by Peggy Savage
He came in, looking tired and drawn. ‘Any news?’ he said.
‘Not from the General Medical Council, Father,’ she said. ‘If that’s what you mean.’
She sat down on her mother’s old chair and watched her father as he raised his head and looked around the room, stopping here and there to look at little things that were precious to him – things that her mother had left behind. He paused at a china cherub that her mother had bought on their honeymoon, at a tapestry fire screen that her mother had worked herself, and then at her mother’s photograph placed carefully and alone on a side table. The room still had a Victorian air, too cluttered for Amy’s taste, but the taste had been her mother’s, and her father would never change it. It kept her alive for him. He had said so often, ‘She would have been so proud of you Amy. I wish so much that she could have seen you qualify.’
It seemed to be the right moment to tell him of her decision, if any moment was right. ‘Father,’ she said, ‘there’s one thing that we haven’t talked about – this terrible war. My problems hardly seem important, except that I could have helped so much more.’
His face became even more agonized. ‘I know,’ he said bitterly. ‘Half the boys in the sixth form have left and enlisted. Young Frensham says he’s going to join the Flying Corps. I can’t bear to think of them….’
She sat beside him again. ‘There’s something I want to tell you, Father.’ He raised his eyes to hers. ‘You must go on teaching, and you must keep this house safe because it’s our home and I shall want to come back to it whenever I can.’
He was quickly alert. He looked almost frightened, ‘What do you mean – to come back to? Where are you going?’
‘I’m going to France.’
He opened his mouth to protest, but she went on, ‘I’ve found out that there are a few British women surgeons going out to form surgical units. I’m going as a medical orderly.’
‘No,’ he said, ‘No, you can’t. It will be too dangerous. You are too young to…. You are too young. Why can’t you do it here in England?’
She got up and stood beside the window, looking out into the street. A young man walked by, wearing khaki. He was walking proudly, very straight. As he got closer and passed the house she saw how young he looked – just a boy.
‘Because,’ she said, ‘because the War Office in its wisdom has turned down the services of women surgeons. Can you believe that? They can’t have their soldiers’ lives saved by mere women, can they? Or perhaps they think we’d all have hysterics and run away. So the women are going to France to work for the French Red Cross.’ The young man walked out of sight. ‘And there are boys out there much younger than I am who are suffering and dying.’
She came back to sit beside him. He said nothing for a while, his face white and stricken.
‘How can you?’ he said eventually. ‘Won’t they know who you are?’
‘They won’t know my face. They’ll know my name, that’s all. So I’ll change it. I’ll use another name. The war is the only thing that anyone is thinking about. They won’t think about me.’
He was still now, resigned. She’s made up her mind, he thought. Nothing will change her when she’s made up her mind.
‘I don’t suppose that I can say anything that will stop you?’
‘No, Father. I’m sorry.’
‘What will I tell people? What shall I say?’
‘There’s no need to say anything. No need to tell anyone what’s happened. Just say that I’ve gone to France.’
‘And what name will you use?’
She smiled. ‘My mother’s maiden name, of course: I’ll be Amy Osborne.’
His eyes filled with tears. She’s going out to die, he thought. She’s going to go into danger, deliberately. He looked around the room again. He could see a young girl at the table by the window, sitting upright, her elbows on the table, her chin in her hand. Her quick eyes were on her book, studying, always studying the science that he taught her. And now it had come to this. His tears began to fall. Perhaps he had been wrong to so encourage her – such a quick, such a purposeful mind. But she was all he had. They spent so much of their time together. How could he not transfer to her his own passion for the growing, expanding, thrilling science that filled his own mind? I blame myself, he thought. I blame myself. He took out his handkerchief to wipe his face.
‘Father, don’t. I’ll be all right, really I will. I’ll be careful. You know me.’
‘Yes,’ he said, ‘I do know you.’ His look was clear: hopelessness and fear.
She knew what he was thinking. ‘You’re so wrong,’ she said. ‘I have every intention of coming through it, hale and hearty. I’ll be back, you’ll see. And Father’ – he seemed to be waiting for the next blow – ‘I’m going to get it back. I’m going to clear my name and get myself back on the Register without any marks against me. I don’t know how, but I’m going to do it.’
How was she going to do it? That night she lay in bed, restless and unsleeping. Was there anything that she could have done, anything that she could have said? She relived that last time over and over again.
She and the theatre sister spread the sterile sheets over the patient on the operating table. There was always some apprehension – taking out an inflamed appendix was not a procedure to be taken lightly. Opening the abdomen at all was a risk, but she had done the operation twice now, and both her patients had survived. She had been able to remove the appendix before it burst, spreading infection into the abdomen, causing peritonitis and almost inevitable death.
The theatre nurse switched on the big overhead light, the anaesthetist adjusted the cylinders on his machine, the young student who was to assist her took up his position across the table.
She knew when Sir William Bulford entered the theatre. She could tell by the change in the atmosphere, the straightening of backs, the slight intake of breaths. She could tell by the way her hair rose on the back of her neck, under her cap. He had every right to be there. As senior surgeon he could do what he wished, watch what he wished. It was his right, his privilege, his duty. The knowledge made a little bile rise in her throat. Out of the corner of her eye she saw him put on his gown and gloves. He came to stand beside her.
‘Good morning, Dr Richmond,’ he said.
She made no reply. She thrust out her elbow to spread the last sterile sheet and he moved away a little.
‘He’s asleep,’ the anaesthetist said. ‘You can start now.’
On the right side of the abdomen she located McBurney’s Point, the junction of the lower and middle third of a line from the anterior superior iliac spine to the umbilicus, under which she might expect to find the appendix. She held out her hand for sister to give her a scalpel, and it rested familiarly in her palm.
She took a breath, then she cut through the skin, clipping off and tying the bleeding points. Then through the muscles – the external oblique, the internal oblique, the transverse. She placed a retractor for the student to hold open the incision.
Beneath the muscles the peritoneum glistened whitely – the protective covering of the abdominal organs. Once through this the die was cast. She must find the appendix and remove it – remove it without damage, without allowing any of the killing pus to escape into the abdomen to cause peritonitis, septicaemia and death. It was infection that killed – infection about which they could do very little, once it had taken hold. These were the invisible murderers – the staphylococci and the streptococci and all the others. It all depended on the strength of the patient – and the skill of the surgeon.
She raised a small pinch of the peritoneum, careful not to pick up the bowel beneath, and then she cut through, opening the abdomen. She gave a small sigh of relief. There was no stench of corruption, just a faint smell not unlike fresh meat. The bowel lay exposed, and by good chance the appendix lay in full view, the swollen red infected tip clearly visible.
Now that she was inside the abdomen she must be quick and accurate. She could
not move away. With a sick feeling of expectation fulfilled she felt Sir William Bulford move beside her so that his thigh was against hers. She clipped off the base of the appendix.
‘That appears to be a fairly easy one,’ he said. He turned slightly, so that the front of his body was against her now, rubbing against her thigh.
She had to ignore him, to concentrate. She removed the appendix, dropping it into the dish that sister offered. She tied off the stump and buried it with a purse-string suture. She checked the rest of the abdomen and all seemed well. She made to take the threaded needle from Sister’s hand, but Bulford put out his hand and stopped her.
‘I’ll close up,’ he said.
She looked round at him. He was looking down at her, a look of bland innocence.
‘That’s not necessary,’ she began, but he took the suture from Sister.
‘You look tired,’ he said. ‘Perhaps you didn’t sleep well last night.’
She didn’t move.
‘There is no need to stay, Miss Richmond,’ he said. ‘I can manage without you. I should go and get some rest if I were you.’
It was an order – there was no doubt about that. She left the theatre, helplessly fuming, and went into the female changing-room. She took off her theatre clothes, putting on her skirt and blouse and lacing up her boots. Anger made her breathless. The man was appalling, brutish. His red, florid face and thick fingers filled her with the utmost repulsion.
She sat on a stool and leant against the wall. Perhaps he was a good surgeon, but she was no longer sure even about that. He was too set in his ways – too resistant to change. He made no secret of his violent opposition to women doctors, especially to women surgeons, but when she was appointed he had been narrowly over-ridden by the Board of Governors. He was clever, though, and ruthless. But even then she hadn’t imagined what he would do.
The next day her patient had a slight but worrying temperature. She arrived to find that Bulford had asked for the dressing to be taken down.
‘Miss Richmond,’ he said. ‘I see that you forgot to put in a drain yesterday. Surely you know how important that is. How else is any fluid or pus to escape?’
She opened her mouth in shock, but he forestalled her.
‘I cannot tolerate this,’ he said. ‘It isn’t the first time. If you are too busy gadding about at night to get your proper rest you shouldn’t be doing surgery.’
‘What on earth do you mean?’ she said. ‘You closed up this patient yourself. You made me leave the theatre.’
He frowned. ‘You really cannot try to make me responsible for your mistakes,’ he said. ‘I have had to put them right too often.’ He walked away from her and into Sister’s office, and she followed him.
She remembered her helpless fury. ‘That is a complete lie,’ she said. ‘How dare you say that in front of the patient and the nursing staff. You know it isn’t true. All my patients have recovered well – and without your help. As for gadding about! I usually spend my evenings studying – the latest methods, in case you haven’t heard of that.’ She shouldn’t have said that, she knew it now. It could only have made things worse. He was white with anger.
‘That’s all, Miss Richmond,’ he said. ‘That is quite enough.’
As she left the ward she passed Sister. She thought she saw a look of sympathy in Sister’s eyes, before she lowered them hurriedly and looked away.
She worked through the morning outpatient clinic and then she walked across the hospital grounds to the nurses’ home. She had been given a room there where she could stay when she was on duty at night. It was raining, and she pulled up the collar of her coat and bent her head, the rain dripping off her hat.
The nurses’ home was bleak – long corridors with the wall below the dado painted a dark yellowy green. It was nearly lunchtime and the smell of boiled cabbage hung about everywhere.
Her room was in the section reserved for the senior sisters. It was hardly comfortable. It was sparsely furnished – linoleum on the floor, a bed, a chest of drawers, a small wardrobe and a washbasin in the corner.
She took off her hat and coat and hung up her coat to dry. She sat down on the bed, staring at the opposite wall. What was she to do? She could leave the hospital and try to get a post somewhere else. That would mean asking Bulford for a reference, and what would he say? With a feeling of sick despair she knew what he would say, or she could guess. His approaches to her were becoming bolder, more frequent. At first she thought it was accidental, an unavoidable aspect of their work – the standing close to her, the innocent seeming touches that no one else would notice. Now his behaviour was unmistakable. On the occasions when they were alone, perhaps in Sister’s office or the theatre office, he would stare at her, looking her up and down, his eyes bulging and lustful, like an animal. Once he had put his hand on her shoulder, his thumb straying to the top of her breast, and she had shrugged him off and backed away. Oh yes, she knew what he would say.
She got up and took a glass of water and stared out of the window. She could see the nurses walking across the quadrangle, their cloaks huddled round them. Carriages and occasional motor cars arrived at the hospital doors. Ambulances brought patients on stretchers, the porters hurrying out to meet them. This was her life.
She rested her forehead against the window. She could leave the hospital without a reference, but where would that get her? She could go to some other town, put up her plate outside the door and hope for the best. The thought filled her with despair. That wasn’t what she wanted, what she had trained for.
She drew back a little, and saw her reflection in the glass, her drawn, slender face, hair in the severe chignon. That was it, wasn’t it? In the eyes of some men, that was her original sin. She was a woman. And that made her incapable of rational thought, fit only to run a house and bear children. Even some women were against women doctors. Even female voices were raised against them. So much for the sisterhood.
Shockingly, horribly, she did not have to decide what to do. Bulford had arranged her life for her. Someone had knocked on her door and told her that Sir William wished to see her in his office. He began at once.
‘I can no longer tolerate your behaviour, Miss Richmond.’
She tried to speak calmly. ‘What do you mean? I have done nothing wrong. It is your behaviour that is intolerable.’
‘Really?’ He smiled at her – a frightening smile. ‘And how many people do you think would support you in that? The students? The nursing staff? I think not.’
She stared at him, wordless, knowing that he had the better of her.
‘I am putting you on suspension,’ he said. ‘And I am going to make a report to the General Medical Council. I shall make it clear that I do not think that you are fit to practise medicine.’
‘You can’t do that,’ she said, appalled. ‘You can’t do that to me.’
He smiled again. ‘Oh, yes, I can.’
The rest was a blur. Days and weeks of waiting, of fear, of almost unbearable rage, of tears, of her father’s distress. And now this – this nothingness, these endless days and sleepless nights.
She lay in her bed and stared into the dark. Her own problems were nothing now. Out there, outside her horrors and troubles there was a war, so savage that the world was already reeling in shock and horror. ‘I’m coming,’ she said to herself, aloud, in the dark. ‘I’m coming. I’ll do what I can – whatever it is.’ Knowing that she could have done so much more was a pain that was hardly bearable.
CHAPTER TWO
1914
TWO weeks later she and her father were standing on a platform at Victoria Station. The platform was crowded and the noise frightful – shouting voices, pounding feet, slamming doors. Even the pigeons had retreated up into the roof. She could see them flying, agitated, up above.
Streams of men in khaki, kitbags on their shoulders, struggled up and down the platform. Corporals with lists shouted orders and the men threw their kitbags into the carriages and followed them,
leaning out of the doors and windows, cigarettes hanging out of the corners of their mouths. Many of them stared at the group of women in uniform and one rosy-cheeked boy gave Amy a cheeky wink. A packed troop train left the station in a clanking of wheels and a cloud of steam, the men shouting and cheering. The station smelt of burning coal and oil and the sharp, acrid smell of new uniforms and new boots.
Amy’s father stood straight and calm, but his face was as white as the newspaper under his arm. He gave a strained smile.
‘You all look splendid, Amy. Very smart and efficient.’
Amy smiled back, trying to hide her own apprehension and keep up the sense of excitement and purpose. The news was too dreadful for words, so many casualties already, so many dead. The men on the trains didn’t seem to be worried, laughing and larking about, but here and there she saw a strained white face and anxious, haunted eyes. Many of them looked little more than schoolboys.
The group of women stood loosely together, friends and relations gathered about them. They were all wearing the uniform of the group that the doctors had called The Women’s Surgical Group. The station master had made a special concession for them and allowed their friends on to the platform to see them off.
‘I’m so glad you’re here, Father.’ Amy squeezed his arm. Quite apart from the comfort of his being there, it meant that she didn’t have to circulate or talk much to anyone else. And thank God for the uniform, she thought. It was a sensible colour, mid-grey. The skirt was short, just above the ankle, not like the fashionable hobble skirts that she thought were so ridiculous. The jacket buttoned up over a blue shirt and tie and the small hat had a little veil at the back to cover the hair.
She glanced across at the group of doctors. They wore the same uniform; they had designed it themselves. The same dress, but that was where it ended. They would be doing the surgery, while she? She felt bereft, as if the whole purpose of her life had been taken away from her, and sick that she had to hide her identity, pretending that she knew nothing. She didn’t know what she would be doing; washing the wounded, probably, feeding, changing beds. If she was lucky she might be promoted to changing dressings.