For her first rotation, Una was assigned to ward six, a surgical ward overseen by Miss Hatfield. Her first day was a harried blur of fetching supplies, mopping up vomit, and lugging soiled dressings down to the waste barrels in the rear yard. At the end of her twelve-hour shift, she trudged back to the nurses’ home alongside Dru. (She was too tired to even say her full name or bother to ask whether Dru minded the nickname.) Dru chattered on about her day with the energy of a child who’d eaten too many sweets. Una nodded every so often but didn’t listen.

Her feet and back ached worse than when she used her ragpicker ruse and spent the entire day diving pockets along Market Street, hunched over and hobbling. Or that time she’d lifted the pocketbook of a U.S. marshal and had to crisscross the city twice over to elude the coppers. The short walk from the hospital seemed like a mile, and when at last they arrived, Una was famished. She attacked her supper like a street urchin, soaking up the soup Cook Prynne served with a roll and shoving it in her mouth. Several bites later, she looked to find all the women staring at her.

“We were just about to say grace, Miss Kelly,” one of them said. “Would you care to join us? Or don’t papists bother to give thanks to the good Lord before they eat?”

Begrudgingly, Una set her roll on her bread plate. “Of course we do. We just don’t make such a big show of it.” She clasped her hands and bowed her head. When the snooty woman finished the prayer, Una made a slow, deliberate sign of the cross. “Is it okay with God if we eat now?”

When no one replied, she reached for her bread, then, thinking better of it, picked up her spoon instead. She’d raised their dander enough for one night. Dru took up her spoon as well. Soon they were all sipping their soup in silence.

* * *

The next day passed little better. Una refused to risk being poisoned by the sewer gases leaking from that strange contraption in the water closet, so she slipped out after breakfast to use the privy three buildings down. Both stalls were in use when she got there, and though she could easily relieve herself in the corner of the yard, it wouldn’t do for anyone to see a Bellevue nurse trainee hiking up her starched skirts and pissing on the ground. But the wait made her late for morning lecture. Not late in the normal sense of the word. In the slums you could arrive just about any time, and no one paid you mind. Even at Sunday Mass, so long as you sneaked in before Father O’Donoghue started reading from the Gospel, you were considered on time enough to meet the week’s holy obligation. But Miss Hatfield hadn’t the magnanimity of Father O’Donoghue. She stopped speaking mid-sentence when Una cracked open the door to the demonstration room and slipped inside.

“Good of you to join us, Miss Kelly,” she said once Una had shimmied past a few of the women to an empty spot at the back of the room. “We were just discussing the importance of cleanliness on the ward. Perhaps you can enlighten the other trainees on the composition of dust.”

Dust? Was this a joke of some sort? But there wasn’t the slightest glimmer of mischief in Miss Hatfield’s eyes. “Dust is made up of . . . er . . . dust.”

A few of the trainees laughed, though Una doubted they could have given any better answer to such an absurd question.

“Incorrect.” Miss Hatfield dragged her finger over the top of the supply cupboard beside her and then held it up. “Dust is comprised of both organic impurities and the germs of disease, hence the importance of its careful and thorough removal. How, then, should we clean it?”

After a moment’s silence, Una realized the question was again directed at her. “With a feather duster?”

“Incorrect once again. If I were as ignorant as you on the principles of cleanliness, I would make a greater effort to arrive on time for lecture.”

Una couldn’t very well tell her there’d been a line at the privy, not without facing more ridicule for avoiding the water closet, so she kept her mouth shut.

“Is there anyone who can enlighten Miss Kelly on the proper instrument for dust removal?” Miss Hatfield said, unfixing her glowering eyes from Una and casting them about the room. “Anyone?”

Una snorted, then covered the noise with a cough. See, she wasn’t the only ignorant one among them when it came to dusting.

Then Dru timidly raised her hand. “Yes, Miss Lewis?”

“A damp cloth or sponge?” “Precisely. Why?”

“To avoid raising the dust.”

“That’s correct. A soft-hair broom may be used if care is taken. The woodwork and windows must be dusted once a week in this manner, the floors at least twice weekly. Always with carbolized water.”

Miss Hatfield droned on about the various chores necessary to maintaining a clean ward. Then she informed the trainees she would demonstrate how to dress a bed.

Una fought back another snort. Surely none of the trainees were so daft as not to know how to make a bed. But when she glanced around, everyone was watching Miss Hatfield intently. Loobies, the lot of them. Perhaps instead of insisting applicants be well-bred and refined, they should require common sense and basic domestic skills.

Later, when they arrived on the wards, Una and the other trainees were tasked with implementing the skills Nurse Hatfield had bored them with that morning. Una begrudgingly got to work dusting windowsills, rinsing bedpans, and changing out the linen. It wasn’t half so hard as Nurse Hatfield had made it seem. She could have spent all morning in line for the privy, missed the lecture completely, and saved herself the browbeating without being any the worse for it. So what if she’d already forgotten how to make carbolized water. Juice from the spigot worked just as well. And never mind which sheet came first. She’d slept for years on a single sheet and pile of straw and was as healthy as a May hedge in bloom.

By midafternoon when Nurse Hatfield made her rounds through the ward to inspect Una’s work, the bedpans were cleaned and stowed away on their appointed shelves, the tabletops and windows were dust free, and every empty bed was neatly made. She stood by as Nurse Hatfield ran her fingers high and low, hunting for dust, and smiled to herself when they came up clean. But apparently clean wasn’t sufficient for the head nurse. She brought the tips of her fingers to her nose and inhaled.

“What ratio of carbolic acid to water did you use?”

“About that, I—” Una was saved from answering when the second-year trainee hurried over to them. A new patient just brought down from the operating theater had begun to hemorrhage. Nurse Hatfield quickly examined the patient with Una and the second-year peering over her shoulder. Blood had soaked through the surgical dressing that stretched halfway across the man’s belly and oozed down onto the bed. Una watched as she peeled back the bandage to reveal a jagged line of stitches sopped in blood.

“Fetch me a basin of carbolized water, Miss Kelly,” Nurse Hatfield said, her voice steady and cool. “One part carbolic acid to forty parts water, as I’m sure you remember from this morning’s lecture.”

Una hastened to the storeroom. Behind her, she could hear Nurse Hatfield interrogating the second-year about the man’s condition before dispatching her to fetch the surgeon. Una found a jar of crystallized carbolic acid. She measured out half an ounce and dissolved it in twenty ounces of water. A faint but sharp odor unlike anything she’d smelled wafted from the basin of liquid. So that was what Nurse Hatfield was sniffing for, Una realized.

She returned to the patient’s bedside with the basin, grabbing a sponge and stack of soft rags along the way. First, Nurse Hatfield used the water to clean her hands. Then she wetted a few of the rags and wiped the man’s incision. Fresh blood leaked around his stitches but not so much as to suggest the type of grave internal hemorrhage the second-year had been afeared of.

“A simple case of delayed clotting, as I suspected,” Nurse Hatfield said, more to herself it seemed than to Una. Already the bleeding had slowed to a trickle.

“So he’ll live?”

“That remains to be seen.” She turned to Una. “Get rid of that sponge you brought over. It’s completely inappropriate for cleaning and dressing a wound.”

“Right, why didn’t I think of that?” Una muttered before she could stop the sarcasm from slipping out.

“A sponge, Miss Kelly, can easily transfer poisonous matter from one wound or sore to another. Tow or cotton-wool soaked in water are much better; they can be disposed of after use.”

“I was just trying to help.”

“Until you grasp the principles of cleanliness and its role in preventing disease transmission, you’ll be of little help.”

Una snatched up the sponge and stomped back to the storeroom. Sponges, tow, rags, cotton-wool—how was she supposed to know the difference between them? Nothing she did would ever be good enough for Nurse Hatfield. Never mind that she’d also brought rags—which Nurse Hatfield had been happy to use—entirely on her own initiative. On the streets, you made do with what you had. A shirtsleeve in place of a handkerchief. A corncob instead of privy paper.

When Una returned, she found the second-year trainee attempting to remove the soiled draw sheet from beneath the patient. Only, there was no draw sheet. As a result, blood had soaked through the under sheet to the mattress. Both would need to be washed and disinfected, and the patient moved to another bed. Nurse Hatfield strode to the other empty beds Una had made and yanked off the blankets. Not a single one met her standards.

She ordered Una to dress them all again properly: under sheet, rubber sheet, draw sheet, upper sheet, blanket. Arms crossed, she stood by, pointing out every wrinkle and poorly tucked corner. When she was finally satisfied, she instructed Una to take the bloodied sheets and straw mattress down to the laundry.

“When you’re done with that,” she added, “report to the third floor.”

“What for?” Una asked, gathering up the stained linen.

“To explain yourself to Superintendent Perkins.”