The Grantville Gazette Volumn II

by Eric Flint

  3

  "Okay, what's up?" Mary Pat sipped her coffee the next morning and sat back in the kitchen chair to get comfortable, trying to gauge Beulah's mood. She didn't look alarmed so much as determined and thoughtful. She had scared Mary Pat a little the day before. For a moment, Mary Pat had thought she was sick. The idea of anything happening to Beulah made her stomach tighten.

  Something was going on, though. What that something might be had teased at the back of Mary Pat's mind all during her shift yesterday. Beulah taking a second day off was absolutely unheard of. Today, Mary Pat herself had a rare day off. It only happened about once a month. Between the hospital and her position in the army, she rarely had any time to herself. It was getting tiring to say the least, even for someone as energetic as she was. She had intended to do some chores and maybe eat out at the Gardens tonight until Beulah went all mysterious on her.

  "I talked to James Nichols two days ago. He and the others want me to become the new dean and get the health care educator programs up and running here and at Jena."

  "They've picked the right person for the job. Congratulations!"

  "You haven't heard the rest of it yet." Beulah replied with a gotcha grin. "We want you to be my assistant."

  Mary Pat didn't spew coffee all over the place but her green eyes did widen. "You could have waited until I didn't have a mouthful of coffee before you said that," she complained. "Exactly when in my spare time am I supposed to be doing this anyway? Not that I don't want to help you out, Beulah, but I just don't have any time."

  "I'm sure that given the military's urgent need for doctors and nurses, they will be more than happy to have you temporarily assigned as my assistant. Your trauma skills will be invaluable. Finding a replacement for you at the hospital is going to be harder but the latest class of nurses' aides and LPNs has just graduated from the tech center at the high school. Not the same as an RN, I know, but they can take up a little of the slack so it won't be as hard. It isn't as though we'd be leaving for Jena tomorrow or anything."

  "My patients..."

  "I know," Beulah interrupted gently. "Neither of us wants to leave them. James and I already had a version of the same discussion. You should have seen me come up with reasons not to do this."

  * * *

  The tension in Mary Pat's voice didn't go unnoticed. Beulah would never say it to Mary Pat but she was worried about the long hours and multiple commitments Mary Pat had taken on the last two years. She was an active duty army nurse and had been deployed all over the area. That meant that although she knew a lot of people and a lot of the local area, she wasn't really close to anyone but her friends Elizabeth, Rodney, Sharon and Beulah herself. When she was home, Mary Pat worked five or six twelve-hour shifts a week at the hospital. She was also one of the most senior officers of the tiny medical corps, which carried its own set of responsibilities and pressures. Having her with Beulah in Jena meant she would be freed up from working sixty-plus hours a week as a staff nurse and her regular military duties. Beulah knew she and Mary Pat weren't the only ones who were getting worn out. So were all the health care types in Grantville. They were stretched way too thin and it wasn't getting any better. If anything, it was worse. Grantville's reputation as a center for healing was beginning to spread. Fortunately, right now the reputation was only local. That was going to change though, sooner rather than later. The demands on their tiny health care system would get nothing but more intense as the war heated up and people found out that they could heal things no one else in this time could.

  Beulah gave a dry, humorous recount of her conversation with James. They shared a chuckle, and a little of the tension eased from Mary Pat's shoulders. Mary Pat's sharp mind would fill in the blanks here and there. She was well aware of how strained the health care resources were in Grantville and its military. Beulah ended her recounting with the role for Mary Pat and why she was needed for the position. Much the same way James did it to me.

  "So you won't take the position without me as your assistant? You're perfect for it." Mary Pat was frowning a bit. "I can understand your points but I still think I could serve better here." Mary Pat reached for the coffee pot and refilled both their mugs before setting the pot back on the small kitchen table. She didn't like to see Beulah handling the heavy pot. Beulah let her think for a few minutes, enjoying the quiet and the aroma of the hot coffee.

  "I don't stand a chance, do I?" She finally asked with a rueful grin. "I know that look on your face, Beulah. You've got all the bases covered and all the arguments ready. I guess we should both be getting used to being ambushed by projects like this. I could see this one coming for you but didn't see it for me." Mary Pat picked up her napkin and waved it like a flag. "Okay, I surrender. When do we get started and what do you think we need to do first?"

  Beulah reached across the table and gave Mary Pat's hand a little squeeze. "That's the spirit. We need to get started now to be ready for the first class in six months. The way I see it, there are a few issues we need to start thinking about right away. Politics, personnel and resources are the three big ones at the moment."

  "One at a time then?" asked Mary Pat.

  "Works for me. Have a preference for which one to tackle first?"

  Mary Pat wrinkled her freckled nose and grimaced. "Let's leave the politics till last."

  "Personnel and resources it is then. I don't know how much of the big picture you've been aware of and it will help me to think out loud, so I hope I don't go over too much you already know. On the personnel side, the first of the German students will be entering the nurses' aide and LPN program. We're lucky to have had the program already set up before the Ring of Fire at the high school. That has meant we haven't had to start totally from scratch, although Hayes and I had to change a few things with the curriculum given what we're facing now. Hayes will be working with us too. Garnet, Courtney and Marcia are doing a great job in the nurses' aide and LPN program. They're all sharp and easy to work with and they have the program delivery down to a fine science. I know that ties up an RN and two LPNs but the work they are doing is too important to interrupt for direct patient care. I don't think we should change anything there. They're all ready to go with the mixed German, up-timer classes starting this summer."

  "I agree about the aide and LPN program. That's been going really well. We have about sixty new aides and nearly twenty new LPNs now. We'll probably want to talk with Garnet, Courtney and Marcia about which of their former students might be good for the new program. Some of them are so new, I don't think any of the hospital staff who have worked with them will have a very good sense of their capabilities yet. Two things, though. My German has gotten pretty good. Are we going to be teaching in German, English or both? And, what about Hayes?"

  "German and English. It will depend on who is teaching what at the university and who the staff mentors are for students. Any applicants are going to have to be fairly fluent in both. Eventually, we'll probably switch entirely to German but that's a long way off. We have too many texts in English and too many people who aren't fluent in German as potential teachers and students. Some of the Germans in Jena and other areas won't be too happy about that, I imagine. English isn't known as a scholarly language in this time. Unless we're careful, it may look like we're excluding German natives from the new educational system at the same time we're using their facilities. We'll have to have some sort of English classes for some of the German students who will be coming to Jena. There's another problem with languages. Latin."

  "I hadn't thought about that one." Mary Pat winced. "No one I know here speaks Latin except Father Larry. Lots of medical terms are based on it, especially anatomy and physiology terms. So we won't be starting entirely from the ground up."

  "We're going to have to learn at least some Latin." Beulah replied. "Many of the textbooks used for medical information now are in Latin. Some of that information is still very relevant. How much and in which texts, I have no idea yet."

  "
Well, we'll be working with him over the next few months at least. We're going to have to put together the curricula and text materials soon. We'll be focusing on the RN- and MD-level training and that will mean higher level synthesis. Plus, I'm hoping he can help evaluate the materials they have at Jena and help us figure out priorities for copying and translation."

  "Okay. You know him better than I do. I know a few of the Jena faculty. They've downsized in recent years because of the war. There aren't going to be a lot of them to help out. The botanical gardens are great though. Werner Rolfinck is probably somebody we'll want to talk to early on. He's been at Jena for several years and heads the medical faculty. He's the one who had the OR theater set up there and is very up on the latest knowledge for this time. He borrowed a copy of a couple of my textbooks a few months ago. The next time I was in Jena, I was going to pick them back up and give him some new material. I had the books copied before I lent them to him. It was lucky I was in the emergency rotation at school. I had several anatomy and physiology texts and a drug book with me that he was interested in." It was Mary Pat's turn to sigh. "I just wish the drug book had more about herbs."

  "We have some more information about herbs from the gardeners in town. I was pleasantly surprised about how much medical information they had. Not to mention the medicinal herbs in various gardens. Standardization of dosages and purity are still issues. Stoner and the others are making progress on that. I just wish we had more scientific basis for some of these new medicines. Some of the herbals claim to be able to cure everything that ails a body, including the common cold." She shook her head in disgust, sending shimmers of silver light flashing around her head.

  "Sorting out what they have at Jena, what we have here and how the herbs are named and grown will take time but once we're rolling, I think it'll be fine. We may have to take at least one of our gardeners with us to Jena. Do you think Rolfinck will be supportive of us coming to Jena and making so many changes in the program? James and Balthazar have both been sending out feelers about it and kind of paving the way. Rolfinck seems very progressive and interested in having the information but it is actually his school after all. We're outsiders coming in with ideas that challenge a lot of dearly held beliefs."

  Mary Pat thought about it for a minute, then shrugged one slim shoulder. "There's really no way to know until we talk with him and the other faculty members. I'd suggest talking to him first. He seems like a very reasonable guy. There are a couple of the faculty who teach what they call iatrochemistry at Jena. It's more similar to our ideas about chemistry than alchemy and that humors stuff. I can't guess how receptive those two will be since I haven't met either of them yet."

  "I haven't met any of them. Haven't been to Jena either. You, at least, will be a somewhat familiar face. That should help. I'm not sure how they are going to react to some of my ideas, however progressive they may be. We're going to have to negotiate carefully. I don't want to come across as know-it-all up-timers. First, because it isn't true. Second, because that kind of attitude will cause nothing but problems. We're having a hard enough time with what we can't do. They may have a hard time with what we can."

  "I agree. Ideas such as?"

  "I've always felt that the split between nursing and medicine was artificial and caused more problems than it helped but it's the time factor that really worries me. We need people trained now. That doesn't even get into content issues like up-time versus down-time knowledge or some of the ethical issues we'll have to deal with. Not to mention that I see men and women having an equal role in health care."

  Mary Pat grinned. "You were saying the other day that things at the hospital were starting to get too routine. A new challenge will be good for you."

  "Yeah, right. Like I need any more challenges. This project will be full of them."

  Mary Pat got up to look for a pen and some paper to start taking notes. "Well, we don't have to solve everything right here and now. Let's think about who we have here and who we need to put together an educational team."

  Chapter Two

  July, 1633

  1

  The four deans of the University of Jena met in Werner Rolfinck's office at the university. Werner was dean of the medical school. Next to him sat Johann Gerhard, the dean of Theology. In his early fifties, Dean Gerhard was conservative, thoughtful and prudent man. Werner was particularly glad he was here, as Johann was known for his ability to smooth troubled waters and had studied medicine for several years in his younger days before turning to theology. He was also someone who listened to arguments, considered carefully and then acted. Werner wasn't sure what Johann thought about the proposed merger with Grantville's medical people. He wasn't sure what he thought of it himself.

  Across from Johann and Werner sat the deans of the schools of Arts and Law, Dietrich Wetzel and Karl Strom. Dietrich was about Werner's age and a good friend. He was a plump, cheerful sort of man who seemed to exist in a perpetual swirl of energetic chaos. Dietrich had incredible ideas. Making them happen was another story. He was usually off on the next idea before the first project was even halfway completed. Karl Strom was his exact opposite in some ways. A member of the minor aristocracy, Karl was meticulous and very cautious in his approach to life. He had a sunny smile but, most of the time, wore a sober face that he thought was more in keeping with his position. Werner wondered if he realized how young and earnest that sober face made him look. Or how like a young man dressing up in his father's clothes. Karl, only twenty-eight, was young for his position as law school dean and painfully aware of it. It could make him rather prickly on occasion.

  Dietrich was all but bouncing in his chair with excitement. Werner stroked his dark, thick mustache to hide the grin trying to escape. "As I told you last time, the Americans want to start a joint medical education program. If we are agreeable, they would like a formal arrangement with the school of Medicine to start teaching nurses and doctors. The arrangement would be the first in a long-term partnership with us. The medical school would expand into a Health Sciences College with schools of Medicine, Nursing, Pharmacy and Allied Health."

  "From what you have told us so far, the other three schools we have now may need to be involved right away as well," Johann said thoughtfully.

  Karl looked startled. "The other schools? But I thought that was further in the future?"

  Werner waved a hand. "You know these Americans. They have laws for everything. The have laws for who can practice, in what area and under what conditions. Fraulein Flanagan tells me they call it 'scope of practice' or some such. I would imagine that as we are setting up the new school, there will be some need to reconcile their laws and ours."

  Karl's ruddy complexion blanched a bit. "Yes, I can see the need. Still. They do have a great many laws. I don't know anything about medical law, though, theirs or ours. I have been mostly looking at constitutional and national law. None of us in the law school have experience in the areas of medical law. We did but with so many students and faculty leaving because of the war..."

  "You could hardly do anything about the war, Karl. We have what we have. It may be that this partnership will attract new students and we will refill the ranks of our faculty as well." Johann's calm practicality eased the anxiety from Karl's face.

  "What about the arts?" Dietrich leaned toward Johann and Karl. "We've been translating a few of the books Fraulein Flanagan lent Werner. Fascinating, just fascinating! And the quality of the illustrations are amazing! We may be able to help with that, too."

  "Mathematics and philosophy are other areas where we may need help, but I'm just guessing. Right now, it's too early to make many plans." Werner knew Dietrich well enough to stop that line of thought before he went to far with it. The School of Arts would be in absolute turmoil if they didn't slow Dietrich down a bit. As it was, that facile brain of his would have a dozen different projects ready to start before he left the room today anyway. "I've talked to the head of the delegation they want to send next month. Fr
au MacDonald will be..."

  "Frau? The head of their medical delegation is a woman?" Johann looked and sounded shocked.

  "Yes." Werner knew he sounded a bit defensive. "I don't know about the rest of the delegation but the leader is a woman."

  "I hadn't realized they had women as physicians." Even Dietrich sounded a bit shocked. Women simply weren't university-educated physicians. Nor were they barber-surgeons or apothecaries, who were seen as lesser levels of healer. Women were usually midwives or herbwives, considered the very lowest of those caring for patients. They were necessary to care for women's mysteries but any of their other activities were not well regarded. There was simply no comparison between a physician and what amounted in their minds to an uneducated herb witch.

  Werner gritted his teeth a bit. "She isn't a physician. She's a nurse." Which of course only made things worse.

  The silence that followed was anything but comfortable for Werner. Intellectually, the deans had known that Americans didn't seem to care about a person's gender very much in terms of one's role in life. Most of the Americans they had each dealt with had been men however. That they understood. Thanks to his meetings with Mary Pat Flanagan, Werner was a little better prepared than the other three but it would be his department that would have to make this work. He wasn't entirely certain how his faculty or students would respond.

  "A nurse?" Dietrich seemed nonplussed. "Nurses to teach doctors, to be dean?"

  Werner hastily explained. "The nurses from the future know a great deal. They have university degrees and some have graduate degrees, including doctorates. Nurses are faculty at medical schools in the future."