The day was bright. Light shone into the room and glimmered on my hands on the scalpel blade.

I said a prayer, not to God, but to my mother and to Pearce. Help me now, I asked.

Then I cut.

I cut into the skin. Beads of blood appeared, like the strand of a necklace laid on the belly from the navel to the pubic hair.

I cut into the tissue and the bright blood flowed over the belly. Hands holding the pledgets reached out and the lint began to soak it up.

I cut into the peritoneum and so into the abdomen. In a calm voice, I instructed the midwife and my other helper to put their hands into the two sides of the wound and hold it open. This they did and I laid down the scalpel and took more lint from them to staunch the bleeding. And as the bleeding lessened, I saw revealed to me the coil of Katharine's bowel and the sack of her bladder and the wall of the womb itself.

I wiped my hand on some linen. I did not look at Katharine's face nor allow myself to imagine her suffering. All of my attention was concentrated in my hands.

I cleaned the scalpel, wiping blood off the exhortation "Do Not Sleep." I positioned the blade above the lower third of the womb and I cut transversely across it.

Again, blood flowed. Onto my hands. Onto the folds of the bowel. I laid the scalpel aside. I put pledgets on and saw them fill with blood. I removed them and pressed clean ones on. I felt a single droplet of sweat slide down my forehead and sting my eye. I could hear my own heart beating and, for one tiny vessel of time, no longer than a single second perhaps, I lost all consciousness of where I was.

But I did not faint or falter. I parted the lips of the incision I had made in the stretched wall of the womb and felt pressing against my fingers the head of the baby.

"Help me now," I said to the midwife, "for my hands are too large to go in. I will hold open the abdominal incision. Put your right hand under the head like a shoe-horn and, not wrenchingly but gently, lever it out."

So I came to Katharine's side and the young midwife I had likened to a flower-seller reached into Katharine's womb and took out the child, first easing out the head, as I had instructed, then putting her small hands under its armpits, and pulling forth the little slippery body.

It was alive.

But it was not Anthony. It was a girl.

Chapter Twenty-Three. A Light on the River

In Genesis, we are told that before Adam's flesh was opened and the rib taken out to be made in Eve, "the Lord God caused a deep sleep to fall upon Adam". I have always considered that this was most thoughtful of Him, for it spared Adam a great amount of pain and, as a physician, I have many times wished that I could bring such oblivion upon my patients before hurting them. Fabricius once talked about a certain Arnold of Villanova, living in the fourteenth century, who had discovered the secret of a sleep that would not be broken by pain, but no record was ever made of the ingredients of the secret and so it has never been whispered to us down the ages. My wish, then, has not been granted, and when I took up my scalpel to make the incision in Katharine's belly, I did not pray for any oblivion for her, knowing it to be an impossible thing; I prayed only for myself – for my own skill.

When I cut into the abdomen, however, she passed into a sudden and profound unconsciousness. It was not caused by the little dribble of opium we had put into her mouth, for opium works slowly and stealthily. I decided at first that the great agony given to her by the wound had made her faint. But several hours passed and she did not come out of her coma. Her breathing became stertorous, like the breathing of Pearce in his last illness. And so I did not know what this sleep could be, unless it was the sleep of coming death.

I could not sew up the slit in the womb, the wall of it being stretched so thin that the sutures would tear it, so I left it to heal and close of itself in its own time. The abdominal incision I stitched together and sprinkled with a little Pulv. Galeni and had the women put lint on it and bandages that encircled the buttocks to bind it. All this I did without Katharine being aware of what was done to her body or even that her child had been brought out of it living like Julius Caesar and like the good Macduff of Shakespeare's play, Macbeth, the story of which had been told to me by Amos Treefeller in his back room smelling of polished wooden hat-stands.

The baby was taken away by the midwife and the other women to be washed and examined and then bound in swaddling. They told me that the infant's head was covered with a soft down "of a reddish colour" and that it was a well-formed child "with a good and lusty cry." And they held it up for me to see its face and I saw that it had a little flat nose like my own. Then they asked me: "What shall we call the baby? What name had you in mind?" And I replied that I had no name in mind, having been told that my child would be a boy and christened Anthony.

The women looked at me reproachfully and snatched the child from my sight. And when they had gone, I sat down and rubbed my eyes and for the first time told myself that I was the father of a little girl, breathing and alive. I put my hands together in the kind of prayer steeple Ambrose used to make and asked for kindness from God and the world towards my girl. "Let her have playthings, as many as I can afford," I added, "but let her not be a plaything for any man." And as soon as I had whispered these thoughts, I decided upon the name Margaret, which was my mother's name and thus to me a serious and precious word. So I got up and went to the women and told them that the baby would be christened Margaret after my mother and after Margaret Fell. They nodded their approval and from that moment, when the child cried and they comforted it, I heard them saying, "Hush, Margaret, all is well."

Yet it was not true. After some hours, during which Katharine did not stir nor move any of her limbs, the midwife uncovered one of her breasts and pinched the nipple, trying to make the milk come, but despite the great heaviness of her breasts there did not seem to be any proper milk, only a little weeping from the teat, which, when the midwife touched it and then licked her finger, had a bitter taste like bile.

"Put the baby to the nipple nevertheless," said Frances Elizabeth, who stood by her daughter and combed her black hair over the soft pillow, "and it will make the milk come."

So Margaret was laid on Katharine's stomach, above the bandaged wound, and her little mouth tickled until it opened and the teat put into it. She began to suck but quickly spat out the teat and screamed and would not, no matter how the midwife tried to persuade her, stay on the breast and suckle. She was put back into the crib and covered with the blankets and quilts made for Anthony. I ordered that a wet-nurse be found.

I sat by Katharine. I picked up her hand, which felt hot with a fever, and held it in mine. I looked at her face – not as the face of a poor woman towards whom I felt utter indifference but as the face of the mother of my child. I wanted to love the face and feel tenderness towards it, but I could not, so I got up and went downstairs, being afraid that Frances Elizabeth would look at me and read my thoughts and my feelings.

I found Finn sitting by the fire in his undergarments, sewing patches onto his Lincoln green. His raggedness has become very dire and, had I the money, I would buy him a new suit of clothes. Nevertheless, the sight of him mending his things made me smile and I could not resist saying to him: "Ah Finn, a new profession, I see: tailor."

He had the wit to laugh. Then he said: "I do not know what to do, Merivel, about how poor I am."