A Nurse's Courage

by Maggie Holt

Day became night: eight o’clock – ten – midnight. Mabel told Mrs Hiscock to go to bed and Teddy was also despatched to his attic room. The contractions had become weaker and Mabel encouraged Maud to sleep in snatches if she could. Such pauses in a long labour were said by some midwives – and Dr Swift, obviously – to be nature’s way of giving the mother a rest, but Mabel knew that without contractions the baby could not continue its journey; she also knew that if Mr Poole were here, he would be talking about sending the patient into hospital for a Caesar . . .

  She laid her head on the bed and dozed while Maud slept fitfully, stirring and moaning at intervals. Two o’clock – four – six. Then, as dawn was breaking over a grey wartime London, Maud started up in bed with a cry.

  ‘I got a feelin’ dahn there, gal, as if I wanted to ’ave a good turn-aht on the lav,’ she groaned. ’Elp me, Mabel, I don’t want to make a great stink!’

  Mabel rose at once. ‘Don’t worry, Maud, it’s not yer bowels, it’s the baby’s head pressin’ down. Come on, dear, put yer knees apart an’ let me see –’

  The cervix was indeed fully dilated, but to Mabel’s dismay the baby’s head was still high and its heartbeat was slowing. They were going to need help.

  Teddy was sent to fetch Dr Swift, and Mrs Hiscock came bustling up to say she had plenty of hot water on her kitchen range. The minutes ticked by to half past six – twenty to seven.

  Teddy returned to say that Dr Swift was out on another case, and that another GP had been telephoned and was on his way. Mabel’s heart plummeted.

  ‘’Ow much longer d’ye reckon, Mabel?’ asked Teddy, putting his head round the door.

  ‘Not long now, Ted, just waitin’ on the doctor.’

  He rolled up his eyes, glancing at Maud who lay exhausted on the bed, her face mottled, her eyes bloodshot. ‘I’m dyin’, ain’t I?’ she muttered. ‘Dyin’ wiv me poor baby not born.’

  Mabel bit on her knuckles as her courage faltered. Was Maud truly going to die with her child? Where the hell was that damned doctor?

  Help us, Lord. Help me to help her. In thy mercy send us help quickly, Lord.

  The doorbell rang again and Teddy went down to let in Norah McLoughlin, her nurse’s cloak wrapped round her against the chill wind. She came into the room, her blue eyes wide.

  ‘Mabel, darlin’, how’s she doin’?’

  ‘Norah! How did you get here?’

  ‘On me own two feet. I been tossin’ an’ turnin’ all night, then I sez to meself, for God’s sake get up an’ go to ’em, wumman! So I’ve left Mrs Lovell in charge o’ the Midway and here I am.’

  Mabel began to speak in a low, rapid tone, able to express her fears at last. ‘We’re goin’ to need help here, Norah. She’ll never push it out herself, an’ we’re waitin’ for some old relief doctor who should be here by now.’ Lowering her voice still further she added, ‘She thinks she’s goin’ to die.’

  ‘Ah, ye’re both tired out, God love ye.’

  Norah sat down beside Maud. ‘Listen, darlin’, ye’re not goin’ to die at all. Ye’ve got yer friends to look after ye and Holy Mary’s prayers to help ye. Hang on to me hand till the doctor comes.’

  The Irish girl’s fresh and hopeful presence was like a breath of cool air in the staleness of the room and, as Mabel felt her courage reviving, they heard the longed-for knock at the door. Mrs Hiscock flew down to let in the doctor who came up and entered the room, carrying his black Gladstone bag. And he was Dr Henry Knowles. Mabel could have wept with relief. He had aged since she had seen him last, though his delighted smile of recognition lit up his tired face.

  ‘Mabel Court! I couldn’t wish for a better nurse. And good morning, to you, my dear,’ he said to Maud, touching her forehead and feeling her pulse as he took in her condition.

  ‘Now, what have we here?’

  ‘My friend Maud Ling, first baby, cervix fully dilated at least two hours, no progress in second stage,’ replied Mabel at once. ‘An’ this is Sister McLoughlin, the one who’s engaged to me brother Albert. She’s come over to help.’

  He smiled and nodded. ‘Ah, yes, Maud Ling, of course I remember. Well, Maud, we’re all here to help deliver your baby. Now, I’ll just open my bag and get everything ready.’

  His findings agreed with Mabel’s and the atmosphere in the room became one of purposeful activity. He put on a rubber apron, donned rubber gloves and spread a towel over a tray provided by Mrs Hiscock. He sent her for a bowl of hot water and took out another towel containing his instruments.

  ‘First of all let’s turn her round so that she’s lying across the bed with her bottom right at the edge and her legs raised. Sister McLoughlin, will you take her left leg and Mrs – er – the right one, thank you. Let’s put this pail down on the floor and I’ll sit on this chair, facing her – so.’

  With a pillow under her head and her legs raised aloft, Maud had the curious sensation of reliving the night when this child had been conceived: when Alex had hoisted up her legs and pulled them over his shoulders. She could hear the doctor talking in a low voice to Mabel.

  ‘Stephen assures me that you’re capable of administering this, just while I do the necessary. The spray nozzle goes on the bottle like this, you see, and –’

  ‘Yes, yes, I know, doctor, I can do it,’ whispered Mabel. ‘And is there a pad or something?’

  ‘Yes, a square of cotton wool between muslin. Would you like me to start it?’

  ‘No, no, you get on with yer job, doctor, I can see to this.’

  She got on to the bed behind Maud. ‘Maudie, dear, I’m puttin’ this soft piece o’ muslin over yer nose an’ mouth like this, see, don’t worry, I’m here with yer, just keep on breathin’ in an’ out, in an’ out – ye’ll smell this stuff, don’t worry, just go on breathin’ in an’ out – good girl!’

  The light spray began to fall upon the pad, filling the room with its odour. Maud screwed her eyes tightly shut and put her trust in Mabel, resisting the urge to struggle. The vapour penetrated her air passages as she breathed in and out, and the sounds and voices faded away as she drifted into the merciful oblivion of chloroform.

  ‘All right, Mabel?’

  ‘Yes, Dr Knowles, she’s away.’

  He took scissors and made a long cut in the vaginal entrance at the back, extending it out to one side. Picking up one of the long-handled forceps blades, he passed it up beside the baby’s head; then he took the other blade and passed it up on the opposite side, so that the two blades closed together, clicking into position and forming a protective cage around the head.

  ‘Say a prayer for her and for me, Mabel,’ he said very quietly to his emergency anaesthetist.

  ‘May the Lord guide yer hands, Dr Knowles.’

  And then the pull. The pull and the pull and the pull and the pull. Mabel dropped her chloroform bottle and pad, to grip Maud under her shoulders to prevent her from being pulled right off the bed, while a horrified Mrs Hiscock and breathless Norah held on to the legs.

  ‘Coming now,’ gasped Knowles. ‘Coming, coming – chin, mouth, nose, eyes – ah!’ The head was born. Knowles dropped the forceps into the pail and guided the shoulders as they rotated. One arm was freed, then the other, and the rest of the body followed at once. A son was born to Maud Ling at twenty minutes past seven on Saturday morning, the thirtieth of March 1918. It was Mabel’s own twenty-fourth birthday.

  Knowles clamped and cut the umbilical cord, and handed the limp, bluish-white baby to Mabel. The expulsion of the afterbirth was followed by a great gush of blood.

  ‘You see to the infant, Mabel, I’ll deal with the mother.’

  They were faced with two dreaded, life-threatening emergencies: a flat, lifeless baby and a post-partum haemorrhage.

  Mabel judged the baby to be between seven and eight pounds. He had a livid purple weal over one side of his face from the forceps blade and his head was elongated by the pressure it had sustained on its long, slow journey. He was a pathetic sight. Mabel laid him on a towel
spread over the other side of the bed. She placed a thin rubber tube into his mouth and throat, sucking at the other end of it, to remove obstructive fluid and mucus. She blew upon his chest two or three times and felt for his heartbeat with a forefinger: she was not sure that it was there. Laying him flat on his back, she let his head fall back over her hand, extending his neck, and then put her open mouth right over his tiny nose and mouth. She blew gently into his lungs, once, twice, three times.

  She saw him give a gasp. His chest jerked. He gasped again, his nostrils flaring. He gave a weak grunt and then another. He jerked again, his little arms and legs flexing convulsively. He gave another grunt, bunching his tiny fists as if fighting; he arched his back, his chest heaved, and air was sucked in through his open mouth and nostrils. The blue skin turned to white and then to dusky pink. Mabel felt for his heartbeat again and there it was, pit-a-pat-pit-a-pit-pat-a, the beginning of a lifetime of beating. He lived and breathed!

  She looked up. Dr Knowles was concentrating his whole attention on arresting the bleeding. ‘Get her further back on to the bed,’ he told his two assistants. ‘And keep her legs raised.’

  He clenched his left hand into a fist and thrust it into the vagina. He put his right hand on the abdomen, compressing the slack womb between his hands for a full minute. When he withdrew his fist, a thin stream of blood trickled forth.

  ‘A pack, I’ll need a pack,’ he said. ‘Open my bag and take out the big roll of gauze and the packing forceps. Bring her legs down – slowly! – and keep them far enough apart for me to put in a pack.’

  Norah produced the pair of long, round-ended forceps that he used to push the whole length of gauze into the vagina, inch by inch, foot by foot, yard by yard until it was all used up.

  Maud stirred and a faint tinge of colour returned to her face as she uttered one word ‘Alex’.

  ‘Ye’ve got a little boy, Maud,’ whispered Mabel.

  ‘Alex,’ said the mother again.

  Knowles looked up, his face grey with the effort he had made. ‘How is he, Mabel?’

  ‘Alive an’ breathin’, Dr Knowles,’ and as if in confirmation a tiny, mewing cry was heard from the towel-wrapped bundle in her arms. She and Norah exchanged a look of mute thankfulness, and Mrs Hiscock blinked and sniffed.

  It was the landlady who saw the doctor sway and she grabbed hold of him, her stout arms round his waist; Norah helped her to heave him on to the bed beside his patient. His skin was pallid and sweating, and he scarcely appeared to be breathing. Norah felt for his pulse and for one unspeakable moment they thought he was dead. Norah quickly loosened his clothing, unbuttoned his shirt and put her hand on his chest. The heartbeat was there, but weak and rapid, and his breathing was shallow.

  ‘We need an ambulance,’ said Norah. ‘Can Teddy run down to the police station and ask them to telephone for one?’

  Teddy was called and sent out straight away on his errand. Mabel told him to ask for a police message to be sent to Dr Stephen Knowles at the East London Hospital.

  By midday the old doctor lay in the London Hospital in Whitechapel Road and Maud Ling, refused admission at the General Lying-In Hospital, was in Women’s II at the Booth Street Poor Law Infirmary. Baby Alexander Ling was installed in Sister McLoughlin’s own room at the Midway Babies’ Home and Mabel Court lay asleep at number 3 Deacon’s Walk; Matthew and Mark were warned by their mother not to disturb her on any account.

  It was five o’clock and Ruby Swayne crept into Mabel’s room. ‘Mabel – Mabel! I’m sorry to wake yer, but there’s a visitor for yer an’ I think ye’ll want to hear his news,’ she apologised as Mabel started up, her eyes unfocused.

  ‘Who? Who is it?’

  ‘It’s young Dr Knowles, yer know, the son. He’s been to see his father. I’ve put him in the front parlour.’

  ‘Oh. Oh, yes. I – I’d better see him.’ Mabel started to get out of bed. ‘Better put me uniform on – an’ Ruby, please stay in the parlour with us, will yer?’

  Stephen rose as the two women entered; Mabel sat down and Ruby stood rather awkwardly beside her.

  ‘Mabel, my dear – Miss Court – I’ve just come from seeing my father and I thought you’d like to know that he’s going to be all right.’

  ‘Thanks be to God.’ She closed her eyes briefly. Even after all that had happened in the last thirty-six hours, the sight of the man and the sound of his voice made her heart leap.

  ‘Yes, I think there’s every reason to hope that he’ll recover from this heart seizure and at least it means he’ll have to retire now. He’s been working much too hard for a man of nearly seventy.’ Stephen clasped his hands behind his back as he continued, ‘He sends you his – his love, and says he couldn’t have managed without you.’

  ‘And I was never so thankful to see anybody in my life as I was when he arrived this morning,’ she answered. ‘Maudie would’ve died with her child unborn, most likely, and if – oh, my God!’ She suddenly covered her face with her hands. ‘I thought we were goin’ to have three deaths in that room this mornin’!’

  Ruby put an arm round her shoulders as she relived the nightmare. ‘An’ then the General Lynn-In wouldn’t take Maud ’cause she was already delivered, so she had to go to Booth Street an’ hasn’t even got the baby with her – he’s at the Midway.’

  ‘Yes, and that’s all for the best,’ he said gently. ‘His mother won’t be able to care for him for some time. I’ve been to see her, too.’

  ‘Ye’ve seen Maud?’ She stared at him.

  ‘Yes, after seeing my father. I thought you’d want to know how she is and I’m afraid it’s not good news, Mabel. She’s running a high fever and there’s bound to be infection after all that internal handling. Now, I believe the baby has grandparents, Mabel, the father’s people. Can you tell me their name and where they – do they know?’

  Mabel was at once defensive. ‘No! They’re not to be told anything at all,’ she said, colouring. ‘She has nothin’ to do with ’em – and they’re nothin’ to do with her!’

  There was no mistaking her strength of feeling. Glancing at Ruby, Stephen attempted to calm her. ‘All right, my dear, don’t be upset, I wouldn’t do anything against your wishes. But we have to face facts, Mabel. If the girl should succumb – forgive me, but puerperal fever is a killer – the grandparents surely have a right – the child has a right to some sort of family life?’

  ‘No! Wait an’ see how Maud goes on, an’ when she’s well enough, she can be asked – an’ she won’t agree!’ retorted Mabel, refusing even to admit the possibility that Maud might yet die. ‘The baby’s in good hands with Sister McLoughlin, an’ he’s not to be taken away from her!’

  Knowles was somewhat taken aback. ‘Very well, Mabel. As I said, I’d never go against your wishes.’

  ‘It’s Maud’s wishes, not mine. And what about your baby, Dr Knowles?’ she asked suddenly. ‘I was pleased to hear from Nurse Marriner that she’s got some sort o’ family life!’

  He flushed. ‘Yes, Mabel, I’m deeply attached to Lily now that I’ve seen her and held her. She’ll be staying with her mother and grandparents until after the war, and then I hope to be a proper father to her.’ He glanced at Mrs Swayne again, and Mabel also turned and caught her eye with a look that said, stay.

  Knowles cleared his throat. ‘I’m more sorry than I can say that you left Shadwell.’

  ‘There’s no need to be, Dr Knowles. I’ve settled down very well in Kennington with Harry’s sister, and I was there for Maud and her baby. I have no regrets at all.’

  ‘How long do you intend to stay here?’ he enquired.

  ‘Like you at the East London, everythin’s got to wait till after the war. I’m takin’ Harry to Belhampton soon for a breath o’ country air, but I can’t leave London while Maud’s poorly.’

  She rose from the chair and smiled for the first time. ‘Thank yer for comin’ to tell me about Maud an’ yer father. I’m very glad he’s better and please remember me to him whe
n yer see him again.’

  She offered him her cool fingers to touch, and Ruby Swayne saw him out. When she returned, she reminded Mabel that they were invited to tea at Falcon Terrace.

  ‘Oh, Ruby, not tonight!’ Mabel groaned, putting her hand to her forehead. ‘All I want is to go back to bed with a cup o’ tea an’ a couple of aspirins. Me head’s killin’ me.’

  ‘But Mabel, Harry’s expectin’ yer! He’s got a present for yer birthday – yer hadn’t forgotten, had yer?’

  Stephen’s prediction of puerperal fever proved only too true. For two weeks Maud lay barely conscious in a screened-off corner of Women’s II, sweating and burning as the fulminating infection of her pelvis destroyed her fertility and came near to claiming her life. The organisms in her bloodstream carried the poisons to every part of her body, erupting in boils and septic spots. Her flesh wasted away, her bright hazel eyes sank deeply into their sockets and her hair fell out in handfuls. Mr Poole shook his head at her bedside and nobody expected her to live.

  ‘They said she’d had a baby,’ muttered one nurse to another as they changed her sheets and foul-smelling pads. ‘Some baby! Anybody can see she’s had an abortion an’ it’s gone septic.’

  And this was the opinion of the patients near to the corner bed. ‘No business to be in ’ere wiv ’er dirty diseases,’ they muttered. ‘Bloody disgrace, puttin’ ’er along o’ respectable wimmin.’

  Even Matron Brewer failed to recognise the vivacious music hall star who had entertained in this very ward more than two years earlier. However, the new Ward Sister of Women’s II, Ethel Davies, was alerted when she received enquiries about Miss Ling from her former colleague Nurse Court, the district nurse who had sent the girl in. She spoke to Maud’s young brother when he visited and mentioned her discovery to Matron.

  ‘Of course I remember the pantomime and Prince Charming,’ recalled Matron, ‘but surely this poor creature can’t possibly be –?’

  ‘She is the same one, Matron,’ insisted Sister Davies and from then on she took a special interest in this patient who clung so stubbornly to life. She fed her drinks of milk and the sweetened, slightly salted barley water which had proved beneficial when no other form of nourishment could be tolerated. Teddy began to look more hopeful, and reported on his sister’s progress to Mabel and Norah who could not visit such a highly infectious case.