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Violet Goodwin clung to the railing of the ship as it pitched. Her insides roiled and her feet slipped, but she needed the breath of fresh air, if only for a moment. She chewed a small sliver of ginger and inhaled, ignoring the salty spray of the ocean that stung her face.

The wild root, along with the dried peppermint leaves she made into tea, were all that kept her from casting up her accounts on this disastrous voyage, as so many of her fellow passengers had done. Even the crew looked faintly green from the relentless waves.

In their five weeks at sea, they’d encountered storm after storm. Dark clouds, blue-purple like the worst bruises, edged onto the horizon just as soon as the last ones cleared. Port, still one week out according to Violet’s itinerary, could not come fast enough.

She closed her eyes for just a moment and swallowed the ginger, then she turned, her feet once again sliding as she took a few careful steps toward the ladder that led below deck.

She needed to tend to her mother, who was so ill she’d barely left their cabin, as well as the other passengers who accepted her help. Her precious store of ginger and peppermint was nearly depleted, but she could ration them for their few remaining days. They would land in England soon enough.

Violet had made it nearly all the way down the narrow ladder when she heard the skid and thump of a body hitting the floor, followed by the kind of howl a human being only made when in intense pain.

When that sound was followed by a low, agonized keening, she took the last few steps of the ladder at a hop and hurried back to her cabin.

“Violet!” her mother exclaimed from the small bed. “You shouldn’t be wandering around alone.”

“I know, Mother,” Violet said as she reached for her medical bag. “I’ll return in a moment.”

“Violet, wait!”

But she was already out the door, her hand gripping the small bag of supplies she’d brought with her on the voyage.

Even this small kit had been too much by her mother’s way of thinking, but Violet was not about to leave the entirety of her medical study behind her in New York.

She’d spent too long and worked too hard to give it all up now.

“Get the surgeon!” she heard someone yell as she rushed up the ladder toward the sound of wailing.

She moved as quickly as she could, lifting up the hem of her woolen traveling gown to keep her balance on the slick, wet deck as she went. She passed several men with their heads bent over the railing, one of whom she noted was the surgeon.

Poor man , she thought briefly, but didn’t feel overly sorry for him.

He’d refused her ginger and peppermint tea only hours ago, implying she was some sort of cotton-headed debutante instead of the practical nurse she had become.

She picked her way past a pile of rope and rigging and found the sailor who had fallen.

One look at his leg, the tibia bone broken and poking through a hole in his bloodied trousers was enough for her to guess what had happened.

But she seated herself beside him nonetheless to ask her standard diagnostic questions.

“My name is Violet,” she began, “and I’m a nurse. Can I help you?”

The man nodded; pain etched onto his face as he clutched his broken leg. His knuckles were white from the strength of his grip.

“You,” Violet said to one of the men standing nearby, “grab his hands.” When he hesitated, she added a stern, “Now!” that propelled him into motion.

The man lowered himself to the deck and held out his hands for the injured sailor, who grasped them.

“Thank you,” Violet said as she reached into her bag for a pair of shears.

“What in hell is happening here?” the captain barked, making his way through the small crowd that had gathered around Violet. “Where is the surgeon?”

“Over there with his head over the rail,” Violet said as she worked.

She’d met the captain on numerous occasions, and though at first, he’d been wary of her mint tea and bite-sized pieces of ginger, he’d refrained from further comment after he saw their results. Namely, far fewer passengers casting their accounts into the sea.

“Carry on then,” he said gruffly as she cut away the lower piece of trouser, revealing more of the man’s jagged, broken bone.

“Goodness,” she said to her patient. “You’ve taken quite a tumble. Did you slip and fall over the rigging?”

“Course he did,” the captain grumbled, although Violet continued looking at the injured man to answer.

“Didn’t slip. Blacked out.”

“Hm.” Violet pulled out her small bottle of iodine tincture to clean the wound. “This is going to hurt. Hold on tightly.”

Both her patient and the man whose hands he held swore roundly as the brown liquid hit the open wound, but Violet continued to work. She’d heard worse before.

“Captain,” she said, pulling a length of wrapped linen from her bag. “Your assistance, please.”

The captain lowered himself to the deck. “You shouldn’t be here,” he said softly to Violet. “The language alone is not fit for your ears. And certainly not…” he gestured to the grisly wound.

“I’d be glad to discuss any ill-effects to my person with you at a later date. But right now, I need you to help me.”

The captain looked at her askance. “Call for the surgeon, Miss. The bone’s broke the skin. It won’t heal.”

Violet glanced behind her, where the surgeon was still dangling halfway over the railing. “He seems to be otherwise engaged.”

The captain looked from the injured sailor to the surgeon then back again and sighed. “What would you have me do?”

Violet wrapped the linen around the man’s leg, covering the break and the cleaned wound. “Find me a wooden slat of some kind,” she said. “No thicker than his thigh. A piece of broken mast or flooring will do. We’re going to set his bone.”

“Absolutely not. I draw the line at quackery. There’s a reason we have a surgeon on board.”

“Charlie Sweet of New England, many sixteenth-century monks, and most of the ancient Egyptians would all disagree with your assessment of bone setting. Now, bring me a slat, Captain, or hold this binding in place while I find one myself. If the swelling gets any worse, we won’t be able to save his leg, and you will have to amputate.

But wouldn’t it be better to at least try to save it?

The surgeon can cut it off later if we fail. ”

“Captain,” the sailor moaned. “Please.”

The captain made some gurgling sound in the back of his throat but stood nonetheless, returning a few moments later with a broken piece of deck.

“Now what?”

“Now we bind,” Violet said, her brow furrowed in concentration.

A great deal of swearing and moaning later, and the sailor’s leg had been set in a traction device that Violet and the captain rigged up in his berth.

After further conversation about the man’s diet, Violet had also given the captain a lecture on the importance of nutrition for the crew–the sailor had blacked out, she suspected, from anemia.

It was a condition she’d seen often enough in the patients she treated in Lower Manhattan who could not afford enough meat in their diets. The crew on this ship had run low on meat nearly two weeks ago, rationing what was left for the passengers.

And then Violet retired to her room, exhausted and with a thin film of sweat prickling her body beneath her modest traveling dress. The ship, at least, had stopped pitching for the moment.

“Hello, Mother,” she said as she entered their cabin.

“Violet, where have you been?”

“Tying a sailor to his berth.” Violet hid her smile as she stowed her bag under her bed.

“You know better than to even joke about something like that, Violet Goodwin. We’ve given you too much latitude in New York, and you absolutely cannot carry on the same way in London. Not when Catherine is counting on you.”

“I will be the model companion, Mother. I promise.”

“Would you consider putting aside this pastime? At least while the season is on? You know as well as I do how important it is that Catherine make a good match. She must marry.”

Catherine, Violet’s cousin, was a year younger than she and born to her mother’s sister, Lydia, and her now-deceased husband the Earl of Chester. Violet was headed back to England to act as a companion for Catherine’s second season.

“It’s not a pastime, Mother,” Violet said. “It’s not embroidery. I have studied for three years to become a nurse, and I won’t change now. Just as you run the timber company with Father, I do this. You can hardly fault me when you’re exactly the same.”

“The company is our family business. My family’s business. It’s not the same at all. And you know the Earl wouldn’t let Lydia so much as speak about timber when he was alive. It’s not easy to be a woman with a profession in America, but it is much harder in England.”

Violet lowered herself to the edge of her mother’s bed. “You agreed after James died to let me pursue this line of study, and you cannot renege now. I will not embarrass you, Mother. Nor Catherine. But I am who I am, which you knew well enough when you asked me to accompany her.”

Her mother sighed. “I just want you to be happy, Violet.”

Violet leaned down and kissed her on the forehead. She wasn’t sure she’d ever be happy again. Not since James’s passing. But there was no reason to say that to her mother.

“I know,” she said. “I love you, too.”