Page 19 of Fair as a Star

“I’ve got another patient to stop in on. You can accompany me part of the way if you like.”

Mark fell in beside him, the two of them walking in the direction of the river. He didn’t say anything. Not at first. The subject was too important to treat lightly.

Black shot a look at the book in Mark’s hand. “Dickens?” His lips twitched. “Not the Bible?”

“Not today, no.” Or any other day this week. Mrs. Arbuthnot wasn’t at death’s door. She needed cheering. Dickens always did the trick. If not him, it would be romantic poetry. Shakespeare, Wordsworth, or Keats. And Mark was in no mood to be reciting love poems.

“If only I’d known that literary works were an alternative text.” Black smiled wryly. “My career might have taken a different path.”

“You considered the church?”

“Not I. My father. It’s the fate of most third sons, I believe. Whether they be spiritually inclined or not.”

Mark gave him a distracted glance. Simon Black was well educated and spoke in the tones of a gentleman, but up to now, he hadn’t been very forthcoming about his forbears. Mark hadn’t liked to press him. One never knew if there was a tragedy lurking in someone’s past. “Your father was a member of the gentry?”

“Something like that.” Black’s expression sobered. “He’s the Earl of Harbury.”

“Ah.” Mark recognized the name. The earl was a staunch conservative, as well as being one of the wealthiest men in the southwest of England. “He doesn’t approve of your chosen career?”

“It isn’t the medical profession he objects to. It’s my liberal views he deplores. That, and my preference for working with the poor. We’re not estranged, but…I’ve done my best to limit our connection. It’s why I prefer the relationship not to become common knowledge.”

“Understandable.” Mark stared straight ahead as they walked. It was another warm summer day in Shepton Worthy, everything bright and blooming with fragrance. He was too preoccupied to appreciate it.

“Mrs. Arbuthnot’s doing better, you know,” Black said. “If that’s what it is that’s troubling you.”

“I’m glad to hear it. But that isn’t what I wanted to speak with you about. It’s something else. A general question.”

“Go on.”

“What do you know about melancholy?”

“Specifically?”

“How to treat it.” Mark paused. “How to cure it.”

“There is no cure,” Black said. “Not as far as I’m concerned.”

Mark’s spirits sank. He’d suspected as much. Still, to hear it from a medical man was akin to a death knell.

“Of course,” Black continued, “there are plenty who would tell you the opposite. Have a look inside any apothecary’s shop and you’ll see shelves of patent medicines infused with opiates and stimulants. Not a one of them is a cure, only a means to sleep longer, or to stay awake for days at a time, depending on the tonic one takes. Many of my patients swear by them.”

“You don’t believe they work?”

Black shook his head. “It’s quackery.”

“Are there no legitimate treatments for melancholy? The genuine affliction?”

“As to that…” Black adjusted his battered leather medical bag in his hand. “Many practitioners prefer the more extreme methods. Ice baths. Various deprivations. Even electrical shocks with one of those newfangled electricity machines.” His brow creased. “I suppose that’s the basis of all of it—to shock the patient out of the melancholy by some dramatic means.”

“You don’t think it’s possible?”

“Not without damaging the patient’s body—or his spirit. There are better methods of treatment to my mind, but as I said, there’s no cure. Not for the acute variety.”

Mark ran his hand over the back of his neck. He didn’t like the sound of any of it. “Are there many varieties?”

“Naturally. It sometimes arises from a particular situation. The birth of a child. A death in the family. Guilt over some kind of misconduct. Those episodes generally resolve themselves at some point.”

That much Mark knew. Over the years, he’d encountered similar evidence of melancholy among those of his parishioners who were undergoing various trials of life. He’d talked with them. Prayed with them. “And the other kind? This acute variety that you mention?”