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 analysis itself. For tests of the highly complex category, the personnel requirements are more stringent. Anyone who is eligible to
perform highly complex tests can also perform moderate-complexity testing.

PTS: 1 DIF: Cognitive Level: 2 REF: pp. 4-5

Copyright © 2016 by Mosby, an imprint of Elsevier Inc. 2

 6. The fastest growing segment of laboratory testing is:
a. dry reagent chemistry.
b. lab on a chip technology.
c. molecular diagnostics.
d. automation of blood cell counting.
ANS: C
In the 21st century, molecular diagnosis is the hottest topic in the clinical laboratory.

PTS: 1 DIF: Cognitive Level: 1 REF: p. 7

7. Informed consent upon patient’s hospital admission can encompass:

a. agreement to the nature of the testing to be done.
b. agreement to what will be done with laboratory test results.
c. implied consent to many routine procedures that may be performed.
d. all of the above.
ANS: D
For laboratories, an important responsibility is obtaining informed consent from the patient. Informed consent means that the
patient is aware of, understands, and agrees to the nature of the testing to be done and what will be done with the results reported.
Generally, when a patient enters a hospital, there is an implied consent to the many routine procedures that will be performed while
the patient is in the hospital. Venipuncture is one of the routine tests that carry this implied consent.

PTS: 1 DIF: Cognitive Level: 2 REF: p. 10

8. The federal legislation requiring strict confidentiality of patient results is:

a. Clinical Laboratory Improvement Act (CLIA ’88).
b. Health Insurance Portability and Accountability Act (HIPAA).
c. National Certifying Agency.
d. combined state laws.
ANS: B
The Health Insurance Portability and Accountability Act (HIPAA) enacted in 1996 requires that any results obtained for specimens
from patients must be kept strictly confidential. Any information about the patient, including the types of measurements being
done, must also be kept in confidence. Clinical Laboratory Improvement Act (CLIA ’88) regulates laboratory testing. The National
Certifying Agency grants professional certification to individuals. HIPAA legislation supersedes any and all state laws regarding
confidentiality.

PTS: 1 DIF: Cognitive Level: 1 REF: pp. 10-11

9. The revised CLIA ’88 and HIPAA regulations give patients:

a. the right to access their own laboratory reports.
b. the right to give a personal representative the patient’s completed test reports.
c. the right to refuse laboratory testing.
d. both a and b.
ANS: D
The new rule revises CLIA ’88 and HIPAA privacy rules to require laboratories to give a patient, or a person designated by the
patient or his or her “personal representative,” access to the patient’s completed test reports on the patient’s or the representative’s
request. Generally, the rule requires that laboratories provide individuals with access to their laboratory test reports within 30 days
of the request.

PTS: 1 DIF: Cognitive Level: 2 REF: p. 11

10. Chain of custody is defined as:

a. physical transport of a specimen needed for legal reasons.
b. escorting patients who are prison inmates.
c. beginning with the moment the specimen is collected and transported to the
laboratory, to the analysis itself and the reporting of the results, each step must be
documented.
d. documentation of quality control when reporting a patient’s laboratory results.
ANS: C
Laboratory test results that could potentially be used in a court of law—at a trial or judicial hearing—must be handled in a specific
manner. For evidence to be admissible, each step of the analysis, beginning with the moment the specimen is collected and
transported to the laboratory, to the analysis itself and the reporting of the results, must be documented—a process known as
maintaining the chain of custody. Specimens that provide alcohol levels, specimens collected from rape victims, specimens for
paternity testing, and specimens submitted from the medical examiner’s cases are the usual types requiring “chain-of-custody”
documentation.

PTS: 1 DIF: Cognitive Level: 1 REF: p. 11

Copyright © 2016 by Mosby, an imprint of Elsevier Inc. 3

 11. Situational ethics is a system of judging acts:
a. by strict principles.
b. by categorical principles.
c. within a context.
d. by legal principles.
ANS: C
Situational ethics is a system of ethics by which acts are judged within their contexts instead of by categorical principles. Hospitals
have ethics committees to evaluate situational ethics cases. Individual laboratory professionals may need to make decisions based
on personal or professional values.

PTS: 1 DIF: Cognitive Level: 1 REF: p. 12

MATCHING

Match the following sections of the clinical laboratory with a representative test or assay for that section. Use an answer only
once.
a. hematology
b. clinical chemistry
c. immunohematology
d. immunology and serology
e. microbiology
1. measures blood glucose and cholesterol levels
2. counts blood cells
3. determines blood groups
4. screens for strep throat infections
5. screens for viral diseases, for example, HIV

1. ANS: B PTS: 1 DIF: Cognitive Level: 1

REF: p. 6
2. ANS: A PTS: 1 DIF: Cognitive Level: 1
REF: p. 6
3. ANS: C PTS: 1 DIF: Cognitive Level: 1
REF: p. 6
4. ANS: E PTS: 1 DIF: Cognitive Level: 1
REF: p. 6
5. ANS: D PTS: 1 DIF: Cognitive Level: 1
REF: p. 6

Match the following acronyms with its full name. Use an answer only once.
a. American Society for Clinical Laboratory Science
b. National Accrediting Agency for Clinical Laboratory Sciences
c. American Society of Clinical Pathologists
6. ASCP
7. ASCLS
8. NAACLS

6. ANS: C PTS: 1 DIF: Cognitive Level: 1

REF: p. 2
7. ANS: A PTS: 1 DIF: Cognitive Level: 1
REF: p. 2
8. ANS: B PTS: 1 DIF: Cognitive Level: 1
REF: p. 2

Copyright © 2016 by Mosby, an imprint of Elsevier Inc. 4

Exploring the Variety of Random
Documents with Different Content
occasional clicking of a cinder on the fender. At intervals the sick
woman uttered a tremulous sigh, and met Mary's gaze with a look of
appeal, as if she recognised in her presence a kind of protective
sympathy; but she had ceased to complain, and the watcher
abstained from any active demonstration. In the globe beside the
mirror the gas flared brightly, and this, coupled with the heat of the
fire, filled the room with a moist radiance, against which the narrow
line of dawn above the window-sill grew slowly more defined. The
advent had been long expected, when sharp footfalls on the
pavement smote Mary's ear, and, forgetting that Kincaid had his own
key, she sprang up to let him in. The hall-door swung back, and she
paused with her hand on the banisters. He came swiftly forward and
passed her with a hurried salutation on the stairs.
There was, however, no anxiety visible on his face as he approached
the bed. Merely a little genial concern was to be seen. His questions
were put encouragingly; when a reply was given, he listened with an
air of confidence confirmed.
"Am I very ill?" she gasped.
"You feel very ill, I dare say, dear; but don't go persuading yourself
you are, or that'll be a real trouble!"
His fingers were on her pulse, and he was smiling as he spoke. Yet
he knew that her life was in danger. The worthiest acting is done
where there is no applause—it is the acting of a clever medical man
in a sick-room.
Mary stood on the threshold watching him.
"Who put that funnel on the kettle?" he inquired, without turning. He
had not appeared to notice it.
"I did," she answered. "Am I to take it off?"
"No."
He signed to her to go below, and after a few minutes followed her
into the parlour.
"Give me a pen and ink, Miss Brettan, please."
"I've put them ready for you," she said.
He wrote hastily, and rose with the prescription held out.
"Where's Ellen?"
"Here, waiting to take it."
A trace of surprise escaped him. He said curtly:
"You're thoughtful. Was it you who put on that poultice?"
Her tone was as distant as his.
"We did all we could before you came; I put on the poultice. Did I do
right?"
"Quite right. I asked because of the way it was put on."
With that expression of approval he left her and returned to his
mother. Mary, unable to complete her toilette, not knowing from
minute to minute when she might be called, occupied herself in
righting the disorder of the room. She had thrown on a loosely-
fitting morning dress of cashmere, one of the first things that she
had made after she was installed here. An instant; she had snatched
to dip her face in water, but she had been able to do little to her hair,
the coil of which still retained much of the scattered; softness of the
night, and after Ellen came back from the chemist's she sent her
upstairs for some; hairpins. She stood on the hearth, before the
looking-glass, shaking the mass of hair about her shoulders, and
then with uplifted arms winding it deftly on her head. The supple
femininity of the attitude, so suggestive of recent rising, harmonised
with the earliness of the sunshine that tinged the parlour; and when
Kincaid reentered and found her so, he could not but be sensible of
the impression, though he was indisposed to dwell upon it.
She looked round quickly:
"How is Mrs. Kincaid, doctor?"
"I'm very uneasy about her. I'm going back to the hospital now to
arrange to stay here."
"What do you think has caused it?"
"I'm afraid she got damp and cold in the garden on Sunday."
"And it has gone to the lungs?"
"It has affected the left lung, yes."
She dropped the last hairpin, and as she stooped for it the swirl of
the gown displayed a bare instep.
"I can help to nurse her, unless you'd rather send someone else?"
"You'll do very well, I think," he said; and he proceeded to give her
some instructions.
She fulfilled these instructions with a capability he found astonishing.
Before the day had worn through he perceived that, however her
training had been acquired, he possessed in her a coadjutrix reliable
and adroit. To herself, she was once more within her native province,
but to him it was as if she had become suddenly voluble in a foreign
tongue. He had no inclination to meditate upon her skill—to
meditate about her was the last thing that he desired now—but
there were moments when her performance of some duty supplied
fresh food for wonder notwithstanding, and he noted her dexterity
with curious eyes. He had, though, refrained from any further praise.
The gratitude that he might have spoken was checked by the
aloofness of her manner; and, in the closer association consequent
upon the illness, the formality that had sprung up between them
suffered no decrease. Indeed it became permanent in this contact,
which both would have shunned.
After the one scene in which she left the choice to him, she had
afforded him no chance to resume their earlier relations had he
wished it, and the studied politeness of her address was a persistent
reminder that she directed herself to him in his medical capacity
alone. She held the present conditions the least exacting attainable,
since the distastefulness of renewed intercourse was not to be
avoided altogether; but she in nowise exonerated him for imposing
them, and she considered that by having done so he had made her
a singularly ungracious return for the humiliation of her avowal. She
sustained the note he had struck; the key was in a degree congenial
to her. But she resented while she concurred, and even more than to
her judgment her acquiescence was attributable to her pride.
On the day following there were recurrences of pain, but on
Wednesday this subsided, though the temperature remained high.
Mary saw that his anxiety was, if anything, keener than it had been,
and by degrees a latent admiration began to mingle with her
bitterness. In the atmosphere of the sick-room the man and the
woman were equally new to each other, and up to a certain point he
was as great a surprise to her as was she to him. She saw him now
professionally for the first time, and she recognised his resources,
his despatch, with an appreciation quickened by experience. The
visitor whom she had known lounging, loose-limbed and
conversational, in an arm-chair had disappeared; the suppliant for a
tenderness that she did not feel had become an authority whom she
obeyed. Here, like this, the man was a power, and the change within
him had its physical expression. His figure was braced, his
movements had a resolution and a vigour that gave him another
personality. He even awed her slightly. She thought that he must
look more masterful to all the world in the exercise of his profession,
but she thought also that everyone in the world would approve the
difference.
The confidence that he inspired in her was so strong that on
Thursday, when he told her that he intended to have a consultation,
she heard him with a shock.
"You think it advisable?"
"I fear the worst, Miss Brettan; I can't neglect any chance."
She had some violets in her hand—it was her custom to brighten the
view from the bed as much as she could every morning—and
suddenly their scent was very strong.
"The worst?"
"God grant my opinion's wrong!" he said. "Will you ask the girl to
take the wire for me?"
It was to a physician in the county town he had decided to
telegraph, one whose prestige was gradually widening, and whose
reputation had been built on something trustier than a chance
summons to the couch of a notability. Mary had heard the name
before, and she strove to persuade herself that his view of the case
might prove more promising. The day that had opened so gloomily,
however, offered during the succeeding hours small food for faith.
Towards noon the sufferer became abruptly restless, and the united
efforts of doctor and nurse were required to soothe her. She was
fired by a passionate longing to get up, and pleaded piteously for
permission. To "walk about a little while" was her one appeal, and
the strenuousness of the entreaty was rendered more pathetic by
her obvious belief that they refused because they failed to
comprehend the violence of the desire. She endeavoured with failing
energy to make it known, and—prevailed upon to desist at last—lay
back with a look that was a lamentation of her helplessness. Later,
she was slightly delirious and rambled in confused phrases of her
son and her companion—his courtship and Mary's indifference. The
man and the woman sat on either side, of her, but their gaze no
longer met. At the first reference to his attachment Mary had started
painfully, but now by a strong effort her nervousness had been
suppressed, and from time to time she moved to wipe the fevered
lips and brow with a semblance of self-possession. As the daylight
waned, the disjointed sentences grew rarer. Kincaid went down.
Except for the deep breathing, silence fell again, until, as dusk
gathered, the sudden words "I feel much better" were uttered in a
tone of restored tranquillity. Turning quickly, Mary saw that her ears
had not deceived her. The assurance was repeated with a feeble
smile; the features had gained a touch of the cheerfulness that had
been so remarkable in the voice. Soon afterwards the eyes closed in
what appeared to be sleep.
Kincaid was striding to and fro in the parlour, his arms locked across
his breast. As Mary ran in, his head was lifted sharply.
"She feels much better," she exclaimed; "she has fallen asleep!"
He stood there, without speaking—and she shrank back with a
stifled cry.
"Oh! I didn't know.... Is it that?".
"Yes," he said, scarcely above a whisper. And she understood that
what she had told him was the presage of death.
After this, both knew it to be but a matter of time. The arrival of the
physician served merely to confirm despondence. He pronounced
the case hopeless, and reluctantly accepted a fee to defray the
expenses of the journey.
"I wish we could have met in happier circumstances," he said....
"You've the comfort of knowing that you did everything that could be
done."
A page with a message of inquiry came up the steps as he left; such
messages had been delivered daily. But on Saturday, when the
baker's man brought the bread to Laburnum Lodge, he found the
blinds down; and within a few minutes of his handing the loaf to the
weeping servant through the scullery window, the news circulated in
Westport that Mrs. Kincaid had died unconscious at seven o'clock
that morning.
While the baker's man derived this intelligence from the housemaid,
Mary was behind the lowered blinds on the first floor, crying. She
had just descended from her bedroom; seeing how deeply Kincaid
was affected, she had retired there soon after the end. He had not
shed tears, but that he was strongly moved was evident by the
muscles of his mouth; and the quivering face of which she had had a
glimpse kept recurring to her vividly.
He came in while she sat there. He was very pale, but now his face
was under control again.
She rose, and advanced towards him irresolutely. "I'm so sorry! She
was a very kind friend to me."
He put out his hand. For the first time since she had met him after
posting the note, hers lay in it.
"Thank you," he said. "Thank you, too, for all you did for her; I shall
always remember it gratefully, Miss Brettan."
He seemed to be at the point of adding something, but checked
himself. Presently he made reference to the arrangements that must
be seen to. That night he reoccupied his quarters in the hospital,
and excepting in odd minutes, she did not see him again during the
day. She found space, however, to mention that she purposed
remaining until the funeral, and to this announcement he bowed,
though he refrained from any inquiry as to her plans afterwards.
"Plans," indeed, would have been a curious misnomer for the
thoughts in her brain. The question that she had revolved earlier had
been settled effectually by the death; now that all possibility of Mrs.
Kincaid's recommending her had been removed, her plight admitted
of nothing but conjecture.
In her solitude in the house of mourning, unbroken save for
interruptions which emphasised the tragedy, or for some colloquy
with the red-eyed servant, she passed her hours lethargic and
weary. The week of suspense and insufficient rest had tired her out,
and she no longer even sought to consider. Her mind drifted. A fancy
that came to her was, that it would be delightful to be lying in a
cornfield in hot sunshine, with a vault of blue above her. The picture
was present more often than her thought of the impending horrors
of London.
How much the week had held! what changes it had seen! She sat
musing on this the next evening, listening to the church bells, and
remembering that a Sunday ago the dead woman had been beside
her. Last Sunday there was still a prospect of Westport continuing to
be her home for years. Last Sunday it was that, in the churchyard,
she had confessed her past. Only a week—how full, how difficult to
realise! She was half dozing when she heard the hall-door unlocked,
and Kincaid greeted her as she roused herself.
"Did I disturb you? were you asleep?"
"No; I was thinking, that's all."
He sighed, and dropped into the opposite chair. She noted his
harassed aspect, and pitied him. The Sunday previous she had not
been sensible of any pity at all. She understood his loss of his
mother; the loss of his faith had represented much less to her, its
being a faith on which she personally had set small store.
"There's plenty to think of!" he said wearily.
"You haven't seen Ellen, doctor, have you? She has been asking for
you."
"Has she? what does she want?"
"She is anxious to know how long she'll be kept. Her sister is in
service somewhere and the family want a parlourmaid on the first of
the month. I am sorry to bother you with trifles now, but she asked
me to speak to you."
"I must talk to her. Of course the house 'll be sold off; there's no one
to keep it on for.... How fagged you look! are you taking proper care
of yourself again?"
"Oh yes; it is just the reaction, nothing but what'll soon pass."
"You didn't have the relief you ought to have had; you worked like
two women."
He paused, and his gaze dwelt on her questioningly. She read the
question with such clearness that, when he spoke, the words
seemed but an echo of the pause.
"How did you know so much?" he asked.
"After I lost my father I was a nurse in the Yaughton Hospital for
some years."
The answer was direct, but it was brief. Half a dozen queries sprang
to his lips, and were in turn repressed. Her past was her own; he
confined his inquiries to her future.
"And what do you mean to do now?"
"I'm going to London."
"Do you expect to meet with any difficulties in the way of taking up
nursing again?"
"I think you know that there were difficulties in the way."
"I have no wish to force your confidence——" he said, with a note of
inquiry in his voice.
"I haven't my certificate."
"You can refer to the Matron."
"I know I can; I will not. I told you two years ago there were
persons I could refer to, but I wouldn't do it."
"May I ask why you should have any objection to referring to this
one?"
She was silent.
"Won't you tell me?"
"I think you might understand," she said in a very low voice. "I went
there after my father's death. I am not the woman who left the
Yaughton Hospital."
His eyes fell, and he stared abstractedly at the grate. When he
raised them he saw that hers had closed. He looked at her
lingeringly till they opened.
"Now that she is gone," he exclaimed unsteadily, "your position is
not so easy! Have you any prospect that you don't mention?"
She shook her head.
"Well, is there anything you can suggest?" he asked. "Any way out of
the difficulty that occurs to you? Believe me——"
"No," she said, "I can see nothing that is practicable; I——"
"Would you be willing to come on the nursing-staff here? We're
short-handed in the night work. It is an opening, and it might lead to
a permanent appointment."
Her heart began to beat rapidly; for an instant she did not reply.
"It is very considerate of you, very generous; but I am afraid that
wouldn't do."
"Why not?"
"It wouldn't do, because—well, I should have left Westport in any
case."
"You meant to, I know. But between the way you'd have left
Westport if my mother had lived, and the way you'd leave it now,
there is a vast difference."
"I must leave it, all the same."
"Pardon me," he said, "I can't permit you to do so. I wouldn't let any
woman go out into the world with the knowledge that she went to
meet certain distress. Your hospital experience appears to solve the
problem. You could come on next week. If your reluctance is
attributable to myself—hear me out, I must speak plainly!—if you
refuse because what has passed between us makes further
conversation with me a pain to you, you've only to remember that
conversation between us in the hospital will necessarily be of the
briefest kind. All that I remember is that I've asked you to be my
wife and you don't care for me—I'm the man you've rejected. I wish
to be something more serviceable, though; I wish to be your friend.
In the hospital I shall have little chance, for there, to all intents and
purposes, we shall be as much divided as if you went to London.
While the chance does exist I want to use it; I want to advise you
strongly to take the course I propose. It needn't prevent your
attempting to find a post elsewhere, you know; on the contrary, it
would facilitate your obtaining one."
Her hand had shaded her brow as she listened; now it sank slowly to
her lap.
"I need hardly tell you I'm grateful," she said, in tones that struggled
to be firm. "Anyone would be grateful; to me the offer is very—is
more than good." Her composure broke down. "I know what I must
seem to you—you have heard nothing but the worst of me!" she
exclaimed.
"I would hear nothing that it hurt you to say," he answered; and for
a minute neither of them said any more. There had been a
gentleness in his last words that touched her keenly; the appeal in
hers had gone home to him. Neither spoke, but the man's breath
rose eagerly, and; the woman's head drooped lower and lower on
her breast.
"Let me!" she said at last in a whisper that his pulses leaped to
meet. "It was there—when I was a nurse. He was a patient. Before
he left, he asked me to marry him. When I went to him he told me
he was married already. Till then there had been no hint, not the
faintest suspicion—I went to him, with the knowledge of them all, to
be his wife."
"Thank God!" said Kincaid in his throat.
"She was—she had been on the streets; he hadn't seen her for
years. He prayed to me, implored me——Oh, I'm trying to
exonerate! myself, I'm not trying to shift the sin on to him, I but if
the truest devotion of her life can plead I for a woman, Heaven
knows that plea was mine!"
"And at the end of the three years?"
"There was news of her death, and he married someone else."
She got up abruptly, and moved to the window, looking out behind
the blind.
"I can't tell you how I feel for you," he said huskily. "I can't give you
an idea how deeply, how earnestly I sympathise!"
"Don't say anything," she murmured; "you needn't try; I think I
understand to-night—you proved your sympathy while my claim on it
was least."
"And you'll let me help you?"
The slender figure stood motionless; behind her the man was
gripping the leather of his chair.
"If I may," she said constrainedly, "if I can go there like—as you——
Ah, if the past can all be buried and there needn't be any reminder
of what has been?"
"I'll be everything you wish, everything you'd have me seem!"
He took a sudden step towards her. She turned, her eyes humid with
tears, with thankfulness—with entreaty. He stopped short, drew
back, and resumed his seat.
"Now, what is it you were saying about Ellen?" he asked shortly.
And perhaps it was the most eloquent avowal he had ever made her
of his love.

CHAPTER XII
So it happened that Mary Brettan did not leave Westport the next
week. And after a few months she was more than ever doubtful if
she would leave it at all. The suggested vacancy on the permanent
staff had occurred before then, and, once having accepted the post,
there seemed to be no inducement to woo anxiety by resigning it.
At first the resumption of routine after years of indolence was
irksome and exhausting. The six o'clock rising, the active duties
commencing while she still felt tired, the absence of anything like
privacy, excepting in the two hours allotted to each nurse for leisure
—all these things fretted her. Even the relief that she derived from
her escape into the open air was alloyed by the knowledge that
outdoor exercise during one of the hours was compulsory. Then, too,
it was inevitable that a costume worn once more should recall the
emotions with which she had laid aside her last; inevitable that she
should ask herself what the years had done for her since last she
stood within a hospital and bade it farewell with the belief she was
never to enter one again. The failure of the interval was
accentuated. Her heart had contracted when, directed to the strange
apartment above the wards, she beheld the print dress provided for
her use lying limp on a chair. An unutterable forlornness filled her
soul as, proceeding to put it on, she surveyed her reflection in the
narrow glass. Yet she grew accustomed to the change, and the more
easily for its being a revival.
The speed with which the sense of novelty wore off indeed
astonished her. Primarily dismaying, and a continuous burden upon
which she condoled with herself every day, it was, next, as if she
had lost it one night in her sleep. She had forgotten it until the
lightness with which she was fulfilling the work struck her with swift
surprise. Little by little a certain enjoyment was even felt. She
contemplated some impending task with interest. She took her walk
with zest in lieu of relief. She returned to the doors exhilarated
instead of depressed. The bohemian, the lady-companion, had
become a sick-nurse anew, and because the primary groove of life is
the one which cuts the deepest lines, her existence rolled along the
recovered rut with smoothness. The scenes between which it lay
were not beautiful, but they were familiar; the view it commanded
was monotonous, but she no longer sought to travel.
Socially the conditions had been favoured by her introduction. The
position that she had occupied in Laburnum Lodge gave her a
factitious value, and gained her the friendliness of the Matron, a
functionary who has the power to make the hospital-nurse distinctly
uncomfortable, and who has on occasion been known to use it. It
commended her also to the other nurses, two of whom were
gentlewomen, insomuch as it promised an agreeable variety to
conversation in the sitting-room. She was by no means unconscious
of the extent of her debt to Kincaid, and her gratitude as time went
on increased rather than diminished. Certainly the environment was
conducive to a perception of his merits—more conducive even than
had been the period of his medical attendance at the villa. The king
is nowhere so attractive as at his court; the preacher nowhere so
impressive as in the pulpit. Ashore the captain may bore us, but we
all like to smoke our cigars with him on his ship. The poorest
pretender assumes importance in the circle of his adherents, and
poses with authority on some small platform, if it be only his
mother's hearthrug. Here where the doctor was the guiding spirit,
and Mary found his praises on every tongue, the glow of gratitude
was fanned by the breath of popularity. Had he deliberately planned
a means of raising himself in her esteem, he could have devised
none better than this of placing her in the miniature kingdom where
he ruled. In remembering that he had wanted to marry her, she was
sensible one day of a thrill of pride: nothing like regret, nothing like
arrogance, but a momentary pride. She felt more dignity in the
moment.
If he remembered it too, however, no word that he spoke evinced
such recollection. The promise that he had made to her had been
kept to the letter, and the past was never alluded to between them.
As doctor and nurse their colloquies were brief and practical. It was
the demeanour that he adopted towards her from the day of her
instatement that added the first fuel to her thankfulness; and if,
withal, she was inclined to review his generosity rather than to
regard it, it was because he had established the desired relations on
so firm a footing that she had ceased to believe that the pursuance
of it cost him any pains. That she had held his love after the story of
her shame she was aware; but that on reflection he could still want
her for his wife she did not for an instant suppose; and she often
thought that by degrees his attitude had become the one most
natural to him.
By what a denial of nature, by what rigid self-restraint, the idea had
been conveyed, nobody but the man himself could have told. No one
else knew the bitterness of the suffering that had been endured to
give her that feeling of right to remain; what impulses had been
curbed and crushed back, that no scruples or misgivings should
cross her peace. The circumstances in which they met now helped
him much, or he; would have failed, despite his efforts; and to fail,
he understood, would be to prove unworthy of, her trust—it would
be to see her go out from his life for ever. Still want her? So
intensely, so devoutly did he want her, that, shadowed by sin as she
was, she was holier to him than any other woman upon earth—fairer
than any other gift at God's bestowal. He would have taken her to
his heart with as profound a reverence as if no shame had ever
touched her. If all the world had been cognizant of her disgrace, he
would have triumphed to cry "My wife!" in the ears; of all the world.
A baser love might well have; thirsted for her too, but it would have
had its hours of hesitation. Kincaid's had none. No flood of passion
blinded his higher judgment and urged him on; no qualms of
convention intervened and gave him pause. It was with his higher
judgment that he prayed for her. His love burned steadily, clearly.
The situation lacked only one essential for the ideal: the love of the
penitent whom he longed to raise. The complement was missing.
The fallen woman who had confessed her guilt, the man's devotion
that had withstood the test—these were there. But the devotion was
unreturned, the constancy was not desired. He could only wait, and
try to hope; wondering if her tenderness would waken in the end,
wondering how he would learn it if it did.
To break his word by pleading again was a thing that he could do
only in the belief that she would listen to him with happiness. If he
misread her mind and spoke too soon, he not merely committed a
wrong—he destroyed the slender link that there was between them,
for he made it impossible for her to stay on. And yet, how to divine?
how, without speaking, to ascertain? What could be gathered from
the deep grey eyes, the serious face, the slim-robed figure, as he
sometimes stood beside her, guarding his every look and schooling
his voice? How could he tell if she cared for him unless he asked
her? how could he ask her unless he had reason to suppose that she
did? The nature of their association seemed to him to impose an
insurmountable barrier between them; in freer parlance a ray of the
truth might be discernible. When she had been here a year he
determined to gain an opportunity to talk with her alone. He would
talk, if not on matters nearest to him, at least on topics less formal
than those to which their conversation was limited in the ward!
Such an opportunity, however, did not lie to his hand. It was difficult
to compass without betraying himself, and, in view of the present
difficulties, he appeared to have had so many advantages earlier
that he marvelled at his having turned them to so little account.
Their acquaintance at the villa during his mother's lifetime appeared
to him, by comparison, to have afforded every facility that he was
to-day denied, and he frequently recalled the period with passionate
regret; he thought that he had never appreciated it at its worth,
though, indeed, he had only failed to benefit by it. The villa now was
tenanted by a lady with two children; and Mary often passed it,
recalling the period also, albeit with a melancholy vaguer than his.
One morning, as she went by, the door was open—the children were
coming out—and she had a glimpse of the hall.
They came down the steps, carrying spades and pails, bound for the
beach, like herself. The elder of them might have been nine years
old, and, belonging to the familiar house, they held a little sad
interest for her. She wondered, as they preceded her along the
pavement, in which of the rooms they slept, and if the different
furniture had altered the aspect of it much. She thought she would
like to speak to them when the sands were reached, and——Then
she saw Seaton Carew! Her heart jerked to her throat. Her gaze was
riveted on him; she couldn't withdraw it. They were advancing
towards each other; he was looking at her. She saw recognition flash
across his features, and turned her head. The people to right and
left swayed a little—and she had passed him. It had taken just
fifteen seconds, but she could not remember what she had been
thinking of when she saw him. The fifteen seconds had held for her
more emotion than the last twelve months.
Her knees trembled. She supposed he must be at the theatre this
week. But, when she saw a playbill outside the music-seller's, she
was afraid to examine it lest he might be staring after her. She
walked on excitedly. She was filled with a tremulous elation, which
she cared neither to define nor to acknowledge. She reflected that
she had left the hospital a few minutes earlier than usual, and that
otherwise she might have missed him. "Missed" was the word of her
reflection. She wondered where he was staying—in which streets the
professional lodgings were. She felt suddenly strange in the town
not to know. She had been here three years, and she did not know—
how odd! In turning a corner she saw another advertisement of the
theatre, this time on a hoarding. The day was Monday, and the
paper was still shiny with the bill-sticker's paste. She was screened
from observation, and for a moment she paused, devouring the cast
with a rapid glance. His wife's name didn't appear, so it wasn't their
own company. She hurried on again. The sight of him had acted on
her like a strong stimulant. Without knowing why, she was
exhilarated. The air was sweeter, life was keener; she was athirst to
reach the shore and, in her favourite spot, to yield herself up wholly
to sensation.
And how little he had changed! He seemed scarcely to have changed
at all. He looked just as he used to look, though he must have gone
through much since the night they parted. Ah, how could she forget
that parting—how allow the fires of it to wane? It was pitiful that,
feeling things so intensely when they happened, one was unable to
keep the intensity alive. The waste! The puerility of loving or hating,
of mourning or rejoicing so violently in life, when the passage of
time, the interposition of irrelevant incident, would smear the
passion that was all-absorbing into an experience that one called to
mind!
She sank on to a bench upon the slope of ragged grass that merged
into the shingles and the sand. The sea, vague and unruffled, lay
like a sheet of oil, veiled in mist except for one bright patch on the
horizon where it quivered luminously. She bent her eyes upon the
sea, and saw the past. His voice struck her soul before she heard his
footstep. "Mary!" he said, and she knew that he had followed her.
She did not speak, she did not move. The blood surged to her
temples, and left her body cold. She struggled for self-command; for
the ability to conceal her agitation; for the power she yearned to
gather of blighting him with the scorn she craved to feel.
"Won't you speak to me?" he said. He came round to her side, and
stood there, looking down at her. "Won't you speak?" he repeated
—"a word?"
"I have nothing to say to you," she murmured. "I hoped I should
never see you any more."
He waited awkwardly, kicking the soil with the point of his boot, his
gaze wandering from her over the ocean—from the ocean back to
her.
"I have often thought about you," he said at last in a jerk. "Do you
believe that?"
She kept silent, and then made as if to rise.
"Do you believe that I have thought about you?" he demanded
quickly. "Answer me!"
"It is nothing to me whether you have thought or not. I dare say you
have been ashamed when you remembered your disgrace—what of
it?"
"Yes," he said, "I have been ashamed. You were always too good for
me; I ought never to have had anything to do with a woman like
you."
She had not risen; she was still in the position in which he had
surprised her; and she was sensible now of a dull pain at the
unexpectedness of his conclusion.
"Why have you followed me?" she said coldly. "What for?"
"What for? I didn't know you were in the town, I hadn't an idea—
and I saw you suddenly. I wanted to speak to you."
"What is it you want to say?"
"Mary!"
"Yes; what do you want to say? I'm not your friend; I'm not your
acquaintance: what have you got to speak to me about?"
"I meant," he stammered—"I wanted to ask you if it was possible
that—that you could ever forgive the way I behaved to you."
"Is that all?" she asked in a hard voice.
"How you have altered!... Yes, I don't know that there's anything
else."
She did not reply, and he regarded her irresolutely.
"Can you?"
"No," she said. "Why should I forgive you—because time has gone
by? Is that any merit of yours? You treated me brutally, infamously.
The most that a woman can do for a man I did for you; the worst
that a man can do to a woman you did to me. You meet me
accidentally and expect me to forgive? You must be a great deal less
worldly-wise than you were three years ago."
She turned to him for the first time since he had joined her, and his
eyes fell.
"I didn't expect," he said; "I only asked. So you're a nurse again,
eh?"
"Yes."
He gave an impatient sigh, the sigh of a man; who realises the
discordancy of life and imperfectly resigns himself to it.
"We're both what we used to be, and we're both older. Well, I'm the
worse off of the two, if that's any consolation to you. A woman's
always getting opportunities for new beginnings."
She checked the retort that sprang to her lips, eager to glean some
knowledge of his affairs, though she could not bring herself to put a
question; and after a moment she rejoined indifferently:
"You got the chance you were so anxious for. I understood your
marriage was all that was necessary to take you to London."
"I was in London—didn't you hear?" He was startled into
naturalness, the actor's naive astonishment when he finds his
movements are unknown to anyone. "We had a season at the
Boudoir, and opened with The Cast of the Die. It was a frost; and
then we put on a piece of Sargent's. That might have been worked
into a success if there had been money enough left to run it at a loss
for a few weeks, but there wasn't. The mistake was not to have
opened with it, instead. And the capital was too small altogether for
a London show; the exes were awful! It would have been better to
have been satisfied with management in the provinces if one had
known how things were going to turn out. Now it's the provinces
under somebody else's management. I suppose you think I have
been rightly served?"
"I don't see that you're any worse off than you used to be."
"Don't you? You've no interest to see. I'm a lot worse off, for I've a
wife and child to keep."
"A child! You've a child?" she said.
"A boy. I don't grumble about that, though; I'm fond of the kid,
although I dare say you think I can't be very fond of anyone. But——
Oh, I don't know why I tell you about it—what do you care!"
They were silent again. The sun, a disc in grey heavens, smeared
the vapour with a shaft of pale rose, and on the water this was
glorified and enriched, so that the stain on the horizon had turned a
deep red. Nearer land, the sea, voluptuously still, and by comparison
colourless, had yet some of the translucence of an opal, a thousand
elusive subtleties of tint which gleamed between the streaks of
darkness thrown upon its surface from the sky. A thin edge of foam
unwound itself dreamily along the shore. A rowing-boat passed
blackly across the crimsoned distance, gliding into the obscurity
where sky and sea were one. To their right the shadowy form of a
fishing-lugger loomed indistinctly through the mist. The languor of
the scene had, in contemplation, something emotional in it, a quality
that acted on the senses like music from a violin. She was stirred
with a mournful pleasure that he was here—a pleasure of which the
melancholy was a part. The delight of union stole through her, more
exquisite for incompletion.
"It's nothing to you whether I do badly or well," he said gloomily.
And the dissonance of the complaint jarred her back to common-
sense. "Yet it isn't long ago that we—good Lord! how women can
forget; now it's nothing to you!"
"Why should it be anything?" she exclaimed. "How can you dare to
remind me of what we used to be? 'Forget'?—yes, I have prayed to
forget! To forget I was ever foolish enough to believe in you; to
forget I was ever debased enough to like you. I wish I could forget
it; it's my punishment to remember. Not because I sinned—bad as it
is, that's less—but because I sinned for you! If all the world knew
what I had done, nobody could despise me for it as I despise myself,
or understand how I despise myself. The only person who should is
you, for you know what sort of man I did it for!"
"I was carried away by a temptation—by ambition. You make me out
as vile as if it had been all deliberately planned. After you had gone
——"
"After I had gone you married your manageress. If you had been in
love with her, even, I could make excuses for you; but you weren't—
you were in love only with yourself. You deserted a woman for
money. Your 'temptation' was the meanest, the most contemptible
thing a man ever yielded to. 'Ambition'? God knows I never stood
between you and that. Your ambition was mine, as much mine as
yours, something we halved between us. Has anybody else
understood it and encouraged it so well? I longed for your success
as fervently as you did; if it had come, I should have rejoiced as
much as you. When you were disappointed, whom did you turn to
for consolation? But I could only give you sympathy; and she could
give you power. And everything of mine had been given; you had
had it. That was the main point."
"Call me a villain and be done—or a man! Will reproaches help either
of us now?"
"Don't deceive yourself—there are noble men in the world. I tell you
now, because at the time I would say nothing that you could regard
as an appeal. It only wanted that to complete my indignity—for me
to plead to you to change your mind!"
"I wish to Heaven you had done anything rather than go, and that's
the truth!"
"I don't; I am glad I went—glad, glad, glad! The most awful thing I
can imagine is to have remained with you after I knew you for what
you were. The most awful thing for you as well: knowing that I
knew, the sight of me would have become a curse."
"One mistake," he muttered, "one injustice, and all the rest, all that
came before, is blotted out; you refuse to remember the sweetest
years of both our lives!"
She gazed slowly round at him with lifted head, and during a few
seconds each looked in the other's face, and tried to read the history
of, the interval in it. Yes, he had altered, after all. The eyes were
older. Something had gone from him, something of vivacity, of hope.
"Are you asking me to remember?" she said.
"You seem to forget what the injustice was done for."
"Mary, if you knew how wretched I am!"
"Ah," she murmured half sadly, half wonderingly, "what an egotist
you always are! You meet me again—after the way we parted—and
you begin by talking about yourself!"
He made a gesture—dramatic because it expressed the feeling that
he desired to convey—and turned aside.