by Kate Eastham
Walking back to the Nurses’ Training School to collect her nurse’s cape and hat before she made her way through the city, Alice was also struck by how much energy she had, even at the end of the day. The last time she’d made this journey her belly had been bulging out of her uniform, her legs were aching and she’d felt like she just needed to lie down. She’d also been weighed down by anxiety. So, managing the niggling worry over leaving Victoria seemed much easier in comparison.
Seeing Eddy perched on the step waiting for her was also an absolute delight. She ran up to her as though she hadn’t seen her for months. Eddy couldn’t stop laughing as Alice pulled her up from the step and danced full circle with her.
‘I did it, I did it,’ she chanted. ‘I did the first day!’
‘Crikey, Alice, don’t let the others see you. They’ll all be going off to have babies if they see how glorious you look after a day’s work.’
‘It was good,’ said Alice, her eyes wide. ‘I was a bit slow at first, but once I got back into it I felt like I’d never been away. And I felt better today than I’d ever done last time, because of … you know …’ She sketched the curve of a pregnant belly with her hand.
‘I’m so glad,’ said Eddy. ‘I’ve been thinking about you all day. I thought you might come out looking like a wreck.’
‘And I’ve been on Male Surgical—’
‘With Sister Law,’ said Eddy, ‘and you’re still smiling!’
‘Yes,’ said Alice. She started to calm down at last and put a hand to her chest as she became aware of how sore her breasts were feeling.
‘Mmm,’ said Eddy, seeing straight away how tight Alice’s bodice looked beneath the starched apron. ‘Good job you’d started reducing the feeds right down and I’d given you those squares of cotton to pack in. Bet you’re feeling it now.’ Eddy started giggling. ‘I wonder if Sister Law noticed that one of her nurses was growing a bigger bosom during the course of the day.’
‘Eddy!’ said Alice, laughing.
As the girls walked back to Stella’s together, each in their district nurse cape and hat, the people on the street smiled at them and some of the cheeky ones even gave a mock salute and called out, ‘Evening, Sister.’ Alice was amazed.
‘I’ve got used to it now,’ said Eddy, ‘but it surprised me as well, at first. But then, when I thought about it, the people are bound to be happy with us nurses and what we try to do for them, in the hospital and in their homes. And, another thing, the district nursing service in Liverpool was the very first in the country. They say that William Rathbone set it up because he’d had a good nurse to look after his wife in their own home. After she died, he wanted other people to have that as well. But then they needed more trained nurses, and that’s when he consulted Miss Nightingale and the Training School got built. And here we are: me and you and Maud, all part of it.’
‘The people are bound to be proud, when you think of it like that,’ said Alice quietly, linking arms with Eddy. ‘And we are lucky to be a part of it all.’
6
‘It can be safely taken for granted … that a thorough hospital nurse can seldom turn herself to any other business.’
Florence Nightingale
The next morning was hard. Victoria had been unsettled all night, maybe teething, maybe just feeling the separation. Alice had been feeding her on and off since the early hours – she’d also lit the stove, made the breakfast, handed her over to Marie whilst she got her uniform on and got ready for work, then she’d tried feeding her again. And then she’d had to hand her back to Marie, screaming.
‘Go, just go,’ shouted Marie, above the outcry. ‘She’ll be all right once you’ve gone.’
Alice nodded. She had no choice: she had to go to work, she needed to finish her training and she needed the money. Even though she would give a good proportion of her wage to Marie and Stella, there would still be some left over for her to put aside. She knew all of this, but this second morning, her heart was even heavier and her body felt like lead as she headed out of the kitchen.
As the front door clicked shut behind her, she could still hear Victoria screaming. Every nerve in her body felt alive with it, the sensation jangling through her whole body, wave after wave.
Glancing back once more down the alley, with tears welling in her eyes, she thought that she might, at least, see the cat trotting along behind her – but even Hugo had deserted her. She felt truly miserable.
Walking out on to Lime Street, Alice saw two policemen in plain clothes standing at the corner of the next alley. She was certain they were the ones who had picked her up and forced her into a carriage the day she was taken to the Lock Hospital. As she got closer, she felt a shudder go through her body, but she knew that she needed to stand tall and look like a nurse. So, lifting her head, she wiped the tears from her eyes, straightened her hat and pulled the cape around her more closely. Her heart was pounding and she held her breath as she walked by as fast as she could, praying that they wouldn’t recognize her.
She didn’t dare look at them but she was alert to any movement. Thankfully, they stayed as they were, and all she could hear was the mumble of conversation as she passed by. It seemed that Miss Houston had been right: the district nurse uniform would serve her well. In fact, she even thought she might have heard one of them call out a friendly ‘Morning, Sister.’
The relief that she felt as soon as she was at a safe distance helped her to calm down. She knew that she would have to trust that by now, Marie had the baby settled. She had to go to work and that was that.
Alice missed Maud so much as she stood on the ward, whilst Sister Law did the head count and assigned tasks. She always used to stand with Maud on this ward. Looking at the other nurses, she felt set apart, distanced, especially from the two new probationers who looked like friends. In fact, they could have been her and Maud last year. I hope, for their sakes, one of them isn’t pregnant, she thought with a wry smile to herself.
‘Am I amusing you this morning, Nurse Sampson?’ said Sister.
‘No, Sister, I was just …’ Alice’s mind was too tired to have a ready response. ‘I’m just happy to be back on Male Surgical, that’s all.’
‘That may well be the case, but try not to show it,’ said Sister, scowling first at Alice and then at each member of the group in turn. Silently, warning them all.
‘Right, Bradshaw and Fry,’ she hissed, in the direction of the new probationers. ‘After your dire performance yesterday, I want you to pay more attention. Start up at the top end of the ward: stripping, cleaning and making up the beds. I will be along to check …’
Alice looked over at Millicent Langtry, but she was staring into space, seemingly oblivious to what had just been said. Alice still couldn’t believe that Millicent was now a trained nurse. She had no idea how she’d got through the twelve months’ training. Maybe because she was always so quiet, she didn’t attract any attention. And without a shadow of doubt, Nurse Langtry, in Sister’s eyes, had the correct moral character; she was clearly unblemished.
Unblemished by life, even by thought, mused Alice.
‘Nurse Sampson!’ called Sister. ‘So sorry to interrupt your meditations but we need to start work. You’d better come with me – that way I can make sure that you stay alert and you’re properly engaged with meaningful tasks.’
Alice felt like telling Sister that she’d better keep an eye on Nurse Langtry in that case. She’d just seen her wander off absent-mindedly. She still couldn’t work Millicent out. Even though she’d been in their set first time round, it was difficult to get a sense of who she really was. Alice knew she was quiet and she always tried to do the best for the patients, but she was so slow with everything, and she struggled to pick up on what a patient’s actual needs were, so much so that Alice always ended up feeling irritated with her.
‘This way, Nurse Sampson,’ shouted Sister from halfway down the ward.
She’d have to remember to look more alert tomorrow morning; s
he didn’t want to end up working with Sister Law every day. And she certainly didn’t want to end up with a bad report. She needed to pass; she needed her certificate, the piece of paper that would give her the right to work as a trained nurse. And then she could stay on and work in the hospital or out in the district, whatever she chose to do.
‘Nurse Sampson, my word, you are in a daydream today … Come with—’
But Sister was cut short as two orderlies came running in through the door with a patient who was covered in blood, lying on a stretcher. Alice had never seen Sister run, but she took off like lightning, speaking to Michael Delaney, the orderly at the head of the stretcher.
‘He was dumped outside the hospital, me and Stephen found him,’ said Michael, desperately trying to catch his breath. ‘Looks like somebody’s put a tourniquet on his upper arm but he’s lost a lot of blood. It looks like he might’ve been stabbed.’
Alice saw Sister put a reassuring hand on Michael’s arm, while her eyes travelled up and down the stretcher, assessing the patient.
The poor man was unresponsive and looked, to Alice, as though he was barely alive.
‘He is very pale, looks like he’s in shock. Take him straight into theatre and put him on the table. You can leave him on the stretcher, he’s too poorly to move,’ said Sister, her voice clipped, full of energy.
‘Right, Sister,’ said Michael and Stephen together, already moving up the ward. Alice could see the faces of the other patients, sitting up in their beds. Some of them looked away, one man crossed himself.
‘We’ve no time to lose,’ said Sister, turning on her heel. ‘Nurse Sampson, I need you to go as fast as you can to Female Surgical, where you will find Mr Jones and Dr McKendrick. Tell them to come immediately.’
Alice ran out of the ward door at full pelt and straight into Miss Houston.
‘What is it?’ said Ada, seeming to know instantly that they had an emergency.
‘We have a man in a terrible state, I need the surgeons,’ Alice called over her shoulder as she careered down the corridor.
When she returned with Dr McKendrick, she waited at the ward door for Mr Jones as he laboured along behind. A man of his age simply could not run down the corridor, and Alice wanted to make sure that she got him directly into theatre.
She followed along behind as he walked up the ward and then in through the doors of the theatre. Alice caught her breath when she saw the high wooden table in the centre of the room. The patient had already been positioned and Sister Law was elevating his arm with one hand and pressing a ball of lint firmly over the wound with the other. His whole body was covered in blood and more blood still oozed from beneath the dressing.
Mr Jones was already at the sink, scrubbing his hands. Miss Houston had her sleeves rolled up and was preparing the instruments.
Alice heard the clink of an enamel bowl as Miss Houston placed it ready. ‘What do you want me to do?’ she said, looking at Miss Houston.
‘You take over from Sister, she needs to get back on the ward.’
Alice was straight there, side by side with Sister Law and taking hold of the ball of lint that she was pressing firmly over the wound. Her hands were instantly covered in blood.
‘That’s right, Nurse Sampson, firm pressure, and you’ll need plenty of lint; the blood is soaking right through. As you can see, the poor man has already lost a great deal. Now take his arm with your other hand – that’s it, lift it as high as you can – that will help slow the bleeding.’ Alice had never seen anyone who wasn’t already dead look as pale as the man lying on the table did.
‘Observe, Nurse Sampson, the signs of exsanguination: pale skin, blue lips and fingertips, collapsed state, shallow breathing … And if you could find a pulse,’ added Sister Law, ‘it would be rapid and thready.’
Alice nodded. It felt good to be in theatre; last time around she’d never once been chosen to come through the door. She could feel her breath coming rapidly and she was a little dizzy with it all – she had never seen so much blood loss before, ever.
‘You are managing well,’ murmured Sister Law, placing a stack of fresh lint pads on the small table next to Alice. ‘I’ll leave you to it now. As you can see, Miss Houston is an extremely capable and experienced nurse, especially in an emergency. Follow her lead and don’t be afraid to ask, Nurse Sampson. Always ask.’
‘Yes, Sister, thank you,’ said Alice, grabbing yet another lint pad.
Mr Jones was next to her now at the table and she removed the ball of lint for a few moments so that he could observe the wound. The surgeon narrowed his eyes and peered closely at it, his nose almost touching the flesh.
‘Ah yes, definitely a knife wound, quite a large blade too, and very sharp. It looks like a deliberate slice rather than a stab, as though someone knew what they were doing. Must have caught the brachial artery. Good job someone had the foresight to apply a tourniquet,’ he said, nodding to a leather thong around the patient’s arm. ‘It isn’t applied firmly enough, but at least it’s done enough to make sure that our man made it as far as the hospital.’
‘Do you think we’ll get away with tying the vessel and stopping the bleeding?’ asked Miss Houston.
‘Sadly, no,’ said Mr Jones. ‘As you can see, the affected arm is blanched; it’s been starved of blood for too long. We’ll have to remove the limb as well, I’m afraid.’
Alice looked at the arm she was holding. She could see calluses on the hand, a broken nail on the man’s thumb. It seemed so personal and so sad that the poor man’s right arm would have to be removed. She glanced at his face: he looked middle-aged with thinning brown hair and a stubble of beard, like any other man you might see walking around Liverpool. But this man has been marked out, she thought, and he will never be the same again.
Miss Houston sprayed some liquid over the instruments and the patient’s arm.
‘It’s carbolic acid,’ she explained. ‘We’ve found that it helps reduce suppuration post-operatively. It will give him a better chance of survival, that’s if he lives through the surgery.’
Alice nodded, trying to take in all the detail, beginning to realize why Maud had been so taken with theatre work. It was sharp, exciting.
‘Stand by with the chloroform, McKendrick,’ said Mr Jones. ‘We don’t want to risk giving it now, but sometimes when they feel the smart of the knife, they start to come round.’
Dr McKendrick nodded; he already had everything prepared. He seemed to Alice to be perfectly calm and she was already admiring the precision of his movements. He and Miss Houston seemed to work instinctively together as they prepared the patient.
First, Mr Jones went into the wound with some forceps, fishing around for the blood vessel that had caused the man to bleed so much.
‘Swab,’ he shouted, and Miss Houston went straight into the wound with a swab held in her bare hands.
‘Got it!’ said Mr Jones at last. ‘Now let’s finish the job and remove the arm.’
Alice felt her heart pounding as she stood ready to assist.
‘I’ll support the arm,’ whispered Miss Houston. ‘Can you stand ready to take it from me once it’s separated? It won’t take him long.’
Alice nodded, not daring to speak and disturb the quiet intent in that room. There was something almost reverent about it.
As the knife slipped through the man’s skin, Alice felt her stomach turn and she was suddenly light-headed. She took a deep breath, a tactic she’d used previously in similar circumstances. This was the first time that she’d seen a major operation, and she was keen to see everything. But the more she watched, the dizzier she felt, and then she could feel a cold sweat breaking out on her skin.
‘Try to stay upright if you can, Nurse Sampson,’ Miss Houston murmured. ‘But if you think you’re going to go over, sit yourself down over there on that stool—’
It was too late, Alice had hit the floor.
When she came to, she was gazing up at the concerned face of Dr McKendrick.
He was smiling at her.
‘I’m so sorry,’ she muttered, feeling like a complete fool. Stretched out on the floor, no use to anybody. ‘Is the patient …?’
‘The patient is fine, Nurse, just fine. Mr Jones is closing up the wound; you can watch if you want, but I think you’re probably best lying here for a while longer.’
‘Yes,’ said Alice, ‘I’m so sorry.’
‘Please do not apologize,’ said McKendrick, his voice clipped and well-spoken, but also gentle. ‘When I was a medical student in India, I fainted every single time I went into theatre for two weeks. I had to take a chair with me in the end, so I wouldn’t cause any trouble. The surgeon was very wise. He knew I would get used to it eventually, and he never turned me away. He told me this: all the best doctors and nurses faint in theatre. They do so because they feel for their patients. I believe this to be true.’
He was probably just being kind, thought Alice, as you are right now, Dr McKendrick. But she smiled up at him and thanked him for his kindness just the same.
She lay on the floor until everything was finished and Mr Jones had left, and then the door swung open and Sister Law was looking down at her, and she almost fainted again on the spot, because Sister was actually smiling. Only for a moment, but to Alice, it was like the sun coming out from behind a black cloud.
‘Right, Nurse Sampson,’ she said, straightening her cap and making sure that the string was knotted firmly beneath her chin. ‘Let’s get you up on your feet and then we’ll find you a cup of hot sweet tea before you get back to work. Don’t you be worrying about the faint – it happens to many people. I, myself, never fainted. Nor did your friend, Nurse Linklater, when she first came into theatre. But we were the exception to the rule. So do not worry.’
