Oh yes, about the ether machine that Paul wants to get. We would surely welcome such an instrument with open arms, many blessings on the donor, and with much relief for some of our patients. However, we have an alternating current and a 210 volt current. A couple of our nurses know just how strong it is, because one of our desk lights that we were using as a physiotherapy light short circuited and the nurses had turned it on, and then took hold of it to adjust it, with the result that they couldn’t take their hands off and none of them had sense enough to turn off the current. Needless to say, both of them, altho not badly damaged, were scared out of about ten years’ growth each. They certainly let out some blood curdling yells.
Still, an ether machine was infinitely more welcome than the stack of men’s pajamas that had arrived a few months earlier. Men’s pajamas, sent to a women’s hospital in rural India.
What got into people? Money was too dear to waste it on trifles nobody out here could use. These things were not only useless to her, they often represented great sacrifice on the part of the sender.
And yet, her natural ingenuity refused to allow anything to languish for long in the closet. Everything found a purpose. Once she had repurposed the gifts, few could even recognize the item’s original intent. Men’s pajamas became layettes for newborns. Tea cozies were ripped apart, combined, and remade into quilted nursing jackets for the new mothers.
But it took time to sort it all out. And time was not always her friend.
Dorothy crossed the hall, her arms laden with the treasures she had collected from the seemingly bottomless closet. The little boy with tuberculosis of the spine was in need of a plaster cast, and after two failed attempts, she had finally contrived a way to fashion it. She had seen only one instance of this type of cast, and that was in her first year as an intern. Now little Vachan presented her with her first opportunity to actually do one herself and so far—without the proper materials—it had not gone well. But in the pre-dawn hours as she struggled to rest, some corner of her mind remained hard at work refining ways to accomplish the task of making a plaster cast without the proper crinoline bandages that would bind to the plaster and hold it in place—on a fidgety little boy. Around dawn the picture fully matured in her mind’s eye.
Lahaori and two of the students prepared five-year-old Vachan, who now lay trembling on the exam table she’d created years ago from an old potting table. It was a far cry better than the collapsible examining table the board had sent out to her. After it lived up to its name one too many times, collapsing under the weight of a critically ill patient, Dorothy consigned it to the closet in favor of the potting table. Cleaned and enameled and with the thin rubber pad she had attached to the surface, it seemed comfortable and less threatening for the children.
April 1934
Mother Dear:
Just how much money is there in my account now, aside from my own personal savings? We have simply got to have some other kind of an operating table. The one that we have is a $39 collapsible one, and it sometimes lives up to its reputation, besides having none of the fixtures necessary for certain important positions. We have to makeshift and then don’t have a safe result. If we could get one that would be safe, work with gear and ratchet in changing the position of the head and body (not on cogs where one has to lift the patient, and the table too in order to change a position) and which had some shoulder braces, knee crutches, etc. It would be marvelous. We could get such a one for about $175. All told if we could have it sent out on Alice’s unused freight allowance, but would have to get the order in very soon if we did so. That can be used within a year, and that would mean that it would have to be started before September first. Don’t order one for us, but let me know as soon as possible.
“Hello, Vachan,” she smiled. The little boy looked at her armful of items and his fear only escalated until she placed a calming hand on his chest and began to massage slowly back and forth.
“I can see that you are so very tired of lying down. Am I right?”
Vachan’s eyes flitted to his mother who stood opposite Dorothy, then quickly back to her as he nodded tentatively.
“Well, of course you are! Why, you can hardly throw a ball or carve an elephant or do any of the things boys your age like to do when you have to lie down all the time, can you?”
This garnered a far more assertive response from the boy.
“Just as I suspected! So I was thinking, we could make a sort of body brace that would help your back when you need to sit up. Would you like that, Vachan?”
Now the boy smiled as he nodded, and Dorothy set to work. The child had granted permission so she would waste not a moment more. Besides, if she didn’t concoct a brace that worked, the boy’s muscles would continue to atrophy until simply throwing a ball would become an impossible dream.
May 1934
We couldn’t get any crinoline for the bandages, and we couldn’t get any bandages already made. We could get the plaster and something that would do very well for the felt. We got the plaster and then debated as to what we could use for the bandages as it has to be stiff. Finally Edna brought out some big pieces of mosquito barring that had been sent out to her which were not large enough to use for nets and which she had wondered what on earth she could use it for. By careful work, and making the bandages double we contrived to get ten three-yard bandages, each six inches wide. We wanted some reinforcing for the cast and used some old corset stays that we found. A long undervest took the place of the stockinette.
“Now take a deep breath, please, Vachan.” She inhaled slowly to demonstrate. Across from her, the boy’s mother inhaled, and then Lahaori—everyone in the room encouraging the child to expand his chest as much as he was able.
“That’s right. Now once again, and hold it for me as long as you can without coughing. That’s it. Good!”
— By rubbing the plaster in extra well while we were putting the cast on, we obtained a very smooth looking one which set rapidly and was very firm. Then we trimmed it out with ordinary shears and Shan knives (more like paper knives but somewhat sharper).
She ran her fingers one last time across the small boy’s plastered torso before the stretcher-bearers carried him to the ward where he would begin his therapy. Smooth. Solid. Not brittle at all, but cool and firm, just as she’d hoped.
“As soon as it’s dry we’ll play a game,” she called after him.
Dorothy took a step to follow him and stopped as her feet crunched across bits of plaster that littered the floor. She raised a hand to fetch a broom, and found one already in the hands of the young nurse attendant, Noori. The quiet girl had seen the need to sweep the floor and was already tending to it.
A thrill of sorts skittered up Dorothy’s spine. The whole affair had proceeded with clinical order. Her staff had quite nicely assimilated the methods she had outlined over and over. Clean and prep, then restore, sterilize, then clean and prep. All about her the small staff could be seen engaging in these very activities—of their own volition—carrying out the tasks without being reminded.
The dustbin rattled and sang as Dorothy brushed small bits of plaster from the soles of her Oxfords. She clapped her shoes together to dislodge the most stubborn bits, and brushed away a small dusting of dried plaster that spilled from the cuff of her sleeve.
A drying clump of plastered bandages caught her eye, and Dorothy dropped her shoes to retrieve it. It rolled nicely in her hand, lightweight, shaping easily into a ball. She set it on the bench and quickly slipped into her shoes.
With a pencil from the pocket of her white coat she scratched a quick but very recognizable portrait of Vachan on the ball’s drying surface as she crossed the hall. His beaming face when he saw it brought a smile to her own.
The day was progressing well. A bit of ingenuity worked for her today, and would work again tomorrow. The practicality of it remained her mantra.
Use what you have.
July 1934
&nb
sp; Someone asked me just how far money will go out here. That depends on whether you are buying food, paying coolies, buying medicine, or buying equipment. We pay 5 Rupees (about $2) for one mond of rice, 80 pounds, and one person eats from one to two pounds of rice a day, so you see that one mond doesn’t go very far. This is especially true when we are feeding many of the patients in the hospital. Some of our patients have all their food brought from home. This frequently complicates treatment considerably. Five dollars will go quite a long ways–it will buy a baby basket and standard, it will keep a baby in the hospital for one month, or it will pay for the support of a student nurse for a month.
Seven dollars will buy a hospital bed for an adult, not a Simmons to be sure, but a Simmons as far as they are concerned. The other day we purchased five lovely wool steamer rugs for the equivalent of ten dollars. These we split into two or three parts each, and so, from the five blankets we have twelve—six for the children’s ward, and six for the woman’s ward. They are fairly good size, too. There are a thousand ways to use every piece, but we have been able so far to grow, and we are trusting that we can continue to do so.
She tossed the lightweight plaster ball to Vachan, who caught it with the clumsy hunger of a child too seldom allowed to play.
Dorothy slowed her racing mind and focused on the boy. She would take a few moments with the little fellow. After all, she had promised him a game.
CHAPTER SIX
TOO LATE. TOO LATE.
The colorful Bohemian mirror Dorothy had just hung on her office wall refused to hang straight. She tapped it lovingly, once on the right, then twice on the left, until it was perfectly plumb. The obliging nail had stood bare since its last occupant had crashed to the floor and shattered to smithereens.
The simple, unadorned but serviceable mirror had gone unreplaced for months, until Dorothy made her long overdue voyage to the States on furlough and rediscovered this charming mirror in her own bedroom in her parents’ home. It had taken some doing fitting it into her already overburdened steamer trunk, but on the matter of the mirror Dorothy would spare no effort. If it came to a choice between sailing back to India with her new walking suit from Bloomingdale’s basement, or taking along the mirror, she would have had quite a battle of it. But as it happened, the mirror finally settled snugly into the trunk’s midsection, padded on all sides by her unmentionables.
Something stirred within her each time she looked at the colorful mirror. It did so much more than simply reflect her image. It seemed to Dorothy that somewhere in the depths of its silvered glass it held a record of her childhood, her youth, her sharply focused medical student determination. Like photographs burned into its invisible depths. And now it would capture and hold the scenes of her life here in Gauhati.
She sat at her desk, still aware of the mirror behind her, cataloguing her every move. It was a nonsensical bit of comfort having it there. It was simply a mirror. Boldly occupying an otherwise bare wall and out of congress with the sparsely furnished, austere office.
But it made her smile.
More often these days Dorothy realized with regular surprise the subtle changes these six-going-on-seven years had wrought. If she stood back far enough from a mirror, there wasn’t a penny’s worth of difference between 1926-Dorothy, second in her class and fresh out of med school, and 1934-Dorothy, fresh back from a six-month furlough to the States. Same weight, same girlish figure, same wavy hair, same smiling countenance. Same impeccable fashion sense.
But sitting here at her desk, with her fingers tracing the worry lines above the bridge of her nose, the creases knit in her forehead when she concentrated, she felt the full weight of her mission. Decisions made in split seconds to save a life, disappointments shouldered when patients refused life-saving treatment, devastating losses of innocent children. These were the things that had reshaped Dorothy’s forehead and robbed her of the easy laughter that she knew now she had taken for granted. The laughter that she sorely missed.
Furlough in Baltimore had brought that crashing home to her. The easy laughter of the young students in the seminar she led at Johns Hopkins seemed so foreign to her, something she had to work at relating to. It was a time she expected to savor, but found that strangely enough, it was Gauhati that felt most like home these days.
Here there were smiles—some easy, some forced, some shy—and the usual light-hearted banter. But laughter? Genuine, from-the-belly laughter? She could no longer summon a mental picture of what that would look like here. What that would feel like. What that would sound like.
The thought had barely formed when a small cry banished it and broke the stillness beyond the window at Dorothy’s back. It startled her enough to drop the chart she’d been updating. Saanji’s chart. Hers was the same story yet again. The family waits too long to bring their daughter, wife, mother to the hospital, until she nearly dies. But at least this time they did bring her. And with every bit of surgical skill within her, and a long, vigilant night, Dorothy had been able to save the woman. Her family would be thrilled, and she intended to praise them publicly for bringing Saanji to the hospital in a timely fashion.
She turned to peer through the jacaranda bushes beyond the window, just in time to see the tail end of a procession scurry through the hospital gates.
“Missahib! Miss—”
“Kika, whatever is—”
“Doctor Kinney, they have taken her! They have taken Saanji!”
“Wh—?”
Dorothy flew to the door in her stockings. Her feet ached so wickedly after long night hours tending to Saanji that she had shucked off her shoes beneath her desk. Now the pebbled path bruised her arches even as her toes crushed jacaranda petals, sending up a fragrant apology that whipped about her skirt. She ran after the small group of peasants that gabbled and grunted excitedly as they scuttled down the path, carrying the barely conscious Saanji who had nearly died the night before.
“Be careful! She’s...oh no! Be careful! You must bring her back! She’s going to be fine! Truly!”
Dorothy scrambled along beside them, trying to make them stop, to listen, desperate to convince the woman’s family that their daughter-sister-wife was going to survive her illness. But the resignation in their eyes, the conviction that the young woman they carried was going to die, was impossible to miss. And they would not let her die in the Christian hospital. They would not dishonor this dear relative by allowing her to die surrounded by things foreign to Hindu. Surrounded by heathen Christians. It would be a humiliation, a disgrace they could not countenance in Saanji’s behalf. They loved her too much.
September 1934
That is where the heartbreak comes into the work out here—they wait so long to bring them in and expect so much in such a short time, and are not willing to give us a chance. To die in the hospital (non-Christian) means that none of her family can touch the body and that the body will have to be taken care of by a very low caste—the matroni and maters (sweepers and those who care for the night soil, etc.).
It would be a terrible disgrace.
The young woman’s father silenced his family and turned to Dorothy. With pain in his eyes he spoke quietly, his words robbing her of breath.
“It is written on her forehead. If she lives or dies, it is already written.”
Dorothy held her tongue, her pleas filling her throat like pitiful fireflies swallowed by the sun. The morning heat warmed the light linen of her hand-tailored surgical coat, caressing her shoulders as she consigned the woman to the care of her relatives. It seemed doubtful that Saanji could survive without continued medical treatment. Maybe after two or three days in the hospital, perhaps, but not so soon after her surgery.
Dorothy could only pray that the inevitable pain they caused the poor girl would not be too great.
That was the way of it out here, in this place with its strange attitudes toward death and dying: a young woman is removed from medical care where she might have survived, in ord
er that her family can prepare her for a death she might have avoided.
Even the children of the village were already steeped in the rituals. With her own eyes Dorothy had watched an eight-year-old son forced to break the jaw of his dead father to ensure his perfect journey in the afterlife.
It is surely one of the hardest things she’s had to do so far in this foreign place, to lift her hands from Saanji and step away from the mewling crowd.
With one last supplication she turned from them, the plea on her lips becoming a prayer while the crowd moved on and the sun warmed her back and the stockinged toes of her shoeless feet curled and flexed in the powdery dust.
. . . .
Dorothy slumped at her desk. The pain of standing by as they carried the woman to her death still sat like a barrier between her and the work that lay on her desk unfinished. She could not move her hand to pick up her pen.
She prayed. Prayed for Saanji, for Saanji’s family, for her staff that surely at this moment felt the same despair she herself struggled against.
It is written on her forehead.
A letter home seemed the only cure to drag her heart and mind back from the dark edge it threatened to occupy. There was never anything quite so effective as “speaking” with her parents to jolt her back onto a productive course.
Saanji’s story was too fresh, too sharp-edged to put on paper as yet. But a half hour at her typewriter worked its therapeutic magic, and Dorothy wrote. Her fingers flew, punching harder than necessary, tangling the keys and ribbons more often than usual, sending the carriage clattering brutally back and forth. But slowly, surely, her pulse returned to normal.
Courage in a White Coat Page 4