A commanding female voice pierced the cacophony of voices and steam engines. “Let me through! Move to the side, please. Out of my way.”

A woman dressed in black with a jaunty green necktie at her throat, pushed her way through the crowd with brisk determination, deftly employing a curved-handle walking stick to prod slow-moving bystanders. She looked at Rhys with an assessing gaze and knelt beside him, heedless of the muddy ground.

“Miss,” Severin began with a touch of annoyance, “no doubt you’re trying to be of use, but—”

“I’m a physician,” she said curtly.

“You mean a nurse?” Severin asked.

Ignoring him, she asked Rhys, “Where is the worst pain?”

“Shoulder.”

“Move your fingers, please.” She watched as he complied. “Does the arm feel numb? Tingly?”

“Numb.” Clenching his teeth, Rhys looked up at her. A young woman, still in her twenties. Pretty, with brown hair and large green eyes. Despite her slim form and fine features, she conveyed an impression of sturdiness. Very gently, she took hold of his arm and elbow and tested the range of motion. Rhys grunted as a spear of agony went through his shoulder. Carefully the woman settled the arm back against his midriff. “Pardon,” she murmured, reaching beneath his coat to feel his shoulder. An explosion of icy heat sent sparks across his vision.

“Agghh!”

“I don’t believe it’s fractured.” She withdrew her hand from his coat.

“That’s enough,” Severin said in exasperation. “You’re going to make his injuries worse. He needs a doctor, not some—”

“I have a medical degree. And your friend has a dislocated shoulder.” She untied the green bow at her throat and pulled the scarf free. “Give me your necktie. We have to secure his arm before we move him.”

“Move him where?” Severin asked.

“My practice is two streets away. Your necktie, please.”

“But—”

“Give it to her,” Rhys snapped, his collapsed shoulder on fire.

Grumbling, Severin complied.

Deftly the woman improvised a sling with the green scarf, knotted it at the level of Rhys’s collarbone, and adjusted the edge around his elbow. With Severin’s help, she slid the necktie around Rhys’s midriff and over the numb arm, securing it close to his body.

“We’ll help you to your feet,” she told Rhys. “You won’t have to walk far. I have the proper facilities and supplies to treat your shoulder.”

Severin scowled. “Miss, I have to object—”

“Dr. Gibson,” she said crisply.

“Dr. Gibson,” he said, with an emphasis on the “Dr.” that sounded distinctly insulting. “This is Mr. Winterborne. The one with the department store. He needs to be treated by a real physician with experience and proper training, not to mention—”

“A penis?” she suggested acidly. “I’m afraid I don’t have one of those. Nor is it a requirement for a medical degree. I am a real physician, and the sooner I treat Mr. Winterborne’s shoulder, the better it will go for him.” At Severin’s continued hesitation, she said, “The limited external rotation of the shoulder, impaired elevation of the arm, and the prominence of the coracoid process all indicate posterior dislocation. Therefore, the joint must be relocated without delay if we are to prevent further damage to the neurovascular status of the upper extremity.”

Had Rhys not been in such acute discomfort, he would have relished Severin’s stunned expression.

“I’ll help you move him,” Severin muttered.

During the short but torturous walk, Severin persisted in questioning the woman, who answered with admirable patience. Her name was Garrett Gibson, and she had been born in East London. After enrolling at a local hospital as a nursing student, she had begun to take classes intended for doctors. Three years ago, she had earned a medical degree at the University of Sorbonne in Paris, and subsequently returned to London. As was common, she had established her practice out of a private home, which in this case happened to be her widowed father’s residence.

They reached the three-story house, tucked in a row of comfortably middle-class Georgian-style terraces built with crimson cutting bricks. Such buildings were invariably designed with one room in the front and one in the back on each story, with a passageway and a staircase on one side.

A maid opened the door and welcomed them inside. Dr. Gibson ushered them into the back room, a scrupulously clean surgery that had been furnished with an examination table, a bench, a desk, and a wall of mahogany cabinets. She directed Rhys to sit on the examination table, constructed with a padded leather top over a cabinet base. The top was divided into hinged sections that could be adjusted to raise the head, upper torso, or feet.

After quickly shrugging out of her coat and pulling off her hat, Dr. Gibson handed them to the maid. She approached Rhys and gently removed the makeshift sling. “Before you lie down, Mr. Winterborne,” she said, “we’ll need to remove your coat.”

He nodded, cold sweat trickling down his face.

“How can I help?” Severin asked.

“Begin with the sleeve on the uninjured side. I’ll take the other. Pray do not jostle the arm any more than necessary.”

Despite their extreme care during the process, Rhys winced and groaned as he was divested of the coat. Closing his eyes, he felt himself sway in his seated position.

Severin immediately steadied him with a hand on his good shoulder. “I think we should cut off the shirt and waistcoat,” he suggested.