in the face if they’re not getting quite enough oxygen into their blood. It’s called cyanosis, after cyan—the shade of blue.
She’s not blue, though, said Bridie Sweeney. More like scarlet.
Well, I said, it starts with a light red you might mistake for a healthy flush. If the patient gets worse, her cheeks go rather mahogany. (I thought of the turning of the leaves in autumn.) In a more severe case, the brown might be followed by lavender in the lips. Cheeks and ears and even fingertips can become quite blue as the patient’s starved of air.
Horrible!
I remembered to turn to the other patient and say, Don’t worry, Mrs. Garrett, you’re not in the least cyanotic.
She gave a little shudder at the idea.
Bridie Sweeney asked, Is blue as far as it goes?
I shook my head. I’ve seen it darken to violet, purple, until they’re quite black in the face.
(Nurse Cavanagh’s fallen Anonymous this morning, as dark as cinders by the time she ran up to him in the street.)
It’s like a secret code, Bridie Sweeney said with pleasure. Red to brown to blue to black.
Actually, in our training, we made…
I wondered if she’d know the word mnemonic. Or alliterative.
…little reminders to commit medical facts to memory, I told her.
Like what?
Well…the four Ts that can cause postpartum haemorrhage—bleeding after birth—are tissue, tone, trauma, thrombocytopenia.
You know an awful lot, Nurse Power.
I gave the young woman a tour of the other shelves and cupboards. If I hand you a metal instrument that’s been used, you can take for granted that I want it sterilised, Miss Sweeney. Lower it into this pot of boiling water with these tongs here and leave it for ten minutes by your watch.
Sorry, I haven’t—
There’s a clock on the wall over there. Then lay out a fresh cloth from this brown-paper packet and use the tongs to set the instrument on the cloth. Anything you haven’t time to boil can be disinfected in this basin of strong carbolic solution instead.
Right.
But was she grasping the importance of what I was saying?
When each item has air-dried, I went on, you move it with the tongs to a sterile tray up on this shelf, where everything’s sterile—thoroughly clean, ready for a doctor. Never touch any of them unless I tell you to, understood?
Bridie Sweeney nodded.
Delia Garrett let out a series of coughs that turned into whoops.
I went over to check her pulse. How’s your stomach now, Mrs. Garrett?
A little steadier, I suppose, she conceded. I blame what happened on that nasty castor oil.
I very much doubted the dose I’d given her could have liquefied her at both ends.
It’s ludicrous keeping me shut up here for a touch of flu! My babies pop out the week they’re due and not before, and I spend no more than half a day in bed, no fuss. Why’s this chit gawping at me?
Bridie Sweeney’s hand shot up to cover her grin. Sorry, I didn’t know you were…
Delia Garrett glared, hands on her belly. You thought this was pure fat?
I pointed out, It says Maternity/Fever on the door, Miss Sweeney.
She muttered, I didn’t know what that meant.
I was taken aback by her ignorance.
Well, I said. Now I’ll show you how to wash your hands.
Amusedly: I think I know that much.
I asked a little sharply, You’ve heard of childbed fever?
Of course.
It can come on a woman anytime from the third day after birth, and it used to kill them at a terrible rate. Our only modern defence is asepsis—that means keeping germs from getting into patients. So now do you see how cleaning one’s hands thoroughly could save a life?
Bridie Sweeney nodded, abashed.
I told her, Roll your sleeves all the way up so you don’t wet them.
She seemed hesitant. When she bared her right forearm, it had a melted look. She saw me notice and she muttered, A pot of soup.
That must have hurt.
Bridie Sweeney shrugged, a monkeyish little movement.
I hoped she wasn’t the clumsy sort. She didn’t seem so. Her hands were reddish, which told me she was used to hard work.
First we pour out boiling water from this kettle, Miss Sweeney, and add cold from the jug.
She immersed her hands in the basin. Lovely and warm!
Take this boiled nailbrush and scrub your hands well, especially the nails and the skin around them.
I waited for her to do that.
Then rinse them in fresh water to get all the soap off. Finally, soak them in a third basin of water…with a full capful of this carbolic here.
I poured it