Coming Home to Liverpool

by Kate Eastham

  Maud walked to work with Alice, as usual. The rain had stopped but the streets were cold and wet. She pulled her cape around her more closely as she walked silently next to Alice, her head heavy on her shoulders.

  ‘Are you sure you’re all right to go in?’ Alice had asked earlier.

  ‘Yes, of course,’ she’d replied immediately.

  What else could she have done? The wards needed nurses, and she needed to speak to Miss Merryweather, because making arrangements for moving back into the Nurses’ Home was at the top of the list that she’d made that morning.

  But as she walked, she became aware of just how different today was to how she’d imagined it would be. This should have been the first exciting day after Harry had arrived; the beginning of the next phase of their lives together. Instead, she was trudging along with a dull ache behind her eyes after her whole life had been turned upside down.

  She gave an involuntary sigh and hoped that she would, eventually, stop thinking about how things should have been. There was no mistaking the events of yesterday – and no changing them, either. All she could do was keep going, carry on with her work. And in time, that would lead her to something else.

  Maud lifted her head and linked Alice’s arm, pulling her close.

  ‘Oh, Maud,’ said Alice, softly.

  ‘I’ll be all right, don’t you worry,’ she said quietly, taking a deep breath and starting to pick up her stride as they reached the bottom of Brownlow Hill.

  As soon as they were in through the front door of the Nurses’ Home, Miss Merryweather’s door clicked open and she appeared, in her bonnet, closely followed by her sister, Miss Elizabeth Merryweather, in her leather gloves.

  ‘Nurse Linklater,’ said the superintendent, before Maud could open her mouth to ask about her move back to the Nurses’ Home. ‘We need you to go straight to Male Surgical. I’m afraid Mr Langer’s condition has deteriorated overnight. He’s spiked a fever and become delirious. The night staff have been sponging him down with cool water, but there is very little change. They need a capable nurse with surgical experience.’

  Maud looked at her blankly for a moment, her heart skipping a beat with concern for her patient.

  ‘They need you, Nurse Linklater, they need you.’

  ‘Yes, Miss Merryweather,’ she said, automatically.

  Sister Law was beside Mr Langer’s bed when Maud arrived promptly on the ward. She glanced up with a frown. ‘He’s in a bad way, Nurse Linklater. I’m afraid that we might well be heading towards poisoning of the blood, if we can’t turn this situation around.’

  ‘How is the wound? Have you been able to examine it?’ asked Maud, already laying a hand on Mr Langer’s forehead.

  He opened his eyes and muttered something in German, moving his head from side to side. His skin was hot and dry.

  ‘Not as yet. You know how dark the wards are at night, and Sister Tweedy didn’t feel that they would gain anything by emptying the fracture box and examining his leg by candlelight. So, Nurse Linklater, the task is yours.’

  ‘Yes, Sister,’ she said, already moving away from the bed to scrub her hands and collect her materials.

  As soon as she uncovered the fracture box, Maud could detect a change in the wound. The bran was soaked through with exudate, and it stank. After emptying it all out, thankful that she’d taken the precaution of separating the loose material from her patient’s leg with a piece of cotton cloth, Maud noted dark green pus striking through the dressing. She knew straight away that this was deep suppuration. A very dangerous and life-threatening complication.

  Mr Langer called out again and started to writhe in his bed.

  Maud was already making her plan. First, he would need a dose of laudanum, not enough to knock him flat – his body would need to battle hard – but enough to settle him. Then, in terms of localized treatment of the inflamed leg, there was really only one option, something that she had read up on in Holmes’s A System of Surgery. They would have to douse the wound with dilute carbolic acid and then pack it twice a day with soaks of the same antiseptic solution. If the poisoning was in the early stages, they had a chance of saving the leg and the man’s life. But if it had gone too far … No, Maud couldn’t think like that, not yet. They had a fight on their hands.

  ‘We need to clear all of the contaminated materials from Mr Langer’s bed,’ said Maud to the nurse who had appeared at the other side of the bed. Not until the woman spoke did she realize that it was Nurse Devlin, and then she remembered that the probationer had told her a couple of days ago that they were about to change wards and she would be going to Male Surgical.

  Maud flashed a grim smile at the probationer. ‘I’m glad it’s you, Nurse Devlin. Now, whilst I go and update Sister Law and collect my materials, I want you to remove all of these soiled dressings and create a clean area for the treatment of this patient’s wound. He is Wilhelm Langer, forty years old, and he sustained a compound fracture of the tibia about three weeks ago. The wound has been suppurating cleanly and showing signs of healing and has been very satisfactory, until today. How we treat this now is of the utmost importance for this man and his family. Do you understand?’

  ‘Yes, Nurse Linklater,’ said Nurse Devlin firmly, already starting to gather the soiled dressings with her bare hands.

  Maud mixed a whole bucket full of carbolic acid solution with extreme care. She wanted it to be strong enough to have an antiseptic effect but not so strong as to cause damage to the wound and the surrounding skin. She placed a white porcelain jug in the bucket and then gathered an India rubber sheet and a stack of towels to protect the bed. This was going to be a messy business.

  Sister Law had already administered the laudanum drops, and she nodded to Maud as she withdrew from the bed. ‘I’ve sent word to Mr Jones and he’ll be here as soon as he can,’ she said.

  ‘Thank you,’ said Maud, turning away to take a deep breath as she was hit afresh by the stench of the wound. Then she gestured for Nurse Devlin to help her open the hinged sides of the fracture box and slip the rubber sheet between Mr Langer’s bandaged leg and the pillow. She was tempted to remove the box completely but didn’t want to risk any disruption to the bone that would only be half healed, at best.

  Before she started to irrigate the wound, Maud instructed Nurse Devlin to pack towels down each side of the leg, to absorb the solution as it spilled out of the wound. And then she went to the head of the bed. Mr Langer had gone quiet, not really a good sign, as the laudanum hadn’t had a chance to start working yet. She explained to him in simple terms what they were about to do to his leg and why they needed to clean the wound. He opened his eyes briefly but showed no other sign of understanding anything that she had said.

  ‘Right, Nurse Devlin,’ said Maud steadily, ‘I’m going to pour the carbolic acid solution from this jug on to the wound. The towels will catch some but it will spill out on to the bed, so your job is to mop it up as best you can. It won’t be a pleasant job; the idea is to flush out all of the bad pus and decaying tissue.’

  Nurse Devlin nodded, her grey eyes wide with expectation.

  ‘Here we go,’ murmured Maud, starting to dispense the cleansing solution. As she poured she made sure to cover every inch of the wound and wash away all sign of suppuration. In due course, she saw the white glint of bone appear but still she continued with the process. Nurse Devlin valiantly mopped up as much of the solution as she could, the sleeves of her uniform and her apron becoming saturated with the stuff.

  After the last half jug was poured, Maud straightened up and surveyed her work.

  ‘Thank you, Nurse Devlin. That looks much cleaner,’ she said, ‘and I think the smell has improved also. Now we need to make the best job that we can of drying this fracture bandage and then, if you could clear away the saturated towels and the worst of the debris, I’ll go and mix some more carbolic acid solution and collect some material for packing the wound. And if you could bring some clean linen back with you, we’ll change
the bed first and then we have a clean area for re-dressing the wound.’

  ‘Yes, Sis—I mean, Nurse Linklater,’ said Nurse Devlin.

  Mr Langer was barely responsive as they changed his sheets, ably assisted by Sister Law who’d rolled her sleeves up for the procedure. As Maud pulled the final creases out from beneath him and smoothed the bed linen with her hand, she thanked Sister Law and then explained to Nurse Devlin about the dressing they were going to use.

  ‘This is called “charpie”,’ she said, indicating a mound of soft fluffy material. ‘It’s linen that’s been unravelled, thread by thread, and it’s ideal for packing wounds. It will absorb the carbolic acid and bring as much of the solution as possible in contact with the suppurating surface.’

  Maud submerged a couple of handfuls of the material in the large bowl of antiseptic. She squeezed it out a little and then packed it expertly inside the cavity of the wound. ‘We’ll cover it with a piece of lint for now,’ she said. ‘We’ll change the dressing later today, and then twice per day, until we can see the healing process resume.’

  Nurse Devlin nodded and then glanced to the head of the bed. ‘I hope this works for you, Mr Langer,’ she murmured.

  Once the process was complete and Maud was satisfied with the secureness of the dressing, the neatness of the bed sheets and the positioning of their patient’s pillow, she asked Nurse Devlin to check Mr Langer’s temperature and then to try him with regular sips of water from a spouted cup.

  ‘Get yourself a stool and sit by him,’ she said quietly. ‘And you must come and find me if there is any change at all in his breathing, pulse or his colour, or if he starts to shiver.’

  ‘Yes, Nurse Linklater.’

  As soon as Mr Jones appeared on the ward, Sister Law summoned Maud to give a full account of Mr Langer’s treatment.

  ‘My dear Nurse Linklater,’ he smiled, ‘the Surgeon General himself could not have devised a better plan. All I would suggest is that you try some kind of stimulant to rouse him – a teaspoon of brandy every two hours should do the trick. And the toes of his foot on his affected leg do look rather congested. Maybe you could cut away some of the bandage, and apply a poultice to encourage circulation – camphor or horseradish, or both. Yes, use the camphor and grate some horseradish on there as well. We need to do all that we can.’

  Maud nodded and made a mental note to start the brandy straight away and show Nurse Devlin how to make the poultice. She didn’t want any chance of it being applied too hot and causing a burn.

  ‘Now all we can do is hope and pray that our measures are enough to save the fine fellow,’ continued Mr Jones. ‘There is nothing more we can do for now. We are, as Miss Nightingale would undoubtedly remind us, at the mercy of the healing powers of nature.’

  There was little change throughout the day in Mr Langer’s condition. Maud and Nurse Devlin checked on him regularly and made sure to give him small sips of water. The teaspoons of brandy made him cough, so most of it came back up, but they persevered. When his wife and children visited, they did what they could to comfort them as they wept miserably by his bed. Maud had to blink back her own tears when she saw the older daughter, Frieda, her voice husky from crying, hugging her younger sister, Martha. Mrs Langer stood by the bed with her arm around her son, staring at her husband’s face, stroking his cheek. It was a desperately sad scene.

  All Maud could do was explain to the family exactly what she had done and what they might expect, but she could see that they were struggling to take it all in. Only yesterday they’d visited and Wilhelm had been sitting up in bed, smiling and joking, with Frieda on one side and little Martha on the other.

  Later on, Maud hovered hopefully by the bed as she supervised the final reading of temperature.

  ‘Still one hundred and five degrees Fahrenheit,’ reported Nurse Devlin, her eyes downcast, ‘and Mr Langer has only taken sips of water all day.’

  Maud’s heart was heavy but she showed no sign of it to her probationer. ‘It’s too soon to see any real change yet. All we can do is stick, without fail, to our treatment plan. Now, come on, let’s get on and renew the carbolic acid soaks in the wound. You can do it, this time.’

  As Maud watched and directed Nurse Devlin, she said another silent prayer for Mr Langer. What she had told Nurse Devlin was correct. It was too soon to see any improvement, she knew that in her head, but her heart yearned to see him open his eyes, smile at them, ask them what had been going on.

  Maud was last off the ward, apart from Sister Law who was giving the report to the night staff. As she walked down the corridor, she felt strangely light-headed, as if she wasn’t quite in charge of her own body. But at least she’d been so involved with her work that she’d had no time to think about Harry or Nancy or any of that.

  Out through the door of the hospital, she kept up her pace as she walked along the path to the Nurses’ Home. I must speak to Miss M first thing in the morning, she thought, and enquire about a room. And I’ll write to Miss Fairchild, tell her what’s happened with Harry, not the full details, not with how frail she is, but enough for her to know that there has been a clear change in our arrangements and Harry won’t be coming to see her. And fingers crossed, I’ll be asking if she can send the sewing machine to the Nurses’ Home. Maud sighed, she’d have much preferred to have gone up there to see her friend, but she knew that she simply wasn’t going to have time, not for a while at least.

  ‘Maud,’ said a voice behind her.

  The voice made her breath catch in her chest. She was tempted to run and keep running. But instead, she stopped in her tracks and turned around. It was Harry, with Rita by his side, the dog’s ears laid back flat against her head. Maud must have walked straight by him, so immersed in her own thoughts that she hadn’t even noticed him waiting in the place he always used to.

  She noted the black smudges beneath his eyes, and his slumped shoulders. He looked like he’d aged at least ten years overnight.

  ‘I need you to listen to me, Maud,’ he said, his voice husky.

  ‘No,’ she said, shaking her head.

  ‘Please, Maud, just listen to me for a minute, please.’

  ‘No,’ she repeated, more firmly, holding up her hand. She could hear the dog whining miserably. Poor Rita, she thought, desperately wanting to reach out a hand to comfort her.

  ‘But Maud, I was drunk, I had no idea what I was doing, I couldn’t even remember being with her. I—’

  ‘No,’ shouted Maud, ‘don’t say anything else. Whether you were drunk or sober, it’s clear that you were with her whilst we were courting. You must have been!’

  He was shaking his head, trying to speak.

  ‘No, I don’t want to listen to you. I don’t even want to see you. No!’

  ‘Maud,’ he sobbed, desperate now, his voice ragged.

  Maud felt her heart pounding against her ribs. She couldn’t stand it, she couldn’t bear to see the wretched figure that was, or used to be, her husband.

  She turned on her heel and started to run. She had to get away.

  ‘Maud, please,’ he called once more, his voice weak, trailing off.

  And just the tone of his voice made her sob, and then she was crying as she ran.

  If it hadn’t been for Alice stepping out through the door and grabbing hold of her, shouting to Harry, telling him to stay away, and then pulling her inside, Maud knew that she might have collapsed in a heap on the ground.

  ‘Men!’ spat Alice. ‘Bloody men!’

  Maud could hear the dog still whining out on the street. It made her feel desolate.

  She held on to Alice until she could stand upright. Then, without saying a word, she walked through to the space inside the building. It was dark outside now and the sky was overcast, so she couldn’t see even one star. But still she gazed up to the skylight.

  ‘Maud?’ said Alice, quietly, beside her.

  ‘I will be all right,’ she murmured. ‘I have to be all right.’ And then she reached out to
take Alice’s hand.

  ‘Nurse Linklater,’ called Miss Merryweather, softly, ‘Nurse Sampson has been telling me that you would like to move back into the Nurses’ Home. Is that correct?’

  ‘Yes,’ said Maud, fishing in her pocket for a handkerchief to wipe her eyes. ‘Yes, I would like that very much.’

  ‘Well, we have a room up on the top floor. It’s a little more commodious than the single dormitory you will remember from your probationer days. I think it will suit you very well, and you can bring a few sticks of your own furniture, if you wish, something to make it your own.’

  ‘Thank you,’ croaked Maud. Then, clearing her throat, ‘How soon can I move in?’

  ‘The sooner the better,’ sniffed Miss Merryweather. ‘I think it would be of great benefit for you to have the seclusion of our four walls as soon as possible, don’t you?’

  ‘Yes, I think it would,’ said Maud, wiping her eyes. ‘I will come tomorrow.’

  Miss Merryweather nodded and then strode back to her room, leaving Maud and Alice to walk back over the coloured floor tiles towards the entrance and make ready to don their capes and hats.

  ‘I never thought he’d dare to show his face,’ murmured Alice, ‘and if he did, I thought he’d come to Stella’s. After all, he used to be a regular visitor there at one time. But coming here, well, it’s not acceptable.’

  Maud tried to form a response but no words would come.

  ‘Now, I’ll check that the coast is clear and he’s not hanging around outside,’ offered Alice, slipping out of the door for a few moments.