MONDAY
FOUR
‘I see you have spent some time in the West Indies, Staff Nurse Jennings.’
The young nurse stopped her unloading of the blood transfusion kit and stared at the Royal Army Medical Corps major. ‘I beg your pardon?’
‘And that your family were in sugar.’
She gave a small laugh of disbelief and put her hands on her hips. Her eyes widened, so they seemed almost too large for the delicate face. ‘How on earth can you know that?’
‘A parlour trick,’ said the major with a smile. ‘Forgive me.’
‘That hardly explains how you come to be familiar with my family history, Major Watson.’ She paused as a low rumble began, like thunder growling on some distant mountains. She put her head to one side and listened carefully. A curl of dark hair looped free from the headdress and she absent-mindedly tucked it away. ‘Their guns. Not ours. You soon learn the difference.’
He frowned as the bright nickel instruments he was laying out on the folding table rattled softly in their steel kidney bowls.
‘Don’t worry,’ she said, ‘we’re out of range here of all but the big ones, and they tend to be used on the towns and marshalling yards. Not the evacuation railheads.’ The Casualty Clearing Station was half a mile from such a railhead, accessed by special wheeled stretchers that ran on a narrow-gauge track. From these improvised tramways, the wounded were transferred to regular ambulance trains.
‘I’m not concerned,’ said Watson. ‘But I have demonstrations to give and samples to stockpile, and I was told this was a quiet sector.’
‘Quiet,’ she explained patiently, ‘means less than a hundred casualties a month. There is no such thing as a totally safe place out here. The guns can start anywhere, anytime.’
Although a relative novice to the front – it was little more than a week since his balloon ride – Watson knew what those falling shells meant. There would be wounded coming through. Casualty Clearing Stations always worked in pairs, and this one, the East Anglian, had been stood down for a few days to enable it to clear the backlog of cases, while another CCS in the same sector remained on alert. If that one, however, ran at or beyond its capacity, the East Anglian would come back into play.
‘And we hadn’t had a “hate session” from the enemy until three or four days ago,’ said Jennings, ‘when some foolish . . .’ She hesitated. Nurses were directed not to comment on anything but clinical matters, and even then, only if invited to.
‘Some foolish what?’
‘It’s nothing, Major.’ Jennings swiftly moved on, pursing her lips at her impetuousness. ‘They’ll be putting electric lights in here within a few days. About time.’
She looked down at the packing case and lifted out The Icehouse, a wooden and zinc box some twenty-four inches on each side. It had cost him sixty shillings of his own money at Army & Navy. ‘What do you intend to keep in here?’ she asked as she laid it on the floor of the tent.
‘Once the cavity is filled with iced water, it will be used to store citrated blood.’
Jennings looked puzzled. Her grey cape, edged with scarlet, told him she was, like most nurses servicing this collection of tented wards in the grounds of a former monastery, a member of the Territorial Force Nursing Service. It was very likely that these staff didn’t keep up with the latest developments, such as the ability to store unclotted blood outside the human body for days at a stretch. From what he understood, few this far forward – be they territorial, reservists, Queen Alexandras or doctors – had much time to read current issues of the British Medical Journal. His task, gained only after much inveigling of the RAMC – and that damned balloon ride – was to spread the gospel of the new methodology in hospitals and CCSs.
The RAMC’s hesitation in allowing him out here had been ridiculous. Apart from one knee that sometimes crackled and creaked and a tendo Achillis that ached after long walks, he was almost as fit as the young doctor who had been wounded at the Battle of Maiwand in Afghanistan. Although, he had to admit, he no longer had that man’s waistline.
‘Careful with the solution bottles, Staff Nurse,’ he warned, as she unwrapped a glass cylinder from its cocoon of corrugated cardboard and newspaper. ‘That’s our secret ingredient. Hand it here, please.’
There came a deeper rumble and for the first time, he felt the impact vibrate through the wooden floor and the soles of his feet. The canvas stirred and tugged against its ropes on one side of the tent and the roof rippled uneasily.
‘That was closer,’ said Jennings with a frown, just as the flap of the tent snapped back with a crack like a whiplash. Standing in the opening was the sister-in-charge, her face almost as crimson as the red cape that proclaimed her a full member of Queen Alexandra’s Royal Army Nursing Corps. The two red stripes on her sleeve told of her rank within her service. The sound of the German guns was momentarily lost beneath her impressive bellow. ‘Major Watson!’
Watson carefully laid down the precious jar of sodium citrate solution on the tabletop before he turned to face her. ‘Sister? How may I be of assistance?’
‘What is the meaning of this?’ She pulled back the canvas further to reveal his two VADs, each holding an Empire medical kit. Standing behind them, and towering over the pair by almost a foot, was Brindle, his designated driver, batman and orderly. Brindle’s long, sorrowful face was even glummer than usual as he secured the entrance flap open with two press studs.
‘Experience dictates that travelling with one medical kit in a war situation is somewhat risky, Sister,’ Watson explained patiently. ‘I always pack a spare.’
Now the colour on her cheeks was a perfect match for the cape. She waved a rolled piece of flimsy pinkish paper at the two women, who were still holding the heavy medicine chests, stabbing at them with it, as if it were a short sword. ‘I am not referring to your travelling preferences, Major,’ she almost snarled. ‘You have brought VADs into my Casualty Clearing Station. VADs!’
She made it sound as if Voluntary Aid Detachment nurses were some kind of vermin. And besides, it wasn’t strictly speaking her CCS; it was Major Torrance’s. But he was at Hazebrouck for a meeting with one of the army’s specialists in gas warfare. ‘When I was at Bailleul hospital,’ Watson said calmly, ‘I requested some assistance during this tour of the clearing stations and field ambulances. The Senior Medical Officer in Charge suggested Nurses Gregson and—’
‘They are not nurses, Major Watson, as you well know. Not qualified nurses. They are auxiliaries. Orderlies. And the Matron-in-Chief herself has forbidden VADs to work this far forward—’
There came another explosion, short and sharp, that made everyone’s heads turn to the source. It had come from Mrs Gregson, the older of the VADs. Her companion, Miss Pippery, a tiny thing who looked to be barely out of her teens, took a small step backwards, as if retreating from a ticking bomb.
Mrs Gregson bent at the waist, put down the medical chest, and stepped over it, so that she stood eye to eye with the sister.
Mrs Gregson, Watson estimated, was thirty or thereabouts, with striking green eyes and, beneath the white VAD headdress, a crown of fiery red hair. The sister was probably two decades older, pipe-cleaner thin, with a mouth pinched by years of keeping her charges in line. Now the opening was reduced further, to a razor cut in a rather sallow face.
When Mrs Gregson spoke, it was with a quiet but stinging force. ‘Sister, I may not have your qualifications, but I have been out here for more than two years. I was running first-aid stations when the worst the men faced was a turned ankle from trying to march in hobnail boots on French and Belgian cobblestones. I drove for McMurdo’s Flying Ambulance Brigade at Mons. Perhaps you have heard of it? I have treated trench foot, venereal disease, lice infestations and lanced boils in men’s buttocks the size of macaroons. I have stuffed men’s entrails back in place and held the hands of boys who cried for their mothers, such was their pain, and of grown men weeping in fear at the thought of going back up the line. I have carried men’s mangled arms and legs to the lime pit, told a private he will never see again, watched men drown in their own fluids from gas, spent weeks wondering if I will ever smell anything in my nostrils other than the stench of gas gangrene. I have shown pretty fiancées what German flamethrowers have done to their future husbands’ faces. Then had to deliver the letter that tells them that they have lost those sweethearts. I have seen enough pus to last me a lifetime, Sister, and my hands are likely ruined for ever from all the scrubbings with carbolic and Eusol because, of course, only a sister can wear rubber gloves, and I do believe, no matter what your dear Matron-in-Chief thinks, that I have earned the right to go where my betters think I am needed in this war, and I also believe that Major Watson’s new method of blood transfusion will save the lives of many who have to this point died for want of fluid and warmth.’ She finally took a breath. ‘Of course, I am not a nurse, nor would I claim to be. I am a VAD and proud of it.’
Mrs Gregson’s short speech never increased in volume throughout its course, but somehow, like a great flywheel pressed into motion, gathered power and momentum as it went. Watson was about to object that is wasn’t strictly speaking his new method of blood transfusion, but decided to stay out of the contest. It would be like trying to separate two Siamese fighting fish.
The guns seemed even louder and much closer in the brittle silence that descended on the tent.
Sister took her time composing her reply. The heightened colour in her cheeks faded, but she twisted the piece of paper she held in her hands as if she were wringing Mrs Gregson’s neck. ‘I did not intend to impugn the service you have given. But there are few here who haven’t performed the same tasks. Isn’t that right, Staff Nurse Jennings?’
‘Yes, Sister,’ she agreed softly, eyes downcast. ‘Although I can’t drive—’
But Sister had turned her attention back to the VADs. ‘You will assist Major Watson, of course, in his important work, and I assume move on with him once the technique for this wonder treatment has been demonstrated. But I do not want you on the re-suss, pre-op or evacuation wards. Or on the officers’ wards in the Big House. It will only confuse the men. I don’t want them to think they are getting . . .’ She paused for a moment and actually smiled before delivering the blow ‘. . . second-rate care.’
Staff Nurse Jennings gave a little gasp.
Mrs Gregson’s answer was thwarted by the popping of a motor cycle as a signals courier appeared in the doorway. He skidded the bike to a halt, raised his goggles off a dirt-encrusted face and shouted something that baffled Watson: ‘Pause!’
‘What about the Plug Street CCS?’ Sister yelled, pointing to the south. ‘Half our staff are on leave.’
The driver shrugged. ‘They’ve been bombed. From enemy aircraft. Direct hits. Not big bombs, but lots of them apparently.’
Sister shuddered at the thought of a shell of any description landing in the midst of a tented CCS and how little protection the thin canvas would provide.
‘Casualties?’
‘I reckon.’
She snapped her fingers at Jennings. ‘I’ll send a runner up to the Big House for the surgical teams. You gather the other nurses.’ She turned to Brindle. ‘Perhaps you can lend a hand at the reception area?’ Finally she addressed the VADS. ‘And you two girls, would you kindly do your best not to get under our feet?’
Once they were alone, Mrs Gregson lifted her long dress clear of the floor and stomped her foot three times, accompanying each percussive blow with a shriek of frustration.
‘Nurse Gregson, I apologize for Sister Spence—’ Watson began.
‘No, no, don’t call me that, she’s right. I am not a nurse. Nor am I . . .’ her lip curled, ‘. . . a girl of any description. “Mrs Gregson” will do just fine. It’s not the first time I have met her kind, Major. Although she is an exceptional specimen.’
‘There might, I fear, be extenuating circumstances.’
‘I knew, Major Watson, when I first set eyes on you and your tubes and syringes, that you were a gentleman. I don’t expect you to take sides. The war between VADs and QAs has been going on almost since hostilities began.’ She took several deep breaths and recovered her composure. ‘We’ll carry on unpacking, Major. You’ll be needed at the triage tent initially. We’ll have you ready for any transfusions by the time you’ve finished.’
One thing still puzzled him. ‘What did he mean by “pause”?’ he asked.
‘PAWs,’ corrected Miss Pippery, spelling it out, her voice sounding slight and reedy after the robust exchange between the two older women. ‘The casualties that are given priority transport from the dressing stations. Penetrating Abdominal Wounds. I think you used to call them Double-Is. Intestinal Injuries.’
He nodded. New weapons, such as shrapnel, needed fresh terminology. And, he reminded himself, new medicine.
‘Which means, Major Watson,’ said Mrs Gregson, ‘we’ll be needing your magic blood a lot sooner than you anticipated.’