The District Nurse

by Annie Groves

  Alice and Edith exchanged a glance as they obediently followed the diminutive superintendent. Their previous matron would sooner have died than make a comment about their legs. Clearly things were very different around here, and Alice had the distinct impression that, whatever else they were in for, it wasn’t going to be boring.

  CHAPTER TWO

  Alice had barely had time to unpack and settle herself in a Spartan but immaculately clean attic room when her first callout came. A young mother was worried about her baby, who seemed to be running an unusual temperature. One of the local doctors had referred her to the district nurses – could somebody come that afternoon?

  The message reached Alice just as she’d found her hairbrush and managed to give her hair a quick tidy as she peered into the small mirror perched on top of the chest of drawers. When not pinned up under her uniform hat or cap, her dark blonde locks reached to her shoulders in natural waves, but it was rare for her to wear her hair down. She was settling it back into its usual neat bun when there was a knock on her door.

  ‘Come—’ she began, but before she could even finish her sentence, in burst a young woman in nurse’s uniform, big blue eyes gazing at Alice with frank curiosity.

  ‘Are you Miss Lake? I’m Mary Perkins and I’ve got the room at the end of this corridor,’ the new arrival announced. ‘Sorry, you’re needed already. Only this minute got here, haven’t you? I’ve been here for two months so I can show you the ropes. We’ll get to know each other properly later, but if your bag is all ready to go, you’d better come with me.’

  ‘I’m Alice,’ said Alice, grabbing her bag, which she’d prepared in advance, and reaching for her navy coat. ‘But I haven’t got a bike yet.’

  ‘Not to worry, it’ll be around the side, they always are,’ said Mary Perkins, who Alice judged to be about Edith’s age, a couple of years younger than herself. ‘This house is a doddle to find, and you’ll be going there often if I’m any judge, and I can tell you right now I’m pretty good at guessing these things.’ She set off at a great pace and it was all Alice could do to keep up as her new colleague dashed along the narrow attic corridor and down the main set of stairs.

  ‘No running! Nurse Perkins, is that you?’ came a grim voice from the storey below.

  ‘Bloody old busybody,’ Mary muttered under her breath, but she did at least slow to a fast walk. ‘Have you met Gwen yet? No? Well, you soon will. She’s Fiona’s deputy, but don’t pay her any mind. Look, this is the way to the side door, it’ll save you time. That’s the district room, and that’s the drying room for your cloak when you’ve been out in the rain, but you can see all that later.’ She ducked around a corner and led Alice out into a sunny yard.

  Alice realised that – as it was on the corner of the road – the nurses’ home had a large area to the side. One wall had been turned into an informal bike shed, with a light timber roof balanced on the top ridge, and a makeshift rack propped so that a dozen or so cycles could be stored beneath it. Mary made her way along and paused at the end. ‘These are the spare bikes – one for you and one for the other new nurse.’

  ‘How can you tell? They all look alike,’ Alice wondered.

  ‘We all put something on our bike to show it’s ours. We’re not meant to but we do.’ Mary pointed to a bike at the far end. ‘See the one with the bit of blue ribbon around the bell? That’s mine. Silly really, but when I was walking out with this chap, he said I looked lovely in blue because it went with my eyes, so I got myself some ribbon to trim my hat, and that was what was left over. Turns out the ribbon lasted longer than he did.’ She shrugged, not overly concerned. ‘I say, have you got a chap?’

  Alice took a step back. She wasn’t accustomed to such direct questions from someone she’d only just met. ‘No,’ she said shortly and then, realising it sounded rude to be so abrupt, ‘I haven’t had time, after studying so hard. Anyway, I didn’t spend all those years training just to give it up to get married.’

  ‘Quite right,’ said Mary. ‘Only I wish they weren’t quite so strict about the rules. In by ten o’clock, no men on the premises, there’s hardly any fun to be had. Still, if you aren’t bothered about that then that’s all right.’

  Alice thought that Edith would find a way around the restrictions within the week, if her past history was anything to go by. But she didn’t offer that piece of information to Mary. Instead she asked, ‘Where am I going now?’

  ‘Jeeves Place,’ said Mary. ‘It’s hard to miss. You go back the way you’d have come this morning as far as the high road. Go straight over – that’s Jeeves Street. The road one further down, parallel to it, is Jeeves Place. Easy. Number nine. Patient’s name is Kathleen Berry, well, that’s the mother. Not sure what her baby’s called.’

  ‘I expect I’ll find out soon, then,’ said Alice, placing her leather bag in the basket of the bike and pushing it carefully towards the side gate. ‘Wish me luck. If I’m not back by teatime, send out a search party.’

  ‘Will do.’ Mary waved cheerfully and her lively rich brown curls bobbed around her face.

  Kathleen Berry tried to shut out the sounds of her baby son’s screaming. She’d tried picking him up and carrying him around, changing his nappy, offering him cold water, feeding him herself, taking him outside, bringing him back in. Nothing helped and now he was working himself up into a proper state. He lay in his makeshift cot, waving his fists in the air, his face an angry red. She didn’t know what to do. She hoped the nurse would get here soon. She was so frightened.

  Her mum had told her not to have anything to do with Ray Berry, that he was a feckless charmer who’d love her and leave her. Kathleen had defended him staunchly. He’d never treat her like that, her mother was just listening to the gossipy old women who had nothing better to do than spread cruel rumours that were without foundation. They were just jealous because they weren’t young any more and had probably never had the attention of a man as good-looking as her Ray. She knew he’d do right by her.

  And Ray had – she had his ring on her finger to prove it. No matter how tough things got she was never tempted to pawn it – it was too precious to her, it stood for everything they’d promised to each other. He’d done his best to provide for her but it hadn’t been easy. People were too quick to believe the gossip and he found it hard to get regular work. One day he’d told her he was going down the docks to see if anything was to be found there, and that had been the last she’d seen of him. One of his mates had dropped round to say he’d signed up for a merchant ship and had set sail that very day. It was too good a chance for him to miss.

  Kathleen knew he’d be back, but the trouble was he hadn’t sent home regular wages. She was never sure what she would get, if anything at all, but she hated to ask anyone for help. She hadn’t known for certain that she was pregnant before he left – she didn’t want to get it wrong and so she’d waited to tell him. He’d set sail without realising he was soon to become a father.

  Now she was stuck with little Brian in this rundown house, which was all she could afford, although if truth be told she couldn’t really even do that. She didn’t even have the whole place to herself – she had the ground floor, with its badly lit front room, cramped kitchen and even more cramped back kitchen, with its doorway into the back yard where there was an outside privy, shared by several families. Upstairs lived the Coynes, who trampled around on the bare boards with no regard of her need to sleep. Then again, they heard Brian’s cries all day and night as clearly as she did.

  ‘Shush, shush,’ she said, trying to keep the desperation out of her voice. ‘Mummy’s here. The kind nurse will come soon, she’ll make everything better, just you wait and see.’ She fervently hoped this was true. Wearily she leaned over the baby and took him up into her arms again, noting that he was still far too hot. ‘Mummy’s going to stand in the door with you, see if that cools you down.’ She shoved open the flaking front door and leant on the creaky frame, grateful for the light breeze to fan their face
s, even if it blew rubbish down the narrow street. Bits of old newspaper tumbled by. She was so tired she could have slept standing up, if she didn’t have little Brian to look after.

  Brian’s cries gradually turned to sad whimpers, but she knew it was because he was too tired to cry lustily any more rather than because he felt better. Anxiously she pressed her hand to his forehead. No, still hot. It wasn’t right. Why was he like this? Was it something she’d done, or hadn’t done?

  Kathleen bit down on her lower lip. It wouldn’t help if she went to pieces. It wasn’t as if she had many people to turn to. Her mother would say it served her right for marrying that good-for-nothing. Besides, her mother had four other children to see to, and three more grandchildren to fuss over. Kathleen knew she was a fair way down the list of her mother’s priorities. Sometimes she wondered if she’d been switched at birth as she couldn’t remember a time when she and her mother had got along. They were just too different, even before she’d met Ray. She knew she was quieter, more serious than her mother, who had a loud voice and coarse laugh. Her other siblings had had no such problems, and Kathleen had ended up distant from all of them as a result. She had one good friend who lived on the next street but she couldn’t expect her to be round every time something went wrong – which seemed to happen more and more. ‘It’s just you and me, Brian,’ she breathed, feeling better for admitting the frightening truth. If only Ray were here.

  She wasn’t sure how long she’d been standing there when there was a rattle of wheels behind her. Turning, she saw it was a tall figure in a navy cloak on a bike that had seen better days. There was no mistaking the woman’s hat though. It was the nurse, at last.

  ‘Mrs Berry? I’m Nurse Lake. Alice Lake.’ Alice dismounted from the bike and propped it against the house, pausing to take the Gladstone bag out of the basket. ‘Hope I haven’t kept you waiting too long.’

  Kathleen could have cried with relief. ‘Come in, come in,’ she said, stepping back inside the house with its meagre furnishings. She perched on a wooden chair, Brian in her arms, and left the one decent armchair for Alice.

  Alice took it, noticing that the cushions were faded and frayed, but had been carefully mended. The young mother before her wasn’t far off her own age, she guessed; maybe a couple of years younger. But her face was creased with lines of worry and she looked as if she hadn’t slept properly for a very long time. ‘Well, Mrs Berry, what seems to be the trouble?’

  ‘Oh, it’s Brian here.’ The words came tumbling out now. ‘He’s ever so hot, he’s been like this since yesterday, and I can’t calm him down. I don’t know what it is. You don’t think … you don’t think …’ She could barely form the words to name her deepest fear. ‘Could it be typhoid, Miss? They had it down Shoreditch way. Took them awful bad, it did, and people died and everything. I couldn’t bear for it to be typhoid, not my Brian, he’s only four months old …’ She hated to cry in front of anyone, let alone a stranger, and hastily cuffed away a tear that she could not hold in.

  Alice recognised that her first task would be to reassure the mother. If she were anxious then her baby would surely pick up on this and react badly. All the way over here on the short journey she’d been wondering what she would do or say, but now her training kicked in.

  ‘I’d be very surprised if it is typhoid,’ she said immediately. ‘But why don’t you let me take a look? How about you put him to lie here on this cushion and we can see what signs of illness he has.’

  ‘He’s dreadful hot, Miss.’ Kathleen set the small body on the cushion and, true to form, Brian started up his piteous screaming again.

  ‘Oh, young man, what can we do for you, eh?’ Alice gently laid her hand on his forehead and agreed that he was indeed very hot. She reached across to her bag. ‘I’m just going to pop this thermometer in his mouth. There, that’s not so bad, is it?’ The baby stopped crying in surprise at the sensation of the cool thermometer. Alice carefully checked the time and withdrew it. ‘Yes, you’re right, it is a little high, but not as high as we’d expect for a case of typhoid.’ She next checked his pulse and breathing, as the first thing the doctor would look for in her report was his TPR: temperature, pulse, respiration. She then pulled up his little shirt and observed his abdomen. ‘Well, there’s no telltale rash. Those two things make me doubt it’s typhoid, Mrs Berry. Tell me, have you been to Shoreditch recently?’

  Kathleen had sagged against the hard back of the chair as Alice had assessed her child, but now perked up as her biggest fear was allayed. ‘Oh no, Miss. We’ve got no call to go down there. Leastways, my Ray’s got a brother down that way but we don’t see him regular. They wasn’t close, you see.’ She sniffed. ‘It’s just … you hear these things … I didn’t know where to turn …’

  Alice made a decision. ‘Mrs Berry, may I make a suggestion? You take a seat in the comfy chair and I’ll make us both a cup of tea. Through there, I take it?’ and before the exhausted young mother could object, she slipped through the connecting door to the back of the house.

  She’d wanted to observe the state of the rest of the place. She knew only too well that typhoid flourished in conditions of poverty which so often led to overcrowding and a lack of hygiene. But here, although money was so evidently painfully short, everything was scrubbed and tidy. What food and drink there was, was covered and protected, and therefore far less likely to be a source of contagion. Somehow the frazzled young woman managed to maintain a clean house, even with a demanding small baby.

  Alice opened one of the two wooden cupboards and found the tin of tea leaves, which was easy as there wasn’t much else on the warped shelves. She set the kettle to boil and found a small amount of milk in a bottle beneath a pottery cooler. She sniffed it dubiously but it was fresh. There was a collection of slightly chipped but matching cups hanging from hooks beneath a wooden rack holding plates from the same set. Alice wondered if they had been a wedding present, as she cautiously unhooked two cups.

  She put the tea things on a tray and then filled a dish of cool water from the one tap in the back kitchen, adding a tea towel she found in the drawer under the sink. Then she carried everything through.

  ‘Why don’t you pour, Mrs Berry, and I’ll sponge down the boy.’ She knelt beside the little figure and gently dipped the towel in water and wiped his hot face very carefully.

  ‘Call me Kathleen, do, Miss. I’m so grateful you came round,’ Kathleen said, her hands shaking a little as she filled Alice’s cup. ‘If it’s not typhoid, do you know what’s wrong with him?’

  Alice smiled reassuringly. ‘Has he been mixing with anyone who’s got a cold? Babies often show a high temperature when you or I would just feel a little under the weather.’

  Kathleen thought for a moment. ‘He might have, Miss. My friend’s brother had to pull out of a match last week as he was took bad but then he was right as rain by the weekend. Could that be it?’

  ‘It could be something as simple as that. Keep him warm, wipe his face with a cool cloth and give him plenty of fluids.’ Alice looked appraisingly at the young woman. ‘You are feeding him yourself still, I assume?’

  Kathleen nodded.

  ‘You might want to consider a supplementary feed, such as Cow and Gate,’ Alice suggested gently.

  ‘Oh no, Nurse. Our family don’t hold with that. Mother’s milk is best, that’s what they say.’ Kathleen knew she could never afford any alternative.

  ‘Well, you’ve got to make sure that you keep your strength up, that you’re taking in enough nutrition to make good milk.’ Alice had noticed the baby was on the scrawny side and suspected the mother was scrimping on meals. She didn’t have a spare ounce of fat on her. ‘Is it just the two of you here?’ She had registered the wedding ring on the young woman’s hand, but also the narrow single bed pushed against the back wall and the clothes rail with a few well-worn frocks on it but no men’s items.

  Kathleen’s head came up. ‘My Ray’s away on a merchant ship, Miss. He’ll be back soon an
d then he’ll see us right. It’s just he can’t always tell us where he is or when he’ll be back, letters take so long, though I always try to keep him up to date with our news. I’m keeping the place nice for when he returns. I’ll be able to pay you then.’

  Alice glanced down. She hated the moment when the subject of money was raised, and had already presumed that Kathleen would fall into the bracket of those too poor to afford to pay, and who would therefore be treated for free. But it was a thorny issue. Everyone had their pride, and just because cash was short didn’t mean Kathleen wanted to be a sympathy case. Alice fixed her gaze on the rag rug on the bare floor, which had been skilfully made, even if not very recently. ‘You might be eligible for extra milk from the local authority. You can drink it yourself and also dilute it for your baby.’

  Kathleen visibly recoiled at the notion of receiving a handout. ‘That won’t be necessary, Nurse.’

  ‘No need to worry about that just now,’ Alice said hastily. ‘You let us know when your husband comes home and we can maybe talk about it then. But in the meanwhile, you mustn’t hesitate to call for us again if the boy doesn’t improve or goes down with something else.’ She looked directly at Kathleen. ‘The best way to keep your child well is to make sure you stay healthy yourself, Mrs Berry. Kathleen.’ She paused to let her words sink in. ‘And that means eating well. I know it’s not always easy to find the time when you are busy but you have to remember to do so.’

  Kathleen flushed. Of course she’d been missing meals. There wasn’t the money to eat properly every day, but she was damned if she’d admit that to the kind nurse.

  Alice had finished her tea and was making ready to leave when there came a knock at the door and a young woman came in without waiting for Kathleen to answer. In the dim light the first thing Alice noticed was her hair – there was so much of it, partially pinned up but most of it falling down around her shoulders, windblown and untameable. ‘Thought you were coming round?’ she demanded, and then stopped in her tracks. ‘Sorry, didn’t realise you had company.’