“Dr. Blair and our nursing staff can certainly handle a case of infection, if that is what is going on. And any of the consulting physicians would be perfectly capable of advising our staff. But what about Mr. Truscott’s threats about the unpaid bill?”
“Leave that for me and my husband to figure out. There really isn’t anything you can do until I have looked through everything here.”
“Yes, I expect you’re right.” Dr. Brown took a deep breath and said, “In any event, you can always contact Dr. Maria Bucknell, our third attending physician. Normally, she would be spending one morning a week here. But she lives in Oakland, and she is currently taking care of a seriously ill relative. In addition, I will write a note to our board president, Mrs. Stone, to apprise her of what is going on. You can rely on her for sensible advice if you can’t reach Dr. Bucknell.”
“Well,” Annie said, “the contracts you signed should give me the needed authority to contact any creditors, as well as patients who might be in arrears. However, if there is something that needs to be done before you return, I will certainly reach out to Mrs. Stone or Dr. Bucknell.”
Dr. Brown stood up again, looking quite determined. “Yes, I feel quite confident you will do all that can be done over the next two weeks. What I can do is go tell Dr. Blair what we have learned and have her make you a copy of the document the Truscotts signed before the operation. Then I will go straight to Harry Granger’s office and see what he knows, if anything, about Phoebe Truscott’s health. I am sure if he hasn’t heard anything, he will be anxious to stop by and see how she is doing. I will give him your name and address and ask him to report anything he learns to you.”
“Thank you. All that will help. Now, if you don’t object, I am going to take all this material back home with me and see what sense I can make of it all before returning tomorrow morning. Maybe it will turn out that the dispensary’s accounts will balance, and Mr. Truscott’s letter is all based on some sort of misunderstanding that can be swiftly cleared up after my husband sends him a diplomatically worded letter. Nate is really very good at finding a way to settle problems amicably out of court, which would be to everyone’s benefit.”
Chapter 8
Friday afternoon, February 24, 1882
Pacific Dispensary for Women and Children
* * *
When Annie got up this morning and saw the rain driving against her bedroom windows, she almost changed her mind about going to the dispensary to look through the office file cabinet. However, by noon, the sky had cleared, a pale winter sun had appeared, and she decided that she shouldn’t let another day pass before tackling this job.
She was also feeling unusually energetic.
Last night was the first night Abigail had spent next door in the nursery. Kathleen said she woke up once in the night but immediately fell back to sleep when Kathleen pulled the covers back up over her.
For the first time, in forever, Annie had slept through the night. It was glorious.
At six this morning, Kathleen brought the baby to Annie, who nursed her while Nate got up and started getting dressed. He then took Abigail so Annie could get dressed. Afterwards, they actually had time for a brief breakfast together, sitting at the table in the bay window, Nate jiggling their daughter on his knee, while they ate their eggs and toast.
This was what she had imagined being a family would feel like once their baby came.
Of course, Abigail broke up this perfect moment by scrunching up her face to indicate some dissatisfaction, and Nate hastily handed her over to Annie with the excuse that he really had to get going. Nevertheless, Annie was in such a good mood, she didn’t even comment on the fact that he was leaving before she started changing their daughter’s smelly diaper.
This good mood fueled her determination to spend the morning completing the work she had done yesterday afternoon and evening, wringing as much information as she could from the papers she brought home with her from the dispensary. Unfortunately, even after going through all the documents, there were still significant gaps in both the income and expenditure columns—gaps that she sincerely hoped would be filled by the information held in the dispensary office file drawers.
So, right around three, after feeding Abigail and putting her down for her afternoon nap, she left for the dispensary, bringing Kathleen with her to help box up any files she would need to bring home. Before Abigail’s birth, Annie just would have spent several days at the dispensary to do her work. But that wasn’t practical now, and she didn’t feel it would be prudent to bring Abigail with her to a place where there were people with a variety of illnesses.
She never understood why doctors hadn’t figured out how even an ordinary catarrhal head cold went from person to person. Although she supposed it didn’t take a scientific education to make the connection between one person’s cough or drippy nose and the subsequent appearance of the identical symptoms in other members of the family. Dr. Brown herself had instructed Annie to be careful about washing her hands every time she had been outside the home and before she picked up Abigail, and she was forever having to remind Nate to do the same when he first came home from work.
Thinking about how awkward it had been to bring the box of paperwork back to the boardinghouse yesterday on the horse car, Annie had chosen to hire a hansom cab this afternoon and ask the driver to return to pick them up at four-thirty. This would give her an hour at the dispensary and get them home not too long after Abigail woke from her late afternoon nap.
Mrs. Stein, the boarder who, with her husband, occupied the suite of rooms across the hall from the nursery, promised to go in and take care of Abigail if she woke before Annie returned. Unfortunately, Mrs. Stein also believed that Annie shouldn’t work outside the home until her daughter was school age, so she had been forced to listen as the motherly woman cautioned her not to make a habit of this galavanting about. She loved Mrs. Stein, but she had to remind herself that loving someone didn’t mean you had to agree with them about everything.
Kathleen hadn’t questioned this trip at all, and on the cab ride to the dispensary, she had peppered her with questions. She shared how excited she was to get a chance to participate in another one of Annie’s investigations of wrongdoing. Annie had tried to persuade her that this was no more than a regular auditing job, and there was no evidence of any crime—beyond possible incompetence on the part of the former treasurer. Her maid had just shaken her head and said she knew better.
Annie put Kathleen’s comments down to the fact that the young woman loved to read penny dreadfuls, which made her see crimes everywhere. Yet, the truth be told, in the years before Abigail was born, a good number of what had seemed like plain accounting jobs had resulted in Annie bringing a number of criminals to justice. However, that was before she became pregnant. Since then, Kathleen, as well Annie’s sister-in-law, Laura, had been the ones who’d been actively involved in solving crimes.
As they stepped down from the cab in front of the dispensary, Kathleen said, “What a lovely building for a hospital! Cozy and home-like. I’m sure I’d feel better just coming to a place like this. St. Mary’s Hospital always makes me shiver, it’s so imposing.”
Annie agreed. “They have done a wonderful job inside as well. You’ll see. Flowers everywhere. If there’s time, I will see if someone can give you a quick tour of the building while I go through and figure out what files I want to take back home. In addition, I need to see if Dr. Blair, the resident physician, was able to make a copy of Mrs. Truscott’s file, the case I was telling you about. I would like Nate to see the files before he tries to arrange a meeting with Mr. Truscott.”
“Mr. Nate is going to meet this husband, not just write him a letter?” Kathleen asked.
“Yes, if possible. When I explained that Dr. Brown was going to have this other consulting doctor, Dr. Granger, look into exactly what has been going on with the wife’s health, he thought it better to wait until we had more information before moving forward. He was h
oping that a personal meeting, gentleman-to-gentleman, as it were, would be more effective than a letter.”
Kathleen said, “I’m sure he will know just what to say, ma’am.”
When they entered the dispensary, Annie saw that Miss Keene was again staffing the reception area and asked her to get Dr. Blair, the young resident physician. Next, she opened the door to the office with the set of keys Dr. Brown had given her.
As Kathleen followed Annie into the room, she exclaimed, “Oh, ma’am, it’s cold in here. Should I light the fire?”
“Yes, I guess you should. Yesterday I didn’t bother, and my hands did get chilled. Then, could you look into that closet? Dr. Brown thought there might be some empty boxes there—from when they moved into the building. I’m hoping we can use them to put the files in for the trip back home.”
While Kathleen went over to the fireplace, Annie moved to the file cabinet and pulled out the top drawer, which was half-filled with file folders and loose pieces of paper. As she feared, the file folders didn’t seem to have any labels on them. She next opened the bottom drawer and saw there were a lot more folders, and these did seem to be labeled. They were filed by month and year, starting with 1875, the year the Pacific Dispensary was founded, followed by folders for each subsequent year, up through February of 1881.
She silently thanked whoever had exhibited this degree of organization. She believed that Mrs. Branting had been elected to the job of treasurer at last March’s board meeting, which would have been right before the dispensary moved into this new building. She suspected that this might be when the problems started. A new building, with all the initial costs to get it going, might simply have overwhelmed a new treasurer. Well, that’s what she was here for, to try and right what had gone wrong. And to do it within the next two and a half weeks.
Chapter 9
Ella Blair thanked Miss Keene for letting her know that Mrs. Dawson had arrived, and she ran upstairs to her attic room to get the copies of the Truscott files that she had made last night. It had been a very busy morning with a couple of difficult cases to handle. That had kept her occupied past noon, then she had to go around with Mrs. McClellan and see all the hospital patients and adjust any medications, something that normally one of the consulting physicians would have done this morning as they made their rounds.
She thought about how different today felt so far…being the only physician in the building. Normally, even when she didn’t see them during her morning hours in the dispensary downstairs, she knew that one of the other three attending physicians was upstairs, making the rounds of the hospital patients and instructing the nurses. Somehow, this always gave her more confidence, knowing they were nearby if she needed them, like the time a mother had brought her son in with a terrible skull fracture.
Not that during her three years of medical school she hadn’t learned about diagnosing and treating all sorts of illnesses and injuries, even a skull fracture. Yet she had to admit there was a big difference between treating a patient who was sitting right in front of you, covered in blood, and reading about patients in a textbook. Not even watching one of her professors make a diagnosis at the bedside of a patient had prepared her for the real thing. Especially since during these clinical lectures at the City and County Hospital, she often found herself elbowed out of the way by the male students. Whether these men, who reminded her so much of her older brothers, were being intentionally obstructive or not, they were all taller than her and hard to see around, so she had felt she missed a lot of the nuance that went into a diagnosis.
Thank heavens for Janie Astrello, her nurse assistant. Janie’s two years of training as a nurse at the dispensary, and her experience working in the afternoons in Dr. Granger’s private practice, made her a font of wisdom, especially during Ella’s first months working in the dispensary. Now, nine months into her residency, Ella felt much more assured of her own skills. As a result, she found fewer occasions when she needed Janie’s help or asked her to go up and get whichever doctor was upstairs to come down to consult.
Nevertheless, there was always more to learn. Every Saturday afternoon, she still met Dr. Brown to go over her case files from that week. Ella would explain her diagnoses, describe what she had done for the patient, and list what medicines she had prescribed. In addition, one of the doctors would try to come down at least once a week to observe her with patients. Later, they might make some helpful suggestions. These sessions were always informative and also helped boost her confidence.
There had been only one occasion when Dr. Bucknell had intervened with a patient. Ella had overlooked the fact that the young girl she was examining was hiding her hand behind her back. Turned out that the girl had a very bad burn, which had become infected. This was the cause of her fever. Without attending to the wound, the girl would have been unlikely to improve.
The girl’s mother had failed to point out the wound, which could simply mean she didn’t understand the connection between the wound and her daughter’s high fever. Or the mother may have been ashamed of how the burn had occurred. Even more disturbing to Ella was the notion that the burn might not have been an accident, but deliberate.
Ella later confided to Dr. Brown how hard it was to see signs of burns and bruises on her patients, sometimes even broken bones, and know that some of these injuries might have been inflicted by a drunken husband or father. She had learned, to her frustration, that when she gently asked patients if anyone had deliberately hurt them, they always said no. Dr. Brown told her that, in her own experience, pressing a patient too hard on the source of their injury simply meant the woman wouldn’t come to the dispensary again, and she might not bring in her children the next time they needed attention. Ella knew she was right. Nevertheless, she found it difficult to accept that there were severe limitations on what she could do for her patients. She could bind their wounds, give them medicine to ease their coughs, set their bones, even do minor surgery on them, but she couldn’t give them a better house to live in, better food to eat, a better job, or a better husband or father.
Shaking off this thought as she came to the door to the office, Ella stopped and briefly observed Mrs. Dawson as she sat at the desk, sifting through folders. She noted that there was another young woman in the room, a black-haired, blue-eyed young woman of obvious Irish heritage who was pulling some boxes out of the closet. Dr. Brown had mentioned Mrs. Dawson might be bringing her maid with her today. Dr. Brown had also told her that Mrs. Dawson, who didn’t look to be more than in her late twenties, needed to do most of her work at home because she had a nine-month-old child and couldn’t be away from home for too long at a stretch.
Mrs. Dawson puzzled her in a number of ways. The existence of the maid and the elegance of Mrs. Dawson’s outfit, a well-tailored navy wool outfit that set off her pale complexion, complemented her reddish-gold hair, and fit her slender shape like a glove, put her in the same class as the wealthy women who financially supported the dispensary or served, like the former treasurer Mrs. Branting, on the board. Women whose dress and demeanor said very clearly that they didn’t need to work.
On the other hand, Dr. Brown had told her that Mrs. Dawson was a woman who ran a boardinghouse and helped support her family doing a job that usually was held only by men. This fit the restrained nature of her dress that said she was woman who had a job to do, who couldn’t be bothered with too-tight corseting that constricted her breathing, a bustle that made it impossible to sit in a chair, or lace cuffs that might get ink-stained. Women, in fact, very much like Ella’s own mother, who juggled motherhood with helping support her family by working with her husband in her dry goods shop.
As Mrs. Dawson looked up and smiled at her, Ella thought that she hoped this impression was correct, because if the dispensary was in trouble, she knew she would much rather have a woman like her mother at her side than a silly woman like Mrs. Branting.
Chapter 10
Annie looked up from the desk and saw Dr. Ella Blair standi
ng in the doorway, a frown on her face. To Annie, she seemed awfully young to be a doctor, certainly no more than in her mid-twenties. While she was wearing a neat, light beige wool dress with a high neck and a very slight bustle, Annie couldn’t help but think that the beige wasn’t particularly flattering to her slightly uneven complexion and light brown hair. On the other hand, the dark brown cuffs and collar provided a nice contrast to the beige, as did the brown leather belt, which showed off the young woman’s slender waist.
Over all, she did appear very professional, and the doctor’s high forehead and long straight nose added to the impression that this was a serious, no-nonsense woman…a woman who could be trusted to take care of you if you were a patient.
Annie said, “Do come in, Dr. Blair. You see me, and my maid, Miss Kathleen Hennessey, hard at work making sense of chaos. Although I have learned that, thanks to a Mrs. Oliver Easton, who appears to have been the board’s treasurer prior to last year, the earlier records are quite well organized. Do you happen to know if Mrs. Easton is still involved with the dispensary and how I might get hold of her if I have questions?”
“Oh, I’m sorry, Mrs. Dawson,” Ella said, “I can’t help you with that. It’s my understanding that Mrs. Easton stepped down from the board because she and her husband were moving…I believe to Portland. I expect that someone has her new address. You might find it in the files. Certainly Dr. Brown or one of the other attending physicians would know.”
“Or I could ask Matron,” Annie stated, smiling to indicate that she wasn’t disparaging Mrs. McClellan’s title.
“Yes, or you could ask Matron.” Ella smiled at her in return, and Annie saw how attractive the young woman could be when she wasn’t frowning.
Lethal Remedies Page 6
