In Falling Snow

by Mary-Rose MacColl

  The surgeons operated constantly through the first week of July. We set up a second theatre at one end of Blanche. The laboratory was working through the nights to keep up with the surgeons. Swabs were taken of wounds on admission and Dr. Dalyell had to sort those with gangrene from those without so that we could prioritise. Vera Collum had trained as a radiographer and now worked with Dr. Savill in the X-ray room. She and two others worked day and night too. Nearly 90 percent of the wounds we saw in those weeks were gangrenous, and the surgeons needed films in order to know what to excise. Mostly they didn’t stop to look for shrapnel, just to clean or amputate to stop the gangrene spreading.

  The Senegalese soldier I’d met on one of my first nights at Royaumont, the one who’d known the dying boy’s village and had spoken the boy’s language, returned to us, this time gravely wounded. He’d lost both of his brothers to the war and now he too would die. I stopped at his stretcher and said a prayer. Allah was the name of his God so I said it to Allah. “Take care of this poor man who will never go home,” I said. He opened his eyes and looked at me. I don’t think he remembered me but I stayed with him as long as I could and I held his cold hand. I don’t know why they’d bothered to move him from Creil. Dr. Henry came up behind me. “This one’s dead, Iris,” she said. “Move on to the next.” I looked up at her and there were tears in my eyes but she failed to see them. “Come on, Iris. We don’t have time to tarry.”

  Later that day, a group of two hundred soldiers, underfed, tired to exhaustion, and ragged, walked by Royaumont. They asked if they could sit on the lawns for an hour or so. We did better, giving them fresh straw to sleep on overnight and a hot meal, and fixing what we could of their minor scrapes and dirty uniforms. Where were their officers? Where was their canteen? These poor boys hadn’t eaten a meal for over a week, hadn’t slept. What we could do for them, for any of them, was so meagre compared with what was happening across France.

  After I finished on the ward again, I went up to my room and lay on my bed but couldn’t sleep. I spent a long time staring up at the ceiling without thoughts, just wide awake. Finally I fell into a fitful sleep but woke after less than an hour feeling worse than when I lay down. I’d never felt so tired and yet I knew I had to go back to the ward. I dragged myself up, washed quickly, dressed, and went down.

  Miss Ivens had operated for eighteen hours straight the day before and had had less rest than me, I was sure. There were no shifts for our surgeons. They just worked while we had urgent cases, and right now we had a constant stream of urgent cases. Miss Ivens was already back at work, according to an orderly I saw on the stairs. Violet had worked through the night too as more casualties poured in. I found her in the cloister and we shared a cigarette before she went off again to Creil to pick up another load. I’d worked hard to learn to smoke. It had taken time but finally I was as competent as Violet. I found it calmed my nerves.

  Violet told me a patient had fallen from her ambulance in the night and she’d had to go back to get him. It shouldn’t have been a reason for mirth but as she told it—she’d heard a thump, assumed it was a pothole, and had driven on, the other patients yelling at her to stop—we both started to giggle.

  “The worst of it is,” Violet said, trying hard to suppress laughter, “I went on for half a mile before I realised what the din in the back was about.” And then she broke up altogether and I joined her, a picture in my head of little Violet, sitting up straight at the wheel of her ambulance in the way she did, leaning forward, peering ahead into the darkness, intent on getting her wounded to Royaumont, ignoring the noise in the back until she could no longer, then realising what she’d done, turning round, just as intent on getting back to the poor wounded man who’d fallen from the truck.

  The man was ambulatory—a minor head injury—and he hadn’t been further injured by the fall. All arrived safely at Royaumont half an hour later. But we couldn’t stop laughing, and all I can say in our defence is that we were exhausted beyond all reason.

  I had continued to worry about Violet’s mental state. She was often in a black mood now and more against the war than any of us. I sometimes thought she might just quit and go home. She didn’t seem to be able to find any good in what she was doing. I was glad we were laughing again, more than laughing, giggling like the young girls we were, as if the horrors all around us were nothing but stories.

  “What’s the joke?” Quoyle asked. Even if we could have got the words out amidst our laughter, I knew she wouldn’t have understood.

  Miss Ivens came out to the cloister then, looking exhausted. She ignored our laughter, which quickly sobered us. “Iris, I need you with me today. I’m meeting with the Croix-Rouge later and I must have you there. There’s trouble again. They want us to open another ward. I can’t see how we can.” Her eyes were wet with tiredness and just for a moment, I thought she might fall over or cry. I got up and, without thinking of the breakfast I hadn’t eaten, followed her back through the abbey and out into the day.

  There were a few women who weren’t cut out for Royaumont—you had to be a certain sort, ready to do whatever was needed, ready to muck in, as Miss Ivens termed it. The hardest thing for those who weren’t suited was admitting it to themselves. They so much wanted to be women of Royaumont, could see something worthy in it I suppose. Miss Ivens usually let them come to their own decision. Who am I to know their hearts? she would say to me. The first matron, Miss Todd, tried her best to fit in but was too steeped in the old ways. She didn’t have the kind of flexibility we needed, not knowing from one day to the next how many wounded would come and how we’d cope. It wasn’t always ordered and neat. The final blow had come when Violet was ill and Matron Todd had suggested sending up to Paris for a man. I really thought Miss Todd was for it. But Miss Ivens was kind, she let Miss Todd resign on her own terms and even wrote to Dr. Inglis later that while Miss Todd hadn’t fitted in at Royaumont, “it’s our fault for asking her to come out in the first place. She wouldn’t want you to know that she cried when she resigned.” Strangely, after Miss Todd left, many of the nurses missed her. Later they spoke of her as their mother away from home. I didn’t find her motherly, but perhaps that was because she saw me as one of Miss Ivens’s crew and not one of hers.

  The only person I remember Miss Ivens speaking to directly about leaving Royaumont was Dr. McCourt, who’d already come to her own decision so it hardly mattered. And I only mention her now because had Dr. McCourt not come to Royaumont, had she not awoken in me a feeling about myself I still don’t quite understand, other than it had something to do with pride and perhaps wasn’t my noblest feeling, had Dr. McCourt not done what she did, I probably would never have taken seriously Miss Ivens’s suggestions to me and the future might have been different. I might have done what my father had told me to do and taken my brother home.

  Dr. McCourt came to us highly recommended from one of the Serbian units. It’s true she hadn’t stayed long in any one hospital but when I raised this, Miss Ivens just said that Dr. McCourt might like change and this was hardly a reason to worry. I met Dr. McCourt on her first day. She ignored me and spoke to Miss Ivens as many doctors did. She was very sure of herself, I remember thinking.

  There was an operative case, a head injury, and Miss Ivens had embarked on a particular course of action, successful with other such cases. War presents so much useful trauma, the same over and over again, and Miss Ivens or one of her colleagues had discovered or read somewhere that if you made a hole in the skull and inserted a drain, the fluid collecting around the brain after trauma would disperse, easing pressure and reducing the mental damage that would render a man useless.

  When Dr. McCourt saw Miss Ivens drill the already damaged skull and insert a catheter drain into the injured man’s head, she was horrified, I think, for she brought it up in the theatre, even though Miss Ivens was leading the procedure and she, Dr. McCourt, was assisting. “Whatever are you doing, Frances?” she said
, despite the fact that Miss Ivens had just explained what she was doing. There was silence in the theatre, for our practice was that the lead surgeon—it wasn’t always Miss Ivens but whoever it was—made the decisions and others followed and no one questioned the lead surgeon, not during an operation and especially not if it was the chief.

  Miss Ivens was for the most part one of the gentlest souls I ever knew, but when you crossed her you were never in any doubt that you had done so. Miss Ivens looked up at Dr. McCourt over her mask, her big brown eyes and dark skin a band of energy across her face, and asked her to leave the theatre. Which of course she did.

  On another occasion, not long after this altercation, Miss Ivens and I were doing her ward rounds. She asked me to irrigate a wound and change a complicated dressing, normally something a doctor would have done herself. Miss Ivens had often used me in this way, even in the operating theatre. The first time, it had been necessity. One of the young doctors, Dr. Henry I think now, collapsed in the middle of an operation. Exhaustion was the culprit. It was during that rush of July when everyone was working an extra share. Dr. Henry fainted and one of the orderlies stood down to help her but Miss Ivens had to continue and she needed a second surgeon but none was available. “Iris,” she said, picking me over more experienced operating theatre nurses. “I need you to help me.”

  To be honest, despite my terrible nerves about making a mistake, there wasn’t much to it, cutting and scraping tissue to remove little pieces of metal and infection while retaining as much good tissue as possible, using an X-ray to guide the knife. The trick, I learned, was to proceed slowly, rather like one does skinning a rabbit so as not to waste good meat. Miss Ivens, busy on a facial reconstruction, left me to my own devices until she’d finished, which eased my nerves considerably and gave me confidence. Surely she’d be watching if there had been a need to do so. When she finished what she was doing, she looked carefully at the man’s thigh where I’d been working, compared my work against the X-ray, in the same way she’d do with a junior surgeon. “This is splendid,” she said. “Where did you train?” and smiled. I remembered that smile. It was like a bath of warm light in a darkness you didn’t even know was darkness, but once you’d been in that light you knew what it was to be back in the dark.

  By the time Dr. McCourt joined, Miss Ivens was using me to assist from time to time. I never felt I was asked to do anything I couldn’t manage and Miss Ivens said that my hands were as nimble as a surgeon’s.

  So on this day Miss Ivens asked me to change a dressing, it was nothing out of the ordinary and she did so confident that I would cause her patient less pain than the assisting doctor for the day, who, while well meaning and competent in diagnosis, was ham-fisted and so nervous about her ham-fistedness that she’d inevitably cause more pain than ease. None of the other doctors took much notice of me or seemed to mind me doing more than my role would strictly permit. I don’t know if they discussed it among themselves, but no one ever said anything to me until Dr. McCourt arrived on the ward that day and exclaimed, in a voice too loud for the space, “Whatever are you doing, nurse? Let me take over.” Miss Ivens had been called away and I had no choice but to stand aside. I hoped and prayed Miss Ivens wouldn’t return before the procedure was finished.

  I watched Dr. McCourt change the dressing, causing far more pain than I would have, and while it may be conceitful for me to say so, the poor patient’s groans were enough evidence that I was right. As she was leaving, Dr. McCourt, who looked impervious to the pain she’d caused, looked at me. She must have seen something in my eyes, something of disrespect, for she said, “I will be talking to Matron about your behaviour, nurse. There is nothing in the world worse than an upstart.” She said it loudly enough that the men around us and the nurses and orderlies heard her. My ears burned with rage and embarrassment but I said nothing. “Yes, Doctor,” she said. I looked at her, unsure what she meant. “Say ‘Yes, Doctor,’” she repeated.

  “Yes, Doctor,” I said, wishing the stone floors of the abbey would rise up and swallow her whole.

  The next week, Miss Ivens told me Dr. McCourt had left. I hadn’t told Miss Ivens about that day and the dressing, but for Miss Ivens, anything but total loyalty was unthinkable. Dr. McCourt had questioned Miss Ivens’s clinical decision making. She had to go. Dr. McCourt left, and while it wasn’t the last we heard from her, she never again served with the Scottish Women’s Hospitals.

  What happened with Dr. McCourt started me thinking along a path, I feel sure now. Dr. McCourt might or might not have been right in her criticism of Miss Ivens. I will never know the truth of that. But she hadn’t shown anything of the skill even someone like me had been able to learn at Royaumont, which would have enabled her to change that complicated dressing without doing further harm to an already traumatised patient. For the first time, I started to think that perhaps Miss Ivens’s faith in me wasn’t misguided kindness. Perhaps I did have some gifts to offer.

  Every year, the Croix-Rouge sent an officer to inspect the hospital and renew our accreditation. The first year they sent an accountant from Paris, a large round fellow who gave us an equivocal report, not failing us but not really lauding us either. But at the end of 1916, they were sending a new auditor, Miss Ivens said, and I was to help.

  The rushes of earlier in the year had finally abated and we’d been able to catch up with the maintenance work on the abbey, emptying the cesspits, working out where we might further expand the wards, finalising the plans for a new staff dining room.

  I went to a Halloween party in Blanche dressed as a kangaroo, using Collum’s fur coat and mittens and a scrunched-up hat as a joey for my pouch. The patients loved the parties we had, playing games like musical chairs or find the slipper as if they were carefree children rather than men who’d seen such horror. At the end, Violet sang for us and I found tears in my eyes listening to her again. The soft autumn sunlight streamed through the big windows and the men were listening intently, their red jackets and blankets against the stone walls, surrounded by staff in all manner of get-up, Berry as a rabbit, Miss Ivens as Father Christmas (“It was all I could find in the costume box, dear”), Dr. Courthald as an Argyll and Sutherland Highlander, Cicely Hamilton as a tank, crawling in under her canvas bath.

  Violet’s voice had come into its own at Royaumont. On All Saints’ we commemorated the dead in the cemetery at Asnières. It was awful to see the graves of the young men and to know they were now gone forever. When Violet stood and sang the “Marseillaise” that day, she herself cried, tears streaming down her face, her voice never faltering.

  I had all but forgotten about the Croix-Rouge officer who had accompanied the accreditation inspection team, the one I’d worked out was Jean-Michel Poulin. In fact, I’d seen his name on a report from a hospital in Reims and assumed he’d transferred north. But the new auditor was one of his colleagues from that inspection team, Dugald McTaggart. I went into the room where the inspector was sitting at the little table we’d set up. I could only see his back, as he was bent over the desk writing something. “Hello. I’m Miss Ivens’s assistant. I’m to help you,” I said in French.

  “Dugald McTaggart. Spy on me you mean?” he said in English and turned around. It was him. He’d only spoken French when I’d met him before and I’d assumed, wrongly, I realised now, that he was French. But he was Dugald McTaggart and not Jean-Michel Poulin. His accent was Scottish-French.

  I’m sure I was blushing. “I imagine so,” I managed to say, switching to English, “if that’s what it takes.”

  “You have given me a beautiful room,” he said.

  “This is the Chapel of Saint Louis,” I said, doing my best to recover my composure.

  “Perfect place for confession?” he said, and smiled. I remembered his smile, the way his face would change from severe to soft in a moment.

  “Or an Inquisition,” I replied.

  “Which do you think we have he
re?”

  “Both?” I said.

  I gave him the schedule of interviews for the morning. “Before we start, I’ll show you around.” Miss Ivens had told me not to let the inspector wander the abbey unaccompanied and to sit in on his meetings. While I had no intention of spending the day shadowing him if he wanted to work on his own, I also didn’t want to let him loose unaccompanied among the orderlies or drivers.

  As he picked up his bag from the table, I noticed his long fingers with well-groomed nails. “So, Iris, you’re still working for Miss Ivens?” I was surprised he remembered me.

  “Yes, but I’m also a nurse,” I said.

  “Ah, I could have picked that. You have a nurse’s eyes.”

  “What does that mean?”

  “Nurses can communicate everything they need to communicate with their eyes, which is why they are invaluable in the operating theatre.”

  The reference made me think suddenly of Al. We had first met in theatre. I felt guilty for no reason I could explain. “And how do you come to know so much about theatre sisters?” I asked.

  “I’m a surgeon. Did they not tell you that?”

  I didn’t say I’d assumed he was an accountant. “No, I didn’t realise they’d send a surgeon this time.”

  As I led him through the abbey, he talked about his work. He’d been a psychiatrist, he said. He’d signed up at the outbreak of war and they’d put him through basic surgical training. “We do what we can for their bodies but no one is caring for their minds. We’ll pay for this.”

  It was something Mrs. Berry had talked to me about. Many of the men who came through Royaumont, especially the ones who’d been wounded once already, woke in the night from terrible dreams, at once shaking as if cold and sweating as if hot, or didn’t sleep at all, smoking constantly through the hours. Some developed facial tics. Many were convinced they would die and could talk about nothing else. Others spoke incessantly with false cheer, or talked of revenge on the Germans. “We see it here too,” I said. “Our priest talks with them. I don’t know what he does but he calms them.”