Then, as if conjured up by the repetition of her name, the dispensary matron, Mrs. McClellan, appeared at the door and said, “Nurse Miller told me you were here, Mrs. Dawson. I’m sorry I didn’t greet you. Is there any way I can help?”
“Oh, thank you, Matron. No pressing questions, other than whether or not you might know where I can find the address for Mrs. Easton, who was the treasurer before Mrs. Branting.”
After Mrs. McClellan told her that she would get this address for her from her own address book, Annie introduced Kathleen to her and asked if it would be all right if she sent Kathleen down to the kitchen so she could make some tea for her and Dr. Blair.
Mrs. McClellan quickly said, “Of course. I’ll get Megs, the servant on this floor, to take her, see that she gets what you need.”
Annie congratulated herself for delivering on her promise to Kathleen that she would get this chance to do a little investigating while they were at the dispensary. She was quite certain her maid would soon be able to discover all there was to learn from the “below stairs” staff.
Meanwhile, she needed to stop wasting Dr. Blair’s time and get to the matter at hand, so as Kathleen and Mrs. McClellan left, she stood up and pulled a second chair next to hers and asked the young doctor to have a seat so they could look over the files she had brought.
Getting right down to business, Ella said, “I’ve done a summary of the case file on Phoebe Truscott for the period prior to her operation. These are mostly notes that had already been copied from Dr. Granger’s file, because he was the doctor who diagnosed her problem and referred her to us for treatment. I hope that was all right, Mrs. Dawson?”
“Oh yes, perfect.”
Ella quickly turned to the papers she held in her hand and said, “As you will read in these notes, Mrs. Truscott came to see Dr. Granger in the spring of 1880, complaining of pain in her abdomen.”
“Dr. Brown mentioned that Dr. Granger is a consulting physician to the Pacific Dispensary. What exactly does that mean?”
“Officially, it means that if I or any of the attending physicians have any questions about how to treat a patient, we can ask Dr. Harry Granger or one of the other consulting physicians for advice. These doctors will also be asked to attend certain operations if the attending doctor feels their expertise can be helpful, and in some cases we will even ask them to do an operation if it is outside our expertise. For example, Dr. Powers is our consulting ear and eye specialist, and we will ask him to do our more delicate eye surgeries.”
Annie nodded, thinking this made a good deal of sense. However, something that Ella said had prompted a question that puzzled her. She said, “I noticed you mentioning that the first name of Dr. Granger was Harry, and Dr. Brown did the same, as if there were more than one Dr. Granger.”
“Oh, that’s because there are two Dr. Harrison Grangers, father and son. Both of them are consulting doctors for the dispensary. To make things even more confusing, both of them are professors in the Medical College of the Pacific. The father always has gone by the first name, Harry, so that’s how people refer to him. The son insists that people call him Dr. Harrison Granger. I’ve heard that he gets particularly incensed when people call him Harry or, even worse, Junior.”
Annie laughed. “Ah, I can understand the confusion. I also wondered whether having a number of consulting doctors was the usual practice for a medical institution.”
Ella said, “It isn’t unusual. Although I suspect that Dr. Brown and the other founders knew that they would have a better chance of getting support from donors if there were men of reputation like both of the Dr. Grangers listed as part of the enterprise.”
Annie said, “Seems a shame that patients…female patients…wouldn’t trust a medical facility unless there were men involved with it.”
“I am afraid you’re correct,” Ella said sadly. “Doesn’t matter how prestigious her medical degree or the years of experience as a physician, a woman has trouble being treated as a professional in this field. And, of course, this can also mean it’s hard to get the experience you need. I know that one of the women who graduated from my own medical school hasn’t yet been able to set up her own practice. And she hasn’t found any other doctor willing to take her on, which means she isn’t getting any experience that would help her get this sort of opportunity.”
“Oh my, that is a shame,” Annie said. “You would think that female physicians, because there are so few, would be at a premium.”
“I think the demand is there. But it’s a question of having the capital to get started. And there are some women patients who resist going to a female, except for female-specific care. And we can’t all be obstetricians or specialists in female diseases.”
Annie smiled inwardly at how fierce Ella Blair sounded.
“I expect you were fortunate to get this position as the resident physician.”
“Oh, Mrs. Dawson, you have no idea how fortunate. I can’t thank Dr. Granger enough for recommending me. I have gotten such a wide range of experience in treating patients.”
“I can see that. And Dr. Brown mentioned that you go over your cases with her?”
“Oh, yes. A residency is a kind of apprenticeship. Both the University of California medical department and the Medical College of the Pacific, where I got my degree, recommend that graduates spend a year as what they call ‘interns’ before setting out in private practice. For some, this means working with an established doctor. But the most coveted internships are found at the City and County Hospital. However, at least so far, none of these internships have gone to female graduates.”
“Ah, and so getting this position will put you on an equal footing with those newly graduated male physicians. I suppose that was one of the goals of the founders, who would have been very aware of the difficulty women physicians faced.”
“Yes, exactly. Additionally, I’ve learned that another benefit of the long list of consulting doctors we have is that they are more likely than other doctors in town to refer their own patients to the dispensary.”
Annie said, “As in the case of Mrs. Truscott.”
“Yes, as in the case of Mrs. Truscott. The problem that first sent her to Dr. Granger was a history of difficulty with her menses, with heavy bleeding and pain. More alarming, by the winter of 1880, her whole abdomen had become distended and painful to the touch. Dr. Granger diagnosed her as having cysts on her left ovary. He recommended that she come to the Pacific Dispensary, where we have the equipment to do a small insertion in order to drain or aspirate the fluid that was building up because of these cysts. This could relieve her of the pain and pressure.”
Annie grimaced, thinking about what that would mean. She said, “And were these…expressions…done?”
Ella took a piece of paper out of a folder and pointed to several dates. “You can see here that the first expression was done in January of 1881. Dr. Brown aspirated nine pints of fluid, which brought down the swelling and confirmed it was a cyst that appeared to be located on the left side.”
“But that was only a temporary solution?” Anna said.
“Yes. Only months went by before the swelling and pain had gotten so bad that she came in again for a second aspiration in August of 1881.”
Annie looked at the notations by this date and said, “Am I right, this time they took out twelve pints? Oh, my heavens, that is well over a gallon of fluid!”
“Yes, and if you look at this next date, less than a month later they did a third aspiration,” Ella said. “This note says that the hard lump that appears to have been the primary cyst had grown over two inches in that month. That was when Dr. Brown, with Dr. Granger’s agreement, recommended surgery instead of another aspiration.”
“Were you at the dispensary during any of this?” Annie asked.
Ella nodded. “Yes, I joined the dispensary in June, so I was able to observe during the second and third aspirations, and during the surgery itself, when the total volume of fluid they removed weig
hed over twenty pounds. Here, you can see that the actual solid tumor, not counting the smaller cysts, weighed seven pounds. No wonder she was in such terrible pain.”
“She wasn’t awake for this surgery, was she?” Annie thought about the pain and difficulty associated with the birth of Abigail…who weighed only six and a half pounds at birth.
“No, she wasn’t. Dr. Blake, who is Dr. Brown’s brother and an expert anesthesiologist, administered the ether.”
“And there were no problems with the surgery?” Annie asked, thinking about the letter from Mr. Truscott.
“No. Although ten days after the surgery, Mrs. Truscott developed a high fever. On examination, Dr. Brown found internal swelling that indicated the possibility of infection. We treated her, and within three days the signs of infection were gone. She wasn’t discharged for another week, when Dr. Brown and Dr. Granger agreed she was safe to do her final recuperation at home.”
“Was that the last anyone saw her at the dispensary?”
“Yes, although I would assume that Dr. Granger, as her primary physician, would have continued to monitor her health,” Ella said, closing the file. “Here, this copy is for you.”
“Dr. Brown assumes the same thing, which is why she was surprised to hear that Mrs. Truscott was now ill, and her husband thought it was because of the surgery.” Annie put the folder under her purse, so it wouldn’t get mixed up with the records she was sorting through.
Ella looked at her watch and stood up, saying, “I need to get going. I believe that Dr. Brown was going to ask Dr. Granger to stop by this evening and let me know what he knew about Mrs. Truscott’s health.”
Annie stood up and reached out to shake the young doctor’s hand, saying, “I want to thank you so much for your time.”
“Oh, it was my pleasure,” Ella said. “And, as Mrs. McClellan said, if there is anything at all any of us can do, please let us know.”
Annie replied quickly, “You could notify me when you hear from Dr. Granger. While these notes and your description of what this poor woman was going through has been very helpful, I really would like my husband to be as fully informed as possible about her current health before he contacts Mr. Truscott.”
Ella had started towards the reception room when she let out a small exclamation. Annie turned quickly around and saw that a tall, silver-haired man, with an impressive mustache, was coming in the door to the office.
A smile lighting up his face, he came rapidly over to Ella Blair and gave her a swift kiss on her cheek. He then stood back and said, “Well, Ella, my dear, how does it feel to be on your first solo voyage as captain of this little ship?”
He then noticed Annie and said, his pale blue eyes twinkling, “And let me guess who this charming woman is. From Dr. Brown’s description, I assume you are Mrs. Dawson, here to untangle the financial mess Mrs. Branting left us in when she abandoned her post.”
He took Annie’s hand, gave it a pat, and said, “I’m Dr. Harry Granger, at your service. And I confess I am really glad to see you. I’ve just come from Mrs. Truscott’s home…and I am deeply afraid we are facing more than a problem of mismanaged books.”
Chapter 11
Friday, February 24, 1882
O’Farrell Street Boardinghouse
* * *
Annie sat in the kitchen rocker, contentedly nursing Abigail, while the hustle and bustle of dinner preparations in the kitchen went on around her. The arrival of Dr. Granger at the dispensary, with his shocking pronouncement, had delayed Annie’s plans to be back at the boardinghouse by four-thirty. But Abigail didn’t seem any worse for the delay.
When Annie and Kathleen had hurried through the back kitchen door, her daughter was sitting in Mrs. Stein’s lap at the kitchen table, throwing bits of cooked carrots down on the floor—much to the delight of Dandy, the Boston Terrier. Abigail screwed up her face and cried, “Mama,” when she noticed Annie’s arrival, fussing until Annie was able to put her to her breast. But Mrs. O’Rourke had later assured her that when Abigail woke from her nap and Mrs. Stein brought her down to the kitchen, she’d not seemed the least disturbed that her mother wasn’t there to greet her.
Now, Mrs. Stein had returned to her sitting room upstairs, and Jamie, Ian, and Emmaline had taken Dandy out for his last long walk of the day. Meanwhile, Beatrice was basting a chicken in the oven, Kathleen was washing up some dishes, and Tilly was icing a cake that Beatrice had made for dessert.
Because the Steins normally ate out on Fridays, and the Misses Moffet often had to go to some wealthy woman’s house to do last-minute dress fittings, Friday dinners were casual affairs. Annie’s sister-in-law, Laura, and Jamie’s mother, Barbara Hewitt, and the three children were often the only boarders who would be sitting down to eat. Tonight, Annie would join them because Nate had told her not to expect him home in time to eat dinner upstairs with her.
As she shifted Abigail over to her other breast, hoping to finish nursing before the children got back, she listened as Kathleen told Beatrice and Tilly all about her visit to the dispensary. As Annie had hoped, after helping Kathleen bring the tea tray upstairs to the office, the dispensary servant, Megs, had been more than happy to show Kathleen around, including accepting her help in delivering an afternoon snack of fruit to the women who were in the maternity wards.
Kathleen was very impressed by the dispensary kitchen, but she was even more excited to describe the maternity wards. She said, “Two women who’d given birth at the beginning of this week shared one of the rooms. Their babies were the cutest little mites. Wouldn’t you know, the girl baby was bald as could be, and the boy had this thick head of black curls. We didn’t go into the second room on that side of the hallway because there was a woman there who was in the middle of labor.”
Annie heard the discomfort in Kathleen’s voice. The young maid’s mother had died in childbirth, along with the baby. Consequently, while Kathleen loved children, Annie knew she had real fear about the process of actually having a child. Mrs. Stein had sent her down to work in the kitchen during Annie’s own long birthing process when she saw how hard it was on the young woman.
Kathleen went on, saying, “In the third room was a really young girl, Hilda, with hair the color of bleached straw and the bluest eyes you ever did see. She had some funny foreign last name. Megs said Hilda’s baby was due any minute, but she wasn’t very big, and so thin, so that didn’t seem possible. I thought she looked sort of sad and lonely, so when Megs had to get back to sweeping, I said I’d stay behind to return the girl’s cup and plate to the kitchen.”
Annie said, “That was kind of you. Did you learn anything of her history?”
“Not much, except she’d been a servant in a private house. Most likely she got turned out when the mistress found out the state she was in.”
Annie noticed that Tilly was nodding knowingly. She supposed that even a girl as young as Tilly had heard of similar cases.
“You said she was young. How young?” Annie asked.
“Sixteen. Least that’s what the dispensary cook told me later. I wouldn’t be surprised if she was even younger. Hilda said she started out in service when she was twelve, like me. I told her some stories about the first house I worked in…made her smile once. I also told her about working for you…and how you let me bring my brother, Ian, to live here and maybe she’d be able to get a place where she could keep her baby. I could see that perked her up some.”
Beatrice O’Rourke, who’d been silent up to now, said, “I’m not sure it was kind to give her false hope, Kathleen. Most likely she’s going to have to give the baby up. No more than a child herself—how’s she going to support her baby?”
Annie sighed. Beatrice was right, but maybe the good women who ran the dispensary had a plan on how to help Hilda and her baby. Surely, she wouldn’t be the first unmarried girl to end up at the dispensary.
When Beatrice saw that Annie had finished nursing Abigail, she came over and took the baby in her arms, while Annie got
presentable. Meanwhile, Tilly went upstairs to start setting the table.
As soon as the younger maid disappeared up the back stairs, Kathleen said, “I didn’t want to tell you this part with Tilly in the room. When I took down the tea things to the kitchen and mentioned how poorly Hilda looked, the cook said the girl had come to them only last weekend. Near death from some potion she took. They had to give her something to get it out of her. Then that Dr. Blair worked through the night to make sure she and the baby were all right. Cook said that Mrs. McClellan, the one they call Matron, is worried that when the time comes, she won’t be strong enough…or that maybe the baby might not be healthy.”
Annie stood and took Abigail back from Beatrice, suddenly needing to feel the reassurance of her own child in her arms. How awful. She remembered how Dr. Brown had reacted so strongly to the idea that Mr. Truscott might be accusing the dispensary of malpractice. Yet, when she thought about Hilda, a child having a child…
An hour and a half later, as Annie finished up the last bit of chicken and potatoes on her plate, she looked with fondness at the three children across the table from her.
Eleven-year-old Jamie Hewitt had lived in the boardinghouse the longest. He moved in three years ago with his mother, Barbara, who was a teacher at Girls High. At the time, he’d been a shy, reserved boy, who tended to be overprotective of his mother. But the arrival in his life of Dandy, his black and white terrier, and then Ian Hennessey, Kathleen’s youngest brother, had brought out a lighter, more fun-loving side to him.
Although in the same class as Jamie, Ian Hennessey was a year older. Where Jamie had sun-touched brown hair and warm brown eyes, Ian was dark-haired and blue eyed, like his sister, and full of mischief and the blarney of the Irish. He was also very bright, and Kathleen had her hopes pinned on him staying in school so he could get a decent job, maybe as a clerk in a store or office. Annie suspected that sometimes she even dreamed he would become a lawyer like Annie’s husband.
Lethal Remedies Page 7
