The Liverpool Nightingales, page 12
‘First things first,’ said the nurse to Maud. ‘Go to the sink and wash your hands with plenty of soap.’
‘Quite right, quite right, Sister. Unlike many, we here at the Liverpool Royal are devotees of Dr Joseph Lister and his new ideas,’ said Mr Jones as Maud went straight to the sink and rolled up her sleeves, scrubbing at her hands as the sound of the patient screaming behind her seemed to fill her whole body. When she turned and walked back she felt again the shock of seeing the man on the table in such pain and she went to him and grabbed his hand, doing her best to try to soothe him.
Maud was fascinated by what happened next. The man holding the lint with the drops came to the other side of the table and spoke soothingly as he applied the lint over the nose and mouth of the screaming patient. Within seconds there was silence in the theatre. The man was knocked out cold or dead. Maud really wasn’t sure which, and given the colour of him it could have been either.
Maud instinctively moved closer to the table to get a better look, and the doctor smiled at her, noticing her interest.
‘Never seen it before?’ he said.
‘No,’ she said, still amazed.
‘It’s chloroform,’ he said. ‘We use it to put the patients to sleep so the surgeon can operate. It’s an anaesthetic.’
An aes thetic, repeated Maud in her head, desperately wanting to remember the name of something so incredible.
‘We have to be careful, though,’ said the doctor. ‘If we give too much we can kill them; if we give too little, the blighters wake up.’
Maud nodded, taking it all in eagerly.
She glanced over to Mr Jones, who had taken the opportunity to have a quick smoke by the open window. She saw him turn and then extinguish the remains before slipping it into his pocket. Then he cleared his throat and looked straight at the man with the anaesthetic. ‘Are we all set, Dr McKendrick?’
‘We’re ready,’ said the man, glancing up from the patient for just a moment.
Mr Jones then strode over to the theatre table and gestured for the nurse to help him move the patient fully on to his back with his arms and legs straight. Once he was satisfied with the patient’s position he took up a knife from where they had been laid out on the small table and without any hesitation he cut through the skin of the man’s belly.
‘Abdominal incision,’ he announced, and the nurse took small pieces of lint in her hand and dabbed at the wound. Maud could see that her hands were immediately covered in blood. It made her legs feel a bit weak to see it but she felt that she wasn’t going to wobble.
‘Next layer,’ said Mr Jones, cutting again, and then Sister dabbed some more, throwing the pieces of lint soaked with blood into the bucket on the floor.
‘And the next,’ said the surgeon, cutting again, and there was more bleeding and more swabs going into the bucket. All the time the nurse’s and the surgeon’s bare hands became covered with more and more blood.
Then the surgeon pulled open the wound and asked Sister to hold it at one side so he could have a good look inside. He put his hand in and fished about a bit and that’s when Maud did start to feel a bit dizzy, seeing the man with his hand inside someone’s body. But she took some deep breaths and managed to stay upright.
‘Ah, there it is,’ said Mr Jones. ‘There it is, look,’ he said, indicating for Maud to come closer.
She peered inside the hole in the man’s body and saw some red, angry, swollen mass that looked like it was full of pus.
‘It’s as we thought,’ said the surgeon, ‘and if I can drain off the pus, I will try to remove the appendix and then our man might just stand a chance.’
To Maud’s horror the patient gave a groan at that moment and started to shift a little on the table. It looked like he was waking up. Dr McKendrick at the head of the table was straight there with the dropper, immediately putting a few more drops of the liquid, the chloroform, on to the lint and then checking very closely on his patient’s condition. All those gathered in theatre were waiting for the patient to settle but not until Dr McKendrick had nodded to Mr Jones were they able to proceed.
Maud was in awe of the man with the chloroform. Without his skill and his careful attention none of this would be able to happen. She had never been so captured by anything before and this whole experience felt like a revelation.
Working swiftly, Mr Jones placed his hands back in the wound. Maud couldn’t see what he was doing but within moments he was using lumps of gauze as he soaked up and mopped out the man’s insides.
Maud could see that it wasn’t just blood coming out. It was yellowish fluid and what looked like yellow pus. Then Mr Jones looked very intently inside the wound for a few moments before going back in with the knife and immediately bringing out a piece of blackened gut with his hand. Sister quickly took it from him with a swab and placed it in a basin. ‘Suture,’ called the surgeon, and Sister was already handing it to him. Then he called for a suture again and he was, at last, sewing up the wound.
Maud didn’t realize how still she had been and how caught up she was in what was going on until it was all over and the nurse was applying a dressing to the wound. Maud watched avidly.
‘She did well, our new nurse, didn’t she, McKendrick?’ said Mr Jones. ‘Most of the probationers and even some of the medical students hit the deck on their first time in theatre. You did well,’ he reitereated to Maud, giving her a warm smile.
‘You did very well,’ added McKendrick more quietly, and Maud noted how refined his accent was.
‘Thank you both. I am so grateful for the opportunity to work with you in here,’ she said, ‘but I have a great deal to learn.’
‘Haven’t we all?’ smiled McKendrick, and then his attention shot back to his patient as the man began to groan and to move a little.
‘I will speak to Sister Law,’ said Mr Jones. ‘I will ask her to send you in again, as often as she can spare you. I think you have the makings of a fine theatre nurse.’
Maud couldn’t believe what had just happened and she was thrilled at what Mr Jones had said.
‘I would like that very much,’ she said eagerly, smiling her thanks to the surgeon, but he was already going out through the door back on to the ward.
When she was back out through the door again herself she realized that it was way past the end of her shift. She had lost all track of time. Sister Law told her to get herself off the ward straight away and she must have agreed to that because it felt like she only started to come back to reality when she was out in the open air walking the short distance back to the Nurses’ Home.
She remembered the whole sequence of the procedure in theatre and it was still playing in her head as she made her way home. Even small details of what McKendrick had told her about the chloroform and what to watch out for: the colour of the patient’s skin and any blueness of the fingertips. It felt like it was ingrained on her mind and might well stay there for ever.
As Maud came in through the now familiar door of the Nurses’ Home she could hear the sounds of their evening meal in the dining room so she headed in that direction. As she entered the room she saw Nancy look up immediately and continue to stare with dead eyes as she crossed the room. Maud also saw Alice glance up as she sat pale and silent with Nancy’s little group of nurses, and the pain on her face made her stomach tighten. She started to go over to Alice – she needed to sort things out – but as soon as Alice spotted her she got up from the table and left the room.
Maud’s heart sank and she suddenly felt the tiredness from all the events of the day starting to catch up with her. She knew that she would have to find a way to speak to Alice but she also knew that she must leave it for now. She didn’t have the strength, she needed to eat and she needed to get some sleep.
Seeing Eddy’s smiling face beckoning her from another table, she went over, grateful in the knowledge that she could let Eddy talk and talk, the words would flow over and around her and there would be no need at all to make any response.
8
‘No training is of any use, unless one can learn 1) to feel, and 2) to think things out for oneself.’
Florence Nightingale
‘Maud, Maud,’ said a voice in a loud whisper and then someone was shaking her arm.
‘Maud, wake up.’
‘What? Is it time?’ said Maud, not knowing where she was.
Opening her eyes she saw Eddy’s concerned face looking down at her. Not used to seeing anything but a smile on Eddy’s face she was instantly worried, even in her sleepy state.
‘What’s wrong?’ she said. ‘What’s going on?’
‘Shhh,’ said Eddy.
Even stranger, thought Maud. Eddy doesn’t usually even think to be quiet.
‘It’s …’ said Eddy, pointing to the dividing wall between their rooms, ‘and Nnn,’ she said, pointing to Maud’s door and across the gallery.
‘What?’ said Maud as quietly as she could.
Then Eddy whispered, ‘It’s Alice. I heard her crying on and off all night and I think it’s something to do with …’ She pointed in the direction of Nancy’s room.
Of course, thought Maud, of course that’s what it was.
‘Ah, right,’ she whispered. ‘I need to speak to Alice somewhere private. She won’t see me, she won’t speak to me. You need to bring her, but where can we go?’
Eddy thought for a moment then whispered, ‘The back yard is the best place, where they keep the coal. I’ll take her there after breakfast. Nancy always goes back up to her room to primp and preen before she leaves for the ward, so she won’t be watching. So when you see us go, you follow, all right? There’s a back gate so you can go straight out to the hospital from there.’
Maud nodded and gave Eddy’s hand a squeeze.
Breakfast seemed to go on for ever that morning and whilst Eddy tucked into her fried egg and extra bread, Maud was struggling to eat anything at all. Maud hated this atmosphere. The sooner she could get things straight with Alice, the better.
As Eddy wiped the egg yolk up off her plate with a piece of bread Maud was beginning to think that she might well have forgotten all that they’d said in her room that morning. But it was almost remarkable in the way that Eddy reacted as soon as Nancy slipped away from the table. She must have been sensing exactly what was happening the whole time. The moment Nancy was gone she was up out of her seat and across to Alice with the remains of the bread in her hand. Maud watched as Eddy spoke to Alice and they both kept glancing in her direction and then Alice looked at her for a longer time and Maud’s heart tightened when she saw how unhappy she was. Then Eddy said something else and, with relief, Maud saw Alice give a single nod of her head and get up from the table to follow Eddy towards the door at the far side of the room.
When Maud opened the door to the yard she found Alice standing with her back to her, facing the wall.
‘I’ll leave you to it,’ said Eddy, slipping by and closing the door behind her, the piece of bread still in her hand.
Maud waited for a moment to see if Alice turned round but she was showing no sign and Maud could see that her shoulders were held very square.
‘Look, Alice,’ she said at last, to Alice’s back, ‘please turn round so that I can speak to you properly.’
But Alice just sighed and continued to look at the wall.
‘All right then,’ said Maud, ‘I’ll just talk to you like this then. Look, I have an idea about what must have happened for you to be like this with me all of a sudden.’ Not sensing any reaction from Alice and seeing her shoulders were still held square, Maud had no choice but to continue. ‘I think Nancy knows about the baby and I think that you’ve assumed that I am the one that must have told her.’
Alice still didn’t speak.
‘Alice, please, you have to listen, you have to believe me. If Nancy has found out about the baby then it has nothing – nothing – to do with me. I promise. I would never tell anyone, least of all her.’
Alice still stood with her back turned.
‘Look, if you don’t believe me then that’s that, there’s nothing I can say or do. But Alice, please, think about it. Why would I tell her? You are my friend and I promised to keep your secret.’
‘Well, how would Nancy know then?’ said Alice, turning to face her at last and folding her arms across her chest. ‘You are the only one that I’ve told.’
‘I have no idea,’ said Maud, looking her straight in the eye, ‘but you have to believe me. I did not tell her.’
Alice bowed her head for a moment and didn’t speak.
‘Maybe she noticed something about you; maybe she guessed. Think back over the last couple of days – could she have seen anything that might have given her a clue?’
‘Not that I know of,’ said Alice quietly, then lifted her head with a look of realization in her eyes. ‘But there was the fried egg thing yesterday morning – that could have been it I suppose. I can stand all the smells on the ward – they never seem to bother me – but the smell of a fried egg first thing in the morning can sometimes really turn my stomach. Well, the girl opposite me had one and instantly I started to heave inside and I had to leave the table. I always sit next to Nance on that table. Sometimes I want to sit next to you and Eddy on the other table but she always looks up when I come into the room and pats the seat next to her. It’s like she draws me to her every time. I didn’t really think anything of it at the time. I mean I’ve got so used to feeling sick all the time, I just jumped up and went straight up the stairs to my room.’
‘That could have been it, it really could. Because, you have to believe me, Alice, I have not told anyone, not even Eddy,’ said Maud.
Alice stood silent again for what felt like a painfully long time, until Maud heard her speaking very quietly. ‘I believe you, Maud. I believe you didn’t say anything to Nancy. Sorry about that.’
Maud let out a sigh of relief. ‘You don’t need to be sorry,’ she said. ‘I’m just glad you believe me. And that we are friends again. That’s all that matters.’
Alice lifted her head and gave her a small smile. ‘We are friends, Maud. I think you are my best friend ever. And I am so sorry, I should have realized that it wouldn’t be you. I should have known straight away.’
‘Look, Alice, please don’t worry about any of that. We are friends and that’s all that matters.’
‘Thank you, thank you,’ said Alice, ‘I don’t know what I’d do without you. I’ve been so worried because Nancy started saying things like, “Well, you know they’ll find out, you know you’ll have to leave,” and all that kind of thing, and it made me panic. I’ve got nowhere else to go, Maud, nowhere. I can’t tell my family, I can’t go home, and Jamie, the father of the baby, well, I really like him, Maud, and we’ve been friends from childhood, but you remember I told you he’s gone far away? He’s in Australia. And you know what makes me really mad as well? We only did it once, just once, on the night before he left. And look at what happened!’
Maud stood quiet, not knowing what to say for the best. But seeing her friend looking so desperate, she knew that she would have to do something other than commiserate. She had to try to lift the mood somehow.
So she reached for Alice’s hand, took a deep breath and brought her voice up a notch, ‘Australia, hey, Australia. Did you not have any other childhood friends who were just nipping back to Ireland or going on a trip to France or even America? But Australia! You know how to pick ’em, Alice Sampson, you certainly do!’
Alice looked up and started to smile with the tears still in her eyes. Maud caught the smile and expanded it with her own.
‘Look, Alice, I have no idea what we are going to do about your situation yet but I will help you in any way I can. You’ve got me working with you on this. As for Nancy, well, I just want to say one thing: do not trust her. Tell her you don’t want to talk about the baby and if she comes back to you with anything else or starts talking about people finding out, you come straight to me, you hear?’
‘Yes,’ said Alice, ‘I will.’
‘Another thing,’ said Maud. ‘I didn’t feel that I could talk to you about this when we first met, but, well, do you want to keep the baby? I mean, I have no idea what women can do in your situation but have you any idea?’
‘I’ve not been able to think straight,’ wailed Alice. ‘And at first when my courses didn’t come and I began to know what had happened I felt absolutely sure that I wanted it. It was his baby and I could still feel his kisses on my lips and his breath on my skin. But now, now that he’s gone, he feels long gone, and I’m trying to do my work here, and I love the work, but I’m so tired all the time and I’m puking in the sluice, and once I had to be sick in my hands. And then Sister saw me with it in my hands and I had to tell her that I’d caught it for a patient when I saw that they were going to be sick, and Sister said, “My goodness, Nurse Sampson, you have amazed me. I would never have thought it from your performance to date, but you have the makings of a nurse after all. I’ve never seen any nurse do that for a patient before ever,” and then she said I might one day make an excellent nurse …’
‘Sorry, Alice,’ said Maud, starting to giggle. ‘Sorry, I just can’t help laughing. It’s just that I can see Sister Law’s face, sorry …’ Then Alice began to giggle as well, and she tried to pull a stern face to look like Sister but she couldn’t stop giggling. Maud put a hand on Alice’s arm and managed to sober up. ‘But seriously, Alice, things must have been so difficult for you all these weeks and I can understand how confused you must feel about the baby. How many months are you, do you know?’
‘Well, I must be about three months gone by now. And I really don’t know what I want any more, Maud. I haven’t felt it move yet. I don’t know when that happens but I think as soon as it does then that’ll be it, I will have to keep it. But how can I keep it? I know that they won’t let me have it at home. We live in a small town in the countryside over thirty miles from Liverpool. Everyone would know and it would bring too much shame on my family. And I’m terrified, Maud, terrified, not just about what I’ll do about here and the work, but two women from my town have died already this year giving birth. What if I’m going to be the third?’
