Then there was Emmaline. Only eleven, but already a beauty, with honey-blond hair, pale blue eyes, creamy skin, and cheeks touched by rose. A mercurial child. Sometimes she seemed as old and wise as the hills, other times an infant, just learning about the world. Some of this reflected her life before she came to live in the boardinghouse last winter. She had never been to school or played with other children before then. Instead, her mother had hidden her away, speaking to her in French and weaving tales of Emmaline’s past that had all proven false.
These three young people, whose backgrounds and personalities couldn’t be more different, had become fast friends, and their laughter filled the boardinghouse, making Annie’s heart lighter.
Yet there was sadness to their lives as well. One of the things that bound them together was that Jamie was fatherless and both Ian and Emmaline orphans. Yet in the O’Farrell Street boardinghouse they’d found mothers a plenty—from the aged Moffet sisters to even the young servant girl, Tilly.
And as for fathers? Well, Nate did try to spend some time with them, but it was Patrick McGee, the Irish copper who was courting Kathleen, and David Chapman, the boarder who had moved out so Annie could have her nursery, who were the most important men in their lives. On Sunday afternoons, the two men often took the trio of children off to watch the ships come into the harbor or to fly kites at Jefferson Park. In addition, they were both very happy to escort Kathleen and Mrs. Hewitt when they decided to take the children to Woodward’s Gardens. Annie thought that both men had wisely decided that the best way to the hearts of the women they loved was through their young charges.
Would Hilda and her child be as fortunate as Jamie, Ian, and Emmaline?
“Ma’am, are you all right?” Kathleen leaned over to pick up Annie’s plate and place it on the tray piled high with the other dishes. “Don’t you be worrying about Abigail, now. When I left the kitchen, she was sitting in that little place we made for her out of the kitchen chairs, just babbling up a storm.”
Annie shook her head and said, “I’m afraid I was thinking about that poor young girl, Hilda. Worrying about what would happen to her and all the women and children who go to the dispensary if it had to close.”
“Oh, ma’am, do you think that’s possible?”
“If I understood Dr. Granger correctly, he was told that Mrs. Truscott didn’t need his services because she was under the care of some female doctor named Skerry. He said that he wouldn’t be surprised if it was this Dr. Skerry who was behind Truscott’s letter and that she would do anything to try to ruin his and Dr. Brown’s reputation, even if it meant urging the Truscotts to sue the dispensary.”
“Oh my!” Kathleen replied. “What are you going to do?”
Annie, touched that her young maid seemed to think it was in her power to do something about this state of affairs, said, “First thing I did was send a note inviting Nate’s friend Mitchell to dinner tomorrow night. He just graduated from medical school, and I thought he might help me understand more about why this Mr. Truscott thinks he could sue the dispensary.”
“Ma’am, isn’t this Mitchell the man who came around when Miss Blaine used to study with Miss Laura?”
“The very one. It was my impression he’s lived in the city for some time. I thought he might even know something about this Dr. Skerry. At the very least, if Mitchell agrees to come to dinner, Nate might make it home on time, for once.”
Chapter 12
Saturday evening, February 25, 1882
Pacific Dispensary for Women and Children
* * *
Ella Blair stood at her attic window, looking out towards the lights of Woodward’s Gardens. Even on a cold winter night, the grounds would be full of family parties with tired but happy children slowly making their way towards the exit. At the same time, there would be a growing stream of young couples getting off the horse cars that would be paying the small fee so they could have oysters at the restaurant, take in the night’s entertainment at the amusement pavilion, or simply find a secluded bench for some privacy.
Hard to remember that there had been a time when she imagined such a future for herself, first as one of those couples and then as one of those parents escorting her children home. Why had that dream faded? Because she chose to pursue a medical career that left little time for any personal life? Or had she chosen to pursue a medical career because she no longer believed there was anyone who would ever want to spend time with her on some park bench, much less marry her?
She sighed then chastised herself for slipping into this self-pitying mood.
She suspected she was just reacting to the tension she’d felt the past two days being fully in charge of the dispensary. And she had missed the company of Dr. Brown this afternoon, acutely aware of how much she looked forward to the time they spent every Saturday, going over Ella’s cases files from the week and reviewing treatment options for the hospital patients.
She didn’t know why, if she were lonely, she didn’t join the ambulatory patients and the off-duty nurses in the dining room. But she had refused herself even that comfort, having some stupid idea that she should keep a kind of professional distance from the patients. Instead, as always, she came upstairs, worked on the case files, and ate a solitary dinner in her room.
She’d spent most of life wishing she didn’t live in such cramped proximity to her family, sharing a bed with a sister, fighting to get a moment’s peace from her brothers’ teasing, trying to study at the table in the noisy kitchen in the flat above her parents’ store. Now, she had a large room all to herself, shelves for her books, a desk with proper lighting, and a spirit stove to heat tea. Yet here she was, feeling lonely because Dr. Brown, one of the few people she felt close to, was out of town for two weeks.
How pathetic.
The small clock she kept in her room chimed softly. Seven-thirty and time to start her evening rounds with Mrs. McClellan. She did enjoy this daily ritual, seeing each patient, consulting with the matron, and instructing the nurses on night shift about which patients needed their vital signs checked regularly, what medications should be administered, and when they should get Mrs. McClellan or her assistant to check on a patient and determine if Ella should be awakened.
A few minutes later, Ella met the matron at the door to the larger nursery, where Mrs. Miller was feeding one of the babies. By this time of night, most of the mothers had gone home to take care of their husbands and other children, which was one of the reasons the dispensary had set the end of visiting hours at seven.
However, the staff often permitted exceptions to this rule. For example, Mrs. Foster was still here, rocking her six-year-old son. He was recuperating from a ruptured eardrum, and since his mother worked days, this was the only time she could see him. In addition, the nurses had discovered that the boy was more likely to go to sleep in his mother’s arms. He probably could have gone home today, but Ella had agreed with Mrs. McClellan’s suggestion that if they kept him until Monday, when Dr. Powers, their ear specialist, was due to come by, he would be able to check the boy to determine if there was any permanent hearing damage from the rupture.
Ella certainly hoped this wasn’t the case. Usually, a rupture was the result of an acute ear infection that would heal on its own. However, by the time this mother had brought her son into the dispensary, the ear infections had been chronic, and the damage might have been permanent.
She couldn’t even fault the mother for the delay in bringing the boy to the dispensary, because it had required her to miss a morning of work. Ella just wished that they could afford to open up the doors to patients a couple of evenings each week. She remembered vividly how her own harried mother snapped at her when she complained about having to stay home from school to tend her youngest sister, Becky, who was forever coming down with one infectious complaint or the other.
She now understood her mother simply couldn’t afford to leave the store to tend to her daughter, much less take her to see a doctor. So she needed
Ella to help out. Becky, who had grown up to be a strong, healthy young woman, often bragged to people that her sickliness as a child was the reason Ella chose to become a doctor. Ella supposed she was right, although at the time, it was more the idea of getting paid to do the nursing she was already doing that had inspired her, not some altruistic vision of curing her sister.
Shaking her head at this memory, she followed Mrs. McClellan into the second nursery, where another mother was staying past the end of visiting hours. Such a sad case. The woman’s infant had some sort of stomach complaint that had severely dehydrated her, which in turn was putting a strain on the child’s heart. The mother’s milk was failing, and the child wasn’t handling the formula they were giving her very well. After examining the infant, Ella told the mother that it would be best if she stayed with her daughter all night, see if she could get her to nurse. What went unspoken was Ella’s fear that the child might not survive the night.
In addition to the night nurse, who would constantly monitor the child, Ella knew that Mrs. McClellan would also check the baby every couple of hours. The ability to sleep in short snatches appeared to be a prerequisite for nurses and doctors who worked in hospitals such as this. Ella herself would set her alarm for midnight and again at six, so she could check on the child’s status. Of course, there was also the possibility that she would be up already if the woman who had just come into the maternity ward this afternoon went into labor. Thank goodness, her attic rooms had the old bell system from when it housed servants. This meant that there was a bell pull on each floor that a staff member could ring to get her attention right away if there was an emergency.
As she was about to leave the nursery, she noticed little Billy, the seven-year-old who was recuperating from bronchitis, wasn’t in his bed. She said, “Matron, did Billy’s parents come take him home this evening? I wanted to talk to them before they did, make sure they know that…”
Mrs. McClellan shook her head and indicated that Ella follow her into the hallway. Once there, she pointed to the open door to Jocko’s room, where the fifteen-year-old boy was reading from a magazine called Young Folks to Billy, who was leaning against the older boy’s shoulder, his thumb firmly in his mouth.
Ella came into the room, which was really no larger than a closet, and sat down on the chair pushed up next to the bed, saying, “Billy, what is Jocko reading to you?”
“Treasure Island, miss. It’s got pirates and everything. Can I stay up, miss? We’re at a real ‘citing spot in this issue.”
Ella looked at Jocko and said, “Are you all right with Billy staying with you a little longer?”
“Yes, doctor, I’d like to have him stay.”
“You’ll ring for the nurse when he falls asleep?”
“Sure, although I don’t mind if he spends the night with me. Keeps me warm.”
Ella looked over at Mrs. McClellan, who nodded her approval. Given the medical crisis that was brewing in the nursery next door, it might be just as well if Billy, the oldest child there, were safely out of the way.
“All right, Jocko, it is a bit chilly this evening. Matron will ask Nurse Miller to stick her head in occasionally to see if you need him to be moved to his own bed.”
Jocko had been brought to the Pacific Dispensary two years earlier, when he was only thirteen. An orphan as far as anyone knew, including Jocko, he had been supporting himself for years as a newsboy. He’d never been to school, but he had taught himself to read from the papers he sold. Then, one day when he was eleven, he slipped under the wheels of a wagon, which broke the femur of his left thigh.
He begged his fellow newsies to hide him from the authorities, fearing that if he was taken to a local hospital that they would amputate his leg. His friends found a back room where a kindly saloon keeper let him stay, until the awful swelling went down, and it looked like he was going to keep his leg. The problem was that the two broken halves of the bones had knit together all wrong and the edges of the two halves of the femur ground together constantly, causing him terrible pain. For a while, he went out every day to sell his papers. But the pain got worse and worse, and eventually he was caught trying to steal laudanum from a local pharmacy, as it was the only thing that gave him any relief.
Instead of handing him over to the local police, that pharmacist, Mr. Sears, brought the boy to Dr. Brown. He knew that the dispensary normally didn’t take children Jocko’s age, and they didn’t provide long-term care for patients, except for those who were terminal, but he correctly judged that they wouldn’t turn the boy away.
That was two years ago. Ella’s assistant nurse, Janie, who had been in the nurse’s training program when Jocko arrived, told Ella that the first thing the dispensary staff were able to do for him was to restore his general health. He was malnourished and suffering from fluid in his lungs and a number of skin infections. These were problems they could remedy fairly quickly. As his overall health improved, they also began to wean him from his dependence on morphine, using warm baths, massages, and milder analgesics to help him cope with his pain.
And they gave him books. The boy was a voracious reader who said that when he lost himself in a good story, he didn’t feel the pain. The tiny room they gave him when the dispensary moved to this building was a testament to his own specific remedy, with bookcases on two walls filled with books, magazines, and newspapers. The books were donated by the women in the Flower Guild, who had made Jocko their special project. The newspapers and magazines came to him via his friends among the newsboys, one of them showing up at visiting hours every day. The nurses joked that they no longer bothered to buy a newspaper themselves but depended on Jocko to tell them all the important local or national news.
Dr. Wanzer had recently consulted a surgeon from Scotland who had treated a similar case, a young sailor whose terrible broken leg hadn’t been properly treated. This doctor had developed a method of re-breaking badly healed bones and clearing out scar tissue so the bones had a chance to knit together properly when splinted. The plan was for Dr. Taylor, the chief surgeon at the City and County Hospital, to operate on Jocko at the dispensary in a few weeks using this method. Even if the boy’s mobility wasn’t completely restored, everyone hoped that this operation would at least relieve his unremitting pain.
As she and Mrs. McClellan left Jocko to resume reading aloud to Billy, Ella again thought about financial problems and Richard Truscott’s threat to sue and what it would mean to Jocko if the dispensary had to close its doors.
After checking in on Mrs. Jenkins, the woman in the maternity ward who was so near term, and determining that she wasn’t experiencing any signs that labor had started, Ella and Mrs. McClellan looked in on the two women who had delivered this week. Both the mothers and their babies were doing quite well and could probably be discharged on Monday. The older of the two women, already the mother of six children, had been very helpful in giving the younger woman advice about how to go about introducing her baby to nursing and how to keep diaper rashes at bay.
The four nurses in training, none having actually had children of their own, said that they often learned as much from their patients as they did from their textbooks. Ella had heard Mrs. McClellan caution them that their job also included getting the women under their care to abandon some of their ideas, since not all their folk wisdom was good for them or their children.
The third maternity room held Hilda Putki, the young Scandinavian girl Dr. Granger brought to the dispensary last Saturday. When they looked in on her, they found she was sleeping. Her light brown hair covered her face, and her left arm was curled protectively around her stomach, which looked huge in contrast to the rest of her.
In some very stark ways, Hilda reminded Ella of Jocko. As far as they could determine, she was an orphan and no more than sixteen, although she was so small that Ella wouldn’t be surprised if she was even younger. They hadn’t been able to learn much more than that from the girl. She wouldn’t say where she had been living, who the baby’s
father was, or what she had taken that had made her so sick.
Ella had been pleased yesterday when Mrs. Dawson’s maid, Kathleen Hennessey, shared what she had learned from the girl, including the fact that she had been a servant in a private household. That was more than they had gotten out of her. Perhaps if this Miss Hennessey came to the dispensary next week with her mistress, Ella should encourage her to spend more time with Hilda. If they could at least get some idea of when the poor girl had been impregnated, that would help, give them a better idea of her due date.
Dr. Granger’s oldest daughter, Lydia, had discovered Hilda lying on the ground near their home, practically unconscious. After getting the girl into their house, she sent for her father. When he got home, he immediately brought the girl to the dispensary. He rightly feared she had taken something to terminate her pregnancy, and he knew that she needed fast attention if there was any possibility of saving her or the baby’s life.
Dr. Granger stayed at the dispensary throughout the night to work with Ella and Mrs. McClellan to purge whatever substance the girl had taken from her system. Then they began to rehydrate her with lots of beef broth. In the morning, Dr. Granger sent a message to his son, Harrison, and asked him to come and examine the girl. Like his father, Harrison was a professor at the Medical College of the Pacific; however, his specialty was gynecology and obstetrics, which was why they usually asked him to come and consult when the dispensary had a particularly difficult obstetrics case. When Harrison Granger arrived at the dispensary, he modified the medication regime they had put Hilda on and gave his opinion that the baby was still viable.
He also told them that, given the youth of the girl and the strain she had already put on her own heart and the baby’s, they should call him as soon as she started exhibiting signs of labor. Ella was particularly grateful that he had said this, given that there was every possibility that Hilda would go into labor during the two weeks when Dr. Brown and Dr. Wanzer were out of town. She had never felt really comfortable with Dr. Granger’s son, even though she had done well in the courses she took from him in medical school, but she knew he was an excellent obstetrician.
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