Did she imagine I was about to share my deepest feelings with her, here, in the laundry room? Perhaps she sensed my hesitation because she said, her tone softening, “I can offer some observations, if you like.”
“Sure, go ahead.” I suspected anything she said would be as meaningless as the fortunes you get for a nickel from that mechanical Gypsy on the boardwalk.
“Well, the part about your father taking you to ride the carousel, that could be simple wish fulfillment. You grew up in an orphanage, didn’t you?” Surprised, I nodded; I didn’t realize Molly knew about the Home. “So, in your dream, you live out your wish. That’s one way to think about it.”
That made some sense, actually. “But what about my hands? I certainly don’t want anyone to sew my hands together.”
“Of course not. Like I said, a dream is the subconscious speaking to us. Sometimes dreams use wordplay or images that seem strange but are fairly obvious if you think about it.” She paused, eyebrows raised, but I couldn’t guess what she wanted me to say. “Well, your hands are literally tied. Maybe you feel helpless about something, unable to do something, constrained by some outside force. You have to figure out what that could be for you, what your subconscious is telling you.”
“I’ll have to think about that, Molly.” The washing machine had stopped agitating and gone into the spin cycle. If I skipped the dryer, I could be out of there in a few more minutes.
“Professor Freud teaches us that dreams about horseback riding typically indicate a desire for the phallus.” She raised an eyebrow at me, but I just shrugged. “The rising water, though, that’s very interesting. More Jungian than Freudian perhaps. At the meetings of the Coney Island Amateur Psychoanalytic Society, we often discuss dream analysis. One of the young men—he’s a homosexual, poor boy—he has a similar image in his dreams. His interpretation is that rising water represents repressed emotions because it’s not a solid thing you can get a grip on, the way it slips through your fingers, yet it’s capable of overwhelming you, of swallowing you up.”
The machine shuddered to a stop. I flipped up the lid and pulled out my wet clothes. “You’ve given me a lot to think about, Molly, thanks, but I have to get going now.”
“Aren’t you going to dry your things?”
“Oh, I’ll just hang them on the balcony. Seems silly to pay a dime to dry something on such a hot day.”
In the elevator I exhaled, relieved at having escaped. I did puzzle over her comment about the boy in their group. They knew he was gay, but he was still in their Society. Maybe Freud’s obsession with sex had made them more accepting than I thought. Accepting, but pitying.
It had been a mistake to humor her. After hanging out the laundry, I put on my sandals, picked up my pocketbook, and headed out to the Medical Academy. If I got there a few minutes before they opened, so be it; I could always sit in the park across the street. Never mind about cryptic symbols and the subconscious. I was going to get real answers.
Chapter Five
FROM HER CRIB IN THE PERTUSSIS WARD, RACHEL STARED at the cart of picture books parked near the door. She had already looked at every illustration and every letter of every word in the book in her crib a hundred times. “One hundred and one,” she whispered. What she wanted was a different book, and she could see them, there on the cart, but Rachel knew better, now, than to ask the nurse to get her one. She’d had a fit, once, when the book she was given turned out to be the same one she’d had the week before. “You’ll have no book at all until you control yourself,” the ward nurse had said, exasperated. Without anything in her crib to look at, Rachel had nothing to do but watch the shadows on the ceiling shift with the passing hours of the day. At last the nurse had relented and brought her the book about the animals getting on a boat, warning, “You must be a good girl from now on or I’ll take it away again.” Rachel had promised, and she had been, for weeks and weeks now, but today, more than anything, she wanted a new book.
The nurse, Helen Berman, was sorting through the paperwork covering her desk. Every now and again she scanned the ward through the window in the wall that separated the nurses’ station from the children. A cramped room built into a corner of the ward, the station served as office, break room, and, when the cot stored under the desk was set up for the night, bedroom. Helen had taken the job at the Hebrew Infant Home last summer when she was just nineteen, fresh out of nursing school and glad to get the position. A year later, though, she felt the walls of the Pertussis Ward closing in. She reminded herself that whooping cough was better than diphtheria or measles—only rickets would have been easier, and the Scurvy Ward was too disturbing—but still the paperwork was overwhelming. Every child’s chart had to be meticulously noted: each meal, every cough, daily temperature, changes in disposition, weekly measurements of height and weight. Nursing school hadn’t prepared her for the precise record keeping required of medical research.
Glancing up, she noticed one of the girls climbing out of her crib. Probably needing to use the toilet, Helen thought. The bathroom was connected to the ward, so there was no danger of a child wandering off. She used to yell at them to stay in their cribs until she realized this put her at their beck and call at all hours of the day and night. It strained her back, lifting their heavy bodies half a dozen times a day—or, worse, changing their sheets when they wet the bed, which they managed to do anyway, the boys in particular. The little ones she kept in diapers, but the bigger ones, well, it was best to let them take care of themselves.
Except for trips to the toilet and a weekly bath, the children in the Pertussis Ward were confined to their cribs; even meals were delivered to them there. When Rachel had been brought here at the end of May after recovering from the measles, she was so exhausted all she could do was lie limp, her eyes, still sore from conjunctivitis, half-closed. Occasionally the coughing would start up, so violent she could hardly catch her breath, until finally she retched and collapsed in relief. All that long summer, as flies buzzed through the open windows of the ward, the whooping cough had come and gone. Eventually, though, as the nights became cooler, the paroxysms came less frequently until finally they had ceased.
As Helen Berman updated Rachel’s chart, she saw that the Rabinowitz girl had turned five last month. Counting back from today’s September date, Helen noted there hadn’t been an episode of whooping cough for weeks. As she finished notating the chart, she decided this one could finally be transferred into the Infant Home itself, where she would join the other girls in kindergarten. Five months in the hospital wing was more than enough for any child.
Rachel hoisted herself over the iron bars of the crib and landed on her bare feet. She crept past the other children who were napping or staring into space or muttering to themselves until she reached the book cart. She wanted to pick a book she’d never seen before, but to do that she had to look at each one, carefully turning the pages. As soon as she recognized a picture, she dropped that book on the pile accumulating in her lap and reached for another. She was absorbed in her task when the ward door opened. Rachel was surprised to see the big nurse with red hands, the one who had taken her clothes and cut her hair back on that first day. Rachel tugged at her hair, long enough now to cover her ears, and hoped she wouldn’t be seen behind the cart.
“There you are!” Nurse Shapiro dashed into the nurses’ station, startling Helen. “Dr. Hess is on his way here. He’s giving the new resident doctor a tour of all the wards. I wanted to warn you that . . . wait, where is that child?” Nurse Shapiro pulled Helen into the ward and pointed to the empty crib. Turning frantically, she spotted Rachel crouched behind the book cart.
“Are you in the habit of letting them run loose?” Nurse Shapiro’s chapped hand closed on Rachel’s arm, hoisting her up, but the books in her lap tipped her forward and she fell, hard, on her knee. “Oh, for goodness sakes,” Nurse Shapiro muttered, picking Rachel up and carrying her over to the crib.
“Believe me, I never let them out unattended,” He
len stammered. “This one is very sneaky.” She shook Rachel’s shoulder. “What have I said about climbing out of your crib?” What she had said was not to bother her just to use the toilet, but Rachel was too confused to answer.
“Listen,” Nurse Shapiro said. “I came to tell you—” The ward door opened again. She and Helen turned as Dr. Hess stepped into the room, guiding a young woman whose dark hair was pulled back in a severe bun. A member of the Ladies Committee, Helen assumed, though the woman’s jacket and skirt were exceptionally plain, nor was she wearing a hat.
“Ah, Nurse Berman,” Dr. Hess said. “I’d like you to meet Doctor Solomon, our new resident in radiology.”
Helen blinked, puzzled, and looked over Dr. Hess’s shoulder for this new resident. Beside him, the young woman cleared her throat and extended her hand. The nurse was grasping the woman’s fingers before she put it together. “Oh, you’re Doctor Solomon.” She offered a friendly smile that was met with a withering stare. Helen instantly formed the opinion that this woman doctor was unattractive, though there was nothing particularly offensive about her features—except, perhaps, her beaked nose. As the doctors brushed past them Nurse Shapiro whispered, “I tried to warn you,” before slipping out of the ward.
Ignoring the nurses, Dr. Hess continued his conversation with Mildred Solomon. “Now, as I was saying, I’ve been skeptical of these new pertussis vaccines. As you well know, the whooping cough comes and goes over the course of months. What may seem like a cure one week could simply prove to be a temporary cessation of the symptoms. Only by comparing a number of subjects over the entire course of the disease can we begin to develop reliable results. What was needed was a controlled experiment. So, for the past hundred days that’s precisely what we’ve done.” Dr. Hess waved his arm across the room, taking in the cribs and the children in them. “I enrolled nine of the children as material for the study. Three were vaccinated before being introduced to the ward, three were vaccinated at the first evidence of whooping cough, and three were never vaccinated at all. I’ve just completed my assessment, and as I suspected, the current vaccination is ineffective.”
“Dr. Hess, I cannot tell you how impressed I am by the opportunities for research the institutional setting affords.” Doctor Solomon’s voice, though pleasant in pitch, was not melodious. She made an effort to keep her tone flat, countering the natural tendency of her voice to rise at the end of each statement.
“I’ve always maintained,” Dr. Hess said, “that the questions being asked in modern pediatric medicine cannot be answered by experiments on animals but must be decided by clinical observations on infants. The ability we have here to control conditions is unparalleled. Nutrition, sunlight, activity, exposure to disease—everything can be controlled and measured. This has proven invaluable for my work on the causes and cures of scurvy. In my study of rickets, however, some unanswered questions remain. For instance, I had hoped to establish whether, if Negro infants were deprived entirely of sunlight, they would develop rickets to the same degree as white infants placed in similar conditions. Without the cooperation of my counterpart at the Negro orphanage, however, such an experiment has proven to be impractical.”
“Still, Dr. Hess, your use of X-rays in the diagnosis of rickets was a tremendous innovation.” When it came to conversing with distinguished physicians, one lesson from medical school Mildred Solomon had taken to heart was the strategic deployment of flattery.
“That’s true, yes. We routinely x-ray every child coming into the institution, as soon as they are cleared of disease, of course.”
Dr. Solomon nodded. “The radiography facilities here at the Infant Home are renowned.” She might have added they were the reason she’d applied for the residency, but she knew people preferred to believe it was some feminine affinity for the care of children.
“There I must credit our donors for their generosity in building and equipping this hospital wing.” Dr. Hess tilted his head in a studied gesture of humility, assuming his connection to the Straus fortune was common knowledge. “Not only do we have a modern X-ray room, but our laboratory is also fully equipped for microscopic tests, throat cultures, and blood work.”
“I am eager to see the X-ray room,” Dr. Solomon said, turning slightly to indicate her readiness to continue their tour.
“Excuse me, Dr. Hess.” Helen had been standing beside them, unnoticed, a chart in her hands. “I was wondering if you would sign off on this child? Since your study has concluded, and she appears to be fully recovered, I thought perhaps she could be released from the Pertussis Ward?” Helen wouldn’t usually display such pluck, but after Nurse Shapiro’s disapproval, she was anxious to rid herself of the troublesome girl.
Dr. Hess took the chart, frowning at the interruption, his pen poised over the paper. His experienced eye took note of a decline in the child’s weight. “Which one is this?”
“Right here,” Helen said, leading them to Rachel’s crib. Dr. Hess glanced down and was struck by the girl’s pallor. Rachel, recognizing his egg-shaped face from her first terrifying day at the Home, cringed. “As long as we’re here, Dr. Solomon,” he said, handing the chart back to the nurse, “would you allow me to demonstrate my method for diagnosis of latent scurvy?”
Mildred Solomon offered a look of professional interest, masking her impatience. “Of course, Dr. Hess.”
“If a child presents with the acute symptoms—loss of teeth, bleeding in the mouth, redness of the gums—there is no question as to the diagnosis. Just last week at the city hospital where I conduct a clinic, a child was admitted with scurvy that had advanced to necrosis of the gum tissue. I can tell you, the odor was extremely unpleasant. In such cases the only course of action is immediate treatment with the established cure of orange juice by mouth. With the latent cases, however, there is opportunity for experimentation, knowing that at any time the progression of the disease can be reversed. Recently, for example, I’ve been attempting intravenous injections of citrated blood.”
“That sounds promising,” Dr. Solomon offered, though it seemed to her a ridiculous idea.
“The results so far are not encouraging.” Dr. Hess looked thoughtfully at Rachel. “See here, Dr. Solomon, the pale skin, the peculiarly alert and worried expression? I have found these to be symptomatic.” He reached for Rachel, who scampered away from the sudden movement with a cry. “Sometimes in cases of latent scurvy, I find as we approach a child’s bed, it whimpers or cries out in terror. Typically, though, it lies quietly on its back with one thigh everted and flexed on the abdomen. Nurse?”
“Yes?” Helen stepped forward.
“Have you noticed this one in such a posture?”
Unsure of what she was being asked, she answered, “I suppose so, at times?”
Dr. Hess harrumphed. “Further examination will show if one or even both thighs are swollen and exquisitely tender, or if there is merely tenderness.” Dr. Hess squeezed Rachel’s leg, pressing the spot where she had fallen on her knee. She cried out. “Ah, you see? Finally, we palpate the ribs for beading.” His fingers dug into her sides, squeezing the breath from her lungs. “This is where the X-ray has proven most valuable, for the beading, which is apparent in the radiograph, is not always discernible through palpation.”
Rachel, released from his grip, retreated to a corner of her crib, panting.
“You can perform your first X-ray on this one, Dr. Solomon. If, in the radiograph, you see beading on the ribs or the characteristic separation of the shoulder, I’ll enroll it in my scurvy study.”
Dr. Solomon leaned over the crib, her elbows balanced on the metal bar. Her thoughtful gaze landed on Rachel, though she was thinking not of the little girl but of her own ambitions. Still, the steadiness of her eyes gave Rachel a feeling she hadn’t known in months: the sensation of being noticed. Rachel thought the lady looking at her was very pretty. She liked how her dark hair and brown eyes brought out the pink in her cheeks. The loose bow tied around her neck swung over the crib
; Rachel reached up and tugged at it. Dr. Solomon, excited at the prospect of finally getting her hands on the Home’s excellent X-ray equipment, allowed herself to be amused by the girl’s antics. After all the discouragement, the competition, the sniping from the other medical students, she, Mildred Solomon, had gotten the coveted residency in radiology, and here, tugging at her necktie, was her first subject. A smile swept across her face, too swift to be stopped. The little girl smiled back. It seemed a good omen. Dr. Solomon straightened up, composed her features, and made her pitch.
“Dr. Hess, knowing of your interest in childhood nutrition and digestion, I wonder if you’ve considered supplementing your use of gastric tubes with barium X-rays?” Dr. Solomon lifted Rachel’s chin with her hand, stretching out the throat. “I recently saw a demonstration of the barium swallow using a fluoroscope—the images were stunning—but wouldn’t it be interesting to chart the entire digestive tract? With a group of subjects of similar size and weight, we would soon develop a basic understanding of normal rates of digestion that could be useful for comparison in cases of blockage or other complaints.”
Dr. Hess considered the idea. “Does the barium remain reflective throughout the entire tract?”
“For the lower intestines, an enema is called for, but yes.”
“It’s a very interesting idea, Dr. Solomon, one well worth pursuing. If the X-ray is negative for scurvy, why not use this one for your first barium series? Either way, let’s transfer her to the Scurvy Ward.”
Dr. Hess nodded to Helen Berman, who made a note on Rachel’s chart. She was sorry the child wouldn’t be joining the others in kindergarten but glad the troublesome girl would, at least, be out of her ward.
RADIOGRAPH SHOWS NO evidence of scurvy. Mildred Solomon made the note on Rachel’s chart with a sense of satisfaction. Now the girl would be hers for the initial series of barium X-rays. If she could impress Dr. Hess with this study, Dr. Solomon hoped she’d get approval for an experiment of her own design, though she hadn’t decided yet what she would propose. Eager to get started, she gave the nurse in charge of the Scurvy Ward instructions that the Rabinowitz girl was to have no food whatsoever for the next twenty-four hours.
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