She went up to her room, and sat for a long time, staring out at the darkness, holding the baby close to her, angry with her mother for reading her so well, and reflecting that rather than she unsettling Tom Knelston, it was he who had unsettled her.
Chapter 12
1947
Alice could hardly believe that here she was. Her very first day as a probationer, actually at St Thomas’ Hospital. She’d done her thirteen weeks at the training school in Godalming and that had been both fun and incredibly interesting; she’d made lots of friends, and it had confirmed what she’d always known, that nursing was for her. And she was for nursing.
She hadn’t been able to start immediately after the war ended, as she’d hoped; you had to be nineteen. She’d completed her Higher and got lots of distinctions, and then, because she was still only eighteen, had had to find something else to do; her parents wanted her to go to some terrible finishing school in Paris, but she’d absolutely refused and finally agreed to do a secretarial course. ‘Nursing may not work out for you, Alice, or one day you may be married and you may want a part-time job while your children are small. Believe me, you can always get a job as a secretary.’
Alice felt sure she could always get a job as a nurse as well, and one she would enjoy a great deal more than typing some stupid man’s letters, but she had learned not to argue with her mother on the subject. It really was a complete waste of time and energy.
She had been interviewed at the hospital, of course, but it hadn’t exactly been gruelling. She had travelled with her mother to the great building, on the River Thames right next to Westminster Bridge and facing the Houses of Parliament, and had sat in the office of a lady called Miss Smyth; as far as she could see the only purpose of the interview was to see that she had nice manners, and had had a basic education. Later she was to discover that you had to be recognisably a Thomas’ type – you needed to be highly intelligent, not merely well-educated, to display a certain self-confidence and outgoingness and above all to ‘speak proper’, as she confided, giggling on the phone to Jillie, after she had got through her first week at the training school,
‘No common voices at St Thomas’, I can tell you,’ she said. ‘All terribly well spoken, we are. Anyway, I love it. I’m just so happy, I don’t know what to do.’
Jillie was now studying medicine, which sounded rather more impressive than Alice’s ambitions, but Alice saw nursing as being in no way inferior to Jillie’s calling. That was what she had for so long wanted to do and at last she was doing it, and she was perfectly happy.
There were thirty girls at the Godalming training school, divided into three houses; Alice was put into the Clock House.
The first piece of medical equipment she was given was a duster: a nurse’s first duty, they were told, was to make sure everything was as tidy and clean as it could possibly be; and her first morning at St Thomas’ reinforced this.
They had to be on the ward by seven thirty when the night staff went off duty. There were three of them, Alice, Hazel and Suzanne, in their new purple-and-white striped probationer uniforms, all trembling, even Alice, the most self-confident of them. They stood in the doorway and looked at the new world which they would now inhabit: at a vast room, very light and airy, with thirty beds, fifteen on each side, with their curtains pulled back; at the patients being washed and tidied; at gas fires mounted on pillars, and an area in the middle where stood a large and impressive boiler and sinks.
A steely-eyed, rather forbidding personage walked up to them and announced, ‘I’m Staff Nurse and in charge of you at this moment at least. Welcome to Clement. You address me as Staff. Sister, as of course you’ll know, is Sister Clement. Let’s get you making yourselves useful. Plenty to do. We divide the ward into three – Dayside, Night-side and Thirds. You, nurse –’ she pointed at Alice – ‘you go onto Dayside. Which means you work on the left side of the ward and your first duties every day are hot dusting. Take your duster –’ she pointed at the boiler area – ‘wring it out in hot water from one of the sinks, and do all the surfaces. Along the rails of the beds, the legs and then the lockers, any brass pieces you can see, and of course the wheelchairs. Put a clean pinny on whenever you come onto the ward – don’t want you getting your uniforms dirty unnecessarily – you’ll find them in the linen cupboard. Now, there’s no time to be lost. At eight, you’ll hear Big Ben strike – Sister will be in for prayers and by then everything has to be in order.’
At eight o’clock, Big Ben did indeed strike and as predictably and promptly, Sister did come in, proceeded to her desk, knelt and said prayers. Looking anxiously at the others for guidance, Alice saw that some of the nurses stood through this, some knelt. For this at least there was no rule.
After prayers, Sister did her inspection: of the general tidiness and cleanliness of the ward, the state of each patient, and any problems that had cropped up during the night of which she was unaware. The patients, who had to lie completely flat for the duration of the prayers, were then allowed to sit up and eat their breakfast.
Breakfast, or rather its preparation, was one of the probationers’ duties: porridge was the standard ration, followed by toast and marmalade and a cup of tea. It was wheeled round on a large trolley, with one of the pros, as they were called, pushing it, and another walking beside her and serving the food. The patients were most polite to them, without exception, and almost as respectful as if they had been, if not Sister herself, at least Staff. They ate everything; rejecting food was simply not an option. ‘And anyway,’ one of the nurses told Alice over lunch, ‘half of them are half starved when they come in, poor things. They think the food is absolutely wonderful.’
Once breakfast was cleared, and the trolley wheeled to the kitchen, they became fractionally more like nurses. All three of them were allotted patients; all three of them became part of a team working under a senior nurse. They had to know everything about each of their patients; their names, of course, but what was wrong with them, how long they had been in hospital, their treatment, their progress. They suffered from a variety of things, some gynaecological or gastric problems, chest infections, chronic bronchitis, some even pneumonia, severe arthritis. Several were anaemic. They all looked to Alice extremely pale and listless, often more anxious about what might be going on at home than their own conditions, she learned. They were also mostly very thin.
Her first medical duties of the day were taking her patients’ temperatures and their pulses; a senior nurse instructed her in the art of taking blood pressure – not easy, but she got the hang of it quickly, to her huge relief, observing from the corner of her eye Hazel, one of her fellow pros, finding it hugely difficult and becoming flustered. There was also the matter of the bedpans: bringing them if required, emptying them in the sluice, asking the delicate twice-daily question about whether they had had their bowels open, which most of the women found desperately embarrassing, especially if the answer was ‘No’. All this had to be recorded in the notes at the foot of the bed, making up the important record, including information on the prescribed drugs.
After which came the terrifying procedure of the doctors’ round. Sometimes, a consultant would be in the team, trailed by a group of medical students, sometimes a senior registrar. God help any nurse who was asked a question about a patient that she was unable to answer.
It was, however, Sister who was the most important figure in the hierarchy; she greeted the doctors at the ward – and had been known to refuse them entry, even the lofty consultants, if she was engaged on an emergency. Alice found this hugely satisfying to observe. Her mother and indeed her friends tended to regard nursing as a humble secondary career to being a doctor; here on the ward, that was absolutely not the case. The ward was Sister’s kingdom and she ruled over it.
And how amazing to work just across the river from one of the most famous and beautiful views in the world, that of the Houses of Parliament and Big Ben, in one of the most famous if not beautiful hospitals in the w
orld. It did have its charms, of course, not least its position, but it had been bombed several times and swift and impressive repairs had nonetheless left it scarred and something of its finer proportions sadly lost.
Oh, she loved it: loved it, and was proud beyond anything to be one of its nurses, its Nightingales (named after its formidable and legendary founder, Florence Nightingale). They were steeped not just in its discipline and its standards, but in the honour of simply being a Nightingale. Admission was not easy, as indeed it was not to any of the great hospitals, Guy’s and Barts and the London. It wasn’t so much that the academic requirements were high, and the social ones higher, it was that becoming a Nightingale admitted you to an association of legendary distinction and indeed conferred something of that distinction upon you. Being a Nightingale meant you had learned invaluable qualities beyond medical skills: self-discipline, calm, and unquestioning adherence to the highest standards.
She might only be a probationer, Alice reflected, as she lay in bed exhausted each night, after her twelve-hour shift, followed by private study, but she was training in those qualities as well as the medical. She could not imagine being any happier.
Laura could not, for the time being at any rate, imagine being unhappier. She was lying in bed, bleeding, in considerable pain, in the full awareness that she was about to lose the third baby that she and Tom had been so joyfully expecting. Well, perhaps a little less joyfully as she had been extremely anxious as well, but she had got further this time, almost to the magic twelve weeks as the midwife at the surgery called it. She had felt much better too, less sick, not so exhausted. But it had all been a wish, a prayer if she had believed in them, a nothingness. She had to retrace her steps along that misleadingly hopeful road, with its landmarks – the first few days when it didn’t happen, each one more hopeful than the one before, then beginning to trust and believe, then telling Tom and seeing his joy, the plans, the looking forward, the sickness even, horrible to be sure, but worth it, the silly conversations about girl or boy, the names – and then suddenly, the shock of the pain, coming out of nowhere, the panic, the instructions from the midwife to take it easy, lying in bed, scarcely daring to move, and then … Then the beginning of the end, the bleeding, staring at it in disbelief, the increasing pain, and more blood, sitting and sobbing, crying aloud, clinging to Tom, and when it was over, the grief, the sense of failure, the knowledge of loss.
It hadn’t been too bad the first time; most people could tell her of a similar experience, people who now had several children, her sister, her mother. She herself had been hopeful, confident, even, the second time, but it had happened even sooner, before the second-month milestone. That time she felt guilty, had thought she should not have gone on teaching, but stayed at home resting. The midwife said no; there was really nothing she could have done.
‘But why? Why does it keep happening?’ she had asked this time, her voice deep with the rawness of her grief. The midwife told her nobody knew, it was a mystery. The only thing they were sure of was that miscarried babies usually had something wrong with them, were best not carried to term – it was nature’s way of dealing with imperfection.
Laura had nodded, too wretched to argue, but later she began to question this cosy, bland philosophy. In the first place, how did they know? How could they look at the mess that was a miscarriage and say, oh, yes, look, definitely something wrong there. It was ridiculous, and she began to feel angry, that she was being fobbed off with something.
A few days later, still miserable and vengeful but recovering, she made an appointment to see the doctor. He looked at her warily as she told her story, then with scarcely disguised impatience as she made her request for further information, perhaps some treatment for repeated miscarriage.
‘Mrs Knelston –’ Dr Andrews looked at her over his spectacles – ‘miscarriage is a perfectly natural process, nature’s way of ridding the body of an imperfect foetus – that is, a baby.’
‘I am perfectly aware of what a foetus is, thank you,’ said Laura firmly. ‘I’m sorry, I don’t believe that is the only explanation for what I have had to endure. It seems to me that there may be other reasons, some failure in my reproductive system that could be addressed.’
‘Well, the person to talk to is a midwife,’ said the doctor. ‘She will know everything there is to know about these things …’
‘I’m afraid I disagree with you,’ said Laura firmly. ‘She seems to know very little, apart from the progress of an absolutely normal pregnancy. So I want to see a specialist in this field, and I would be grateful if you would recommend one to me.’
‘That would involve either a very long wait, or your paying rather a large fee,’ said Dr Andrews, in tones that made it clear the latter route was not remotely within Laura’s reach. ‘These men are highly qualified.’
‘I would hope they are,’ snapped Laura. ‘Are they all men? Could I not see a female gynaecologist? I would greatly prefer that anyway.’
The doctor glared at her, looked at his watch and then told her that there was a hospital, the Elizabeth Garrett Anderson in Bloomsbury, which specialised in enabling poor women – he put a stress on the word ‘poor’ – to obtain medical help from gynaecologists.
‘You would need a letter of referral. And then you would have to make an appointment.’
‘I am quite capable of that,’ said Laura. ‘How and from whom would I obtain this letter of referral?’
‘I am too busy to do it now, if that is what you want – you will have to call back for it in a week or ten days.’ Dr Andrews sighed.
‘Really? So long? To write a letter?’ Laura was beginning to feel quite cheered up by this battle with the medical hierarchy, which baffled her greatly at the same time. What was she meant to do? Go home quietly and continue having miscarriages, being told it was nature’s way? Was there some reason women were not allowed to seek further help with this miserable problem? She wondered if it would have made a difference if Tom had come with her; she suspected it would. She was fairly sure the doctor would then have belittled her further, would have addressed all his remarks to him.
‘Mrs Knelston, I have a great many patients. Yours will not be the only letter I will have to write. Now, a few details quickly, if you please? This is your second miscarriage?’
‘Third,’ said Laura.
‘And had you reached the end of the first trimester?’
Laura knew what he was doing, trying to make her feel stupid because she didn’t know what trimester meant. He had clearly taken a great dislike to her.
‘Not quite,’ she said. ‘I had missed two of my monthly periods, and was about halfway through the third month.’
He nodded, looked up at her and said, ‘You can come and see if the letter is ready in a week.’
‘How kind. Good afternoon,’ said Laura. ‘And thank you for your help.’
When Tom got home that evening, expecting to find the wretchedly depressed wife he had left that morning, and hoping he had sufficient emotional resilience to meet her needs, he found her quite changed. She made him a cup of tea and said she felt all was not quite lost and that she had been making enquiries and she was hopeful there might be another way out of this unhappiness than simply accepting what had happened to her so far. ‘If there isn’t, well, at least I shall have tried. What a disgusting creature Dr Andrews is,’ she added, sitting down with her own cup of tea.
‘Really?’ said Tom. ‘I’ve always found him very nice and helpful. And he has a large panel. He’s not all bad.’
‘You might ask him, next time you have to go and see him, if he’s joining your Mr Bevan’s National Health Service,’ said Laura. ‘He might be a bit less nice and helpful after that.’
‘Of course I will,’ said Tom. ‘I’m sure we shall be able to have a very interesting conversation about it.’
‘Now, let me tell you about the Elizabeth Garrett Anderson Hospital in London. It’s where I plan to go as soon as your nice and helpfu
l Dr Andrews will give me a letter. Oh, and I can make an appointment, of course. There’s quite a long waiting list. Don’t look so suspicious – it’s specifically for poor women to get help. I’m sure your Mr Bevan would approve.’
‘I wish you wouldn’t keep calling him that,’ said Tom and then, because she seemed so much more cheerful, he told Laura he had been invited to give his speech about the lack of medical provision for ex-servicemen at a big meeting in Winchester. It had seemed wrong to think hopeful thoughts of his own, when Laura’s situation was beginning to seem so fruitless, but he was beginning to feel he really had something to contribute to not just this but many other causes.
‘Ned, darling, hello, how lovely to see you. It’s been much too long. How are you, and what are you doing here?’
‘Same as you, I daresay,’ said Ned, smiling with genuine pleasure at Wendelien, as she approached him at a fast trot across the marbled, art deco foyer of Claridge’s Hotel. ‘Having a jolly evening. You look marvellous, Wendelien.’
‘Thank you. I so love these clothes. You know they put dreary old Stafford Cripps into a frightful rage, said there should be a law against them. Such a relief after those skimpy short skirts we’ve been wearing for ever.’
She was dressed, like all fashionable women of the time, in Christian Dior’s New Look, a full-skirted, almost-ankle-length dress: this one in dark red taffeta, with long tight sleeves, and a swathe of black lace round her shoulders, her gleaming dark hair pulled back in a chignon.
‘Thank you. If we can’t have a jolly evening here, there’s not much hope for us at all. So lovely, isn’t it?’
‘It is indeed. And I so loved them giving the penthouse to poor Mr Churchill after he lost the election, to stay as long as he wanted.’
‘My favourite story is him making it Yugoslavian territory, so that Crown Prince Alexander could be born on his own country’s soil.’
‘I know, wonderful. Anyway, how are you, Ned? Who are you meeting?’
A Question of Trust Page 13