“And where is that, I might ask, and by whose authority?” He was slipping on his white doctor’s lab coat. All the other doctors had given them up as too impractical to keep clean.
“Is there some higher authority that guides the use of needed equipment? After all, I or one of my staff orders it, supervises the training for it, cleans it, and runs it.” I hadn’t had enough sleep the night before. I knew I was being testy, but I couldn’t seem to stop myself. “But if you want to take over some or all of those duties…”
“Don’t get smart with me, young lady. That is surgical equipment. We can’t have nurses trotting off with it willy-nilly.”
I took a breath. Challenging him would be of no benefit. “We need it for the new respiratory tent.”
“Since when is listerizing a treatment for gassed patients? Who ordered that?”
He had caught me in the undefined middle ground between what nurses could do within their own practice and what required doctor’s orders. I needed to tread carefully. “It’s not an individual treatment. It’s part of maintaining as sterile an environment as we can. And it’s not for gassed patients. It’s for the newly arrived men with respiratory conditions.”
“I’ve heard more about that. They’ve not even seen battle. Why are we giving them special treatment? A sterile environment? Have you lost your mind completely? Or noticed we’re in the midst of a war?”
“If we don’t control the spread—”
“Listen to me, Miss Stimson. You get back to work saving the lives of the men who’ve been fighting. That’s what we’re here for. They’ve run out of strong men in Blighty. They’re sending over the weak and the cowards now.”
“They’re Canadian.” I couldn’t seem to help myself.
His face reddened, and he yanked the cart out of my hands. “You haven’t heard the last of this.” He rattled away, his white coat flapping after him.
CHAPTER 18
The good news was American combat units were arriving in theater in increasing numbers. The bad news was the enemy was stepping up their attacks, sensing a need to weaken the Allies before they could establish more strongholds.
And still, our beds were filling with influenza patients. I could see Dr. Valentine’s dire prediction heading toward us like a locomotive. Phil was traveling back and forth to Paris nearly every week, causing me to worry he would collapse from exhaustion. His damaged tissues and muscles had not had time enough to heal.
We needed to simultaneously care for our current patients, plan a new place to send the influenza patients, protect our staff, and prepare for the oncoming wave of casualties. It was my nature to worry about every possibility, but I couldn’t, or I would spin my wheels and get nothing accomplished. And I had to be careful not to tread into areas that were not my responsibility.
Although I was invited to the medical staff meetings, I was a guest. Whenever I offered opinion outside my official duties, I got cold stares. Even so, at the last staff meeting, I had requested time at the next one to discuss that hazy line between what I or my nurses could do without first getting a doctor’s approval. To function more smoothly, we needed better ground rules.
After that, the only way to succeed was to divide and conquer the tasks: first determine if I or my staff was responsible, then prioritize according to urgency, then assign to the most appropriate people. Of course, that all sounded simpler than it actually was.
Over the next few weeks, trainload after trainload brought a mix of casualties. Thanks to Fred’s work in identifying places for quarantine, we weren’t getting still healthy soldiers. But the numbers of soldiers with pneumonia and influenza were increasing steadily, sometimes outnumbering the wounded.
Squarely in my area of responsibility was to protect my staff from injury and illness as best we could. As I lay on my bed, not sleeping due to the images of coughing men spewing clouds of infection toward my nurses, an idea dawned on me. Our dwindling supply of face masks would never be enough for all these patients or for our nurses to change even once a day for very long. We were two weeks away from our next shipment, possibly a week if I got on the phone to London several times a day to beg for a rushed order.
My pleasant trip to downtown Rouen and meeting with the baker inserted itself in my dreams. Then the ladies chatting in rapid French in the fabric shop next door. As I tried to enjoy my mind’s seeming distraction, I realized there was a connection my sleepy mind was trying to make. I sat bolt upright.
The townspeople were always eager to help, and there seemed not much we could ask of them without stripping them of their own meager supplies. But pretty fabric was one thing that was in abundance. Paris may have been the fashion center, but Rouen had been producing wool and cotton fabric for centuries. During my visit to a fabric shop, the eager proprietor had shown me bolts and bolts of cotton fabric, with tiny flowers and other designs. She waved at the fabrics, then waved disparagingly at the rather empty streets. From what I could determine, she was telling me no one is buying. The fabric and sewing trades were large, but the demand for their goods was low.
So when it seemed to be a respectable enough hour in the morning to summon Benjamin, I made a cup of tea to take to him. I rapped lightly on the door of the hut he shared with several other men. After a few tries, I got some groans in response, and I cracked the door open. “Benjamin? It’s Matron. Can you come to the door?”
Within a minute, the young man slipped out into the dark alley, lit only by the kerosene lamp I carried.
“What’s wrong?” He was hopping on one foot as he slipped a sock on the other.
I felt embarrassed; this was no emergency. It was simply my need to push forward with my idea as soon as possible. I held up the teacup, which Benjamin looked at with suspicion. He took the cup but coughed at the awkward moment.
“Can you take me into town? I want to be there when the shops open at seven o’clock.”
Benjamin took a sip of the hot tea. “Of course, Matron.”
“I should explain… I need to—”
“There’s no need to explain.” He checked his watch. “If you say you need to be there at seven, then I’ll be ready with the Ford at six thirty.”
My embarrassment ebbed. Indeed, outside medical staff meetings, my word carried some weight. It would have been too easy to abuse it, and I vowed to not squander any influence with selfish requests.
* * *
We arrived on the dot of seven, but to my chagrin, the fabric shop was not yet open, despite what the posted sign said. Apparently on lundi (Monday), seven o’clock arrived closer to eight. Happily, the bakery next door was open, and the scents of fresh bread and croissants lured Benjamin and me over for a treat. During the drive, I had explained to Benjamin that I planned to ask for help from the women in town to make face masks for our nurses.
We sat in delicately twined wrought-iron chairs. “Do you have a pattern for them?” Benjamin had switched to coffee, possibly to simplify the order by holding up two fingers. He made a funny face as he took a swig.
“Here, try with some cream.” I pushed the small carafe toward him, then pulled a little diagram from my leather pouch. “It’s not a true pattern, but I think they can figure it out from this.”
Benjamin examined my drawing. “If I can make a suggestion? Instead of a rectangle, make it smaller on each end. Then when you gather the folds, it will be less bulky to sew. The straps should connect here—”
“How do you know so much about making face masks?”
“You Yanks have been here only a year and arrived with shiploads of supplies. We’ve been at this for nearly four. We’ve had to sew patches on uniforms with thread cannibalized from other uniforms. We learned from the locals to wear cloth over our faces when the spring winds come. Otherwise, you’re breathing in some fine cow manure dust.”
“I’m sure you’ve done much tougher things.”
He looked at me, then away, in that misty-eyed stare I’d seen in so many of the soldiers. “I’ve been on the front lines, behind, and in between. Been shelled as an infantry bloke, shot at as an orderly carrying stretchers, and have driven through minefields. So yeah, I’ve seen my share.”
“Anything you want to tell me about?”
“I’ve got some interesting scars on my chest.” He rubbed above his sternum.
“From shrapnel?”
“Righto. Shrapnel in my heart.”
That got my attention. “Oh my. That’s not usually a survivable wound.”
“Guess I was one of the lucky ones. They opened me up, cut out a piece of my rib, peeled back the lining of my heart, and plucked out that piece of lead. Sewed me up, and I was good for a while. But my hands and feet kept turning blue, and I couldn’t catch my breath. They wanted to open me up all over again, but I didn’t want to go through that bollocks twice.”
I glanced at his fingernails, a telltale place to assess how well someone’s blood was oxygenated. They were nice and pink and normally shaped, with no clubbing of the fingertips, which could indicate low blood oxygen over a long period of time.
“So what happened?”
“This was in a hospital in Belgium, and those nice doctors said they’d let me be. But then the British took over, and I had no choice. They said the first operation was dodgy, so they whipped me back into surgery. When they opened me up, they found a piece of my skin had gotten stuck on my heart, keeping it from beating properly. So they sliced it clean off, and here I am today.” He took a swig of the coffee and winced.
“But I guess they didn’t want to send you back to the front.”
“No, ma’am. They made me an orderly at the base hospital, and when they found out I could drive like a demon, I did that too.” He nodded toward the window. “Hey look, Matron. The fabric store is opening.”
It seemed he was done storytelling for the moment. How painful it must have been to remember and share such an ordeal, but also hard to live and move on without expressing it. I was glad to have been the ear he chose.
* * *
The shop was small, maybe ten feet by fifteen. It was stuffed to the ceiling with bolts of colorful fabrics, and an entire wall was covered with notions: needles and thread, all manner of buttons, and lengths of cloth tape I hadn’t a clue how to use.
Benjamin needn’t have worried about a pattern for face masks. As soon as I pantomimed a mask over my face, the elderly but spry proprietor took me to a back room, where there was a stack of fifty or so masks, made from colorful fabrics.
“Combien?” she asked. How many?
I was startled that any would already be available and hadn’t yet calculated the number I needed. I did some quick mental math: number of nurses working each shift times number of shifts per day. If they all wore them, 130, which I thought was best for now. But they would need to be laundered each day, and there would need to be a second set while the first was laundered. We needed at least 260.
“Deux cent soixante.” I was proud that at least I knew my French numbers.
The frail woman, dressed in a white dress with tiny blue flowers, clapped her hand to her mouth. “C’est impossible!”
I had reached the limits of my French and asked Benjamin to translate a question. “How long would it take to make that many?”
The answer came, and Benjamin translated, “The girls, a dozen or so, can each make one or two a day after school.”
“Girls? Filles? How old are they?”
I was especially sensitive to seeing children put to work. In Harlem, we had little boys as young as seven admitted to the hospital with frostbite from being outside all night selling newspapers. And at Barnes Hospital in St. Louis, we had seen dozens of boys who had been recruited from orphanages to work at the many glassworks factories across the river. These child workers were shipped from all over the Midwest, arriving in boatloads on the Mississippi and trainloads into East St. Louis, their small hands valued for cleaning glass bottles.
Although the newspapers and factories claimed the children had a better life than where they came from, it still broke my heart when I saw their injuries.
A federal law passed in 1916 finally put limits on children working in factories, but there were still industries where it was allowed. I fully intended to find a way to support more protections for children in the United States.
But my reaction in the French shop was out of place. The woman waved me off and turned her back. Chagrined, I realized I had insulted her and her culture. Indeed, France had had child labor laws in effect for fifty years before they started being adopted piecemeal by some states back home.
“Désolé.” I’m sorry. “Benjamin, can you please order enough fabric and thread for the project and offer your pattern if she wants it? And let’s take some fabric back with us to get started with.”
* * *
The revised admission process became routine. We got the influenza patients through the bathhouse and settled into beds in the newly designated ward in quick order, as they didn’t require X-rays or evaluation by a surgeon. There was some griping among the nurses, which was unusual for them.
“Why don’t they just put these crybabies back on a ship home? They haven’t even dirtied a pinky, and they’re taking up beds needed by the heroes out there fighting,” said one to the nods and scowls of the others.
This attitude displeased me greatly and came as rather a surprise. I called together all the nurses on duty for an impromptu counseling session. “Ladies, we have newly arrived soldiers who have been stricken before they even set foot on a battlefield. This is through no fault of their own, and I can only imagine the discomfort they must feel at this circumstance. If they recover, they will go on to serve. If they don’t, they will have given their lives to the effort, the same as any other of our fallen.” I looked at each one of their faces, not singling any of them out.
“You will treat them with the utmost respect. They will receive the same care, that is, the best care possible from us. If you cannot do this or doubt your ability to protect yourself while caring for them, you may ask your shift leader to assign you to a different unit. Is this understood?”
They sheepishly murmured, “Yes, Matron.”
It was the only time I ever had to make such a statement.
* * *
My little Charlotte had been assigned to the respiratory tent and was her same dedicated self, bringing books and little treats to the men, who were feverish and coughing but otherwise unharmed. Apparently, she had an elderly uncle back home who had a huge personal library. He was sending his treasures to her, a few at a time.
She borrowed a metal cart that was used to pass medications and loaded it up every time she received a shipment of books. Then, she went down the ward, spending time with each patient to find what might suit them. Many asked her to sit on the chair next to their bed and read to them.
Between her long shifts, then the book sessions, I was becoming worried. She was just a slip of a thing when we started, and now her cheeks were starting to hollow.
When she reached the end of a row of beds and was about to roll her cart down the other side, I pulled her aside.
“Miss Cox, are you getting enough sleep? When was your last meal?”
“Oh, I’m just fine, Matron. Don’t you worry about me.”
“I am worried. If you don’t take care of yourself, you can hardly take care of the others, and they need you.”
“If I can’t do this for the men, I will surely break down. It is such a relief from seeing the burned and bleeding and…” She shook her head. “Not that I mind that work, you understand. But I need this”—she waved toward the pale but otherwise whole men—“more than they need me.”
“That’s all well and good. But this is a special situation in here.” I pointed t
o a quarantine sign and then to my own face mask.
“I’m being careful, Matron.” She held up her gloved hands.
“You think you are. But I saw you lean in close to a patient and pull up your mask.”
Charlotte reddened, and she looked away. “He couldn’t understand me. It was just one moment.”
“It only takes one moment.” I let this sink in.
“Yes, Matron. I’ll be more careful.”
“All this work you’re doing would be over. Not only that, you could become another burden to be cared for. Do you want that?”
I knew I had hit home by the way her eyes watered. Maybe I had been too harsh; she was such a delicate soul. But I shook off my doubts. It wasn’t my job to coddle.
CHAPTER 19
I barely had time to make a quick round of the wards before a meeting scheduled to discuss the limits of our nursing practice. I was hoping we would be allowed the use of aerosolized antiseptics whenever we saw fit. It was foolish of me to take the equipment from the operating theater, even though it wasn’t being used. That was apparently an overstep of the boundaries I sought to make more clear.
I had already written to my uncle Lewis for some guidance. Of course, his experience was limited to use in operating rooms, but I thought we should at least explore the idea for our respiratory patients.
On my rounds, I first went to the intake “lounge.” We had adopted the French word, as it sounded so much more pleasant than tent or ward. There was the usual assortment of men in dirty uniforms, with bandages wrapped around heads or arms or chests. One of them greeted me by name.
“Matron Stimson!” He looked all of nineteen years old, with closely cropped sand-colored hair, deep blue eyes, and red and silvery burn scars around his nose and mouth. I had no recollection of him. My eyes drifted to the rank insignia pinned on his collar. A Canadian private.
“Good afternoon, Private. Are you being treated well here?”
“You don’t recognize me, do you?” The soldier laughed and proceeded to lift his shirt. “Maybe this will refresh your memory.”
The War Nurse Page 20
