When I left Reading to begin a new life as a nurse at the London Hospital, I was conscious of the paradox. Returning to the place I’d been rescued from two decades earlier did seem a strange choice. Was it the inevitable pull of fate or an unwitting attempt to help others from a privileged position? I honestly didn’t know.
On seeing Whitechapel again as a naive twenty-seven-year-old, I could not believe that a prestigious hospital, famed for its matron and the skill of its surgeons, could exist in such a neglected district. Men and women were wandering the streets with black eyes and missing teeth, many of them drunk, stumbling towards their next gin or the doss house. Everything was bleak and drained of colour. And yet, standing amidst this grey gloom as if it had been lowered from the heavens on winches, was the London Hospital: a white-fronted beacon dumped on a wasteland.
I arrived a day too early for my hospital interview and was dispatched to a boarding house, instructed to go straight there, with no messing about. ‘There are no sights worth seeing here,’ I was warned. ‘Get yourself a room, something to eat, stay inside, and come back tomorrow.’ I spent that night listening to freakish, animalistic howls coming from the street outside. I stared at the ceiling that sagged above my head, convinced it would collapse if I shut my eyes. In the morning, the landlady told me, in a voice like a pipe-smoking mariner, that I could not have porridge that morning because a mouse had drowned in it.
The next day at the hospital, when I saw the nurses gliding about like starched icebergs, it was impossible to imagine I could ever be one of them. Matron’s portrait hung on the wall outside her office and may as well have been Queen Victoria herself. Nursing positions were hard to come by. There were applications and interviews, and a girl’s background had also to be examined. For Matron Luckes’ nurses were a new breed, an attempt to professionalise the care of the sick, to employ educated women, and to submit them to a regime of intense and militaristic training. They were to work alongside doctors, and as such would have to demonstrate they could conduct themselves appropriately, behave with discipline and follow instruction to the letter. This was not an easily won opportunity; the support of doctors and governors had to be extracted over years. The wrong recruit could contaminate this brave new experiment, and there were already too many who felt threatened by the concept of a troop of professional women, an oxymoron in their view, and wanted it to fail. Despite the obstacles, I was accepted as a sister probationer.
The London Hospital offered care to the working classes of the East End. It was funded by donations, but that was never enough. Surgeons didn’t get paid at the hospital; they worked there for the experience and the reputation it earned them, and they made their money by private practice. We took all emergencies and accidents, being so close to the docks and located among the abattoirs, the bell foundry and the factories that crushed bones. A person could get drunk enough to forget their own name on fourpence worth of gin, but could not earn enough to eat, so most patients were malnourished. In Whitechapel, the music halls, the travelling navvies, the sweeps and the sailors were all thrown together. Desperation and lunacy were provoked by starvation, laudanum and alcohol; it was inevitable this would erupt on occasion, and that gave surgeons their opportunity. It was why they all came to the London; it was why Thomas came. Like vultures, to pick over the broken bodies and chase glory.
I soon learned it was best not to think about the scale of human despair or the sheer pointlessness of healing. The destitute were sent to the workhouse, the wealthy rooted out and sent away, but they all came and tried. There were syphilitic women with noses half sloughed off and swollen bellies that carried the same disease. There was the tide of infants brought in already dead, poisoned with opium or gin by their halfwit mothers. These women would cry and beg for help, wail about how they hated their children and couldn’t afford to feed or clothe them, but if ever I dared suggest they avoid having more, the abuse would come like a flood. Ceaseless childbearing was an inevitable curse to these women and they accepted their fate without question. When finding food and keeping warm was an all-consuming occupation, it left little appetite to improve one’s circumstances. I learned to keep my mouth shut, for no one wanted a priggish nurse lecturing them about abstinence. I’m sure I was most annoying when I was still trying in earnest.
Soft-cheeked boys would be carried in by old dockers with faces like weasels. The canny older men gave the youngest the most dangerous jobs. I shall never forget the two Polish brothers, one fourteen, the other nine or ten. The older one came in carrying the younger. They had a job of putting in rivets, and the older one had dropped a piece of scalding metal in the eye of his brother, who would now lose it. The next day the older brother was back, having tried to burn his own eye out with a scalding iron. When asked why, he said their mother had told him to do it; to make it fair before God.
*
By the time Emma Smith was brought into the receiving room in April 1888, I’d seen three years of the futility of Whitechapel at the London. I’d had my fill. Aisling had gone and I was barely eating or speaking. I was thoroughly miserable. Matron gave me the talk: how the resilience of her nurses was of utmost importance and that professionalism must be maintained at all costs. We were not individuals but a single mass working towards the same purpose. There was no time to indulge in personal issues. Her nurses were pioneers, no ordinary women, and all emotions must be suffered in stoic silence. Scared of losing my job, and now alone, I convinced her I could work.
Sister Park had been moved into my room. She was pleasant enough, but no Aisling, and I resented her for that. Having this stranger in what had been our space, singing and forcing her gaiety on me, was torture. I had to fight the urge not to roll her up in the rug and throw her out of the porthole window. She would blather on and I would sit there, saying nothing and staring at the ceiling. I was still finding strands of Aisling’s hair about the place and I would take each one and wind it about the handle of her hairbrush until it shone like a band of copper. Sister Park caught me doing this and looked at me strangely. But it made perfect sense to me; it didn’t seem such an odd thing when you had loved a person. I would save every trace of her I could.
Sister Park also snored. I used to lie there and listen to her snuffling like a farm pig, dreading what horrors the next day would bring. When morning came, all I wanted to do was sleep. I didn’t know how I was going to last each day let alone the rest of my contract at the London. I had years ahead of me.
And then in came Emma Smith.
She was carried into the hospital between two dishevelled women who reeked of old booze, together with the usual fug of the unwashed and general dampness. The enquiry officer assumed they were drunk and tried to send them away. But he stepped aside when he saw the smeared trail of blood behind Emma.
The two women could only give scant details of what had happened to their friend. The older one with the bloated face of a drinker was the deputy at the doss house where Emma had been staying, and the younger girl with white hair had only known Emma for a few weeks but had been sharing her bed for convenience’s sake. Emma was in her forties, they thought, but age was hard to gauge in women like her. Her skin was like an old saddle, the bottom half of her face was collapsed and narrow for lack of teeth, and her reddish hair was thin and brittle. She was so bony that when we lifted her onto the bed she flew up in the air as if we were hoisting a sack of oat-chaff.
She’d been beaten. Her face was bruised and swollen and her ear was bleeding. The other two women huddled in the corner, like timid mice.
‘They jumped her on the corner of Osborn Street and Brick Lane,’ said the white-haired girl. ‘She said there was three, maybe four. They took her purse and all of ’em done her and then shoved a broom handle up her, she reckons.’
‘A broom handle?’
My cheeks burned as soon as I understood. I turned around to hide my face and saw Nurse Mullens smirking from under her freckles at my ignorance; clearly, I was the only virgin in the room. I told Mullens, who was more junior, to take the women out of the emergency room. She didn’t look so smug then. She hated taking instruction from me, but she had no choice.
Left alone with the bleeding woman, I attempted to peel back her clothing, which was rotten and crawling with lice. When I drew back her skirts, I saw a shawl looped around the top of her thighs; it was thick with blood. Once Mullens was back, I tried to pull the shawl away with my fingers while she stood by with clean bandages. We had not worked together much, which was obvious from the way we constantly bumped into one another and tried to do the same task. Aisling and I had been in synchronicity, moving in anticipation of the other, like swans, each instinctively knowing our place. We fitted together perfectly.
Mullens was as pretty as a painted porcelain doll: bright, vivacious and charming, with the small and obvious features of the type that turn men’s heads. Aisling had a fresh and open face, far superior to Mullens’ in my view, and pink lips that were always in a half-moon curve. By comparison, Mullens was a sugar-coated tart, with her lumps and bumps and bouncing auburn curls. I had never known what it was to be a pretty girl; my features were all in the right place but forgettable. As well as being pretty, Mullens was reliably stupid. She was easily distracted and always found the time to flirt with any man who so much as looked at a scalpel. I always imagined she was destined to have a life easier than mine, but on that I would be proved wrong.
When we had almost finished unwrapping the shawl from between the woman’s legs, the blood came flooding out faster. The trays either side of the bed filled and then started dripping onto the floor.
Emma Smith sat up, gasped, and in a last burst of consciousness grabbed my arm, staining the sleeve of my uniform with her bloody fingerprints. ‘Please, don’t. If it comes off, I will break apart,’ she said. She looked at me with wide eyes, then her fingers slipped, her eyeballs rolled back, and she fell back onto the bed.
I could only stare at the bright red marks on my sleeve, but Mullens was beginning to panic.
‘Where’s the bloody doctor?’ she said, desperate for him to come, as was I. ‘Sister Chapman, what shall we do?’
There was nothing we could do. Emma Smith had been ripped apart from front to back passage. Her stick-thin legs, yellowed and covered in bruises, hung at a horrifyingly unnatural angle.
Dr Shivershev finally arrived, much to our enormous relief. He was a good doctor, if cold, distant and impersonal. He wasted no regard on us mere nurses. Behind him, his three dressers stood alert, like trained gundogs, and behind them were his pupils, all smooth-faced, blinking eyes and flat haired. They peered around the one in front.
Dr Shivershev examined Emma Smith for no longer than two minutes and told us to make her comfortable and stem the bleeding as much as we could.
‘Aren’t we going to theatre?’ I asked.
Mullens stared at me. A nurse was meant to wait for instruction from a surgeon and was certainly not expected to challenge him.
Dr Shivershev looked at me with raised eyebrows, then back at Emma Smith. ‘You think if I operate on her she will jump off the bed and go home tomorrow? If she’s not dead within the next day or so I’ll be surprised.’ And with that he left, his dressers and pupils scurrying behind him like an entourage of privileged rats.
Emma Smith was translucent, as if all her insides had emptied and now all that was left was an empty grey sack. I felt a strange tingling in my cheeks, and I thought I might be sick. For some reason I laughed, which made no sense. Mullens stared at me in horror, as if I were laughing at the death of the woman on the bed, but the truth was, I had realised the ridiculousness of it all, the waste of effort. It was pointless. Emma Smith was going to die and, if we were honest, we all knew there would be scores more like her. Our pathetic attempt to help her, if we were any help at all, felt as good as holding up a cup to catch a flood.
We were in the laundry room, changing our uniforms, when Mullens said, more to herself than to me, ‘Who’d do such a thing as that? Who would put a broom handle inside a woman? What a vicious thing.’
I didn’t say a word. I was consumed by the sense that something terrible was about to happen. I should have realised then that I wasn’t well, but too conscious of my last conversation with Matron, I waited until Mullens had left and then slapped my own cheek, hard, three times. For what was another dead woman? I had seen hundreds – what was one more?
Emma Smith had further inconvenienced us by leaving her insides all over the receiving room, so when Mullens returned we went to fetch Dykes, one of the ward maids. We called ward maids ‘scrubbers’, though it was wise not to do so within earshot of Matron. Dykes had been one of the hospital’s old, unqualified nurses, the very ones Matron Luckes’ radical new scheme had sought to get rid of. Most of the old nurses had duly left to go to the prison service or the workhouse infirmaries, but a few, like Dykes, had stayed and taken roles as ward maids. Dykes was also the woman to go to if you found yourself pregnant.
When we asked her to come, she screwed up her face and reluctantly agreed. She dragged her noisy old bucket behind her and the screech of it was unbearable to my ears. I genuinely could not bear it. I kept telling her to stop it, but she would make it quiet for only a few seconds, then go back to scraping it along the floor.
I began to see flashes: blobs and patches, ghosts of the blood left behind by Emma Smith. Spots and swirls appeared and disappeared. When I saw something from the corner of my eye, I would spin around and it would disappear, but when I closed my eyes and opened them again, more would come. I felt light-headed. I touched the back of my neck and it was wet. I panicked and thought I must be bleeding somehow, but it was only my own perspiration. And yet the hall wasn’t hot. There was something wrong with me. My heart thumped and my hands shook. When I closed my eyes, I saw only blood on the back of my eyelids. I slapped my face again as hard as I could.
Mullens gave me another look. This time she had the same expression Sister Park had had when she’d seen me collecting Aisling’s hairs. ‘Are you well, Sister Chapman?’ she asked suspiciously.
‘I’m tired, is all.’
The hall had rows of benches much like a church, except I’d never seen these empty. The sound of all the people talking was like a million squawking seagulls. The scraping of Dyke’s metal bucket was like the squealing of a pig who knew it was about to be slaughtered. I went to a wall to lean up against it, put a hand to my chest and felt what was like a tiny foot trying to break out.
A girl, fourteen at most, came towards me. ‘Nurse, won’t you look at my baby? He’s not right.’ She thrust the newborn in my face. ‘Will you tell me what’s wrong with him?’
The child was still covered in the white matter from its birth, fixed in a stiff arch and livid. It was dead and horribly malformed. I pushed the girl and her dead baby away from me. Dyke’s steel bucket was still screaming and I could only think of making her stop.
‘Will you stop! Stop it, Dykes!’
The hall fell quiet and every face turned to look at me, like a sea of china plates. Even Dyke’s mouth hung open.
A man on the bench nearest me, a syphilis sufferer with a false silver nose and bushy whiskers, stood up, took his cap off and said, ‘Nurse, won’t you take my seat?’
I pushed past him, through the hall, out of the front doors and onto the street.
I ran and ran, past stunned faces like streaks of oil in a blur. I ran all the way to the garden behind the crypt and hid there until my breathing calmed down.
I would not be the one left behind. In that moment, I knew I had to find another path. It would be uncomfortable, but I had to do it, because left to my own instinct, I would be the coward and retreat to the familiar. I would end up three feet from where I started. I would not live out my days around people like Emma Smith until I became one of them. I had to find my way out.