by Kate Eastham
That’s more like it, thought Maud, taking a moment to untie her apron and refasten it tightly around her thin waist.
‘Nurse Linklater,’ cried Dr McKendrick, his dark eyes sparkling with life. ‘Welcome back. We have missed you,’ he said, laying the wooden box down with a firm clunk on a small table. ‘Although your friend Nurse Sampson was able to do some of the work, it wasn’t quite her speciality.’
‘Ah, yes, she wrote to me and told me that she’d fainted,’ smiled Maud, as she adjusted the position of the small table where McKendrick had placed his wooden box.
Mr Jones gave a grunt of recognition as he stood in the corner of the theatre, finishing his smoke.
‘And Miss Houston has been telling me all about your adventures in New York,’ continued Dr McKendrick, as he unpacked a bottle of chloroform, some squares of lint and a glass dropper.
Then the door swung open and Michael and Stephen were there, both red-faced, as they heaved either end of the stretcher that was barely wide enough to carry the man’s large frame.
Mr Langer looked groggy from the laudanum but as they slid the stretcher from under him he shouted out in pain.
Michael winced visibly and grabbed the man’s hand. He didn’t leave him until Dr McKendrick was speaking quietly to him as he prepared to administer the chloroform. Maud saw him use the dropper and carefully count the drops as he delivered them on to the lint. Seeing him work, the sureness of his movements and the way he observed his patient took Maud back to the very first time she’d been in this theatre room and witnessed her first operation. The magic of chloroform never failed to impress her, no matter how many times she saw it used. And the smell of it, that heady aroma, made her feel that she was definitely back where she belonged.
‘Have you seen those new chloroform masks that some have started to use?’ she asked, once their patient was anaesthetized and she was busy loosening the temporary dressing that covered the wound on Mr Langer’s shin.
‘Yes,’ said Dr McKendrick, scrunching his brow with interest. ‘In fact, I have a friend coming to see me soon who has been using one. I’m certainly going to look into it. Did they have them in New York?’
‘Yes, the surgeon who I worked with, Dr Emily Blackwell, she found that the right mask can deliver chloroform much more evenly. She very much approved of their use.’
Maud saw him raise his eyebrows at the mention of Dr Blackwell’s name.
‘Oh,’ he said, ‘a woman surgeon. There is great progress going on in the world, Nurse Linklater. Great progress. I don’t know how long it will be in Britain, or in my country of birth, India, before they are admitting female doctors. But we can only hope.’
‘What’s that?’ frowned Mr Jones. ‘Women surgeons?’
‘Yes, indeed, Mr Jones.’
‘Hmph,’ he said, mumbling something else that Maud couldn’t quite catch.
As Mr Jones was washing his hands, Maud used the dressing forceps to remove the lint from the wound. She had to take a deep breath when she saw the broken end of white bone protruding from a bloodied mess on the man’s shin.
‘Good work, everything laid out in a logical order,’ smiled Mr Jones, glancing at the instruments as he walked towards the table drying his hands. ‘There’s a good strong tibia,’ he said, peering closely at the wound. ‘Just a shame that it’s now on the outside of the man’s body. At least, though, it looks like our Mr Langer has a decent circulation to his foot, so we’ve got time to make a good job of this. First things first, we need to tie off all the bleeding vessels with ligatures …’ Just as Mr Jones took up his forceps, the door swung open and a young man with thin hair and small, deep-set eyes entered.
‘Ah, Mr Stafford,’ said Mr Jones, with an edge to his voice. ‘So glad that you could escape the clutches of your fellow medical students and find time to join us.’
The young man didn’t offer any apology but, instead, pursed his lips and went straight to the table, making a move towards the pile of clean swabs.
‘Please stop right there, Mr Stafford,’ said Maud.
She had never seen anyone look properly down their nose, but that’s exactly what the young man did.
‘I need you to go first, please, and scrub your hands with carbolic soap. Before you even think of assisting,’ she said, with cut-glass precision.
‘And who are you?’ blustered Mr Stafford.
‘I am Nurse Linklater,’ Maud said steadily, tilting her chin towards him. She heard Mr Jones almost snort, to stifle a laugh, as the medical student huffed and puffed and flushed bright red.
‘Mr Stafford,’ insisted Mr Jones, as he stood with his instrument poised above the patient’s leg, ‘Nurse Linklater is a senior theatre nurse. She knows what she’s about. And not only that, she is following the direct guidance of Dr Joseph Lister of Glasgow, the master of germ theory. Do as she says, otherwise I will most certainly have you removed from this theatre.’
Maud saw the young man glare at her with something approaching hatred, but she met his gaze with equal fire. She didn’t care what some medical student thought, all that mattered was the welfare of her patient. And if he overstepped the mark again, she would boot him out of theatre herself.
As Mr Jones started to swab with one hand, searching for bleeding points, Maud stood ready to collect the swabs. There were some small pieces of dead tissue and slivers of bone that he also pulled out, and Maud collected each one reverently on a piece of lint. She avoided looking at Mr Stafford. It was enough to feel him there, still glowering as he stood ready with a clean swab in his newly washed hand. In due course, there was a great deal of bleeding, and so he was kept very busy mopping up the blood and throwing each saturated swab, with a satisfied grunt, into the enamel bowl on the floor.
‘Now, Mr Stafford,’ murmured Mr Jones, as he scrutinized the mess of bone and muscle exposed before him, ‘there isn’t any way that I can suture this wound. The whole thing will have to heal by granulation, from the bottom up. But let’s see if we can get this broken bone back into some kind of line. And maybe I could use some adhesive lead tape to stretch across and try to bring the edges of the wound at least partly together – we do, of course, need to leave space for the pus to escape when suppuration commences. Are you ready with the compresses and the muslin bandage, Nurse Linklater?’
‘I am,’ stated Maud, glancing down to check that she also had a dry roller of bandage to hand. ‘We’re all ready.’
‘We need a pillow as well to support the leg in the fracture box.’
‘There’s one there, on the shelf,’ said Maud, grateful to Sister Law and her exquisite organization.
‘Right, Mr Stafford, I need you to put some traction on this leg by grasping the patient’s ankle and giving it a good, strong pull.’
The medical student nodded and took up his position at the end of the table.
‘Nurse Linklater and Dr McKendrick, you’ll both need to hold on to our man at the top end. Are we all ready? When I say pull … you pull, Mr Stafford, and I’ll push the tibia back into alignment. Are you ready? Go!’
Maud and Dr McKendrick looped their arms under the patient’s arms and clung on for dear life as Mr Stafford’s face turned bright red with the effort and Mr Jones did his work within the wound. She heard the grating of bone on bone as something went back into place. It made her feel a bit light-headed, but she held on to Mr Langer with all her might.
‘That seems to be a reasonable position,’ murmured Mr Jones. ‘Hold fast where you are, Mr Stafford,’ he said, holding on to the leg to maintain position. ‘Now, Nurse Linklater, if you could apply the compresses to the sides of the leg and bandage them in place. And then, finally, we’ll get the leg positioned in the fracture box.’
‘Righto,’ said Maud.
‘We might need your assistance as well, McKendrick,’ said Mr Jones. ‘If we, all three, lift the leg together then we might be able to avoid disrupting the position of the bones. Nurse Linklater can then bandage around us – le
aving the wound at the front of the leg exposed, of course. We’ll dress that separately.’
Maud worked like fury, her hands covered in the slimy egg white solution.
‘Good work, Nurse Linklater. Now, in with the pillow,’ directed Mr Jones, as he and Mr Stafford lifted the leg once more.
Maud turned and grabbed the pillow, and then slid it smoothly beneath the leg.
‘Finally, we all need to lift the leg again, whilst Nurse Linklater slides the fracture box into position.’
Maud went to the wall and picked up the wooden structure. She opened up the hinged sides, laying it flat, and as they lifted the leg, still on the pillow, she slid it beneath.
‘Good show,’ breathed Mr Jones.
Maud already had a dry bandage to secure the patient’s foot to the wooden base of the box, and then they were ready to fold up the sides.
‘Right,’ said Maud, checking the position of the leg in the box, ‘I just need to apply a dry dressing to the open wound and give one final spray of carbolic acid. But we will, of course, have to continue to be scrupulous with wound care and handwashing,’ she said, glancing directly at Mr Stafford. ‘And make an accurate recording of temperature, three times daily.’
Mr Jones stood nodding. ‘I think, given your plan, Nurse Linklater, Mr Langer’s leg will have no choice but to heal.’
‘Isn’t it all a little over the top, all this handwashing and spraying with carbolic acid?’ added Mr Stafford, looking down his nose again.
Mr Jones sighed. ‘You need to keep up with the times, Mr Stafford. Lister’s ideas on germ theory are making a huge difference in hospitals throughout the country. Mortality rates have fallen from something like forty to as low as four per cent in some cases. Not even the most hidebound old surgeon, mired in tradition, could ignore results like that. Surely?’
Mr Stafford cleared his throat and looked a little downcast. Maud almost felt sorry for him.
‘I’ll ask the orderlies to come in and move our patient back to his bed,’ called Mr Jones as he moved towards the sink, with Mr Stafford in tow. ‘Let’s get our hands scrubbed, and go and see how things are fixed on the Female ward.’
After they were gone, Dr McKendrick gave Maud a sympathetic glance. ‘I think our current medical student still has a great deal to learn.’
‘Yes, I think so too,’ breathed Maud. ‘But it’s more a frame of mind than anything else, isn’t it? And I’m not sure that any amount of learning can change that. Now, how is our Mr Langer? Is he showing any sign of waking up?’
After the orderlies had been in to move the patient, and Maud had almost finished the scrubbing and cleaning in theatre, Sister Law came through the door. ‘My word, Nurse Linklater, you’re doing a thorough job in here,’ she said, coming to a halt at the opposite side of the theatre table. ‘And Mr Jones has been singing your praises, loud and clear, out on the ward. Well done.’
Maud halted in her final polishing of the surgical instruments. It was unprecedented for Sister to say such a thing.
‘Thank you,’ she stammered, ‘but I do still have a great deal to learn.’
‘Of course, don’t we all?’ smiled Sister, her eyes gleaming. And then she actually grinned.
Maud nearly fainted on the spot. She never thought that she’d ever be faced with the sight of Sister Law grinning from ear to ear.
‘You have done very well, Nurse Linklater,’ repeated Sister. Then, clearing her throat, she regained her composure. ‘Now, I need to tell you about another new admission – a fifty-three-year-old man with abdominal pain, suspected inflammation of the appendix. You know the drill. Dr Jones is just completing his examination of the patient, and he’ll be back in theatre directly. I’ve sent for Dr McKendrick, and the patient should be with you in about ten minutes. Will you be ready?’
‘I will,’ said Maud, starting to arrange the instruments the minute Sister Law turned and made her way to the door. Then she removed her soiled apron and reached for a fresh one from the pile that was ready and waiting.
In fact, they had yet another case after that, and her work in theatre kept her busy for the rest of the day. She’d hoped to have some time to nip over to Female Surgical and check on Sue and Dolores, but there was no chance. Her work was all-consuming.
Maud emerged, at last, through the door of the theatre room, just as the night staff were coming on duty.
‘Good evening,’ she murmured to Sister Tweedy, as she made her way up the ward with her assistant nurse. Then she went straight to Mr Langer’s bed and was pleased to find that he was resting peacefully, flat on his back, with what even looked like a satisfied smile on his face. You get some rest, thought Maud, you’ve got a long road ahead of you. Then, lifting the sheet to expose his injured leg, she made one final check of her dressing.
‘You get off now, Nurse Linklater,’ called Sister Law, sternly.
It’s a good job I know her better now, thought Maud, smiling to herself as she walked off the ward. Otherwise I’d be spending all night wondering what the heck I’d done wrong.
As Maud walked back with Alice, through the city, Alice recounted all the details of her day on Female Surgical. Maud was heartened to hear that Sue was stronger and she’d been up out of bed for a short walk. ‘Oh, but that medical student, Mr Stafford, it’s a good job I caught him. He was going to take down her dressing! It’s perfectly fine – clean and dry, not a sign of any exudate. And the earliest we can remove it is tomorrow, all the nurses on the ward know that. So I stopped him. And he wasn’t too pleased.’
‘Thank goodness you saw him,’ said Maud, proceeding to tell her all about the incident that she’d had with him in theatre.
‘Well,’ said Alice, ‘this’ll amuse you. You know you explained to Dolores Williams all about how babies are born? Well, she only went and told the Reverend Seed about it – and how you’d told her the proper name was “vagina”.’
‘Oh no,’ said Maud, mildly horrified.
‘Nurse Devlin heard the whole thing. She said he went bright red, even his ears. But he continued to stand by Dolores’s bed and listen to everything that she had to say. And you know what she’s like, she talked on and on.’
Maud giggled. ‘Well, at least she’s remembered all the information I gave her. But what about the poor chaplain?’
‘Oh, he’ll be all right,’ said Alice, confidently. ‘Lawrence is very shy, but he’s a good sort, and much more worldly wise than you’d think.’
‘Ooh,’ giggled Maud, ‘Lawrence. You and he are on first name terms, then?’
‘Yes,’ said Alice, flushing pink. ‘But that doesn’t mean anything. I’m on first name terms with you …’
‘But, Alice, I’m not a man,’ smiled Maud, linking her friend’s arm and pulling her close. ‘A man who, by all accounts, has been following you around like a puppy ever since you went back to work at the Infirmary.’
‘Well, yes, but it’s complicated. I thought, at first, he was just being friendly and welcoming me back to finish my training. But then, well, he made it clear what his intentions were, and he was very kind to me when all that stuff was going on with Jamie. We’ve been going out for afternoon tea, and he is very sweet. But the problem is, I still can’t think of him as anything more than a nice friend.’
‘Even so, Alice. Clearly, he really likes you. And even from the little that I know about him, he seems to be such a lovely man.’
‘Yes, he is,’ said Alice, ‘and I do like him. But I’m not sure if that’s enough. I mean, look at you and Harry – that was always clear from the start. I saw your face after he was admitted to the ward that day, all beaten up. You took one look at him and you fell for him, there and then. Even though he had a busted, broken nose. And, as it turned out, in due course, he felt the same about you. Isn’t that how it’s supposed to be?’
Maud sighed. ‘Don’t ask me. I’ve no experience of men, apart from Harry. That was how it was for me and him, but it makes more sense to think that it’s all
probably a bit random. There shouldn’t be any right way or wrong way for it to start, and there certainly needs to be a lot of work invested in keeping any kind of union between two people going. So, I’ve really no idea how it all works. I thought that I would be the last person in the world to even consider getting married, especially after I started nursing. But now look at me, waiting excitedly for my husband to return home.’
‘Mmmm, life does have a habit of playing mysterious tricks at times, doesn’t it?’ mused Alice as they walked along. ‘Ooh, the other thing I wanted to tell you. We need to get Sue some new clothes. Her mam came at visiting time and I asked her if she could bring something in. That old dress she was wearing – the one we cut off – had to go to the incinerator. We did manage to find a whole set of hospital nightgowns, but even the smallest are swamping her. She needs something her own size. And I think, in a few days, when she’s feeling stronger, it would be good to have her up and dressed in proper clothes. But her mam said that the one dress was all Sue had. So I was thinking, you know that gold ring that she found, the one she gave to me? I thought that maybe we could take it to the pawn shop and get some money for it, use it to buy her some clothes.’
‘We can’t do that,’ said Maud, outright. ‘We said that we’d take the ring back to Lewis’s, ask if any of their customers had lost it.’
‘Yes, but Maud, that was before Sue had her accident. Surely things have changed now?’
‘Not really, it’s still the right thing to do. Think about it, Alice. What if you’d lost something really precious, something of sentimental value? Wouldn’t you want the chance of getting it back?’
‘Yes,’ sighed Alice, ‘I suppose you’re right. But what if someone does claim it? What can we do about Sue? I mean, I could find some extra money, out of my savings, that might work …’
‘No, Alice, you need that money for Victoria. But I might have some to spare, and I could ask Miss Fairchild if she would help. After all, look what she’s done for Alfred. But first, we’ll take the ring to the shop and see if we can find the rightful owner.’