The next morning, Una forced herself out of bed the moment she heard Dru stirring. She used the water closet instead of the privies down the block, pinching her nose and holding her breath the entire time. It turned out that the strange cord dangling from the box above the toilet brought a gush of water that flushed her urine from the pot. She pulled the cord three more times out of sheer curiosity and would have stood looking longer had she not become dizzy for want of air.
Miss Hatfield stared cutty-eyed when Una arrived for lecture—on time and attentive. Clearly she was disappointed Superintendent Perkins hadn’t given Una the boot and was itching to catch her next slipup. But Una wouldn’t give her the slightest excuse to haul her up to the third floor again.
That proved easier said than done, though. Whatever principle the trainees learned in morning lecture—the importance of ventilation and sources of bad air in the sick room, temperature, deodorizers, the difference between absorbent and antiseptic disinfectants—Nurse Hatfield expected Una to have mastered by afternoon rounds. If Una had opened the windows to encourage the circulation of fresh air, Nurse Hatfield would stalk up and down the ward, making sure each patient’s bedclothes were sufficient to keep them warm and screens were in place to block them from the slightest draft. If Una had the windows closed and stove lit to expel impure air through the flue, she would interrogate Una as to whether the cooler air being drawn in from the hall was itself fresh and properly ventilated. If Una set out bowls of charcoal to absorb deleterious substances in the surrounding atmosphere, Nurse Hatfield questioned why she hadn’t used porous clay instead, though she’d said herself in lecture that the two were interchangeable.
It didn’t help that the moment Nurse Hatfield arrived, every patient, resting quietly only moments before, was suddenly in need of a bedpan or glass of water or warm fomentation. While the second-year trainee handled anything requiring medical knowledge or skill, these common drudgeries
fell to Una, who frequently found herself juggling water pitchers and linen and metal basins sloshing with vomit or piss back and forth across the ward as Nurse Hatfield quizzed her about the different types of antiseptic. But though she sometimes confused Condy’s fluid and chloralum, or let the ward’s temperature stray a degree or two from the prescribed range of 65 to 68 degrees and was chastened for her negligence, she was not summoned back to the superintendent’s office.
Two weeks in, Una felt like she’d finally gained her footing in this strange place of ordered bedlam. It wasn’t so different, after all, reading a patient like she’d read a mark. A greenish cast to a patient’s cheeks, and she was quick to fetch a basin lest he vomit. Dry lips and tongue smacking meant he’d soon be in want of water. A tight expression and skittish eyes told her the patient needed a bedpan but was too embarrassed to ask.
She’d even begun to anticipate Nurse Hatfield’s arrival. As on the streets, those ruled by habit made easy dupes. In addition to rounding with the physicians in the late morning after the trainees’ lecture, Nurse Hatfield visited each ward again in the afternoon. She always began on the second floor at two o’clock, after taking tea with Superintendent Perkins and the other head nurses, inspecting wards seven and eight before descending the stairs at the east end of the north wing. From there she continued in ascending order beginning with ward one. Taking into account that she spent an average of twenty minutes scrutinizing each ward, Una could expect her at four o’clock and seldom a minute before. So the wall clock’s single, low gong at three thirty served as Una’s warning. She tidied the long table in the center of the ward, smoothed the patients’ blankets, tucked in loose sheets, and emptied any malodorous basins. By the time she heard Nurse Hatfield’s clipped footfalls approaching, she was ready to greet her with a serene, if fake, smile.
Una was so intent on keeping the ward clean and Nurse Hatfield mollified that she hardly noticed anyone else at the hospital. Doctors came regularly to check on the patients, visitors sat at the bedside, kitchen staff delivered meals, workhouse women scrubbed floors and washed windows. But unless Una was tripping over a worker’s mop or fetching a distraught wife a hankie, she was too busy to pay any of them much mind. The physicians issued their orders to the second-year, seemingly oblivious to Una, even as they pushed aside the screens she’d carefully arranged to
protect patients from drafts and tossed their dirty equipment on her newly made beds.
One morning, arriving at the ward after morning lecture, Una noticed one of the patients sweating and shaking. He’d had some surgery or other and been brought to the ward two days before. When she asked if he was cold or feeling ill, he replied in gibberish. She might have taken him for a foreigner and shrugged it off, but they’d had a perfectly articulate conversation in English just the day before. Besides, she’d spent enough time with her father to recognize the signs. As the second-year was busy redressing another patient’s wound, Una slipped the man a cup of brandy and went about her work.
Not long after, a group of several physicians arrived accompanied by Nurse Hatfield for morning rounds. They moved their way from one bed to the next like a rent collector and his thugs move through a tenement, heedless of anyone’s purpose but their own. When they got to the addled patient, they carried on as usual, an older man with a trim, graying beard lecturing and questioning the younger men. The patient, Una happily noticed, was no longer sweating or trembling. When one of the physicians asked him how he was feeling, he answered back in plain English. But then the older physician leaned down, nose to nose with the man, and sniffed.
“Who’s given this man spirits?” he shouted.
The second-year who’d been following behind the group, picking up discarded bandages and tucking the patients back in, scurried over. “No one, sir.”
“I smell brandy on his breath plain as day. How can we undertake the second half of his operation when he’s been allowed to imbibe scarcely an hour beforehand?” A flush had crept into his cheeks. He turned back to the patient. “Who gave you drink this morning?”
The patient rattled his head. “I don’t right remember, Doc. Could’ve been an angel.”
“An angel.” The physician snorted. “Was she wearing blue and white?” “I think so.”
“And a puffy cap?”
“Sounds about right.”
The physician turned back to the second-year. Her posture seemed to shrivel, and she took a step back. Una, watching from across the room, grabbed a basket of laundry and tiptoed toward the door.
“I didn’t give him anything,” the second-year said. “I swear. It must have been the probationer.”
All eyes flickered to Una. Three more steps, and she would have made it to the door.
“You,” the physician said to her. “Come here.”
Una set down the basket and wiped her hands on her apron to buy herself a moment’s time. Her heart inched into her throat as she tried to figure another way out of the situation. The physician’s cheeks grew redder. Nurse Hatfield could barely contain her smile as if she were already envisioning hauling Una up to the superintendent’s office.
“Hurry up, girl. I haven’t got all day.”
His brusque, self-important tone settled it for Una. She walked over with her shoulders back and head high.
“Did you give this patient brandy this morning?” “I did.”
The physician blinked.
“He’s got a bad touch of the horrors, this one.” “The horrors?”
“I think she means delirium tremens, sir,” one of the younger physicians said.
Una nodded. “If he’d gone much longer, he’d have had a fit.”
The older physician scowled at her. “And what makes you at all qualified to make such a diagnosis.”
Experience, you old bloat, Una wanted to say. Instead she told him about the man’s sweating, trembling, and nonsensical speech.
“That could be the manifestation of several ailments, not just delirium tremens.”
“Yes, but with the yellowing about his eyes, I thought there was a good chance he’d been in his cups—er—imbibing strong spirits for a great while. If he’d been admitted suddenly for surgery and not had time to dry out, well, then the horrors—delirium tremens, I mean—seemed a plausible cause.”
The physician stepped closer, the others giving him a wide berth. “You are a nurse. No, not even a nurse, a probationer. You are not and never will be a doctor. It is wholly beyond the scope of your duties, not to mention your intellectual capacity, to diagnose and treat patients. Your job is, or
was”—his eyes cut to Nurse Hatfield and back—“to carry out my orders. Quietly. Efficiently. Without question or conjecture.”
Una itched to haul back and punch him. And why not, if she were already about to be expelled? Her fingers were closing into a fist when one of the other men said, “I gave her the order, sir.”
Both Una and the older physician turned to look at the man. It was the same young doctor who’d had enough sense to know that the horrors was the same damned condition as the fancy named “delirium tremens.” Una had seen him a time or two before on the ward, usually in the company of other physicians. Despite his neatly trimmed mustache, he had a youthful face with a faint dappling of freckles across his nose. His hair, a bit too long, was the color of cherrywood and curled upward at the ends despite a generous slick of pomade. Were it not for his eyes, which had the stillness of one who’d seen and endured the thorny courses of life, Una would have thought him far too young to be a doctor. As it was, she questioned whether he was having a go at her or simply was a fool.
“I . . . er . . . noticed the patient’s symptoms this morning on my way up to the theater and instructed this nurse to medicate him with brandy until we could confer on the best course of treatment.”
The older physician glowered at him. “Why didn’t you speak up sooner, boy?”
Color bloomed across the younger physician’s face, from the tip of his nose to his ears. Before he could respond, the other man continued, addressing the group at large. “What are the appropriate treatment options for delirium tremens?”
“Hydrate of chloral or opium,” another of the young doctors said with a hint of smugness.
“Very good, Dr. Allen. Both are suitable options that would not preclude surgery today as the administration of such a significant quantity of brandy has done.” He turned to the freckle-nosed doctor. “A mistake, I think, your grandfather would not have made.”
“Yes, sir,” the chastened doctor muttered, though he too looked like he wished to sock the old man.
Hydrate of chloral was ordered for the patient and the physicians continued their rounds. Nurse Hatfield followed them, but not without a sharp glance in Una’s direction. You won’t wriggle free next time, her eyes
seemed to say. The second-year elbowed Una in the ribs. “No matter what the doctors tell you, leave the dosing of medicine to me, probationer.”
Una nodded. Her heart still beat high in her throat alongside her voice box. Her limbs tingled like they did when she narrowly escaped the coppers. It took her a moment to order her thoughts and remember what the dickens she’d been doing before this whole mess began. Even once her hands were occupied again dusting the patients’ nightstands, her mind raced and gaze wandered to the young doctor. Just what was he about, anyway? What advantage was there in speaking up for her? Surely he meant to lord this over her somehow.
Una realized she’d been dusting the same table for several minutes, rubbing with such vigor patches of the varnish were gone. She rattled her head and moved on, but not without another glance in the doctor’s direction.
A few minutes later, she overheard the stodgy old physician adjourn for lunch. Nurse Hatfield and the doctors dispersed. Una’s taut muscles relaxed at their departure. Now maybe she could finally focus on her tasks. But the young doctor remained, lingering at one of the patient’s bedside. Una waited for the second-year trainee to disappear into the storeroom, then stalked over to him.
“What’s your angle?” she whispered.
He looked up from the patient. “Excuse me?”
“You and I both know you didn’t tell me to give that man brandy.” “Would you rather I have let you take the blame and be expelled?”
“Yes. No.” Una huffed. “But I don’t mean to live under your thumb because of it.”
The doctor laughed—a pleasant, guileless sound that disarmed her. “You’re not like the other nurse trainees. What’s your name?”
She hesitated a moment, then narrowed her eyes to make it plain she didn’t trust him. “Miss Kelly.”
“Well, Miss Kelly, your astute observation may well have saved that man’s life. If he’d started to seize during surgery, who knows what could have happened. A slip of the hand, a nick with the scalpel, and he could have bled out right there in the operating theater. Not to mention the risk of aspirating. You don’t need a cup of brandy to do it. A convulsing man’s own bile and saliva is enough.”
Una glanced down the row of beds to where the man lay resting. She’d never saved anyone’s life before. A strange lightness pushed at the walls of her chest. She frowned. Do-gooding was more trouble than it was worth, she reminded herself, and went against all her rules.
“I should have recognized it myself,” the doctor continued. “My father tried to give up intoxicating spirits on more than one occasion.”
When she turned back to him, his eyes had drifted from her to stare at some spot on the floor. “I thought physicians were supposed to come from good families. Cream of the crop and all that.” The man’s cheeks reddened, and Una regretted the impertinence of her remark. “Not that I believe any of that hogwash. Good men drink same as bad. And most have their reasons.”
He looked up at her again with an obliging smile. His ivories were almost white and straight enough to be fake. What a price they’d fetch!
“You take far more liberty with your words than any of the other trainees I’ve met also,” he said.
Her stomach tightened. She had been far too familiar with him, using words like hogwash. She ought to be more guarded. Stick to her demure, well-bred woman ruse. But it wasn’t just his laugh that disarmed her. He seemed different from the other physicians, though not in any obvious way. The expensive brown wool suit he wore was just as stodgy. His posture just as self-assured. And yet, it was as if he too didn’t quite fit in. “You mean I’m not mute.”
“That you certainly are not. Dr. Pingry about had a convulsive fit himself when you walked up and plainly admitted you’d administered the brandy. The look on his face alone was worth standing up for you.”
The second-year’s footfalls sounded at the far end of the ward as she emerged from the storeroom carrying an armful of supplies. Una took a step back and busied herself dusting the nearest bedside table. She didn’t need to add immodestly fraternizing with an intern to her list of the day’s misdeeds. “I can stand up for myself, thank you very much.”
That irksome chuckle again. “I have no doubt, Miss Kelly.”
