The Midwife

by Jennifer Worth

  As my eyes became accustomed to the gloom I discerned a few other things: several saucers lying around on the floor with bits of food and milk in them; a small wooden chair and table with a tin mug and teapot on it; a chamber pot; a wooden cupboard with no door. There was no bed, no sign of a light, nor of gas or electricity.

  In the corner furthest away from the hole in the ceiling was a decrepit-looking armchair in which an old woman sat, silent, watchful, her eyes filled with fear. She shrank back in the chair as far as she could go, her old coat pulled tight round her, a woollen scarf over her head and covering half her face. Only her eyes showed, and they penetrated mine as our gaze met.

  “Mrs Jenkins, the doctor tells us you are not well and need home nursing. I am the district nurse. Can I have a look at you, please?”

  She pulled her coat closer round her chin and stared at me silently.

  “Doctor says your heart’s fluttering a bit. Can I feel your pulse, please?”

  I put out my hand to feel her wrist pulse, but she pulled the arm away from me with a terrified intake of breath.

  I was nonplussed, and felt a bit helpless. I didn’t want to frighten her, but I had a job to do. I went over to the unlit stove to read the notes by the light coming through the ceiling: there had been evidence of a mild attack of angina pectoris when the patient had fallen in the street outside the house, and an unnamed resident had carried her back to her own room. The same man had called a doctor and admitted him. The woman had obviously been in pain, but this seemed to pass fairly quickly. The doctor had been unable to examine the patient, due to her violent resistance, but as her pulse was fairly steady, and her breathing had improved rapidly, the doctor had advised a nursing visit twice a day to monitor the situation, and suggested that the Social Services department might improve the woman’s living conditions. Amyl nitrite had been prescribed in the event of another attack. Rest, warmth, and good food were advised.

  I tried again to feel Mrs Jenkins’ pulse, with the same result. I enquired if she’d had any more pain, and got no reply. I asked if she was comfortable, and again there was no reply. I realised that I was getting nowhere, and would have to report back to Sister Evangelina, who was in charge of general district nursing.

  I was not too keen on reporting my total failure to Sister Evangelina because she still seemed to think me a bit of a fool. She called me ‘Dolly Daydream’, and spoke to me as though I needed to be directed in the most rudimentary points of nursing procedure, even though she knew I had about five years of nurse’s training and experience behind me. This, of course, made me nervous, and so I dropped or spilled things, and then she called me “butter-fingers”, which made it worse. We did not have to go out together very often, which was a relief, but if I reported, as I would have to, that I could not manage a patient, inevitably she would have to accompany me on the next visit.

  Her reaction was predictable. She listened to my report in heavy silence, glancing up at me from time to time from under thick grey eyebrows. When I had finished, she sighed noisily, as though I were the biggest fool ever to carry the black bag.

  “This evening I have twenty-one insulin injections, four penicillin, an ear to syringe, bunions to dress, piles to compress, a cannula to drain, and now I suppose I have to show you how to take a pulse?”

  I was stung by the injustice. “I know perfectly well how to take a pulse, but the patient wouldn’t let me, and I couldn’t persuade her.”

  “Couldn’t persuade her! Couldn’t persuade her! You young girls can’t do anything. Too much bookwork, that’s your trouble. Sitting in classrooms all day, filling your heads with a lot of cods-wallop, and then you can’t do a simple thing like taking a pulse.”

  She gave a contemptuous snort and shook her head, spraying the bead of moisture that balanced on the end of her nose all over her desk and patients’ notes that she was writing up. She drew a large man’s handkerchief from beneath her scapular and wiped up the fluid, which caused the ink to smudge, and so she humphed again, “There now, look what you have made me do.”

  The further injustice made my blood boil, and I had to bite my lips to prevent a sharp reply, which would only have made things worse.

  “Well then, Miss Can’t-take-a-pulse, I suppose I will have to go with you at 4 p.m. We will make it our first evening visit, after which we can both go our separate ways. We will leave here at 3.30 p.m. sharp, and don’t be a minute late. I won’t be kept hanging around, and I shall want my supper at seven o’ clock as usual.”

  With that, she pushed her chair back noisily, and stomped out of the office, with another pointed “humph” as she passed me.

  Half past three came round all too quickly. We pulled the bicycles out of the shed, and the nun’s silence was more eloquent than her grumbling had been. We reached the house without a word, and knocked. Again no reply. I knew what to do, so told Sister about the man on the second floor.

  “Well, get hold of him then, don’t stand around talking, chatterbox.”

  I ground my teeth and started throwing stones up at the window in a fury. It was surprising I didn’t break the glass.

  The man shouted out, “I come”, and hid behind the door again as we passed. However, he then added “I come no more. You go round back, see? I not answer no more.”

  In the dim light of Mrs Jenkins’ room a cat came towards us, mewing. The wind made a curious sound as it hit the hole in the roof. Mrs Jenkins was huddled in her chair, just as I had left her in the morning.

  Sister Evangelina called her name. No reply. I was beginning to feel justified - she would see that I had not been exaggerating. Sister walked over to the armchair. She spoke gently, “Come on, mother. This won’t do. Doctor says there’s something up with your ticker. Don’t you believe a word of it. Your heart is as good as mine, but we’ve got to have a look at you. No one’s going to hurt you.”

  The bundle of clothes in the chair didn’t move. Sister leaned forward to feel her pulse. The arm was pulled away. I was delighted. “Let’s see how Sister Know-all copes,” I thought.

  “It’s cold in here. Haven’t you got a fire?”

  No reply.

  “It’s dark, too. What about a light for us?”

  No reply.

  “When did you first feel bad?”

  No reply.

  “Do you feel a bit better now?”

  Again, total silence. I was feeling very smug; Sister Evangelina appeared as incapable of examining the patient as I had been. What would happen next?

  What in fact did happen next was so utterly unexpected that, to this day, more than fifty years later, I blush to remember it.

  Sister Evangelina muttered, “You’re a tiresome old lady. We’ll see what this does.”

  Slowly she leaned over Mrs Jenkins and as she bent down she let out the most enormous fart. It rumbled on and on and just as I thought it had stopped it started all over again, in a higher key. I had never been so shocked in all my life.

  Mrs Jenkins sat upright in her chair. Sister Evangelina called out: “Which way did it go, nurse? Don’t let it get out. It’s over there by the door - catch it. Now it’s by the window - get hold of it, quick.”

  A throaty chuckle came from the armchair.

  “Cor, that’s better,” said Sister Evangelina happily; “Nothing like a good fart to clear the system. Makes you feel ten years younger, eh, Mother Jenkins?”

  The bundle of clothes shook, and the throaty chuckle developed into a real belly laugh. Mrs Jenkins, who had never been heard to speak apart from obsessive questions about babies, laughed until the tears ran down her face.

  “Quick! Under the chair. The cat’s go’ it. Ge’ it off him quick, e’ll be sick.”

  Sister Evangelina sat down beside her, and the two old ladies (Sister Evie was no spring chicken) rocked with laughter about farts and bums and turds and stinks and messes, swapping stories, true or false, I couldn’t tell. I was deeply shocked. I knew that Sister Evie could be crude, but
I had no idea that she possessed such an extensive and varied repertoire of stories.

  I retreated to a corner and watched them. They looked like two old hags from a Bruegel painting, one in rags, one in a monastic habit, sharing lewd laughter with the happiness of children. I was completely out of the joke, and had time to ponder many things, not least of which was how on earth Sister Evangelina had been able to produce such a spectacular fart at that precise moment. Could she command one at will? I had heard of a performer at the Comédie-Francaise, immortalised by Toulouse-Lautrec, who would entertain the Parisian audiences of the 1880s with a rich variety of sounds emitting from his backside, but I had never heard of, still less encountered, anyone who could actually do it. Was Sister Evangelina gifted, or had she acquired the skill through hours of practice? My mind dwelled with pleasure on the possibility. Was it her party piece? I wondered how it would go down at the convent on festive occasions, such as Christmas and Easter. Would the Reverend Mother and her Sisters in Christ be amused by such a singular talent?

  The two old girls were so innocently happy that my initial reaction of disapproval seemed to be churlish and mean-spirited. What was wrong with it, anyway? All children laugh endlessly about bottoms and farts. The works of Chaucer, Rabelais, Fielding, and many others are full of lavatorial humour.

  There was no doubt about it. Sister Evangelina’s action had been brilliant. A masterstroke. To say that a fart cleared the air may seem a contradiction in terms, but life is full of contradictions. From that moment on, Mrs Jenkins lost her fear of us. We were able to examine her, to treat her, to communicate with her. And I was able to learn her tragic history.

  ROSIE

  “Rosie? Tha’ you, Rosie?”

  The old lady lifted her head and called out as the front door banged. Footsteps were heard in the passage, but Rosie did not enter the room. Things were happening fast to improve Mrs Jenkins’ living conditions. The Social Services had been called, and some cleaning had been carried out. The old armchair had been removed because it was full of fleas, and another donated. A bed had also been provided, but had never been slept in. Mrs Jenkins was so accustomed to sleeping in an armchair that she could not be persuaded to try the bed, so the cats slept on it. Sister Evangelina commented wryly that the new government must have more money than sense to provide Social Services for cats.

  The most remarkable change was the repair of the hole in the roof which Sister Evangelina achieved through single-handed combat with the landlord. I was with her when she mounted the rickety stairs to the second floor. I would not have been surprised if they had given way under her considerable weight and warned her accordingly, but she glared at me, and strode up them to put the fear of God into the landlord.

  She banged hard on the door several times. It opened a crack, and I heard, “What you want?”

  She demanded that he come out and speak with her.

  “You go away.”

  “I will not. If I go away, it will be to set the police on you. Now come out and talk to me.”

  I heard words like “disgrace”, “prosecute”, “prison”, and whining pleas of poverty and ignorance, but the net result was that the hole in the roof was patched up with a heavy tarpaulin, weighted down with bricks. Mrs Jenkins was delighted, and grinned and giggled with Sister Evie as they shared a cup of strong sweet tea and a piece of Mrs B.’s homemade cake that Sister Evie invariably brought with her when she visited Mrs Jenkins.

  A tarpaulin to mend a hole in the roof may seem inadequate, but there was no chance of getting anything better or more durable. The building was condemned for demolition, and the fact that it was still lived in at all was due to the acute housing shortage caused by the bombing of London in the war. People were glad to live anywhere they could find.

  The coke stove was usable, but furred up, and Fred, boilerman extraordinaire of Nonnatus House, cleaned and serviced it. Sister Evangelina was determined that Mrs Jenkins should stay in her own home.

  “If the Social Services had their way they would put her in an old people’s home tomorrow. I’m not having that. It would kill her.”

  When we first examined Mrs Jenkins we had found her heart to be quite fair. Angina is common amongst the elderly, and with a quiet life, warmth, and rest, it can be kept under control. Her main problems were chronic malnutrition and her mental state. She was clearly a very strange old lady, but was she mad? Would she do any harm to herself or others? We wondered if she needed to see a psychiatrist but we could not tell without assessing her over a period of weeks.

  The other problems were dirt, fleas and lice. It was my job to clean her up.

  A tin bath was brought from Nonnatus House, and I boiled up water on the coke stove. Mrs Jenkins was dubious about all this, but I only had to mention that Sister Evangelina wanted her to have a bath, and she relaxed and chuckled, champing her jaws.

  “She’s a good ’un, she is. I tells my Rosie an’ all. We ’as a good laugh, we ’as. Rose an’ me.”

  I had quite a job persuading her to undress, and she was very apprehensive. Under the old coat she wore a rough wool skirt and jumper, but no vest or knickers. Her frail little body was pathetic to behold. There was no flesh on her, and all her bones stuck out at sharp angles. Her skin hung loose, and I could count every rib. The revulsion she had hitherto inspired in me turned to pity when I beheld her frail, skeletal body.

  Pity is one thing, shock another. Shock was waiting for me when I took her boots off. I had noticed her huge man-sized boots before, and wondered why she wore them. With difficulty I untied the greasy knots and undid the laces. She wore no socks or stockings, and the boot would not budge. It seemed stuck to her skin. I eased a finger down the side, and she winced. “Leave it be. Leave it.”

  “I’ve got to get them off to put you in the bath.”

  “Leave it,” she whimpered; “my Rosie’ll do it by an’ by.”

  “But Rosie’s not here to help. If you will let me, I can get them off. Sister Evangelina says your boots have got to come off before you have your bath.”

  It would be a long job, so I wrapped a blanket over her and knelt down on the floor. Some of the skin was indeed stuck to the leather, and tore as I eased the boot back and forth. God knows when they had last come off. Eventually I eased the boot over her heel and pulled. To my horror there was a sort of scratching, metallic sound. What was it? What had I done? As the boot came off, an extraordinary sight met my eyes. Her toenails were about eight to twelve inches long, and up to one inch thick. They were twisted and bent, curling over and under each other, and many of the toes were bleeding and suppurating at the nail-bed. The smell was horrible. Her feet were in a terrible condition. How had she managed to tramp all over Poplar for so many years with feet like that?

  She didn’t even murmur as I was taking the boots off, though it must have hurt, and she looked down at her bare feet with no surprise - perhaps she thought everyone’s toenails were like that. I helped her over to the bath, and it was surprisingly difficult because, without her boots, she had lost her balance and the toenails kept getting in the way, nearly tripping her up.

  She stepped over the edge of the big tin bath and sat down in the water with delight, splashing and giggling like a little girl. She picked up the flannel and sucked the water noisily, looking up at me with smiling eyes. The room was warm because I had stoked up the fire, and a cat strolled up and looked curiously over the edge of the bath. She splashed him in the face with a giggle, and he retreated, offended. The front door banged, and she looked up sharply. “Rosie, that you? Come ’ere, girl, an’ look a’ yer ol’ mum. It’s a rare sight.”

  But the footsteps went upstairs, and Rosie didn’t come.

  I washed Mrs Jenkins all over, and wrapped her in the big towels provided by the Sisters. I had washed her hair and wrapped it in a turban. I had not seen too many fleas, but I applied a sassafras compress to kill any nits. The only thing I could not cope with were her toenails - a good chiropodist would
have to be called in for such monsters. (I am reliably informed, incidentally, that Mrs Jenkins’ toenails are to this day displayed in a glass case in the main hall of the British Chiropody Association.)

  The nuns always kept a store of second-hand clothes, rescued from many jumble sales, and Sister Evangelina and I had sorted out some garments which I had brought with me. Mrs Jenkins looked at the vest and knickers and stroked the soft material with wonder.

  “Is this for me? Oh, it’s too good. You keep ’em fer yourself, duckie, they’re too good for the likes o’ me.”

  I had difficulty in persuading her to put them on, and when she did, she rubbed her hands up and down her thin body with amazement, as though she couldn’t get over her new underwear. I dressed her in the jumble-sale clothes, which were all too big, and quietly put her old clothes out the back door.

  She settled comfortably in the armchair, stroking her new clothes. A cat jumped on to her knee, and she tickled him gently.

  “What’ll Rosie say when she sees all this finery, eh, puss? She won’ know ’er ol’ mum, she won’, dressed up like a queen.”

  I left her with the happy feeling that we were doing a great deal to improve her intolerable conditions. Outside, I put her flea-ridden clothes into a bag, and looked for a dustbin. There were none to be seen. There was no provision for waste disposal in the area because no one was supposed to be living in the condemned buildings, so no public services were provided. The fact that people were living there and everyone, including the Council, knew about it, made no difference to official policy. I left the bag of clothes in the street amongst the piles of rubbish already lying around.