When He Was Wicked (Bridgertons #6)(102)

“Let’s go home,” she said softly.

He nodded.

She took his hand, gently pulling him away from the clearing, back toward the wooded area that lay between the churchyard and Kilmartin. Michael leaned into her tug, but before his feet lifted from the earth, he turned back toward John’s grave and mouthed the words, Thank you.

And then he let his wife lead him home.

“I wanted to tell you later,” she was saying. Her voice was still shaky with emotion, but she was starting to sound a bit more like her usual self. “I’d planned a big romantic gesture. Something huge. Something…” She turned to him, offering him a rueful smile. “Well, I don’t know what, but it would have been grand.”

He just shook his head. “I don’t need that,” he said. “All I need…I just need…”

And it didn’t matter that he didn’t know how to finish the sentence, because somehow she knew, anyway.

“I know,” she whispered. “I need the exact same thing.”





Epilogue





My dear nephew,

Although Helen insists that she was not surprised at the announcement of your marriage to Francesca, I shall own up to a less clever imagination and confess that to me, it came as a complete shock.

I implore you, however, not to confuse shock with lack of acceptance. It did not require much time or thought to realize that you and Francesca are an ideal match. I don’t know how I did not see it before. I do not profess to understand metaphysics, and in truth, I rarely have patience for those who claim that they do, but there is an understanding between the two of you, a meeting of the minds and souls that exists on a higher plane.

You were, it is clear, born for each other.

These are not easy words for me to write. John still lives on in my heart, and I feel his presence every day. I mourn my son, and I shall always do so. I cannot tell you what comfort it gives me to know that you and Francesca feel the same.

I hope you will not think me self-important when I offer you my blessing.

And I hope you will not think me foolish when I also extend my thanks.

Thank you, Michael, for letting my son love her first.

—from Janet Stirling, dowager Countess of Kilmartin, to Michael Stirling, Earl of Kilmartin, June 1824





Author’s Note





Dear Reader,

I have subjected the characters of When He Was Wicked to more than their fair share of medical misfortune. Researching the conditions of both John and Michael was complicated; I had to make sure that their disease processes made scientific sense, while at the same time revealing only what was known by medical science in 1824 England.

John died of a ruptured cerebral aneurysm. Cerebral aneurysms are congenital weak spots in the walls of blood vessels within the brain. They may lie dormant for many years or they may rapidly enlarge and then rupture, leading to bleeding in the brain, which can be followed by unconsciousness, coma, and death. Headaches brought on by ruptured cerebral aneurysms are sudden and explosive but can be preceded by a lingering headache for some time prior to the actual rupture.

Nothing could have been done to save him; even today approximately one-half of ruptured cerebral aneurysms lead to death.

During the 19th century, the only way to make a definitive diagnosis of a ruptured cerebral aneurysm was at autopsy. It is extremely unlikely, however, that an earl would have undergone a postmortem dissection; therefore, John’s death would have remained a mystery to those who loved him. All Francesca would ever know was that her husband had a headache, lay down, and died.

The turning point in the treatment of cerebral aneurysms came with the widespread use of angiography in the 1950s. This technique, which consists of the injection of radiopaque dye into the vessels feeding the brain to give an X-ray picture of the vascular anatomy, was developed by Egas Moniz in Portugal in 1927. An interesting historical footnote: Moniz won the Nobel Prize for Medicine in 1949, but not for his work in the ground-breaking and life-saving field of angiography. Rather, he was honored for his discovery of the frontal lobotomy as a treatment for psychiatric illness.

As for malaria, it is an ancient disease. Throughout recorded history, it has been observed that exposure to warm, moist, humid air is associated with periodic fevers, weakness, anemia, kidney failure, coma, and death. The name of the disease comes from the Italian for “bad air,” and reflects the belief of our ancestors that the air itself was to blame. In When He Was Wicked, Michael cites “putrid air” as the source of his illness.

Today we understand that malaria is in fact a parasitic disease. The hot, swampy conditions themselves are not to blame, but rather serve as breeding grounds for mosquitoes of the genus Anopheles, the vector of the infection. During an insect bite, female Anopheles mosquitoes unwittingly inject microscopic organisms into the hapless human host. These organisms are single-celled parasites of the genus Plasmodium. There are four species of Plasmodium that can infect people: falciparum, vivax, ovale, and malariae. Once in the bloodstream, these microorganisms are swept into the liver, where they multiply at a furious pace; within a week, tens of thousands of parasites are released back into the bloodstream, where they infect red blood cells and feed upon the oxygen-carrying hemoglobin inside. Every two or three days, through a synchronized process that is poorly understood, the offspring of these parasites erupt from the red cells, leading to high fevers and violent chills. In the case of falciparum malaria, the infected cells can become sticky, and glom onto the inside of blood vessels in the kidney and brain, leading to renal failure and coma—and death, if treatment is delayed.