Love and Music Will Endure (10 page)

‘Probationers Buchanan, MacKay, Ross and yes, you too MacPherson, report to male surgical where you’re to learn about the application of carbolic acid dressings,’ Sister MacLean’s voice was like a gale hurtling down a close. ‘Come on now, I mean at once,’ she scolded, ‘Make sure your caps are straight.’

The four women hurried out of the ward. Buchanan and McKay moved with the supple grace of youth while the older two waddled along behind them. When Màiri had first arrived at the hospital she had kept craning her neck in wonder at the domed and pillared entrance, but now she scarcely noticed it and grumbled about the climb up the grand staircase.

Sister MacLean was a staunch member of the Free Church, a stickler for high standards, both moral and professional. Màiri had worked diligently and so avoided being scorched by her tongue. She was apprehensive at leaving the familiar surroundings of the chronic ward but at least Catriona Ross was coming too. She was a fellow Highlander, middle-aged and widowed like herself. Catriona’s parents had been evicted from Islay. Her Gaelic sounded quaint and ill-favoured to a Skye ear but she was a quietly resolute woman who had lived in Glasgow for many years and was well informed about the ways of the Royal.

‘Come on now, we’ll have to put on a good show,’ she told Màiri as they hurried on their way, ‘It’s a different set up from Sister MacKay’s incurables. The surgeons have their dressers to treat their patients and they don’t like nurses interfering.’

‘We’ll have to set them straight then,’ muttered Màiri, folding her blacksmith’s arms across the upholstered slab of her bosom.

‘Well, let’s look at the lie of the land first. This part of the hospital was very famous when Mr Lister was here. Have you heard about him? He saved a lot of lives. Well, I suppose you wouldn’t as you were living in the backwater of Inverness,’ she grinned. ‘No? He’s regarded as a saint by the folk of this city and not just by the Papists either, even though we Protestants aren’t supposed to believe in saints.’

‘So what did he do?’

‘He saved the lives – and the limbs – of badly injured patients who in the past would have had to endure amputations and probably died from sepsis. I heard about his first case from a nurse who was there.’ She paused.

‘Go on, then.’

‘A wee lad was brought in. Jamie Greenlees he was called. He had been run over by a cart and his leg was badly broken with a compound fracture. Other surgeons would have cut his leg off at once but Mr Lister didn’t. He reset the bone. Then he used carbolic acid to wash out the wound and soaked the dressing with it. After that his leg was bandaged, splinted and left. All the doctors kept hovering around the child, sniffing the dressings when they passed his bed. When he started to cry, complaining that his leg hurt, they all shook their heads, “I said all along it wouldn’t work.” But there was no fever and no stink. After four days Mr Lister came to cut the dressing open himself. Everyone was holding his breath. One of the dressers knelt down beside Jamie to remove the splint and unwind the bandages. Mr Lister removed the tin foil holding everything in place and prised off the dressing. He raised it slowly to his nose before passing it around to the other doctors. It was like a miracle. There was no inflammation or suppuration, only some redness on the edge of the wound and a healthy bloody crust forming.’

‘That was amazing indeed. So was it the carbolic that made his leg sore?’

Catriona nodded. She finished her story as they were arriving at Men’s Surgical, ‘The wee boy piped up, “So tell me, Mister will yae, if it’s so much better why is mae leg so sore?” Everyone laughed and Mr Lister smiled and patted the lad’s head. Then he cleaned and dressed the wound and this time left it for another five days. Wee Jamie still had no fever and he began to eat as much as the horse that ran him down. After six weeks he walked out of the hospital, fit and strong on two legs as good as they were before. And that was only the first one. Mr Lister did the same for many more poor folk.’

During the following weeks Màiri watched with interest to see how Mr Lister’s new methods were used on patients who needed operations for accidents, tumours and tubercular infections of the bones. At the same time she was frustrated by how little the nurses were allowed to do. As Catriona had warned, the dressers ferociously guarded their role in tending wounds and nurses were excluded from ward rounds. Màiri observed as much as she could. She was horrified and surprised to see that some of the doctors scarcely washed their hands between patients. It seemed so different from the care that was taken over keeping wounds clean. She scowled, her lips clamped tight with the effort of not protesting. She was tormented by memories of the midwife with the black rinds of dirt under her nails, who had attended her at Màiri’s birth.

For a time she reluctantly heeded Catriona’s warnings about keeping quiet but one day she passed Miss Tait, the Matron, in a corridor. Bobbing in a half curtsey she spoke, keeping her voice low and calm, ‘Matron, may I ask you a question?’ She rushed on without waiting for a reply, ‘I’m working on Men’s Surgical and I cannot understand why some of the doctors don’t wash
their hands between patients. We nurses are very particular about cleanliness and I understand that Mr Lister …’

‘Enough, Probationer MacPherson,’ the Matron sucked in her withered cheeks and glared at Màiri through gimlet eyes, ‘It’s not for you to ask questions. We work under the direction of the medical staff.’

‘But surely …’

‘Don’t contradict me,’ she retorted, her bony wrist protruding from her dark sleeve as she waggled her index finger, ‘If you continue to be insubordinate I will make sure that you do not complete your training in this hospital. You are here to watch, learn and obey instructions.’

Màiri was silenced but not cowed by this encounter. She looked out for the fair, angular young man who had fainted in the chronic ward. She saw him one day with the other dressers on male surgical and waited for a chance to speak to him.

‘I see that you’ve changed wards too,’ she observed. He flushed when he recognised her, grinned awkwardly and smoothed down his sandy hair. He looked so young that he reminded her of her son. ‘I’ve got a stronger stomach now. The only problem here is the carbolic. I end up reeking like a chemical laboratory. And just look at my hands,’ he complained, showing her fingers as
grey-white
and puckered as those of a drowned sailor.

‘Can I ask you a question? I don’t understand why it is that so much care is taken with dressing the wounds but some of the doctors don’t bother to wash their hands. I’ve heard about how Mr Lister insisted on cleanliness in everything.’

The young man nodded, ‘He was very particular in everything he did – and devoted to the care of his patients. He came in every day to check on his patients’ progress, even on Sundays.’

‘So why did he leave the Royal?’

He dropped his voice. ‘The Hospital Board said that he cost too much money because he kept his patients in for too long. He kept them until they were completely healed, even if it took months. Then he wrote a report about how unhealthy the surgical wards were when he arrived in Glasgow. There were bodies from the cholera outbreak in ’49 buried in quicklime in the foundations. The Royal never forgave him for writing that.’

‘So he sticks by his beliefs.’

‘Aye, he didn’t try to court popularity. Mind you, all famous doctors will fight to the death over their pet theories, rather like your Highland clans.’

They were both laughing when the young man saw a doctor approaching, with a disapproving expression on his face. He suddenly remembered that he was one of the chosen medical race while this ageing woman with her roughened hands was from the servant classes. The narrow causeway that had appeared between them was abruptly swept away. He raised his voice, ‘Well, Nurse, that’s all I can say.’ As he turned away he muttered, ‘If you need to know any more you’ll have to go and ask the great man himself.’

Màiri tried to silence her questions after that but they wouldn’t be gagged. As a child she had been taught to respect men in authority. The Minister was a Man of God with book learning far beyond her own understanding. Then over the years she had struggled with her disillusionment as the Church preached meek submission to parishioners who were being driven from their land. Now as a nurse she was expected to venerate doctors but so many of them seemed to ignore good sense when it came to cleanliness.

The only answer was to stop brooding and take action, like that time long ago when the crowd in Inverness had tipped the potatoes into the harbour. How exciting that had been, scaring the folk in charge who were always telling the likes of her how they should conduct themselves.

A week later Màiri boarded the train to Edinburgh. She had told no-one of her plan; not her friend Catriona who would raise her eyes to Heaven and call her a fool, nor her sensible daughter Flora who would try to soothe her as if she were a fractious child.

She boarded the train buoyed up with her daring, but when she reached Edinburgh she felt weighed down by the stern, grey city. The castle, looming over the city from its high vantage place made her shiver. It reminded her of the last time she had seen the castle in Inverness at the time of her trial. Did this castle also contain a court and might she be arrested for making a nuisance of herself? She let out a bitter laugh then looked around in apprehension in case people in Princes Street turned to stare at her, wondering if she had escaped from an asylum. But no-one paid her any attention. As an older woman, dressed in her worn plaid cloak she was anonymous, even invisible. She asked a labourer for directions to the hospital. He was intent on his own journey and told her, barely glancing up. Once there, she looked around until she found a notice announcing Mr Lister’s twice weekly lectures. At that moment she blessed Flora’s insistence that she persist with learning to read and write English. Even better – what luck – there was a lecture due to begin in an hour. She stayed on the fringes of the crowd which milled in the dark corridor leading to the theatre. It was mainly young boisterous men, who ignored her. When the door was opened they spilled through.

‘Come on lads,’ a voice shouted out, ‘Shut the door quickly before any of Mr Lister’s microbes get in.’

She slipped in under cover of the laughter and edged into a space near the back of the tiered rows. There must have been nearly two hundred people there and the air thrummed with anticipation. One group started singing,

to the tune of the Burns song, ‘A man’s a man for a’ that.’

Màiri smiled to herself. The high spirits reminded her of Murdo and the other young men who had been racing the horses while the service was going on at the Fairy Bridge, and young Anndra of course, brave and beautiful as Finn McCoul himself. But that was so long ago.

She looked down the steep drop to the stage where there was a narrow wooden table surrounded by sawdust-filled trays to catch the spilled blood. A few upright chairs were arranged against the partition in front of the first row of seats. The scuffling feet and murmured conversations stopped as a small, solemn procession entered. It was led by a man holding aloft a covered tray of instruments. A dresser followed, carrying a bottle of chloroform and a mask to anaesthetise the patient. The third figure brought in a piece of apparatus on a tripod. Màiri could make out a lever and a bottle. So she supposed that must be the carbolic spray. Two older men followed, walking stiffly and unburdened by equipment. Last to arrive was a trim, erect figure, a man not much younger than Màiri herself. His hair was thinning at the crown but growing in thick swathes at the sides of his face where it merged with the tufts of greying side whiskers. That must be Mr Lister. More dressers followed, wearing blue overalls and bringing the patient, lying down on a trolley. Lister bent down to speak to the figure, murmuring gently. While an assistant administered the chloroform the surgeon surveyed the audience
with an air of calm authority. He started to speak in a clear but soft voice, with a slight hesitancy. Everyone craned forward to listen.

‘This lady has a tumour which requires a mastectomy. She is in her middle years, no longer of childbearing age but responsible for the care of a young family. As a result of this operation she may at best make a complete recovery while at worst she will have gained some extra time to continue a productive life.’

He fell silent for a moment and briefly closed his eyes as if in prayer. Màiri wondered if he was thinking about his sister Isabelle. Catriona had told her how he had operated on his sister against the advice of other surgeons. ‘She lived for another three years because of his courage,’ Catriona had said. But what would it feel like to slice into the living flesh of someone you loved? Màiri could imagine acting as a midwife for one of her daughters but that would be different because they would be striving together, helping a new soul into the world. Still, childbirth, like surgery, was shadowed by fear.

Lister’s eyes snapped open. He stood erect and alert until everyone was completely silent before starting his lecture.

‘As you know gentlemen I have long been a champion of the antiseptic method of surgery, ever since I read an account of the experiments of the esteemed French chemist, Louis Pasteur. I first encountered his work when I was not a great deal older than some of you. Often in promoting the efficacy of the antiseptic approach I have felt like poor Sisyphus condemned forever to push a heavy boulder up a steep hill. I have wished that germs were as obvious as green paint so that I would be spared the endless task of trying to convert the sceptics, both inside and outside our profession.’

He paused and smiled slightly. One of the dressers began cranking up the lever of the spray apparatus. There was a gentle
hiss and a faint chemical smell began to seep through the theatre. Suddenly a clear, loud voice slashed into the Sunday service hush, ‘Let us s-pray’.

A collective gasp shuddered around the building, horrified at the sacrilege. Lister gravely lifted his head to gaze in the direction of the voice and raised an eyebrow. Then he stepped forward, holding his arms out behind him. One of his assistants respectfully helped him out of his black frock coat. While Lister carefully folded back his shirt cuffs the young man held out his operating coat for him to put on. Màiri gasped. Even from her position near the back she could see that the garment was old and stiff with a rusty plumage of dried blood. She bowed her head quickly, fearing that she had drawn unwanted attention to herself.

As Lister operated he continued his lecture, his voice confident and fluent.

‘Gentlemen, as surgeons you must never let theories stand in the way of your observations. There are of course different theories as to whether the removal of the lymph glands is appropriate during a mastectomy.’ He inclined his head towards a young man near the front who had raised his arm. ‘Yes, what is your view on the subject?’ he asked, smiling gravely.

‘Surely it is best to remove the glands, thus ensuring that all malignancy is destroyed.’

‘That is indeed a valid argument but how does the surgeon know whether the tumour is malignant or not?’

‘I don’t know, Sir.’

‘An honest answer. Always remember that we know so little. I don’t know the answer either. Observation is not enough to make a reliable diagnosis. The surgeon should never cut more than the necessary minimum. So how shall I decide? What do I know about this patient? She’s a woman who has had a hard life
and is not well nourished. That would suggest that the minimum of surgery would be advised. However the tumour is extensive and has been growing for some time. I suspect that it is probably malignant. So I shall remove the glands to give her the best chance of survival.’

Màiri had been so absorbed in the drama of the operation that she had almost forgotten her reason for attending. It was only as Lister removed his gory operation coat and the audience began to shuffle to their feet that she remembered with a jolt that she would have to approach him. Most of the students scuttled out quickly like children released from school but a few people were walking down the steep central steps to approach the eminent surgeon. She hovered behind them, noticing his prominent nose below the broad furrowed forehead and the deep clefts slicing down from the corners of his mouth. When it was her turn to speak she looked directly into the deep set eyes, level with her own. His lips set into a thin, dour line and she hurried to speak before her courage shrank too much.

‘Sir, I feel honoured to have watched you at work. I have come to put a question to you. I understand the importance of using carbolic in the dressings and spray. Could you tell me please why there is less attention paid to keeping everything else as clean? I have noticed at the Royal where I work that doctors are not always careful about washing their hands and,’ she gulped, ‘excuse me for saying this but I noticed that you wore a dirty old operation coat yourself.’

Màiri felt her cheeks ripen to a red embarrassment in the stunned silence.

‘Are you a doctor, Madam?’ His tone was distant.

She took a deep breath and rallied, ‘No indeed, Sir. I am a nurse and a good one, as you are a good doctor. And I am a Skye woman who is not afraid to ask an important question.’

‘So I see. I have visited your majestic island,’ he replied with a faint smile. ‘And now you must excuse me Madam.’

‘We must each of us follow our own way,’ she said quietly as he swept away.

Lister turned to his companions, ‘How was such a person able to gain admittance? You know that I disapprove of the fairer sex attending medical lectures and she was not even a lady.’

‘Shall I go and apprehend her, Sir?’ enquired one of the dressers.

‘No, that won’t be necessary. What an extraordinary woman.’