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As the examination nears, Hazel does her best to focus on her studies and avoid thinking about the mutilated corpse and her kiss with Jack. At Iona’s insistence, she goes for a walk in Princes Street Gardens. Looking around at the other well-to-do people enjoying the sunshine, Hazel wonders, “How did the rich so easily dismiss the chaos and terror within their city?” (217). A socialite named Hyacinth Caldwater asks Hazel about her engagement to Bernard. Although Hazel estimates that the woman is about 50, she is pregnant. Mrs. Caldwater credits Dr. Beecham’s medical advice with her pregnancy. Hazel returns her attention to the book Dr. Beecham gave her and discovers a diagram of the human hand tucked between its pages. The parchment is old and faded, leading her to believe that the diagram is the work of Dr. Beecham’s illustrious grandfather.
The next person to interrupt Hazel’s reading is Bernard. He apologizes for his disreputable behavior at the party and once again asks Hazel to marry him. She thinks longingly of Jack but accepts Bernard’s proposal, certain that there “was only ever one life for her if she wanted to survive” (222). Bernard asks if Hazel has another suitor, and she assures him that there was never “a Bavarian duke or whomever else anyone in the New Town has invented in order to amuse themselves while the theater is closed” (223). Hazel’s white lie reassures Bernard, but her thoughts turn to Jack after he leaves.
Jack awakens to frantic knocking at the theater’s doors. He briefly hopes that Hazel has come “to find him, to run away with him” (227). Instead, he finds a frantic Jeanette clutching her stomach. Jack brings the girl to Hazel. Jeanette stopped menstruating months ago, but she’s never been with a man. When Hazel examines her, she finds a “scar crusting with green pus […] four inches across, below her belly button” (232). Jeanette claims she’s had the scar since her appendix was removed when she was seven, and she mentions having nightmares of a one-eyed monster around the time her recent symptoms began. Hazel cleans and bandages the scar and tells Jeanette to come back if she doesn’t feel better in a week. She also encourages Jack and Jeanette to bring others in need of treatment to Hawthornden Castle.
Over the next two weeks, dozens of people come to the dungeon for help, and Hazel treats everything from toothaches to broken bones. When the first patient with the Roman fever arrives, she tells the household staff that they are welcome to live in the guesthouse if they feel unsafe remaining in the castle. One day, Isabella comes to the dungeon. The woman is already in labor, and Jack and Iona assist Hazel with the delivery. Jack gives the newborn the music box he originally intended to give to Isabella, which he has repaired. Isabella names her child Hazel in honor of the young woman who saved her and her baby, and Hazel tries to conceal the tears that spring to her eyes at this gesture.
Jack likens his prior feelings for Isabella to admiring a masterful painting of a candle, whereas his love for Hazel is like “seeing fire in person for the first time” (243). Jack finds Hazel beside a stream outside the castle and tells her that she’s incredible and brilliant. Hazel admits that she feels like “a silly little girl playing dress-up and pretending” (244). She’s terrified of making a mistake and harming one of her patients, and he assures her that it’s all right to be afraid. It begins to rain, and the teenagers take shelter in the stables. They kiss, and Jack tells Hazel that she’s beautiful. When she says that no one has ever told her that before, he emphatically promises to appreciate her beauty every day for as long as he lives.
A week later, Hazel loses her first patient to the Roman fever, and Jack finds her weeping beside the body. When he begins to dig a grave for the man, she protests that she should study his body. Jack assures her that it’s all right for her to grieve her lost patient instead. Hazel treats the remaining fever patients with wortflower, the herb that Jack’s mother used to brew into tea. The plant improves the patients’ conditions, but she continues to hope for a complete cure. She writes a letter to Dr. Beecham asking for his thoughts on the possibility of inoculation for the Roman fever. Hazel eagerly awaits his reply and imagines herself becoming “the most famous physician in the kingdom, all before the age of twenty” (250). Munro, who now has only one arm, comes to the castle looking for Jack.
Munro tells Hazel and Jack that he went to Greyfriars by himself to dig up a pregnant woman because those bodies fetch a higher price. While he was in the graveyard, a man wearing a top hat appeared and rendered him unconscious with a handkerchief that smelled like death and flowers. When Munro awoke, he was under a heavy veil, and the man wheeled him into a surgical theater. He cried out, and a doctor made him fall back to sleep with another dose of “blue potion” (257). When Munro regained consciousness, he was at Saint Anthony’s hospital, and his left arm was gone. Hazel inspects the tidy stitches in Munro’s shoulder and offers him a job at the castle. Certain that an unknown criminal is targeting the poor, Hazel asks a constable to come to Hawthornden. The officer dismisses Munro’s story as a ploy for the noblewoman’s pity and tells Hazel that he hopes her father returns home “before his daughter becomes a public disruption instead of just a fool” (261).
Hazel continues administering wortflower to her Roman fever patients and reporting her findings to Dr. Beecham, but she has yet to receive a reply. Burgess, a boy from Beecham’s class, catches the fever and comes to the castle. Hazel reveals that she disguised herself as George Hazleton and tells Burgess about her deal with the doctor. Jack interjects by asking whether Hazel’s fiancé will allow her to practice medicine even if she wins the wager, and he leaves the room when she replies that “the Physician’s Examination is a far more pressing concern than [her] silly marriage” (266). Burgess remains at Hawthornden for treatment and helps Hazel prepare for the exam.
A letter from Dr. Beecham advises Hazel to abandon her efforts to treat patients with wortflower, claims that inoculation is impossible for the Roman fever, and states that “the well-being of the patient must supersede a doctor’s overzealous ego” (268). Humiliated, Hazel burns the doctor’s letter, but Burgess insists that the wortflower tea is helping him. Adding to Hazel’s agitation, Jack leaves Hawthornden Castle to look for work. He promises her that he won’t dig up any more bodies, but his promise does little to reassure her when he is gone for days.
Jack tries without success to find employment. Someone advises him that there are jobs in America, but he can’t bear the thought of leaving Hazel. Jack feels ashamed of the differences in their social status and wonders how he could “ask her to give up an earl when he couldn’t even make a decent wage” (274). He decides that his only option is to resume his work as a resurrection man. He regrets breaking his promise to Hazel, but reasons that she doesn’t understand what it’s like to live in poverty.
With the Royal Physician’s Exam one week away, Hazel attends a dinner party at Almont House in honor of her engagement. The men, including Bernard, behave patronizingly towards her. One of the guests is Baron Walford, who has a false eye. The baron claims that he will soon regain his sight thanks to an upcoming operation at the Anatomists’ Society. Hazel attempts to learn more, but Bernard tells her to focus on their wedding. When Bernard escorts Hazel to her carriage, she informs him that she’s currently treating patients and tells him that she may have to call off their engagement if he stands in the way of her medical career. Bernard agrees that they will “figure it out from there” if she passes the exam and makes her promise to abandon her dream if she fails (278).
In the novel’s fourth section, Hazel’s decision to turn Hawthornden Castle into a refuge for those in need furthers her growth and her relationship with Jack.
Class continues to play an important role in these chapters and becomes a key aspect of the novel’s consideration of The Duality of Life and Death. Class is often the dividing line between life and death, and in Chapter 24, Hazel wonders how the rich can promenade as though nothing is wrong while the poor die of the plague. Although less catastrophic than the Roman fever, Hazel also sees her engagement to Bernard as both literally and figuratively a matter of life and death. As a noblewoman, she has been taught from a young age that marriage to a powerful and wealthy man is the “one life for her if she wanted to survive” (222), and without him she has no certain means of supporting herself. At the same time, she understands that marrying him might mean death in a metaphorical sense: the death of her ambitions, her hopes for the future, and her capacity for romantic love. Bernard’s status makes him an eligible prospective husband for Hazel, but it also makes him arrogant and shortsighted. He can’t imagine that anyone besides a noble could rival him for Hazel’s hand, so he believes her lie that there is no other suitor.
Unbeknownst to Bernard, Hazel and Jack’s relationship develops further in this section. This progress stems from Hazel’s decision to turn the castle into “a teaching hospital for one” (234). This choice offers invaluable opportunities to put her medical studies into practice, but it is rooted in compassion rather than merely ambition. Unlike the novel’s antagonist, Hazel uses her knowledge and skills to aid those most in need rather than those who can enhance her wealth or position in society. One of Hazel’s greatest achievements is the delivery of Isabella’s baby, which develops the theme of The Duality of Life and Death. This achievement also prompts Jack to realize that he is in love with the noblewoman. In Chapter 26, he calls her “brilliant” and even “miraculous” (246).
This outpouring of affection comes at a time when Hazel’s confidence is shaken by fear. Although she’s studied theory for years, her books couldn’t prepare her for the reality of having human lives hang in the balance of her decisions. As someone more comfortable with his emotions, Jack is able to assure her that her fear is natural. The promises of eternal devotion Jack makes to Hazel at the end of Chapter 26 show the influence of the theater on his imagination, but the feelings underneath his flowery language are real. Chapter 27 further explores Hazel’s ambition and Jack’s efforts to protect her emotions and humanity. The protagonist still wants to cure the Roman fever and become a celebrated physician, but she’s also growing close to real people who have the disease. When she loses her first patient, Jack shows her that it’s all right to grieve and that a dead body can be someone to mourn, not a subject of study. Hazel’s growth makes Dr. Beecham’s letter in Chapter 29 all the more galling. He accuses Hazel of letting her ego take precedence over her patients’ wellbeing. There was a time when she was more concerned about her ambition than anything or anyone else, but that time is past.
This section yields more clues about Dr. Beecham’s plans and further evidence of The Brutality of Corruption. Munro and Jeanette join the growing list of lower-class individuals whom Beecham uses to source body parts for higher-class patients. Munro’s account in Chapter 28 mentions ethereum and the man with the top hat who assisted with Beecham’s demonstration, foreshadowing the famed doctor’s guilt. The corruption in Edinburgh taints its law enforcement as well. The constable is utterly disrespectful towards Munro because of his class and Hazel because of her gender. Although Munro’s story fails to secure help from the law, his account allows Hazel to save Jack’s life later in the story.
Munro’s arrival disrupts the routine Jack and Hazel have built together and spurs Jack to take life-threatening risks. When Jack offers to help his friend find work, Munro fires back, “How’s your work at the theater going, Jack?” (259). The barb hits home. Jack’s sudden urgency about finding employment is connected to his hope of asking Hazel to choose him over Bernard and the shame he feels about his class. While Jack doesn’t want to break his promise to Hazel, this is easier when he reminds himself of the vastly disparate lives they’ve led. He’s had to create his own opportunities to eke out a living, and the illegal work of digging up bodies has allowed him to survive this long.
As the fourth section draws to a close, the novel’s suspense climbs once again. This is largely due to Jack’s prolonged absence from Hawthornden. In addition, the seemingly impossible operation Baron Walford claims he’s about to have foreshadows key events in the next section and prompts the question of what other marvels Dr. Beecham can achieve. In Chapter 31, Hazel raises the stakes of the test even higher by making a wager with Bernard. The suspense mounts as the Royal Physician’s Exam and the novel’s climax draw near.
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