gelatinous flesh, trying to ignore the briny, metallic taste.

Griffith reaches into his bag, and pulls out a human shin bone. He holds it parallel to his mouth, and blows on a hole. The bone whispers an ethereal, fractured note.

This is Griffith’s third attempt at a bone flute. He adds extra holes or widens them to extend his musical range and precision, but constant tinkering has broken the previous flutes. Invariably, he sources fresh bones from our patients' discarded limbs.

Shaw is still talking to the barmaid, and has convinced her to eat one of our oysters. She puts the oyster to her mouth, swallows, and then retches. She spits, and a pink projectile shoots across the room like a dart, landing neat in a shocked clerk’s tankard. The room falls silent. Even Snodgrass abandons his description of the play. The barmaid storms off.

All grace, Shaw saunters over to the traumatised clerk, gives a half bow, and retrieves his pinkie finger from the tankard. He places a shilling on the table in compensation for the tainted ale.

The apprentices erupt in acclaim, beckoning their waggish comrade back and delivering toasts and back slaps.

In the tumult, I slip out.

When I indentured as a surgeon, it was out of appreciation for the intricacy of God’s creation, and a desire to help my fellow man transcend the maladies of this fallen world.

I never imagined it would involve musical instruments of human bone, parlour games with severed fingers, or the shrieks of mutilated and dying patients.

And my first practical exam is tomorrow. This time, I won’t be operating on a cadaver, but a living patient, who could die if my hand trembles.

I would run home’to Essex, but the hospital won’t refund my indentures if I quit, and my family cannot afford to apprentice me to another trade.

In my desperation, I have resorted to the apothecaries of Soper Lane. Most of them offered me opium. Opium won’t do, I can’t sleepwalk through a surgery. One of the dingier stores, managed by a compounding apothecary with a lazy eye and a scraggy beard, offered to mix a medicine that would invigorate my spirit, and let me work without fear or qualm.

I go now to collect my prescription. Before today, I wasn’t sure if I would take it, but I see now that I must kill my womanly squeamishness if I am to thrive as a surgeon. Is God not a stern father? Must we not be cruel to be kind?

Imagine my surprise when I reach the apothecary’s shop, and observe burly porters carrying out the chairs and tables.

I dart inside, and see an old woman examining the brass contents of a box of weights. Much of the shop is empty, plundered of its Mason jars of sugar and ambergris wrapped in beeswax.

“Hello, dearie. You looking for old Mr Thimble? He went to bed for the last time a few days ago. A mercy, really. Most of the precious stuff’s been taken for debts, but there’s a few knicknacks of interest here and there. If you're looking to buy any of them, I’ll give you a fair price. The copper vessels are already spoken for, mind you.”

“Oh, no, I was actually one of his… customers. He was making a medicine for me.”

“Should have been making medicine for himself, it seems. Never know when our time comes.”

“I don’t suppose he’d already done it? Mixed up the medicine? It might be ready for me.”

“Well, you’re welcome to check, but I don’t like your chances. It’ll be behind the counter if it’s anywhere. He didn’t have that many customers, towards the end. You know how people like to talk.”

I slip behind the counter. The shelves below the counter are as barren as the rest of the shop, with only some dried fruit and piles of loose paper. But poking out from one of the stacks of paper, I see the edge of an envelope. I pull it out. The envelope is a piece of paper that has been folded over multiple times, and written on it are the words, ‘dragon’s teeth’.

“It seems to be here - that’s lucky. I’ll just take it now. I’ve already paid. But here, have this sixpence. As thanks for your help. I’ll also make sure to pray for the soul of the departed.”

“No need, dearie. The professionals are on the job. We’ll make sure the prayers go to the right place. You’ll just get in the way.

At that, I dash out of the shop, determined to make my way home without any further misadventure.

When I get back to my lodgings, it is becoming dark. I light a candle, and examine the envelope at my table. Dragon’s teeth. Like the legend. Plant dragon’s teeth, and warriors will grow from the ground. Strength. Resilience. Power. This must be my medicine.

I untuck the sides of the envelope, and lift the first layer of paper. Inside, I see a list of scribbled ingredients. I unfold the next layer, and turn the contents onto the table.

Nothing more than a few grains of powder. I touch them with my finger, and press them to my tongue. They taste of salt.

My eagerness spoils like overripe fruit, and my bile rises, cold and dry.

I hold the creased paper close to my face, squinting to decipher the scrawled recipe. Salt. Garlic. I can get those from my landlady’s pantry. In fact, most of these ingredients are easy to find. Only one of them is harder to source.

Human bone.

I think of what I just tasted, and hurl the paper away from me. In bleary candlelight, I fancy I can see skeletons dancing on the walls, metacarpal bones slapping patellas.

Then I remember the histories of medicine. Mithridatium. Theriac. Medicines of Kings, reputed to grant immunity to poison, or cure any ailment. Many of their ingredients are close secrets, known only to the stately apothecaries of Venice. It is well known that there is vitality trapped in the bodies of the untimely dead. Why not their bones as well? Could bone be the answer I am seeking?

Strength. Resilience. Power. Yes. These must reside in our bones, in the pink jelly within them. Bone may be the true source of life.

I’ll try it. For the sake of the desperate man I will soon operate on, I will try it.

I return to the hospital, letting myself in through the servant’s door. Nurses float through the halls on obscure missions. They would never question the movements of a surgeon, even an apprentice still learning his trade, even one afoot in the quiet hours.

I pass through the operation chamber’s anteroom, watched by jars of floating eyeballs, preserved in amber goo. From nails on the wall hang sharp tools, their edges still sticky with blood from the day’s exertions. The room is perfumed in lavender and sage, to protect the surgeons from the poisonous aroma of decay.

Lighting the oil in a dark lantern, I tiptoe down wooden stairs, into the basement.

This is where we keep the bones.

The nightsoil men take away the fleshy remains of our dissections and amputations. They charge a premium for the service, citing the revulsion of sanitation workers at our necessary ministrations. But the bones have always been a problem. Masterless dogs often poke through the dustheaps. Even for the jaded residents of this city, a terrier skipping down the streets with a human femur in its jaws has the capacity to shock.

So as we dissect, we extract the bones, and toss them into a bucket. We then empty the bucket of bones into the cellar. At times, we use sledgehammers to break up the bones for disposal. But it’s easy to put off this burdensome task, and it’s a large cellar,  and so we often let the bones accumulate. That is how we came to have a large cairn of human bones in the cellar of the hospital.

The sledgehammer is hanging on the wall. I won’t need it. There are ample fragments of bone scattered across the dirt floor. My heart pounds. To steady my nerves, I imagine them as pieces of wood. I fill my pockets with harmless chips and splinters. Then I run up the stairs, and exit the hospital as quickly as decorum will allow.

My landlady greets me at the door. The hour is late, but she is used to the erratic habits of students. I tell her the ingredients I need tonight. In respect for a medical student’s superior education, she does not ask questions. But experience has told me that there will be an additional expense added to my weekly bill for lodgings.

Only when I am within my apartment, and have the fragments of bone arrayed on the table, do I realise my mistake.

These are too large to ingest. I need a powder. If only I had crunched the bones back in the cellar. But thinking of that leering, jumped pile of bones, I know I could not have lingered there for long, without terror stopping my heart.

Inspiration strikes. I take a fragment of shoulder bone, and place it under the leg of the table. Then I lift the table, and slam it down hard on the bone. It takes many blows, but I finally crack it. A few precious grains are dislodged, and I scoop them up. But I need more.

My landlady taps politely on my door, asking about the noise. Through the door, I tell her I am doing an urgent scientific experiment. She asks me to think of the other guests, and the lateness of the hour. She leaves the ingredients I requested on a tray outside my door.

I look around my room for anything that could help me. I have no hammer. No saw. Perhaps I could ask the landlady for a mortar and pestle?

But then I see the candle flame, flickering in front of me.

I hold a shard of bone in the flame. Long minutes crawl by, with no progress. I dig through a drawer for more candles, and use the first candle to light them. I bunch them together on the table, so that their fires join. Now the flame burns as brightly as a spirit lamp. Then I return the bone to the fire.

Before long the bone begins to char, and I smell the tickle of smoke. I must be careful to not blacken it too much, though, for I might damage the vital element within the bone. 

Satisfied with my progress, I place the blackened bone under the leg of my chair. One sharp blow and it crumbles. I have the bone powder I need.

In a ceramic cup, I mix the bone dust with the salt, garlic, and other ingredients. Then I swirl it with my finger.

I drink.

That night, I dream.

I am sitting at my table, but it has been placed at the beach. In the distance, I see the Chain Pier. This must be Brighton. The sand is coarse and grey, and feeble waves expend themselves on the shore. It is dawn, and the sky is pink and purple.

Sitting opposite me is a skeleton, its face an eternal grin.

In its hands, it holds a bone flute, identical to the one Griffith plays, down to the drilled holes.

Nimble bone fingers plug holes, and it lifts the flute to its teeth.

The skeleton lowers its jaw to blow on the holes. Instead, the jaw falls off, plunging into the sand.

It lowers the flute, and a howl swirls in the skeleton’s ribcage. Across the table, I am blasted by a stream of hot, rancid breath. My ears ring with the skeleton’s anguish.

Then I wake up.

Truly, I have never felt better! My mind is calm, like a clear pond at midday. I could lie here, mind empty, not a care in the world. But I feel the urge to go and do!

I jump out of bed, and savour the warm sunshine that peeks in through my window. Today, I am a man with a purpose. My first patient awaits!

Breakfast has been laid out by my landlady. I relish the bread and dripping, and for the first time in my life ask for seconds. A young man needs fuel to face the day!

As I walk through the streets, I see a flower seller. I place a coin in their gloved palm, and take a violet. You know, this is the first time I have ever had a flower in my buttonhole. I must look quite the dapper gentleman.

Before long, I am at the hospital. I track down the nurses who will assist me in the operation today, and ask them about their jobs, families, favourite penny dreadfuls, opinions on the Punjab, thoughts on the expansion of male suffrage, and what they would do first if they inherited an African diamond mine. Who knew nurses held such vivid and interesting opinions? 

They introduce me to my patient. Taking off the foot, I see! A railway worker, foot mangled by a track switch. Not too hard a job, but he’s having second thoughts. I tell him that I will operate on him today, if I have to drag him to the table myself. That shut him up!

Over the next hour, I prepare by sharpening my knives on a scouring block. I wonder if it would be easier just to use a sword, slice off the foot in one clean swing. But no, this is an exam, they expect me to display the techniques I have practiced.

The moment arrives. I leave the patient to the nurses, and in the operating room face the gathered audience of the surgeon and my fellow students. I tell them that they’ve often seen me with a foot in my mouth, but hopefully they won’t witness that today. They are more startled than amused, but no matter. I’m sure they will warm up.

The patient is fighting the nurses, shouting that they don’t want me to operate on them. He barks unkind words like ‘daft’ and ‘lunatic’. The working classes… they never understand when something is for their own good. I creep up behind him, and give him a hard rap on the head with the butt of my Liston knife. That shocks him into compliance.

I grip his leg in one hand, and jam in the knife. I can’t believe I was so concerned. It’s no different from cutting a doll out of paper to amuse a child. You just have to use a little more force. And cut around the bones, obviously. In moments, the deed is done, and the nurses bind the leg in bandages.

True, there is a little more blood than usual, but they can’t fault me for tardiness.

The surgeon nods. We are now brothers in the trade.

I present the foot to my colleagues. I open my mouth, and insert the toes.

In stories, I have sometimes read of a person being carried on a crowd’s shoulders. Until today, I did not know it happened in real life. My friends carry me to Doctor B’s Head, hooting and singing all the way.

In all my life, I have never known ale to taste so sweet. Is that a tang of orange I detect? And the cloying sweetness of baking bread? And then there’s the oysters. I see now I have been unkind to oysters. For one with an open mind, they dance on the tongue like mermaid ballerinas. I resolve to break this establishment's record for total number consumed in one sitting.

While my friends gossip and play their games, I engage the barmaid. She has recovered from Shaw’s prank, but is still wary. In the next few minutes, I learn where to buy cheap ribbons of good quality, discover how to hold three mugs of ale between your fingers, hear about her childhood affliction of the lungs, and am confided in that she had a brief but terrifying encounter with Spring-Heeled Jack.

Then I tell her that I have a strange pain in my foot. She bends over to look. I lift my leg, and the shoe comes off. Inside, there is the stump of a severed foot.

She howls and runs away. To accomplish this amusing jape, I had placed the foot from the operation in my shoe, and pulled down my trouser leg over my own foot. I prise the patient’s foot out of the shoe, and reinsert my own.

And I laugh, the best of my life, a laugh that begins in the navel, and shakes your body, and closes your eyes.

When I open them again, the room is full of skeletons.

Each patron of the tavern has been replaced by a moving skeleton. They mime the actions of life, just like the medieval dance of death. Here, one breaks the top of a kidney pie with his knife, and sucks up the smell. There, one places cards on the table in a game of Patience. Across the table from me, one of them has flute before its teeth, and blows a thin and sinister note.

Once again, I slip out.

As I walk the streets of London, I see more skeletons. One pushes a cart piled with rags. Another, a small skeleton that seems like a child, sits on the footpath, dangling a skeleton rat by a skeleton tail. And a dog’s skeleton circles me, barks at me, nips at me.

Cold sweat runs down my face, and my hair prickles.

I need more of the powder.

I let myself into the hospital, skeleton nurses striding past me in oblivious silence. I walk into the operating room, the scene of my triumph a few hours ago, now hollow as a worm-eaten apple. I walk through the anteroom, with its preserved eyeballs and bloody tools. I take the dark lantern, and I walk down the stairs.

Before me is the pile of bones, golden in the yellow light of my oil lamp. Anonymous skulls are scattered throughout the heap, looking in every direction, like a curious Hydra. The stack is fringed with tiny finger and toe bones. Ribcages fence the jumble. Forearm and shin bones jot out like spears poking from the linked shields of a Roman legion.

I take the sledgehammer off the wall, and swing it down on this mountain of death. Collarbones crunch, and thighs fracture, and I keep swinging, until the bones no longer resemble people.

Now sweating from the hard labour, I kneel in the pile of powdered bones, and start to giggle. I dip my hand in, scoop the flakes into my mouth, crunch them with my teeth, and swallow, the fragments rough on my throat as they go down.

My word, I did make a fuss for a moment there.

I shouldn’t worry. I have all the bone powder I could ever want. If today’s operation is any sign, in a decade I could be running the hospital.

I stand, and dust myself off. I pick up the lantern, and turn to leave.

Behind me, I hear a sound not unlike sand falling in an hourglass.

I turn, and see the crushed bones swirl, small eddies twisting into larger tornadoes, forming a vortex of cutting shards. The bone cyclone descends on me, and I feel little kisses all over my body as a thousand pieces of bone gouge into my skin, and burrow ever deeper.

I look down on my hands, and see the skin stripping like peeling paint, and watch as chunks of red and white muscle tumble away. My wetness falls to the ground like baptism water.

Finally I see only a skeleton’s hands. I flex them, watching the miraculous coordination of carpel and metacarpel.

God’s work, in his image.

I live here now. Nobody would think to look for a missing surgical apprentice in a pile of discarded, forgotten bones. I even see my old friends from time to time, when they throw a fresh bucket of bones onto my pile. I see them, breathless from the day’s toil, betrayed by their feeble flesh. Little do they know the secret power of life lies within them, just below the skin.

For now, I am content. I dream of bliss and power.

But my brothers are out there, prisoners of selfish meat.

One day, I must stir, and set them free.

But for now, I am happy to lie here, not a care in the world.

Can’t you see my grin?