Annie asked, “How many nurses do you have?”
“There are four in training, although all of them have had experience working with patients before. One, Miss Kate Dewar, is in her second year. The other three, Miss Dora Thurston, Miss Bessie Kirk, and Mrs. Miller, just started with us this fall. In addition, we are very blessed to have Mrs. McClellan as the dispensary’s matron. She is an excellent nurse who got her training at Bellevue’s training school for nurses in New York. Her assistant, Miss Matilda Kibler, graduated last year from our own training program. This means that we have a total of six resident nursing staff here full-time. A seventh nurse, Miss Astrello, who also graduated from our training school last fall, works with Dr. Blair in the downstairs dispensary, Monday through Friday.”
Dr. Brown then opened a door to a sunny room that held two beds, both occupied by patients. Each bed was made up with sparkling white sheets and a colorful quilt, and next to each bed stood a small wooden chair on one side and on the other side a small table that contained a carafe of water and tumbler. There was a single bureau under the room’s window and on the wall across from the beds there was a fireplace, where there was a small fire burning merrily, chasing away the morning chill. On the bureau and the fireplace mantel were several vases holding fresh flowers.
A pretty young woman stood beside one patient, sponging off her face. An older woman stood listening to the pulse of the other patient, and she assumed this was the dispensary matron, Mrs. McClellan. Annie found the matron intriguing; she was so full of contradictions. On one hand she appeared to be in her fifties or early sixties, with her iron gray hair pulled back in a severely coiled braid and a stern expression on her face. Yet her skin was smooth and unblemished, showing only a few lines around her blue eyes, which held a distinct sparkle. Her dark navy silk dress was plain but well-tailored, in contrast to the very utilitarian nature of the highly starched white apron she wore over her dress. A lovely cameo pin sat squarely in the center of the fall of lace that trimmed the high neck of her dress, in odd juxtaposition to the stethoscope that hung down over the top of the apron. The total impression she gave, however, was of a woman who could handle any eventuality, social or medical.
The younger woman, on the other hand, looked exactly as Annie would have expected a nurse to look. She wore a simple pale blue cotton dress and a white apron, so all-encompassing that only the sleeves and the back of the dress were visible. From the waist of the apron were pinned a number of implements that Annie didn’t recognize but figured served some medical purpose. On top of the young woman’s light brown hair, which curled around her face, perched a starched white cap that rose to a rounded peak at the front. Her face glowed with youth and health, and her brow was wrinkled in a fetching frown of concentration as she carefully attended her patient.
Dr. Brown drew Annie to the older woman, saying, “Mrs. McClellan, this is Mrs. Dawson. She will be here off and on during the next few weeks, getting a report ready for the board meeting. I would like you to give her any help you can.”
“It’s my pleasure to make your acquaintance, Mrs. Dawson,” the woman said, her deep voice adding to her aura of authority. “If you have any questions, do ask one of the nurses or servants to come find me.”
She smiled pleasantly, but she quickly turned back to the patient she’d been attending, helping the older woman sit up and pouring her a glass of water.
Dr. Brown clearly got the message and didn’t linger in the room, only taking the time to briefly introduce Annie to the young nurse, Kate Dewar.
As they went back into the hall, Annie said, “You have done a beautiful job of making these rooms cheerful and home-like.”
Dr. Brown looked pleased. “Thank you. We believe that a positive environment plays an enormous role in helping a patient regain their health.”
Annie noticed that a woman, wearing a neat black dress and white apron, was busy sweeping the back hallway. She wondered if the black dress indicated this was a servant, not a nurse.
Dr. Brown, having seen where she was looking said, “We have seven servants working for us. Every room is dusted, swept, and mopped daily to maintain perfect cleanliness. And all the linens and nightgowns are washed at least once a week, more often, if needed. This is absolutely essential to ensure that there is no communication of diseases between patients.”
Annie remembered how every time Dr. Brown saw her or her daughter, she carefully washed her hands with soap that she said was made out of carbolic acid. The nurse who attended her at home when she was having Abigail had even brought a cake of this soap with her, which she and the doctor used each time they checked to see how far along Annie was in her confinement.
Dr. Brown interrupted this thought, saying, “We have two wards on this side of the floor and three on the other, and generally all the beds are full. As I told you earlier, some of these patients are paying clients, and the income from them is crucial for supporting our charity cases. That’s why Mr. Truscott’s failure to pay his bill is so distressing. The cost of Mrs. Truscott’s operation and after care was quite high, and there was no reason not to expect to have that cost covered, since Mrs. Truscott is a woman of means. I just hope you don’t discover we are in arrears collecting any of the other fees owed us.”
Annie sincerely hoped so, as well.
As they turned to go back to the front of the house in order to mount the stairs to the second floor, Dr. Brown said, “Matron and her assistant occupy the two rooms under the stairwell, while upstairs in the attic is where our resident doctor has a good-sized bedroom that also doubles as a study.”
When they arrived on the second floor, Annie heard an infant cry behind a door to their left, and her body instantly responded. She told herself that even if Abigail woke from her nap before she returned, she would be fine. Kathleen could feed her some applesauce and let her pick at some boiled potatoes, which she quite liked. But Annie’s breasts ached, and she prayed that the thick padding of the nursing corset would do its job.
Meanwhile, Dr. Brown opened a door on the other side of the hallway and said, “This is one of three rooms for pregnant and newly delivered mothers. Each can accommodate two patients, and while it is currently empty, I know that one of the dispensary patients will be coming in tomorrow. She is near term and her last confinement was difficult. Dr. Blair, our resident doctor, will deliver her. The poor woman lives in a crowded one-room apartment with her husband and four children. Thank goodness there is a grandmother who will be able to take care of the other children for a few days while the woman recuperates.”
The room she showed her, like the ones below, had two beds. But in this case, they also had little cribs next to each of them. She was surprised to note that the room also contained little stoves and modern washstands—with porcelain handles that indicated that there was both hot and cold running water available in the building.
She wondered if this meant that these women were expected to be more mobile, able to take care of themselves and their babies. She thought how fortunate she’d been when her daughter was born. All she really had to do was nurse Abigail; everything else was taken care of by her servants. Imagine being the poor woman who was going to have to go home, where she would be expected to take care of her baby and immediately resume all the other tasks confronting a mother of four children, and probably a demanding husband.
That thought fled when she followed Dr. Brown into the room across the hall where she had heard the infant’s cry. At the front of the house, the room was filled by the morning sun. Six good-sized cribs stood in rows, each holding children who ranged from small infants to a sturdy toddler who sat playing with a stuffed animal. Two of the cribs had women sitting next to them, probably the children’s mothers. A nurse, who Dr. Brown introduced as Mrs. Miller, looked up from the crying infant she was holding and nodded briefly at them.
Dr. Brown introduced the two mothers to Annie and then said, “Did you notice the quilts on the beds downstairs and on these c
ribs? They were provided by the Fruit and Flower Mission and Sewing Bee, organized by the Plymouth Congregational Church on Eleventh Street. They also bring in fresh flowers every day and fresh fruit in season. We are so thankful for their support.”
Annie wanted to stay around and meet all the children, learn their stories, but seeing the clock on the mantel, she knew she couldn’t afford the time. She said, “Perhaps we should move on. I know that you have a lot to do today to get ready for your trip, and I would like to get a sense of what I am up against by seeing the office and what your former treasurer has left behind.”
“Certainly, Mrs. Dawson. But first, let me take you down to the basement, because I want to introduce you to Dr. Ella Blair today. Ella is a remarkable young woman. Parents run a dry goods store and somehow she was able to juggle helping them with the store and completing the normal class at Girls High so she could become a school teacher. She saved up money from that job so she could go to the Medical College of the Pacific. Graduated last year, first in her class. We are lucky to have her this year as our resident physician. She and Mrs. McClellan are the staff members who will be most helpful if you have any questions.”
As they went towards the back of the house, where Annie guessed there were the traditional servants’ back stairs going all the way to the basement, Dr. Brown opened a door to a full washroom that held several bathtubs and toilets and told her the next room held another five cribs for children, all full at this time. At the end of the hall, there was another closed door to a room that Dr. Brown said housed the four nurses in training.
As they walked towards the back stairway, Annie noticed an open door to a room at the very back of the house. Going past the door, she got a glimpse of the occupant, who sat in bed, reading a book, a thatch of blond hair sticking up around a thin, pale face.
As they started down the stairs, Dr. Brown said quietly, “That young patient is Jocko. He’s almost sixteen years old. Normally we don’t take children over the age of ten, but he has a very painful condition with his leg that keeps him bed-ridden. He has no family to care for him, so he is a permanent guest in the dispensary for now. We hope that we can get him healthy enough to withstand surgery next month, which may be able to give him some relief.”
Before Annie could ask for more detail about the boy, Dr. Brown ushered her into a hallway that led to the very back of the basement, where the first room she showed Annie was the laundry. Two large women were hunched over steaming tubs of soapy water, scrubbing away, and the room held rows of drying racks covered by numerous small items like towels and pillowcases and nightgowns. Dr. Brown introduced the women by name, and then she led Annie past several rooms she said housed the dispensary servants.
The next room they visited was the kitchen, which was twice the size of the kitchen in Annie’s home. Two young scullery maids were hard at work washing up the breakfast dishes, while an older woman nodded brusquely before turning back to the chicken she was busy plucking. The woman’s age and elaborately starched hat proclaimed that she was the cook. Dr. Brown whispered that she had previously worked at a local hotel but had agreed to work for the Pacific Dispensary after one of their consulting physicians had successfully cured her sister of a chronic ear infection.
Looking at the stack of dishes piled high next to the sink, Annie thought about how many people this kitchen staff had to serve. Her own cook, Mrs. O’Rourke, with the help of Kathleen and Tilly, cooked for a household of fifteen—counting boarders, Annie’s family, and the three servants. This cook had to prepare meals for up to twenty-two patients, when all the beds were full, plus the six live-in nurses, the resident physician, Dr. Blair, as well as the seven servants. Thirty-six people in all, many with specific medical needs! No wonder they were fortunate to get a cook who had once worked in a small hotel. But the cost to the dispensary must have been enormous.
Dr. Brown’s tour of this section of the basement ended with the dining room, where the medical staff and the ambulatory patients would come to eat their meals. Annie noticed a number of high chairs, so she expected that some of the children also ate down here. Apparently, the dining room acted as a reading room as well, with a bookstand that held magazines, a couple of daily newspapers, as well as well-worn books—including some that looked like they were children’s books. When Dr. Brown indicated that all these reading materials were donated, Annie wondered if anyone had bothered to keep track of these donations. Normally she would include all donations in an audit, whether in cash or in kind. But she wouldn’t be surprised if she found this to be one more area where Mrs. Branting had failed to fulfill her responsibilities.
Next, Dr. Brown showed her into a room they reserved for operations, pointing out the sink where staff could wash their hands with carbolic soap, the cabinets holding various metal implements, which Annie had thought looked quite like instruments of torture, and the bottles of ether that could be used to make the patient insensible during an operation. In the middle of the room was a tall table, over which hung a large gas chandelier. Annie had already noticed that the entire building used gas lighting, but she could see that this chandelier would provide a powerful and necessary source of illumination for the doctors performing operations.
The floor, unlike the oiled wood that was found in the upper floors, was a light-colored linoleum. Doctor Brown said this was preferable because it could be scrubbed down with a carbolic soap without being damaged. She said this was in the interest of keeping the room as clean as possible. She used the word sterile, which Annie hadn’t ever heard used before in this context.
Finally, Dr. Brown quite proudly led her into the suite of rooms that held the dispensary proper. The first room was a waiting room that was furnished with chairs that lined the walls, all of them occupied by an assortment of patients. There were women with children of varying ages; two of the women were visibly pregnant. There were two elderly women, one who gave them a toothless grin while her hands busily knitted away at a long scarf, while the other appeared to be asleep, her chin on her chest, her breath coming in long, halting wheezes. What struck Annie most forcefully was how anxious and tired all the younger women were, their faces drawn, mouths pinched, foreheads creased by frowns. She felt like such an ungrateful fool to have been complaining to Dr. Brown about her own life.
After giving everyone a pleasant good morning, the doctor took Annie into the adjoining room that looked remarkably like Dr. Brown’s own medical offices. She introduced Annie to the resident physician, Dr. Ella Blair, and her nurse assistant, Miss Janie Astrello. They were in the middle of examining an infant about the age of Abigail. In contrast to her own daughter, this baby was thin and barely able to hold her head up, and there was a painful rash around her mouth. The baby’s mother looked in little better condition, with dark bruise-like shadows under her eyes that suggested sleepless nights trying to sooth a fretful child.
Annie couldn’t help but think about how the five-dollar fee she had paid Dr. Brown yesterday would have been an insurmountable sum for most of the women she’d seen out in the waiting room. In contrast, at this dispensary, poor women and their children got the services of trained physicians and nurses for free. The only fee the dispensary collected was twenty-five cents for any medicine the doctor might prescribe. And even in this case, if a woman couldn’t afford to pay for the prescriptions, she would be given the medicine, free of charge. What a blessing this must have been for the poor women who made their way here. No wonder the waiting room was so full.
Annie had taken this auditing job as a way to help out Dr. Brown and, to be honest, to get out of the house and possibly make a little money. Now, however, having finished the tour of the building, the job had taken on a whole new importance to her.
Just thinking about all of the women and children in the waiting room and the children who filled the cribs upstairs, and imagining how terrible a life that poor boy Jocko would face without the help of the dispensary staff, Annie knew she had do everything in her pow
er to help this noble institution survive. Even if it meant turning her husband into a debt collector to get the Truscotts to pay their bill, if that was what it would take to restore the dispensary’s financial health.
Chapter 6
The entire tour had taken more than half an hour, and while Annie had thousands of questions for Dr. Brown about all she had seen, she needed to get started on the work that had brought her here, looking through the financial records that Mrs. Branting supposedly had left behind in the office. Annie’s plan was to be home by eleven-thirty at the latest, hoping to get there before Abigail woke up from her nap and discovered her mother or, more importantly, her mother’s milk wasn’t at her disposal.
As Dr. Brown took her back to the reception room, where the tour had begun, she saw that a well-dressed young woman was putting a bunch of flowers into a vase on a table next to one of the chairs that lined the walls. Dr. Brown introduced her as Miss Keene, one of the dispensary volunteers. She mentioned that in addition to staffing the reception room during afternoon visiting hours or taking people on tours of the facilities, volunteers like Miss Keene were responsible for distributing the flowers that were delivered every day and running to a nearby pharmacy if it was time to restock supplies.
When they came to a closed door at the far end of the reception room, Dr. Brown pulled out a small ring of keys and said, “Here are the keys to the office, the desk, and the file drawer. Oh, and this small one is for the cash box, which should be locked in the desk drawer. Mrs. McClellan and Dr. Blair have copies, but I will give you this set until we get a new treasurer.”
Lethal Remedies Page 4
