Art by Leslie Harker – -http://portlandportfolio.blogspot.com/ – click to enlarge

Following the events of 1846, the medical establishment of Innsmouth consisted, in its entirety, of one apothecary, Mr. Martin (whose business was shuttered for some time), the midwife Mrs. Coster, and Dr. Francis Hamilton.

Dr. Hamilton considered himself a gentleman physician and surgeon, which took some believing, even for him. Physicians did not generally wish to be confused with surgeons or dentists; they did not yank teeth out of rotten gums, or amputate broken limbs, or cut for the stone. But all these things Dr. Hamilton was not too proud to do, or to bill for.

After the elder Dr. Hamilton passed away in 1844, the younger Dr. Hamilton had some notion of selling the house and the practice, and seeking appointment at the hospital in Arkham or in Boston, where he had old colleagues. His intended in Innsmouth had died of cholera some years before, and he had no great interest in marrying any longer; his one living sister was wed and lived out in Salem, and he himself had little society in town. In 1846, however, it became clear to Dr. Francis Hamilton that he was quite fixed in place.

There was that night in 1846: it was spoken of, if at all, as the night that they – , and then the speaker would look at the listener, and the listener would nod, and the speaker would go on.

That night had come to Dr. Hamilton without warning. The doctor was not a political man, or a joiner; he did not concern himself with the business at the town hall or the harbor. All that had troubled him at that time was that Belinda, the girl who kept house for him, had been saying things were “terrible scarce” at all the stores, and no new orders were getting in anywhere in town. He had been eating plain salt-scrod for nigh on three days. Before he blew out his candle that night, he thought, that business had better get sorted, else I am going to run out of calomel next week.

It was sometime close to midnight when the pounding came at his door downstairs. Dr. Hamilton woke to it immediately – he knew the sound of a knock at all hours – but it was Belinda that stayed downstairs, and Belinda answered first; and Belinda screamed.

At the sound of it, Dr. Hamilton moved as quickly as he could, but he was met halfway up the stairs by Duncan Meaney and Jim Robertson. These were two rough, poor young men he knew only vaguely. Duncan stood with one hand around Belinda’s throat and another twisting her arm behind her back, and both were covered in blood that did not appear to be theirs.

“You’re coming with us, sir,” said Duncan. “I’m awful sorry, but you’re coming with us. Bring your – bring anything you can think of, there’s men hurt. There’s all kinds of men hurt. Now. Now!”

“By God, you ha’n’t had to threaten that girl. Or me,” said Dr. Hamilton some minutes later, after Duncan had grabbed him by the arm and dragged him out the door. “What the hell do you think of me, boy? Have I ever not come when I’m called in the night?”

To this, Duncan said only, “You’ll see. Just come on, sir. Just come see.”

Between them, Duncan and Jim led him to the town square; and Dr. Hamilton saw.

When Frank Hamilton was young, his late father had instructed him on how to build a set of doors in his head. The elder Dr. Hamilton had not been a man of impractical or intangible advice, and his son took it to heart when he gave it.

When you are called out to see things that seem too terrible to bear with, he had said, look at the first terrible thing, and then set it out into the hall behind you, and shut the door behind it. Then look at the next terrible thing; then set it out in the hall, and shut the door behind it. In this way, you will find yourself behind a set of strong doors, alone with the thing you have been called to do, and you will be alone to do it.

Dr. Hamilton had a great deal of injuries to treat that night, and he set them all behind the doors. Later, he opened a few of the doors, out of interest.

Most of the men who were not yet dead had lost fingers or hands. Some had been bitten off, and some had been pulled out of the joints, as if from a cooked fowl. None of those who had borne with the pulling-out lived through to the morning.

Years later, Dr. Hamilton learned that many of the ones who had done this thing were under the impression that the men’s bones would grow back, like the claws of crabs, as indeed their own fingers or hands would have done. Those from offshore did not at first seem to know or care what exactly men’s flesh would bear with; then, later, it seemed to Dr. Hamilton that they did, in the sense that slaveholders knew what negroes would bear, and cared exactly as much as they had to.

The doctor was therefore considerably alarmed when it came to his attention, some weeks later, that a number of alliances were to be made with the gentlemen and ladies from offshore. But what could he do? – he would be needed worse than ever. Who else would come out here? Who would know what to do, when he hardly knew himself?

One damp, black spring day, he was called out to see Mrs. Dalton; so she called herself, but six months before she was simply Miss Ann Dalton, and Dr. Hamilton had known that all her life. This, too, was a new custom, and it had to go unremarked.

When Mrs. Dalton’s sullen maid came to his study, she would only say, “Her back hurts. Was all she said to tell you, was her back hurts.”

This meant that Dr. Hamilton had to prepare for anything. When a lady said her back hurt, it meant that there was something wrong between her head and knees that embarrassed her – diarrhea, costiveness, vomiting, monthly pain, anything. It could also mean that her back hurt. Dr. Hamilton had no way of knowing till he saw her.

His maid showed him into the parlor of her rooms, a downstairs floor on Leverett Street. It would have been a fine place for a young couple, but there was no one who lived there except Mrs. Dalton. She sat on a red chaise-longue in her unlit parlor, bent over, her hands clasped and folded, her blonde-brown curls hanging limply across her face.

Dr. Hamilton strode forward with the sort of heartiness that was expected of him in this situation.

“Good afternoon, madam. No, no – stay seated, do not move yourself too much until I know what the matter is. Now tell me,” he said, bending slightly towards her, “when exactly did your trouble begin?”

Mrs. Dalton, her face flushed hot and red, opened her mouth and shut it, then began.

“There’s – my back was scraped hard and it bled and now it won’t stop hurting me, I was careless, it was my fault, but now it hurts just to feel clothes move against it, and it’s hot to touch, I hoped you could…”

“I will have to see it,” said Dr. Hamilton, after Mrs. Dalton showed no inclination to finish her sentence. “Belinda will be right here. If you’ll step over to the light, here, and uncover it, please. Would you like to call your maid to –”

“No, sir. No, thank you – Belinda, please…”

Mrs. Dalton stood, her shoulders still hunched, and stepped awkwardly towards the light from the lace-curtained windows. Dr. Hamilton looked politely aside. Ladies did not undress for their doctors if they could possibly help it, and he did not like to make it more difficult than it needed to be. He heard the fumbling, rustling noises of Belinda assisting her with the laces at the back of her outfit, and then a sticky kind of peeling sound. Mrs. Dalton gave a gasp and a whimper.

“Here, sir – here it is – ”

Dr. Hamilton turned to look at Mrs. Dalton’s back as Belinda took away her soft high-necked linen chemise, which was stained at the back with dried brownish and yellow fluids. Mrs. Dalton was still wearing her stays, but she hunched and crossed her chest with her forearms as if she were entirely naked in the world.

“Ah,” he said. “I believe…I believe I see.”

Dr. Hamilton had never paid attention to any fashions in women’s clothing, or indeed in men’s, but after this visit, he came to realize how many women he saw in town who never wore any outfit without a high-necked blouse and long sleeves. There was a spiderweb cloak of scratches, cuts, and bites across the shoulders and the back of Mrs. Dalton. Some cuts were healed, some were freshly raised. A set of scratches on the lady’s left shoulder blade was visibly infected, and swollen with pus.

Dr. Hamilton had seen and drained worse wounds than this. Nonetheless, for the first time in years, he turned his face from an injury, and snarled with disgust.

“. . . doesn’t mean any harm by it,” said Mrs. Dalton, so soft and small that Dr. Hamilton could barely hear it.

“Doesn’t he?” Dr. Hamilton said, before biting hard against his tongue. Mrs. Dalton made an odd sort of chuffing sound, and bit her lip. The doctor’s jaw set. He tried not to hate her.

Was it more revolting that the creature had done this, or that the woman would lie barefaced to him about it? Of course, married women always lied to him about certain kinds of bruises. Dr. Hamilton expected that, and indeed it was rather sweet, in its way. It was tender for a wife to defend a man from his own weakness, and he liked to see that a woman thought so much of her husband. But those had been different times, and different husbands, and different sorts of blows.

Dr. Hamilton gritted his teeth, and spoke as coldly as he possibly could.

“Belinda – lancet, towels, charcoal and dressing. Madam, I am going to drain and clean this, and then Belinda is going to set a charcoal poultice to it, and she will show you how to make your own. Change the dressing once a day, until it is no longer hot to the touch. You needn’t trouble me again – not unless it’s still hot to the touch in three days or so. Send for me then.”

Dr. Hamilton did not really want to be unpleasant as he set about his work, and yet he strove to be just that. He dared not seem soft enough to make the poor thing start to weep; then he would have to commiserate, wouldn’t he, and hear her side against his, and it might simply start with putting a kind hand on a lady’s head, but then where would it end for him?

“In the future,” he said, “take care of these things yourself, and they should not grow inflamed.”

Once their business was done, Dr. Hamilton shut the door behind himself as he left. But in the night, his thoughts grew careless, and the doors opened.

It was eleven p.m. in the black of his room when Dr. Hamilton suddenly sat upright, pulled out his chamberpot, and retched dry into it for three solid minutes, bringing up nothing but a mouthful of spit and hot acid from his throat.

He was not ill, not as such. It was simply that he had thought of the wounds again, and understood them. He had not understood them before. He had seen the trouble and treated it, but he had not understood the wounds. The crescents of cut-marks on the shoulders were the marks from rows of teeth, the clawed scratches were dug into the blades of the back; and she had said that he did not mean any harm.

A good deal of weddings, such as they were, had taken place in the fall of 1846, according to the quiet customs of those from offshore. As that next year wore through, Dr. Hamilton expected that he would soon be called upon to see far worse than what Mrs. Dalton had shown him. What surprised him, in the event, was that he was not called for at all.

Most middling women only ever resorted to the midwife, but Dr. Hamilton always came out if Mrs. Coster had trouble she could not manage, and Mrs. Coster was never called out to one of the great houses; only a doctor would do. He certainly heard that the daughters of those houses were expecting – young Mrs. Gilman, the youngest Mrs. Marsh – and, sometime later, he heard that their children had arrived; but he was not sent for.

Were there attendants from offshore? Did the Esoteric Order of Dagon have some ghastly ritual to perform? Or was there some hybrid vigor in that blood that allowed the women to drop these children so easily? This last idea, the doctor entertained only once; it came on so suddenly that it made his fingernails bite into his own palms.

Dr. Hamilton did attend on several newly married ladies with maiden names not long after they lay in childbed, but they had ordinary troubles, various inflammations – nothing that he might not have seen otherwise. Their infants looked healthy, red and sound in their limbs; no one spoke to him about their health. There was no chatter in the house about these children, about their names or their strong lungs or their hopes. When he had done speaking with the mother, he always asked kindly after the child, as he would have done in any case, and some aunt would show him the bundle with all the pride and joy he expected to meet with when he presented his bill.

One half-snowed-over afternoon in late November of that year, Dr. Hamilton at last got a call that came to show him a good deal of what he wished to know about, although, as it happened, that call did not have to do with going to any woman’s aid. It was simply that Jack Morton, a brawny young man of whom Dr. Hamilton knew very little and no good, came to the back door with his hat in his hand, white-faced and red-eyed.

“My brother Ben,” said Jack, “Lord love him. Could you come and see, sir?”

Dr. Hamilton knew that there were several Morton boys, and none amounted to much, but they took care of each other. Jack looked ill himself.

“What’s the trouble?”

“Damned if I could say,” said Jack. “He’s devil-sick and swelled up and he can’t move off his bed hardly. A’n’t been up in weeks, won’t see us in his room, and he’s lyin’ there says he just wants to go and die.”

“Well,” said Dr. Hamilton, “we can’t have that, can we?”

Dr. Hamilton’s interest in this call was not great, considering how little he looked forward to billing the likes of Benjamin Morton, but nonetheless he reached for his coat and his hat. With his black bag in hand, Dr. Hamilton followed Jack through the ruts and tracks in the ill-cleared roads to Witham Street, to a railroad flat on the ground floor of a decaying wood-frame boardinghouse. Here the Mortons stayed when they were ashore, but there was no one in the place now except Ben, who lay alone in his back room.

“Go on, Jack,” said Dr. Hamilton, as he stood in the doorway, and stared at the shadow of Ben. “Leave us be.”

Morton lay on the bed in a great mound, turned on his side. Dr. Hamilton had a vague and fleeting memory of Ben Morton’s frame from two years before, when Morton had smashed open his fingers on another man’s teeth and had to have the cuts seen to. Morton had been a big man then, but not a fat one. He seemed now to weigh nearly three hundred pounds, mostly in his abdomen. It was beginning to sway and bow the thin mattress below him. His face and neck were swollen and edematous. Even his arms were puffed.

“Good afternoon, Mr. Morton.”

“Doctor,” he said, thick and slurred.

Dr. Hamilton set down his bag, and began to peel back the cheap, sweat-soaked blankets from Morton’s half-dressed form.

“How long has this trouble been going on?”

Morton said something through a congested throat. Dr. Hamilton bent closer to hear him.

“Bleed me out, Doc,” he said. “Do it now. I got to die.”

Dr. Hamilton’s hands faltered, but he responded simply, “Why would you say a thing like that?”

“You can’t help. There’s no help.”

“Be good enough to let me tell you that, Mr. Morton. Now I have to know: how long has this been going on?”

Morton did not answer, and Dr. Hamilton did not wait for an answer; he continued to examine the man’s body. For his part, he agreed with Morton, more or less, but a doctor could not take such orders as that from a patient.

Morton’s stomach bulged out of his unbuttoned trousers as if it had split them apart. Great pink stretch marks had appeared along the sides, and the pores of the stretched skin gaped open, gleaming, inflamed and moist. The skin was chill at the chest and arms, feverish at the abdomen.

In the damp silence, Dr. Hamilton measured Morton’s pulse, and wondered why the smell of the room was so offensively familiar. Particular smells often told a doctor a great deal in a sickroom, but this was one that Dr. Hamilton could not quite place. He removed his fingers from Morton’s wrist, and the mark of his grip did not disappear.

“The less you tell me, the less good I can do,” he said at last, “but it is clear that you have a severe dropsy and I believe it to be associated with one or several growths, from which it may be possible to – ”

Morton took Dr. Hamilton’s hand and placed it palm-down, almost tenderly, on the upper right quadrant of his abdomen. Hamilton shut his eyes.

“Did you feel it?” said Morton at last.

“Yes,” said Dr. Hamilton at last. What he had felt was not a sensation that a physician ever forgot, nor was it one that he might mistake for anything else. It was the kick of an infant against the side of its mother’s womb.

Now Dr. Hamilton realized that he could recognize the odor of Morton’s room. He smelled like menstruous matter. The air was chokingly thick with the smell of a woman’s unwashed monthly cloth.

“Coming along down by here, now,” said Morton, and moved the doctor’s hand to the nearly vertical side of his gut, where, indeed, another and fainter kick could be felt.

“Think there’s five of them,” said Morton. “Might be six.”

Eventually, Dr. Hamilton said, “Well, I tell you again, Mr. Morton, you have got to let me know exactly what you know about this. Everything, you hear me? Start as far back as you can. It could still be I can save you, or save someone else from it.”

“I doubt the hell out of that,” said Morton, and blew a spit-bubble from between his lips in a sort of laugh. Nonetheless, a moment later, he began to speak, and Dr. Hamilton listened.

Benjamin Morton had been a jobbing fisherman till he came upon more interesting work, having joined the Order and finding his fortunes improved considerably thereby. As this had been the case, it was pressed upon him, together with a number of young men in his position in 1846, that he should oblige the ladies and gentlemen of the Order by taking a wife according to their particular arrangements.

Morton resisted this request as long as he might; but at last he gave in, for fear, he said, of what they might do to one of his brothers at sea, simply for his own disobedience. A certain ceremony was performed, and he was given in hand a lady from offshore; and her name was Mialai-thy’temai.

Morton took this creature to his quarters, but his temper turned, and he would do no more with her. He cursed her, and he said he would not touch her, and she could go back to Hell where she came from, or sit and stare in that corner with her great idiot eyes all she wanted, but he had had enough of the arrangement at the moment he saw her, and would have no more of it.

At that, Mialai-thy’temai stood to her great height and said: “Just as you like, sir, I do not touch you tonight or after that or after that; I have more to do than with this business; but I tell you, I have got to get a child before the moon turns twice, and if you wait me longer, you will not like it well.”

With that, she left. She returned twice in the next two months, and said again what she had said; and twice, Morton refused her. Four months after their wedding, Mialai-thy’temai returned for the third time and the last. That had been this past April.

So much Dr. Hamilton could piece together from Morton’s storytelling, scattered and lowdown and vile as it was. What Morton said next was harder to understand; Dr. Hamilton supposed at first that he was raving.

“Said it was a change of life she had. Said not every – not everyone had a change of life – said she would’ve stayed a she for longer if she’d got a child at the right time, but she didn’t, and so that change come on her and she was he now. And it was none of, none of his fault if he a’n’t done his duty by the arrangements, and he wouldn’t have, no one could say that of him. So he did what he did. And here I am.”

“What do you mean – what he did?” said Dr. Hamilton. Morton did not answer; Dr. Hamilton said again, “What do you mean what he did?”

At that, Morton reached out, took Dr. Hamilton’s tie in one hand, pulled his ear to the level of the bed, and told him.

As Dr. Hamilton listened, he eased himself down to the floor, and at last sat cross-legged until Morton stopped speaking. There he stayed for some time, gray-faced, and wondered if he should, after all, bleed Morton to death – just gently, of course, without a word, as if he had drawn off too much by accident. What was Morton now? A man made a woman by force? Or only a poor host, as to so many worms?

“Tells me if I kill myself they’ll have my brothers. Slow and alive, he said. Says I can’t hurt the babies. I – Lord help me, I want to die, I don’t want to hurt ’em, I just, I want to…”

“I see,” said Dr. Hamilton. Later, the stupidity of this remark would gnaw at him, but at the moment there was simply nothing else to be said.

Merciful to bleed him out – but what was that for him to judge? Here was the matter. There was this Mialai-thy’temai offshore, and whatever she was – he was – he expected that Morton would bear living children. What if he did not – if the doctor was called out to help, and he did not? Well. This, then, was the business at hand.

Dr. Hamilton raised himself from the floor, paced once or twice, and thought very carefully – first about doors; and then about the caesarean procedure as it might be applied to a multiple birth.

That night, a heavily draped and very slowly moving Ben Morton was led slowly down the icy steps, with Dr. Hamilton’s arm supporting him, and through the streets to the doctor’s study. It took an hour, with two stops for Morton to rest.

“We can’t say when you…when the time for this is coming,” Dr. Hamilton had said. “It’s a good deal of trouble, but it’s best for you to stop along of me.”

“He has to know where I am,” was all Morton had said. “We got to send word. Else he should think… He has to come and see.”

“Let him,” said Dr. Hamilton. “Send word. Do what you wish. You’ll lie downstairs. People come and go out the side door there. I’ll have the girl make you up a pallet. The floor will be good for your back.”

They did not speak again until they had reached Dr. Hamilton’s house. Dr. Hamilton guided Morton through the basement door directly into his study, where he received such patients as did not have the money to summon him to their homes. There, the doctor ordered Belinda to spread spare blankets over the bare floor, and then again over the bulk of Morton.

As Morton’s pulse was very high, Dr. Hamilton bled him somewhat to relieve the pressure of his apoplexy, and this helped Morton to rest. He slept a choking, noisy sleep while Dr. Hamilton sat at his writing-desk, head in his hands, craned over his account-book and log of supplies.

Some nine days passed in this fashion. Belinda kept Morton cleaned and fed, while Dr. Hamilton saw to other patients, and did his best to see them at home or keep them out of the study in any case. When time permitted, Dr. Hamilton read extensively in his library. This gave him no further help, nor did he honestly expect it to. He prepared for a birth in the study, and he prepared for a death.

To prepare for a birth required no new goods – he had forceps, oil, cloth, dressings and water to boil – but, as it appeared to him that the infants would not have a living mother, someone would have to nurse them. To that end, he consulted his own records, and sent Belinda to fetch Miss Ida Landry out of number ten, Shurtleff Street.

“There is a certain lady,” said Dr. Hamilton to Miss Landry, “who has good reason to keep her name quiet, and to be frank I do not believe she will live through her birth, let alone have the health to nurse. I need your help, if you can give it. For this, I can pay you in board, and in trade on a bill of mine in some time to come. Will you help me?”

Miss Landry chewed a stray strand of her hair; she did not appear to notice she was doing so. At last she said, “What kind of…is the baby a…”

Dr. Hamilton answered her with a chill stare, and repeated, “Will you help us or will you not?”

Miss Landry’s shoulders sagged.

“I suppose so.”

“Very good, my dear,” said Dr. Hamilton, gently clasping her hand. “Thank you very much indeed.”

Miss Landry was seventeen, and bereaved a month before, shortly after giving birth to her first and only child. Dr. Hamilton had been kind enough to leave no bill when he departed her family’s ragged rooms on Shurtleff Street. There had been nothing he could do for Miss Landry’s infant girl, and in any case, he doubted he would have seen any money or trade from the likes of the Landrys. The child’s father, Miss Landry said (quite unasked) had gone whaling, and would marry her when he returned; but her eyes were dropped when she said it, and her mother looked aside with a scowl.

Dr. Hamilton did not know that he would need a wet-nurse; he did not know what would be born, or if they would be born alive, but he determined to prepare. For five or six of them, he feared he would need three wet-nurses, but he only knew of the one girl just now who would serve. Rice-gruel would have to do otherwise.

Morton prepared himself for death, so far as Dr. Hamilton could see. His brother came to see him, and they had low, choked words between them. Whether the boys learned anything of the nature of Morton’s ailment, Dr. Hamilton could not say. He had told Morton that he’d better not speak of it; to that Morton did not respond, but only made a sort of hissing noise, burbling with spit, that answered for a laugh.

Neither brother spoke to Dr. Hamilton of the matter of the bill, which robbed him of the opportunity to wave his hand and say, “We must not speak of such things just now”. Quietly, he resented this. Dr. Hamilton had not reckoned the expense of this treatment, in the sense that he had said to himself, I do not reckon the expense of this, and said it several times quite firmly. But, then, he was recompensed; he was paid in the opportunity to observe this thing. It was nothing anyone else had ever had. Whether he would live to speak of it was another matter.

The labor came in the middle of the afternoon, when Dr. Hamilton was at his desk and otherwise occupied. He had come to ignore Morton’s moans, whines and unpleasant noises, and did not at first take great notice.

“Doc,” Morton cried at last, “it’s my back. It’s breaking my back.”

“Is it,” he said, rubbing his aching forehead; then Morton gave a strangled, piercing cry. Dr. Hamilton’s eyes flew open.

On examination of Morton’s abdomen, he saw that a silverish liquid had leaked from the pores that were in the middle of the stretch marks. These pores gaped so much now that they were red as little lips. It seemed as if a fresh mucus membrane were appearing behind them.

“Has to be now,” moaned Morton. “Has to be now, oh, God, I can’t – ”

It was a small mercy that the sound of a grown man’s screams had never attracted much attention from Dr. Hamilton’s neighbors. In the past, there had never been much that Dr. Hamilton could do for the pain of operations, except to make them as quick as he might. Now, at least, he had ether. He soaked a sponge at the bottle’s mouth, stuffed it into the vaporizer, and dosed Morton as best he could.

Belinda was scraping a pot in the kitchen when Dr. Hamilton threw the door open behind her and slammed it to the wall. She barely startled; this was not the first or last time that he came looking for her bloodstained and in haste.

“What’s the moon, Belinda?”

“Waning quarter,” she answered instantly. It had become a common question in town.

“Ah. Right,” he said, and chewed his lip. “Well. Look, go down to Shurtleff Street and get that Ida Landry out of number ten. Take her around the parlor, don’t bring her downstairs. No one’s to come in, not even if he’s got a piece of bone sticking out of him, you hear?”

Belinda had learned that it was best to begin moving as soon as the doctor gave her orders. She had her cloak around her shoulders by the time he had finished speaking.

Within the hour, Belinda returned with Miss Landry, and set her awkwardly in the parlor, on the worn red sofa.

“Stay there,” was all she said; and from there she went to the kitchen, and down the basement stairs, where she knocked softly on the study door. She had just pressed her right ear to the door panel when Dr. Hamilton yanked it open, and seized her arm as she stumbled.

“Belinda,” he said. “Meat.”

“What?”

Behind him, there were thin and choking newborn cries.

“Get me flesh. What is there? Is there mutton? Ham? Go get fish if you have to – get a chicken, get a cat, go get it – ”

With this, he was shaking her shoulders. Belinda shrieked and pulled away.

“There’s ham – just enough for – ”

“Get it, I don’t care! Bring it here!”

When she returned with an armful of cheesecloth wrapped around such ham as they had in the icebox, she heard the cries of an infant from behind the study door. At her knock, Dr. Hamilton opened the door and said gently, “Please, stand here – hold him for me, just a few moments. Don’t go anywhere. Don’t take him to Miss Landry. Not just yet.”

Into her waiting arms, he pressed a red-faced, bundled newborn, and slammed the door.

For the next ten minutes, Belinda had nothing to do but stand in the poor half-light and examine this hiccuping, whining child. It was certainly not the first newborn she had held. He was, she could only say later, the most ordinary baby – a bulldog face, a mouth smeared with mucus, a chunk of cord and damp matter at his belly.

There was only the one child that was born human, and needed Ida Landry. There were four that were otherwise.

The four of them – as Dr. Hamilton began to think, all in one phrase – needed flesh, not milk. It had not taken more than a single look at the opening and shutting of their tiny mouths to tell him this. Nonetheless, it was less trouble to feed them than he supposed it would be. The flesh itself did not matter – ham, fish, rats – he ordered Belinda to find what she could, and she did. All he had to do then was throw it into the tub. They would tear it apart for themselves, living or dead. Then they slept, for four hours or five. When one began to cry, the others were soon awake, and crying themselves; and then Dr. Hamilton fed them again.

Dr. Hamilton could not tell whether he was overfeeding them or not, but he did not wish to risk too much hunger in them. He knew well enough what a starving litter of newborn animals might do to each other, and he did not wish to explain any loss whatsoever to the gentleman who was expected. He was expected; so much Morton knew, and no more.

“He’s coming,” Morton said simply. “Said he would, when he – he said he would, to come see them, see what they were and take the ones as belonged with him. I said to Jack, they got to send word to the Order – somebody had to tell him I ha’n’t made away with myself or nothing, just came over elsewhere to have ’em . . .”

“And so he’ll come here, will he?” snapped Dr. Hamilton.

“Suppose so,” said Morton, and shut his puffed eyes. Dr. Hamilton bit the inside of his cheek until it drew blood.

Later, he would learn that the ones from offshore were attentive fathers, when the time came. They did not trust any woman – or her family – not to kill a child of theirs a-borning. The husband would come to his wife to see that his child was whole and was healthy, and if it was not, he would know why.

These children, at least, were quite well, insofar as Dr. Hamilton was any judge. The boy upstairs was not in any difficulty, and as for the four downstairs in his study, who could kill the likes of them? What concerned Dr. Hamilton, and what he had not prepared for, was that Morton himself was going to live. Few men had been opened as he was and lived long afterwards. Indeed, many wise men had chosen death over the prospect of such surgery, and you could not call this business surgery. Yet here Morton was, and he looked less like dying every day.

The infants had not, in fact, eaten Morton from the inside out. Each of them slid out of Morton’s abdomen in a purple sac, fitted to its body, with a cord that had apparently adhered to his peritoneum, but now snapped free easily. Inside the sacs, the infants each had a navel-cord attached to its abdomen. Four of the infants chewed their own cords away; the fifth, the one who slept upstairs, had required Dr. Hamilton’s assistance for this. Morton lay there like a slashed wineskin, with great wounds where five stretchmarks had been, but his organs had not been injured.

As soon as time permitted, Dr. Hamilton had cleaned the peritoneal injuries and sutured them. It was not that he supposed the man would live, not for a moment, but it would have taken special effort for him not to dress a wound that lay before him. It was simply a thing that his hands undertook, and in any case, it was the neatest thing to do. When the shock got on with killing Morton, the corpse, at least, could be more easily laid out.

After that, Morton simply went on not dying. Soon enough Dr. Hamilton realized he could not fail to feed him; the man had to be anemic. He needed hot spirituous drinks, broth and egg possets, and such of these as Dr. Hamilton could obtain, he got.

By the fifth day, Morton’s continual failure to die was almost an irritant. Dr. Hamilton found himself sitting at his desk in his study across from a tub of squirming fish-infants and a man who, although much deflated, remained bedridden – floor-ridden, as it were – in his pile of stained blankets against the wall. It was a family scene that rapidly lost any charm it held.

“I believe,” he said at last, “once you’ve had words with the gentleman, and all this – disposition has been made, you can be moved home. You should send for someone to aid you getting back – in a chair, I should say, because you mustn’t walk. But from here I can tell you what ails you, and you can have it seen to. There is no reason you should not recuperate in your own room.”

To this, Morton made no answer.

Dr. Hamilton had, of course, asked Morton, “When do you suppose, – when do you look for him to come?”

He could not frame the question any better than that, but it did not matter. Morton was no help; he only grunted, and gave a shrug. The gentlemen from offshore only moved in town in the new moon, or in the blackest storm – that was as much as the doctor knew; and the next new moon would be tomorrow. What else could he do, but count upon that?

Dr. Hamilton had a good deal else to do. There had been no less suffering upstairs, for all this business, and that was almost delightful to him, by now. He was called out for a dental abscess, two tooth-pullings, and a case of worms. To all these visits he went on foot, wrapped in his worn wool greatcoat, with his leaking boots filling again and again with melted snow and ice from the half-frozen earthen streets; and every step away from his house was a relief.

The doctor sat up with Morton that night. Morton had not asked him to do it. He said nothing much to the doctor as they sat there in a pool of greasy yellow lamplight, just as they had the few nights before; just as before, the doctor read to himself and drank hot rum-and-water. He did not know what to expect that he should hear, or see. Consequently, he did his best to expect nothing.

As it happened, the doctor stepped away from the study around nine o’clock, having gone behind the stairwell to answer a call of nature; then he returned, pulled the sticking door behind him, and turned to see Morton being held aloft by both shoulders in the grasp of a gentleman from offshore.

The gentleman stood to his full height, some seven feet tall, with his great frog-legs extended to the full. Two soft antennae on his head, which brushed the brick ceiling, swung towards Dr. Hamilton; and then the gentleman turned.

“Doctor,” he said.

Dr. Hamilton’s knees gave beneath him. He grasped the wall and slid his hand roughly down it, so he could give himself at least the dignity of appearing simply to sit down suddenly on the floor. He spoke at last, in gulps and whispers.

“Sir,” he said, “I do not believe I heard you come in.”

The gentleman shrugged. The outside door was shut; none of the windows were open. He could only have been admitted by someone who shut the door after him, and the only man there was Morton.

“Mr. Morton,” said Dr. Hamilton, “is in a very delicate state of health and he should not be -”

He was interrupted by a deep, hoarse growl, not directed at himself but at Morton. The gentleman had spoken directly into Morton’s ear, his long-jawed, needle-toothed head leaning over his shoulder. It sounded as if two of his words were say again.

“Doc,” said Morton. He turned his head as best he could, and then he began to smile. “Doctor, I told Mialai, here, I said to let me go. Said I’d rather die than go on like I was.”

Mialai-thy’temai nodded to Dr. Hamilton.

“You now, you hear this, so,” he said. With that, he took Morton’s chin firmly in his heavy, clawed hand, seized his shoulders in the grip of his jaw, and twisted. Dr. Hamilton squeezed his eyes shut.

Morton made a kind of whine; then there was a crack, then a thump. In the silence, almost unconscious of himself, Dr. Hamilton went to his knees and bowed his head before he opened his eyes again.

“Four are here,” said Mialai-thy’temai at last. “He said five.”

Dr. Hamilton had to puzzle his words together for a moment; then he spoke.

“There – yes. One more child. A boy, sir. We set him to nurse, he’s with his nurse just now, but – ”

Mialai-thy’temai took only two steps across the room to reach Dr. Hamilton; he picked the doctor up by both shoulders, just as he had Morton. Dr. Hamilton shut his eyes as soon as he heard the crackling footfall of the gentleman’s fins, but once Mialai-thy’temai picked him up, Dr. Hamilton could feel the great head sliding forward across his shoulder, the ridged bone and skew-angled teeth of the jaw scratching the skin of his neck. Mialai-thy’temai spoke from his throat.

“Bring him here.”

Five eventful minutes later, Dr. Hamilton returned to the study. His legs were still shaking slightly, as the gentleman had dropped him directly on the ground after giving his order. Nonetheless, Dr. Hamilton had made it up the basement stairs at a great turn of speed, snatched the sleeping infant from Ida Landry’s arms without a word, and returned as quickly as he might. The child squeaked and smacked his lips, but he did not yet begin to wail.

Dr. Hamilton kept his eyes fixed on the child, and extended his arms gingerly from the shoulder, in the universal human gesture of offering an infant to be held.

“Show.”

“Sir?”

Dr. Hamilton could not understand this at first. He risked a look upward, and his muscles froze.

Mialai-thy’temai was not as Dr. Hamilton had left him. He was covered with great mottled streaks and lumps of light green and turquoise – he was, in fact, covered with his own four children. The infants adhered to his back and his stomach. Their tiny fingers and phalanges had found ridges and old barnacles in the surface of him, and latched flat and tight; their little mouths suckled peaceably at his hide.

The green-gold iris of the gentleman’s eye swiveled in its socket, first the one and then the other, as he turned his head this way and that to regard Dr. Hamilton.

“You show me – healthy? Yes? Show his skin! All his skin! Now!”

Dr. Hamilton desperately fumbled at the infant’s blankets, and this did indeed trigger its wailing. For a moment, he truly believed that they both would die, he and the child together, in some inexplicable fit of wrath from the creature that had fathered it.

Mialai-thy’temai snatched up the child as lightly as a dead bird. Dr. Hamilton could not focus his eyes on what was before him, on what was to happen to the child then at the hands of its father. But nothing did. Mialai-thy’temai made a deep clicking noise. It seemed all was to the gentleman’s satisfaction.

He deposited the infant back into the damp wad of muslin in Dr. Hamilton’s arms, and said,

“Well and well. You keep. I come back.”

Dr. Hamilton reflected on those words for many years.

The gentleman certainly had not lied. He did indeed come back, at the new moon of every month. He came back with gold, with a handful of long-sunken coins or jewelry that he threw on the floor. He came to hold the child at his great arm’s length, to see if it was injured or neglected, to look it up and down with first one eye and then the other. Then he would shove the boy back into Dr. Hamilton’s arms, and leave.

Two of the Morton boys, Jack and Bill, had come for Benjamin Morton’s body, once Dr. Hamilton had sent word that he had passed. Dr. Hamilton had had Belinda lay him out and wrap him tightly in muslin, to present the most decent corpse that he might, and to head off any questions about how much smaller he was now. Jack and Bill, gray-faced and silent, did not behave as if they knew they were now uncles. Later, Dr. Hamilton considered how best to tell them, but he never did find the words.

Young Morton was seven months old before Dr. Hamilton dared inquire of his father when, in fact, the child was to be taken elsewhere. As it turned out, he had nothing to fear. The gentleman simply ignored him. Human speech interested Mialai-thy’temai not at all, no more than the meowing of a cat, unless it was in answer to a question of his. And he had no questions for Dr. Hamilton, other than whether the child was healthy. At last, Dr. Hamilton saw that the gentleman meant exactly what he had said, no more and no less: you will keep him, and I will come back.

After Dr. Francis Hamilton passed away in 1882, the youngest Dr. Hamilton had no notion of selling the practice. Indeed, he had carried it on for three years already, as the elder doctor had terrible arthritis, together with a number of nervous afflictions. The young doctor, a broad-shouldered, genial fellow, took good care of his uncle Hamilton, who had always taken such good care of him.

Dr. Morton Hamilton had taken courses by correspondence from the Medical College of New York, and had assisted in the doctor’s study for many years, but he had attended no medical school in person. This was not because he lacked knowledge or diligence; he had a good deal of both, and he understood that it was wisest and best to stay close to home. In any case, no one had cause to complain of him. He remained in the house with Mrs. Hamilton, his Aunt Belinda, and looked after her, and after his family’s business.

L.T. Patridge is originally from Greenville, Mississippi, and currently resides in the metro-Boston area.  To the best of her knowledge, she is the only former Delta debutante who writes Lovecraftian fiction.  She blogs at ltpatridge.wordpress.com.

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Story illustration by Leslie Harker.

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