VIGIL IN THE NIGHT
By A. J. Cronin
“Vigil in the Night” by A. J. Cronin from Good Housekeeping magazine (© A. J. Cronin, 1939) is reproduced by permission of PFD (www.pfd.co.uk) on behalf of the Estate of A. J. Cronin.
CHAPTER 1
Though nearly six o’clock, it was still dark that bitter winter morning. In the small isolation ward of Shereford County Hospital there was silence, the queer silence of the sickroom, broken only by a thin and rasping sound, the breathing of the child in the screened-off cot at the end of the ward.
Seated beside the cot, quite motionless, Nurse Lee kept her eyes on the face of the child, fighting her weariness, religiously maintaining the vigil she had kept the whole night through. The patient was a little boy of two, and on his chart, seen dimly above the cot, were two simple but significant words: Laryngeal Diphtheria. A serious infection. And a serious case. Last night when the ambulance had rushed him in, only an emergency tracheotomy had saved him. She herself had helped Dr. Hassall with the operation. And now, with the tiny silver tube shining among the bandages round his thin throat, with ten thousand units of anti-diphtheria serum battling the poison in his blood, he was holding his ground, beginning slowly to creep back from the dark precipice of death.
Instinctively, without sound, Nurse Lee moved. Bending forward, she slipped the inner tracheotomy tube from its enclosing sheath, deftly cleansed it, and in the same second slipped it back. The baby’s breathing came easier, softer. Next the nurse trimmed the spirit flame beneath the long-spouted kettle which sent its stream of vapor across the tented cot. And then, with a glance at her watch, she charged the hypodermic which lay on a table beside her and in three quiet movements injected the prescribed dose of strychnine into the child’s thigh. The boy barely stirred at the swift insertion of the needle.
Again the nurse sat back, somewhat stiffly, in her wooden chair. The sense that her patient was moving evenly through this terrible crisis of his illness filled her, despite her almost insupportable fatigue, with a deep and thrilling joy. It was this she lived for, the secret motive, the very purpose of her life. Sitting there, her cheek cupped in her palm, illuminated only by the shadowed lamp, Anne Lee looked absurdly young to be a fully trained nurse. She was only twenty-four. Yet she had just completed her three years’ training at Shereford and been given her certificate. Slenderly built, with fine capable hands and a spare, sensitive face, she had an almost austere beauty redeemed by the sweetness of her mouth and the steady brightness of her wide dark eyes. Her uniform, in its blue-and-white neatness, became her perfectly. Her immobility held watchfulness. It was now six o’clock, and her relief was due at any moment. The thought that the incoming nurse was her own sister Lucy caused a faint smile of tenderness to curve Anne’s lips. She adored Lucy, had always loved and mothered her, though a bare eighteen months lay between their ages. Perhaps it was because they had been left alone so early and so suddenly by the death of their parents. This tragedy had made it a necessity for the girls to earn their livelihood. Anne had always wanted to be a nurse, and a few months later Lucy had been persuaded to follow her to Shereford Hospital.
This winter morning, ten minutes past six showed on the ward clock when Lucy came on duty. Lateness was not tolerated at Shereford, yet there was no shadow of reproach on Anne’s face as her sister approached. She merely stood up, smiling a greeting without complaint. Then she stretched her cramped muscles and began, in a low tone, to run over the details in the duty book. There were no other serious cases in the little isolation ward, merely two adult cases recovering from mild diphtheritic infection. The center, the whole focus, of attention must be upon this cot.
“You understand that, Lucy,” Anne concluded, inclining her head toward the cot. “Nothing else matters in the ward. It means that you must special him. Get into that chair and don’t move till Sister Hall comes on at eight o’clock.”
Lucy nodded and sat down. Her manner was unreceptive and ungracious, as though she felt the instruction Anne had given her wholly unnecessary.
“It’s the membrane,” Anne added, lingering a moment, trying to convey to Lucy something of her own intense interest in the case. “You see, the serum’s beginning to loosen it. And every now and then it blocks the tube. That’s what you’ve got to watch for.”
“I know, I know,” Lucy answered shortly, as though she felt the explanation quite superfluous. “I’ve listened to old Hassall’s mucky lectures as well as you.”
Anne said no more. Sometimes Lucy’s sharpness hurt her deeply. But then, Lucy was always difficult in the morning. She stood a moment, surveying the semi-conscious child; then she walked down the ward, picked up her cape in the vestibule, and passed through the swinging doors beyond.
Outside in the hospital courtyard the darkness had not lifted, and a few stars shone palely in the heavy sky. The keen wind caught her braced figure, yet she turned her face to it gratefully. Always after her night duty, no matter how inclement the weather, she would come for a few moments to drink in the sea-borne freshness of the morning air. Beneath her, as she stood surrounded by the low huddle of the hospital buildings, the bulk of Shereford lay blackly, a harsh little township with its grim mine headstocks and its fleet of fishing smacks that wrested a hardy living from the sea. It was, indeed, a dour and gauntly fashioned North of England community.
Much as she loved it, Shereford was a small place. She had a greater, a more wonderful ambition for Lucy and herself. When Lucy took her certificate next month, they would set out together for a big city hospital.
Who knew but what they might conquer the world! Again Anne smiled happily at her secret thoughts and swung round to retrace her steps toward the nurses’ home.
As she did so she heard a cry. Startled, she drew up short, conscious of a figure running wildly through the darkness toward her.
CHAPTER 2
When Anne left the ward, Lucy had tried to settle herself more comfortably in her chair. But the chair was hard, and Lucy scarcely awake. She was unable to find ease, and the petulant expression on her pretty face deepened. She hated rising early, hated coming down to the shadowy ward—that was the worst of nursing, getting out of a warm bed at such unearthly hours—and above everything she hated not having had time to get her morning cup of tea.
Lucy was addicted to this morning cup of tea; it drew her together, restored her temper. And the more Lucy thought about it, the more her petulance increased. She was a plump little thing, with a happy-go-lucky air and sharp challenging eyes. Her soft fair hair came coquettishly from beneath her nurse’s cap. At her best she looked roguish, bold, and full of fun. Now, however, her sense of injury imparted to her enticing features a sulky frown.
Inwardly she fumed and fretted, and at last she could stand it no longer. She told herself that Anne was a regular fussy old woman; and bossy, too, when it came to that! What right had she to lay down the law? The child was perfectly all right. Defensively Lucy stretched out her hand and fingered the thin white wrist. Yes the pulse was excellent—quick, of course, but quite firm. She would not be away a minute. And she must, simply must, have that cup of tea. She rose and moved noiselessly into the ward kitchen.
But back in the ward the sick child in his little cot stirred. For some moments after Lucy had left him he lay breathing rapidly but regularly, flat on his back, the steam floating gently across his pale upturned face. His long dark lashes deepened the blue shadows beneath his eyes. One tiny hand, protruding from the blankets, was clenched nervously, as though in combat with some hidden enemy.
Suddenly there came a change. The baby’s breathing lost its measured rhythm. All at once a moist wheezing, a kind of bubbling sound, filled the air, and at the same instant a greenish clot o
f the diphtheria membrane spouted from the orifice of the tracheotomy tube in the child’s throat. There it hung, blocking the tube, sucked in and out with each labored, difficult breath.
It was an awful moment in that vacant, darkened ward. And something terrible was in the mortal struggle which ensued. The sick child tried with all its enfeebled force to expel this impediment to its breath. The small hands clenched together, the face grew dusky with the effort, the legs kicked weakly. But the effort was too feeble; the choking membrane still remained. And now the child’s breath was coming shallower, more and more spasmodically. The face turned still more livid. The whole of the little chest was shaken convulsively with the effort to draw in the precious air. Such anguish could not endure. One last frightful spasm came, a final choking noise, then all was peace. The tiny hand that had been so tightly clenched opened out like some strange flower, the fingers unfolding slowly like petals in the sun. Then the child finally lay still, arms outstretched, as though pleading.
It was then that Lucy returned to the ward. Comforted by her hot cup of tea, her good temper thoroughly restored, she approached the cot. There, before the silent babe, she drew up. Then everything came on her at once. Her eyes, transfixed, dilated in horror. A cry of sheer terror rose and died in her throat. She lost her head completely. Instead of clearing the tube and striving immediately to restore those stifled respirations, she wrung her hands and, calling wildly on her sister, rushed panic-stricken from the ward.
CHAPTER 3
Three minutes later Anne was back beside the cot. She snatched out the blocked and useless tube. Then with forceps she widened the opening in the windpipe, swabbed it free of membrane, and began desperately the movements of artificial respiration. While she worked, her face set and pale, she exclaimed in a tense, unnatural voice: “More strychnine. And get me one c.c. of camphor in oil. Also some pure ether.”
With trembling fingers Lucy obeyed. The strychnine was given, then the camphor.
The movements were continued, frantically, feverishly. The perspiration gathered on Anne’s brow. Her lips became more pale and set. Even as she went on, hoping against hope, doing everything within her power, she knew in her heart that it was useless. And so, in the same tone as before, she threw out the command, “Fetch Matron.”
Lucy shivered and went haltingly from the ward.
It seemed no time at all before the ward was full of people: Matron Lennard in her dressing gown, Sister Hall, Nurse Gregg, and Nurse Jenkins, strangely unfamiliar without her collar or cuffs, then old Doctor Hassall himself. They all began to do their utmost. Anne stood by the cot, erect, watching them, watching their useless, quite useless efforts. Beside her, hands interlocked in agitation, was Lucy.
Finally the matron raised her head. She was a fragile figure with pure white hair, now strangely disordered, and eyes studious and severe. Gazing at Anne, she said in a strained, accusing tone, “How did this happen?”
There was a pause that seemed interminable. Then Anne answered: “The tube became blocked. We did everything, everything we could.”
“Why did you let the tube get blocked?” asked Dr. Hassall harshly.
Another silence.
Dr. Hassall drew the sheet over the dead child’s face. Nurse Gregg had gone into the kitchen. She was a sharp-featured, unpleasant woman and had always been vaguely hostile to Anne. Now she returned hastily. She declared with an air of discovery:
“Matron, I’ve found something out. Someone has just made tea in the ward kitchen.”
Every eye was turned on Anne.
The matron got control of herself, tried to infuse reason into her voice. “Did you really make tea in the kitchen when you should have been attending to your patient?”
Anne forced herself to meet the matron’s frigid stare. If she answered that question, Lucy would be lost.
“Why—” she faltered, trying to shield her sister, and hopelessly broke down.
Another question came, inexorably accusingly. “At what time did the tube become blocked?”
That question was more dangerous than the last. It meant the finish of Lucy. Vividly, unmistakably, Anne saw it all. Lucy had not yet taken her certificate. This dreadful thing would mean the blighting of her career before it had begun. Every instinct of love and protection rose up in Anne. Almost unconsciously her decision was made. For Lucy’s sake she lied deliberately.
“At five minutes to six I felt tired. I thought I would make myself some tea. I felt sure the patient was all right. When Lucy came on duty, she called me. I saw what had happened. We worked on him—” her eyes traveled toward the ward clock, then returned bravely to the matron’s—“we worked for nearly three-quarters of an hour. But it was—it was no use!”
A gasp came from the thin lips of Nurse Gregg, from Dr. Hassall an imprecation of disgust. There was a long silence. Anne still held herself erect. Lucy, supporting herself by the bedrail, seemed unable to speak.
At last the matron said to Anne in a voice of ice: “Go to your room. You will be dealt with later.”
CHAPTER 4
Alone in her own room, Anne waited as the hours dragged by. It was a tiny, narrow room at the end of the corridor of the nurses’ home. For three years it had been her home. Here she had lain down, tired out, at the end of her day’s work. Here she had risen to face another dawn. It held her own few things—a photograph of her parents, one of Lucy, a school group, the old silver-backed toilet brushes that had been her mother’s. But now it seemed oddly alien to her. Or she to it. Her ear, acutely tuned, heard the distant sounds of the hospital’s routine. But as this long and harrowing day went on, no one came near her.
Then, toward three o’clock, a knock on the door made her heart jump. Perhaps it was the matron. But no, when the door opened, it was only Nurse Jenkins, who entered with compressed lips, carrying a tray. She peered at Anne, then with a kind of unwilling affection declared:
“I’m not supposed to be here. You know that, don’t you? I’m liable to have my head taken off if I’m caught. Yet I couldn’t help thinking you’d be starving.”
“Thank you, Nurse. But I’m not hungry.”
“Don’t be a fool. You’ll need all your strength for what’s coming to you.”
Under the compelling acrimony of Nurse Jenkin’s eye, Anne began to eat the sandwiches and cocoa the older woman set before her. A dried-up, testy little woman of uncertain age, Martha Jenkins was the epitome of melancholy failure. She was probably over sixty. Yet somewhere beneath that desiccated exterior there lay a heart. She had a great affection for Anne; yet rather than show it she would have died.
“A pretty fix you’ve landed yourself into,” she now ruminated acidly. “And a pretty commotion you’ve caused in this hospital. The place is humming with it. Nurse Gregg has been saying this was bound to happen sooner or later, saying that you were too good to be true.”
“Nurse Gregg was always my friend,” said Anne with sudden bitterness.
“Oh, I stuck up for you,” replied Nurse Jenkins. “I shut them up.”
Anne was silent. This good old soul’s defense was not the one she would have wished. “Where is Lucy?” she asked.
“On duty. She don’t say much.”
Another silence.
“What do you think they’ll do with me?” Anne spoke dully.
“You’ll find out only too soon, I’m afraid. There’s a special committee meeting at five o’clock.”
Nurse Jenkins reached forward and patted Anne’s arm. Her faded old face suddenly was human.
“Don’t take on, my dear. They can only throw you out. And, mark my words, that’s the best thing that could ever happen to you.” Old Martha paused to take a long breath. “While I’m about it I’ll give you my opinion. Yes, and my advice. Nursing’s a rotten job. You’re better out of it. I’ve had my fill of it. Year after year I’ve worked myself to the bone. And what is my reward? I haven’t got a penny to show for the penal servitude I’ve suffered all my life. And
when I’m worn out, when my rheumaticky bones refuse to work any more, they’ll chuck me aside like an old boot without a pension. I’ll be fit only for the workhouse. And there’s hundreds like me. It’s a scandal crying out to heaven. You know I’m right, even though you’ve only had three years of it. You know the life is slavery.
“You’ve been careless and foolish, but it’s the luckiest thing that ever happened to you. You get out, my dear, and stay out. Marry that garage fellow that’s sweet on you—Joe Shand, isn’t it? Have a home of your own and a lot of children. They’ll give you all the nursing you want. And believe me, it’s the only kind of nursing any real woman wants. I wish to heaven it had come my way!”
The old nurse subsided, exhausted by her outburst. Anne gazed back at her with grave intensity. For the moment she forgot her present trouble, so bent was she on expressing the inmost conviction of her heart. She murmured, as though to herself:
“I know it’s true, a great deal of what you say. But I love my work. It’s wonderful work, work that really matters. We’re wretchedly paid; we’ve got to put up with a lot. But it could be changed. If only we’d stick together, fight together, we could get better conditions for ourselves. That’s one of the greatest ambitions of my life, to try to do that. But even if we always had to work under the most miserable conditions, I still think it would be worthwhile to be a nurse.”
Nurse Jenkins sniffed as she rose. “Well, your theories are very nice, my dear. But they don’t seem to work out in practice. You take my advice, my girl, and clear out of nursing while the going’s good.”
Left alone with her thoughts, Anne felt with renewed intensity the horrible anomaly of her position. What a hypocrite Martha must think her! Yet her determination grew firmer. She had taken up her attitude. No matter what it cost her, she must protect Lucy.
CHAPTER 5
At half-past five there came the dreaded summons from the matron. Anne’s blood pounded in her ears as she entered Miss Lennard’s familiar office.