Ella Blair thanked Miss Keene for letting her know that Mrs. Dawson had arrived, and she ran upstairs to her attic room to get the copies of the Truscott files that she had made last night. It had been a very busy morning with a couple of difficult cases to handle. That had kept her occupied past noon, then she had to go around with Mrs. McClellan and see all the hospital patients and adjust any medications, something that normally one of the consulting physicians would have done this morning as they made their rounds.
She thought about how different today felt so far…being the only physician in the building. Normally, even when she didn’t see them during her morning hours in the dispensary downstairs, she knew that one of the other three attending physicians was upstairs, making the rounds of the hospital patients and instructing the nurses. Somehow, this always gave her more confidence, knowing they were nearby if she needed them, like the time a mother had brought her son in with a terrible skull fracture.
Not that during her three years of medical school she hadn’t learned about diagnosing and treating all sorts of illnesses and injuries, even a skull fracture. Yet she had to admit there was a big difference between treating a patient who was sitting right in front of you, covered in blood, and reading about patients in a textbook. Not even watching one of her professors make a diagnosis at the bedside of a patient had prepared her for the real thing. Especially since during these clinical lectures at the City and County Hospital, she often found herself elbowed out of the way by the male students. Whether these men, who reminded her so much of her older brothers, were being intentionally obstructive or not, they were all taller than her and hard to see around, so she had felt she missed a lot of the nuance that went into a diagnosis.
Thank heavens for Janie Astrello, her nurse assistant. Janie’s two years of training as a nurse at the dispensary, and her experience working in the afternoons in Dr. Granger’s private practice, made her a font of wisdom, especially during Ella’s first months working in the dispensary. Now, nine months into her residency, Ella felt much more assured of her own skills. As a result, she found fewer occasions when she needed Janie’s help or asked her to go up and get whichever doctor was upstairs to come down to consult.
Nevertheless, there was always more to learn. Every Saturday afternoon, she still met Dr. Brown to go over her case files from that week. Ella would explain her diagnoses, describe what she had done for the patient, and list what medicines she had prescribed. In addition, one of the doctors would try to come down at least once a week to observe her with patients. Later, they might make some helpful suggestions. These sessions were always informative and also helped boost her confidence.
There had been only one occasion when Dr. Bucknell had intervened with a patient. Ella had overlooked the fact that the young girl she was examining was hiding her hand behind her back. Turned out that the girl had a very bad burn, which had become infected. This was the cause of her fever. Without attending to the wound, the girl would have been unlikely to improve.
The girl’s mother had failed to point out the wound, which could simply mean she didn’t understand the connection between the wound and her daughter’s high fever. Or the mother may have been ashamed of how the burn had occurred. Even more disturbing to Ella was the notion that the burn might not have been an accident, but deliberate.
Ella later confided to Dr. Brown how hard it was to see signs of burns and bruises on her patients, sometimes even broken bones, and know that some of these injuries might have been inflicted by a drunken husband or father. She had learned, to her frustration, that when she gently asked patients if anyone had deliberately hurt them, they always said no. Dr. Brown told her that, in her own experience, pressing a patient too hard on the source of their injury simply meant the woman wouldn’t come to the dispensary again, and she might not bring in her children the next time they needed attention. Ella knew she was right. Nevertheless, she found it difficult to accept that there were severe limitations on what she could do for her patients. She could bind their wounds, give them medicine to ease their coughs, set their bones, even do minor surgery on them, but she couldn’t give them a better house to live in, better food to eat, a better job, or a better husband or father.
Shaking off this thought as she came to the door to the office, Ella stopped and briefly observed Mrs. Dawson as she sat at the desk, sifting through folders. She noted that there was another young woman in the room, a black-haired, blue-eyed young woman of obvious Irish heritage who was pulling some boxes out of the closet. Dr. Brown had mentioned Mrs. Dawson might be bringing her maid with her today. Dr. Brown had also told her that Mrs. Dawson, who didn’t look to be more than in her late twenties, needed to do most of her work at home because she had a nine-month-old child and couldn’t be away from home for too long at a stretch.
Mrs. Dawson puzzled her in a number of ways. The existence of the maid and the elegance of Mrs. Dawson’s outfit, a well-tailored navy wool outfit that set off her pale complexion, complemented her reddish-gold hair, and fit her slender shape like a glove, put her in the same class as the wealthy women who financially supported the dispensary or served, like the former treasurer Mrs. Branting, on the board. Women whose dress and demeanor said very clearly that they didn’t need to work.
On the other hand, Dr. Brown had told her that Mrs. Dawson was a woman who ran a boardinghouse and helped support her family doing a job that usually was held only by men. This fit the restrained nature of her dress that said she was woman who had a job to do, who couldn’t be bothered with too-tight corseting that constricted her breathing, a bustle that made it impossible to sit in a chair, or lace cuffs that might get ink-stained. Women, in fact, very much like Ella’s own mother, who juggled motherhood with helping support her family by working with her husband in her dry goods shop.
As Mrs. Dawson looked up and smiled at her, Ella thought that she hoped this impression was correct, because if the dispensary was in trouble, she knew she would much rather have a woman like her mother at her side than a silly woman like Mrs. Branting.