THE BOTTOM DROPPED OUT OF PIGS 21 page

Puddings arrived, and Sister Julienne rose to serve them. A strange noise from across the table caught my attention, and I looked in that direction. To my astonishment, it was Sister Evangelina, laughing! In fact she was laughing so much, she was spluttering into her napkin. Her neighbour Jimmy,

kind and gentlemanly, patted her on the back and handed her a glass of water. She gulped it down, and sat, dabbing her eyes and nose, muttering through chokes and giggles.

“Oh dear. This is too much for me

... it takes me back to the time when ...

oh, I shall never forget ... ”

Jimmy set to work seriously slapping her back, which seemed to help, but it caused her veil to slip sideways.

We were all determined to get to the bottom of this. Never before had Sister Evangelina been seen laughing convulsively in the Convent, and it obviously had something to do with young men in nurses’ bedrooms.

“What happened? Tell us.” “Come on, now. Be a sport.”

Sister Julienne paused, serving spoon in hand.

“Oh come on, Sister. You can’t leave us in suspense like this. What’s the story? Jimmy, give her another glass of wine.”

But Sister Evangelina couldn’t, or wouldn’t, tell. She blew her nose, and wiped her eyes. She spluttered and gurgled and coughed. But she wouldn’t say any more. She just grinned mischievously at everyone. A grin from Sister Evangelina was unheard of, never mind a mischievous one!

Sister Monica Joan had been watching this little exhibition with half-

closed eyes, and a tiny smile playing round her lips. I wondered what she was thinking. Sister Evangelina certainly looked a mess, with her veil askew, her face bright red, moisture seeping from every orifice. I feared an icy comment and so, I think, did Sister Evangelina, for she looked at her tormentor with apprehension. But we were both wrong.

Sister Monica Joan waited until the laughter had subsided, and with the timing of an instinctive actress recited slowly and dramatically, ” ‘Oh - I shall remember the hours that we spent, In age I’ll remember, and not to repent.’”

She paused for effect, then leaned across the table towards Sister Evangelina, and winked. In a stage

whisper that could be heard by all, she said confidentially, “Don’t say another word, my dear, not another word. The nosy lot. They clamour and clatter. They chatter and natter. Don’t feed their idle expectations, my dear, ’twill only debase your memories!”

She looked Sister Evangelina straight in the eyes, and winked again, with warmth and understanding. Was it possible? Did I imagine it? Was it a trick of the light? Did Sister Evangelina or did she not, wink back?

Sister Evangelina never told. I daresay she went to her grave with the story locked in her heart.

The puddings were a masterpiece of Mrs B.’s creative skills. Sister

Monica Joan had two helpings of ice cream with chocolate fudge sauce and a little apple pie. She was in brilliant form.

“I remember a young man shut in a wardrobe at Queen Charlotte’s Hospital,” she recalled. “He was locked in for three hours. It would have been perfectly all right, and no one would have found out, but the foolish fellow had borrowed his father’s horse, and tied it to the hospital railings. Now you can hide a young man in a wardrobe or under a bed. But how, I ask, can you hide a horse?”

With a gasp I realised that these memories dated back to the 1890s! What happened? But she wouldn’t remember.

“I only remember the horse tied to the railings.”

What a pity! Life is so fleeting, and the past so rich. I wanted to hear more. Her mind was perfectly clear at that moment, and knowing how it could cloud over, I asked if she had not found the discipline and petty restrictions of nursing to be intolerable.

“Not a bit of it. After the confinement and restraints of family life, nursing was freedom and adventure. We did not have the licence you young people enjoy today. It was the same for all of us. I recall my cousin Barney. His mother, my aunt, had a French maid. One day - in the middle of the day, my dears - she, my aunt, stepped out on to the

terrace to find the French maid seated on a chair, and Barney on his knees placing the shoe on to the foot of the gel. The shoe.”

She paused and looked around her. “Not the petticoat, or anything like that. Just the shoe. My aunt screamed and fainted, I was told. The maid was immediately dismissed, and the family was so scandalised that Barney was given a ten pound note, and a one-way ticket to Canada. He was never seen or

heard of again.”

Mike speculated that being sent off to Canada was probably the best thing that could have happened to him. Sister Monica Joan looked very thoughtful before replying, “I would like to think

that. But it is just as likely that poor Barney died of hunger or disease in the Canadian winter.”

It was a sobering thought. I asked for more stories. She smiled at me indulgently.

“I am not here for your entertainment, my dear. I am here by the grace of God. Four score years and ten, it has been. A score too long ... too long.”

She fell silent for a minute, and no one dared speak. She had seen so much, done so much in life - fighting for independence in her youth; entering a religious order in middle age, wartime nursing and midwifery in the London Docks when she was nearly eighty years

old. Who could match such experience? With a slightly amused, slightly

quizzical expression in her fine eyes, she looked around at us, so young, so frivolous, so superficial. Her elbow was resting on the table, her slender fingers supporting her chin. We were spellbound by her presence.

“You are all so young,” she mused reflectively. “Youth is the first fair flower of spring.”

Lifting her head, she spread out her eloquent hands towards us. Her face was radiant, her eyes shining, her voice joyful and triumphant.

“Therefore ... ‘Sing, my darlings, sing, Before your petals fade, To feed the flowers of another spring.’”

SMOG

Conchita Warren was expecting her twenty-fifth baby. I had seen quite a lot of the family during the past year because Liz Warren was the dressmaker of my dreams. She was the oldest daughter, twenty-two years old, and had been making clothes since she first had a doll. It was all she had ever wanted to do, she told me. On leaving school at fourteen, she went straight into an apprenticeship with a firm of high-class dressmakers, with whom she still worked. She did not usually take private clients at home because she said the mess was such that she couldn’t ask ladies to come to the house for fittings.

However, as I was accustomed to the house, it did not bother either of us. She was an expert in her trade, and enjoyed making garments for me over many years.

I had always loved clothes, and took a good deal of time and trouble over them. My clothes were specially made for me, and I turned my nose up at ready-to-wear stuff. Today this would be unusual and terribly expensive, but it was not the case in the 1950s. In fact it was cheaper. Really good quality clothes could be made for a fraction of what they cost in the best shops. Beautiful materials could be found in the street markets, going for a song. I usually designed my own things, or adapted

styles. When I lived in Paris, I would attend the catwalk shows of the great French couturiers - Dior, Chanel, Schiaparelli. The opening of the season was, of course, reserved for the press and the very rich, but after about two or three weeks, when the excitement had settled down, the fashion shows continued, perhaps twice weekly, and anyone could attend. I loved them, and made careful notes and sketches of what I knew would suit me, in order to have them made for me later.

The only trouble was finding a dressmaker skilled enough to make her own paper patterns. Liz was perfection. She not only made up her own patterns, but she had a real stylish flair, and often

suggested or adapted things to suit the cloth or the cut. We were about the same age, and it was a happy collaboration.

During one of these visits Liz told me, with a wry smile, that her mother was expecting again. Together we speculated on how many more Conchita was likely to have. Her precise age was not known, but she was probably about forty-two, so she could have another six to eight babies. Going on past form, we put our money on a total of thirty babies.

Conchita booked again with the Sisters for another home confinement, and requested antenatal visits at home. For continuity’s sake, I was asked to take the case. She was in perfect condition again. She looked radiant, and

did not really look pregnant until about twenty-four weeks, although once again her dates were uncertain. The youngest little girl was one year old. Len was all excitement and anticipation, as though this were only his second or third baby.

It was winter, and very cold and icy. Heavy snow clouds hung over the city, trapping the smoke fumes from all the coal fires, steam trains, and steam engines, the profuse smoke from the ocean-going vessels, and above all the factories, which were largely fuelled by coal. A thick London smog developed. One can have no conception these days of what they were like. The air would be heavy, foul-smelling, and a thick yellowish-grey colour. It was

impossible to see more than a yard ahead, even at midday. Traffic was virtually at a standstill. The only way a vehicle could move would be for a man to walk ahead of it, carrying two bright lights - one to shine ahead of him, so that he could find his way, and the other shining behind him for the vehicle to follow. These smogs were a feature of many winters in London at the time, and lasted until the atmospheric pressure lifted, allowing the trapped fumes to escape.

Conchita must have gone into the backyard for something. She either slipped on the ice, or tripped over something she could not see. She must have fallen heavily and lay partly

concussed on the freezing concrete for some time. The only children in the house were the little ones under five. She was found by the other children when they came home from school. Apparently she was sufficiently conscious to crawl and with the help of her children, all under eleven, she got back into the house. There was evidence that she had tried to do so before but, being unable to see through the smog, had actually crawled away from the house. It is a miracle that she did not die of exposure. She was in a bad way. A small child went to get a neighbour, who wrapped her in blankets and gave her hot brandy and water. Older children began returning home after 4 p.m. and

learned of their mother’s accident. Len and the oldest boys were last to return, because they had been on a job in Knightsbridge and the journey home had taken two and a half hours.

That night Conchita went into labour.

The phone rang at about 11.30 p.m. I was called to the phone, as it was my case. I was aghast - firstly because of the premature labour, and secondly because of the weather conditions. How on earth was I to find my way to Limehouse? I was speaking to one of the elder sons, who briefly explained the circumstances. My first question was, “Have you called the doctor?” Yes, he had, but the doctor was out. “Well, you must keep on

trying,” I said, “because your mother may be ill. If she was concussed, and her temperature dropped a lot, she may need medical treatment, quite apart from the pregnancy. Ring the doctor again now. He may have difficulty getting to you, but so will I.”

I replaced the telephone, and looked out of the window. I couldn’t see a thing. Thick grey swirls of fog seemed to be circling the window panes, trying to get in. I shivered, as much with apprehension for Conchita’s awful plight as reluctance to go out at all. The sirens from the river boats, and those in the docks, moaned a hollow call.

We had hardly been out of the house for three days, hoping and praying

that no one would go into labour before the smog lifted. It was a situation I could not, should not, handle alone.

I went up to the Sisters’ floor to call Sister Julienne. Nuns go to bed a about nine o’clock because they get up before 4 a.m. for the first Office of the day, so eleven-thirty would be the middle of the night for them. Nonetheless, with the first light tap on the door, Sister was awake.

“Who is it?,” she called out.

I said my name, and that Conchita Warren was in premature labour.

“Wait a minute.”

I waited thirty seconds, and Sister joined me in the corridor, shutting the door of her cell behind her. She was

wearing a coarse brown wool dressing gown, and, amazingly, her veil. The question, does she go to bed in the thing? flashed through my mind. It must be damned uncomfortable.

But there was no time to reflect upon the habit of a nun. I told her briefly the story that had been given to me over the telephone.

She thought for a moment and said, “Limehouse is over three miles away. You might not get there. There is no point in me, or any of the midwives, coming with you, because two people can get lost just as easily as one. You must have a police escort. Go now and ring the police, and God be with you, my dear. I will pray for Conchita Warren

and her unborn baby.”

The knowledge that Sister Julienne would be praying for us had an extraordinary effect. All the tension and anxiety left me, and I felt calm and confident. I had learned to respect the power of prayer. What change had come over the headstrong young girl who, only a year earlier, had found the whole idea of prayer to be a joke?

I spoke to the police and told them it was an emergency. I was told that the safest way to get there would be to walk, but the quickest would be by bicycle. The policeman said: “There is no point in sending a car, because you can’t see further than the bonnet, and we would have to have a man walking ahead. We

will send a bicycle escort.”

I said I would be ready within ten minutes. My delivery bag was already packed and ready. All my thoughts were with Conchita - I did not think that the baby was likely to survive at around twenty-eight weeks gestation. Finding the bicycle shed in the smog and loading up my bike was a tricky business, but I was at the front of Nonnatus House in less than ten minutes.

Two policemen arrived shortly after on bicycles with very powerful lights, front and rear, which illuminated about two yards ahead. One rode ahead of me, and I was instructed to follow him. The other rode beside me, I being on the kerb side. Thus we progressed

with surprising speed, because there was no other traffic around.

Looking back over nearly half a century it seems absurd to be racing to an emergency labour on bicycles at about ten miles per hour. But even today I can think of no better way. What would be the advantage of the most powerful police car with nil visibility?

We arrived at the Warren household in less than fifteen minutes. I could not have done it alone. The men said they would wait, in case I needed them further, and a couple of the Warren girls took them down to the kitchen for a cup of tea.

I went upstairs to Conchita. She looked ghastly, deathly white, with

bright pink splodges under her eyes. She moaned. I took her temperature, which was 103°F. At first I could not feel her pulse, but, on careful counting, I found it to be 120, and intermittent. Her blood pressure was barely perceptible. Her breathing was shallow and rapid, at around forty breaths per minute. I watched her in silence for a couple of minutes, as a contraction came on. It was powerful, and her features distorted in pain, a high-pitched groan emanating from her throat. Her eyes were open, but I don’t think she could see anyone.

Len was cradling her in his arms. The suffering on his face was enough to break your heart. He was stroking her hair, and murmuring to her, neither of

which she seemed to feel or hear. Liz was in the room.

I enquired if the doctor had been called. He had, but was still out on a call. The call had been put through to another doctor, who was also out with a patient. All doctors worked terribly hard at these times. The London smogs were notorious killers.

I said that we should arrange for a hospital admission as soon as possible.

“Is she tha’ bad?” Len asked.

It is astonishing how people do not see what they don’t want to see. To me it was obvious that Conchita could easily die, especially if complications arose from labour and delivery. But Len couldn’t see this.

I went and spoke to the policemen. One said he would telephone the hospital. The other one undertook to try to find one of the local GPs and escort him to the house, if possible. How an ambulance would get there and back was an open question.

I returned to Conchita, and started to lay out my delivery things. It was possible that I would be alone with a premature delivery, and a sick and possibly dying woman.

Suddenly I remembered that Sister Julienne was praying for us. Again, the relief was overwhelming. All my fears vanished, and the calm certainty that all would be well flooded my mind and body. I remembered the words of

Mother Julian of Norwich:

“All shall be well, and all will be

well

and all manner of things shall be well.”

I must have given a great sigh of relief, which Len picked up. He said, “You reckons as how she’ll be all right then, do you?”

Should I tell him that Sister Julienne was praying for us? It seemed so silly, almost irrelevant. But I did; I felt I knew him well enough. He didn’t dismiss it.

“Well, I reckons as ’ow its goin’ to be all righ’, then, too.”

His face was brighter than it had been since I entered the room.

It would have been advisable to examine Conchita vaginally to see how far she was in labour, but I couldn’t get her into the right position. She wouldn’t allow Len or me to move her. Liz explained to her in Spanish what was required, but she didn’t understand or respond in any way. I could only assess the progress of labour from the strength and frequency of contractions, which were approximately every five minutes. I listened for the foetal heart, but couldn’t hear a thing.

“Is the baby alive, then?” asked

Len.

I didn’t like to say a straight “No,” so I hedged my bets.

“It’s unlikely. Remember your wife

got very, very cold today, and has been unconscious. Now she has a fever. All this will affect the baby. I cannot hear a heartbeat.”

One of the real problems of premature delivery at the stage of pregnancy Conchita had reached is that the foetus is often lying transversely across the uterus. A human baby ideally should be born head first. A breech delivery is possible, but difficult. A transverse or shoulder delivery is impossible. The head does not normally descend into the pelvis until after thirty-six weeks. A foetus of around twenty-eight weeks is quite large enough to block the cervix completely if contractions push it downwards in the

transverse position. In that event, without surgical intervention, the death of the baby is inevitable. I palpated the uterus trying to find out the baby’s position, but it was no use, I could not tell. A vaginal examination might have enlightened me, but there was no way that we could persuade Conchita to cooperate.

All I could do was wait. The minutes between contractions ticked by slowly. They were coming every three minutes now. Her pulse was more rapid, 150 per minute; and her breathing seemed to be more shallow. Her blood pressure was quite imperceptible. I prayed for a knock on the door to announce the arrival of a doctor or the

ambulance, but none came. The house was silent, save for the low moaning of Conchita as each contraction came and went.

Inevitably the contractions became stronger, and it was then that Conchita began to scream. I have never in my life, before or since, heard such terrifying sounds. They came from the depths of her suffering body with a force and power that I would have thought impossible, given her fevered, debilitated state. She screamed on and on, wild terror in her unseeing eyes, the sound reverberating wave after wave against the walls and ceiling of the room. She clung to her husband, tore at him, until his face and chest and arms

were bleeding. He tried to hold her, to comfort her, but she was quite beyond comfort.

I felt helpless. I did not dare to give her an analgesic to lessen the pain and quieten her, because her pulse and blood pressure were so abnormal, and I knew that any drugs would probably kill her. I thought that if it was a normal delivery she had a chance of living; if it was a transverse presentation she would die, unless an ambulance were to arrive quickly. I could not get near her to feel the uterus, or even to hold a leg, as she was throwing herself around the bed with the strength of a wild animal in a trap.

Poor Liz looked terrified. Len, with

unconditional love, was still trying to hold her in his arms and console her. She sank her teeth into his hand with the strength of a bulldog, and hung on. He didn’t cry out, but winced with pain, sweat and tears falling from his forehead and eyes. He didn’t even try to force her jaw open or to pull away. With alarm, I thought that she would sever a tendon. Eventually she loosed the hand, and flung herself to the other side of the bed.

Then, as suddenly as it had started, it was all over. She gave a terrible cry, and a massive push, and water, blood, foetus, placenta - everything - was delivered on to the bed sheets at once. She fell back exhausted.

I could feel no pulse at all. Her

breathing seemed to have stopped. But I could feel a flutter of a heartbeat, so I listened with my stethoscope. It was faint and irregular, but it was there. The foetus was blue, and looked quite dead. I snatched a large kidney dish from the dresser, scooped everything into it, and dumped it on the dresser.

“Now we must quickly get her warm,” I said, “cleaned up and comfortable, if she is to stand a chance. You help me, Liz - clean warm sheets, a couple of hot water bottles. I will check the placenta in a minute to see if it is complete. If we can get her to drink something hot it will help. Hot water and honey would do; a teaspoon of brandy in it would be even better. The main thing

is to treat the shock. And let us all hope and pray that the bleeding won’t get worse.”

Len went out to issue some instructions, and to pacify the terrified family gathered around the door. Liz and I started to clean the dirty sheets and linen from under Conchita. Len soon returned with clean sheets and hot water bottles, and Liz and I started to make the inert body comfortable.

Len must have gone over to the dresser. Liz and I had our backs to it, busy with Conchita. We heard a gasp.

“It’s alive!” “What!” I cried.

“It’s alive, I sez. Ve baby’s alive. It’s movin’.”

I rushed over to the dresser, and looked at the gory mess in the kidney dish. It moved. The blood actually moved. My heart stood still. Then I saw the tiny creature in the pool of blood, and its leg moved.

Oh, dear God, I could have drowned it! I thought.

I lifted the tiny body out with one hand and tilted it upside down. It seemed to weigh nothing. I have held a new born puppy of about the same size. My head raced.

“We must clamp and cut the cord quickly. Then we must get him warm.”

It was a little boy.

I felt desperately guilty. The cord should have been clamped five minutes

earlier. If he dies now, it will be all my fault, I thought. I had discarded this tiny living soul to drown in a dish of blood and water. I should have looked more closely. I should have thought.

But wallowing in self-reproach gets us nowhere. I clamped and cut the cord. I felt the fragile rib cage. He was breathing. He was a survivor. Len had warmed a small towel on a hot water bottle, and we wrapped him in the cloth. He moved his head and arms a little. All three of us were stunned by the life in the baby. None of us had seen a human child quite so tiny. A baby that is two months premature usually weighs about four pounds, and seems tiny enough. This baby was about one and a half pounds

and looked like a tiny doll. His arms and legs were much smaller than my little finger, yet a miniscule nail completed each digit. His head was smaller than a ping-pong ball, and looked disproportionately large. His rib cage looked like fish-bones. He had tiny ears, and his nostrils were the size of a pin-head. I had never imagined that a baby of around twenty-eight weeks could be so lovely. I felt I ought to suck the mucus from his throat, but was terrified of hurting him. Anyway, when I got the catheter, it was far too large, and would never have gone into his mouth. To force a hosepipe into a normal baby’s mouth would have been just as inappropriate. So I just held him nearly upside down

with one hand, and gently rubbed his back with one finger.

I had no experience of caring for a premature baby, and did not know what to do. All my instincts told me that he must be kept warm and quiet, preferably in the dark, and with frequent feeding. No cot was ready. Where could we put him? Just then Conchita, who was lying quietly, spoke.

“Niño. Mi nino. Donde está mi niño?” (Baby. My baby. Where is mybaby?)

We looked at each other. We had all thought she was semi-conscious or asleep, but obviously she knew exactly what had happened, and wanted to see her baby.

“We’ve gotta give ’im to ’er. Liz, you tell her he’s very little and we’ve gotta be very careful with him.”

Liz spoke to her mother, who smiled slightly and sighed with weariness. Len took the baby from me and sat down beside his wife. He held the baby in one hand so that the child lay within her gaze. Her eyes had been vacant and unfocused for several moments and I don’t think she saw or understood at first; she had expected to take a full term baby into her arms. Liz spoke to her again, and I heard the words.

“El niño es muy pequeño.” (The baby is very small.)

Conchita struggled to adjust her

vision to the minute scrap held in Len’s hand. You could almost see the struggle and the effort it cost her. Gradually she became aware, and with a sharp intake of breath put out a shaking hand to touch the child. She smiled, and murmured “Mi nino. Mi querido nino,” (my baby, my darling baby) and drifted off to sleep, her hand resting on Len’s hand and the baby.

Just then, the Flying Squad arrived.

THE FLYING

SQUAD

An Obstetric Flying Squad was provided by most big London hospitals, and I believe by all regional hospitals, as an emergency backup for domiciliary midwifery. The service must have saved thousands of lives, because before the 1940s, when no service existed, a midwife could find herself entirely alone with any obstetric emergency - such as a mal-presentation, haemorrhage, cord prolapse, or placenta previa - and all she could do would be to call in the local GP who might or might not be skilled in midwifery.

It was the proud boast of the Flying Squad of the London Hospital that i could reach any obstetric emergency in twenty minutes. But that was reckoning without a London smog. When the policeman contacted the hospital about Conchita no ambulance had been available to bring the Flying Squad. The smog caused acute and deadly respiratory failure in thousands of old people each year, and every doctor and ambulance was out on these cases. When one finally did return to the depot, the driver, who had been working non-stop for sixteen hours, was sent off duty, and another had to be found. Even then, a policeman had to cycle in front of the ambulance to guide it - hence the delay

Date: 2016-04-22; view: 644