The War Nurse

by Tracey Enerson Wood

A soldier on a stretcher in the far corner began to cough violently and retch.

  “Charlotte, can you please do what you can for that patient?”

  As we unloaded the ambulatory patients, I checked each one for urgent conditions so that Fred could see them before the long trip back. Finding none, we crowded them into the ambulances. I consoled myself that they weren’t much more cramped than they had been on the train, and they certainly didn’t complain.

  But still, my mind turned the corporal’s words over and over. Why was there a mystery about these injuries? Was there just a lack of communication between the field station and transport, or was something else going on?

  I decided the best way to find out was from someone who was there. Late that evening, I went to the ward where Amiens arrivals had been assigned. Most of them were asleep. The room reverberating with the sound of loud snoring didn’t seem to disturb them in their exhausted states. But midway down the center row of beds, I found a soldier sitting up, his legs dangling over the side of the bed.

  I picked up the clipboard attached to the foot of his bed, noted his name and last vital signs. “How are you feeling, Private Riffle?”

  He was hunched over, reminding me of elderly patients suffering from emphysema. He twisted his head around to see me. “Can’t complain.”

  An American accent. I looked again at his flow sheet to confirm. “Where are you from?”

  “Iowa originally. But we deployed from Fort Riley, Kansas.”

  A coughing fit interrupted the symphony of snoring. Then, one after the other, the patients fell into coughing fits, as if they were passing them along like a baton. Private Riffle coughed as well and wiped a suddenly bloody nose.

  I gave him a towel, but it seemed the issue resolved quickly on its own.

  “Has this been happening often?”

  “Yeah, off and on.” He peered at me over the brown towel. “I mean, yes, ma’am.”

  He was so green, he probably just got out of high school.

  “Can you tell me more about what happened to your unit? I understand you may have been attacked by some new type of hard-to-detect gas.”

  “My unit?” He looked around at his fellow patients. “No, I don’t know any of those guys. I just arrived in country and got real sick after a few days. Don’t know from what. Maybe a sneak attack, something random.” He hacked, then wiped his mouth.

  I unwrapped the stethoscope Fred had lent me from around my neck. He had been coaching me on breath sounds. “Can I have a listen?”

  From the rales and rhonchi, the bubbling and low whistles I could hear through the stethoscope, I knew his lungs were quite wet. The lower portions of his lungs had no sound at all, not a good sign. He probably had pneumonia, and from the sounds of the coughing and wheezing in the rest of the crowded ward, so did most of them.

  “Thank you, Private.” I helped him into bed, with an extra pillow to raise his head.

  It seemed we were sent not a trainload of injured soldiers but a group of men probably infected with a contagious disease. I needed to put the entire ward on respiratory isolation. And what about Fred, myself, and the others who had come into contact with them?

  It was eleven o’clock at night, after a very long day, but I would have to wake Fred.

  CHAPTER 16

  I changed to a fresh uniform, then brushed and twisted my hair into the French knot I had seen local women do, telling myself the whole time I would freshen my appearance for any doctor I needed to consult in the middle of the night.

  As I approached the door to Fred’s hut, I could hear a soft snore and couldn’t help my mind from wandering back to his warm body cuddling me against the bitter chill of the barn. Shaking off those thoughts, I rapped on his door.

  A snort and a groan.

  I rapped again. “Dr. Murphy, it’s Matron.”

  “Jules?”

  “Yes. We need you in the respiratory tent.”

  “Come in here.”

  I looked down the path both ways. No one was about, but still I couldn’t risk someone seeing me entering his hut. “Um, I… Why don’t you meet me in the mess tent? I’ll make some coffee. It’s urgent but not an emergency.”

  “For God’s sake, just get in here.”

  If I left the door open, it shouldn’t be a problem, I thought. “Okay, coming in.”

  Fred was sitting up in bed, wiping his glasses with a cloth, his hair a wild mane. He was undressed, at least from the waist up. “About time.” He must have sensed my tension. “What has you so riled up? I don’t think it’s a patient going south. You’re acting too strangely.”

  “Well, two things, actually. I’m uncomfortable coming in here, and we’ve got a pressing problem with a group of men just admitted before their first battle.”

  His eyes followed mine to his hair, and he ran his fingers through it. “I’m quite the sight, I’m sure, but you’ve seen worse.”

  “It’s not that, and you know it.” I looked toward the door I had left open. “We can’t let prying eyes see me here and make the wrong assumptions.”

  “I don’t give a crap.” He pushed aside his covers, revealing, thankfully, a set of boxer shorts. He waved in the general direction of the lone chair in the room, where a pair of slacks were slung.

  “Well, we can discuss that at another time.” I grabbed the slacks and set them next to him. “We’ve just admitted thirty men with respiratory symptoms. Fever, cough, some short of breath.”

  “Gas attack?”

  “No. These are all new arrivals. Haven’t been close to the front.”

  “That doesn’t rule it out. Bastards could have spies sneaking canisters aboard troop ships.”

  The strange reports I had received from the corporal on the train with the patients and the American private had made me suspicious of the nature of their conditions. “I don’t think so. No burns, and fever isn’t—”

  “Let’s go take a look.” He had slipped on his pants and was fishing about the wooden wardrobe that occupied a corner of the hut.

  On the way to the intake ward, I filled Fred in with what I knew.

  “I think I know what you’re thinking, and I agree,” he said.

  “Something contagious.”

  He nodded. “If it’s tuberculosis, there’s little we can do but isolate them and keep them hydrated. If it’s a virus, pretty much the same treatment, but they should bounce back more quickly. We could try quinine, I suppose, if we have any.”

  We had arrived at the entrance to the newly designated respiratory tent. From a table just outside the door, I picked up two face masks the nurses had fashioned from some gauze and rubber bands so as not to deplete the supply for surgery. I handed one to Fred, then slipped one on myself.

  There were two rows of fifteen men, lining the long outside walls of the tent. Most were sleeping. One of my nurses was holding a basin under the chin of her patient, who was in the midst of a coughing fit.

  “So we’ll give support, but it will have to run its course. Do you think we have enough space between patients?” I asked.

  He fidgeted with the rubber bands encircling his ears. It certainly wasn’t a comfortable feeling. “It would be best to put each of them in their own tent. Is that possible?”

  I huffed at his rhetorical question. But he had a point. What choices did we have? There was some space in the postoperative tent. But to put the respiratory cases in there seemed a dangerous combination. “The only way to do that would be for the doctors to double up in their huts. Nurses are already two to a hut, but maybe we can stack them, like on the ship. We’ll all bunk together.”

  “I’d be okay with that if I get to choose my bunkmate.” His eyes crinkled above the white gauze.

  Ignoring his attempt at humor or flirtation, I pressed on with my official duties, mindful that there were thirty-one set
s of ears that might appreciate a tidbit of gossip. He had turned to exit the tent, and I double stepped to keep up with him. “I’ll need written orders for the isolation, quinine, and whatever else you might want to try.”

  “Respiratory isolation and comfort measures.” He yawned, blinked back the sleep I had interrupted. “Write it up, and I’ll sign. Also isolation from anyone who has had contact with them without mask and gloves.” He stopped walking. “Wait, you were at the CCS today. Were you exposed?”

  I bit my lips. I had anticipated this question but still had not thought it through. I needed to review the whole day in my head. “Probably.”

  “Jesus. If you get so much as a sniffle, I want you to report to me.”

  Thankfully, although I was down for a few days with bronchitis, I bounced back quickly, and I watched my nurses like a hawk, but so far, they had remained healthy.

  CHAPTER 17

  Poison gas was unquestionably an atrocious weapon, but it did provide a tiny glimmer of light. It helped us learn how to care for the ever-growing number of victims of the respiratory condition we now believed was influenza. The two groups needed similar care, but this led to a perplexing problem.

  When I did my initial rounds one frosty morning, I found Nora, the night supervisor, just going off her shift, having an argument with Dr. Valentine. She had her arms crossed over her chest in a defensive position, but there was no mistaking the fire in her eyes. “Yes, he may be your surgical patient, but I’m telling you he’s not being assigned to this ward.”

  “Good morning,” I greeted them. “What seems to be the problem?”

  Dr. Valentine had dark circles under his eyes and appeared more rumpled than usual. “I just spent four hours in surgery saving the life of a man who your nurse doesn’t feel is fit for her ward. He needs respiratory isolation, and this is the respiratory tent you insisted on.”

  “Indeed it is. What is your concern, Nora?” I asked.

  “In addition to the burns Dr. Valentine has operated on, this poor soldier has been exposed to mustard gas. There is little we can do for his poor burned lungs, but we must at least keep him away from the influenza patients.”

  “But that’s the point of this ward, isn’t it? All the masking and gloves and extra room? To protect them from one another and to protect the staff?” His voice was hoarse with fatigue.

  “You both have a point. But this isn’t an issue to decide now, when you’re on the brink of exhaustion. We’ll put the patient in the officers’ tent for now. It’s nearly empty.” I gently steered Dr. Valentine out of the tent by his elbow. He was too tired to resist.

  Dedicating two tents to respiratory isolation was out of the question for the moment. We hadn’t the supplies, the room, or the staff to manage it. But Nora was right. We had seen the havoc the flu caused on healthy lungs. There was no telling what would happen to the gassed patients if they contracted it. So I had the tent divided by heavy canvas drapes, added a handwashing station to each end, and advised the supervisors to assign the nurses to one side or the other. Likewise, the patients were assigned to the flu side or the nonflu side.

  * * *

  The gassed patients had seemed to do better with a daily dose of sunshine and fresh air. Each day, we bundled them up and rolled their beds outside. The men always enjoyed the outing. The sight of them, some wrapped in white bandages from head to toe, lying with their arms outstretched as if to capture the healing rays of the sun, at once raised my spirits and put a lump in my throat.

  When the weather was cold, it wasn’t safe to bring them outside. But they became more and more restless, needing more pain medication, and generally irritable. Skin infections increased at an alarming rate, and the coughing grew worse by the day.

  It seemed to me that the influenza patients would also benefit from fresh air, and a less germ-infested working space would be of benefit to the staff as well. I came up with a plan to bring some of the healing powers of the outdoors in. We needed more beds, and tents were being added. When it came time to place the tents, I requested their direction be changed so that the large flaps on each end could be opened to the prevailing winds.

  Summer would be the most important, and the cooling winds came from the north and west in the summer. In the winter, we had the westerlies and also a warming wind from the south. So we placed the tents with their flapped sides open toward the west.

  The first new tent had just been set up and the beds and equipment placed as a trainload arrived with dozens more influenza patients. I went out to the receiving area to help unload the ambulances. I opened the back door of one and found twelve men in American uniforms, sitting on the floor or standing against the walls, playing cards or making bets.

  “What are you fellows doing?” I asked rather rhetorically. They looked at me rather sheepishly, then all started talking at once.

  “Wait. You.” I pointed to one who had the stripes of a corporal.

  “We’re all fresh off the boat, ma’am. Barely got to our unit when one guy started coughing his lungs out. So the LT sent our whole platoon to the CCS. They didn’t know what to do, so we got sent here.”

  “Are any of you ill or injured?” A chorus of nos and shaking of heads, and one “this guy here is not right in the head” with a friendly shove.

  “So you’ve been exposed but not sick.” It appeared they were sent to be quarantined, but we weren’t set up to do that. And neither were the units. “Okay, guys, seems you’re pretty comfortable here for now. I’ll get you some food and water. Just stay put.”

  A quick tour of the other ambulances showed me much of the same thing, but mixed in with the healthy soldiers were a few with fevers and coughs. We separated them out straightaway, and I hurried off to check with the doctors for what they wanted to do.

  I hastily arranged a meeting with Fred and Dr. Gross right there in the receiving area. We also sent for my brother Phil, as he was steadily increasing his work with infectious diseases.

  Our little group went up to the ambulance full of poker-playing soldiers.

  Fred asked, “You guys don’t really want to be here, right?”

  They just laughed. “Beats the front,” one said.

  “How about we set you up in a chambre d’hôte for a week or so? I got a friend in Rouen with some rooms.”

  They all cheered, and with a few words to the ambulance driver, Fred had them on their way.

  As I steered the doctors to the next ambulance, I asked the obvious. “That’s a wonderful solution for them, but how many French hoteliers do you know?”

  “Ah, the lady asks too many questions.”

  The three doctors laughed and cheered.

  “You know what I mean. And how will we pay them?”

  “Let’s just say they’re returning a favor. And this is just temporary. I’ll get on the horn and find some space in neighboring hospitals. Beyond that, it’s headquarters in Paris’s problem, not ours.”

  “Good, because running a quarantine for healthy, rambunctious soldiers is not something I want my nurses involved with.”

  “How much room do you have in the tent for respiratory cases?” Dr. Gross asked. His specialty was ophthalmology, but he frequently treated patients with facial burns and gassed patients as well.

  “It holds thirty all together, and there’s maybe a dozen patients in there now. A few gassed patients, one suspected TB.”

  Phil winced. “We really need to get the TB case out of here. As for the gassed—”

  Fred interrupted. “This isn’t Barnes. We can’t have a separate ward for every diagnosis.”

  “What do we do then?” I asked. “We have the one tent for all of them. The staff wear masks, sometimes gloves, and we pushed the beds farther apart, but that’s about the only difference.”

  Fred used his thumb to point at the soldiers in the trucks behind him. “Separat
e out the soldiers suffering from flu symptoms, clean them up, and admit them to the tent for infectious respiratory conditions. The healthy ones can wait here until we find a place for them.”

  “How far apart should the beds be?” I asked.

  Fred shrugged. “Just spread them as much as you can within the space.”

  He was not forthcoming with how much distance was needed, probably because no one really knew. We knew that people in the same household were likely to infect one another but didn’t know if that was because they breathed the same air, touched the same things, or were close enough to cough their germs at one another.

  Phil couldn’t give a concrete answer either. In fact, he merely added to our worries. “I imagine the germs are spreading hand to hand, maybe survive in the air, long after someone has left the room,” he said.

  “We can manage keeping them from contaminating things with their hands, but what about the air? How far could a sneeze carry the germs? A cough? Do we need to wash their bedding and clothes individually, like with smallpox or lice?”

  “I’m sorry, Jules,” Phil said. “We just don’t have those answers yet. Run some electric fans, and do the best you can with what you have.”

  The more I thought about it, the more I felt sucked into a vortex of never-ending worries. There was, in fact, only so much we could possibly do. We couldn’t put the men, or those who cared for them, in protective bubbles. We had to use what we had, which was bleach, rubbing alcohol, and a disinfectant that we aerosolized during surgery. Since we only did emergency surgery at night, it occurred to me that I could borrow one of those units from an idle operating theater. My mind buzzed, and I began to feel more hopeful.

  That was until I met with the roadblock of Dr. Valentine, just as I thought we were making great progress.

  * * *

  “What the hell do you think you’re doing?” Dr. Valentine stopped me as I wheeled a cart out of the operating tent.

  “Borrowing this equipment from an unused space to use where it is vitally needed.”