Two days later, Una arrived at ward six to find the second-year seated on a stool with her head cradled in her hands. A bucket was wedged between her knees. She glanced up at Una with bloodshot eyes, then grimaced and threw up into the bucket. Una fetched a damp cloth, returning just as the second- year threw up again.
“Are you all right?” Una asked. “Perhaps you should lie down a moment.”
The second-year shook her head. “Shall I go find Nurse Hatfield?” “No!”
Una took a step back at the sharp reply. She’d never heard the second- year speak above a whisper.
“I’m fine,” she said more quietly. “It will pass, I just need a moment.”
Her face was pale and beaded with sweat. Her legs trembled around the bucket. Whatever ailed her, it likely wouldn’t pass in a moment or anytime soon, but Una let her be and went about her work.
Though they were assigned the same ward, she and the second-year hadn’t interacted much. Una wasn’t even sure of her name. Miss Caddy? Miss Catson? Miss Carlisle? Whatever her name, she’d made it clear that Una was a lowly probationer, whose standing on the ward was barely above that of the workhouse helper women and the unwelcome rats. Una’s job was to dust, make beds, roll bandages, attend to the personal cleanliness of the patients, and otherwise stay out of the way. Only when and if she passed her probation would Una be worth notice.
But that hadn’t stopped Una from noticing her, and—come to think of it
—the second-year had been acting strange the last few days. Resting often. Picking at her lunch. Popping in and out of the water closet.
Half an hour passed, and the second-year had managed to stand and attend to a few patients, only to rush back to her bucket. When she finished dry heaving, she waved Una over. “Mr. Kepler in bed four is having surgery
in an hour. I’m supposed to accompany him.” She winced and clutched her stomach as if she might retch again. “If I’m not well enough to attend, I need you to go in my stead.”
“Are you mad? I haven’t the slightest idea what to do in the operating theater.”
“Another nurse will be there to assist the physicians. You need only wheel the patient upstairs and be on hand to fetch supplies.”
“But I—”
“It’s only a lithotomy procedure. It shouldn’t take any longer than an hour.”
“Nurse Hatfield would never countenance such a cracked plan.” “She won’t know. You’ll be back long before afternoon rounds.”
Una crossed her arms and eyed the second-year head to toe. “Why don’t you want Miss Hatfield to know you’re sick? You ain’t contagious, are you?”
“Of course not. It’s just a passing—” She grimaced. “A passing trifle.” Suddenly it hit Una. “You’re apron up!”
“Whatever are you talking about?”
She leaned closer and whispered, “In the family way.”
“I most certainly am not.” But a sudden flush of color from throat to forehead belied her words.
Consorting with men during a trainee’s tenure at the school was strictly forbidden. A flirtatious smile was enough to get you expelled. A baby would do the trick quicker than you could let out your laces.
“They’ll find out sooner or later,” Una said, but not unkindly. She’d known dozens of women who’d found themselves in the same predicament and not always by choice. “Unless you mean to go to an abortionist.”
The second-year shushed Una with her hand. “Four months, and I’ll have my certificate. No one’s going to find out unless you tell them. And God help me if you do, I’ll—”
“I won’t tell anyone. It’s not their business no how.”
The second-year looked relieved. “And you’ll go with Mr. Kepler for his surgery?”
“You promise to give Nurse Hatfield a good report about me for the rest of my probation?”
She nodded.
“All right, I’ll go, so long as it’s like you say, and I won’t have to do anything more than fetch supplies.”
But the more the second-year described what Una was to do, the more unsettled her own stomach became. First, she must bathe the patient and dress him in a loose-fitting gown that could easily be removed once they reached the operating theater. Then a stretcher must be prepared, and the patient carried upstairs. When Mr. Kepler was situated on the operating table, Una must ensure that all of the following were on hand: towels, wash- hand basins, soap, hot and cold water, carbolic acid, carbolized oil, small bowls to receive the discharges, sponges, flannel and muslin bandages of various sizes, cotton wool, tow, lint, charpie, linen compresses, pins, needles, and thread.
“And make sure the sponges are free from sand or pieces of shell,” the second-year reminded her as she readied Mr. Kepler on the stretcher. “During the procedure, the assisting nurse will hand you the bloodied sponges to clean. Wash them in cold water and squeeze them as dry as possible.” She fussed with the bow at Una’s neck and straightened her cap. “For heaven’s sake, try to look competent and don’t tell anyone you’re a probationer.”
If she was well enough to do so much bossing, maybe she was well enough to take the patient to surgery herself. Una was about to say so when the second-year hurried to the bucket and heaved up the last of her breakfast.
Two orderlies arrived, fitting long wooden poles through the side loops of the canvas stretcher Una had laid out beneath Mr. Kepler. They raised him unceremoniously from the bed and carried him from the ward. Una glanced back at the second-year. This was an awful plan. True, if Una didn’t botch things, she’d have leverage. And with both Nurse Hatfield and Dr. Pingry eager for her expulsion, Una desperately needed an ally.
But if she made a mess of things, Una would get the boot right alongside the second-year. Not to mention this man’s life was on the line. Picking people’s pockets was one thing. Her marks were all fat chuffs anyway who could afford to be charitable. But Una didn’t need the weight of Mr. Kepler’s death hanging over her. Not when she already felt partially responsible for what happened to Traveling Mike. The skin on her arms prickled at the thought of him lying dead in that alley. Even though she
hadn’t any part in his murder, he wouldn’t have been there if it wasn’t for her.
Una rattled her head. The second-year was flapping her hands for Una to hurry along. Her expression—that of untempered desperation—didn’t bolster Una’s confidence. She took a deep breath, then scuttled off, following the orderlies through the interconnected wards, past the main hall, and into a tiny room.
“Get the door,” one of the orderlies said to her.
Una looked around but didn’t see any door. The orderly sighed and nodded to a latticework of metal folded like an accordion. When Una tugged, the metalwork unfolded into a floor-to-ceiling gate that closed them inside.
But what were they doing in such a small room? There’d scarcely be space for the surgeon, never mind his equipment. And if Una remembered correctly from her tour of Bellevue that first day, operations took place on the fifth floor, not the first.
A moment later, Una had her answer. A creaking sounded above them, and the entire room lurched upward. Una gasped and braced herself against the wall. The orderlies chuckled.
“Ain’t you ever been in an elevator before?” one of them asked.
Una straightened but kept a hand pressed flat against the wall just in case. “Of course I have,” she lied. “I was caught off guard, is all.”
The creak and whir of the machinery made her heart race while the strange sensation of moving upward roiled her already uneasy stomach. She had heard about ascending rooms in fancy hotels and stores, thinking you’d have to be mad to trust a few ropes and pulleys with the weight of an entire room. Had she known just what sort of death box she was stepping into, she’d have gladly taken the stairs.
When the elevator finally stopped, Una made sure there was solid ground on the other side of the gate before tugging it open. She stepped out on shaky legs. She’d ridden in an elevator. An elevator! She’d be a legend in the Points if they knew.
But Una had little time to relish in her triumph. The orderlies bustled with the stretcher down a short hallway and into a large oblong room. Sunlight streamed in through a bank of double-tall windows at the far end. Tiered seating curved halfway around the room, rising at a precarious pitch above the operating stage where a lone table sat.
Una’s mouth went dry as a church wafer. Already men were crowding into the seats, pressed together shoulder to shoulder, and spilling onto the steps. The second-year had warned her that a few medical students might be in attendance to observe, but Una hadn’t expected a floor-to-ceiling audience.
The orderlies hoisted Mr. Kepler onto the table, withdrawing the poles from the stretcher and then departing. Mr. Kepler too seemed overcome by the enormous room and gaggle of onlookers, glancing at Una with fearful, pleading eyes. She went over and took his hand. It was cold and sticky with sweat. Or was that her own sweat?
She realized she ought to act the part of a nurse and say something comforting, but she didn’t trust her voice not to warble. Instead she gave his fingers a sound squeeze and bared her teeth in what she hoped was more smile than grimace.
“Who are you?” a female voice said behind her.
Una turned and saw a plump, heart-faced nurse staring at her. “I’m . . . er
. . . Nurse Kelly . . . filling in for Nurse . . .” Damn it, Una had again forgotten the second-year’s name.
“Nurse Cuddy?” “Yes!”
“You’ve worked in the operating theater before?” Una nodded, fearing how hollow yes would sound.
The nurse stared at her a moment, her eyes—already too small for her face—narrowing until they all but disappeared. “All right, then. Get to it.”
Una nodded again and glanced about for the storeroom. Several doors opened off the theater stage. She picked one and walked confidently toward it. Nurse was a ruse like any other, after all. It only worked if you wore it well. The door she’d picked led to a dark broom closet. She closed it quietly and tried another. This one opened to a large storeroom stocked with various-sized basins, sponges, towels, and bandages of every sort. She filled her arms with all the supplies she could remember from Nurse Cuddy’s long list and a few others just in case.
Back in the operating room, she laid everything out on a long table. At some point between mixing up a bowl of carbolized water and readying the washing basins for the sponges, Una’s hands stopped trembling. In addition to setting out several bleeding-bowls, she filled a wooden tray with sawdust
and placed it under the operating table. A floor slick with blood could cause the surgeon to slip, Nurse Cuddy had warned her.
She struggled to ignore the murmur of voices from the seats above as she worked. The low hiss of the kettle set to boil on the small iron stove. But eventually, even her thudding pulse quieted.
When the assisting nurse finished readying her own table of shiny metal supplies, she came over and appraised Una’s, sending her back to the storeroom for a few more sponges and another square of flannel. Then she sent her to fetch more water for the kettle, chastening her that the air must be kept moist and pure.
Just as Una returned with the water, the team of surgeons arrived, led by Dr. Pingry. Una froze, the kettle whining beside her. She’d been too preoccupied remembering how many towels and buckets and bandages were needed that she hadn’t considered who might be performing the surgery. She shuffled back until her rear hit the wall, hoping to somehow blend in with the plaster. Surely he’d recognize her again and recall that she was a mere probationer with no business in the operating room.
But she may well have been an ornament on the wall for all the attention he gave her. He grabbed a blood-stained smock from a nearby peg and threw it on over his suit, walking right past the bowl of carbolized water she’d prepared to disinfect his hands. He stopped center stage beside the operating table and addressed the crowd of medical students.
“You are here today to witness a lithotomy for an unpassable bladder calculi. I will begin the procedure by . . .”
Unlike when he’d lectured to Una and the other nurse trainees, his voice now was resonant and lively. He spoke at length about the patient and his condition, gesturing to Mr. Kepler but never actually looking at him, as if he were no different from the table of bones he’d displayed for the trainees.
The two other doctors who had entered with him didn’t bother with smocks but took off their suit jackets and rolled up their sleeves. Una winced, recognizing one as the young doctor who’d saved her from being expelled over the unfortunate brandy incident. Dare she hope he wouldn’t notice her either?
Both men washed their hands in the bowl of carbolized water before joining Dr. Pingry beside the operating table. After he’d finished his bombastic description of the forthcoming procedure, Dr. Pingry introduced the two younger men as his senior and junior interns, Dr. Allen and Dr.
Westervelt. Una noticed a wave of murmurs through the audience at the name Westervelt. The doctor whom Una recognized colored about the ears. She’d seen that name before, Westervelt, but couldn’t remember where.
She refilled the kettle, then slunk along the wall back to her supply table, stepping as softly as possible to avoid notice.
Dr. Pingry turned from the audience to Mr. Kepler and scowled. “Why isn’t the patient in the correct position, nurse?” He said this to the assisting nurse, who in turn glared at Una. She gave an apologetic smile.
Despite her evening study sessions with Dru, Una had no idea what a lithotomy actually was. While the assisting nurse wrangled Mr. Kepler’s feet into stirrup-like contraptions that raised and spread his legs, Dr. Pingry turned back to the audience. “This is why women will never be surgeons. They’d just as soon enter the bladder from the mouth as the perineum.” The medical students chuckled, and the nurse flashed Una another squinty-eyed glare.
“There,” Dr. Pingry said, turning back to the operating table while still speaking loudly enough for the audience to hear. “Now that we are at last ready, my junior assistant will prepare and administer the ether while Dr. Allen assists with the procedure.”
Not Dr. Westervelt, but “the junior assistant.” Even Una registered the slight. She wondered if he felt the same way Una had under Marm Blei’s heavy thumb, stifled and unappreciated. But his expression was impassive as he approached the supply table. He grabbed a towel and wad of cotton without looking at her and returned to the operating table. Una was both relieved and perturbed that he didn’t notice her.
She watched as he fashioned a cone from the towel and a sheet of folded newsprint, then packed it with cotton. The assisting nurse handed him a bottle of ether, which he took and placed the cone over Mr. Kepler’s nose and mouth, instructing him to breathe deeply. He carefully dripped ether onto the cotton through the top of the cone. Soon, Mr. Kepler’s hands unclenched, and his whole body relaxed into the stillness of sleep.
“He’s ready,” Dr. Westervelt announced, and the procedure began.
Aside from rinsing a few blood-stained sponges, Una had little to do. She stood on her tiptoes to get a better view as Dr. Pingry made a small incision just below Mr. Kepler’s scrotum. She didn’t flinch at the sight of blood and watched in amazement as, after some discussion, Dr. Pingry extracted a jagged yellow stone the size of a peach pit. He held it up for the audience to see, and several onlookers grimaced and shifted uncomfortably.
As Dr. Pingry pulled several waxed ligatures from the buttonhole of his lapel and began stitching the incision, Una’s attention drifted back to Dr. Westervelt. He had remained at the head of the operating table, closely monitoring the patient and administering a few more drops of ether as needed. Una rarely found well-bred men attractive—their skin too pale, their hands too soft, their posture too rigid with an undeserved confidence. But there was something about Dr. Westervelt that intrigued her; beneath his polished exterior, she sensed a certain toughness.
He glanced up from the table and caught her gaze. Una quickly looked away, feeling a rush of heat spread up her neck. With the surgery over, Dr. Pingry dismissed the restless crowd, tossing his bloodied smock onto Una’s table and rinsing his hands in a bowl of water.
“Make sure any discharges from the wound are cleaned immediately,” he said without looking at her, “and keep a strict record of the urine he passes.” Then he left the operating room, followed by Dr. Allen and Dr. Westervelt.
Una felt herself relax for the first time since stepping into the elevator. She had done it—Una Kelly, a thief in hiding, had made it through an entire surgery disguised as a nurse. If she could pull this off, surely nothing could stop her from passing probation.
