by Emma Fraser
Afterwards Isabel hurried along the corridor, her shoes echoing on the dark brown tiles. She was in danger of being late for ward rounds. That Forsythe had droned on long after the time allocated to the lecture had passed would not be deemed a good enough excuse.
She ignored the lift at the end of the hall, not trusting the ponderous contraption to reach the third floor without breaking down. Lifting her skirts, she bounded up the stairs two at a time, smiling at the startled looks of nurses as they passed her. She made it just in time to see her fellow students follow Dr Galbraith, the specialist in infectious diseases and chests, through the double doors of Women’s Medical. She licked her palms and quickly smoothed her hair. No doubt her cheeks would be bright red from her exertions but there was nothing she could do about that.
Rows of cast-iron beds lined the ward on either side and the patients in them were tucked up with almost military precision, no crease daring to ruffle the starched smoothness of the sheets. Sister always made sure that no patient was eating or, God forbid, requiring a bedpan when the consultant was on the ward. Everything stopped for the Grand Rounds.
After a quick sweep of her pristine ward with a critical eye, Sister hurried over to them. Her nurses were standing to attention, arms behind their backs as if they, too, were on military parade.
‘Shall we make a start?’ Galbraith barked. ‘What do you have for me, Sister Logan?’
‘We have a double pneumonia in Bed One, Doctor,’ she replied, as she led them across the ward.
The woman’s breathing was laboured and she had the cyanotic tinge of death on her lips. A bottle of dextrose and saline fed fluid into her veins, and her head and shoulders had been raised to help her breathing. There was little else that could be done. She would either recover or, as seemed more likely in this case, simply slip away.
‘Who can tell me about this patient?’ Dr Galbraith asked.
Isabel pushed her way to the front. ‘Mrs Campbell is thirty-three. She has four surviving children, all under the age of five. They live in a one-roomed tenement in the Grassmarket.’
Dr Galbraith raised his head and stared at her over the top of his half-moon glasses. He pursed his lips. ‘That is all very well, Miss MacKenzie, but I want to know about her medical condition. To be a doctor is to be concerned with science. Physicians must remain detached from the patient and not be concerned with his or her circumstances. If a doctor chooses to become involved, he will seek unique solutions and that goes against what it is to be a scientist. If you wish to see the patient as a person, you should have become a nurse. It is a profession, after all, more suited to the feminine sex.’
Her fellow students tittered. Isabel felt herself flushing with anger and had to bite her lip to stop herself replying that patients could not be seen as separate from their circumstances. Coal miners got black lung because they worked in coal mines; children died because they didn’t get enough nutritious food to eat and poor women continued to die in childbirth at a rate ten times that of their richer sisters. That she knew this wasn’t because she was a woman: it was because statistics proved it. Of course Mrs Campbell’s living conditions were relevant. Enlightened physicians, like Dr Littlejohn, knew this. That was why he’d insisted medical students go into the poorest houses in Edinburgh and seek out patients with tuberculosis so that they could be offered treatment before the infection took hold. This practice had fallen away under Dr Galbraith and the numbers dying from the disease had risen once again. Only the female students studying at the Bruntsfield Hospital, for women and children, continued with the visits.
‘Mrs Campbell presented at the outpatients department with a three-week history of shortness of breath,’ Isabel continued, keeping her voice even. ‘She was admitted to the Lister Ward and had treatment with ultraviolet light for fourteen days. At first she showed signs of improvement but five days ago her condition deteriorated. On examination, the right lower lobe was dull to percussion and there were bronchial breath sounds – signs of lobar pneumonia. Over the last twenty-four hours she has had haemoptysis, producing prune-coloured blood when she coughs.’
‘Better, Miss MacKenzie. Anyone else?’ Dr Galbraith glanced at the other students.
‘Not much to add, sir,’ one said. ‘The prognosis is death within forty-eight hours.’
Although Isabel knew he was right, she winced. She was glad the woman was unconscious and unable to hear her death sentence. Impulsively she took Mrs Campbell’s hand and squeezed it. ‘Could I ask Sister what the nurses are doing to make Mrs Campbell more comfortable?’
Dr Galbraith’s bushy brows snapped together. ‘I think we can take it for granted that Sister and her nurses are doing everything they can. As I said, if you’d prefer to be a nurse, Miss MacKenzie, I’m sure that can still be arranged.’
‘Nevertheless,’ Isabel persisted, ‘the patient’s extremities are cold. I know we must keep the windows open but it’s chilly in here, even with the heat from the stove. Have the nurses tried to keep the blood moving by massaging the patient’s limbs?’ Perhaps she should have let it go, but Mrs Campbell needed someone to speak for her.
Sister Logan stepped forward and smoothed her apron. ‘I would like to answer that, Dr Galbraith. Never let it be said that patients on my ward don’t get the best treatment.’ The look she gave Isabel left her in no doubt that she hadn’t made an ally. ‘We are just about to give out the hot-water bottles. And I never heard of massage making a difference. Unless there is something I should know?’ Her voice rose in disbelief. ‘Besides,’ she gestured towards the ward, ‘I have fifty-nine other patients to look after. I suggest that my nurses’ time is better spent looking after those who have a chance of recovery.’
She was right. Whatever they did wouldn’t change Mrs Campbell’s outcome.
Dr Galbraith looked at Isabel with derision. ‘You may, if you wish, Miss MacKenzie, stay with the patient and try whatever you please. Or you can carry on with rounds. The choice is yours.’
It wasn’t a choice. The message was clear. If she wanted to continue studying at the Royal Infirmary, she had to act like the men.
Giving Mrs Campbell’s hand one last squeeze, Isabel followed Dr Galbraith to the next patient.
Chapter 18
Edinburgh, October 1913
Jessie wiped sweat from her eyes as another plume of steam filled the room. The washhouse was unbearably hot at this time of year. She plunged her arms into the water and, taking hold of the washboard, started scrubbing vigorously.
She and Tommy had been married for more than a year and a half and their baby, a little boy, was eleven months old. Although she loved being a wife and mother, she found the days difficult to fill and, without her wage, money was tight.
Tommy wouldn’t be pleased if he knew she was taking in washing from the houses in Trinity, but what he didn’t know couldn’t hurt him. She hated keeping secrets from him, but the extra money would come in useful when it was time for Seamus to go to school.
‘Hey, Jessie, how’s that man of yours doing? Not given you another baby yet?’ the woman next to her asked, with a leer. Lizzie Blackstock was all right. Most of the women were. They hid kind hearts under their caustic remarks and Jessie enjoyed their wit.
‘One baby’s enough right now, Mrs Blackstock. Not all of us are up to looking after six children under five, like you.’ And as most of the other women did, if truth be told. Jessie sneaked a glance at Lizzie. She was thirty but looked fifty. Her hair was already going grey, her face lined, and the few teeth she had left were brown from the tobacco she chewed. And judging by the way her worn skirt clung to the mound of her belly, there was another on the way – and in the very near future too, judging by the size of her. Lizzie lived a few streets from Jessie in a similar tenement. One room, a shared toilet on the landing and a small, dirty back close was no place for eight of a family. It was no place for three of a family either, but Jessie was determined that one day she and Tommy would have a house with a sep
arate bedroom. Perhaps even a front room.
She glanced at the other women bent over the sinks. They all had the same exhausted faces, the same peeling red hands and clothes that had seen better days. On the other hand, they were quick to smile, found humour in almost every situation and would give their last penny to help someone if she needed it. Almost all had families the size of Lizzie’s. Jessie knew that the more children she had, the less chance there was that she and Tommy would make it out of Pennyworth Row. Thank God she knew how to douche after sex. It was something else she kept from Tommy. She would have another child, but only when Seamus was a little bigger or when they had saved enough money to leave the tenement they were in.
‘Maybe he finds your bones too hard for him, Jessie,’ a woman quipped. ‘Don’t you know men like a bit of something to get hold of?’
‘He likes my bones well enough,’ Jessie replied. If the women thought they could make her blush, they were mistaken. After three years of banter from the inmates at the workhouse Jessie had heard it all.
‘“He likes my bones well enough,”’ Lizzie mimicked. ‘How come you speak so fancy, Jessie? Is there something you’re no’ telling us?’
Jessie laughed. ‘What? Like I’m really the daughter of Lady and Lord Muck who’ve fallen on hard times? That’d be right.’
‘Well, why’s your accent funny? Come on, Jessie. Tell us.’
‘It’s funny because I’m from Skye. And I speak fancy, as you call it, because English was taught to me when I was at school so I learned to speak it properly. We spoke Gaelic at home.’
A wave of sadness surged through her. For a moment she wished she was back on Skye. There she could breathe. On good days, washing was done in the open air at the loch, with her mam and the other women from the village for company. But Mam wasn’t there any more. She was with God, and Jessie should be glad of it, although she couldn’t bring herself to be. At least she had Tommy. If Mam hadn’t died Jessie couldn’t have come to Edinburgh to be a nurse, and if she hadn’t come to Edinburgh she wouldn’t have met Tommy. Mam had always said that no one knew what God had in store for you, so you should look at everything as a chance. It would have been better if she was still alive, living with her and Tommy in Edinburgh, but what was the point in hankering for what you couldn’t have?
‘Where’s Skye?’ a younger woman, with pockmarks from a bad case of smallpox, asked. ‘Is it near here?’
‘It’s a three-day journey by boat,’ Jessie said.
She rinsed the clothes in the sink and carried them across to the mangle. She’d have time to use the baths next door while the clothes dried in the stove-heated room. It would cost a few of her precious pennies, but it was worth it. Her neighbour Peggy was watching Seamus for her and wasn’t expecting her back for another hour or two. Tommy wouldn’t get home from the shipyard until nearly eight. By that time she’d have the washing returned to its owners.
After wringing the clothes, she hung them in the drying room. She frowned as she remembered Seamus’s cough. It had kept her up most of the night. She had boiled kettles and the steam had seemed to help for a while, but she wouldn’t be happy until it was completely gone.
Maybe she should skip her bath and make do with the tub in front of the fire after she’d put Seamus down for the night. She shook her head. No, that wouldn’t do. If she waited until Tommy was home, he’d want to wash her back, then one thing would lead to another and they’d end up in the bed making love. She couldn’t depend on her douche too often.
Suddenly she was anxious to get home and back to Seamus. What if his cough had worsened while she’d been away? What if he was fretting for her? No, it was better to have a wash at the sink before Tommy came home and use the extra time to make him something nice for his tea. Maybe some potted sheep’s brain. She cooked it just as her mother had taught her and Tommy liked it. A sheep’s head had the added benefit of being cheap and she could also make soup that would last the week.
As soon as she could, she waved goodbye and set off up the cobbled street towards her home. At three o’clock the streets were thronged with people selling from carts and housewives doing their shopping. A fishwife was hawking the day’s catch from a basket she wore around her shoulders as she walked the streets, looking for customers.
In the close of Jessie’s tenement, barefoot children were playing a make-believe game with sticks and pieces of rubbish they had retrieved from the outside midden. Jessie had tried to tell the mothers not to allow the children to do that but her pleas had fallen on deaf ears. The women were only too glad to have the children out from under their feet and occupied. It was so different from her childhood, spent running across the heather-covered moors, breathing in the fresh, clean air and paddling in the sea. How Seamus would love it on Skye. Eager to see him, Jessie ran up the rickety back stairs leading to her tenement and called in for her son.
‘I’m sorry. I know I should have been back sooner.’ She looked past Peggy for her child and her neighbour stood aside to let her in. Like Jessie’s, Peggy’s home was a single room with a recessed bed on one side and the rest of the space used as a kitchen-cum-sitting room. When Jessie saw Seamus sleeping on the bed, anxiety knotted her stomach. He was a lively baby who would normally be playing on the kitchen floor or trying to pull himself up by holding onto the table leg.
‘He’s no’ been himself all day,’ Peggy said. ‘He wouldn’t take the porridge you left for him and he’s been sleeping most of the time.’
Jessie rushed over to him. Seamus’s breathing was laboured and he was flushed. Apart from his cough, he’d seemed normal earlier. Alarm shot through her. Her child wasn’t well. There had been a number of deaths recently from diphtheria and it was possible that somehow Seamus had caught the infection. Please God, she hadn’t brought it into her home from the washhouse. She’d been so careful to keep her child away from any source of infection.
She gathered Seamus into her arms and, with a quick word of thanks, ran up the flight of stairs to her home. As soon as she was inside she set the kettle to boil. Perhaps she was being over-anxious. Maybe another dose of steam would help.
But it didn’t. If anything his breathing became worse. He opened his eyes once, smiled weakly, then fell straight back to sleep. Jessie made up her mind. She went to the jar on the mantelpiece and grabbed a handful of the precious shillings inside. She would take him to Leith Hospital, but she had to be quick. They closed the gates at five and it was already after four. She’d have to take a cab.
‘Please, God,’ she whispered, ‘let my baby be all right.’
It was almost five by the time Jessie arrived at Leith Hospital. Hansom cabs were hard to find down by the docks as there wasn’t much call for them among people who could rarely afford even to take the tram. In the end she had run all the way, holding Seamus close to her chest.
There were around twenty people in the outpatients department still waiting to be seen. In the time it had taken for Jessie to reach the hospital, Seamus was worse. A lot worse. His small chest rose and trembled with the effort of taking each breath.
Jessie hurried to a nurse who was standing behind a lectern taking names of patients waiting to be seen. She pushed her way to the front of the queue, ignoring the muttered curses from those waiting patiently in line.
The nurse’s mouth tightened. ‘You have to wait your turn,’ she said.
‘Please, Nurse,’ Jessie said. ‘It’s my wee boy. He can hardly breathe. He needs to see a doctor right now.’
‘Everyone needs to see the doctor right now,’ the nurse replied, unmoved. ‘It will go faster if you wait in the queue, like everyone else.’
Jessie looked at the patients. None seemed in urgent need of help. ‘Please,’ she begged again. ‘My son can’t wait.’
An older woman near the front of the queue spoke out: ‘Let the lassie go first. Anyone can see her bairn needs attention.’
There were a few murmurs of ‘Aye’ from the rest of the line and t
he nurse gave in. ‘Name?’
‘Jessie Stuart. My boy is Seamus Stuart. He’s eleven months old. Please fetch the doctor.’
‘Have you money?’ the nurse asked.
Jessie pulled the coins from her pocket and thrust them at her. ‘Take this. It’s everything I have.’
‘Sit over there.’ The nurse nodded to an overcrowded bench. ‘I’ll let the doctor know you’re here.’
When she turned to the next patient without calling for the doctor, Jessie’s frustration boiled over. ‘Nurse,’ she said, forcing herself to sound calm, ‘my child needs to see a doctor now.’
‘And I said I’d let her know. She’s with a patient at the moment.’
Jessie looked around the cavernous building, and spotted another nurse who was occupied with a trolley. She hurried over to her. ‘Please, Nurse,’ she said, ‘my baby can’t breathe properly. He needs to see a doctor now.’
The nurse stopped what she was doing. Whatever she saw in Jessie’s face seemed to convince her. ‘Let me have a look.’
Jessie unwrapped Seamus from his blanket. He was limp and barely conscious.
Alarm crossed the nurse’s face. ‘Follow me.’ She led Jessie into a room with an examining couch and a dressings trolley.
‘Undress your child,’ she said, ‘while I fetch the doctor.’
Relieved that at least this nurse seemed to appreciate the urgency, Jessie unwrapped Seamus from his blanket and gently undressed him. She laid him on the couch and covered him with her shawl.
After what seemed like hours but was only a few minutes, the nurse returned, followed by a woman in a dark suit.
‘Where’s the doctor?’ Jessie asked frantically.
‘I am Dr Harcourt,’ the woman said stiffly. ‘Now, if you will remain calm, I will examine your child.’
‘I think it’s diphtheria,’ Jessie said. ‘I don’t know where he could have picked it up. I’ve always been so careful.’ Once again, her mind flashed back to the washhouse. Silently she promised God she would never go there again, if only He’d let Seamus be all right.