Farewell To The East End

by Jennifer Worth

  Novice Ruth took her final vows and practised her calling for about twenty years. But in the mid-1970s she encountered a spiritual crisis, which in religious language is called ‘the black night of the soul’. It is a most terrible experience, probably more shattering than the worst kind of divorce. It is well known and documented in monastic literature, and is a spiritual phenomenon to be dreaded, yet in some ways welcomed, as it is a testing of the soul and suffering can lead to an enriched spiritual experience. Sister Ruth was tormented for years with no respite and eventually renounced her life vows and left the order.

  Sister Bernadette, an inspired midwife from whom I learned all the practical skills of the profession, also left the Order but for a very different reason. She worked faithfully all through the 1960s and ’70s as a midwife. In the 1980s, when the HIV virus infected the Western world and when medical and nursing staff were vulnerable to being infected, she nursed AIDS patients at a time when the mortality rate was close on 100 per cent. Throughout the 1980s there had been debate in the Church of England about the ordination of women, and in 1993 the General Synod voted that women could be admitted to the priesthood. Sister Bernadette could not take this. Deep religious conviction based on theology and history told her that it was wrong. She was in her seventies and crippled with arthritis, but she had the courage of her convictions to leave the Anglican Church. This meant that she would have to leave the Sisters with whom she had shared her life. She was accepted into a Roman Catholic order, where she lived the strict life of a solitary contemplative, devoting her time to prayer and meditation.

  Ambition is a double-edged sword. One side will cut through stagnation and lead to a new life; without ambition, mankind would still be living in caves. But the other side can be destructive, leading to feelings of loss and regret. I was ambitious, and my sights were set high. I was planning to be a hospital matron or at the very least a sister tutor, and I would have to climb the ladder of the nursing hierarchy. A district nurse and midwife was only a lower rung on that ladder. I did not really want to leave the Sisters, but I knew that, if I stayed with them, I would stagnate. I loved the Sisters and their devotional life, and I loved the fun and freedom of district work in the docklands, but to continue would have rendered me unsuitable for the discipline of hospital work, which was very strict indeed in those days. I left the Sisters in 1959 to become a staff midwife at the London Hospital, Mile End Road, where I enjoyed seeing more of Cockney characters. But it took a long time to settle down to the rigours and discipline of hospital routine. Eventually the move paid off, and after a couple of years I obtained my first junior sister’s post at the famous women’s hospital, the Elizabeth Garrett Anderson in the Euston Road (now sadly closed). Later I became night sister there, which in those days meant being in overall charge of the hospital throughout the night. Then I became ward sister of the Marie Curie Hospital in Hampstead.

  I was climbing the ladder, as anticipated. But then I met a certain young man, and ideas of becoming a hospital matron seemed rather irrelevant. We have been happily married for about forty-five years at the time of writing. After our children were born I gave up full-time nursing, but continued part-time.

  In 1973, after a twenty-year nursing and midwifery career, I left nursing altogether. All my life I had been a frustrated musician, and with intensive study, supported by my husband, I achieved a Licenciate of the London College of Music and later a Fellowship and started twenty-five years of music teaching.

  IN MEMORIAM CYNTHIA

  This book was dedicated to Cynthia as early as 2004, but she never read it. In June 2006 Cynthia died. She had had cancer six years previously, which had been successfully treated, and she and Roger had continued their adventures, but in 2004 he developed congestive heart failure, from which he died about eighteen months later. Clinical depression returned to cloud Cynthia’s mind during his last illness, and then there was a recurrence of the cancer.

  She died as she had lived, quietly, peacefully and with no fuss. Gently she let go of life, and had said to many people that death was what she wanted. She knew it was approaching, and was content. ‘I hope I have been useful,’ she whispered to me a few days before her death. Cynthia received her last communion and she, who was virtually sinless, made her confession and received Holy Unction.

  Her stepson, her sister and I were with her during the last five days of her life, and on the final day, when to all appearances she was unconscious, I said to her slowly and clearly, ‘I am so thankful I have been with you.’ Her eyelids flickered, and she breathed rather than spoke the words, ‘And so am I.’ In my experience the dying always know who is with them and need the love they bring.

  Cynthia was Godmother to my elder daughter, Suzannah, who had sent a card to her during that week. It was a complete surprise to me, and I read it aloud to Cynthia. The words were so beautiful I cried as I read them, and Cynthia smiled her slow, sweet smile, and whispered, ‘I remember too.’

  It may seem pointlessly sentimental to those who do not know either character, but for me a testimonial to my dear friend is necessary, and so I quote my daughter’s card in full:

  Dear Cynthia,

  I am thinking about you a lot at the present time, but most especially I am remembering past times and what you have meant to me over the years.

  When I was a little girl, I remember dropping a bowl of jelly on the floor twice, and the second time the bowl broke! I was so upset I cried, but you didn’t get cross.

  I remember what fun it was when you took us up into the bell tower of Roger’s church. You let us ring the bells – you said it wouldn’t matter if all the people in the village thought it was the wrong time.

  I remember sleeping in the caravan and being kept awake all night by the owls and the bells. More recently I remember visiting you when our girls were little. You took us for a lovely walk along the coast, and you made them a special pudding with smiley faces on.

  Most recently you sent me some of your jewellery, and you patched up my old bear, which you made for me when I was christened.

  All these things are memories I will treasure forever – they remind me of you, my Godmother. Over the years I have come to realise that you are essentially what a Godmother should be. Thank you for being you. Bless you, now and always.

  Your loving God-daughter

  Suzannah XXX

  FAREWELL TO THE EAST END

  The Sisters had opened Nonnatus House in the 1870s to meet the needs of women living in dire poverty. However, during the 1960s things began to change rapidly, and the old way of life vanished.

  One by one the docks closed; air freight had replaced the old cargo boats, and the dockers became redundant. At the same time demolition of bomb-damaged and slum property started, and people were rehoused out of London in the new towns. For many this was life-shattering, particularly for the older generation who had lived their entire lives within a radius of two or three streets, close to their children and grandchildren. The rehousing programme tore apart the extended family, which had provided the unity and been the strength of East End life for generations. Families in the suburbs started a new, more affluent life, and began to feel ashamed of their old Cockney dialect with its distinctive accent, its idiosyncratic grammar, its delicious word order, its double and triple negatives, its back slang and rhyming slang. Sadly the old Cockney lingo virtually disappeared.

  In the 1960s vast areas of London were torn down, and with them went the Canada Buildings. The heart went out of old Poplar.

  I wandered around the Buildings after they had been evacuated. Where little girls had played hop-scotch and skipped, where boys had played football or marbles, where women in curlers and head scarves had gossiped and men exchanged racing tips, where teeming human life had been lived in all its rich fecundity was now a ghost town. Hollow sounds echoed up the walls of the high buildings, a dustbin lid rolled across the cobbles, a broken door swung against a wall. In the court, where costers had once trundled
their barrows, stood rows of municipal rubbish bins. Where once there had been washing lines festooned with clean washing, broken lines now trailed in the dirt. Where the coalman with his horse and cart had sauntered in stood a notice – NO ENTRY. Stairways up which women had heaved everything, including a baby in its pram, were barricaded with the notice DANGER. Dark corners, where giggling and kissing had once been heard, were now filthy, piled high with detritus blowing in from the yard. Windows, where net curtains had fluttered, were boarded up. Doors that had always been open were now permanently closed. No movement, no life, no humanity. I left the Buildings and never went back.

  IT IS FINISHED

  The exodus of the traditional Cockney people affected the Sisters’ practice, especially when the docklands became ‘smart’. Newcomers did not know, nor particularly want to know, about the nuns. The National Health Service and the fashion of going into hospital to have a baby reduced their midwifery practice considerably. The advent of the Pill in 1963 brought it to an end altogether. Women, for the first time in history, had control over their own fertility, and the birth rate plummeted. Throughout the 1950s the Sisters had delivered around 100 babies per month. In the year 1964 that number had dropped to four or five.

  The Sisters, who had done so much to help the very poor in the slums of Poplar, were no longer needed.

  They had come to Poplar in 1879, when there was virtually no medical or nursing care, and their dedication and self-sacrifice had saved the lives of thousands of poor women. They were known and loved by everyone living in the area, but in the brave new world of modern technology, the nuns suddenly seemed absurdly old-fashioned. The history of these heroic women was forgotten.

  This may seem a sad outcome. But the Sisters were first and foremost a religious order living under monastic vows in the service of God, and they did not look at it that way. A century earlier they had been called to nurse the sick and deliver the babies of those who could not afford medical attention. This vocation they had faithfully carried out for nearly 100 years. If the poor no longer needed them, they had fulfilled their mission and they were well pleased. ‘It is finished,’ were Christ’s last words from the cross. A life’s work fulfilled and finished is a triumph.

  The nuns closed their nursing and midwifery practice and turned to other work – drug abuse, shelter for the homeless, working with the deaf, helping Asian women to integrate into British life, and in the 1980s they started working with AIDS patients. They continue to do these and other tasks into the new millennium.

  In 1978 Nonnatus House was closed after ninety-nine years of service to the people of Poplar. The Sisters removed to the Mother House, to await God’s calling for work – they knew not what or where. They left quietly and with no fuss. Perhaps only the local clergy and a handful of older people were aware that they had gone.

  And here my tale ends, with the closure of Nonnatus House.

  THE END

  GLOSSARY

  This glossary by Terri Coates MSc, RN, RM, ADM, Dip Ed.

  Afterbirth. Also known as the placenta (see below). It is called the afterbirth because it is expelled from the womb after the baby has been born.

  Amniotic fluid. The water that surrounds a baby in the womb.

  Antenatal. The term used to describe the whole of pregnancy from conception to the onset of labour.

  Anterior presentation. The back of the baby’s head in labour will normally be in the front or anterior part of the mother’s pelvis. The anterior presentation is the most favourable for the baby to adopt for a normal delivery.

  Asphixia pallida. A newborn baby that has become very pale (grey/white) because there is no attempt to breathe and the heartbeat has become dangerously slow.

  Atelectasis. An incomplete expansion of lobules (clusters of alveoli) or lung segments may result in partial or complete lung collapse. The collapsed tissue, unable to perform gas exchange, allows unoxygenated blood to pass through it unchanged, producing hypoxemia (deficient oxygenation of the blood). Atelectasis can be present at birth (incomplete expansion of the lungs), or during adulthood (from a collapsed lung). Prognosis depends on prompt removal of any airway obstruction, relief of hypoxia, and re-expansion of the collapsed lobule(s) or lung(s).

  b.d. The medical shorthand used as an instruction on prescriptions to mean twice a day. From the Latin bis die.

  Cervix. The cervix is the neck of the womb or uterus.

  Caesarean section. An operation to deliver a baby through an incision in the mother’s abdomen

  Chloral hydrate. Chloral hydrate was a mild sedative and analgesic used in the early stages of labour. The drug was given as a drink with either water and glucose or fruit juice. Chloral hydrate is an irritant to the stomach and often caused vomiting, so is no longer used.

  Contraction. A contraction is the intermittent tightening of the muscles of the uterus (womb) which are painful during labour.

  Cord presentation. The cord is palpable at cervix through the intact membranes.

  Crown. The top of the baby’s head, usually the first part of the head to emerge. When the top of the head emerges it is said to crown.

  Crowned. When the widest diameter of the baby’s head is at the vaginal opening during delivery the head is said to have ‘crowned’.

  Curette. A surgical instrument that comes in different sizes and shapes that is used to scrape away unhealthy or unwanted tissue.

  D and C. Dilatation and curettage (D and C) is an operation to remove any pieces of placenta or membrane from the uterus to prevent further bleeding or infection.

  Dates. The date that the baby is due.

  Eclampsia. Eclampsia is a rare and severe consequence of pre-eclampsia. It is characterised by convulsions and is an infrequent cause of death of a mother and unborn baby.

  Ergometrine. Ergometrine is an oxytocic drug which makes the muscle of the uterus contract after delivery.

  Eve’s rocking. An outdated method of resuscitation. Chest compressions are more effective and are used with mouth-to-mouth resuscitation.

  External Cephalic Version (ECV). Rotating the unborn baby or foetus into a position more favourable for a normal delivery.

  Exsanguinate. Extensive blood loss. Possibly fatal.

  First stage of labour. The first stage of labour is from the start of regular painful contractions until the cervix (neck of the womb) is fully open.

  Forceps. Forceps are used to gently hold tissue during an operation or surgical procedures.

  Full term. The length of a pregnancy is nine months (forty weeks). Full term is considered to be thirty-eight to forty-two weeks of pregnancy.

  Fundus. The top of the uterus.

  Gamgee. Absorbent tissue.

  Gas and air machine. Gas and air was a popular form of pain relief for labour. The air has now been exchanged for oxygen, but the term ‘gas and air’ is still used. The ‘gas’ too has changed over the years: the ‘gas’ in current use is nitrous oxide.

  Gestation. The gestation is the number of weeks of pregnancy.

  Gluteous muscle. The gluteous or gleuteous maximus muscle is the large muscle in the bottom.

  Higginson’s syringe. A type of flexible syringe with a long nozzle usually used to administer enemas.

  IM. Intra-muscular or into the muscle.

  IV. Intra-venous or intra-venous infusion may be more commonly known as a drip (in this case blood).

  Lobeline. A respiratory stimulant.

  Left side. Positioning women on their left side for delivery was popular for a while. Women are now encouraged to choose the position for delivery that is most comfortable for them. The left side or left lateral position is rarely used.

  Menorrhagia. Excessive menstrual blood flow.

  Nurse. Title of nurse is now rarely used for or by midwives. Midwifery is an entirely separate profession. Many midwives were trained as nurses, but this dual qualification is now less common.

  Obstetric forceps. Forceps used to grasp the foetal head to facili
tate the delivery in a difficult labour.

  Occipital protuberance. Or occiput is the back of the baby’s head.

  Os. The opening of the cervix which leads into the womb.

  Otitis media. Inflammation or infection of the middle ear.

  Oxytocic drugs. Drugs such as Oxytocin or Ergometrine that make the muscle of the uterus contract after delivery and are used to either assist the delivery of the placenta or control bleeding after delivery of the placenta.

  Paediatrician. A doctor who specialises in the care of children.

  Peritoneum. The lining of the abdominal cavity.

  Pathology lab. Laboratory where samples of blood would be sent for confirmation of infection.

  Pethidine. A drug used for pain relief in labour.

  Perineum. The area of skin between the vagina and the anus.

  Phthisis. Tuberculosis of the lungs. No longer in scientific use.

  Pink eye. Conjunctivitis is also known as ‘pink eye’, an inflammation of the conjunctiva of the eye. The conjunctiva is the membrane that covers the eye.

  Pinards. A simple trumpet-shaped stethoscope used by the midwife to listen to the baby’s heartbeat before birth.

  Pitocin. An early proprietary brand name for an oxytocic drug used for induction of labour or treatment of uterine inertia.

  Pituitrin. A hormone produced by the pituitary gland, which helps enable lactation. The hormone also stimulates contraction of the uterus and was formerly used to help to induce labour.