“We must empty out these rooms, Dr. Ladd,” Davie said. “We must get all but the worst wounded outside. Every man here must be washed as clean as he would be on his wedding day. We must give them clean linen outfits to wear. We must get rid of this straw and set up hammocks. Straw on a hard floor is the worst thing in the world for a wound. A hammock lets a man rest easy and draws the flesh together. They must have wine three times a day and all the fresh food we can gather.”
Dr. Ladd hesitated. This advice contradicted everything American doctors had been doing. But their results had been so murderous, he was ready to change his mind.
“Dr. Ladd,” Kate said, “last night you told me you were so discouraged you were ready to give up medicine. Why not make this an experiment?”
“We cannot do worse than we have been doing,” Dr. Ladd said.
Such impromptu procedures may seem unbelievable in our more organized modern age. But the Revolution - especially the medical side of it - was a very disorganized war. Washington had to use all his slender manpower to maintain his fighting army. No one had much interest in or time for the medical department. Its record was so awful, I suspect the generals were inclined to stay as far away from it as possible. This explains why the Kemble Manor hospital was allowed to go its own unorthodox way.
Before the end of the day Jonathan Gifford’s efforts to raise food bore fruit, literally and figuratively. He had gone to the leader of the Quaker community in Shrewsbury and described the situation at the hospital. The Quakers responded with the generosity for which their sect was famous. They saw it as an opportunity to erase the stigma of disloyalty which violent Whigs like the Slocums had fastened on them. A procession of wagons came up the drive. Black Sam led it with a pipe of wine from Liberty Tavern. Behind them were loads of fresh apples and peaches and pears, dozens of loaves of freshly baked bread, a whole wagonload of hams, sides of freshly slaughtered beef.
Dr. Ladd could not believe it. “My God,” he said, “these fellows will eat better than the King of England.”
“And what is wrong with that?” Kate asked.
“It seems a waste on dying men.”
“They are not dying,” Kate said.
Dr. Ladd was only echoing the prevailing opinion in the American army. His attitude explained the strange passivity of the wounded men. For most of them the words “wound” and “hospital” were synonymous with death. It explained the low quality of the orderlies, the indifference of doctors like Lummes. Kate and Caroline and Dr. Davie fought this pessimism day and night. It was exhausting work. Sukey was their only assistant. When she collapsed from fatigue, Caroline recruited me. I went reluctantly and found myself working twelve to fourteen hours a day. No one else volunteered to help us. Everyone was too frightened by the stories of rampant death and disease in other army hospitals.
Kate did persuade the women of our neighborhood to cut up their silk and linen petticoats and sew them into shirts and pantaloons for the wounded men. Jonathan Gifford journeyed to Little Egg Harbor and bought three hundred hammocks from a warehouse in that busy privateering port. By the end of the week the stinking straw was gone, half the men were wearing light silk or linen pantaloons and jackets and the other half at least had bad their filthy clothes washed along with their even dirtier skins. This was exhausting work in the savage heat of midsummer. Think about washing two hundred and eighty men, two hundred of them too weak to help themselves. Their wounds had to be examined and dressed. The orderlies refused to do any washing. They said it was damn nonsense. Dr. Ladd was totally ineffectual when it came to giving them commands. Sukey and I took turns working with Dr. Ladd in the kitchen while Kate and Caroline worked with Dr. Davie in the dining room.
Dr. Davie was in his sixties. He was semiretired when the war began and was not used to such extreme exertion. On Saturday night he looked desperately weary as he finished examining the last patient on our muster roll.
“You must go home this instant,” Kate said. “And stay in bed all day tomorrow.”
“What about yourself?” he said. “I don’t like your looks any more than you like mine.”
He was right. Kate was staggering with exhaustion. She had been working all day and sitting up half the night with some of the most seriously wounded, trying to ease their pain, giving them water and wine whenever they wanted it, talking to them, trying to strengthen their tenuous grip on life.
“I am not sixty years old,”. Kate said.
“I think I will rest like the Lord Jehovah on the seventh day,” Dr. Davie said, putting on his coat and walking heavily to his chaise. “On Monday we can begin to practice some medicine. The first thing we must do is replace all those damn rag bandages with lint, good clean lint. Nothing better speeds the digestion of a wound - ”
Kate walked with him to his carriage. He climbed into it with the gasping effort of a man mounting a steep ladder or an almost perpendicular hill.
A half-hour later, Jonathan Gifford was sitting in the taproom at Liberty Tavern listening to Daniel Slocum telling everybody that the war was as good as over. In a week or two at most, the French fleet would help the Americans capture New York and destroy the British army. A shout of alarm from Black Sam drew the Captain and others into the yard. They found Sam standing beside Dr. Davie’s chaise, gently shaking him.
“He’s in a powerful sleep, Captain Gifford. I can’t wake him up.”
“Get Lieutenant Rawdon from the house,” Jonathan Gifford said. “He knows something about medicine.”
Rawdon came on the run. They carried Dr. Davie into the taproom and Rawdon felt his wildly fluttering pulse, noted the twitching of Davie’s right hand and cheek, and diagnosed apoplexy. He forced some wine down his throat and helped carry him up to his bed.
“Is there anything you can do?” Jonathan Gifford asked, as Molly and Barney McGovern tried to make Davie comfortable. “We might do a number of things,” Rawdon said. “Some people recommend blowing sneezing powders up the nose or tobacco smoke down the throat from an inverted pipe, clysters up the rectum, taking twelve ounces of blood from the arm and eight from the jugular. I think they are all forms of torture. That is why I quit medicine, Captain Gifford. I prefer to let nature heal in her own way.”
“Rawdon!” Davie called. He managed to open one eye. His voice was thick, his breathing ratchety. “Rawdon,” he said, “you must go down there to the hospital and help those lads. They need a real doctor. You must make the ladies - Kate - rest - or - ”
“Kate? What is wrong with Kate?”
“Go - go. Don’t argue with a dying man.”
“You are not dying,” said Rawdon. “This is a second-degree apoplexy. You will have some palsy as a result of it, But you’ll be back to work in a month.”
“If you’re right - you can expect a horsewhipping in that time if you don’t - go.”
“I will go - for only one reason. To prevent the flow of extravagated blood to the base of your brain.”
In medical terms Rawdon was telling Davie he was in danger of having apoplexy of the third degree if he did not keep quiet. He strode out of the room. “I knew it,” Davie muttered. “I knew it from things the fellow said to me after he was shot. He’s a better doctor than I am.”
Thomas Rawdon rode down to Kemble Manor through the moonless darkness of that night, his mind a bitter blank. He was still furious with Kate for the accusation she had flung at him in the rose garden. With that objectivity which was one of the most unexpected aspects of his character, he admitted she had told him the truth. He had carried that rose mallow back to his room and left it on his night table. More than once he picked it up and watched it die. The green stem withered, the petals drooped and crumbled. He was doing the same thing, he told himself. Those violent words had ripped up his fragile roots. This time he would not bother to ask Jonathan Gifford for a gun. He would steal one of the dueling pistols from behind the bar. In the center of the rose garden he would blow out his brains. They would find the n
ote in his pocket, accusing her of his murder. Werther and his sell-pitying sorrows had wandered to America.
This was still Lieutenant Rawdon’s frame of mind when he arrived at Kemble Manor. It was after midnight. A single candle glowed on the hall table. Although the worst odors had been banished, the house was still permeated by the presence of two hundred and eighty sweating men. I encountered him as I came out of the kitchen with some fresh wine. “Where is Kate, Jemmy?” he asked.
I pointed to the south parlor.
He took the wine from me and entered the parlor. The room was full of restless, groaning men. The only illumination was two candles in sconces on the wall. In this flickering light he could see Kate, standing beside a hammock, dipping a cloth in a bowl of water and patting it on a man’s forehead. Lieutenant Rawdon also saw a number of less visible things.
This woman had the weight of the world’s suffering on her weary face. But she bore it gladly, almost proudly because she was not simply enduring it. She was fighting it, fighting the suffering he had fled the teaching hospitals of Edinburgh to avoid. For the first time he faced the inner pattern of his life. He saw why he had refused to accept this gift of healing which his teachers in Edinburgh had assured him that he possessed in the highest degree. The bitterness that had swelled cancer-like inside him for so many years burst at the thought. The arrogance of God or Fate or whatever it was controlling our little destinies to inflict this gift on him after all those arid loveless years of growing up with disapproving relatives and those dry, moralizing letters from the man who signed himself Father. He would show them all, father, aunts, uncles, God, by doing nothing whatsoever with this gift. That had been the real uprooting, the beginning of his romance with death. The drift into the stupid game of first infuriating then pleasing Father. Accepting a commission to fight in a war he despised.
Yet here was this girl with no special gift except her beauty, something that a man dying of bitterness might justly expect as consolation, like Father’s inheritance, here was this girl who had had a monster for a mother, had fallen in love with the wrong man, been abused brutally by her own people, here she was, ravaged by exhaustion, giving herself, her sympathy, her presence to that suffering man in the hammock. The girl had become a woman, a woman with the strength to do this incredible thing. How could he explain it?
Standing there in that fetid room with the sounds of suffering beating against him, Thomas Rawdon did not know the whole answer. More important for him at that moment was what he saw large. This woman’s sympathy, caring, tenderness while he had nothing but his posturing bitterness. She had discovered a fundamental secret, the multiplication of love - while he had learned nothing but subtraction, the amputation of the roots of life.
In that same searing moment Thomas Rawdon glimpsed the possibility of not merely understanding but sharing this new love - new for him at least - that he recognized on Kate’s face. Something he had not experienced for so long he had forgotten the name stirred in his soul - hope, personal hope, without the usual echo of self-mocking laughter. He walked down the lane of hammocks to Kate’s side.
“Allow me,” he said.
She was amazed but almost too tired to show it.
“What are you doing here?” she said leadenly as he lifted the man’s head and placed the glass of wine to his lips.
“What are his symptoms?”
“He calls for water constantly. He seems to have a violent fever. I thought some wine - ”
“Get a candle from the wall and bring it over here.”
Kate obeyed. With the added light he noted the man’s eyes were yellowish and inflamed, his face bloated. He was breathing with difficulty. “Do you have a sharp pain in the back?” Rawdon asked.
The man nodded.
“I think it is spotted fever. We will know that for certain by tomorrow. By then it may be too late. We must move him out of this room. immediately. It is highly contagious.”
Fortunately the man only had a shoulder wound. He was able to walk. They took him into the manor’s empty carriage house, hung a hammock for him, and left him with enough wine and water to last until morning.
On the way back to the manor house, Rawdon told Kate about Dr. Davie. Kate wept from grief and weariness. “It’s my fault. I should have known he was too old - ”
“No. It’s my fault. If I had come when you asked me - ”
“No, that is my fault too,” Kate said. “I was too cruel in what I said. I could see how much it hurt you. I still have a terrible temper, Thomas. When I get in a passion I’m an ignorant foolish girl all over again.”
Rawdon shook his head. “You’re a woman. If you give me a chance, Kate, I will try to become a man to match you.”
FOR THE NEXT two months, Kate worked beside Thomas Rawdon seven days a week as he struggled with fevers, infections, ulcers, gangrene, and the constant indiscipline of the orderlies. The results they achieved soon converted Dr. Ladd and everyone who visited the hospital into disciples of Rawdon’s approach to medicine, with its stress on cleanliness, good food, affectionate care, and a minimum use of strong drugs. By the middle of the summer, two hundred wounded were on their way to full recovery. Thirty-six remained in doubt. Only forty-four had died. There was not another American army hospital that could match this record.
Kate deserved a major share of the credit for this achievement. Most of the responsibility for running the hospital on a day-to-day basis fell to her. As the summer advanced, Caroline became heavily involved in the Kemble Manor farm, the mill, and her Colt’s Neck property. A carper might say she spent inordinate amounts of time at Liberty Tavern discussing these matters with her business partner, Captain Gifford, but Kate was no carper. Besides, she was too busy buying food, helping Sukey supervise newly hired white and black servants in the kitchen, berating the orderlies, and helping me nurse the more serious cases.
The experience was a turning point in Kate’s life. It gave her a new sense of self-worth, a genuine self-confidence. At least as important was the change she saw in Thomas Rawdon. From a man absorbed in his own melancholy he became a doctor with a genuine passion to heal. Within a month she was convinced that it was no mere performance for her sake. No actor could feign the anguish she saw on his face when a patient died, or the compassion when a suffering man begged him for opium to ease his pain.
With Kate’s help he kept voluminous records on each patient. During hours when he should have been sleeping, he discussed these with a convalescent Dr. Davie, comparing standard diagnoses and prognoses with what he saw in the record, trying to learn the only way a good doctor learns, from experience, the Unflinching analysis of visible evidence.
Listening to these discussions, and daily becoming more adept at recognizing and grouping symptoms, Kate found herself fascinated by the mysteries and challenges of medicine. She began reading textbooks in Dr. Davie’s library and soon persuaded Rawdon to conduct little seminars on the front steps of Kemble Manor in the evening for herself, Dr. Ladd, and me.
Rawdon had a truly original mind and the courage to condemn stupidity and malpractice wherever he saw it. Above all, he rejected the standard, so-called heroic approach to treatment, with its reliance on bleeding and dangerous drugs. He was even more iconoclastic about current practice in childbirth and infant care, where mortality was shockingly high. On this subject, Kate had a hundred questions. Dr. Ladd and I had done most of the talking when Rawdon discussed the latest medical thinking about wounds, infections, fevers. But we could not match Kate’s hunger for knowledge about a branch of medicine which affected the health and happiness of almost every woman. She was intrigued to learn that British doctors were educating midwives. American doctors were trying to drive them out of business. Rawdon thought making better use of the midwives was sensible, because modesty made most pregnant women prefer to deal with a woman. Besides, intelligent midwives knew more about childbirth than the average doctor, whose knowledge of anatomy (female or male) was too often rudiment
ary.
By the time our seminars ended, I knew I wanted to be a doctor. So did Kate. Before long, I hope Americans shall see the end of the prejudice that bars women from a profession to which they are so naturally suited. But in 1778, a realistic woman - which was what Kate had become - knew she could never win acceptance from either the public or the medical profession. She realized that she would have to be satisfied with a participation in the art of healing, through her husband.
When the last wounded man left for the army in late October, our hospital closed. Kemble Manor became Caroline Skinner’s private home again. While the orderlies loaded the wagons and cleaned up the sickrooms, Kate and Rawdon walked in the park. The air was rich with Indian summer sunshine.
“What will you do now, Thomas?” Kate asked.
“Marry you,” he said.
“Oh? It is nice of you to tell me in advance. When is this great event to take place?”
“As soon as possible.”
“A British officer marrying one of the enemy? What will the King say?”
“Damn the King. I will resign my commission tomorrow. I will become a citizen of the United States and take over Davie’s practice. I will put my roots down here, Kate, with you.”
“And your father - your inheritance?”
“Damn them both. You are worth ten times more than a hundred thousand pounds to me, Kate.”
She took both his hands and raised them to her lips. “Thomas, I love you. I love these hands for the comfort they bring the sick. I want them to - to comfort me. You have had my heart from the day you first persuaded me to call you Thomas. But we must be realistic. As long as the war lasts, an ex-British officer cannot practice medicine here. People like Slocum will slander you as they are slandering Father. Worse.”
The Heart of Liberty Page 41