A Nurse's Courage

by Maggie Holt

  And Albert was back at sea, having spent most of the daylight hours of his leave at the Midway Babies’ Home where he had played with the older children, and charmed Mrs Lovell and the other members of staff. Norah had been grateful for every moment spent with him and had not cried when they had to say goodbye again; she had held him close and assured him that he was in the care of the Sacred Heart of Jesus. Privately she reproached herself that he had seen so little of his sister.

  As always, it was her work that provided Mabel with a safety valve, though her transfer to Heckford Ward the following week introduced her to some of the saddest cases in the hospital. It contained mainly medical conditions and had a high mortality rate. The East London was in the forefront of research into ‘marasmus’, a blanket term to describe a variety of little-understood wasting diseases, mysterious intolerances of the digestive system, and even when a cause was discovered, as in diabetes, the cure was not necessarily forthcoming straight away. Most of Mabel’s time seemed to be taken up with feeding and replacement of body fluid in a last-ditch attempt to halt the muscle wasting, but all too often her final task was to wrap the pathetic skeletal bodies into tiny white shrouds, which then had to be stitched and labelled for the mortuary.

  ‘It was for children dying of cholera that Dr Nathaniel Heckford founded this hospital, Nurse Court,’ said the middle-aged Sister, traditionally called Sister Heckford, after the Ward in her care. ‘He began it in an old warehouse at Ratcliff Cross, just a dispensary for women and children, and he never lived to see the building we have here today. We like to think that we’re still carrying on his tradition of caring – towards recovery if possible, but if not, well – we’re here beside them to the end.’

  Sadly, the war had brought about many cuts and curtailments to the work of the East London. The glass-fronted summer house known as the Pavilion at the back of the hospital building was closed for the summer months due to staff shortage, and its tubercular patients transferred to long-stay sanatoria.

  ‘It’s a pity we can’t use it for the bronchitics and asthmatics who need all the sunshine and fresh air they can get.’ Sister Heckford sighed. ‘But of course they’re not such a problem in the summer. You should see Heckford in the winter, Nurse Court, with fish kettles going full blast and steam tents all down one wall! And of course the fires in the wards cause a lot of dust. But this warm weather brings enteric fevers and gastroenteritis, like poor little Annie Reeves in bed 4, getting weaker every day before our eyes. It makes us all feel so helpless.’

  And as Mabel gazed upon the pinched grey face and sunken eyes of the three-year-old girl, she could only pray for a miracle.

  On the whole she got on well with the other ward staff, though there was a section of the medical students and probationers who joked about her constant preoccupation with replacements of body fluids in sick children. ‘Never miss a chance to give a drink to a dehydrated child. As soon as they wake up from sleep, when ye’re makin’ their bed, or if they want the potty – any time is drinky-time! And don’t just put the feeding cup by the bedside – make ’em drink it!’

  ‘I can’t get little Annie Reeves to take anything, no matter how much I try,’ said a third-year helplessly. ‘She doesn’t respond at all, poor little thing.’

  At that moment Dr Lamarr, the senior house physician, appeared on the ward, accompanied by two medical students. He nodded briefly to the staff nurse, and turned down the corners of his mouth at the sight of Annie, prostrate and semi-conscious in her cot. ‘Hm – what have we here?’ he asked.

  The question was directed at the students, but Mabel did not realise this and answered promptly. ‘She was brought in with enteritis, Dr Lamarr, and everythin’ goes in one end an’ out the other,’ she said, handing him the cardboard folder with Annie’s details. The students exchanged a look.

  ‘Have you tried a slow rectal infusion of saline?’ asked Lamarr.

  ‘No good givin’ rectal saline or anythin’ else while she’s passin’ these liquid stools, doctor,’ Mabel said somewhat impatiently. ‘Better try subcutaneous Ringer’s solution.’

  ‘Hm-mm, I suppose so, then.’ The doctor’s tone was not hopeful.

  ‘D’ye want to give it, or one o’ the students – or shall I?’ asked Mabel, who had already prepared a large sterilised syringe containing two ounces of the special preparation of saline and glucose. When Lamarr did not answer, she proceeded to clean the skin of Annie’s right armpit, then carefully injected three or four drachms. A swelling appeared beneath the site, and Mabel withdrew the needle and gently massaged the area. The swelling disappeared fairly quickly as the fluid dispersed, and the procedure was repeated into the left armpit while doctor and students looked on.

  Lamarr proceeded with the ward round, and on returning to Annie the effect of the injection of fluid was noticeable. She stirred and whimpered.

  ‘All right, Annie dear, Mabel’s here – have a nice little drink, there’s a good girlie.’ The spout of the feeding cup was put to Annie’s dry lips and she sucked a few drops from it.

  ‘Right, well – it seems to have done the trick for the time being, anyway. I hope you’ll remember what you’ve seen and learn from it,’ Lamarr said to the students as they turned to leave the ward. ‘It’s a relatively simple procedure that a trained nurse can do, as you saw.’ The truth was that Lamarr disliked giving fluid by direct subcutaneous injection and, if the site should become infected, he did not care to take the responsibility for it. The staff nurse with the jarring voice had obviously wanted to show off her skill and in any case the child was not much longer for this world.

  ‘Hasn’t he got the most gorgeous dark eyes!’ whispered the third-year as he left.

  June came in with sunshine and clear skies; the windows of the East London were opened to their fullest extent and cots were taken out into the courtyard at the back of the main building, behind the closed Pavilion.

  Two important items of news arrived one Monday morning. First there was a letter from Aunt Nell and Mabel put it beside her place to read during the first sitting of dinner, for surely it must contain news of Alice, now two or three weeks past the true expected date for her baby’s birth. As Mabel was about to rip it open she became aware of a group of nurses at the table next to hers exchanging the latest hospital gossip.

  ‘I say, have you heard the news?’

  ‘No, what about?’

  ‘Guess who’s come back on surgery and anaesthetics, starting from today, looking ten years older and walking with a stick!’

  ‘Go on, tell us!’

  But Mabel knew at once and her heart gave a sudden lurch. Stephen Knowles’s army service might be ended, but he had lost no time in returning to the place and the work he loved, and where he was so sorely needed. Mabel thought quickly: if he was back on surgery, she would not be likely to see much of him on Heckford Ward. And his wife would be between five and six months by now, and presumably had not miscarried this time, which must be a great relief to them both, she thought. And wondered why her hands shook as she opened her letter.

  It drove all other thoughts from her mind for the time being, for she had become an aunt.

  ‘My dear Mabel,’ wrote Mrs Somerton.

  Prepare for a happy shock! I know that you will rejoice to know that your sister Alice was safely delivered of a son in the early hours of this morning, Saturday, the second of June. She went into labour on Thursday, but her pains were not recognised as such by the midwife who said it was far too early and must be indigestion. So poor Alice lay in pain all Thursday night and on Friday the midwife had to admit that the birth was soon to take place, and sent for the Westhouses’ doctor. After a long and very painful ordeal she was delivered this morning, and little Geoffrey weighs six and a half pounds. The midwife says he would have been eight pounds at least if Alice had gone the full time, so I suppose we must be thankful that the birth was several weeks premature, not being due until the end of July. Their vicar was called to christen h
im at midday because of this.

  Both mother and child are doing as well as can be expected, though poor Alice is exhausted after such a long labour, and I understand that little Geoffrey is rather slow to suck. The midwife says this is quite usual in premature babies, and has been giving him a little boiled milk and water in a bottle to tide him over until Alice’s milk comes in. Thomas and I are so relieved, and of course the Westhouses are overjoyed to be grandparents, though it was a shock! And Daisy, like you, is an aunt. Geoffrey is a sweet baby with blue eyes and fluffy fair down all over his dear little head. I hope it will not be too long before you can visit us again, Mabel, and see your nephew for yourself.

  Mabel set the letter aside and offered up a silent prayer of thanks that the ordeal was over and that the baby was relatively small. He would go through life never knowing that he was the only issue of the last baron of Houghton Hall – and Alice, who had pulled off her daring deception, aided by Nature, must be feeling the greatest relief of all. Mabel noticed that her aunt had said nothing at all about Gerald, the new father. What were his thoughts about the baby?

  Mabel was at the office desk when the surgeon limped into the ward the following afternoon.

  ‘Good afternoon, staff nurse. I’ve been asked to see a boy brought in on Monday – oh, good heavens, Mabel Court! My dear girl, how are you?’

  ‘Oh, er – good afternoon, Dr Knowles.’ Mabel rose hurriedly to her feet. ‘Very pleased to see yer after yer – er –’ She faltered, shocked at his appearance, so much aged since she had last seen him at Christmas; his hair had turned completely grey. ‘Oh – d’ye need a chair?’

  She brought forward the chair she had been using and he winced as he lowered himself on to it, placing his walking stick across his lap. ‘Trouble is, Mabel, it hurts my thigh when I stand up and still hurts my backside to sit down. A right pain in the arse, you could say, begging your pardon.’

  ‘Let me fetch yer a cushion –’

  ‘I can’t tell how glad I am to see you, Mabel. I heard about Harry and what happened at the theatre – these stories get around and I was very sorry. How’s the dear chap doing now?’

  Mabel had no sooner begun to speak than Sister Heckford bustled in and claimed his full attention, having known him before the war. She took him to see a boy with a high fever and swollen glands of the neck, possibly tubercular, in which case he would need surgery for their removal. Mabel got on with her observation round, taking pulses and giving drinks, but before Knowles left the ward he sought her out and spoke briefly to her again.

  ‘There’s a lot I want to ask you, Mabel. When are you next off in the evening? I’m not driving yet, and still a bit creaky on the left leg, but we could go down to the Prospect of Whitby and share a glass by the river if that’s all right for you. Thursday any good?’

  She nodded, and saw Sister’s eyebrows shoot up.

  On Heckford Ward there was also cause for rejoicing, marked by the grateful tears of little Annie Reeves’s parents. Against all the odds the child had recovered from a severe attack of gastroenteritis and Dr Lupton, the consultant physician, was fulsome in his praise of Dr Lamarr and the Ward Sister, though the latter quickly pointed out that her junior staff nurse had spent literally hours giving fluids by subcutaneous injection and by mouth, so preserving Annie’s life over the crucial days of the acute infection. Dr Lupton then asked Nurse Court personally about her impressions of Annie’s progress and recovery.

  ‘D’ye know, I began to think that it might clear up, sir, by the smell o’ them stools!’ she told him with a confident air. ‘It wasn’t yer usual marasmus smell, nor cholera, it was more like as if she’d ate somethin’ that’d gone off an’ given her food poisonin’. And another thing – she had that acidy smell on her breath that they get when they’re short o’ fluid, d’ye know what I mean? Yer can tell a lot from usin’ yer nose!’

  The physician listened and nodded politely as her eager, unselfconscious words carried down the ward to the group of medical students accompanying the great man on his round. It was impossible for them to keep straight faces.

  ‘Good enough for our concert party!’ murmured one young man with a mischievous look.

  ‘You could write a song for us, Thompson, and Tim and I could fit it to music,’ said another amidst suppressed laughter. ‘What about something from Chu Chin Chow?’

  ‘Yes! “Any Time’s Drinky-time”!’

  ‘Ssh! Here comes Sir – straighten your tie and shut up.’

  ‘Ah, there you are, Mabel! What a pretty dress, just right for an evening like this.’

  Stephen took her arm, leaning on her slightly, holding his stick in his left hand. And of course that made her think of Harry.

  ‘Now, you must tell me all about what’s been happening,’ he said, smiling, ‘especially about Harry and that rapscallion Albert.’

  ‘Me two favourite subjects, Dr Stephen! Well, Albert leads a charmed life, thanks to Norah McLoughlin’s prayers to the Sacred Heart, or so she says – did yer know she’s at the Midway Babies’ Home now, and don’t yer dare say a word against Mrs Spearmann, ’cause what she’s done for those dear children is nothin’ short o’ miraculous!’

  ‘I wouldn’t dream of contradicting anything you say, Mabel Court. Just go on talking to me.’

  And so she chattered away happily as they walked down Glamis Road, past the old fish market on the opposite side to the hospital, and on reaching the Highway they crossed the bridge to Wapping with its wharves and warehouses. Work was almost over for the day, but a group of dockers were still unloading the diminished cargoes of tea, sugar, tobacco and other commodities that had evaded the German U-boats; an exotic mixture of smells wafted to them on the slight breeze from the water. The river was full of small craft, the barges and lighters that nipped in and out among the larger vessels unable to pull into the shallows. A few gulls wheeled round above them in the clear sky.

  She suddenly fell silent and he saw her gazing downriver.

  ‘I don’t suppose Albert’s leave was very long,’ he said quietly, and she shook her head.

  ‘Just Thursday to Monday, while the Galway Castle was being refitted. Oh, it isn’t that I begrudge one minute o’ the time he spent with darlin’ Norah, but – I miss him too, y’see.’

  ‘I know, my dear, and I’m so sorry. Come on, here’s the Prospect of Whitby. Let’s go in and sample the casks!’

  It was still early evening, before the rougher element had arrived, the dockers and watermen. Babies sat in battered prams outside the door and bare-footed, gap-toothed children waited at the kerbside, sharing a few chips or eating a slice of bread smeared with jam.

  Stephen nudged her. ‘See those little girls with nothing on their bottoms?’

  ‘Saves the washing,’ she promptly replied. He smiled to himself. Always practical, this girl.

  The sun-browned faces of the children looked up at the couple and a small boy suddenly grinned and called out, ‘’Allo, Nurse Cork!’

  She recognised him as an outpatient who had come for daily treatment of impetigo and sore eyes back in her early days at the hospital, and she was touched that he still remembered her. The sight of these cheeky, ragged urchins in all their dirt and poverty stirred something deep within Mabel and a tender, reminiscent smile played about her mouth.

  ‘Harry and me always said that one day we’d run a children’s shelter for the Salvation Army,’ she told him, clasping her hands together. ‘Oh, how I used to hope and plan and dream about what it’d be like, and the things we’d do for ’em!’

  How lovely she looks, the poor darling, he thought involuntarily, and immediately frowned at himself. ‘Come on, let’s go in and sit in the back parlour.’ He took her arm, at the same time fumbling in his pocket for a cigarette.

  After the daylight the smoke-stained old inn seemed very dark. Its small round windows were not designed to let in much light, and the flagstoned floors and cast-iron hearths, now empty, gave a sense of its murky pa
st merging with the present troubled times, as if to remind them that this war too would become history. Settled by the window overlooking the waterfront, Mabel poured out her heart to this man; tears welled up when she spoke of Harry Drover and Knowles produced a large handkerchief, which he handed to her in silence.

  She told him that she no longer had any expectations of Harry’s recovery.

  ‘I clung to those hopes for so long, Stephen. There was a time when he seemed to be comin’ back to the land o’ the livin’, but now I don’t think he even wants to.’

  ‘Because the real world has been too cruel for him to cope with, Mabel. That’s why he’s turned his back on it.’

  ‘He just wanders in a world of his own, dreamin’ about –’ She hesitated, for this was very private territory, shared by no one else, not even Norah or Maud.

  ‘Can he talk with you, Mabel?’

  ‘No, he stammers so badly, I do most o’ the talkin’. He loves me to sit beside him – close, so’s he can – touch me.’

  Stephen drew on his cigarette and exhaled deeply. ‘Ah, yes. Oh, God, poor Harry. And you don’t mind, Mabel?’

  She raised her eyes to his and looked straight at him. ‘O’ course I don’t mind! Harry and me loved each other as soon as we met, all them years ago when I was sixteen. We’ve waited an’ waited, our marriage plans’ve been put off again and again, and it breaks me heart to see him like this –’ Her words ended on a stifled sob. ‘It’s all very well for you, Stephen, ye’ve got yer wife an’ soon ye’ll have a child – that’s somethin’ Harry an’ me’ll never have!’

  She wept afresh, stifling the sound with the handkerchief.

  He leaned towards her, putting a hand lightly on her shoulder. ‘Oh, Mabel, Mabel! My dear girl. You’re right, of course, and I don’t blame you for saying so, but it isn’t as easy as it may appear. I blame myself for what happened at Christmas – should have kept off the drink, it was damned irresponsible. I could have been knocked off in France and she’d have been landed with a fatherless child.’