After prayers, Sister did her inspection: of the general tidiness and cleanliness of the ward, the state of each patient, and any problems that had cropped up during the night of which she was unaware. The patients, who had to lie completely flat for the duration of the prayers, were then allowed to sit up and eat their breakfast.
Breakfast, or rather its preparation, was one of the probationers’ duties: porridge was the standard ration, followed by toast and marmalade and a cup of tea. It was wheeled round on a large trolley, with one of the pros, as they were called, pushing it, and another walking beside her and serving the food. The patients were most polite to them, without exception, and almost as respectful as if they had been, if not Sister herself, at least Staff. They ate everything; rejecting food was simply not an option. ‘And anyway,’ one of the nurses told Alice over lunch, ‘half of them are half starved when they come in, poor things. They think the food is absolutely wonderful.’
Once breakfast was cleared, and the trolley wheeled to the kitchen, they became fractionally more like nurses. All three of them were allotted patients; all three of them became part of a team working under a senior nurse. They had to know everything about each of their patients; their names, of course, but what was wrong with them, how long they had been in hospital, their treatment, their progress. They suffered from a variety of things, some gynaecological or gastric problems, chest infections, chronic bronchitis, some even pneumonia, severe arthritis. Several were anaemic. They all looked to Alice extremely pale and listless, often more anxious about what might be going on at home than their own conditions, she learned. They were also mostly very thin.
Her first medical duties of the day were taking her patients’ temperatures and their pulses; a senior nurse instructed her in the art of taking blood pressure – not easy, but she got the hang of it quickly, to her huge relief, observing from the corner of her eye Hazel, one of her fellow pros, finding it hugely difficult and becoming flustered. There was also the matter of the bedpans: bringing them if required, emptying them in the sluice, asking the delicate twice-daily question about whether they had had their bowels open, which most of the women found desperately embarrassing, especially if the answer was ‘No’. All this had to be recorded in the notes at the foot of the bed, making up the important record, including information on the prescribed drugs.
After which came the terrifying procedure of the doctors’ round. Sometimes, a consultant would be in the team, trailed by a group of medical students, sometimes a senior registrar. God help any nurse who was asked a question about a patient that she was unable to answer.
It was, however, Sister who was the most important figure in the hierarchy; she greeted the doctors at the ward – and had been known to refuse them entry, even the lofty consultants, if she was engaged on an emergency. Alice found this hugely satisfying to observe. Her mother and indeed her friends tended to regard nursing as a humble secondary career to being a doctor; here on the ward, that was absolutely not the case. The ward was Sister’s kingdom and she ruled over it.
And how amazing to work just across the river from one of the most famous and beautiful views in the world, that of the Houses of Parliament and Big Ben, in one of the most famous if not beautiful hospitals in the world. It did have its charms, of course, not least its position, but it had been bombed several times and swift and impressive repairs had nonetheless left it scarred and something of its finer proportions sadly lost.
Oh, she loved it: loved it, and was proud beyond anything to be one of its nurses, its Nightingales (named after its formidable and legendary founder, Florence Nightingale). They were steeped not just in its discipline and its standards, but in the honour of simply being a Nightingale. Admission was not easy, as indeed it was not to any of the great hospitals, Guy’s and Barts and the London. It wasn’t so much that the academic requirements were high, and the social ones higher, it was that becoming a Nightingale admitted you to an association of legendary distinction and indeed conferred something of that distinction upon you. Being a Nightingale meant you had learned invaluable qualities beyond medical skills: self-discipline, calm, and unquestioning adherence to the highest standards.
She might only be a probationer, Alice reflected, as she lay in bed exhausted each night, after her twelve-hour shift, followed by private study, but she was training in those qualities as well as the medical. She could not imagine being any happier.
Laura could not, for the time being at any rate, imagine being unhappier. She was lying in bed, bleeding, in considerable pain, in the full awareness that she was about to lose the third baby that she and Tom had been so joyfully expecting. Well, perhaps a little less joyfully as she had been extremely anxious as well, but she had got further this time, almost to the magic twelve weeks as the midwife at the surgery called it. She had felt much better too, less sick, not so exhausted. But it had all been a wish, a prayer if she had believed in them, a nothingness. She had to retrace her steps along that misleadingly hopeful road, with its landmarks – the first few days when it didn’t happen, each one more hopeful than the one before, then beginning to trust and believe, then telling Tom and seeing his joy, the plans, the looking forward, the sickness even, horrible to be sure, but worth it, the silly conversations about girl or boy, the names – and then suddenly, the shock of the pain, coming out of nowhere, the panic, the instructions from the midwife to take it easy, lying in bed, scarcely daring to move, and then . . . Then the beginning of the end, the bleeding, staring at it in disbelief, the increasing pain, and more blood, sitting and sobbing, crying aloud, clinging to Tom, and when it was over, the grief, the sense of failure, the knowledge of loss.
It hadn’t been too bad the first time; most people could tell her of a similar experience, people who now had several children, her sister, her mother. She herself had been hopeful, confident, even, the second time, but it had happened even sooner, before the second-month milestone. That time she felt guilty, had thought she should not have gone on teaching, but stayed at home resting. The midwife said no; there was really nothing she could have done.
‘But why? Why does it keep happening?’ she had asked this time, her voice deep with the rawness of her grief. The midwife told her nobody knew, it was a mystery. The only thing they were sure of was that miscarried babies usually had something wrong with them, were best not carried to term – it was nature’s way of dealing with imperfection.