Had She But Known

by MacLeod, Charlotte;

  It is something of a stunner to realize that in this well-equipped, well-managed city hospital, Miss Wright and the assistant supervisor were the only two bona fide registered nurses. Out of the thirty on the wards, twenty-nine were still enrolled in the recently instituted training program. Their graduation would raise the number of fully accredited nurses in the entire United States of America to 500.

  Thus Mary Roberts, the youngest in her class, was in the vanguard of a movement that had already begun to change the entire concept of medical patient care. She probably wasn’t thinking much about that, her main concern would have been how to budget her new salary. No charge was made for tuition and lessons were given in the evenings, after the student had put in her ten hours on the wards.

  As a probationer, Mary had received only her room and board. Having been officially accepted as a student nurse, she was entitled to a monthly wage of eight dollars. Out of this, Nurse Roberts must furnish herself with official blue-and-white-striped hospital uniforms, white Eton collars, some of the white lawn neckties worn by both nurses and doctors, and heavy, wide-belted white aprons. By now she recognized the need to get sturdy material that would stand up to the ferocious hospital launderings. She must own a thermometer in a case, a pair of curved bandage scissors, and dressing forceps, as well as a little black chatelaine bag in which to hang these instruments from her apron belt. Smack on top of her head she must wear a cap the size of a muffin, made of stiff tulle that had to be pleated just so into a band. These caps were a dreadful nuisance to make, so Mary gladly paid one of the more experienced nurses fifteen cents to do the job for her.

  It was the rule for first-year students to gain experience by working successively in every part of the hospital, alternating day and night duty. Nurse Roberts was also now eligible to be called to the operating room at any time; she learned to keep her clothes laid out, ready to be donned in a hurry if the night watchman came thumping at the door. In time, she became a junior ward nurse, with a new probationer under her who cried a lot. During night duty, she might be in charge of two or even three wards all by herself, with the gas jets turned down to eerie blue points. Should an emergency arise, she must handle it as best she could. One night on the obstetric ward, Mary couldn’t get hold of an intern in time to deliver a baby so she delivered it all by herself, and managed just fine.

  There were lots of babies, some of them legitimate, some not. They all got the same care, as did their mothers. The hospital at that time was in the red-light district, so many of the female patients were prostitutes, inmates of the nearby bawdy houses. Most were ignorant and none too clean. A few had come from higher walks of life; one had taken morphine in a suicide attempt and had to be walked up and down for hours on end to save her life. Some had been slashed with knives or razors in jealous drunken brawls, more often they were being treated for venereal diseases. During her second year on the wards, Mary developed a coppery rash and feared the worst, but it turned out not to be syphilis. Whatever it was, it went away and Mary kept on working.

  One cold winter night a policeman came in crying, carrying in his arms a little newsboy terribly burned from a fire he’d lit trying to get warm. Another boy had lost his hand in a printing press, he begged Mary to save it. Still another had fallen under a train and had his whole arm and shoulder sliced off. He came out of the anesthetic singing “After the Ball Is Over” again and again and again. An old woman insisted on giving the young nurse a quarter for being so kind. Mary went out on her break and spent the quarter on oranges for her patient—oranges were one of the things the old lady was allowed on her diet. A man was brought in who’d been through a flywheel. Every bone in his body was broken, he seemed to be made of jelly. There was nothing the staff could do but give him opiates and hope for his sake that the end would come soon.

  Mary was in charge of the emergency ward the night six policemen carried in a man who had killed his wife with an ax, then cut his own throat so deeply that he was drawing what breath he could get through an exposed larynx. She wondered why they couldn’t just let him die.

  “You’ll have to save him to be hanged,” said the policeman.

  Once his neck was healed, the noose went around it and justice was served.

  Being a nurse was somewhat like being a Mother Confessor. Mary became accustomed to having patients grab her by the arm and pour out their troubles: tales of unfaithful husbands, of ungrateful children, of villainies and depravities beyond anything she could ever have dreamed. Despite the attempts of kind lady visitors to steer them on to the paths of righteousness, every single one of the prostitutes was planning to go back to her old job as soon as she got well. A few even tried to persuade Mary to go with them. She found herself having to be extremely selective in choosing topics for conversation when she went back to visit her family.

  Even though the Robertses lived only a thirty-minute trolley ride away from the hospital and Mary got her half-day every week, visits home didn’t happen often. Inevitably, the gulf was widening. Olive was entering her teens, totally involved with her school and her friends. Tom was seldom around, Cornelia didn’t even want to hear the word hospital. Mary tried to enter into the family gossip, but her mind kept drifting back to the new world of which she was now a part. The others sensed this and resented it. She wasn’t their little Mamie any longer, she’d broken out of the pattern.

  And she was too tired to care. Better to spend her free time right here at the hospital, catching up on a little of the sleep she’d lost during the past week, studying for her examinations or darning her stockings while she soaked her swollen feet. She saw her old friends’ names in the papers. They were going away to school or college, staying home and giving parties. Once Mary was invited, and went. She danced till three o’clock in the morning, got back to the hospital at four, was immediately tagged for an emergency in the operating room, and went from there to her regular daytime duty. Thirty-six hours without rest or sleep convinced Nurse Roberts that the old life was indeed a thing of the past.

  Mary lost her childhood habit of spinning romantic fantasies. She no longer had that recurrent dream of walking down the aisle all by herself in a magnificent wedding gown, with every eye on her and no bridegroom to clutter up the scenario. From now on, such dream castles as Mary might build would have full basements and modern plumbing. She was maturing, and she had come to realize that the real sins are those not of the flesh but of the spirit, that she was somehow akin to everyone whose life touched hers in any way. Henceforth, she would never be able to hate anybody.

  Despite the long shifts, the indifferent hospital food, her perennially sore feet, and her inability to sleep during the day while she was on night duty, Mary was managing well enough. There were only two things that really got to her. One was having the night watchman rouse her out of a sound sleep in the middle of the night to assist at an emergency in the operating room. The other was having to lay out a body.

  No matter at what hour of the day or night a patient died, the nurse who’d been on the case was expected to perform that final service. It meant going to the mortuary, a small room at the top of the building that could be reached only by the elevator and a short flight of stairs. In keeping with the Victorian emphasis on showing respect for the dead, the room had stained-glass windows. It held little else except a table in the center where the body would have been carried by male attendants and left for the nurse to cope with.

  This was not the ideal job for a young woman still in her teens, but Mary got stuck with it just like the rest. Usually the nurse in charge would be allowed a helper. The two women would try to make sure they had everything they needed with them, otherwise one would have to go off after the missing item, leaving her partner in that isolated mortuary with a stiffening corpse and a severe case of cold feet.

  The laying-out process consisted of washing the body, plugging all the orifices with wads of cotton, tying up the jaw with a strip of bandage, veiling the naked cadaver in a che
ap cotton hospital shroud, and raising the head enough to keep the blood from congesting the face. From then on, it was up to the undertaker. A nurse had no time to waste in grieving for a dead patient—there were too many live ones needing her back on the wards.

  Emergency duty at night was less spooky but potentially more harrowing. There was, to begin with, the agony of getting up, dressing in a rush, and hurrying to the operating room. No matter what the hour, Miss Wright would be there first, calm and in control as always. She would know which of the staff surgeons was operating and exactly what he would want in the way of solutions, catgut, needles, and other small particulars. Nurses would be flying around following her orders, filling the irrigators, getting the sterilizers working, adjusting the black rubber sheets and the buckets. The surgical intern would be laying out the instruments, the anesthetist would be hovering in the anteroom next to the blanket-covered cause of all the bustle. One or two outsiders would be hovering too, like as not. These would be the friends who’d brought in the patient, embarrassed and nervous about what might be going to happen.

  Sometimes, after everything had been got ready at top speed, the whole crew would have to stand around until the surgeon could get to the hospital, maybe by streetcar, maybe driving his own buggy at top speed, rattling into the courtyard with his horse in a foam. As a staff member, the doctor would collect no overtime for the job ahead of him. Nobody would call him a hero except possibly those few in the operating room who’d witnessed what skill, what strength, what courage he might have displayed in carrying out some remarkable feat of surgery.

  One night when Mary reported for duty she found that Dr. Stanley Marshall Rinehart would be operating. During her probation, she’d barely laid eyes on the man who was responsible for her being on the staff, but she’d had many an earful about him from the older nurses. S.M. was a good surgeon, everyone granted him that, but he was a hellion to work for. If the least little thing was not exactly the way he wanted it, he’d blow the roof off. Mary was in a swivet lest she trigger any fireworks, but she managed not to make a mistake and S.M. was so engrossed in his work that he didn’t even notice she was there.

  Later, during a daytime operation, Mary got a firsthand experience of the Rinehart temper. Another nurse had bungled the sponge count. This time S.M. had every right to wax wroth. Not keeping an accurate count of those sterile gauze pads used to clean the cavity during an operation opened the dread possibility that one might get left inside when the incision was sewn up. S.M.’s virtuoso performance that day sent the peccant nurse out of the operating room in a state of hysteria. Mary’s trusty subconscious took careful note of the incident for future reference.

  CHAPTER 8

  Love Among the Ruins

  Mary did have some notion of trying to put her hospital experiences on paper. A few times, after going off duty, she went back to her room, picked up a pencil, and wrote a sentence or two; but the subject was so overwhelmingly complex and she was always so desperately tired. Being shifted around from ward to ward, from day duty to night and back again, made it impossible to get into a manageable routine. One of the biggest disruptions occurred when smallpox broke out in the men’s surgical ward while she was on duty there.

  The hospital had to be quarantined, and only those suffering from smallpox would remain. Any other patient well enough to travel was sent home, any sick one who could be moved was taken to the municipal hospital. Most of the Homeopathic’s nurses went along with them, but Nurse Roberts got turned down for transfer as being too young. Instead, she got locked in with a few other staff members and the smallpox patients.

  Since smallpox was terribly catching and often deadly, this lock-in was serious business. Policemen were set outside to guard the doors. Nobody could go anywhere except to the courtyard or the roof for an occasional badly needed breath of fresh air. The empty wards must all be fumigated. The nurses got stuck with that job. The procedure involved sealing every window with strips of paper soaked in flour-and-water paste, piling a small cairn of bricks in the middle of the ward, setting a large pan of formaldehyde in the middle, dumping in a red-hot brick, and running like mad for the door.

  Even with the doors closed, the acrid fumes leaked into the corridors. Everybody developed a nasty cough, nobody showed much interest in food although the kitchen staff stayed bravely on the job. As far as the smallpox itself was concerned, the medical staff didn’t worry much. They’d all been vaccinated. This smallpox was not the confluent type, and the cases still on the wards were mild ones. Their biggest enemy was boredom.

  Used to being worked off their feet ten or twelve hours a day, nurses and orderlies didn’t know what to do with all this enforced leisure. Their problems were not so much with the sick men as with the convalescents. The better they got, the worse they resented being kept in quarantine. They threatened to mutiny and march out of the hospital in their nightshirts, even if it was December. The men squabbled among themselves, they started a miniature riot or two. One day they relieved the monotony by smashing up the furniture.

  Despite the quarantine, some of the staff doctors were allowed to come in. It was during this period that Mary really began to know Stanley Rinehart. In order to relieve some of the tension, the staff tried hard to arrange various diversions for the patients. At Christmas, somebody smuggled in a tree. Each patient got an orange and a pair of socks. They were taken to the hospital chapel. Mary played the piano and S.M. led the carol singing. She discovered that he had a splendid baritone voice. Refreshments were served, and the two musicians got to talking. S.M. told Mary that he’d been in the glee club at Adrian College before he’d gone on to study medicine at Hahnemann. She was duly impressed.

  At long last the quarantine was lifted, the formaldehyde smell was replaced by the somewhat less repellent odor of iodoform, the wards filled up again. Mary was reassigned, this time to the pediatric ward. S.M. had some patients there, and Mary marveled at the way he’d march into the ward, cast a stern look around through his pince-nez, be suddenly engulfed by a flock of adoring children, and settle down to play with them.

  How could a grown man get so much fun out of a bunch of sick youngsters? To Nurse Roberts, they were just small, wiggly objects that had to be washed, fed, medicated, and toileted. She was still too young herself to feel much empathy toward sick children. She was too tired to play. She was fed up with the hospital, bored with herself. What had happened to her brave aspirations toward higher education? When had she last picked up a book for pure pleasure? How could she dig herself out of this rut?

  Just why a girl of Scotch-Irish extraction suddenly elected to study German is open to conjecture. Considering how high a percentage of the hospital’s patients were of German origin, how many still spoke the language of their forebears, Nurse Roberts’s interest seemed reasonable enough. Rinehart was a German name, and Mary had learned that S.M. wasn’t the ogre some people thought he was. Maybe it wouldn’t hurt to ask his advice.

  It did not hurt a bit. S.M. thought Nurse Roberts’s idea was just great. The following day he brought a little German book to the ward and suggested that the aspiring student might care to drop in at his office on her next afternoon off so that he could help her practice pronouncing her umlauts.

  For a doctor at the Pittsburgh Homeopathic to display anything other than a professional interest in a nurse was verboten in any language. Furthermore, Stanley Rinehart was just starting his private practice. He had no time for dalliance, much less was he in any financial shape to take on the responsibility of a very young wife. But umlauts involved a good deal of lip-puckering and it did seem a pity to waste all that effort on a few paltry vowels with dots on top.

  Mary made little headway with her German, but she did develop a knack for articulating umlauts. One pucker led to another, the balmy spring weather led to clandestine buggy rides, that old covered bridge over the river might have been built for lovers. It was only a matter of time before Dr. Rinehart stopped his horse halfway a
cross and popped the question.

  What was a dutiful student nurse to say? In the merry month of May, Nurse Roberts was engaged. Secretly, of course—once again she was wearing a ring on a ribbon around her neck. This time the stone was not an ugly sardonyx, this time the ring would not be given back.

  As for keeping their troth a secret, Mary and Stanley hadn’t a prayer. The other nurses, the orderlies, the doorman, the night watchman, the hospital officers, even the patients on the wards and possibly the babies in the nursery had all been taking a keen interest in the burgeoning romance. Mary and S.M. were under constant surveillance. One night the chief engineer from the boiler room sighted the lovebirds together at a restaurant and the cat was out of the bag. There was only one thing to do, and S.M. did it. He stomped into C.C.’s office and announced in stentorian tone that he intended to take Nurse Roberts out for a drive.

  He might as well have requested permission to burn down the hospital. Dr. Rinehart was hauled before the entire board of directors, but they didn’t scare him a whit. Upstairs, hanging over the banister, Mary could hear her feisty swain informing the board and probably the whole hospital that he intended to marry Nurse Roberts and was about to give her an airing in his buggy, come hell or high water.

  Thoroughly cowed, the board saved face as best they could. The engagement was not to be announced until Nurse Roberts had finished her course. She must not wear her ring, she must conduct herself at all times with utmost propriety. They knew better than to try laying any caveats on young Dr. Rinehart; they dispersed in thoughtful silence. Mary crept downstairs with shaky knees and got into the buggy.